Bruce Dow, M.D.

Surviving Day Two

During the period from 1991 to 1993 I was a Research Fellow in psychiatry at the University of California, San Diego (UCSD). It was the time of the first Gulf War. Vietnam Veterans who had been hiding out in their homes or in the woods for years were coming “out of the woodwork” into the open, their traumatic war memories having been triggered by the fighting in Iraq and Kuwait.

Vietnam Veterans and PTSD

I felt close to Vietnam Veterans, as we were nearly the same age. I decided in the early nineties to specialize in posttraumatic stress disorder (PTSD). Little was known about PTSD at the time. This presented a challenge to me. I became interested in the idea that PTSD was predominantly a disorder of sleep, and could be treated by helping PTSD sufferers get a good night’s sleep.

There were a few reports in the literature indicating that recurrent nightmares could be eliminated by changing their endings. A study conducted at the VA Medical Center in Phoenix had utilized dream revision treatment in a group setting, with encouraging results. I decided to try such treatment with Vietnam veterans in San Diego.

Dream Revision at the San Diego VA Medical Center

In 1993-1994 I was hired by the VA to set up an inpatient PTSD program. From late 1993 to mid 1994 I conducted a weekly dream revision group at the San Diego VA Medical Center. Both inpatients and outpatients with PTSD were invited to attend. Each week one veteran would be asked to present his nightmare to the group. We would then discuss the dream in detail, and put our heads together in a collective effort to change it. The veterans became very skilled at this, since they had been in Vietnam and had extensive technical knowledge regarding the paraphernalia of war in that setting.

Jack was a heavily decorated Army Major, forty five years old at the time he attended our “Dream Team” therapy group at the San Diego VA. He was married for the third time, Caucasian, with two grown children. He was a “Mustang”, having risen in the ranks from enlisted man to officer. He was big and tall, over three hundred pounds, a red-haired Irishman with a twinkle in his eye. He later became a “fee-basis” (VA contracted) patient in my outpatient practice as a civilian psychiatrist.

Memories of the Vietnam War

The revised version of Jack’s dream, worked on by the Dream Team in April, 1994, was entitled “Surviving Day Two”. In the dream, as in real life, Jack had just arrived in Vietnam for his first tour of duty. He was an FNG (f…ing new guy). A group of ten American soldiers were standing near a Vietnamese Coke (Coca Cola) girl, who was selling Coke and rice husks. Some of the soldiers were “short timers”, getting ready to return home. They told Jack to stay away from them; FNG’s were dangerous; he could get them killed. As he moved away from the group the Coke girl set off two hand grenades, killing herself and all ten of the American soldiers. Jack’s fresh uniform was covered with little bits of blood and body tissue. He felt terrible. The dream had tormented him regularly for many years since the event in Vietnam in 1966 more than 25 years earlier.

In the revised dream developed by the group, the hand grenades are given a longer fuse, providing fifteen seconds for the Americans to get away after the Coke girl activates the audible “spoons” on the two grenades. The men are at a safe distance when the explosions occur. The Coke girl blows herself up, but none of the American soldiers is injured. Jack’s uniform is still clean. There are no American body parts. The short timers are able to board the “Freedom Bird” and fly home to the US from Vietnam.

Successful Dream Revision

Jack told me that his nightmare did not come back after that single dream revision group therapy session. As his outpatient psychiatrist and therapist for eleven years (1996-2007), I was able to verify this for myself. He had other nightmares that we worked on, but this one did not come back.