This paper follows the progress of intensive psychoanalytic psychotherapy offered to a severely abused and deprived 5–year-old boy in the first eighteen months of treatment. It attempts to show how certain adjustments to technique need to be considered to allow such a traumatized child to benefit from the held that is available. When a young child has encountered profound setbacks to early developmental processes the work in therapy must account for the absences of more ordinary communication and the presence of features which are full of mistrust and emotional bleakness. The role and the personality of the therapist are challenged in ways which demand an approach which may be considered unusually active in order to try to shape some meaning for the child without an emotional vocabulary.