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Now it is in this respect that the essential difference between the dream-work and schizophrenia becomes clear. In the latter, what becomes the subject of modification by the primary process are the words themselves in which the preconscious thought was expressed; in dreams, what are subject to this modification are not the words, but the thing-presentations to which the words have been taken back. In dreams there is a topographical regression; in schizophrenia there is not. In dreams there is free communication between (Pcs.) word-cathexes and (Ucs.) thing-cathexes, while it is characteristic of schizophrenia that this communication is cut off. The impression this difference makes on one is lessened precisely by the dream-interpretations we carry out in psycho-analytic practice. For, owing to the fact that dream-interpretation traces the course taken by the dream-work, follows the paths which lead from the latent thoughts to the dream-elements, reveals the way in which verbal ambiguities have been exploited, and points out the verbal bridges between different groups of material - owing to all this, we get an impression now of a joke, now of schizophrenia, and are apt to forget that for a dream all operations with words are no more than a preparation for a regression to things.

The completion of the dream-process consists in the thought-content - regressively transformed and worked over into a wishful phantasy - becoming conscious as a sense-perception; while this is happening it undergoes secondary revision, to which every perceptual concept is subject. The dream-wish, as we say, is hallucinated, and, as a hallucination, meets with belief in the reality of its fulfilment. It is precisely round this concluding piece in the formation of dreams that the gravest uncertainties centre, and it is in order to clear them up that we are proposing to compare dreams with pathological states akin to them.

The formation of the wishful phantasy and its regression to hallucination are the most essential parts of the dream-work, but they do not belong exclusively to dreams. They are also found in two morbid states: in acute hallucinatory confusion (Meynert’s ‘amentia’), and in the hallucinatory phase of schizophrenia. The hallucinatory delirium of amentia is a clearly recognizable wishful phantasy, often completely well ordered like a perfect day-dream. One might speak quite generally of a ‘hallucinatory wishful psychosis’, and attribute it equally to dreams and amentia. There are even dreams which consist of nothing but undistorted wishful phantasies with a very rich content. The hallucinatory phase of schizophrenia has been less thoroughly studied; it seems as a rule to be of a composite nature, but in its essence it might well correspond to a fresh attempt at restitution, designed to restore a libidinal cathexis to the ideas of objects.¹ I cannot extend the comparison to the other hallucinatory states in various pathological disorders, because in their case I have no experience of my own upon which to draw, and cannot utilize that of other observers.

¹ In the paper on ‘The Unconscious’ we recognized the hypercathexis of word-presentations as a first attempt of this kind.