Psychoanalysts have not studied nightmares with near the rigor they have applied to dreams. In this absorbing and provocative book, the authors develop a complex formulation of the role of nightmares in posttraumatic patients. Much of the book is based on a seven-year study of inpatients in a veterans hospital. In an impressive synthesis of several different perspectives, including attention to narcissistic elements of shame and humiliation, a psychoanalytic understanding of dreams, and an intergenerational family focus, the authors evolve a revised concept of wish fulfillment linked intimately to the integrity of the self. Although familiar with the language of descriptive psychiatry, the authors take an approach that is always psychoanalytically informed, and they end the book with some useful considerations about the implications of their theory for treatment strategies.