In this paper, I describe the first 2 years of intensive psychotherapy of a multiply traumatized 5-year-old girl. I explore some of the ways in which violent and traumatic experiences were re-lived in the therapy and how they impacted on both patient and therapist. Within the discussion and illustrated by clinical vignettes, I consider the importance of play, not only as a vehicle for symbolic communication or as a means of re-playing and re-working internal object relationships, but also as the arena in which new experiences can be forged into internal reality, often for the first time. I also hope to raise for further consideration questions about the complex and disturbing experiences, pressures and technical dilemmas that are frequently encountered in such work.