Dreams Dome: Do dreams shield the psyche in times of continuous Stress | Tamar Kron

Abstract

Results of analysis of 531 dreams, collected from 44 women living near the Gaza Strip in Israel under continuous rocket attacks, are presented.

The most frequent themes found are: 'Togetherness,' 'Being active,' 'Stress-related situation,' 'Fear and anxiety,' 'Helplessness' and 'Masochism.'

The participants were divided into three age groups – Young, Intermediate and Old, and differences between the occurrence of dream themes in each group were examined. Results indicated high incidence of 'Togetherness' and 'Stress-related situation' themes in the young age group, while 'Symbolic' and 'No escape' themes were found to be significantly low in the same age group.

On an unconscious level, the young age group seems to be the most vulnerable to the stress-related situation, the old age group is the least influenced by it, and the intermediate group makes the most psychological efforts at coping with it.

Keywords: Dreams, stress-related situations, trauma, traumatic dreams, coping mechanisms

Since 2000, the residents of the Israeli town of Sderot – a brief kilometer away from the Gaza Strip – have lived under the threat of continuous rocket attacks. From that time, an estimated thirteen thousand rockets have been fired at the town and its area. In the following study we present the dreams of Sderot residents, who live, suffer and attempt to cope with a situation of constant terror. Encapsulating the two major aspects of this study, the term "Dream Dome" alludes to the missile defense system named "Iron Dome," employed by the Israel Defense Forces in defending Sderot and its surrounding areas against attacks.

Studies conducted in Sderot, the surrounding communities and kibbutzim indicate that a significant proportion of the population suffers from at least one symptom of Posttraumatic Stress Disorder (PTSD). In addition, residents of the area who did not report a specific symptom did nonetheless report suffering from emotional distress and physical symptoms (Nuttman-Shwartz & Dekel, 2009; Ablin et al., 2010; Besser & Neria, 2010; Diamond et al., 2010; Gelkopf et al., 2012).

Already in 1920, when he became aware of the inconsistency of traumatic dreams with his wish-fulfilling theory, Sigmund Freud wrote: "Now in the traumatic neuroses the dream life has this peculiarity: it continually takes the patient back to the situation of his disaster from which he awakens in renewed terror…" (Freud, 1920, p. 9). Trying to resolve this inconsistency, Freud explained the nature of trauma in war and trauma neurosis: "Such external excitations as are strong enough to break through the barrier against stimuli we call traumatic… An occurrence such as an external trauma will undoubtedly provoke a very extensive disturbance in the workings of the energy of the organism, and will set in motion every kind of protective measure. But the pleasure-principle is to begin with put out of action here. The flooding of the psychic apparatus with large masses of stimuli can no longer be prevented: on the contrary, another task presents itself – to bring the stimulus under control, to 'bind' in the psyche the stimulus mass that has broken its way in, so as to bring about a discharge of it" (ibid, p.34).

Recent studies regarding the dreams of people who live in situations of continuous stress show that the content and characteristics of traumatic dreams are determined by a number of variables, each related to the trauma itself and to the participative experience. In general, the dreams of people who have experienced stress and trauma are more concrete than symbolic, and include more fragmentary narratives than dreams of those who have not experienced trauma (Nadar, 1996; Brenneis, 1994; Varvin et al., 2012).

Phelps et al (2011) and Phelps, Forbes & Creamer (2007) point out that memory of traumatic events is stored differently than for general events. Traumatic memories remain unprocessed. Thus the hallmark of the PTSD nightmare is "a repetitive replay of the traumatic event, complete with accompanying cognitive, affective, physiological and behavioral response" (p.342) and can recur for decades.

Other studies argue that dreaming allows the cognitive-emotional processing of traumatic events. For example, dreams of children under continuous stress because of war and terror were found to be characterized by negative emotions, anxiety, horror and the absence of solutions to problems (Punamaki, 1999; Punamaki et al., 2005; Punamaki & El Sarraj, 2006; Valli et al., 2005; Valli et al., 2006).

These studies suggest that dreaming may be adaptive for the children's coping capacity in continuous stress situations.

Ernest Hartmann was a leading contemporary theorist and researcher who offered a detailed explanatory description of the adaptive function of dreaming. According to Hartmann (2008), dreaming is at one end of a continuum of mental functioning. At this end, neural connections are formed more easily than when in a waking state. These connections are not made randomly, rather they are guided by the dreamer’s emotions, with the dream’s “Central image” (CI) representing or expressing the dreamer’s emotion. Hartmann refers to this connection-making as "weaving in" material – in other words, connecting stressful experiences and emotions with existing memory.

According to Hartmann, in addition to this specific function of dreaming, the waking-to-dreaming continuum has an adaptive function, and thus it is not necessary for the dream to mirror the actual traumatic experience. The powerful images found in the dreams of those who have experienced stressful events express the dreamers' emotions.

Hartmann defines the CI of the dream as “a striking, arresting or compelling image – not simply a story – but an image which stands out by virtue of being especially powerful, vivid, bizarre or detailed” (Hartmann, Zborowski & Kunzendorf, 2001, p. 36). He proposes a direct positive relationship between the strength of the dreamer's emotion or emotional concern and the intensity of the CI as rated by judges. A key aspect of Hartmann's (1998) theory is the role of the CI as explanatory metaphor. In earlier formulations of the theory the CI was described as contextualizing imagery because it created a picture context for the emotion elicited by the original waking event. The quintessential tidal wave dream is a pictorial metaphor for a waking traumatic experience of exposure to an overwhelming and harmful force. Both experiences are strongly associated with the emotion of fear. Hartmann has provided numerous examples of such metaphoric dream imagery, drawn from dreams of people who have experienced trauma, and together with his coworkers has compared dreams of various naturalistically occurring groups or dreams recorded after a major traumatic international event ( Hartmann & Basile, 2003; Hartmann & Brezler, 2006; Hartmann, Kunzendorf, Rosen & Grace, 2001). The results confirm that central dream imagery is stronger for individuals who experience a traumatic event. These findings are entirely consistent with an abundance of persuasive examples of such connections from the dream literature (e.g., Faraday, 1972; Hill, 2003).

In our study we collected more than 500 dreams of Sderot residents and the surrounding area during 2009. The continuous stress situation in the area is characterized by fluctuations in the intensity of rocket attacks. The dreams collected for our study followed a stormy period of rocket attacks. Our hypothesis is that the situation of continuous stress is manifested in dreams, which we study in order to expand our knowledge concerning: a) the effects of the traumas, and b) the functions of the dream in coping with the continuous traumatic situation.

Participants and methodology

Participants included 44 women, all residents of the Sderot area. We chose to include women participants exclusively for the following three reasons: First, more women than men agreed to take part in the research. Second, results of research into gender differences in dream recall indicate that women have more frequent dream recall than men (Schredl & Reinhard, 2008; Georgi, Schredl, Henley-Einion & Blagrove, 2010). Finally, demographic studies of populations exposed to traumatic situations (terror attacks, missile attacks, etc.) have found that women suffer significantly more from PTSD and stress-related symptoms (SRT) than do men (Bleich et al., 2003; Bleich et al., 2006; Norris et al., 2002; Raviv et al., 2000; Hobfoll et al., 2011).

The participants were recruited by the chain-referral  or "snowball" sampling process. This method has its disadvantages (the initial participants tend to nominate people who they know well, thus not enabling a diverse sample). Nevertheless, we chose this method for two reasons:

 +We sought participants who were not patients or clients being treated in a mental health or social work organization. Thus a sampling frame was difficult to establish.

+We sought participants who were willing to write down their dreams and share them with us. The chain referral process allowed us to reach subjects who fulfilled this criterion and who could otherwise not be reached.

+ The youngest participant was 14 years old and the oldest was 65 years old.

All the participants agreed to be interviewed and signed an informed consent form. In the case of participants under the age of eighteen, their parents signed a form consenting to their participation in the study. The researchers met twice with each participant. The first meeting consisted of an open interview of thirty to forty minutes, where questions were asked relating to background, residence in the area and its consequences, feelings and their manner of coping. Participants were also asked about their sleep and dreaming patterns. At the end of the first meeting, each participant received a dream diary, a notebook prepared by the researchers, which included an instruction page. Each page began with the same sentence: "Last night I dreamed that…" Participants were instructed to write down their dreams and all associations to the dream for four weeks. In this manner, a total of 531 dreams were collected.

Dream content analysis

In analyzing the dreams, we looked for recurrent "central themes" which could be related to the continuous stressful situation. In the first stage, two of the authors of the current paper and five additional psychologists examined the dreams and revealed forty central themes. In the second stage, the three authors of the current paper assessed the dreams separately and indicated (0 for "No" and 1 for "Yes") the presence of each theme per dream.  A theme was coded 1 only if its presence was acknowledged by all three judges. In the third stage, the percentage of occurrences per theme out of the total number of dreams was calculated. Initially starting with a long list of themes, those finally selected appeared in at least 10% (53) of the total cohort of 531 dreams.

A list of themes follows, including its definition and the percentage of its appearance in the total data base of dreams.

Stress situation related dreams (29.38%): A dream fit this category if there was any mention of the threat of terror, rockets or physical injury resulting from an attack or accident. Also, if a CI (Hartmann, 2008) appeared, representing strong emotions aroused by the traumatic situation.

Fear and anxiety (31.83%): A dream fit this category if there was any mention of fear or anxiety, and when an experience of fear, panic or horror was described.

Helplessness and loss of control (33.33%): A dream fit this category if an experience of loss of control of the dreamer in the dream situation and/or feeling of helplessness was reported by the dreamer.

No escape (14.12%): A dream fit this category if the dreamer's attempt to get away from the dangerous area (where there is high probability of rocket attacks) failed to bring about positive results or if the dreamer also encountered danger in the refuge to which he/she had escaped (this theme was included for its relevance to the stress situation).

Active ego (62.34%): A dream fit this category if the dreamer is active in the dream, regardless of whether the activity is useful or futile.

Coping with the situation (23.73%): A dream fit this category if the dreamer attempts to actively cope with the immediate danger situation (looking for shelter, survival techniques, protecting the children, etc.).

 Togetherness (68.17%):A dream fit this category ifthe dreamer is not alone, experiences being together with or getting support from others in the dream situation.

Symbolic dream (32.20%): A dream fit this category if it featuredfantastic or metaphoric events that did not or cannot happen in reality.

Masochistic dream (50.09%): A dream fit this category if it featured a negative self-image, and/or a negative chain of events (Beck, 1967). This analysis was made utilizing the Beck scale (ibid.) for the measurement of masochism in dreams.

Shadow (29.00%): A dream fit this category if it featured the appearance of a human figure, animal or symbol, representing the repressed or unaccepted parts of the dreamer's personality. Shadow also refers to enemy or aggressive figures.

Personal issue (PI) (40.30%): A system of related thoughts and emotions tied together around a central theme which is not related to the traumatic situation, and which the dreamer is preoccupied with, either consciously or unconsciously.

Statistical Analysis

The cohort of dreams included 531 dreams as reported by 44 women. The mean number of dreams per participant was 12.07 (sd=8.10; median=11), 18 women (40.9%) had 10 dreams or less, 23 women (52.3%) had 11 to 20 dreams and 3 women (6.8%) had 21 dreams or more.  At the first stage of analysis, we calculated percentages of theme occurrences within the data base. In order to account for variations in the number of dreams per participant, the calculation was repeated twice:  A. Participants-based calculation: The percentage of occurrences of each theme was calculated per individual participant and then the mean occurrence was calculated in relation to the total number of participants. Thus, each participant had the same effect on the total mean; B. Dreams-based calculation:  The occurrences of each theme were calculated in relation to the total number of 531 dreams. Thus, participants who dreamed more abundantly had more impact on the total mean. At the second stage of analysis, participants were divided into three age groups and the occurrence of dream themes was compared between groups. Since, at the first stage of analysis, the two methods of calculation yielded similar results, the occurrence calculation for the groups comparisons relied on percentages from the total cohort of dreams (531 dreams). Based on the bionomic nature of the data, comparisons were conducted by means of Multivariate Analysis of variance (MANOVA) and included three stages:

Results

Table 1 summarizes the mean percentage of the themes, both in relation to the total data base of dreams and to the total number of participants.

   Table I: Themes occurrences

Togetherness	68%
Active Ego	62%
Masochistic dream	50%
Personal Issue (PI)	40%
Helplessness and Loss of control	33%
Symbolic dream	32%
Fear and Anxiety	32%
Stress Situation Related Dreams	29%
Shadow	29%
Coping with the Situation	24%
No Escape	14%

Percentages sum up to more than 100% since many dreams include several themesv

       

As can be seen in Table I, there were almost no differences between the two calculations, and the most prevalent dream themes were Togetherness and Active ego. These themes might be related to waking life strategies for coping with stress situations, and will be discussed in detail in the Discussion section below.

Other themes that seem to be related to the situation (stress situation related, fear and anxiety, helplessness) appear in about one-third of the dreams, while half of the dreams are masochistic dreams. These findings are an unconscious manifestation of the reality of concrete danger and distress as a result of living under continuous threat of rocket attacks.

Other themes that appear at a relatively high frequency (PI, Symbolic dreams, Shadow), may or may not be related to the given situation and will be discussed later.  Generally, the frequency of Symbolic dreamsis quite low, corresponding with findings in other studies of dreams in traumatic situations. The frequency of Shadowimages isalso generally low, contradicting the expectation that the shadow of "the enemy" would appear in high frequency in this population. Is the absence of Shadow images related to the fact that rockets have no face and the danger comes “from above?”

Following studies regarding the dreams of children in stressful and traumatic life situations, we assumed that differences between age groups would be found among our subject population (Raviv, A. et al., 2000; Punamäki, R.L., 1999; Punamäki, R.L.et al., 2005; Valli, K. et al., 2005; Valli, K. et al., 2006). We divided the research population into three age groups – Young 14-19 (19 participants; 204 dreams); Intermediate 20-44 (17 participants; 222 dreams); Old 45-65 (8 participants; 105 dreams) – and looked for differences in the appearance of themes in their dreams. The percentage of occurrences of each theme in the total number of dreams was calculated for each age group separately.

Table II: Percentages of Themes among Age Groups

Theme	Young (14-19)	Middle (20-40)	Old (41+)
Stress Situation Related	37%	25%	23%
Fear &Anxiety	35%	30%	29%
Helplessness andLoss of control	33%	33%	33%
No escape	10%	18%	14%
Active Ego	60%	64%	63%
Coping with the Situation	26%	23%	20%
Together	78%	60%	66%
Symbolic	22%	40%	36%
Masochism	50%	54%	44%
Shadow	24%	35%	28%
PI	29%	45%	51%

 

Table II presents the differences in theme occurrences (out of the total number of dreams) between the three age groups. A MANOVA including all the themes yielded significant results. Examining the table for the univariate effect we noted that the Together theme was significantly higher among the younger age group in comparison to the intermediate group. The Stress situation theme was also significantly higher among the younger age group in comparison to both the intermediate and older group.

The Personal issues and Symbolic themes were significantly lower among the younger age group in comparison to both the intermediate and older group. The Shadow and No escape themes were significantly lower among the younger age group in comparison to the intermediate group.

 

Discussion

Managing terror:  Coping with the threat of terror

There are likely to be considerable individual differences in the manner in which individuals cope with the threat of terror (Silke, 2003).  One of our hypotheses is that studying our participants’ dreams can enhance our knowledge of how dreams function in coping with a continuously traumatic situation.

Our finding that the theme of Togetherness (where the dreamer is not alone or experiences being together with or getting support from others in the dream situation) is the most frequently occurring theme (68%), corresponds to findings on actual terror management. As attachment theorists have long noted, one important way of coping with threats to one’s safety is to seek support from others (Bowlby, 1969). Primary support is likely to be derived from romantic partners, friends and family (Lazarus & Folkman, 1984). Clinical studies have demonstrated that such support may be of particular importance during times of war or following the witnessing of a terror attack.  For example, in their study of those directly affected by bombings in Yugoslavia, Putnik and Lauri (2004) found that interpersonal relationships became closer, with respondents reporting the provision and receipt of heightened levels of support. The importance of interpersonal support and, in particular, the support provided by romantic partners has been added to the Terror Management Theory (TMT) (Pyszcynski et al., 2003).  During times of stress, close relationships can act as a fundamental anxiety buffer, providing a ‘symbolic shield against the awareness of one’s finitude’ (Mikulincer et al., 2003, p. 37). Mikulincer et al. (2003) argue that the formation of close relationships during periods of mortality salience functions ‘side by side and in interaction with other mechanisms’ (p. 26).

Perceived social support  has been found to be associated with psychological well-being in times of stress (Norris & Kaniasty, 1996; Norris et al., 2002) or terror attack (Hobfoll et al. 2006; Hobfoll et al., 2011), and with resilience in life-threatening conditions (Shalev et al., 2006). In a study of gender differences in coping with chronic terror, it was found that social support is one of the main methods of coping for women, more so than for men (Zeidner, 2006). This was also found in a study of the effects of insecure attachment orientations and perceived social support on posttraumatic stress and depressive symptoms among civilians exposed to the 2009 Israel-Gaza war. Findings revealed that perceived social support was significantly associated with low levels of PTSD and Major Depressive Disorder (MDD) both during the Gaza war and for four months following the cease-fire (Besser & Neriya, 2010).

The frequency of the Active ego theme(where the dreamer is active in the dream,

regardless of whether the activity is useful or futile) was found to be the second most prevalent theme (62%).  This finding can be interpreted as compensatory to the quite high frequency of the Masochism theme in dreams (50%) and the Helplessness and loss of control theme (33%).  In a telephone survey conducted with a national representative sample of Israelis during a period of extreme threat of terrorists attacks (the Second 'Intifada' – years 2000-2003) it was found that among the 512 participants, the most prevalent coping mechanisms were active pursuit of information about loved ones and social support (Bleich et al. 2003). In a study of gender group differences in coping with chronic terror it was found that women used problem solving coping strategies more than men (Zeidner, 2006).

Differences between age groups

Looking at the differences in frequency of themes across the three age groups, we find that there are no differences for some themes. Helplessness and loss of control seem to be a common experience for all participants and appear in the dreams of the three age groups with almost the same frequency. The Active ego appears in more than 60% of the dreams, with no differences between the age groups. The Masochism theme appears in about 50% of the dreams, again with no differences between the age groups, and can be understood in connection to the reality of the life-threatening stress situation. It could be argued that this finding agrees with Hartmann's Central Image theory, which in the dream represents the emotions aroused by the stress situation.

Altogether, the differences between age groups indicate that the young age group is the most vulnerable of all. Indeed, the younger age group had significantly high frequencies of situation-related stress themes. The younger age group had the highest frequency of the theme Togetherness (78%), significantly more than the intermediate group. This finding may be understood as seeking social support on an unconscious level as a means of coping with chronic stress.

The frequency of Symbolic dreams is significantly low within the younger age group in comparison to the two other groups. This finding may reflect the traumatic response and the vulnerability of this group as well as corresponding to other findings in dream research regarding people who have experienced stress and trauma (Nadar, 1996; Brenneis, 1994; Varvin et al. 2012).

PTSD dreams are often literal representations of the traumatic event, reflecting the psyche's inability to process and integrate the event through symbol formation (Levy, 1995; Wilmer, 2001; Varvin et al. 2012).

A different portrayal of reactions to the chronic stress situation on the unconscious level surfaces in the dreams of the old age group, where the frequency of the theme "PI" is the highest (51%). Although this finding was not statistically significant, it is compatible with Erich Neumann's principle of “Centroversion,” which derives from Jung's theoretical premise of individuation (Neumann, 1954). Centroversion is the movement of the psyche towards integration, a process which involves the ego's shifting from preoccupation with the outside reality to the inner world. According to Jung and Neumann, this shift usually occurs about midlife.

The intermediate group records the highest level of the No escape (dreams which describe futile attempts to run away from the dangerous area) theme (18%, which is significantly more and nearly double that of the younger age group). This finding surprised us at first, as we predicted that this group, including a majority of mothers with young children, would be the most preoccupied with active coping also on the unconscious level. At the same time, this finding can explain the high level of the Active ego theme in this group (64.4%). It can be safely assumed that the ambivalence on the mothers' part in regard to remaining in or leaving the area is more profound.  In order to cope with the stress situation these women also need deeper inner work which is conveyed through the relatively high frequency of Symbolic dreams (40.09%, the highest of all the groups and significantly higher when compared to the younger age group). This finding echoes the outcome in a study by Kron & Brosh (Kron & Brosh, 2003) on the relationship between dreams during pregnancy and postpartum depression. They found that women whose dreams during pregnancy reflected inner work  as preparation for the upcoming birth did not suffer from postpartum depression, while women whose dreams were shallow and 'nice' during their pregnancies, did suffer from postpartum depression.

In conclusion

 Do dreams shield the psyche in the same way that the Iron Dome physically shields against falling rockets? On the unconscious level it looks as if the younger participants are the most traumatized and the intermediate group has the greatest propensity to cope with the situation. The older participants are more engaged with their inner world than with the stress situation. We venture to say that the Dream Dome is most needed among the 20-45 year old women, who need to care for themselves as well as for their families.

We conclude with a Symbolic dream from the intermediate group:  "I was near thekibbutz dining room with my younger son and met my two daughters with another boy. I asked them: “Where will you run to if you hear the warning siren?” They pointed to the house of one of the grandmothers which has a security room. I said “OK,” and started to walk with them in the direction of the house. Suddenly, a huge helicopter came out of this house and flew very low in the direction of the dining room. I looked at it admiringly and said to one of the kids: “Look, it’s a show,” believing that these were our soldiers, but suddenly the helicopter opened up and out came figures from Star Trek and started shooting. One figure shouted: “Run for your life,” and I started to run in the direction of our home with my son."

 

References

1. Ablin, J.N. et al. (2010).  A tale of two cities – the effect of low intensity conflict on prevalence and characteristics of musculoskeletal pain and somatic symptoms associated with chronicstress. Clinical and Experimental Rheumatology. 28(6 Suppl.63), 15-21.
2. Besser, A. & Neria, Y. (2010). The effects of insecure attachment orientations and perceived social support on posttraumatic stress and depressive symptoms among civilians exposed to the 2009 Israel–Gaza war: A follow-up Cross-Lagged panel design study. Journal of Research in Personality. 44, 335-341.
3. Bleich, A.,Gelkopf, M. &Solomon, Z. (2003). The psychological impact of ongoing terrorism and suicide bombing on Israeli society: A study of a national sample. Journal of the American Medical Association. 290, 612-620.
4. Bleich A., Gelkopf, M., Melamed Y. & Solomon Z.(2006). Mental health and resiliency following 44 months of terrorism: A survey of an Israeli national representative sample.BMC Medicine, 4:21.
5. Bowlby, J. (1969). Attachment and Loss: Volume 1: Attachment. London: The Hogarth Press and the Institute of Psycho-Analysi
6. Brenneis, C. B. (1994). Can Early Childhood Trauma Be Reconstructed From Dreams? On the Relation of Dreams to Trauma. Psychoanalytic Psychology11(4):429-447.
7. Diamond, G. M., Lipsitz, J. D, Fajerman, Z. & Rozenblat, O. (2010). Ongoing traumatic stress response in Israel. Professional Psychology: Research and Practice. 41(1), 19-25.
8. Faraday, A. (1972). Dream Power. New York: Coward, Mccann & Geoghegan, Inc.
9. Freud S. (1920).  Beyond the Pleasure Principle. Standard Edition 18, 3-36. London: The Hogarth Press.
10. Gelkopf, M.,Berger, R.,Bleich, A. & Silver, R.C. (2012). Protective factors and predictors of vulnerability to chronic stress: A comparative study of four communities after seven years of continuous rocket fire. Social science and medicine. 74, 757-766.
11. Georgi, M., Schredl, M., Henley-Einion, J. & Blagrove, M. (2012). Gender differences in dreaming in childhood and adolescence: The UK Library study. International Journal of Dream Research, 5, 125-129.
12. Hartmann E. (1998).  Dreams and nightmares. Cambridge, Mass.: Perseus.
13. Hartmann, E., Kunzendorf, R., Rosen, R. & Grace, N. (2001a). Contextualizing Images in Dreams and Daydreams. Dreaming, 11, 97-104.
14. Hartmann, E., Zborowski, M. & Kunzendorf, R. (2001). The emotion pictured by a dream: An examination of emotion contextualized in dreams. Sleep and Hypnosis. 3.33-43.
15. Hartmann, E. & Basile, R. (2003). Dream Imagery Becomes More Intense After 9/11/01. Dreaming, 13(2), 61-66.
16. Hartmann, E. & Brezler, T. (2006). A Systematic Change in Dreams after 9/11/01. Sleep 29-S, A- 48.
17. Hartmann, E. (2008). The Central Image Makes “Big” Dreams Big:  The Central Image as the Emotional Heart of the Dream.  Dreaming, 18 (1), 44-57.
18. Hill, C. E. (2003). Dream work in therapy: Facilitating exploration, insight, and action. Ed. by Clara Hill. Washington D.C.: American Psychological Association.
19. Hobfoll, S. E., Canetti-Nisim, D. & Johnson, R. (2006). Exposure to terrorism, stress related mental health symptoms, and defensive coping among Jews and Arabs in Israel. Journal of Consulting and Clinical Psychology, 74, 207–218.
20. Hobfoll S.E., Mancini A.D., Hall B.J., Canetti D. & Bonanno G.A. (2011). The limits of resilience: Distress following chronic political violence among Palestinians. Soc Sci Med, 72(8), 1400-08.
21. Kron, T. & Brosh, A. (2003). Can Dreams During Pregnancy Predict Postpartum Depression?  Dreaming, 13(2), 67-81.
22. Lazarus, R.S. & Folkman, S. (1984). Stress, appraisal, and coping. N.Y.: Springer Pub.
23. Levy, M.I. (1995). For the Defense. The monthly journal of the Defense Research Institute, Chicago, Illinois.
24. Mikulincer, M., Florian, V. & Hirschberger, G. (2003). The existential function of close relationships: Introducing death into the science of love. Personality and Social Psychology Bulletin, 7, 20–40.
25. Nadar, K. (1996). Children's traumatic dreams. In: Barrett, D. Trauma and dreams. 9-24. Cambridge US: Harvard University Press.
26. Neumann, E. (1954).The origins and history of consciousness. Translated from the German by R.F.C. Hull. Bollingen Series XLII. Princeton University Press.
27. Norris, F. H., Friedman, M. J., Watson, P. J., Byrne, C. M., Diaz, E. & Kaniasty, K. (2002). 60,000 disaster victims speak: Part I. An empirical review of the empirical literature, 1981–2001. Psychiatry, 65, 207–239.
28. Nuttman-Shwartz, O. & Dekel R. (2009).  Ways of coping and sense of belonging in the face of a continuous threat. Journal of traumatic stress. 22(6), 667-670.
29. Phelps, A.J., Forbes, D. & Creamer, M. (2007). Understanding posttraumatic nightmares: An empirical and conceptual review. Clinical Psychology Review.28.338.355.
30. Phels, A.J., Forbes, D., Hopwood, M. & Creamer, M. (2011). Trauma-related dreams of Australian veterans with PTSD: Content, affect and phenomenology. Australian and New Zealand Journal of Psychiatry. 45(10), 853-860.
31. Pyszczysnki, T., Sheldon S. & Greenberg J. (2003). In the Wake of 9/11: The Psychology of Terror. Washington, DC: American Psychological Association. Punamäki, R-L. (1999). The Relationship of Dream Content and Changes in Daytime Mood in Traumatized vs. Non-Traumatized Children.Dreaming. 9(4) 213-233.
32. Punamäki, R-L., Ali, K. J., Ismahil, K. H. & Nuutinen, J. (2005). Trauma, Dreaming, and Psychological Distress Among Kurdish Children.  Dreaming. 15(3), 178-194.
33. Punamäki, R-L., Komproe, I.H., Qouta, S., Elmasri, M. & de Jong J.V.M. (2005).  The role of peritraumatic dissociation and gender in the association between trauma and mental health in a Palestinian community sample.American Journal of Psychiatry. 162, 545–551.
34. Putnik, K. & Lauri, M. A. (2004). Coping mechanisms and social support during aerial bombing. Social Psychology Review. 6, 14–29.
35. Raviv, A., Sadeh, A., Silberstein, O. & Diver, O. (2000). Young Israeli’s reactions to national trauma: The Rabin assassination and terror attacks.Political Psychology, 21, 299–322.
36. Schredl, M. & Reinhard, I. (2008). Gender differences in dream recall: a meta-analysis. Journal of Sleep Research, 17, 125-131.
37. Shalev A., Tuval R., Frenkiel-Fishman, S. & Hadar, H. (2006). Psychological responses to continuous terror: A study of two communities in Israel.American Journal of Psychiatry. 163, 667–673.
38. Silke, A. (2003). Terrorists, victims and society: Psychological perspectives on terrorism and its consequences. Sussex, U.K.: John Wiley & Sons.
39. Valli, K., Revonsuo, A., Pälkäs, O., Ismahil, K. H., Ali, K. J. & Punamäki, R-L. (2005). The Threat Simulation Theory of the evolutionary function of dreaming: Evidence from dreams of traumatized children. Consciousness and Cognition.  14, 188-218.
40. Valli, K., Revonsuo, A. Pälkäs, O. & Punamäki, R-L. (2006). The Effect of Trauma on Dream Content–A Field Study of Palestinian Children Dreaming. 16(2), 63-87.
41. Varvin et al. (2012). Traumatic dreams: Symbolization gone astray. In: Fonagy, P. et al. The significance of dreams. London: Karnac.
42. Wilmer, H.A. (2001). The healing nightmare: War dreams of Vietnam veterans. In: D. Barrett, ed. Trauma and Dreams, pp.85-99. Cambridge, Mass: Harvard University Press.
43.  ZeidnerGender Group Differences in Coping with Chronic Terror: The Israeli Scene. Sex Roles, 54(3-4),297-310.

   

   Table II: Percentages of Themes among Age Groups

Theme	Young (14-19)	Middle (20-40)	Old (41+)
Stress Situation Related	37%	25%	23%
Fear &Anxiety	35%	30%	29%
Helplessness andLoss of control	33%	33%	33%
No escape	10%	18%	14%
Active Ego	60%	64%	63%
Coping with the Situation	26%	23%	20%
Together	78%	60%	66%
Symbolic	22%	40%	36%
Masochism	50%	54%	44%
Shadow	24%	35%	28%
PI	29%	45%	51%

---