The hand represents the "acts of the hand" - those things that you do, have done or would do. In this scene it indicates that when committing an act or deed coming of a wrong perspective (the left hand) you are actually choking yourself. Choking yourself represents the idea of cutting yourself off from access to air, which means denying yourself access to higher consciousness and intelligence, especially God's Intelligence.

Sleeping on your back implies resting with complete peace of mind in a position, or with an attitude, that allows you to face the Lord. (face pointing upwards) Yet this scene shows that where you see yourself in such a position you are actually choking yourself. Note that reality would show that you do not rest at ease face up. (you are a side sleeper)

Feeling too paralyzed to stop implies that you feel you are unable to make a move to stop yourself from doing this. This is creating great anxiety on a subconscious level (the dreaming level), an anxiety that increases the longer you persist in this wrong doing. The anxiety has now become so extreme that it has begun to affect you even on a fully conscious (the awake) level. [Are you perhaps trying to live by ignoring the beliefs you were brought up with? Where there is anxiety within, you will be very prone to anxiety in the physical world - because there is no base of security within you.] You need to really wake yourself up, i.e. come to a greater state of awareness about this situation.