Imagery and posttraumatic stress disorder: an overview.

A review of theories of traumatic neurosis or posttraumatic stress disorder reveals a relative neglect of the role of posttraumatic imagery. The broad range of imagery has not been recognized, nor its role in the disorder adequately formulated. A two-dimensional framework for understanding posttraumatic stress disorder based on 1) repetitions of trauma-related images, affects, somatic states, and actions and 2) defensive functioning puts into perspective the centrality of traumatic imagery, implies a reorganization of DSM-III criteria, points to new directions for research, and clarifies diagnostic and clinical confusion.