Insight and Dissociation in Lucid Dreaming and Psychosis

Dreams and psychosis share overlapping features in symptoms and brain activity, offering a testable model for conditions like schizophrenia and delirium. This review examines two key concepts: insight and dissociation. Insight in dreams is central to lucid dreaming, where dreamers become aware they are dreaming and often try to control the narrative, alongside dissociative experiences similar to depersonalization and derealization. These concepts also apply to psychotic illness. While insight may be harmless in lucid dreaming and even beneficial in psychosis, dissociation remains poorly understood. Comparing these phenomena helps clarify their psychological and neurophysiological roles.

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Abstract

Dreams and psychosis share several important features regarding symptoms and underlying neurobiology, which is helpful in constructing a testable model of, for example, schizophrenia and delirium. The purpose of the present communication is to discuss two major concepts in dreaming and psychosis that have received much attention in the recent literature: insight and dissociation. Both phenomena are considered functions of higher order consciousness because they involve metacognition in the form of reflective thought and attempted control of negative emotional impact. Insight in dreams is a core criterion for lucid dreams. Lucid dreams are usually accompanied by attempts to control the dream plot and dissociative elements akin to depersonalization and derealization. These concepts are also relevant in psychotic illness. Whereas insightfulness can be considered innocuous in lucid dreaming and even advantageous in psychosis, the concept of dissociation is still unresolved. The present review compares correlates and functions of insight and dissociation in lucid dreaming and psychosis. This is helpful in understanding the two concepts with regard to psychological function as well as neurophysiology.