This paper is an attempt to present and discuss the application of psychodynamic thinking and practice to working with people with epilepsy. The paper provides a general explanation of what epilepsy is, followed by a brief review of the existing psychoanalytic literature in relation to epilepsy. The core of the paper is a detailed case study describing a time-limited psychodynamic counselling with a patient in an epilepsy outpatient clinic at a large general hospital in the UK. This account aims to highlight some of the issues and themes in working with people with epilepsy, and to add to the limited literature available on psychodynamic work with this client group.