This article is a telescoped narrative of a seven year psychodynamic therapy with a chronically depressed, chronically suicidal, often paranoid woman who presented with a classic Borderline Personality Disorder. An unexpected and powerful moment of physical contact in an otherwise austere therapeutic relationship marked a turning point in a treatment that was blocked. After the patient and clinician integrated this experience, there was a subtle but significant change in the transference reflecting a change in her core paranoid structure.