The paper “Who Cares?” describes attachment-based psychoanalytic psychotherapy with a man who had repeated experiences of early abuse and trauma, both in his birth family and in care. The paper makes use of recent developments in attachment theory including the Circle of Security® and attachment-based systems and applies them creatively to understanding how attachment traumas have impacted on this man and his later relational life. This includes reflections on the impact of such trauma on his responses to caregiving, his ability to care-seek, his response to feelings of threat, his internal environment, his sexuality, his peer relationships, and his ability to explore, relate, and develop in his external environment and relationships. The paper highlights some of the clinical issues that arose in the work and identifies what was helpful in enabling this man to develop both an increased sense of well-being, and an ability to explore, internally and externally.