Psychotherapy Part 78

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Habits.--In the correction of troubles of sleep one of the difficulties that the physician has to contend with when patients have grown accustomed to staying up late and finally have so disturbed their sleep mechanism that symptoms of insomnia develop, is the declaration that there is no use for them going to bed early since they cannot sleep. If a man has been accustomed for a long period to go to bed between midnight and 2 a. m. and his habits are suddenly changed so that he goes to bed at ten or even eleven, it is very likely that for some time after retiring he will not sleep. If he grows over-anxious he may toss and become somewhat feverish and then, even when the accustomed time for sleep comes, he may not secure it.

Besides, the depression consequent upon failure to sleep when he has fulfilled his physician's directions and when he knows that this is considered an important adjuvant in his treatment, acts as a distinctly discouraging factor. Under these circ.u.mstances it is important to recall to him that one habit can only be removed by the making of another. It may be necessary to send him to bed for awhile only an hour earlier than before until he has grown accustomed to going to sleep somewhat sooner, and then this habit, in turn, be changed to an earlier hour so as to secure all the sleep that is necessary.

In a word, insomnia is not a definite affection to be treated by giving one or the other of one's favorite drugs, or if these should fail trying still others, but it is a condition of mind very often predisposed to by certain conditions of body. If this condition of mind can be adjusted by careful attention to the correction of whatever may be physically out of order, then there is every reason to look for definite improvement very soon and complete cure without any delay. Insomnia is not the awful ailment that it is sometimes pictured, nor all that it appears to the excited imagination of the young person who loses a few hours' sleep; but a manifold condition to be dealt with very differently in different individuals, according to the indications of the case. If the patient's confidence can be secured that means more than almost anything else that can be done. If a little patience is exercised in obtaining such definite details of the mental state and of certain physical factors as may seem quite trivial to the patient yet are really predisposing elements for his affection, the therapeutics become comparatively simple. It is the use of tact and judgment in this matter that means most, however, and then very few drugs will be required. Between the habits consequent upon the opiates and certain of the serious hemolytic conditions due to the abuse of coal-tar products, this is a consummation that may well be worked for a.s.siduously.

CHAPTER VIII

SOME TROUBLES OF SLEEP

Certain annoying incidents in connection with sleep annoy those affected by them so much as to arouse them very completely from sleep and make them wakeful for a time. Nothing disturbs most people so much as the thought that some pa.s.sing incident, a little out of the common, is quite individual and peculiar to them. If they are at all nervous they are likely to think that it portends some serious ailment, either present or about to {664} develop. Nothing rea.s.sures them more than to learn that these incidents are not so uncommon as they imagine, indeed that many of them are quite frequent, and, above all, that many people who have had them are still alive and well beyond threescore and ten, and laughing at the fears of their earlier years.

Starting.--Perhaps one of the most annoying of these incidental troubles is starting in sleep. It occasionally happens that just about the time a person is dozing off he suddenly starts and, almost before he realizes it, is fully awake, his heart beating emphatically and there may even be a little feeling of oppression on the chest. The cause is not the same in all cases and individual differences are worth investigating. In most people this starting means that there is, for the moment, some mechanical interference with the action of the heart and that a systole has been delayed and has been pushed through with more force than usual because of this delay. A full stomach will occasionally cause this, especially if patients lie on their left sides. In some people even a drink of water taken just before retiring will be sufficient weight to cause this interference with heart action. An acc.u.mulation of gas in the stomach will do it by pushing up against the diaphragm. Where there is a distinct tendency to the acc.u.mulation of gas in the stomach I have sometimes been sure that the expansion of the gas consequent upon the cozy warmth of the patient in bed, or its greater effect upon the stomach because the relaxation of sleep affected even the stomach walls slightly, was the cause of it.

It happens more frequently in the old than it does in the young, but it is observed at all ages and patients are usually quite disturbed about it, as, indeed, they are likely to be with regard to anything that affects their hearts.

The thought that this forcible beat must mean some serious pathological condition will obtrude itself on many people, and if it does sleep is sure to be disturbed. Even though there may be no discoverable lesion of the heart, these patients often, though they are physicians, will worry lest some underlying condition should be developing. The first patient who ever described this symptom to me told me of it while I was a medical student and he is still alive and in good health, though he is past seventy. At the time I went over him rather carefully with the idea that there might be an organic heart lesion, but found none. The prognosis of these cases is always favorable, for there are many who suffer yet live long. I have found if to occur particularly in elderly people when they were a little overtired on going to bed, or in anemic young people when they had had somewhat more exertion than usual during the day. Unless there is really some demonstrable heart lesion the start does not mean anything and patients can be rea.s.sured at once. They should be counselled against lying on the left side, though in some of them it will occur even while lying on the right side and then the mechanism of its production seems to be the gaseous over-distention of the stomach.

Patients may be told at once that it occurs in a large number of people and then, instead of lying awake and worrying about it as they often do, they learn simply to place themselves in a more comfortable position and go to sleep again without solicitude. They would learn this for themselves in the course of time, but the physician's rea.s.surance will enable them to antic.i.p.ate the lessons of experience and they will thus be saved worrying.

At times this starting from sleep seems due to some unusual noise. In {665} certain nervous states even slight noises produce an exaggerated reaction and there seems to be a surprising, almost hypnotic, acuity of hearing just at the moment when all the other senses are going to sleep. Any of the small noises that sound so loud in the stillness of the night may serve to wake the patient so thoroughly after a preliminary doze that sleep is disturbed for some time. As a rule, however, such noises would not disturb people if they were in normal healthy condition, or at least the disturbance would be only momentary. The solicitous effort that some people make to get away from every possible noise is an attempt in the wrong direction. We have heard of people building special houses, or noise-proof rooms in the center of houses where they hoped it would be impossible to be disturbed. What is needed is not so much an effort to secure absolutely noiseless surroundings, which is almost impossible in any circ.u.mstances, be it city or country, but to change the patient's physical condition so that slight noises are not reacted to so explosively. There are many general directions for this and certain drugs, as the bromides, are of distinct service. On the other hand, the taking of cinchona products seems often to emphasize it.

I have found that two cla.s.ses of nervous patients particularly were likely to be disturbed by these starts in their sleep. The first cla.s.s is perhaps the larger. They are the patients who do not eat enough.

They will usually be found to be underweight and to be nursing some thought with regard to their digestion, or some supposed idiosyncrasy towards food that is keeping them below the normal weight for their height. Nothing makes sleep lighter than a certain amount of hunger.

This hunger may be disguised so completely, or so covered up by the patient's persuasion that more food cannot be taken without serious gastric disturbance, that it may pa.s.s utterly unnoticed. When such patients are disturbed early in the night, it usually means that besides taking a not quite sufficient amount of food they are taking more tea or coffee or some stimulant than is good for them. I say some stimulant because in several cases that I investigated rather carefully the cause seemed to be the alcohol taken with one of the largely advertised patent medicines, a supposed digestive tonic, consisting mainly of dilute alcohol, and really about as strong as whiskey. When the tendency to be startled occurs in the early mornings, then people need to eat something simple just before they go to bed.

The other cla.s.s of cases who are likely to start at night in their sleep are those who do not get out into the air enough during the day or who sleep in rooms insufficiently ventilated. At the beginning of the night the lack of ventilation makes the sleep light and easily disturbed. After a certain number of hours have been spent in a badly ventilated room the patient sinks into a rather deep sleep, which is likely to be dreamy, however, and then he is rather hard to waken, but wakes not feeling rested, but on the contrary often heavier and more tired than on retiring. In these cases an investigation of the amount of air the patient is allowing to enter his sleeping room or that his circ.u.mstances provide him with is extremely important. As for those who do not get out enough during the day, it is easy to understand that their sleep may be light. To them, as a rule, it will be a surprise to find how much depth is added to their sleep by an additional hour or two in the air. Commonly, people who do not get out much during the day are shivery and {666} suffer from cold, especially in the winter time, and so they are likely to keep their rooms rather tightly closed. In this case they have two reasons for a tendency to be wakeful, which is emphasized if there are noises near them or if there is anything that disturbs their sleep.

In young children, of course, it must not be forgotten that starting in sleep may be due to the twitching pains of a beginning tuberculous joint disease. At times the children are so young, or the symptoms so vague and the tenderness, if there is any, so deep, that the real significance of this may not be recognized. The most successful treatment for these starting pains in children that has thus far been found, forms a striking commentary on what we have just been saying with regard to fitful sleep when ventilation is insufficient or when the patient has not been out of doors enough during the day. The children from the New York hospitals who in recent years were taken down to Sea Breeze during the autumn and winter and made to live in wards, the windows of which were constantly open so that the temperature was often below fifty, so that doctors and nurses had to wrap themselves up warmly and sometimes cover their heads and their hands, had all been sufferers from these starting pains before this experience, but gradually they lessened in frequency until after a few months the crying of a child at night because of these pains was extremely rare. The lesson is evident, and abundance of air not only cures tuberculous conditions, but also makes the nervous system so much less irritable that starting pains do not so easily affect it.

Noise.--Slight noises often make it impossible for nervous people to sleep. This is much more a question of personal sensitiveness and anxious expectancy and over-irritability than anything else. One distinguished physician whom I knew was extremely sensitive to noise and would be awake for hours if wakened up early in the night by the slamming of a door or a call in the street or anything of the kind. He suffered from insomnia to a noteworthy degree and found to his surprise that he could sleep better on a train than anywhere else.

After he had lost two or three nights of sleep he actually used to make arrangements to take a berth on an express train going out of his city, ride until the morning and then come back. He usually slept well amidst all the noise and jar of the train, though he would be quite sleepless at home as the result of even slight noises. I have known people suffering from insomnia who took a long ocean trip on a slow vessel and who slept well amidst all the noises of shipboard, but were light sleepers after landing, and felt that they missed the noise and bustle. Of course, in these cases the rocking movements sometimes predispose to sleep. It is not the custom now to rock infants to sleep and a very definite agreement seems to have been come to among pediatrists to forbid the practice as harmful. It is probable, however, that the instinct of the race in the matter was not at fault.

Rocking seems to relax a certain tension of muscles that of itself prevents the brain anemia which is the physiological basis of sleep.

It is extremely difficult for nervous people to relax themselves completely, and the rocking movements, by tending to help them in this matter, are excellent predisposing factors. A rocking chair or a hammock furnish abundant proof of this.

Noise in general, as regards its relation to sleep, is an extremely individual matter. Habit plays the largest role in the matter. We all know the {667} stories of men who have gone to great expense in order to build noise-proof rooms and yet have found afterwards that they did not sleep well. The rustle of the bedclothes as their thoraxes rose and fell in respiration was enough to disturb them when they allowed themselves to become over-sensitive about noise. We all know how impossible sleep becomes with a rustle of a mouse in the wastepaper basket, or the scratching of one on the wainscoting. On the other hand, anyone who has lived in a large city where past hundreds of thousands of homes the elevated trains thunder every few minutes all during the night, or the trolley goes rolling by within a few feet of the bed, knows, too, that a great many people become accustomed to noises so as to be utterly undisturbed by them, though at the beginning any such insensitiveness to noise seemed out of the question.

I remember having a patient who insisted that he could not sleep so near the elevated. At the end of a week he had lost so many nights of sleep that he was almost in despair. If he did get sound asleep he said he used to hear the thunder of the elevated train coming toward him in his dreams and he would begin to pull his feet up so as to get them out of the way of the train, yet always with the feeling that he could not get them quite far enough, until his knees were almost to his chin. Under the influence of a little bromides, two hours more of outdoor air than he had been accustomed to before, and some rea.s.surance that noise need not disturb sleep at all if taken philosophically, he learned in the course of two weeks to sleep quite peacefully and now has lived for ten years where the elevated pa.s.ses within ten feet of his window, which is wide open for seven months in the year and always at least slightly open, except in the most stormy weather. It is a question, then, of the individual much more than his surroundings. The problem is to predispose the mind to sleep and then the senses will not disturb it except under special circ.u.mstances.

As a matter of fact, noises usually disturb people very little at night. The most surprising things can happen between 12 and 3 o'clock and attract no attention. Burglars calmly blow up a safe in a hotel confident that if there is no one awake when the explosion occurs there will be no investigation, because even though people wake up at the noise, they will wait for its repet.i.tion in order to see what it means, will not get up to investigate, especially in cold weather, and usually promptly go to sleep again.

Lying Awake.--There are many people to whom lying awake carries with it a sense of discouragement and dread. They seem to forget that lying awake and occupation with pleasant thoughts may be made a very agreeable pastime by those who are not over-anxious to sleep and who let the pleasant thoughts that may be suggested by the environment or the noises that are heard flow through consciousness. Everyone knows how pleasant it is or may be to listen to the rain patter on the roof of a country house, or to hear the murmur of the ocean or of the wind through the trees when there is not too much anxiety about to-morrow and to-morrow's occupations and the necessity for sleep to be ready for them. Stewart Edward White, in his series of essays on "The Forest," has a chapter on Lying Awake at Night that can well be recommended to the attention of those who complain bitterly of an hour of sleeplessness. Of course, in his case the lying awake is in the midst of the forest with all the witchery of wind in the trees and the {668} unusual sounds of forest life, while ordinary lying awake is in the rather monotonous environment at home, but still there is much that can be said for his insistence that in peaceful brooding, faculties revive while soft velvet fingers are laid on the drowsy imagination and you feel that in their caressing vaster s.p.a.ces of thought are opened up. The impatience that comes to so many almost at once if they fail to go to sleep promptly only serves to keep them awake just that much more surely.

Very often, as suggested by Mr. White, this wakefulness occurs just when a good night's rest is surely expected. There is sometimes even a preliminary period of drowsiness. Then some little noise that ordinarily would not be noticed at all floats into the consciousness with a vigor that indicates that one sense is thoroughly awake. The very surprise of it wakes up the other senses with a start and then comes the thought that there is to be no sleep for some time. If this is resented, the period of wakefulness will be all the longer. If, when it has proved to be inevitable, one sits up quietly, reads a book for a time, plays a quiet game of solitaire, it may be on a board kept beside the bed for such purposes, or in some quiet way succeeds in bothering away the thought of insomnia, then almost surely sleep will come after a time, quietly and restfully, and the lost period will not prove harmful. If nature does not want to sleep she must not be forced into it, but gently led and after a time the wakefulness will disappear.

Night Terrors.--One of the troubles of sleep that is more often called to the attention of the physician than almost any other, is the so-called "night terrors" of children. Little ones wake with a scream, sit up in bed, evidently terrified, usually trembling, and ready to seek refuge from something that has seriously disturbed them. Under Dreams we have called attention to the fact that usually these terrors are due to a dream. Sometimes the dreams are the ordinary experience of supposed falling in sleep, from which the patients wake very much startled, or they are repet.i.tions of exciting scenes through which they have pa.s.sed, or of stories that they have heard, or, above all, plays that they have seen. Ghost stories, for instance, told shortly before they go to bed will often disturb children. Fairy stories and the ordinary myths of childhood, usually with a happy ending and without any serious terrors in them, are not so likely to disturb them. Melodramatic theatrical performances to which children lend themselves and their attention with great concentration of mind, have nearly as much effect on them as if they pa.s.sed through the actual scenes. Every physician knows how much a fright is likely to disturb a child and cause it to wake many a night afterwards in a state of terror.

Respiratory Interference.--It is particularly important to remember that any interference with breathing will almost surely wake the child in a seriously startled condition. Adults are often affected by this same sort of dream, due very often to some pathological condition in the throat around which a series of dream ideas collect with somewhat poignant results. I have known a man suffering from elongated uvula wake up thinking that he was suffocating because, as he thought, he had nearly swallowed his tongue, or at least had been trying to do so.

The sensation was so startling that it brought him to his feet at once. I have known a patient traveling a long five-days' railroad journey and suffering severely from train catarrh, come to the {669} persuasion that he might suffocate during sleep because his nose was completely stopped up and he had not the habit of sleeping with his mouth open. As a result his sleep was as much disturbed by his mind as his breathing. If these affect adults so strongly, it is easy to understand why children should be so frightened by them. Children who are mouth-breathers from adenoids or nasal obstruction, and still more those whose nasal breathing apparatus is not completely stopped up, but who are frequent intermittent mouth-breathers, are especially likely to be troubled in this way. The neurosis known as nervous croup, due to a spasm of the vocal cords, occurs oftenest in this cla.s.s of children and is an a.s.sociated phenomenon to that of night terrors.

Sleeping in the Light.--The habit of accustoming children to sleep with a light in the room nearly always lessens the depth of their sleep. They are more easily wakened and their sleep is not so refreshing. Besides, if they do not grow accustomed to the dark when they are young, they may always retain a dread of the dark and will require some light in the room where they sleep. Nature intended that the eyes and the optic nerve should have as complete a rest as possible and even with the lids lowered some light stimulus, if it is present, finds its way to the nerve fibers. Hence the desirability of having as far as possible an absolutely dark room. For some very timorous children, this may seem impossible. Many mothers will recall how awful the dark seemed to them and what shadowy shapes loomed up in it. It will usually be found on inquiry, however, that in these cases the children, after having been accustomed to sleep with some light and after having had all sorts of exciting pictures shown them and stories told them, were asked to sleep in the dark. From the very beginning they should be accustomed to sleeping in the dark and then it has none of the terrors thus pictured.

CHAPTER IX

DREAMS

Dreams, that is, thoughts and illusions and mental phenomena of various kinds that occur during sleep, have always been interesting to the psychologist, and have usually been related to physicians by patients either because they were thought to have a significance related to disease, or because something in them disturbed the patient's mind. This is almost as true in the modern time as it was long ago. It is curiously interesting to note that the very latest development of psychotherapy includes the use of hints obtained from dreams in order to determine the origin of psycho-neurotic conditions and certain of the minor psychic disturbances, and also as a foundation for treatment. The oldest stories of therapeutics that we have are those of patients waited on by the priest physicians of the olden times in the temples, who were supposed to be greatly helped by information obtained from the patient's dreams. It is interesting to read such recent studies as that of "Incubation in the Old Temples,"

by Miss Ingersoll, with the thought in mind that we are once more a.n.a.lyzing dreams in order to accomplish a similar purpose.

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Dreams are so often a source of disturbance of mind for patients, lead to such disturbed sleep, or even so affect the bodily health that it is important for anyone who wants to influence patients through their minds to know the significance attributed to dreams by the most recent studies of them. This is all the more important because dreams are such a universal phenomenon. From our earliest years we dream. The night terrors of children are probably due to dreams and show that even as early as the age of three we dream vividly. Doubtless some of the terrifying dreams of childhood are similar to those that we experience later. Dreams of falling, dreams of being cold, of being out of breath, with vivid repet.i.tions of exciting scenes through which they have gone during the day, or which they have seen in picture or been told in story, form the substance of these dreams. Children are likely to be much disturbed by them. They wake in a terror of anxiety, in cold sweat, and crying bitterly because of their dream visions.

Older people are not so much disturbed at the moment, but often brood over dreams and may be seriously affected by them.

It is difficult, however, to persuade many people that their dreams have no special significance, either of present or of future evil, and to many the fact that they dream much becomes a suggestion of wakefulness that disturbs sleep and makes them quite unequal to the next day's work, because they have the feeling that, as they have been dreaming all night, they must be quite tired. Tiredness in nervous people is often a matter of the mental state rather than of physical exhaustion or genuine mental weariness. The actual place of dreams in psychology, then, becomes an important consideration in psychotherapeutics.

Our real advances in the knowledge of the significance of dreams have come from the study of the dreams that are common to most people.

These show us exactly how and why dreams occur and just what their meaning is. Probably the most familiar dream common to all the human race is that of falling from a height. Everyone has been wakened with a startled sense of intense relief that the sensation of falling was illusory. The waking came just before the bottom was reached. There is a tradition that if one ever did strike the bottom in one's dream it would be the end and that death would result as surely as if the fall were real. So far we have had no one come back to tell us of that, and the tradition is reasonably safe from direct contradiction. It serves without any reason, however, to disturb timorous people and make them dread to fall asleep again. Often this dream-falling so seriously affects sensitive individuals that they do not get to sleep for an hour or more and occasionally those with an inclination to insomnia may even suffer for the rest of the night from the effect of it. It is important to explain, then, what we know about the causation of the dream. In nearly all cases the subject on waking finds himself on his back, and then the inclination is at once to turn over to the side with a sigh of relief. Commonly the dream occurs rather early in the night, when a rather heavy meal has been taken shortly before retiring. The weight in the stomach, particularly if considerable liquid has been taken, seems to press upon the abdominal aorta and interferes, to some extent at least, with the circulation to the legs.

This deprives little nerves at the periphery of the body of some of their nutrition and causes a tingling feeling in them. This is quite different from pressure {671} on nerves, which gives the sensation termed "being asleep" to a limb. This tingling feeling resembles that which we experience when going down rapidly in an elevator. It is the falling sensation. This sensation tries to force its way into the consciousness and in this process does not completely wake consciousness up, but brings about an a.s.sociation of ideas connected with falling--hence the dream of being on a height and of falling therefrom out of which we wake so startled. The whole process instead of being injurious is really conservative. It is important that the aorta should not be pressed upon and this is the mode by which awakening is brought about and the position shifted so that further interference is stopped, though we ourselves are quite unconscious of the real purpose that has been accomplished. An explanation of this kind usually makes people who suffer from such dreams and have been disturbed by them much more tolerant of the phenomenon and more ready to go to sleep again, since evidently nature can be trusted to care for them even during sleep.

After the sensation of falling probably the commonest dream that humanity has, at least in the civilized state, is that of being out in some public place without sufficient clothing. Usually we wake just to find that some portion of our anatomy has been exposed to the air and that it is cold. It is this sensation gradually forcing its way into consciousness that has gathered around it a group of ideas that form our dream.

Among men, a familiar dream is that of running for a car, or away from something, or to catch someone, and finding that it is almost impossible to move. We are so out of breath that we are scarcely able to drag one foot after another and, indeed, sometimes we seem to be actually rooted to the spot. We cannot move at all. When we wake after this dream we find that, because of a cold in the head, our nose is stopped up by the secretion and that our mouths are shut and consequently we were getting no air. When that sensation tries to break into the consciousness there gather around it certain familiar ideas usually a.s.sociated with being out of breath and hence we have the dream of trying to run without being able to move.

Frequency of Dreams.--Nervous people often complain that they dream all night or else very frequently, and that as a consequence their sleep is not restful. It is probable that there are always ideas in the mind and that literally we dream without ceasing. These ideas, however, do not get into our consciousness except just during the process of waking. All those who have investigated the subject of dreams are practically agreed on this. In subsequent paragraphs we quote a number of good observers on this subject. Certainly this is what we should expect from what we all know about day-dreaming. We can never catch ourselves during the day without finding some thought wandering through our minds. If we want to understand dreaming during sleep this day dreaming is instructive. We jump from one idea to another, apparently without a connection; yet there is always some connecting link. We have just read in the paper of someone in Cairo, and we think of old Egypt, and then of old Babylonia, and the Code of Hammurrabi, and the laws of the Medes and the Persians, and Xenophon and our school days, and of an old schoolmaster now a missionary in j.a.pan, and of j.a.panese art and of an American artist much influenced by it, and of one of his great windows in a church in New York and of social work in connection with that church, {672} and of settlement houses and then Hull House, Chicago, and then of the Adamses in Ma.s.sachusetts, and so on.

Thus, also, do our minds go flitting round apparently during the night. We remember only such things as are brought into our consciousness directly and emphatically during the process of wakening. During our day dreaming we recall only those things which for some reason led us to think consciously about them and then follow out our thoughts to definite conclusions. It is an interesting study to follow back our day dreams through their wanderings to the origin.

As a rule, however, we lose track of the connections and after a time remember only some of the wonderful transformations and transmigrations of thought; and so it is in our dreams.

With regard to the frequency of dreaming. Sir Arthur Mitch.e.l.l in his book "Dreaming, Laughing, and Blushing" (London, 1905), insists on the great probability of the constancy of our dreaming during sleep. He says:

It seems to me that there is no such thing as dreamless sleep.

During the whole continuance of sleep, the mind, I believe, is occupied with a certain kind of thinking which works round what I have called hallucinations. I do not expect to be able to prove the correctness of this opinion as to the persistence of dreams all through sleep, but I think that it can easily be shown to be possibly correct. I go further, and say that many things show that it is probably correct. I may not be able to prove absolutely its correctness, but it is proper to bear in mind that it is quite as difficult to prove absolutely that it is not correct. My difficulty is frankly avowed. Many things, however, are taught in biology as being certainly true. In regard to which a like avowal could be made but is not made. There is what has been called a "conjectural biology."

We do not and we cannot remember much of what we have been thinking about while we are awake. This is unquestionably true in a large sense. But, nevertheless, we do not doubt that we have been thinking continuously. We do not suppose that at any time all thinking had ceased, though we may be completely unable to recall what it was about.

He shows further that many writers on dreams and careful students of the subject in the past have come to the same conclusion. Robert Dale Owen, for instance, deliberately endeavored to find out whether he had always been dreaming just before he awoke. After months of observation he records that in every instance he was conscious of having dreamed.