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Introspections   |    
A Mid-Winter Night’s Dream
Samuel G. Siris, M.D.
Am J Psychiatry 2006;163:1883-1883. doi:10.1176/appi.ajp.163.11.1883
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The holidays had passed, and I was sitting in my office doing January paperwork when a knock came on the door. “Come in,” I said. The door swung open, and “Thomas” (not his real name) stood there awkwardly in the hallway. Long a patient at our day center, Thomas usually seemed awkward socially, with his unkempt appearance, cautious style, and literal interpretation of the world. “What’s up?” I asked.

“I had an interesting dream last night,” he replied. “I’d like to tell you about it. Can I come in?”

“Sure,” I said, “I have a couple of minutes right now. Tell me the dream.”

“Actually, there were two dreams,” he continued, coming only halfway into the office, “one after the other—and very vivid. In the first dream, one of my molars fell out—or really more popped out. It turned out to have a spring under it, which came out, too. I don’t ever believe I’ll ever forget the look of that spring. Just an ordinary spring, but I’ll always remember the way it looked. And then in the second dream, there was an awful cockroach. So I stepped on it and killed it, and when I did, a spring came out of it. What do you think the dreams mean?”

“Maybe they mean that we’re in the middle of winter, and you’re dreaming of spring,” I offered.

Thomas laughed and then suddenly sobered and added, “That’s crazy.”

“Dreams are a bit crazy, it’s true,” I replied. “They play with words or images or ideas. Often there are some real thoughts involved, perhaps even important thoughts, in a kind of code. Sometimes we can figure them out, and sometimes we can’t. That’s just the way dreams are.”

Thomas paused. “OK, then, never mind the dreams. There’s something else I’ve been meaning to tell you,” he went on. “When I ride here on the bus, it’s all right until the bus starts to get full. Then I start to feel terribly uncomfortable; there’s just not enough room. Sometimes it gets really bad, and it stays awful until the crunch is over, and the bus empties out again later on its route.”

“You know,” I responded, “the thing about springs is that the more you press in on them, the more you squeeze them together from the outside, the more tension they have. It’s sort of like what you are telling me about you on the bus—the more your space gets squeezed, the more tension you experience.”

“Now, that’s very interesting,” Thomas commented, staring at me. “I’ll have to think about that for a while.” He then pivoted abruptly and strode off, disappearing down the hall.

I went back to the paperwork, pleased by my interruption, and better remembering why I had gotten into psychiatry in the first place.

+Address all correspondence and reprint requests to Dr. Siris, Zucker-Hillside Hospital, 75–59 263rd St., Glen Oaks, NY 11004; ssiris@lij.edu (e-mail).

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