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The author presents a model of clinical intervention based on patients’ mentalization, or mind reading, that is, the function of the mind to understand the mind. The action of mind reading means a type of thought, mostly not conscious, implicit, often not even encoded in words, that expresses the meaning “I think that you think that I think.” Thoughts about the analyst’s states of mind crowd the minds of patients, taking shape in these questions: “What do you think I have in mind?” and so “How do you plan to act towards me?” If the analyst does not capture and does not disambiguate the doubts, the patient’s perplexity and insecurity can intensify and produce emotions of anxiety, fear, fright, but also anger towards a silent interlocutor. Conversely, the analyst who mentalizes the state of mind of the patient and verbalizes it heteroregulates the patient’s fears and anxiety level. Mentalization and affect regulation are also related to the analyst’s recognition of the patient’s metacognition process. At the conclusion of the theoretical section, a clinical sketch shows examples, and highlights in therapeutic work the abovementioned theoretical issues.