Nightmares of a hospitalized rape victim

The author presents case material, including nightmares, of a recently raped female psychiatric inpatient. The material shows dream dynamics that include latent content, dreamwork, secondary revision, and unconscious wishes that attempted to deal with this woman's sense of fragility, guilt, and especially shame. The author suggests that such dreams deal not simply with the trauma of forced sexual contact, but also with the coexisting fear and humiliation related to the risk of being murdered; with preexisting trauma that amplifies the shame and guilt; and with the anticipation of retraumatization during heightened posttraumatic vulnerability. Although conclusions from a single case cannot be generalized to all rape victims, a close examination of the clinical data suggests that treatment needs go far beyond consideration of the traumatic event in isolation.