Bion asserted that the possibility of change inherent in emotional growth and development was inevitably linked to fears of catastrophe. Did he intend this to apply to all patients and parts of the mind, or only to psychotic areas of functioning? Does subsequent clinical experience substantiate the universality of this assertion? These questions will be taken up from a general theoretical perspective in an attempt to understand what Bion had in mind when he proposed this view, and a clinical case will be presented to illustrate and examine the link between catastrophe and change.