Insight and Dissociation in Lucid Dreaming and Psychosis

Abstract

Dreams and psychosis share several important features regarding symptoms and underlying neurobiology, which is helpful in constructing a testable model of, for example, schizophrenia and delirium. The purpose of the present communication is to discuss two major concepts in dreaming and psychosis that have received much attention in the recent literature: insight and dissociation. Both phenomena are considered functions of higher order consciousness because they involve metacognition in the form of reflective thought and attempted control of negative emotional impact. Insight in dreams is a core criterion for lucid dreams. Lucid dreams are usually accompanied by attempts to control the dream plot and dissociative elements akin to depersonalization and derealization. These concepts are also relevant in psychotic illness. Whereas insightfulness can be considered innocuous in lucid dreaming and even advantageous in psychosis, the concept of dissociation is still unresolved. The present review compares correlates and functions of insight and dissociation in lucid dreaming and psychosis. This is helpful in understanding the two concepts with regard to psychological function as well as neurophysiology.

Keywords: EEG; REM sleep; affective disorder; consciousness; delirium; dreaming; lucid dreaming; psychosis.

FIGURE 1

State-dependent coherences in the 40 Hz frequency band. Short and long range coherences obtained for waking (top), lucid dreaming (middle) and REM sleep (bottom). Coherences are indications of interscalp networking and synchronization. Coherences are averaged across electrode pairs in 4 s epochs. Short-range (55 pairs) was defined as less than 10 cm and long-range (65 pairs) as larger than 15 cm inter-electrode distance. Coherences are lowest in REM sleep and strongly enhanced in lucid dreaming.

FIGURE 2

State-dependent power in the 40 Hz frequency band. This figure shows standardized 40 Hz power (36–44 Hz) in waking (black), lucid dreaming (red) and REM sleep (blue) in a single subject. 40 Hz band activity was chosen because effects of lucid dreaming were greatest here. Activity in the 40 Hz band has often been linked with conscious information processing in waking. Topographic images are based on movement-free EEG episodes and are corrected for ocular artifacts. For each state, power values are averaged across the respective episode. Depicted averages are based on episodes of equal duration. Compared to REM sleep, lucid dreaming shows increased 40 Hz activity across the entire cortex. The increase is strongest in frontal regions (left frame) and weakest in occipital regions (right frame).