Eye Movement Desensitization Reprocessing (EMDR) is a controversial treatment for Posttraumatic Stress Disorder that requires clients to make rapid eye movements while revisualizing a traumatic event. Although seemingly effective, the process by which EMDR exerts its effects is poorly understood. We propose that EMDR's eye movements facilitate the orienting response, i.e., the attentional adjustment to unexpected stimuli. Since the orienting response has been implicated in spontaneous transformations of dream content during REM sleep, we reasoned that, similarly, activation of the orienting response during EMDR may facilitate content transformations in traumatic memories. To examine this hypothesis, 25 undergraduates completed 20 seconds of eye movements or 20 seconds of visual fixation before each of two tasks: 1) a covert visual attention task, in which a cue indicated the likely position of a subsequent target, and 2) a sentence rating task, in which sentences with either metaphoric or non-metaphoric endings were rated for strikingness. Repeated measures ANOVAs indicated that the eye movement manipulation facilitated attentional adjustments to targets presented in invalidly cued locations and increased the extent to which metaphoric sentence endings were found striking. Together these results suggest that the eye movements in EMDR induce attentional and semantic flexibility, thereby facilitating transformations in the client's narrative representation of the traumatic event. The implications of these findings for theories of dream formation and metaphor comprehension are also considered.

Masochistic dreams, as defined by Beck (1967), are reportedly more prevalent among women and individuals with past or present depression. However, it is unclear whether these prevalence differences are a function of depressogenic personality traits or fluctuating mood symptoms. In the present study, 30 men and 30 women without histories of major depression slept two consecutive nights in a sleep laboratory and reported their dreams from each REM period on the second night. Dream content from this sample was compared to that of 60 depressed participants who were studied previously under the same protocol. Analyses did not support a heightened prevalence of masochistic dreams among women or depressed individuals. Interestingly, the masochistic dreams of the non-depressed sample were equally distributed across the night, whereas depressed individuals tend to report masochistic dreams closer to morning. This hypothesized pattern suggests that masochistic dreams may be pathognomic of depression in that their occurrence near the end of the night affects morning mood with negative dream residue.

To test that REM sleep and/or dreaming aid in the overnight regulation of negative mood, 60 student subjects, selected to have no current or past episodes of depression, were tested with the Profile of Mood States (POMS) before and after two nights of laboratory sleep. There was a significant overnight effect of sleep on the Depression scale (Dep) both on a sleep-through night and a night of REM awakenings for dream recall. Pre-sleep Dep was significantly correlated with the affect in the first REM report. Although Dep scores were truncated due to the screening criteria, a subgroup of the 10 highest scorers differed from the 50 low scorers in the distribution of dream affect categories across the night. Low scorers displayed a flat distribution of positive and negative affect in dreams, while those with some pre-sleep depressed mood showed a pattern of decreasing negative and increasing positive affect in dreams reported from successive REM periods. This suggests that dreaming may actively moderate mood overnight in normal subjects.

To test the hypothesis that REM sleep and/or dreams contribute to overnight mood regulation, 61 subjects were tested on the Beck Depression Inventory (BDI), and for 3 nights of monitored sleep on two occasions, once close to, and 1 year after, a marital separation. Forty-nine percent of the variance in the follow-up BDI could be accounted for by the initial BDI score, and three sleep and dream variables associated with the mood regulatory hypothesis: eye movement density in the first REM, strength of the affect in the first dream and total number of negative dreams recalled from REM awakenings. Among the 39 who met BDI depression criteria initially, 71.8% could be classified correctly as remitted or not remitted at follow-up by discriminant function analysis based on the presence of negative dreams the first vs. second half of the night. Subjects reporting more negative dreams at the beginning and fewer at the night's end were more likely to be in remission 1 year later than were those with fewer negative dreams at the beginning and more at the end of the night. Early negative dreams may reflect a within-sleep mood regulation process taking place, while those that occur later may indicate a failure in the completion of this process.