Articles: Dreams can be valuable in therapy &
Geropsychologists find success, satisfaction with all manner of online training {Below}

Dreams can be valuable in therapy

By Leslie Ellis, Ph.D.
January 5, 2021

Clinical dreamwork and the science of dreaming are separate worlds that rarely cross-fertilize. However, those who work with dreams in clinical practice have much to gain from current dream research findings.

We now know much more about the nature and purpose of dreaming than we did even a decade ago, and this new information strengthens the case for using dreams in psychotherapy.

Although dreams continue to evade definitive understanding, there is evidence that they are implicated in both memory consolidation and emotional regulation, and these two processes may be linked via dreams. Dreams also shed light on our pervasive unconscious processes.

At the end of a lifetime of researching and working with dreams, Ernest Hartmann, M.D., concluded that dreams are like therapy because both “make connections in a safe place.” He came to view dreaming as at one end of a continuum, waking thought at the opposite end and daydreaming somewhere in the middle.

Dreams are a form of mental activity mediated by the neurochemical properties of the sleeping brain – which dampens down executive functioning and amps up emotional processing. Neuroimaging technology shows that in dreaming, the limbic system is even more active than when we are awake.

Researchers Josie E. Malinowski, Ph.D., and Caroline L. Horton, Ph.D., conducted a comprehensive review of sleep and dream research into emotional processing and memory consolidation and developed a theory about how these processes work together.

Research supports the fact that we have better recall for events with an emotional charge. We are inundated with far more information than we can assimilate; emotion appears to “tag” the most impactful events for future recall.

In dreaming, events from our lives are broken into parts and only the most salient elements are woven into the associative web of our memories. This, say the researchers, is what gives dreams their peculiar mix of past and current images and events.

This theory suggests we dream about what evokes emotion because this helps us retain salient information in a form that is accessible for future use. Research shows that we also dream about what we repress, so even when an emotional charge flies under the radar of consciousness, our dreams incorporate these events.

Looked at in this way, the strangeness of dreaming begins to make some sense, and its usefulness in therapy becomes more clear. In both dreaming and therapy, we attend to what brings up emotional responses, especially those things we repress or find hard to assimilate. Then we weave these into our web of associative memory while attenuating the emotional charge.

Dreams are like an astute therapy assistant who offers an uncensored look at our

client’s most salient emotional concerns, pointing the way to what needs attention

and weaving that into what is relevant from the past. They open up important

conversations that might not otherwise happen.

In many ways, the science of dreaming supports the original theories and practices of the first great dream therapists, Sigmund Freud and Carl Jung. However, there has been a major revision in understanding the nature of the unconscious.

Far from being a seething caldron of repressed and forbidden drives, as Freud thought, implicit processes are now seen as both pervasive and adaptive.

According to John A. Bargh, Ph.D., and Ezequiel Morsella, Ph.D., “Contemporary social cognition research on priming and automaticity effects have shown the existence of sophisticated, flexible and adaptive unconscious behavior guidance systems.”

The idea of an adaptive unconscious was proposed by cognitive neuroscientist Michael S. Gazzaniga, Ph.D., who has suggested that as much as 99 percent of our cognition is unconscious and that, as a result, free will may be an illusion.

An expert in neuroscience and psychoanalytic theory, Efrat Ginot, Ph.D., says that dreams can give us a glimpse into our adaptive unconscious processes.

She describes our emerging understanding of dreaming as “engaged not in simple consolidation of new/recent memory, but in processing associative memories and as such, they offer “great therapeutic opportunities. Very often, more than the remembered content, the affect resurrected in dreams is significant for the possibility of change. As often experienced in treatment, the intense emotions that are revealed in dreams seem to provide one of the most direct accesses to what lies underneath.”

Ginot believes that the clinical relevance of dreaming is strengthened by this new information:

“Dreams can no longer be thought of as simply carrying repressed or dissociated memories or as a defense against unpleasant instincts. As part of always active brain/mind processes, they allow us, however strangely, to peek into unconscious processes as interpreted, recalled and retold by our conscious self.”

As such, dreams are an invaluable asset to the process of psychotherapy. Their relevance has not faded in light of current scientific research; in fact, quite the opposite.

Leslie Ellis, Ph.D., has a private practice in Vancouver, British Columbia, and is the author of A Clinician’s Guide to Dream Therapy. She offers online training in focusing, dreamwork and trauma treatment for therapists. Her web site is located at: www.drleslieellis.com.

Geropsychologists find success, satisfaction with all manner of online training

By Paula Hartman-Stein, Ph.D.
January 5, 2021

While many psychologists who provide behavioral health services to older adults are bemoaning 2021 Medicare cuts, online gero-entrepreneurs are helping older adults, family caregivers and staff in long-term care in locations around the world and getting paid for their expertise – with no dependence on insurance and without leaving home.

Training webinars conducted through Zoom, podcasts, blogs, monthly memberships, YouTube videos and sales of products through websites have become online platforms for innovative geropsychologists.

On March 13, applied gerontologist, Cameron Camp, Ph.D. director of research and development at the Center for Applied Research in Dementia in Solon, Ohio, arrived in a Cleveland airport after conducting several days of in-person training for staff in long-term care facilities in Missoula, Mont.

"That was my last plane trip for business. I cancelled a training in France scheduled three weeks later. If I hadn't done so, I might still be in Europe due to Covid travel restrictions," he said.

After that, Camp said his online training presence accelerated.

He's conducted about 30 webinars from June to December, reaching long-term care staff and managers worldwide. His Montessori-based method of dementia intervention is certified through the National Council of Certified Dementia Practitioners (NCCDP) and much of his online training comes through that affiliation.

"A sociological shift has occurred because of Covid," he said. "Acceptance of distance training is much greater than it ever has been."

Camp's organization also offers environmental scans of group homes where a resident uses an iPad to show him the facility's interior.

And a national company that manages senior living residential communities recently hired Camp to design a program, Engagement During Covid, to teach family members ways to have positive interactive visits with loved ones they cannot visit.

"We help the staff and family learn ways of reducing isolation and loneliness with the help of technology," he said.

Regina Koepp, Psy.D., a board-certified geropsychologist from Atlanta, began her business, GeroChampions, in 2018 after designing training programs while she worked at a veterans administration hospital.

"I wanted to find more ways to educate providers and families on topics involving mental health and aging while being more inclusive, without being dry or too cerebral, and making the content inviting and digestible," she said.

On the day of our interview, Koepp had just completed a lunch-and-learn online program for a local agency on driving issues with older adults. She has a free checklist on her website describing the biggest driving red flags.

"I have a passion for teaching about dementia and sexuality; e.g., how consent is determined, who decides if the person has the capacity for sexual self-determination and other related issues that arise in long-term care settings. Directors of nursing welcome help with this issue," she said.

After ten years at a VA hospital, she became tired of the bureaucracy and annoyed by the Trump

administration's shutdown of diversity training programs. In September, she left her position and

now devotes herself to her business full-time, producing weekly podcasts on the psychology of

aging, offering online courses and training and conducting live question-and-answer sessions

for groups. Koepp serves on the ethics committee for the Georgia Psychological Association and

is careful to include disclaimers on her website that her consultations and training are for

information purposes only and do not take the place of medical or mental health services.

Natali Edmonds, Psy.D., a board-certified geropsychologist from Phoenix, manages her online business, Dementia Careblazers, and is employed full-time in a remote geropsychology position.

"My business started as a 'passion project' initially," she explained. "In 2017, I posted my first video online on the difference between dementia and Alzheimer's and started my business officially the following year. Now I have 220 archived videos about caregiver stress."

Edmonds wrote a dementia survival guide, offered free of charge and downloaded by 15,000 people from her website. She posts videos through YouTube to reduce caregiver stress, records the videos through her cell phone, and edits them herself.

"I've gotten 4 million views on YouTube," she said. "The key to success using YouTube as a marketing tool is to be consistent and post once a week," she said.

Edmonds monetizes her business by offering courses accessible 24/7 for caregivers along with live question-and-answer sessions offered six times a year in a group format. In addition to U.S. customers, she reaches caregivers in Canada, Australia and Malaysia.

Edmonds and Koepp both learned the nuts and bolts of their online businesses by investing in the 12-week Digital Course Academy by Amy Porterfield.

"I did not get information on the entrepreneurial process from APA," Edmonds said. "Porterfield's course provided me the motivation, inspiration and courage I needed."

For 33 years, Joe Casciani, Ph.D., of San Diego, spent 80 percent of his professional time as a businessman and administrator, heading up two large companies that provided mental health services in nursing homes in multiple states.

In 2019, Casciani's entrepreneurial bent led him to the entirely new world of e-commerce.

"I wanted to move into an area where I had more autonomy," he said. "Although Medicare regulations were always challenging but not insurmountable, the challenges were managing providers' schedules, complying with documentation and ongoing recruiting. I wanted to create an online community of seniors and provide successful aging content to them."

He began the Living to 100 Club, offering individual and organizational memberships and hosted a weekly cable radio program for a year through VoiceAmerica.com, interviewing experts on various aging topics. He currently records podcasts and hopes to get advertising sponsors. He's written a book, Living Longer is the New Normal, does public speaking to community groups, writes newsletters and offers brief individual consultations to inspire and educate.

"Straddling the world of business is exciting, and it has enabled me to learn and have fun," he said.

Edmonds wishes more people would become online educators because there are not enough people offering these services.

"The medical model of educating people through brief contacts and handing out pamphlets is distant and insufficient to meet the needs of the growing numbers of older adults throughout the world," she said.

Paula Hartman-Stein, PhD is a geropsychologist, educator and co-editor of Enhancing Cognitive Fitness for Adults. She conducts webinars on what’s preventable in dementia and the emotional, cognitive, and spiritual benefits of Vitamin N for nature. Her website is www.centerforhealthyaging.com.