Despite the early interest of Freud and Ernest Jones, posttraumatic nightmares have long been exempt from psychodynamic investigation. The neglect is accounted for by one simple reason: posttraumatic nightmares have not been viewed as psychodynamic events at all. Rather, they have been assumed to be literal replays of trauma to which the dreamer was subjected; in Freud's terms, such nightmares have been understood as simple "manifest content" lacking and latent meaning. In Posttraumatic Nightmares, Melvin Lansky challenges this long-accepted view in the first comprehensive study of posttraumatic nightmares as true mental products rather than signs of posttraumatic reaction.

Lansky's study draws on a unique research project. He and his colleagues compared nightmare texts with conscious reports of trauma in a population of 200 psychiatric inpatients hospitalized over a seven-year period. This project showed that patients' retelling of nightmare scenarios was significantly discrepant from the patients' waking accounts of their traumas. Furthermore, the distortions served the dream work in the manner of everyday dreams: they helped to screen out intolerable latent dream thoughts.

Posttraumatic Nightmares is not only an empirically grounded expansion of psychoanalytic dream theory to the phenomena of posttraumatic nightmares. It is a refinement of dream theory per se. Enriching psychoanalytic theory with the insights of family systems theory, recent trauma research, and contemporary perspectives on affect, Lansky proceeds to a clinically compelling finding: that posttraumatic nightmares, understood psychodynamically, can play a major role in the treatment of trauma victims.