SOMNAMBULISM

A dissociative reaction in which repressed impulses, anxieties or conflicts are acted out during sleep.Somnambulism is more than merely walking in one’s sleep, since the sleeper not only leaves his bed, but engages in some more or less complex activity that fulfills a wish or releases tension. Somnambulistic states have been described as fugue states occurring during sleep. They are, usually shorter than fugues, since they last only a few minutes or at most a half hour. Different types of activities may be performed during the episode—for example, the sleeper might re-enact a traumatic event, write a letter revealing hidden feelings, or rummage through the attic to find a photograph of an old flame.There are a number of fallacies about chronic sleepwalkers. Contrary to popular opinion, they may actually injure themselves. Somnambulists have been known to fall down stairs and step in front of moving cars. Such accidents do not often occur, however, since their eyes are open and they usually respond to warnings. Many people think it is dangerous to awaken a sleepwalker, but this too is false. He may be surprised and bewildered when suddenly awakened, but this does him no particular harm.Somnambulism occurs primarily in individuals who have a tendency to act out their tensions rather than discharge them in dreams and fantasies alone. The actions they perform may, however, serve other purposes than reduction of tension. The re-enactment of a disturbing experience may be an unconscious attempt to gain control over it, and the peculiar gestures or strange behavior of the sleepwalker may represent an attempt to resolve an emotional conflict. During sleep one young man climbed on a table and waved his arms as if he were addressing an audience. When he was awakened, he revealed that he had dreamt he was standing on a soap box in Hyde Park delivering a speech about freedom for all men. It was later found that he had been rebelling against his parents, who were loathe to give him any independence.Somnambulism is most common among adolescents, and occurs in males more often than females. They are generally immature, suggestible, dependent individuals who exhibit other neurotic symptoms as well. Short-term therapy is usually effective in eliminating the symptom, but it may be replaced by other neurotic manifestations. In that case, more extended psychotherapy is usually recommended.Illustrative Case:A thirteen-year-old boy would get up in his sleep and walk to his parents’ bedroom, open the door, and attempt to get into their bed. If they asked him what he wanted, he would either murmur unintelligibly or walk on toward the front of the house. If they said, “Go back to bed,” he would turn round, go to his own room, and sleep until morning.This boy was strongly attached to his mother. His father, of whom he had always been afraid, was idealistic, but strict and demanding; he never showed the boy any affection. The latter’s attitudes toward his father were so strongly repressed that he never became consciously angry at him, although he was frequently severely punished. He was often in a state of severe conflict about masturbation, felt worthless and guilty and feared discovery and disapproval. As a result of this fear, he became markedly fatigued. Unconsciously he longed for his parents’ affection and approval and at the same time felt strong hostility, particularly toward his father. One by-product of this situation was that he became excessively religious.Walking into his parents’ bedroom was an unconscious way of satisfying impulses which were totally repressed in the waking state. (Maslow and Mittelmann, 1951)