In this paper, using my clinical work with a 3-year-old boy who lost his hearing when he was between 9 and 12 months old, and whose disability was only discovered when he was 22 months old, I will explore two issues of paramount technical importance when working with trauma. Firstly, it is crucial to create a boundary around the traumatic event, so that life before, during and after the trauma can be circumscribed and the traumatic event explored and hopefully understood and integrated. Secondly, it is of paramount importance to establish the level of developmental organization at the time of the trauma, especially in relation to the capacity to integrate bodily affects into mind. I will show how trauma and its vicissitudes are directly dependent on the person's capacity to resolve the splitting that trauma creates in the mind, and also the key role played by the use of metaphors in the process whereby trauma becomes thinkable and can therefore be integrated into the self.