This paper describes psychotherapy with two adolescents who are in the care of the local authority. Attention is drawn to the fact that the social workers responsible for these young people can be drawn into the chaos, despair and helplessness of their client's internal states. This is linked to the therapist's struggle to think, maintain hope and sustain a structured space. Interpretations address the leading anxiety and transform repetitive acting out into communication. The paper illustrates the relationship between the compulsion to act out and the bleakness of an internal world within which there is no sustaining object, and explores the potential for a therapeutic setting to provide a structured space within which traumatic experiences can be named and thought about.