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A neuropsychodynamic view of dreaming

Article in Neuropsychoanalysis · May 2023

DOI: 10.1080/15294145.2023.2197002

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A neuropsychodynamic view of dreaming

F. Castellet y Ballarà, C. Spadazzi & R. Spagnolo 
Received 30 May 2022, Accepted 16 Feb 2023, Published online: 05 May 2023

 Download citation  https://doi.org/10.1080/15294145.2023.2197002

ABSTRACT

Functional neuroimaging and neurophysiological techniques open fascinating

new perspectives on the psychodynamic understanding of dreams. The article
o"ers a review of the recent relevant neuroscienti#c and psychoanalytic
literature, including the “inferential brain” model’s recent revolutionary approach.
This model proposes a correlation between the neurophysiological and the
clinical role of dreaming. A growing framework of animal and human research
converge on the concept of the evolutionary role of dreaming in maintaining
brain homeostasis. Functional recordings show that the same brain structures
and circuits are involved in dreaming as well as waking states, thus proving that
dreams are a particular form of consciousness, where the brain’s synaptic
architecture is remodeled through memory retrieval and reconsolidation. The
partial deactivation of cortical prefrontal regions during dreaming facilitates the
emergence of emotional contents belonging to subcortical and limbic structures,
allowing emotional self-regulation and a better emotional balance during waking
states. According to the inferential brain model, a speci#c function of dreaming
would be to organize and update a virtual reality model which informs both the
body and the external world of the organism’s expectations. Moreover, the iconic
and metaphorical language of dreams is neither bizarre and meaningless per se,
nor does it hide a latent content to be revealed through interpretations. Instead,
the manifest content of the dream needs to be “unraveled” into its emotional
roots. In conclusion, within a framework which includes psychoanalysis,
theoretical and a"ective neurosciences, dreams represent the via regia not to the
unconscious but to self-awareness and emotional self/regulation.

 KEYWORDS: Dreaming neuropsychoanalysis inferential brain predictive processing

a"ective self-regulation

 Previous article View latest articles Next article 

Since the end of the 1990s, the growing links between neuroscience and
psychoanalysis are leading to the development of productive interactions aimed
at a better understanding of mental functions. Dreams, as well as delusions, are
located in a functional “in-between” area in relation to consciousness, or a “third
state of being,” according to the historical de#nition of the REM phase by
Aserinsky and Kleitman (1953). The oneiric process can therefore be understood
from both a neuroscienti#c and a psychoanalytic perspective. Dreaming has been
investigated in neuroscience research in relation to brain areas,
neurotransmitters, memory circuits, and the dream wake rhythm which foster
the dream genesis and its unfolding. The oneiric process also contains – in
psychoanalysis – the meaning and therapeutic usefulness of dreams. Thus, the
approach to dreams from a neuropsychoanalytic vertex implies a binocular
vision, where the psychological meaning interacts with the neurologic bases
which are able to activate and maintain the oneiric function. In the meantime,
this vertex elicits an attempt to integrate sophisticated neuroimaging
techniques – and other methods – with the understanding of “how” an individual
dreams as well as “why” he/she has that dream, with that manifest content and
with that particular a"ective state, in that moment of his/her life. Using fMRI, “hot
zones” have been highlighted in the posterior cortical area which are activated
during the dreaming activity (Siclari et al., 2017). The EEG detection of neural
activity in these areas predicts dreaming in 87% of cases. However, it is still
uncertain how dreams start and what triggers activate them. Their research is
related only to the detection of neural activity in the 5 minutes prior to waking
up, therefore the activation of the “hot zones” might re$ect only the brain’s
representation of the dream’s content (Xiao, 2017). Moreover, typical
neuroimaging and EEG techniques have still strong limitations in the exploration
of the deeper subcortical layers of our brain; therefore, their results do not
exclude the possibility that the actual triggers of dreams would be in other areas
related to the emotional brain, such as the limbic system (Miletić et al., 2022;
Solms, 2021). Pioneering research (Horikawa et al., 2013) focuses on the
possibility of screening dream images in real time, while the individual is still
dreaming, bypassing the memory circuits. Which other developments in dream
research can be hypothesized in a technologic future closer to us then we can
imagine?

In the last 50 years, within the psychoanalytically informed research and

community, the central position of dreams has never been discon#rmed.
Nevertheless, dreams have been and are still considered in di"erent ways,
depending upon the analyst’s theoretical background. So, close to Freudian
theory, they are considered belonging to the area of drives, as related to
repressed desires including resistance mechanism and the emergence of the
transference process, or as a representations of parts of the self (Kantrowitz,
2003). More recently, they are considered a virtual reality model formally
equivalent to the generative models implicit in unconscious inferences according
to the Bayesian model of the brain as inference machine (Hobson & Friston,
2014).

Wilfred Bion can be considered the author who formulated a theory of dreaming
and wakefulness closer to the present neuroscienti#c view. Bion (1991)
completely reframed the oneiric process. According to him, dreams are a psychic
activity which guarantees mental health, as a continuum between consciousness
and the unconscious in a two-way street: dreams are the realization of emotional
experiences foreclosed during wakefulness. In his assessment regarding working
through emotional experiences, substantially di"erent from Freud, there is no
di"erence between dreaming state and waking state. The transformation of beta
elements into alpha elements is similar in the two states. The symbolic
transformation of emotional and sensorial experiences is due to the dream, even
during wakefulness (Schneider, 2010).

Following Bion, Ogden (2010) and Grotstein (2000) stress the continuity and
complexity of the oneiric function in relation to psychotic and non-psychotic parts
of one’s personality. These characteristics make the dream a fundamental
element in the capacity to modulate the states of the self (i.e. self-regulation).

Nowadays, a scienti#cally updated psychoanalytic vision of dreams implies the

inclusion of other investigative methods (from neurophysiology to neuroimaging)
alongside the analytical/clinical ones, in an attempt to understand “what” an
individual dreams in relation to “why.” Psychoanalysis, neuropsychology, and
neurophysiology currently focus their research on dreams following their own
speci#c #elds, which concern respectively: the subjectivity of dreams related to
their content; the involvement of cognitive functions; and the circuits involving
the formation of dreams. These three levels are diversely included within the
three disciplines’ protocols and all together constitute the domain of
neuroscienti#c research on dreams.

Therefore, while neurophysiology and neuroimaging research revolves around

the organization of sleep (EEG #gures, neuronal circuits, the involvement of
molecules, and peptides), the other two areas (psychoanalysis and
neuropsychology) share some basic assumptions regarding the symbolization of
early experiences (including preverbal ones); the search for solutions to daytime
con$icts; and the promotion of communication between a"ective systems,
fantasies, and memories. Psychoanalytic research, more than other disciplines,
involves the meaning of dreams, both in the analyst/patient relationship and
within the patient’s mental economy, as well as the patient’s dream associations.
These protocols have the value not only of testing some psychoanalytic
hypotheses, but also of broadening our knowledge on the functions of the dream
in the organization of mental activity.

Fosshage’s studies (2013) have been focused in this direction. Summarizing his
thinking on dreams:

Dreaming is thinking when we are asleep. By de#nition, dreaming is

 unconscious thinking, and I see it as the continuation of implicit and
explicit processing that occurs during waking. It o"ers the best window
into unconscious thinking. And what do we dream about? We dream
about our most immediate concerns: our dreams include attempts to
resolve con$ict, to self-regulate, to regulate a"ect, to envision and
move developmentally, to fortress threatened patterns of
organization, to consolidate new experience, and to integrate and
enhance new learning. (p. 253)

This assertion has the value of bringing dreams out of the entangled
desire/motivation theorized by Freud and post-Freudians. It extends our vision
on the role played by dreams in the regulation of a"ects and memories. The
study of dreams has thus become part of numerous empirical research
protocols, based on large case studies, which also take into account the
uniqueness of dreams and the dreamer’s history. We will brie$y describe some of
these studies.

The Frankfurt fMRI/EEG study (FRED) group has been conducting research, using
the Moser Method, on the dreams of patients who have been depressed for
several years (Fischmann et al., 2013). Their focus was on the changes in brain
functioning during psychoanalytic psychotherapy treatments. Brain structures
were monitored via fMRI and EEG. To sum up, comparing the dreams at the
beginning of psychoanalytic treatment with those at the beginning of the third
year of analysis, the research documented the following results:

- a signi#cant change in relational patterns (self/object),

- an increase in the range of actions of the dream-subject,

- an increase in the expression of the emotional spectrum.

The research also highlighted, through the analysis of individual dreams, the
changes in the dream atmosphere, namely, the possibility of expressing a wider
variety of a"ects, emotions, and problem-solving skills in the dream.

In Belgrade (Hau et al., 2013; Varvin et al., 2012), a group of colleagues conducted
research on dreams produced in a sleep laboratory, with people involved in the
Balkan Wars. The dreams were studied following the Moser Method, associated
with PEA – Psychoanalytic Enunciation Analysis. Thirty dreams of 25 PTSD
patients were analyzed; the control group involved 25 subjects (and 30 dreams)
with traumatic experiences, although they had not developed PTSD. The
statistical analysis highlighted a di"erent representation of the trauma in the two
groups. The group with traumatic experiences, but without PTSD, succeeded to
produce entire dream sequences, organized in a narrative plot, with rare
awakenings. The PTSD group, in contrast, had frequent awakenings during
recurrent dreams (which involved the trauma). The results showed that, in the
group with PTSD, the ability to symbolize was intact, but the narrative structure
of the dream was absent; in fact, the dreams often presented a single image,
sometimes #guratively not connected to the trauma, even if full of anguish.

Similar research was carried out by Cartwright et al. (1984). In this protocol, the
dreams of 20 depressed patients following divorce were analyzed. The research
showed that the daily emotional worries entered the dreams in a di"erent way in
patients in remission compared with those not in remission. The latter
manifested in their dreams a lesser ability to link a"ects to memories and to
experience emotions. The author concludes that the dream content is linked to
the dreamer’s daily worries and contributes to the regulation of the mood
disorder only when the a"ects are within a certain de#ned range. If the a"ect is
excessively high or low, in such a way that it cannot be connected to the related
memories, this dream function fails. If this function fails, the transformative
process of emotions during sleep – and therefore also during wakefulness – is
blocked. Therefore, patients not in remission had no way of using the dream to
regulate the a"ects and their mood disorder persisted.
Furthermore, Cartwright et al. (1984) demonstrated how a"ects and memories
appear in dreams concerning both past and present events, and also show how
in dreams there are elements indicative of the evolution of treatment and the
remission of symptoms. Dreams convey information directly concerning the
analytic trend and its evolution. This was also highlighted by Kramer et al. (2015),
who addressed the topic of a"ects in the dream, involving the beginning and the
end of the analysis. The authors presented a descriptive analysis of the manifest
dream content of 63 patients. Dreams were analyzed according to a grid on
which psychodynamic parameters were present such as: a"ects, associations,
transference, gender, relational progress, and other categories. This research
demonstrated a prevalence of negative a"ects in the dreams at the beginning of
analysis and the prevalence of positive a"ects in dreams at the end.

The research on which daily worries enter the dream turns out to be very
meaningful. Hartmann and Brezler (2008) investigated the reaction to the attack
on the Twin Towers. The authors collected 880 dreams from 44 people (10
dreams from before the traumatic event and 10 after). The goal was to assess
whether the traumatic event had brought about any changes in the “Central
Dream Imagery,” which they de#ned as: “A contextualizing image or central
image is a striking, arresting, or compelling image – not simply a story – but an
image that stands out by virtue of being especially powerful, vivid, bizarre, or
detailed” (p. 214). The expected results of an increase in the intensity of the
Central Dream Imagery were con#rmed, but the images collected were not
directly related to the Manhattan scene. The majority of the images were related
to the fear of being attacked. This fear was represented through scenes of daily
life and not through the attack on the Twin Towers itself. In other words, the
dreams represented the concern linked to the attack, but not directly the images
of the collapse of the Twin Towers.

It is therefore highlighted that the dreams linked to traumatic events are not
dreams of replication of what has actually been witnessed, but that dreams
create images from scratch as a function of the daytime emotional request.
Domho" (1996, 2011) and Domho" and Fox (2015) considered the relationship
between dreaming, the stages of mind wandering and daydreaming. In addition
to the images of “Figurative Embodiments,” other images, de#ned as “unrealistic,”
appear in dreams and they could represent forms of cognitive impairment or
malfunction. These “unrealistic” #gures are also called “bizarre” (Blechner, 2013)
and generate in the dreamer a feeling of unrelatedness.

In accordance with this research, it is evident how a"ective experience, daily

worries, and the emotional world appear directly in dreams through the
production of images, some conforming to the reality represented and others
created from scratch. Examples of “unreal” or “bizarre” images are part of the
common dream baggage. These images arouse interest as they go beyond the
common sense of the iconic representation to cross over, through sensory
solicitation, into the representation of a"ects and in general into the
representation of the internal world. Schredl (2010), researching on 4000 dreams
(laboratory and spontaneous) found that 100% of these present a visual content,
57% auditory, 8% vestibular, and just under 1% other sensory content. On this
strong sensory and a"ective arousal, Fosshage (1997) adds:

I do not consider that images are chosen for the purpose of disguise
and are, therefore, transformed into other images. Instead, I feel that
the dreamer selects images for their evocative power and actual
usefulness in imagistic thinking, in a manner similar to a waking
person selecting words to further the process of thinking and
communicating. (p. 443)

And he continues by supporting the thesis that images should not be translated,
but must keep the metaphor open, even when the discourse of the dream does
not appear logical and coherent. Regarding the dream inconsistency, Blechner
(2001) speaks both of the “grammar of irrationality,” which characterizes the
cognition of the dream with respect to wakefulness, and of disjoint cognition
(Blechner, 2005, 2013). In his 2013 paper, he writes:

Hobson calls these dream formations “incomplete cognitions”; Freud

(1900) calls them “intermediate and composite structures.” I call these
dream formations “interobjects” (Blechner, 2001). Rather than focus on
what they are not (not complete condensations), I would prefer to
focus on what they are (new creations derived from blends of other
objects). (p. 172)

Broadening the theoretical horizon of dreams, we could say that bizarre

elements, paradoxes, hyper-sensorial unfolding, and intense emotional reactions
are admitted into dream consciousness as a consequence of the loosened link
with the prefrontal critical processes, the inhibition of executive functions, and
the excitement of subcortical limbic structures (the emotional brain). As stated by
Nielsen and Stenstrom (2005):

Clinical and brain imaging studies link episodic memory and

autonoetic awareness with activity in several prefrontal brain regions
(medial, dorsolateral), visual cortex, and medial temporal lobe,
including the hippocampus. Hippocampal regions are especially
implicated when the self-referential quality of the memory task is high.
Changes in brain function during REM sleep, especially increased
activity in the hippocampal formation and decreased activity in
prefrontal regions, are consistent with the view that altered episodic
memory functioning linked to these brain regions contributes to the
unique quality of dream experience. (p. 1287)

Fragments of episodic memories (characters, settings, objects), mediated in the

temporal and hippocampal structures; motivational incentives and emotional
sequences (generally a prerogative of the limbic system and insula); as well as
semantic information widely distributed in the cortices – all together, these
elements or processes constitute the content of the dream. Therefore, they
create the illusion of a #rst-person perspective and the sense of the continuous
present (Nielsen & Stenstrom, 2005).

To demonstrate the temporal dimension of dreams, by analyzing 470 students’

dreams, Nielsen et al. (2004) described the double-time process by which
daytime residue gets into dreams. There is a #rst time, called day-residue e"ect,
in which the main characteristics of a daily event enter the dream directly, as
opposed to the dream-lag e"ect, in which the speci#c event enters the dream
later, after about a week. Moreover, in the wake of this work, Nielsen and
Stenstrom (2005) conducted a review of similar studies, pointing out that dreams
do not portray the entire sequences of episodic memories, their fragmentation
being much more common. These authors suggest that the dream should
propose a sort of subjective “here and now” which produces a coherent and
continuing narrative, due to the autonoetic awareness of dreams. Then, dreams
seem to talk to us at present time, and “present tense is the one in which the
desire is represented as ful#lled” (Freud, 1886-1899, p. 535). But desire could be
also understood as an emotional need, and this joining of meanings opens the
door to the stimulating relationship between dreaming and a"ect regulation.

According to the authors and studies previously reported (Bion, 1991; Cartwright
et al., 1984; Ferenczi, 1932; Grotstein, 2000; Hartmann, 1998; Langille, 2019;
Sterpenich et al., 2020), one of the main functions of dreams is to rebalance the
basic emotional systems (a"ective self-regulation). This rebalance takes place
during danger-less sleep, thanks to its deactivation of the anti-gravity muscular
system. During the waking state, it allows an a"ectively integrated and optimal
functioning of the superior cognitive cerebral regions of the hemispheric
neocortex.

How do dreams contribute to emotional self-regulation? According to Solms

(2018), Freud’s statement – that drive is the demand made upon the mind for
work, due to its bond with the body – is transformed into the pressure upon the
mind to strive for the body’s homeostasis until it reaches its setting point (Solms,
2018). According to Solms and Panksepp (2012), the homeostatic pressure of
drives is felt as “a"ects” in organisms with a nervous system. Damasio (2018)
states that this pressure is felt at its source, directly, i.e. at a subcortical level in
the medulla oblongata and in the limbic system. Some of these cerebral areas do
not possess the blood–brain barrier; therefore, they would be directly in$uenced
by brain-gut axis neuromodulators. Therefore, a"ects are one of the main causes
of dreaming as well as of any other psychic action (Solms, 2021; Solms & Friston,
2018). Once transformed into images, words, sounds, or other sensory-
perceptions, taking data from long-term memory (LTM), they are processed and
mentalized at a cortical level. During the waking state, verbalization involves
prefrontal regions. A"ect mentalization allows for a delay of action as response
to reality and a comparison/elaboration with previous experiences stored in the
LTM.

From yet another perspective, that of the prevalent bi-personal, object-relational

theory of contemporary psychoanalysis, a"ects and dreams can also be
understood as a reaction of the body–mind to the interactions with other’s body–
minds (Ferenczi, 1932; Lichtenberg et al., 2010; Revonsuo, 1995, 2000, 2006).
During developmental stages, basic survival and healthy development depend
upon those interactions. In adult life, self-stability is also based upon these
relations through mirroring and narcissistic support. The individual, from this
point of view, is conceived as continuously immersed in a relational matrix
(Mitchell, 1988) where its corresponding a"ects and dreams represent the more
useful and clear descriptions of the present interactions in relation to the
individual’s or group’s homeostatic needs. In this context, each dream is thought
to represent a"ectively charged relations with other people, animals, plants,
things or is centered on one’s own body.

It is worthwhile to note that dreams are always represented in the present time,
even when they regard past events, as if the related memory were
recollected/dreamt again in order to be reconsolidated. This memory
reconsolidation (Alberini, 2013) of traumatic events in less traumatic versions,
 Full Article  Figures & data  
therefore bound with less unpleasant a"ects, may represent the core of the self-
repairing and a"ect
 References self-regulatory
 Citations  Metrics function of dreaming (Fischmann &

Leuzinger-Bohleber, 2018). Thus, dreaming can be associated with the reparation

 Reprints & Permissions
of traumatic memories, which are able to trap the subject in the vicious circle of
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repetition compulsion. In analytic treatments, reparative dreams can also be
conceptualized as the e"ect of the intense co-transference between the patient’s
and analyst’s internal worlds. Analyst’s and patient’s dreams are often an
exhaustive description of the a"ects they exchange.

As a consequence of these various and potentially overlapping important

functions of dreaming, it is possible to reverse the classical Freudian assumption
of dreams as the “guardian of sleep” (Freud, 1886-1899). In fact, we can suggest
that we sleep in order to dream and not that we dream in order to sleep (Kracke,
2015, p. 121). Dreaming is a sort of bridge between mental realms not always
linked to each other during waking or, from another viewpoint, the privileged
place for the expression of the multiple selves represented in the various
characters in the dream. Therefore, we believe that dreams represent the via
regia not to the unconscious but to self-awareness, understood as a moment of
insight where an intra-psychic fact, or an embodied memory, becomes
In this article
emotionally real and a psychic “fact.”

Dreams, and speci#cally nightmares, as iconic thoughts of basic emotional

systems, have a central role in helping to focus on repressed – or unrepressed –
embodied emotions, related to early relational traumas (Lyons-Ruth et al., 2006;
Ogden et al., 2006; Van Der Kolk, 2014). In a related vein, Bromberg’s theory of
dissociation and of multiple selves (Bromberg, 1998) could be integrated with the
theoretical models of the empirically investigated dream functions. Bromberg
theorizes that the mind is structurally dissociated, in which the experience of a
unitary self is a necessary illusion. Following this theory, it is possible that the
dreaming state corresponds to a process of necessary integration-cooperation
among our several di"erent selves. Every self would be the sediment – located in
the long-term memory – of several self-object relational experiences, including
the associated a"ects of procedural memory. The external relations world,
during the waking state, is a continuous stimulus to the individual’s mosaic of
selves, with unavoidable, potentially de#cient, con$ictual, and frustrating
situations.

Di"erent parts of the self seem to be represented in alternate shifts during REM
and NREM sleep (McNamara, 2004). Moreover, dreams work at #nding solutions
and trade-o"s between selves with di"erent needs or among identi#cations with
contradictory self-objects. In the case of patients, even adults, su"ering from
long-term consequences of early relational trauma, dissociative defenses, and
dissociated selves can appear as nightmares. There is experimental evidence
(Fischmann & Leuzinger-Bohleber, 2018) that repetitive traumatic dreams or
recurrent nightmares can be understood as embodied memories of early
traumatic relations which are the expression of abuse as well as neglect.
Nightmares are often the pristine representation of traumatic memories
belonging to early infancy, dissociated in the body and somatized (Bucci, 2018).
Moreover, the complete lack of nightmares and dreams would indicate worse
conditions and a bad prognosis for a therapeutic success.

On this topic, Fischmann and Leuzinger-Bohleber (2018) listed the modi#cation of

the manifest dreams which signals an ongoing therapeutic process and the
patient’s structural improvement. The passage from dreams with animals to
dreams with people, the widening of the emotional spectrum in intensity and
quality, the appearance of the analyst as a source of comfort, and so on, are all
characteristic changes occurring in dreams. In the a"ectively charged analytic
relation, the patient’s whole body reacts with the whole body of the analyst. In
patients with a history of early relational trauma, with di&culties in verbalizing
embodied memories, a dream or a repetitive nightmare will often provide a #rst
description of the trauma. Nightmares of total immobility, hopelessness, terror
coupled with feeling of imminent death, and the complete lack of help and
protective #gures, are typical in patients a"ected by early relational trauma
(Lyons-Ruth et al., 2006). Often, in the course of therapy, the #rst clues of
improvement can be detected when #gures providing some form of help begin to
appear – nightmares transform into anxious dreams. Also, according to Moser
and von Zeppelin (1996), dreaming is a thinking process aimed at the resolution
of relational con$icts due to instinctual needs/drives that are not welcomed in
the external world, or are actively contrasted, shaping a traumatic area.
Therefore, dreaming is a mental activity aimed at emotional self-regulation.
Emotional auto- and co-regulation can happen also in the waking state through
an elaboration of past life events linked to the events narrated by dreams.
Consequently, the manifest content of a dream could be a very useful indicator
of the present therapeutic process, especially when it is accompanied by a
widening of the a"ective spectrum and the appearance of positive a"ects.

A last and potentially revolutionary contribution to the understanding of dreams

comes from psychophysics and the inferential brain model or Bayesian brain
(Bucci & Grasso, 2017; Hobson & Friston, 2014; Solms & Friston, 2018). In this
model,

perceptual synthesis results – not from (bottom-up) sensory

impressions forcing themselves on the brain – but from an active
process of (top-down) prediction and con#rmation – where predictions
(fantasies) are generated in a virtual model of the world and then
tested against sensory reality. (Hobson & Friston, 2014, p. 9)

This very private theatre of virtual reality is especially manifest in dreaming. Sleep
and dreaming in particular are processes that require the nightly suspension of
sensory inputs in order to foster synaptic plasticity with the aim of reducing the
redundancy and complexity accumulated during the waking life. Virtual reality
models are in this way updated and modi#ed every night. From the point of view
of the social brain, predictions (fantasies) regard the intentions of signi#cant
others, their internal worlds, or more precisely their theory of mind. Actually,
they are predictions about predictions, or second-order/meta predictions, having
the goal of realizing a synchrony of intentions and the sharing of a similar model
of the ecological niche the group inhabits. In lay terms, synchrony is gradually
realized through the sharing of the same dream or vision of the present reality
and the future to be, in spite of the fact that any prediction or fantasy is unique
to any individual due to his own history and experience.

Discussion

Ten years ago, in their comprehensive review on dreams, Blundo et al. (2011)
a&rmed that dreaming and its associated oneiric activity had multiple
fundamental functions for the psychophysical wellbeing of a person. At that time,
neuroscienti#c knowledge did not yet o"er many answers regarding the
biological functions of dreams. Nonetheless, as surveyed in the previous
paragraphs, the centrality of dreams in self-awareness, self-regulation, a"ect
regulation, memory consolidation, and internal con$ict resolution, is now
increasingly acknowledged (Langille, 2019; Sterpenich et al., 2020). Only a few of
the cited authors (Blechner, 2001, 2013; Domho", 1996, 2011; Domho" & Fox,
2015; Hobson & McCarley, 1977) speci#ed cognitive distortions or relative
dysfunctions as explanations of the apparent bizarreness of some dreams,
whose importance in the general functioning of brain cannot be ruled out so
easily.

Recently experimental evidence from Giulio Tononi’s group, from human and
animal studies, “support that emotions in dreams and wakefulness engage
similar neural substrates, and substantiate a link between emotional processes
occurring during sleep and emotional brain functions during wakefulness”
(Sterpenich et al., 2020, p. 1). According to these authors, fearful dreams were
followed by better emotion regulation in response to fear-eliciting stimuli during
wakefulness, demonstrated through fMRI and correlated with increased medial
prefrontal cortex inhibitory activity towards the limbic system and the amygdala
(Sterpenich et al., 2020).

In clinical psychodynamic psychotherapy and psychoanalysis, it is certainly useful

to know that sleeping and dreaming facilitate the storage of recently acquired
information as long-term memories (Born et al., 2006; Langille & Brown, 2018;
Simon et al., 2020; Stickgold et al., 2001). Actually, the emotional pain that brings
patients to psychotherapy is rooted in embodied and implicit memories, together
with their associated a"ects. According to the neuropsychoanalytic hypothesis of
a"ects as the primary source of mental life (Solms & Friston, 2018), in the analytic
exchange and in the interpretation of the oneiric material, a"ects need to be the
focus of the analyst’s attention. Therefore, we can consider dreams as virtual
iconic-#lmic enactments that take place in the inner theatre of the mind, while
the external world is excluded. Following the consolidated classical analytical
technique, dream interpretation aims to unveil defense mechanisms as well as
reveal the latent content with respect to the manifest content (Freud, 1886-1899),
whereas according to contemporary neuroscienti#c research, as described
above, a dreaming state is a particular state of consciousness with a high
a"ective and iconic content (Carhart-Harris, 2007; Windt, 2010). Therefore, the
interest of contemporary psychoanalysis in understanding dreams is not directed
at decoding symbols or enucleating the meaning of their underlying latent
content from their manifest content. It is, instead, directed at collecting
information about the patient’s emotional inner world, the structure, and the
a"ective relationships of the self, considering their transformations during
psychotherapy.

The opposition between manifest and latent content of dreams dates back to
more than a century ago when Freud proposed his theory of dreaming in 1900.
This distinction formed the basis for the psychoanalytic metapsychology of that
time, where consciousness and unconsciousness were strongly separated and,
while consciousness was evident in itself, unconsciousness was revealed by the
latent content of dreams. Nowadays, neuroscientists have largely converged on
assuming that the unconscious and the automatic functioning of the mind are
the standard of our mental functioning and not the exception. Therefore,
consciousness is the mystery to be addressed, including dreaming as an altered
state of consciousness. Moreover, consciousness is a very limited function for a
memory capacity that corresponds to the working memory of 7 plus or minus 2
digits.

Many di"erent psychotherapeutic approaches agree on the centrality of emotion

identi#cation, verbalization, and working through. According to Lane et al. (2022),
emotional awareness, emotional re/experiencing, and emotional memory
reconsolidation are components in the process of therapeutic change. Dreams
highlight the emotions (and hence, the basic needs) that are active in that
particular moment in the life of the dreamer. More precisely, emotions play a
central role in the procedural relational memories (expectations) that determine
how the person experiences his/her relational world. For analysts, they provide
the compass (via regia) to the actual needs and con$icts to be addressed in the
“here and now” of the session. As a corollary to the above, emotions are not only
biologically embedded in our body (expressing our vital or basic needs), but also
culture-bound and context-dependent, at least in their social expressions. This
fact makes a further request on the analyst: to be emotionally available, and
possibly in tune with the individual, cultural, and biological characteristics of the
patient. Finally, we believe that the ability to tolerate Otherness in its various
aspects, and to listen for unexpressed emotions, is a crucial aspect of
psychoanalytical work.

As a consequence, it is not the single dream, detached from the therapist–patient

relational context, which provides the essential information for the therapy, but
the whole contextual sequence in which it is framed. Here “context” means the
actual as well as transference relationships with the patient, the reality of the
setting and of daily events, as well as the patient's biography and pathobiography
– basically, the ecology of the patient’s mind. So, dreams can be considered the
expression of primary basic emotional systems as well as the via regia to
emotional self-awareness, mentalization, and self-regulation (Barrett, 2017); in
this view, the characters appearing in dreams represent the constitutive
multiplicity of the dreamer’s self.

The inferential brain model or predictive processing adds complexity to the

previous attempts to explain why and how we dream, and at the same time
o"ers a unifying theorization about all our brain–mind functioning, a welcome
insight into the phenomenal aspects of dreams and an elegant explanation of its
evolutionary role (Hobson & Friston, 2014). Emotions, in this model, (Seth, 2013)
are considered bodily predictions of the state of our internal organs, visceral
sensations, and constitute the building blocks of an embodied conscious
experience (i.e. our body’s feelings are a combination of interoceptive and
cognitive predictions), in relation to the external world. Just like any other
expectation, the emotions are updated during dreaming into a more adapted
generative model of our relational world (Seth, 2013).

Taking the above into consideration, in our clinical practice we see the emotional
content of a dream as a useful sort of GPS or compass indicating, within the
analytic process, where the patient and the therapeutic relation stands and
where it is going.

Conclusion

This review of the literature concerning the functions of dreams indicates that
dreaming plays an evolutionary role in maintaining homeostasis from a cognitive
and a"ective point of view. The relative deactivation of cortical prefrontal regions
facilitates the emergence into dream consciousness of more emotional contents,
belonging to subcortical and limbic structures. Emotions are then expressed in
an iconic and metaphorical language. The majority of scholars, as mentioned,
have underlined the iconic and metaphorical language of dreams which is neither
bizarre nor meaningless per se, but does need to be “unraveled” in its emotional
roots. Moreover, according to the inferential brain model and predictive
processing, dreaming, as any other brain or bodily function, follows the
imperative of maintaining the organism’s homeostasis in its own ecological niche.
Therefore, the function of dreaming would be to organize and update a virtual
reality model that informs the expectations the organism has of the external
world and of its own body.

Taking all of this into account, the evidence in the literature summarized in this
paper, as well as our clinical experience, suggest that the meaning of dreaming,
represented by embodied memory and emotional virtual scenarios, should be
understood by unveiling the patient’s core emotional struggles, his/her way of
dealing with it, in daily life as well as during the analytic session. Thus, the
analyst’s function is not to highlight the dream’s latent content through
interpretations, but to tune into the emotions elicited, and actively ask about the
patient’s feelings when they are not spontaneously reported. This narrative, often
co-constructed in clinical situations, o"ers precious information about the
ongoing therapeutic process of internalized dysfunctional relational models
which can be transformed into more adaptive ones.

Disclosure statement

No potential con$ict of interest was reported by the author(s).

References

1. Alberini, C. (2013). Memory reconsolidation. Academic Press, Elsevier.

[Crossref], [Google Scholar]

2. Aserinsky, E., & Kleitman, N. (1953). Regularly occurring periods of eye motility
and concurrent phenomena during sleep. Science, 118(3062), 273.
https://doi.org/10.1126/science.118.3062.273
[Crossref], [PubMed], [Web of Science ®], [Google Scholar]

3. Barrett, D. (2017). Dreams and creative problem-solving. Annals of the New

York Academy of Science, 1406(1), 1–97. https://doi.org/10.1111/nyas.13412
[Crossref], [Web of Science ®], [Google Scholar]

4. Bion, W. R. (1991). Cogitations. Routledge. [Google Scholar]

5. Blechner, M. J. (2001). The dream frontier. Analytic Press. [Google Scholar]

6. Blechner, M. J. (2005). The grammar of irrationality. Contemporary

Psychoanalysis, 41(2), 203–221.
https://doi.org/10.1080/00107530.2005.10745859
[Taylor & Francis Online], [Web of Science ®], [Google Scholar]

7. Blechner, M. J. (2013). What are dreams like and how does the brain make
them that way? Contemporary Psychoanalysis, 49(2), 165–175.
https://doi.org/10.1080/00107530.2013.10746542
[Taylor & Francis Online], [Web of Science ®], [Google Scholar]
 8. Blundo, C., Bruschini, M., & Blundo, C. (2011). Il sonno e il sogno [Sleep and
the dream]. In C. Blundo (Ed.), Neuroscienze cliniche del comportamento (pp.
181–191). Elsevier. [Google Scholar]

9. Born, J., Rasch, B., & Gais, S. (2006). Sleep to remember. Neuroscientist, 12(5),
410–424. https://doi.org/10.1177/1073858406292647
[Crossref], [PubMed], [Web of Science ®], [Google Scholar]

10. Bromberg, P. M. (1998). Standing in the spaces. Essays on clinical process trauma
and dissociation. Routledge. [Google Scholar]

11. Bucci, A., & Grasso, M. (2017). Sleep and dreaming in the predictive
processing framework. In T. Metzinger & W. Wiese (Eds.), Philosophy and
predictive processing. Frankfurt am Main. [Google Scholar]

12. Bucci, W. (2018). The primary process as a transitional concept: New

perspectives from cognitive psychology and a"ective neuroscience.
Psychoanalytic Inquiry, 38(3), 198–209.
https://doi.org/10.1080/07351690.2018.1430966
[Taylor & Francis Online], [Web of Science ®], [Google Scholar]

13. Carhart-Harris, R. (2007). Waves of the unconscious: The neurophysiology of

dreamlike phenomena and its implications for the psychodynamic model of
the mind. Neuropsychoanalysis, 9(2), 2.
https://doi.org/10.1080/15294145.2007.10773557 [Taylor & Francis Online],
[Google Scholar]

14. Cartwright, R. D., Lloyd, S., Knight, S., & Trenholme, I. (1984). Broken dreams:
A study of the e"ects of divorce and depression on dream content. Psychiatry,
47(3), 251–259. https://doi.org/10.1080/00332747.1984.11024246
 [Taylor & Francis Online], [Web of Science ®], [Google Scholar]

15. Damasio, A. (2018). The strange order of things: Life, feeling, and the making of
cultures. Pantheon Books. [Google Scholar]

16. Domho", W. G. (1996). Finding meaning in dreams: A quantitative approach.

Plenum Press. [Crossref], [Google Scholar]

17. Domho", W. G. (2011). Dreaming as embodied simulation: A widower’s

dreams of his deceased wife. Dreaming, 25(3), 232–256, updated in 2015,
upload on www.dreamresearch.net. https://doi.org/10.1037/a0039291
[Crossref], [Google Scholar]

18. Domho", W. G., & Fox, K. R. (2015). Dreaming and the default network: A
review, synthesis and counterintuitive research proposal. Consciousness and
Cognition, 33, 342–353. https://doi.org/10.1016/j.concog.2015.01.019
[Crossref], [PubMed], [Web of Science ®], [Google Scholar]

19. Ferenczi, S. (1932a/1988). The clinical diary of Sandor Ferenczi. Harvard

University Press. [Google Scholar]

20. Fischmann, T., & Leuzinger-Bohleber, M. (2018). Dreams. In H. Boeker, P.

Hartwich, & G. Northo" (Eds.), Neuropsychodynamic psychiatry (pp. 137–156).
Springer Ed. [Crossref], [Google Scholar]

21. Fischmann, T., Russ, M. O., & Leuzinger-Bohleber, M. (2013). Trauma, dream,
and psychic change in psychoanalyses: A dialog between psychoanalysis and
the neurosciences. Frontiers in Human Neuroscience, 7, Article 877.
https://doi.org/10.3389/fnhum.2013.00877
[Crossref], [PubMed], [Web of Science ®], [Google Scholar]
22. Fosshage, J. (1997). The organizing functions of dream mentation.
Contemporary Psychoanalysis, 33(3), 429–458.
https://doi.org/10.1080/00107530.1997.10746997
[Taylor & Francis Online], [Web of Science ®], [Google Scholar]

23. Fosshage, J. (2013). The dream narrative. Contemporary Psychoanalysis, 49(2),

253–258. https://doi.org/10.1080/00107530.2013.10746552
[Taylor & Francis Online], [Web of Science ®], [Google Scholar]

24. Freud, S. (1886-1899). Pre-psycho-analytic publications and unpublished

drafts (J. Strachey, Trans.). In J. Strachey (Ed.), The standard edition of the
complete psychological works of Sigmund Freud, (pp. 1–411). Hogarth Press.
[Google Scholar]

25. Grotstein, J. S. (2000). Who is the dreamer who dreams the dream? Analytic
Press. [Google Scholar]

26. Hartmann, E. (1998). Dreams and nightmares. Plenum. [Google Scholar]

27. Hartmann, E., & Brezler, T. A. (2008). Systematic change in dreams after
9/11/01. Sleep, 31(2), 213–218. https://doi.org/10.1093/sleep/31.2.213
[Crossref], [PubMed], [Web of Science ®], [Google Scholar]

28. Hau, S., Jović, V., & Rosenbaum, B. (2013). Traumatic dreams – Symbolization
and a!ect regulation. Prague Panel. IPA Congress, Praga, August 1/3, 2013.
[Google Scholar]

29. Hobson, J. A., & Friston, K. J. (2014). Consciousness, dreams, and inference.
The Cartesian theatre revisited. Journal of Consciousness Studies, 21(1–2), 6–32.
[Web of Science ®], [Google Scholar]
30. Hobson, J. A., & McCarley, R. W. (1977). The brain as a dream state generator:
An activation-synthesis hypothesis of the dream process. The American Journal
of Psychiatry, 134(12), 1335–1348. https://doi.org/10.1176/ajp.134.12.1335
[Crossref], [PubMed], [Web of Science ®], [Google Scholar]

31. Horikawa, T., Tamaki, M., Miyawaki, Y., & Kamitani, Y. (2013). Neural decoding
of visual imagery during sleep. Science, 340(6132), 639–642.
https://doi.org/10.1126/science.1234330
[Crossref], [PubMed], [Web of Science ®], [Google Scholar]

32. Lane, R. D., Subic–Wrana, C., Greenberg, L., & Yovel, I. (2022). The role of
enhanced emotional awareness in promoting change across psychotherapy
modalities. Journal of Psychotherapy Integration, 32(2), 131–150.
https://doi.org/10.1037/int0000244 [Crossref], [Web of Science ®],
[Google Scholar]

33. Kantrowitz, J. L. (2003). Tell me your theory. Where is it bred? A lesson from
clinical approaches to dreams. Journal of Clinical Psychoanalysis, 12(2),
151–178. [Google Scholar]

34. Kracke, W. (2015). Freud’s dream theory and the recent dream-lab research:
Do they clash? Annual Psychoanalysis, 38, 119–130. [Google Scholar]

35. Kramer, M., Glucksman, M., & Myron, M. D. (2015). Dream research:
Contributions to clinical practice. Routledge. [Crossref], [Google Scholar]

36. Langille, J. J. (2019). Remembering to forget: A dual role for sleep oscillations
in memory consolidation and forgetting. Frontiers Cellular Neuroscience, 13(71),
1–21. https://doi.org/10.3389/fncel.2019.00071 [PubMed], [Google Scholar]
37. Langille, J. J., & Brown, R. E. (2018). The synaptic theory of memory: A historical
survey and reconciliation of recent opposition. Frontiers System Neuroscience,
12, 52. https://doi.org/10.3389/fnsys.2018.00052
[Crossref], [PubMed], [Web of Science ®], [Google Scholar]

38. Lichtenberg, J. D., Lachmann, F. M., & Fosshage, J. L. (2010). Psychoanalysis and
motivational systems: A new look. Taylor & Francis Ltd. [Google Scholar]

39. Lyons-Ruth, K., Dutra, L., Schuder, M., & Bianchi, L. (2006). From infant
attachment disorganization to adult dissociation: Relational adaptations or
traumatic experiences? Psychiatric Clinics, 29(1), 63–86.
https://doi.org/10.1016/j.psc.2005.10.011 [Google Scholar]

40. McNamara, P. (2004). An evolutionary psychology of sleep and dreams.

Greenwood Publishing Group. [Google Scholar]

41. Miletić, S., Bazin, P.-L., Isherwood, S. J. S., Keuken, M. C., Alkemade, A.,
Forstmann, B. U (2022). Charting human subcortical maturation across the
adult lifespan with in vivo 7T MRI. NeuroImage, 249, 118872.
https://doi.org/10.1016/j.neuroimage.2022.118872
[Crossref], [PubMed], [Web of Science ®], [Google Scholar]

42. Mitchell, S. A. (1988). Relational concepts in psychoanalysis: An integration.

Harvard University Press. [Crossref], [Google Scholar]

43. Moser, U., & von Zeppelin, I. (1996). Der Geträumte Traum. Wie Träume
Entstehen und Sich Verändern. [The dreamed dream: How dreams come about
and how they change]. Kohlhammer. [Google Scholar]

44. Nielsen, T., & & Stenstrom, A. (2005). What are the memory sources of
 dreaming? Nature, 437(7063), 27. https://doi.org/10.1038/nature04288
[Crossref], [PubMed], [Web of Science ®], [Google Scholar]

45. Nielsen, T. A., Vealain, D. G., Stenstrom, P., & Powel, R. A. (2004). Immediate
and delayed incorporations of events into dreams: Further replication and
implications for dream function. Journal of Sleep Research, 13(4), 327–336.
https://doi.org/10.1111/j.1365-2869.2004.00421.x
[Crossref], [PubMed], [Web of Science ®], [Google Scholar]

46. Ogden, P., Minton, K., & Pain, C. (2006). Trauma and the body. A sensorimotor
approach to psychotherapy. W.W. Norton & Company. [Google Scholar]

47. Ogden, T. H. (2010). On three forms of thinking: Magical thinking, dream

thinking, and transformative thinking. Psychoanal Quaterly, 79(2), 317–347.
https://doi.org/10.1002/j.2167-4086.2010.tb00450.x [Taylor & Francis Online],
[Google Scholar]

48. Revonsuo, A. (1995). Consciousness, dreams, and virtual realities.

Philosophical Psychology, 8(1), 35–58.
https://doi.org/10.1080/09515089508573144
[Taylor & Francis Online], [Web of Science ®], [Google Scholar]

49. Revonsuo, A. (2000). The reinterpretation of dreams: An evolutionary

hypothesis of the function of dreaming. Behavioural and Brain Sciences, 23(6),
793–1121. https://doi.org/10.1017/S0140525X00003976
[Crossref], [PubMed], [Web of Science ®], [Google Scholar]

50. Revonsuo, A. (2006). Inner presence. MIT Press. [Google Scholar]

51. Schneider, J. A. (2010). From Freud’s dream work to Bion’s work of dreaming:
 The changing conception of dreaming in psychoanalytic theory. International
Journal of Psycho-Analysis, 91(3), 521–540. https://doi.org/10.1111/j.1745-
8315.2010.00263.x [Taylor & Francis Online], [Web of Science ®],
[Google Scholar]

52. Schredl, M. (2010). Characteristics and content in dream. International Review

Neurobiology, 92, 135–154. https://doi.org/10.1016/S0074-7742(10)92007-2
[Crossref], [PubMed], [Web of Science ®], [Google Scholar]

53. Seth, A. K. (2013). Interoceptive inference, emotion, and the embodied self.
Trends in Cognitive Sciences, 17(11), 565–573.
https://doi.org/10.1016/j.tics.2013.09.007
[Crossref], [PubMed], [Web of Science ®], [Google Scholar]

54. Siclari, F., Baird, B., Perogamvros, L., Bernardi, G., LaRoque, J., Riedner, B.,
Boly, M., Postley, B. R., & Tononi, G. (2017). The neural correlates of dreaming.
Nature Neuroscience, 20(6), 872–878. https://doi.org/10.1038/nn.4545
[Crossref], [PubMed], [Web of Science ®], [Google Scholar]

55. Simon, K. C., Nadel, L., & Gómez, R. L. (2020). Parameters of memory
reconsolidation: Learning mode in$uences likelihood of memory
modi#cation. Frontiers in Behavioral Neuroscience, 14, 120.
https://doi.org/10.3389/fnbeh.2020.00120
[Crossref], [PubMed], [Web of Science ®], [Google Scholar]

56. Solms, M. (2018). Book review of The strange order of things: Life, feeling, and
the making of cultures by Antonio Damasio. Rivista di Psicoanalisi, LXIV, 4:921–
928. Cortina: Milano. [Google Scholar]

57. Solms, M. (2021). The hidden spring. A journey to the source of consciousness.
 Pro#le Books. [Crossref], [Google Scholar]

58. Solms, M., & Friston, K. (2018). How and why consciousness arises: Some
considerations from physics and physiology. Journal Consciousness Study,
25(5–6), 202–238. [Web of Science ®], [Google Scholar]

59. Solms, M., & Panksepp, J. (2012). The “Id” knows more than the “Ego” admits.
Brain Science, 2(2), 147–175. https://doi.org/10.3390/brainsci2020147
[Crossref], [PubMed], [Google Scholar]

60. Sterpenich, V., Perogamvros, L., Tontine, G., & Schwartz, S. (2020). Fear in
dreams and in wakefulness: Evidence for day/night a"ective homeostasis.
Human Brain Mapping, 41(3), 840–850. https://doi.org/10.1002/hbm.24843
[Crossref], [PubMed], [Web of Science ®], [Google Scholar]

61. Stickgold, R., Hobson, J. A., Fosse, R., & Fosse, M. (2001). Sleep, learning and
dreams: O"-line memory reprocessing. Science, 294(5544), 1052–1057.
https://doi.org/10.1126/science.1063530
[Crossref], [PubMed], [Web of Science ®], [Google Scholar]

62. Van Der Kolk, B. (2014). The body keeps the score. Brain, mind, and body in the
healing of trauma. Penguin Books. [Google Scholar]

63. Varvin, S., Fischmann, T., Jovic, V., Rosenbaum, B., & Hau, S. (2012). Traumatic
dreams: Symbolization gone astray. In P. Fonagy, H. Kachele, M. Leuzinger-
Bohleber, & D. Taylor (Eds.), The signi"cance of dreams: Bridging clinical and
extraclinical research in psychoanalysis (pp. 185–214). Karnac Books.
[Google Scholar]

64. Windt, J. M. (2010). The immersive spatiotemporal hallucination model of

 dreaming. Phenomenal Cognitive Science, 9(2), 295–316.
https://doi.org/10.1007/s11097-010-9163-1 [Crossref], [Web of Science ®],
[Google Scholar]

65. Xiao, L. Y. (2017). Unraveling the mystery of dreams. Journal of Thoracic

Disease, 9(9), 2732–2735. https://doi.org/10.21037/jtd.2017.07.103
[Crossref], [PubMed], [Web of Science ®], [Google Scholar]

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