What Does A Clinically Anxious Person Dream About?

Psychologist Anton Rimsh describes the preoccupations of the clinically anxious as represented in their dreams.

By Mark Travers, Ph.D. | July 16, 2022

A new study published in Dreaming takes a deep look into the dream contents of people with anxiety disorders. The study suggests that these overwhelming distressing dreams can spill into the person's waking life creating a painful negative feedback loop for the sufferer.

I recently spoke to Psychologist Anton Rimsh of Universität Düsseldorf to understand why anxious people are haunted by certain recurring imagery and situations in their dream life. Here is a summary of our conversation.

Could you describe the characteristics of a dream of a person experiencing clinical anxiety? Did you find any recurring patterns or images in your study?

Of course, there were a lot of typical characteristics, symbolism, imagery, patterns, etc. found in dreams of clinical anxiety sufferers, which were definitely recurring and representative.

The results reveal that the dream contents of anxiety patients differed significantly from the dream contents of healthy persons and contained more negative and unpleasant elements.

Several particular dream topics were found to be more prevalent in anxiety patients compared to healthy persons. These themes included, among others:

  1. Being chased and pursued
  2. Being physically attacked and facing aggressive actions
  3. Being frozen with fright
  4. Quarrels and verbally aggressive interactions
  5. Anxiety and fear about aggressive actions from others
  6. Fear of falling and being in danger of falling
  7. Being excluded and being rejected in social situations
  8. Death of parents and family members
  9. Accidents and car or plane crashes
  10. Facing failures and being unsuccessful

Dreams of anxiety outpatients also contained larger and more diversified casts of characters, higher numbers of distinct activities, social interactions, higher numbers of aggressive and sexual interactions, lower numbers of friendly interactions, higher frequencies of failures and misfortunes, unlucky, dangerous and threatening situations and events, and a lower prevalence of successes as well as more negative and less positive emotions.

They also had higher numbers of locations and settings, more negative evaluations and assessments, and were characterized by higher numbers of objects of different sizes.

Dreams of anxiety patients were also distinguished by a higher number of different male human characters and of unknown characters and strangers.

The results show that dreamers' ex-partners or ex-spouses are also more frequent in dream contents of anxiety disordered individuals than in dreams of healthy people.

Regarding different activities in dreams: location changes, traveling and transportations, verbal communications, expressive communications and thinking activities were more frequent in dreams of anxiety sufferers.

With respect to dream emotions of anxiety patients, their dreams contained a higher presence of anger, fear, apprehension and sadness than dreams of healthy individuals.

In addition, their dreams were clearly distinguished by a much fewer number of positive and happy emotions, such as joy and happiness. The high presence of negative emotions, namely anxiety, fear and apprehension, and the lower numbers of positive emotions in dreams of anxiety patients allowed us to conclude that their dreams may represent the experience of a frightening, hostile and dangerous environment in their waking life.

The data indicates that dream contents of clinical anxiety sufferers are distinguished by higher levels of general negativity and failures. Likewise, such results indicate that dreams of individuals with anxiety disorders may contain higher numbers of various threats, misfortunes and dangerous situations and events which could not be successfully coped with, avoided, or overcome.

Dreams of anxiety disordered patients were also characterized by common presence of high velocity and fast speed, in general, and, subsequently, fast-moving characters, objects, transport and vehicles, as well as high and strong intensity and power.

Thus, we can assume that the presence of an anxiety disorder instigates a higher overall subjective intensity of dream experiences and dream imagery. In accordance with this notion, we concluded that the dream contents in anxiety patients not only exist in large numbers, but also are experienced by them with a particularly high subjective intensity and emphasis.

Why do you think that a person suffering from an anxiety disorder puts so much importance on the interpretation of their dreams?

Individuals suffering from anxiety disorders generally tend to be preoccupied and concerned with the major part of their waking life experiences and events. They tend to analyze, consider and contemplate their actions and experiences much more thoroughly and in detail than other people during their waking life.

Therefore, it seems quite logical that they also would tend to think about their dream experiences and dream events much more profoundly and would also tend to analyze and interpret their dream content in greater detail. This implies a higher tendency to interpret their dreams more frequently as well.

On the other hand, we may also hypothesize that through the interpretation of dreams such individuals are attempting to find and uncover some clues for their waking life concerns. Thus, they may be using the interpretation of their dreams as some sort of a road-map to overcome their waking life problems more efficiently.

What advice would you have for someone who might be experiencing such dreams on a regular basis?

The best advice which I could give for a person who experiences such dreams on a regular basis is to consult with a psychologist or better, with a practicing psychotherapist, and most preferably, with a practicing psychoanalyst. This is because they usually have the necessary experience, skills and knowledge of working not only with anxiety disorders, but also with a person's dreams.

The best way to cope with and get over such a state is with the help of a practicing psychoanalyst- psychotherapist, experienced in working with dreams and anxiety disorders.

Your research suggests that anxiety patients had a higher rate of dream incorporation into their waking life. Could this create a negative feedback loop from dream to reality and back to dream (since the dreams are negative in nature)?

Yes, exactly. Their dreams had more incorporations from their waking life and were more associated with real waking life experiences than dreams of healthy people.

This allowed us to hypothesize and suggest that their dreams, which are in general more negative, may worsen their anxiety symptoms and their mood in waking life and make it more negative and depressing.

Therefore, yes, this is quite right, we may suggest that such a negative feedback loop really may exist — while their dreams are negative and depressing, they influence and worsen the usual waking life mood of anxiety patients, whilst worsening and strengthening their anxiety and consequently, their anxiety symptoms during their everyday life.

And, vice versa, such negative and depressing mood and tone during the waking life, as well as a heightened anxiety and anxious experiences during the day may affect and worsen dream experiences during the night

So, this process may also be called and represented as a 'vicious circle,' which is not so easy to break or tear. And in order to do so, an individual requires professional and qualified help from a practicing psychotherapist.

How do you hope your research contributes to intervention efforts?

It can generally be concluded that the results of the present study have practical relevance and potential for the application of dream material and contents in professional psychological and psychotherapeutic practice when working with people diagnosed with clinical anxiety disorders.

By working with dreams from the perspective of understanding how they may reflect a personal clinical pathology and mental disorders, psychotherapists may be able to formulate a professional opinion on the capabilities and limitations of a given clinical patient more quickly, precisely and meaningfully using these client dream characteristics and data, as well as better understand his or her psychological profile.

These data might be helpful in dealing with the individual's creative potential for productive psychotherapeutic counseling work and more effective and beneficial psychotherapeutic treatment courses.

Knowing particular imagery, contents, emotionality and themes of dreams in anxiety outpatients might help in guiding a psychotherapist during a treatment course and helpserve as an orientation in terms of specific fears or apprehensions of a particular patient with anxiety disorder.

The present study thus provides a systematic insight on the influence of different types of anxiety disorders on dreams, dream content and characteristics, and outlines specific features of dreams of clinical patients with anxiety disorders.

These studies thus add further knowledge of dreams and dreaming in anxiety disorders, which may be helpful for the understanding of these mental disorders and the relationships between dreams and waking life may unveil causes of dream disturbances, such as bad dreams or nightmares, in patients with anxiety disorders and may probably unveil causes for the maintenance of anxiety disorders.