The current study empirically investigates patient agency as a multi-layered and dynamic construct. We explored how agency appears before, during and after 20 sessions of psychodynamic therapy. Building on the Listening Guide, we examined interviews with a woman who had depressive complaints, paying attention to the main plot lines, associative logic and musicality in speech. As a result, we constructed four voices (i.e., ‘the caregiver's voice’, ‘the silent dictator’, ‘the inexplicable’, and ‘encouragement and doubt, fright and relief’) that shifted dynamically throughout the interviews. Each voice follows an idiosyncratic logic when it comes to agency. We interpreted the results building on psychoanalytic theory and the postmodern story notion and nuanced the concept of agency as implying both a subjective component that creates room for change and an egoic component that has a certain inertia and sustains the illusion of mastery.