"Everybody distracts me and prevents me from succeeding”: A psychodynamic-oriented approach of medical students’ dreams of evaluation

Abstract

This investigation was based on 216 dreams of medical students about situations of evaluation. The manuscript reports on (i) how these situations are dreamt and what this reveals about dreaming students’ subjectivities, and (ii) the psychodynamic approach taken for the investigation of the dreams. Dreams were analyzed with a data-driven method based on three inter-related psychodynamic dimensions appearing in the dreams: quality of internal objects of the dreamer, intensity of the dreamer’s defensive stance and narcissistic impact of the evaluation situation on the dreamer. Presence or absence of good enough internal objects determined intensity of the defensive stances and the narcissistic impact. For some dreamers, the dreamt evaluation situation appeared as a catastrophic event associated with very negative experiences (e.g., feelings of despair and desire to die), despite the massively erected defenses (e.g., immature defenses like projection); inner objects appearing in the dreams of these students showed important deficits (e.g., abandon or rejection of the dreamer). This investigation of dreams revealed, that the issue of evaluation is very sensitive and represents for some of the medical students a major narcissistic threat. The psychodynamic approach chosen to approach the dream seem to be coherent, in line with psychodynamic dream research and allows to gain some insight into medical students’ subjectivities with regard to the omnipresent issue of evaluation.