My treatment of Lily, a patient whose previous analyst had succumbed to Alzheimer’s disease, was marked by extremes in her feelings for me. Following an initial period of seeming indifference in which she struggled to make sense of her long analysis, she came to idealize me intensely. Soon after, she met even slight lapses in my empathic attunement with ferocious rage and anguished despair. Acknowledging my lack of attuned responsiveness seemed only to increase her suffering. I finally came to understand the meaning of her pained reactions when I re-experienced the sorrow I felt at the ending of my own analysis. The coincidental onset of my own mother’s dementia and eventual death during my work with Lily had blinded me to her fear that I would re-traumatize her and had prevented me from helping her to grieve.