The dreams of a patient with chronic PTSD suggested that she was engaged in an unconscious search for a ritual to address one of her traumas. As dream analysis proceeded, the ritual was imagined, thought through, and planned jointly by therapist and patient, and eventually it was performed by the patient outside of the treatment setting. The positive effect of the ritual on working through of the trauma became evident in subsequent dreams and in a significant reduction of overt symptoms. Anthropological and psychological views of ritual, particularly concepts related to the numinous aspect of these activities, provide a context for the therapeutic intervention.