Therapeutic action in Christine Kieffer's treatment of “Dina” inheres in the re-organization of Dina's implicit patterns of affect and arousal regulation, which, in turn, facilitate moments of mutual recognition and enhanced reflective capacities. This article explores the case in the context of contemporary psychoanalytic theories that embrace the fundamental significance of implicit, non-linear mutual and self-regulatory processes. The discussion highlights the role of maternal disrupted affective communication patterns in the development of dysfunctional attachment and the acquisition of controlling strategies that further compromise an individual's ability to form healthy relationships. Dina's growth in the context of her relationship with her analyst illustrates many of the key concepts in theories of intersubjectivity, mentalization, and psychoanalytic complexity.