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EMDR and trauma-focused CBT are considered to be the most effective treatments for PTSD, since they show high efficiency in symptom reduction. However, PTSD focused-treatment requires therapists to also address the subjective experience of patients who suffer from a dreadful internal reality and a threatening external reality. By relating to some of Bion's major ideas, the author demonstrates the interface between Bionian thinking and several components and techniques of PTSD-focused treatments. The role of the therapist during specific stages of PTSD-focused treatment, such as the processing of traumatic material and in vivo exposure, is also discussed.