Visiting psychologist Carolyn Fern's newest patient is Josephine Ruggles, an heiress whose nightmares leave glyph-shaped wounds across her back. Miss Ruggles's case is unusual, even for an institution like Arkham Sanatorium. Her case takes an even stranger turn after she claims to have met Malachi - Carolyn's former patient whose treatment was cut short when he was brutally murdered - in her dreams. When Carolyn uses hypnotherapy to address Josephine's trauma, they find themselves both journeying to a strange place Josephine calls "the Dreamlands."