The Dream Keeper‘Bring me all of your dreamsYou dreamerBring me all yourHeart melodiesThat I may wrap themIn a blue cloud-clothAway from the too-rough fingersOf the world.’Langston Hughes (1932)In this article we discuss working with an older client whom we both worked with at different points over a three-year period. Our client displayed a complex range of symptoms consistent with PTSD, unresolved loss and depression and, somewhat staggeringly, had suffered a recurrent distressing dream for over 60 years. We demonstrate how an evolving integrative formulation guided our interventions with this client and argue that the pivotal piece of work involved a re-scripting of the recurrent dream. We propose that this intervention, comprising an overarching life review framework, cognitive restructuring, behavioural experimentation and containment within a strong therapeutic relationship, was ultimately associated with a reduction in distress. We hope to illustrate how such an approach can be helpful and that meaningful change is possible in the oldest-old who suffer from chronic PTSD.