Death Stud. 2013 Sep;37(8):750-67.

Dreams of the dead among Cambodian refugees: frequency, phenomenology, and relationship to complicated grief and posttraumatic stress disorder.

Hinton DE1, Field NP2, Nickerson A3, Bryant RA4, Simon N5.

Department of Psychiatry, Center for Anxiety and Traumatic Stress Disorders, Massachusetts General Hospital, Boston, Massachusetts 02114, USA. devon_hinton@hms.harvard.edu

Program in Clinical Psychology, Palo Alto University, Palo Alto, California, USA.

Department of Psychology, Boston University, Boston, Masschusetts, USA.

School of Psychology, University of New South Wales, Kensington, Australia.

Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts 02114, USA.

Abstract

The authors investigated the importance of dreams of the deceased in the experiencing of prolonged grief (PG) and posttraumatic stress disorder (PTSD) among Cambodian refugees who survived the Pol Pot genocide (1975-1979).

Such dreams were frequent in the last month (52% of those surveyed), and most often involved a relative who died in the Pol Pot period. Past month frequency was correlated with PG severity (r = .59) and PTSD severity (r = .52).

The dreams were almost always deeply upsetting because the dreams indicated the deceased to be in a difficult spiritual state. Dreams of the deceased as a central component of PG and PTSD among Cambodian refugees is discussed.

PMID:  24521031

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This article profiles bereavement among traumatized Cambodian refugees and explores the validity of a model of how grief and post-traumatic stress disorder (PTSD) interact in this group to form a unique bereavement ontology, a model in which dreams of the dead play a crucial role. Several studies were conducted at a psychiatric clinic treating Cambodian refugees who survived the Pol Pot genocide. Key findings included that Pol Pot deaths were made even more deeply disturbing owing to cultural ideas about "bad death" and the consequences of not performing mortuary rites; that pained recall of the dead in the last month was common (76 % of patients) and usually caused great emotional and somatic distress; that severity of pained recall of the dead was strongly associated with PTSD severity (r = .62); that pained recall was very often triggered by dreaming about the dead, usually of someone who died in the Pol Pot period; and that Cambodians have a complex system of interpretation of dreams of the deceased that frequently causes those dreams to give rise to great distress. Cases are provided that further illustrate the centrality of dreams of the dead in the Cambodian experiencing of grief and PTSD. The article shows that not assessing dreams and concerns about the spiritual status of the deceased in the evaluation of bereavement results in "category truncation," i.e., a lack of content validity, a form of category fallacy.

PMID:

23868080