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In 1985, British psychoanalyst Hanna Segal delivered the paper ‘Silence is the Real Crime’ to the first meeting of the group International Psychoanalysts Against Nuclear Weapons in Hamburg, appealing to her fellow analysts to counteract the denial of the geopolitical realities that characterized the late Cold War by intervening in public debates regarding the threat of nuclear war. A year later she gave a paper in London discussing clinical cases of patients who brought their nuclear anxieties to the couch. This article considers Segal's political and clinical writings on the psychological consequences of the atomic age, situating them in the context in which she was living, writing and practising as an analyst: 1980s Britain in a moment of ‘nuclear anxiety’. I argue that Segal's anti-nuclear writings shed light on what she called the ‘very very tricky’ relationship between psychoanalysis and politics. Segal confronted the tension between maintaining clinical neutrality in the consulting room while publicly expressing her political commitments, wrestling with the complex relationships between individuals and the societies in which they live.