This article was downloaded by: [Gazi University]

On: 18 August 2014, At: 06:24

Publisher: Routledge
Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer
House, 37-41 Mortimer Street, London W1T 3JH, UK

Neuropsychoanalysis: An Interdisciplinary Journal

for Psychoanalysis and the Neurosciences
Publication details, including instructions for authors and subscription information:
http://www.tandfonline.com/loi/rnpa20

The Neuropsychology of Dreams: A ClinicoAnatomical Study

Ramon Greenberg M.D.

11 Waverly Street, Brookline, MA 02146, e-mail:

Published online: 09 Jan 2014.

To cite this article: Ramon Greenberg M.D. (1999) The Neuropsychology of Dreams: A Clinico-Anatomical Study,
Neuropsychoanalysis: An Interdisciplinary Journal for Psychoanalysis and the Neurosciences, 1:1, 128-130, DOI:
10.1080/15294145.1999.10773253
To link to this article: http://dx.doi.org/10.1080/15294145.1999.10773253

PLEASE SCROLL DOWN FOR ARTICLE

Taylor & Francis makes every effort to ensure the accuracy of all the information (the Content) contained
in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no
representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of
the Content. Any opinions and views expressed in this publication are the opinions and views of the authors,
and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied
upon and should be independently verified with primary sources of information. Taylor and Francis shall
not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other
liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or
arising out of the use of the Content.
This article may be used for research, teaching, and private study purposes. Any substantial or systematic
reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any
form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http://
www.tandfonline.com/page/terms-and-conditions

128
that Schacter is unaware of this, it gets scanted in
the main part of Searching for Memory and is not
adequately brought to bear in "The Memory Wars."
The case for therapeutically recovered memories
pales compared to the case against them. His cautions
notwithstanding, Schacter's arguments of doubt are
more than convincing to me, and can be made even
stronger by including the role of social forces in influencing memory. His efforts to identify "shades of
gray" (p. 277) seem more rhetorical than real, and the
"middle ground" (p. 277) he hopes to mark out, more
virtual than real.

Downloaded by [Gazi University] at 06:24 18 August 2014

III
Searching for Memory is a magnificent book. Schacter
draws from a richly textured and vast pallet of often
conflicting information to paint a wonderfully detailed
panorama of memory, the mind, and the brain as seen
in the advances of the last several decades. His love
for his subject, as well as his extraordinary erudition,
are unmistakable. Judged from the standard of how
many references I checked off to locate and read, it
is a treasure trove. I only wish he had stated his pervasive doubts about the recovered memory issue less
ambiguously, and hope I have not overestimated his
skepticism in the process.

References
Andreason, N. (1995), Posttraumatic stress disorder: Psychology, biology, and the Manichaean warfare between
false dichotomies. Amer. J. Psychiatry, 152:963-965.
Southwick, S., Morgan, A., Nicolaou, A., & Charney, D.
(1997), Consistency of memory for combat-related traumatic events in veterans of Operation Desert Storm.
Amer. J. Psychiatry, 154:173-177.

c. Brooks Brenneis, Ph.D.

2700 Marshall Court
Madison, Wisconsin 53705
e-mail: brenneis@facstaff.wisc.edu.
The Neuropsychology of Dreams: A Clinico-Anatomical Study by Mark Solms. Hillsdale, NJ: Lawrence Erlbaum, 1997, 292 pp., $55.95
This book is a goldmine, full of many deep veins although it also has a few shallow ones. The author
provides an extremely rich view and review of the

Book Reviews
role of the cerebral cortex in dreams. He does this in
three parts: (1) a comprehensive review of neurologic
literature from the nineteenth century to the present;
(2) his own study of 361 cases with cerebral lesions
and a group of symptomatic controls without CNS
pathology; and (3) a series of hypotheses he develops
which weave through the clinical material and help
keep a focus on the meaning of the findings. The major
impact of this book is how clearly the author demonstrates the crucial role played by a number of telencephalic structures in the generation of dreams. This
convincingly contradicts the long accepted notion that
REM sleep and therefore dreaming is mainly the result
of pontine activity. The pontine theory has contributed
to the belief that dreams are inherently meaningless.
For psychoanalysts such an idea should not make
sense. Indeed, this reviewer's sense, as an analyst, that
dreams could not be purely based on pontine activity
led to a study (Greenberg, 1966) showing the important role of the visual association cortex in the parietal area in the generation of the eye movements in
REM sleep. At the same time animal studies also
showed the cortical contributions (Jeannerod, Mouret,
and Jouvet, 1965). Nonetheless, the belief in the central role of the pons persisted. Solms' book should put
an end to such thoughts as he shows, both in his review
of the literature and from his own cases, the essential
role of the cerebral cortex in the generation of and
quality of dreams.
Solms begins his presentation by describing the
Charcot-Wilbrand syndrome based on case reports by
Charcot and Wilbrand. These turn out to be two different disorders although they have been lumped together
as one. In the Charcot form the patient loses visual
dreaming although dreams continue in other modalities. Such patients also suffer from visual irreminiscence, a condition in which they lose all visual
imagery in waking life. The Wilbrand variant seems
to have complete cessation of dreaming. Interestingly,
the lesions in these two forms of disorder are in different locations and have differing waking symptoms.
Charcot's variant and subsequent cases like it seem to
have bilateral lesions in the medial occipital temporal
areas, while Wilbrand's variety is most clearly the result of bilateral lesions in the medial basal frontal areas. As Solms provides his extremely comprehensive
review one learns that lesions in a number of other
cortical and subcortical areas can affect the subjective
experience of dreaming. He describes increases in intensity, decreases in intensity, and loss of some sensory modalities in dreams. He clearly demonstrates
how the effects on dreams are not the result of primary

129

Downloaded by [Gazi University] at 06:24 18 August 2014

Book Reviews
sensory region impairment but are the result of damage to areas where perceptions are integrated and processed. The import is that dreams develop from the
inner and private life of the mind, drawing on stored
rather than currently impinging sensations. To put it
succinctly, what the mind cannot experience, cannot
be dreamed about. For those more interested in this
aspect of dreams see Greenberg (1966) and Greenberg
and Liederman (1966). Solms describes in great detail
the many different areas of the brain where damage
affects dreaming and where the defect in waking mental life is clearly reflected in the disordered dreaming.
This is a major observation which those interested in
dreams must keep in mind, and the author provides
ample evidence for this statement. In fact he provides
more than he realizes, for there is another side to this
connection between waking and dreaming mentation:
the emotional life of the patient. While the author acknowledges that some of the changes in dreams may
be "functional," I feel he doesn't fully present the
possibility that nightmares, of increased or decreased
intensity, or even in some cases cessation of awareness
of dreams may stem from patients' reactions to the
effects of their cortical lesions on their lives. As he
described the sudden and traumatic occurrences, I
found it hard to ignore this factor in the changes in
patients' experience of their dreams. Adding this factor does make somewhat fuzzy the purity of the effect
of the brain lesions. However, we must learn to deal
with this additional complexity.
Solms presents two other trains of thought which
should be of interest to psychoanalysts. One that really
impressed me followed his discussion of the movement in dreams from abstract thought to concrete images. It brought to my mind Freud's (1900) discussion
in chapter 7 of the regression in the perceptual system
involved in the generation of dream images. Sure
enough, Solms quoted this very passage on the next
page. On the other hand, Solms would like to have us
believe, on the basis of his findings, that dreams really
are the guardians of sleep. It is with regard to this that
I find the main shallow vein in this book. The discussion of REM sleep research is limited to four pages
plus interpolated referrals to REM studies in parts of
the book. In many ways it is not fair to ask more of
the author of such an encyclopedic book. However, I
am afraid that while Solms clearly suggests further
important REM sleep studies that still need to be done,
he has failed to integrate many existing REM sleep
studies. These make a strong case for the need for
REM sleep and support the idea that sleep may be the

guardian of dreams. Furthermore, I think the absence

of the consideration of a large body of REM sleep
research has led to the author's too ready dismissal
of any higher level functions for the dream process
(Greenberg and Pearlman, 1993). Thus, in what is a
superb contribution to our appreciation of the role of
a complex cortical system to dreaming, we find the
author falling into the camp of what Freud called the
,'physiologists" who minimized the meaning and the
function of dreams.
To summarize, this is a superb book. Despite the
enormous amount of detail involved in describing
many different case reports, the book holds together
because of the way Solms connects the findings with
his hypotheses about the roles of different areas of the
brain. The major areas that he pinpoints as playing
crucial roles are the medial temporal occipital, the medial basal frontal, and the lower parietal convexity.
The book will be a major source for anyone interested
in knowing about the role of the cortex in dreams.
The book also points toward further research on the
connections between REM sleep and dreaming and
fits nicely with more recent work demonstrating brain
activity by using PET scans (Hong, Gillin, Dow, Wu,
and Buchsbaum, 1995). The findings show clearly the
elaborate networks in the brain that are involved in
dreaming. For me this book reinforces Freud's recognition that the study of dreams clearly reveals "mind"
and "brain" connections.

References
Freud, S. (1900), The Interpretation of Dreams. Standard
Edition, 4&5. London: Hogarth Press, 1953.
Greenberg, R. (1966), Cerebral cortex lesions: The dream
process and sleep spindles. Cortex, 2:357-366.
- - - Liederman, H. (1966), Perceptions, the dream process and memory: An up-to-date version of Notes on a
Mystic Writing Pad. Comprehen. Psychiatry, 7:517-523.
- - - Pearlman, C. (1993), An integrated approach to
dream theory: Contributions from sleep research and
clinical practice. In: The Functions of Dreaming, ed. A.
Moffit, M. Kramer, & R. Hoffman. Albany: New York
State University Press.
Hong, C. C., Gillin, J. C., Dow, B. M., Wu, J., & Buchsbaum, M. S. (1995), Localised and lateralized cerebral
glucose metabolism associated with eye movements during REM sleep and wakefulness: A positron emission
tomagraphy (PET) study. Sleep, 18:570-580.

130
Jeannerod, M., Mouret, J., & Jouvet, M. (1965), Etude de
Ia mortricite oculaire au cours de Ia phase paradoxale du
sommeil chez Ie chat. Electroenceph. Clin. Neurophysio1., 18:554-566.
Ramon Greenberg, M.D.
11 Waverly Street
Brookline, MA 02146
e-mail: ramon~reenberg @ hms. harvard. edu

Downloaded by [Gazi University] at 06:24 18 August 2014

The Symbolic Species: The Co-Evolution of Language and the Brain by Terence Deacon. New York:
W. W. Norton, 1997, hardcover $29.95, paperback
$15.95
A few years ago the UCLA neuroanatomist and psychologist Harry Jerison asked, "What is so great about
being smart?" with the implication that in our species'
history, it is hard to conclude that our intelligence and
our capacity for complex symbol use has done us more
good than harm. What is ironic and prophetic, as Terence Deacon shows us in his extraordinary text, is that
symbol use itself may be the only means available for
shifting the balance toward a kind of positive outcome
for ourselves, if not for the planet. The more we understand about the nature and origin of our symbolic capacities, he claims, the better we can regulate our
enormous cognitive potential. He wrote his "mystery
novel," as he calls it, with this goal of increasing our
understanding about how symbol reference and language came about, and ultimately, of who we are.
For about a year several UCLA linguists, psychoanalysts, and psychologists and I met weekly, reading,
discussing, and debating The Symbolic Species:
The Co-Evolution of Language and the Brain. We all
concluded that this is a profound work, remarkable
for its scholarship and extreme detail, and deserving
dedicated study. Here, I will sketch out a broad and
oversimplified overview of Deacon's complex evolutionary scenario, and then discuss a few of his essential arguments.
Somewhere in our fuzzy past there were groups
of australophithescines who had already been bipedal
for some time and who could communicate with context-bound gestures and sounds. These foraging hominids lived in the savannas of eastern and southern
Africa. We can only marvel that they survived at all
in what must have been a continuously perilous environment. Except for their nascent evolutionary edge
of symbolic reference, we might very well not be here,
or might not know it. The time was about 2 million
years ago; it had taken several more million years to
get to that point from the great bifurcation that split

Book Reviews
man-to-be from the great apes. Then, something very
strange happened. A shift in cognition, specifically in
abstracting capacities and learning by logical and semantic categorization, began to dominate the experience of these individuals and groups, which hitherto
had been limited by mental representations of stimulus-response associations to the mostly local context
of rewards and punishments. Environmental events always had signal value about how to react for all animals, but if a new waterhole was associated with the
possibility of reduced thirst, the only condition that
guided the approach behavior of prehominids was the
appraisal of immediate safety. But with a doubling of
brain size in what was to be a shift from australopithescines to true hominids like Homo habilis (tool
man), a new condition and option became possible.
With improved cognitive hardware the hominid could
apply a system of divergent ideas and images based
on principled rules. Homo habilis felt the urge to approach water, but instead of drinking, might consciously wait for an animal to drink first, then follow
the animal to see if the water was deadly or safe to
drink. A logical theory had been conceptualized and
tested. Many of his or her vertebrate ancestors could
learn the stimulus-response associations that, together
with instinctual responses, made survival possible. But
this hominid and his kind also could learn "the system
of relationships of which these correlations were a
part." If this individual's logical experimentation allowed for survival and offspring later on, he or she
could then carry the gradually developing genetic predisposition for flexible rule-guided behavior into the
next generation. Remarkably, in the initial nonresponse, the stimulus to approach water was intentionally used against itself. He or she delayed gratification
conditional upon reasoning, thinking, planning, vicarious trial-and-error, long-term memory-all of these
nonautomatic capacities. This was possible because of
a simple but effective gestural and guttural system of
rule-based and communicated labels for objects and
actions developed within groups of individuals. The
neurobiological substrate for this advance in everyday
experience of early hominids was actually not new;
many primates can do a bit of this if given enough
training and exposure in a controlled setting. But for
more advanced hominids, it became a primary problem-solving tool and the natural thing to do. In its
fullest developments it would provide humans with
"an unprecedented sort of autonomy or freedom from
the constraints of concrete reference."
The neurobiological cause and consequence for
this symbolizing capacity, according to Deacon, is the
property of an expanded prefrontal cortex (PFC) in