RUNNING HEAD: DEATH AND THE DREAMER 1

Death and The Dreamer

Dennis Higgins

Adelphi University
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Death and The Dreamer

All my Abnormal Psychology professor ever had to do, she would say, was “pay taxes,

stay black, and die,” which would elicit a chuckle from anyone who wasn’t currently trying to

get her to do something. The humor in that statement comes from, like so much of our humor,

from our deepest vulnerabilities, be they in our finances, our identities, or, greatest of all

vulnerability, our mortality. We find comfort in laughing about these inherent and unavoidable

vulnerabilities because the alternative is maddening.

The fact that we are imperfect beings with finite lifespans means we will not do

everything and be everywhere we want to be. As such, how we spend that limited time and

opportunity is very important. So much so that when key individuals in our lives reject us, the

effect can be as damaging as any physical injury. Social death, as it were, is as tragic as physical

death. Since our relationships are as critical to us as life itself, we guard our vulnerability through

the organization of our personality and psychological defenses. As a psychotherapist working

with veterans, I have found that the fear of vulnerability inherent to all of us is exponentially

compounded by the martial culture that profoundly shaped who the veterans are today. Working

with that vulnerability is key to working with veterans.

Vulnerability, Mortality, and Relationships

Shabad (2006) discusses this vulnerability in the context of the helplessness inherent in

facing death and its parallel in what happens when significant figures in our lives reject our

relationships. Considering our death, he notes, shatters any grandiosity about our lives and forces

us to consider the quality of our lives as it is a finite and limited object. This drive for quality of

life leads us, as social creatures, to look for quality primarily through our relationships with

others. The specifics of these relationships are a reflection of who we are as people. Fromm’s
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(1947) different character orientations illustrate how individual motivations can make themselves

apparent through the nature of our human relationships. That our personalities are driven by

vulnerability to engage in these relationships, and the patterns in our relationships can be

illustrated in how we perceive and defend against our vulnerability, it makes sense that

vulnerability should be considered front and center in the therapeutic relationship.

Mortality and Vulnerability

Mortality, Shabad (2006) writes, is the beginning of any discussion of vulnerability. He

begins by examining how small we can seem against the backdrop of the infinite cosmos and

how fragile we are in the face of it. The fact that we all will eventually end but the universe will

continue on is daunting, to say the least. As such, Shabad writes, it is important to recognize that

we cannot control the quantity of life we have, but we have influence over the quality of life.

Veterans are no stranger to the threat of mortality. Combat is an obvious threat to a

warrior’s life, but even training can be deadly. Grossman (1996) recalls witnessing the death of a

fellow soldier during the parachute jump of a training exercise and how processing that death

with his fellow paratroopers and learning to accept it strengthened his unit. He also makes note

of how victims of atrocities and terrorism can find post-traumatic growth as well. While

Grossman does not say so explicitly, he suggests that acceptance of our mortality gives us

strength over our sense of vulnerability. What Grossman discusses is a healthy way to process

mortality. Shay (1994) discusses how the threat and realizations of mortality can create what he

calls “the berserker state” in which the warrior finds himself in a frenzy believing he cannot be

killed. Denying that vulnerability, Shay notes, engenders situations that can lead the way to

actions that further alienate the warrior from society. This creates situations of isolation that only

exacerbate the problems facing veterans.

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Shame, Self-Consciousness, and Defense

According to Shabad (2006), self-consciousness and shame occur when a relational

connection is disrupted or one pursued was never realized. Instead of looking to others, the

critical eye turns inward. He notes that it is because of this inward judgment that any

relationship, regardless of healthiness, is better than none at all. This self-judgment looks at

relational failures as personal failures, regardless of any true culpability in the failure. This

creates a sense of shame and a pattern of withdrawal. Perfection becomes a requirement and

situations where shame could manifest are avoided. Grossman (1996) notes that many of the

activities veterans were called upon to perform in the military, killing the enemy in particular,

are direct violations of unspoken social contracts. The shame attached to those violations can be

powerful and, when left unprocessed, results in complex defensive functioning and strained

interpersonal relationships.

Social Death as Physical Death

Shabad (2006) notes that because we only have a finite amount of life, how it is spent

becomes crucial to well being. He discusses how we are dependent on social contact when we

are vulnerable children. Developing a secure attachment to our primary caregiver is key to

coming to terms with our vulnerabilities and developing mechanisms to feel safe in life.

Problematic attachment styles lead to self-consciousness regarding our vulnerability, which is

exposed to us in these situations. This challenges one’s self-worth and leads to fears that are as

powerful as death. Shame will reduce a person to inaction as much as fear will. Shabad even

links shame and death through the word “mortification,” being so ashamed, one wishes they

were dead.
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Veterans, combat veterans in particular, tend to isolate themselves because of the shame

they carry. Much like combat veterans are committing suicide at a higher rate than the general

population, combat veterans commit social suicide at a higher rate as well. Shay (1994)

compared how Vietnam veterans would isolate themselves from other soldiers or units that they

perceived as a threat to their lives, weakening unit cohesion and effectiveness and actually

creating a more salient threat to the soldier. In a later book, Shay (2002) also noted that many of

the veterans he worked with clinically would focus on their job to the detriment of interpersonal

relationships. At best, only workplace relationships suffered. At worst, some of the veterans he

worked with reported estrangement from spouses, children, and other family and friends.

Working with Vulnerability

Shabad (2006) suggests that when working with those who have turned away due to

shame and fear of vulnerability, it is vital for therapists to move directly into the dark place the

patient is retreating from (and into). Being silent is colluding with the patient’s anxiety that what

he is ashamed of must continue to be covered up.

The Dreamer

As an example of how mortality, vulnerability, and defensiveness intersect, I will discuss

a veteran I have been working with at the Brooklyn VA for the past eight months. As he comes

in with detailed, vivid dreams, I will call him The Dreamer.

Case Background

The Dreamer is a white man in his late sixties. He has been married for almost fifty years.

The Dreamer is a retired mechanic. He lives in a house he bought in the late 1970s in Staten

Island. While he was born in the South, he has been a resident of New York City since his

childhood. His parents stayed married until his father passed away approximately fifteen years
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ago. His mother is also deceased. He has a younger brother and sister. The Dreamer reports a

childhood environment that was highly chaotic. His father was physically, verbally, and

emotionally abusive to all members of the family. He was also violent towards people outside the

family, and The Dreamer reports his father engaging in fistfights with neighbors and others in the

community with little provocation. The Dreamer’s relationship with his brother was contentious

and violent, with The Dreamer initiating the violence after considerable verbal provocation from

his brother. He reports being very protective of his sister and mother. In this chaos, he strongly

identified with escapist fantasies. He reports wishing he could have a family like those on

popular television shows (“Father Knows Best” being the most frequently cited) and developed a

code of behavior similar to the archetypal loner hero from the Western genre. It is this latter code

of behavior that really defines how The Dreamer acts interpersonally.

The Dreamer is a high school dropout who left school to be a construction worker with

his father. When he was old enough, he enlisted in the U.S. Army and served two years in

Germany and one year in Vietnam. He spent most of his time in Vietnam as a gate guard to a

motor pool in Bien Hoa, and he reports being on many patrols in the area, but minimizes the

amount of combat he experienced. Following his military service, he worked at a mechanic in

many different auto shops until he was hired by the NYC Department of Sanitation as a truck

mechanic, where he worked until retirement in his early sixties.

While The Dreamer does not endorse any specific family history of mental health issues,

his father’s behavior is symptomatic of Antisocial Personality Disorder.

The Dreamer reports that he has few friends and prefers solitude. His relationship with

his wife is rocky, and he reports that they have dramatically different personalities. She is as

social as he is solitary and as focused on appearances and the opinions of others as he is focused
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on maintaining his own valence with a strict internal code of behavior. He has an equally

conflicted relationship with authority. He reports that he will work hard and not make waves

unless he sees hypocritical behavior on the part of authority figures. The Dreamer reports no

difficulty breaking rules in order to make a point in line with his internal code.

The Dreamer earned his sobriquet by initially seeking mental health treatment due to

exceptionally vivid and violent nightmares. These nightmares are not specific historical

experiences, but have symbolism that reflects different aspects of his history. The three themes in

particular that stand out are a jungle theme, dangerous animals chasing The Dreamer, and

ambivalence towards the medical profession. While he readily discusses traumatic events

regarding his childhood, he is more reticent to discuss his experiences in Vietnam, frequently

deflecting any discussion to interactions between him and officers he disliked, avoiding

discussion of combat exposure. He has endorsed detachment from others and solitary

inclinations and a restricted affective state. His sleep disrupted by these nightmares and he has

reported a history of irritable behavior and aggressive outbursts. These posttraumatic symptoms

have had limited impact on his occupational functioning but have greatly restricted his social

functioning. The Dreamer entered therapy in order to make sense and achieve mastery over his

dreams. Through our therapy, we discovered considerable repressed rage and anger that he wants

to address and process.

The Dreamer and Defensive Vulnerability

Early in his life, The Dreamer suffered narcissistic injuries when his father would

verbally abuse, demean, and reject him. The Dreamer says his grit and determination was

developed because any project he would work on he would be told he would fail at by his father.

This had the effect of spurring The Dreamer to solve problems in a creative manner with
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intuition, as he could count on no guidance from his father. Another salient story that The

Dreamer frequently recalls is his pride in getting a 95 on a test in grammar school. His mother

was happy about the grade, but his father ripped the test and asked The Dreamer why he didn’t

get a hundred. These assaults against The Dreamer’s self created a heightened sense of

vulnerability and a need to defend against perceived threats. Expressed emotions, The Dreamer

reports, were targeted by his father and were, therefore, repressed and hidden. This, as much as

his combat experience in Vietnam, created a perfect storm of restricted affect and limited social

interaction. It also created a repressed aggression. He could not act out against his father, so he

had to swallow his anger. When it would come out, there was usually some kind of external

provocation and The Dreamer reports that, in the fights he got into, his rage was blinding and he

often remembers little from those infrequent incidents. His reticence to discuss his Vietnam

combat experience, particularly in the context of anger, leads me to question what actions in

Vietnam have contributed to suppressing his aggression.

Treating the Dreamer

When looking at how the Dreamer’s treatment has progressed, I will first explain

historically how our treatment operated. This will give a context for change that will be

explained in an ideal relationship. When we understand the ideal, we can see then how pursuing

that ideal has changed our therapeutic relationship.

The Therapeutic Relationship As It Existed

When the Dreamer comes in, he will typically begin right away with his dreams. He will

start telling the story and move through the dream until it is complete. As someone who has

considerable difficulty remembering my dreams, I am envious of his ability to recall the dreams

in their entirety. We would discuss the content of the dreams in a somewhat concrete manner. In
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the session where the Dreamer reported being chased through a jungle by a gorilla, he also

mentioned his father scaring him as a child by hiding behind the shower curtain and surprising

him wearing a gorilla mask. We would tend to focus on direct interpretations.

The dream work would eventually transition to discussion of different interactions the

Dreamer would have with people, contemporary or historical. After he would share an anecdote,

I would typically interpret the content of them and reflect historically how the themes reflected

in the dream were developed in his childhood. This would repeat itself every week and while his

nightmares reduced in frequency over time, the content of his dreams were still charged with

emotions that the Dreamer was not able to express in person.

The Ideal Therapeutic Relationship

The Dreamer has entered treatment in order to treat his nightmares, which reflect his

vulnerability and aggression. Getting him to be more comfortable with his vulnerability would

require exposing him to aspects of it in a safe, controlled manner and showing him that he can

survive being vulnerable. The aggression he fears would also have to be explored in full. He

usually begins every session discussing a dream he had over the previous week before moving

into other topics.

After hearing his dream, I would ask the Dreamer how he felt discussing the dream in the

present time as well as how he felt when he woke up from it. Comparing the reactions between

then and now can be useful for showing the patient that negative affect is transient. Then I would

ask him what he thought the dream meant. This would give me an idea of how self-aware he was

about the symbolism inherent in his dreams.

Since many of his dreams have ambivalent relationships with medical personnel, I would

ask him how he feels about coming to mental health treatment. I’d ask him his opinions of the
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medial personnel that he has encountered at the VA and, in particular, his opinions of myself and

other mental health staff he has worked with. His dream relationship with medical personnel is

often contentious based upon the personnel doing something that puts the Dreamer at risk. I

would discuss with him the risks he feels about discussing his history with me, as I feel his

reluctance to share his emotions is based upon that fear.

On my end, I need to overcome fear of my own aggression that has hindered me from

addressing the Dreamer’s aggression. In some ways, I feel the hesitation is mutual. Even among

non-combat veterans, the military indoctrination process inculcates a sense that violence can be

the answer and creates soldiers who can kill if the mission requires it. Combat deployments

reinforce this and the training ahead of the deployment further cultivates a mindset where

violence of action is the primary doctrine and necessary for survival. Since both of us are aware

of what we are capable of, I think we are both resistant to address anger. The military reflex is to

meet aggression with greater, more decisive aggression. The relationship is one of mutual respect

and admiration and the potential for decisive aggression on one of our parts towards the other is

terrifying. Given that I am the therapist, I need to create a space where we can mutually explore

the Dreamer’s aggression in a manner that does not trigger a military reaction and escalate the

conflict. This would have a twofold message—one that aggression can be explored and that

military indoctrination is not the final answer in how we can live our lives following service.

Changes in the Therapeutic Relationship

Utilizing a more interpersonally focused approach to the Dreamer’s therapy has been

slow but shows promise. After he detailed one of his dreams where he was being chased by an

unusually persistent and intelligent snake, I asked the Dreamer what he thought might be chasing

him. To this, he responded, “I’m chasing myself,” which I thought was a very insightful
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response. This encouraged me to ask him about many of the more prominent features of his

dreams. In one, where a taxicab driver who was supposed to take him to see me, the taxicab

driver frequently misunderstood the Dreamer’s directions (which were to a different hospital

than we see each other at). When I asked him why he thought the taxicab driver had trouble

understanding him, the Dreamer replied, “people don’t understand where I’m coming from most

of the time, anyway.”

When the Dreamer told me a story about a fight he got into at an old workplace in the late

1970s, he minimized how violent his response was to being surprised by a coworker who was

playing a joke on him. I pressed for more information and he was reluctant to provide it. I asked

him if he was uncomfortable describing his anger. He then started to tell me a story about

something else to illustrate “how his mind works.” I let him finish the story, and then asked him

why he told me that story when I asked him a different question. He laughed and said, “My

deception didn’t work, huh?” At this point, he will acknowledge that he is uncomfortable

discussing his anger, but will not go into any reasons or actually broach the subject. I still need to

see why he can’t tell me, which might be illustrative of why he can’t tell himself about his anger.
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References

Fromm, E. (1947). Man for himself: An inquiry into the psychology of ethics. New York: Holt,

Rinehart and Winston.

Grossman, D. (1996). On killing: The psychological cost of learning to kill in war and society.

Boston: Little, Brown.

Shabad, P. (2006). To expose or to cover up: Human vulnerability in the shadow of death.

Contemporary Psychoanalysis 42, 413-436.

Shay, J. (1994). Achilles in Vietnam: Combat trauma and the undoing of character. New York:

Scribner.

Shay, J., Cleland, M., & McCain, J. (2002). Odysseus in America: Combat trauma and the trials

of homecoming. New York: Scribner.