A SUPPLEMENTARY DREAM TECHNIQUE WITH THE CHILDREN’S

APPERCEPTION TEST’
ALBERT C. CAIN
Children’sPsychiatric Hospital
Univer& of Michigan

INTRODUCTION
The technique described briefly below is best viewed in the context of recent
attempts to gain more direct projective test expression of unconscious fantasy
material by ‘inducing’ natural defense mechanisms in the testee c3). Our assumption
is that under the additional protective guise provided by these artificially-induced
defenses, the ego may tolerate far less censored fantasy production. What follows is
the presentation of such a supplementary cllnical technique found valuable first
with the C. A. T. and later with other thematic tests. Children’s frequent ending of
a story-and often enough their escape from creating much of a story-by having
some or all of the characters go to sleep or be asleep on C. A. T. cards 5 , 6 and 9 pro-
vides an opportunity to introduce such a technique. By this projective device within
a projective device, our hope was to elicit less disguised expression of unconscious
material, probe the flexibility or thickness of defenses, and perhaps a t times obtain
a core sample of the layering of defenses.
TECHNIQUE
At the end of any story in which the central figure is sleeping, the last inquiry is
“What did X dream?”. (This form of question is far more likely to net a dream
than asking whether X had a dream.) We have never found it necessary to explain
to the child what a dream was. Upon the child’s presentation of a dream, we leave
to the examiner the question of the likely value and effects of further inquiry into
the dream content. Occasionally with cards 5 and 6 we inquired into the dreams of
each of the three figures said to be sleeping. The results have been sufficiently re-
warding that this is now done as often as not.
RESULTS
Roughly 80% of the children, covering the entire spectrum of childhood psycho-
pathology from mild adjustment problems within normal limits to childhood
psychoses, responded with a dream. The technique so far has been used and worked
readily with children six years and older, and with those of borderline intelligence
and above (the borderline and dull average intelligence group seemed particularly
receptive to the technique). The “dream” inquiry nevertheless remains something
less than pure magic. The negativistic, defiant child insists the figure is not dream-
ing; the suspicious child is as guarded and distrustful as ever; the child producing a t
best fragmented associations continues to barely look a t the cards. Much as reported
by Jones with the Negation T. A. T. ( 3 ) , though, there are a number of children pro-
ducing otherwise meager, usually highly descriptive stories, who seem almost re-
lieved by the further disguise and partial release from the card stimulus that the
dream provides; they create rich dreams, and sometimes even $pontaneously intro-
duce dreams into later cards. Especially useful as it may be for this group, the
dream inquiry’s value has been broad enough to suggest its routine use, and even
some extensions within and beyond C. A. T. administration. Brief excerpts, some
using but portions of a single dream, will serve to illustrate the type of results ob-
tained.
‘The work with this technique was part of a project at Children’s Psychiatric Hospital utiliiing
supplementary dream, negation, and fairy tale task instructions to various projective testa. Partici-
ante included Marc Pilisuk, Barbara Maupin, and Drs. Bettie Arthur, Ann Vroom, Jeree Pawl, J.
kichard Metz, and Mary Jane Keller. The author is especially indebted to Dr. Anna S. Elonen for a
critical reading and suggestions.
182 ALBERT C. CAIN

Rick, intensely attached to his mother and with a longstanding slee disturbance of an un-
clear nature, simply has all the figures asleep in his story to Card 5. &e dream hae the child
sleepwalking, walking to his parent’s bedroom, staring lengthily at their bed, then getting into it.
A brain injured boy who has been mercilessly pushed by a nagging, perfectionistic, com-
pulsive father, tells a story to Card rY 1 (T.A. T.) of a boy who, after being badly pressed by his
male violin teacher, falls asleep while he should be studying. After being rudely awakened and
punished, the boy apologizes contritely. In the dream, however, the boy smashes his violin to
bits throws it away. (The history revealed that Pete obeys his father, but has torn up school
work, threatened and attacked his male teacher).
The story to C. A. T. Card 18 of a very, very good boy, who is even sweeter to his new baby
brother than to his mother, is limited to trivial conversationbetween the monkies. The youngest
monkey goes off to bed and sleeps. His dream-of picking up and hurling away a baby monkey.
The reader’s impression from these examples may be of a technique mostly
providing an uncomplicated reflection of unmodulated impulse life. While such
dreams have been given frequently enough, the complexity of the dreams may reach
the followingproportions: “Well, he dreamt that he was in this great big cave with a
bunch of mountain lions, and he was in the cave and when the mountain lions started
at him, he threw this torch at ’em and they went back and then he had a gun on
him and then he went down farther and farther and suddenly he came into this
valley where he had been before and all the people didn’t believe he was in this valley
so he went-came . . . back into the cave and the mountain lions were there yet, so
he crawled out of the hole and he went home.” Or, in another elaborate dream where
the story proper simply had all three bears sleeping: “They’re dreaming of going
outside-play in the snow. It’s cold out, freezing cold-they like to play in the cold
. . . brother bear wants a sweater and they don’t have any money for it . . . they’re
playing in the snow, and they fall down and die (?) Cuz a knife is stuck up in the
snow-arrow, when a hunter was shooting arrows. And the two mommie bears die,
but not the baby bear, the baby bear was covered with ice . . . but he never, never
died cuz he had magic powers.”
To state their scope without focusing on details, the dreams have ranged
through: rabbits being skinned alive by hunters; “gonna get killed”; “gonna live
2,000 years”; learning that this is not Kis real family-the young rabbit had been
kidnapped; owning the whole world; having a real child, not a doll; the boss letting
him be boss for one whole day; discovering that the goblin who came a t night and
scared you, but who you caught and ate, was really your mother disguised; ‘‘he shot
his father”; being a foreign dog in a strange place, surrounded by dog police, not
knowing what had been done wrong, but still being dragged off to jail.
The dreams, in brief, have been found to contain a wide sampling of psychic
contents : pure wishes (conscious and unconscious), specific fears and vague appre-
hensions, particular impulse-defense constellations, major reality concerns, sexual
identity confusions, fantasies of omnipotence, unconscious perceptions of parents,
reflections of parental handling and attitudes, superego accusations and actual
events. In one instance, a major symptom which had remained unknown through
the full initial intake was revealed. The dreams’ relation to the stories from which
they sprang also varied greatly: from sheer repetition to obvious continuation of the
story; from continuations visible only by interpretation of unconscious linkages to
a few instances where there seemed no discoverable relationship whatsoever. Much
remains to be learned of the dreams’ relationship to other projective material, so
too their relationship to the dreams related in the initial psychiatric interview, to
later data from therapy, and to our general knowledge of children’s dreams “in the
raw.’’ The material elicited corresponded most closely in impulse and imagery to
that produced on the Rorschach, though the story form necessarily meant greater
secondary elaboration. While in a few cases the data or inferences from the dream
(and the ways the dream was used or rejected) were unique amidst the body of test
and interview material gathered, the preponderance simply supported and strength-
ened notions gained from less fantasy-dominated, greater inference-requiring data.%
%U wted interpretive parallele between a dream within a dream or a play within a play (1.1) and
the p r f i c t a of t h i technique bore little fruit.
A SUPPLEMENTARY DREAM TECHNIQUE WITH THE CHILDREN’S APPERCEPTION TEST 183

We were initially concerned that the dream material itself might have too great
an influence on the remainder of the child’s C. A. T. performance, influencing it in
unknown directions. Careful attention to this possibility has convinced us this is
rarely the case, at least to any significant extent. Nevertheless there were cases
where children mentioned dreams on later cards spontaneously; where they had the
animal in a very human fashion reassure itself “it was only a dream” ; there was one
instance where a child appeared to avoid allowing the characters to fall asleep lest
their dreams be solicited; two others where the relatively undisguised material they
had let come through made patients openly anxious during the next card; and one
instance where a clinging, panphobic girl, initially considered only “phobic and
immature”, never could recover the defenses eschewed in a dream inquiry, per-
severating severely pathological material throughout the rest of the C. A . T., and
giving full evidence (soon confirmed from other sources) of a basic psychotic process.
Beyond the great deal yet to be learned about this technique, as suggested
above, and the cautions to be observed both in its administration and the inter-
pretation of its gleanings, there only remains to be noted our extension of the tech-
nique t o any occurrence of ~a character being unconscious (e.g., under hypnosis,
knocked out, etc.) in a story, and to stories on other thematic tests (T. A. T., Michi-
gan Picture Test, Symonds Picture Story Test) where a character is seen as asleep
or unconscious.
SUMMARY
A technique is presented which, by artificially inducing natural defense mech-
anisms in the test-taker, encourages less censored fantasy expression on thematic
tests. The initial investigation of the technique was confined to the C. A. T. When-
ever a character in a story told to the C. A. T. was said t o be sleeping, the child was
asked, “What did he dream?” Roughly 80% of the children tested, including those
whose story material was slim and unrevealing, responded with a dream, the dream
content often being relatively transparent. Examples are presented illustrating the
products of this technique. The kinds of fantasy material elicited are noted, and the
effect of the dream inquiry upon the stories to follow is considered. Possible ex-
tensions of the use of this supplementary clinical technique are suggested.
BIBLIOGRAPHY
1. FREUD,S. The Znterpretation of Dreams. Standard Edition of the Complete Psychological Works.
Vol. 4. London: Hogarth Press, 1953.
2. GRINSTEIN, A. The dramatic device: a play within a play. J . Amer. Psychoanal. Assoc., 1956,
4,49-52.
3. JONESR. M. The negation T. A. T.: n projective method for eliciting repressed thought content.
J . Proj. !f’ech., 1956, 90, 297-304.

A COMPARISON OF T H E SENTENCE COMPLETION RESPONSES O F

PSYCHOPATHS AND PRISONERS1
LEONARD KINGSLEY
Veterans Administration Hospital, Brooklyn, N . Y .
PROBLEM
This study investigated the suitability and applicability of the Sentence Com-
pletion Test (SCT) to the study of the personality structures of psychopathic offend-
ers. Specifically, does the SCT significantly differentiate between psychopaths and
other prisoners and “normals”? Only one other study has been found which reports
on the SCT responses of prisoners(’).
‘Grateful acknowledgment is made to Dr. Ardie Lubin and to Major Harold Williams, Walter
Reed Army Institute of Research, for their suggestions.