This essay discusses the initial period of work in a clinical case undertaken by a first-year psychological therapies trainee. It describes the challenges of beginning such work in tragic circumstances, how the therapist and the institution managed that, and the emergence of creative possibilities alongside painful and deadening experiences. Developmental implications for the child are reflected on, as the themes of the work and the therapeutic relationship are described and illustrated with vignettes. The value of the psychological therapist's observant thoughtful presence, and naming and containing the child's emotional experiences is noted, and alongside a supportive network, considered to facilitate a more creative engagement with life for this young child.