Case Studies
2026: Online Advance Publication
Dream processes and affect regulation in psychotherapy: a longitudinal clinical case study
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Published: 31 July 2026
0
Views
0
Downloads
Authors
Anxiety disorders frequently emerge in contexts of chronic interpersonal stress and are often accompanied by disturbances in affect regulation and heightened sensitivity to bodily signals. In patients with chronic somatic conditions, these processes are commonly conceptualised within psychosomatic frameworks emphasising interactions between emotional regulation and stress-related bodily systems. Although psychotherapy may facilitate psychological adaptation, less is known about how dream processes reflect ongoing changes in affect regulation during treatment. The present study explores longitudinal changes in dream narratives during psychotherapy in a patient with anxiety and depressive symptoms in the context of ulcerative colitis. A qualitative, process-oriented longitudinal case study was conducted within analytically oriented psychotherapy with a 28-year-old patient. Over one year, the patient recorded dreams, from which five clinically significant dreams were selected. Dream reports were analysed alongside psychotherapy process notes and in-session associations using thematic analysis, informed by Jungian amplification. Three thematic constellations were identified: vulnerability and loss of control; threat perception and emotional overwhelm; and emerging control and agency. Early dreams reflected helplessness and heightened threat sensitivity, whereas later dreams increasingly depicted the dream-ego as capable of recognising danger and responding more adaptively. Findings suggest that dream processes may serve as indicators of changes in affect regulation and relational functioning, offering a process-sensitive window into psychotherapeutic change in psychosomatic contexts.
Downloads
Download data is not yet available.
Citations
Ableidinger, S., De Gennaro, L., Mota-Rolim, S., Scarpelli, S., Bolstad, C. J., Bjorvatn, B., Espie, C. A., Dauvilliers, Y., Korman, M., Landtblom, A. M., Plazzi, G., Matsui, K., Yordanova, J., Bjelajac, A. K., Reis, C., Chung, F., Merikanto, I., Wing, Y. K., Partinen, M., Macêdo, T., … Holzinger, B. (2026). Lucid Dreaming: Not Just Awareness, but Agency. Journal of Sleep Research, 35(2), e70181. doi: 10.1111/jsr.70181
Ambrosio, L., Senosiain García, J. M., Riverol Fernández, M., Anaut Bravo, S., Díaz de Cerio Ayesa, S., Ursúa Sesma, M. E., & Portillo Vega, M. C. (2015). Living with chronic illness in adults: A concept analysis. Journal of Clinical Nursing, 24(17-18), 2357-2367. doi: 10.1111/jocn.12827
American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.). American Psychiatric Association Publishing.
Bandelow, B., & Michaelis, S. (2015). Epidemiology of anxiety disorders in the 21st century. Dialogues in Clinical Neuroscience, 17(3), 327-335. doi: 10.31887/DCNS.2015.17.3/bbandelow
Bonaz, B. L., & Bernstein, C. N. (2013). Brain–gut interactions in inflammatory bowel disease. Gastroenterology, 144(1), 36-49. doi: 10.1053/j.gastro.2012.10.003
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101. doi: 10.1191/1478088706qp063oa
Braun, V., & Clarke, V. (2019). Reflecting on reflexive thematic analysis. Qualitative Research in Sport, Exercise and Health, 11(4), 589-597. doi: 10.1080/2159676X.2019.1628806
Crits-Christoph, P. (2002). Psychodynamic-interpersonal treatment of generalized anxiety disorder. Clinical Psychology: Science and Practice, 9(1), 81-84. doi: 10.1093/clipsy.9.1.81
Dang-Vu, T. T., Desseilles, M., Petit, D., & Maquet, P. (2010). Neuroimaging in sleep medicine. Sleep Medicine, 11(7), 639-650. doi: 10.1016/j.sleep.2007.03.006
Ellis, L. A. (2016). Qualitative changes in recurrent PTSD nightmares after focusing-oriented dreamwork. Dreaming, 26(3), 185-201. doi: 10.1037/drm0000031
GBD 2017 Inflammatory Bowel Disease Collaborators (2020). The global, regional, and national burden of inflammatory bowel disease in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. The lancet. Gastroenterology & Hepatology, 5(1), 17-30. doi: 10.1016/S2468-1253(19)30333-4
Glucksman, M. L. (2001). The dream: A psychodynamically informative instrument. Journal of Psychotherapy Practice and Research, 10(4), 223-230.
Gracie, D. J., Irvine, A. J., Sood, R., Mikocka-Walus, A., Hamlin, P. J., & Ford, A. C. (2018). Effect of psychological therapy on disease activity in inflammatory bowel disease: A systematic review and meta-analysis. The Lancet Gastroenterology & Hepatology, 3(3), 189-199. doi: 10.1016/S2468-1253(17)30383-0
Gross, J. J. (2015). Emotion regulation: Current status and future prospects. Psychological Inquiry, 26(1), 1-26. doi: 10.1080/1047840X.2014.940781
Günther, C., Rothhammer, V., Karow, M., Neurath, M. F., & Winner, B. (2021). The gut–brain axis in inflammatory bowel disease—Current and future perspectives. International Journal of Molecular Sciences, 22(16), 8870. doi: 10.3390/ijms22168870
Hayes, A. M., & Andrews, L. A. (2020). A complex systems approach to the study of change in psychotherapy. BMC Medicine, 18, 197. doi: 10.1186/s12916-020-01662-2
Hayes, A. M., Laurenceau, J.-P., Feldman, G. C., Strauss, J. L., & Cardaciotto, L. (2007). Change is not always linear: The study of nonlinear and discontinuous patterns of change in psychotherapy. Clinical Psychology Review, 27(6), 715-723. doi: 10.1016/j.cpr.2007.01.008
Jung, C. G. (1960). The structure and dynamics of the psyche (Collected Works of C. G. Jung, Vol. 8). Princeton University Press.
Jung, C. G. (1964). Man and his symbols. Doubleday.
Kandel, E. R. (2001). The molecular biology of memory storage: A dialogue between genes and synapses. Science, 294(5544), 1030-1038. doi: 10.1126/science.1067020
Kessler, R. C., Chiu, W. T., Demler, O., Merikangas, K. R., & Walters, E. E. (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 617-627. doi: 10.1001/archpsyc.62.6.617
Knox, J. M. (1999). The relevance of attachment theory to a contemporary Jungian view of the internal world: Internal working models, implicit memory and internal objects. Journal of Analytical Psychology, 44(4), 511-530. doi: 10.1111/1465-5922.00158
Knox, J. M. (2001). Memories, fantasies, archetypes: An exploration of some connections between cognitive science and analytical psychology. Journal of Analytical Psychology, 46(4), 613-635. doi: 10.1111/1465-5922.00290
Knox, J. M. (2003). Archetype, attachment, analysis: Jungian psychology and the emergent mind. Brunner-Routledge.
Lane, R. D., Ryan, L., Nadel, L., & Greenberg, L. (2015). Memory reconsolidation, emotional arousal, and the process of change in psychotherapy: New insights from brain science. Behavioral and Brain Sciences, 38, e1. doi: 10.1017/S0140525X14000041
Neuendorf, R., Harding, A., Stello, N., & Hanes, D. (2016). Depression and anxiety in patients with inflammatory bowel disease: A systematic review. Journal of Psychosomatic Research, 87, 70-80. doi: 10.1016/j.jpsychores.2016.06.001
Nir, Y., & Tononi, G. (2010). Dreaming and the brain: From phenomenology to neurophysiology. Trends in Cognitive Sciences, 14(2), 88-100. doi: 10.1016/j.tics.2009.12.001
Pesant, N., & Zadra, A. (2004). Working with dreams in therapy: What do we know and what should we do? Clinical Psychology Review, 24(5), 489-512. doi: 10.1016/j.cpr.2004.05.002
Roesler, C. (2018). Dream content corresponds with dreamer’s psychological problems and personality structure and with improvement in psychotherapy: A typology of dream patterns in dream series of patients in analytical psychotherapy. Dreaming, 28(4), 303. doi: 10.1037/drm0000092
Samuels, A., Shorter, B., & Plaut, F. (1986). A critical dictionary of Jungian analysis. Routledge.
Schiepek, G. (2009). Complexity and nonlinear dynamics in psychotherapy. European Review, 17(2), 331-356. doi: 10.1017/S1062798709000684
Vassilev, I., Rogers, A., Kennedy, A., & Koetsenruijter, J. (2014). The influence of social networks on self-management support: A metasynthesis. BMC Public Health, 14, 719. doi: 10.1186/1471-2458-14-719
Walker, M. P., & van Der Helm, E. (2009). Overnight therapy? The role of sleep in emotional brain processing. Psychological bulletin, 135(5), 731. doi: 10.1037/a0016570
Whiteford, H. A., Degenhardt, L., Rehm, J., Baxter, A. J., Ferrari, A. J., Erskine, H. E., Charlson, F. J., Norman, R. E., Flaxman, A. D., Johns, N., & Vos, T. (2013). Global burden of disease attributable to mental and substance use disorders: Findings from the Global Burden of Disease Study 2010. The Lancet, 382(9904), 1575-1586. doi: 10.1016/S0140-6736(13)61611-6
How to Cite
Dream processes and affect regulation in psychotherapy: a longitudinal clinical case study. (2026). Research in Psychotherapy: Psychopathology, Process and Outcome. https://doi.org/10.4081/ripppo.2026.895
Copyright (c) 2026 the Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.