We Can Control Our Dreams
The enduring nature of dreams lies in their mysterious nature. With all our advances in technology, we still don’t understand why people dream and what exactly determines the contents of our dreams. Our forebearers considered dreams to be omens and premonitions of the future, while Sigmund Freud described dreams as windows into our subconscious mind. Today, we hypothesize that dreams are the product of our brains consolidating and processing memories from the day. Anecdotally, this conjecture seems to make sense. I often have dreams that relieve what I did and what I felt during the day, and the most vivid dreams are the ones that elicit the strongest emotions.
What is curious is that while the literal act of dreaming is retrospective and looks toward our past to construct itself, the figurative act is extraordinarily prospective. Dreams are borne out of the reality of today, but are anticipatory of the future.
Our ability to shape these figurative dreams is what makes them so potent. Unlike the uncontrollable narratives of our sleeping mind, our waking dreams—our visions and goals—can be refined, revised and acted upon. By choosing to focus on hopeful possibilities rather than limitations, we afford ourselves agency in shaping the future. Rheumatologists, in particular, must harness this ability, using our unique perspectives to dream up solutions that address the complexities of our patients’ needs.
The Art of Dreaming
Interestingly, not all people dream in the same way. There is an elite group of super-dreamers, of which I am not a member, who engage in lucid dreaming. Lucid dreams are those in which the dreamer becomes aware they are dreaming and uses this awareness to guide the narrative or explore possibilities within the dream. For some, lucid dreaming is a form of practice to simulate reality and confront challenges in a safe, imaginative space.2
What’s fascinating is how lucid dreaming mirrors the deliberate act of creative problem solving in the waking world.3 As rheumatologists, we face the most complex cases in medicine, which demand a curious blend of imagination and precision. Just as a lucid dreamer may experiment within the bounds of their dream, we can experiment within the framework of our knowledge and experience, envisioning new approaches to treatment, patient education or care delivery in the confines of our own clinic spaces.
Dreaming, in this sense, is as much an art as it is a science. It requires both structure and flexibility—a willingness to imagine beyond the obvious while remaining tethered to what is achievable. The most impactful dreams are not those that ignore reality, but those that engage with it creatively, finding new ways to address old problems.
