The disruption and loss characterizing the lives of severely traumatized individuals, and particularly those who have been exiled, are addressed in “The Presence of the Past: Extreme Traumatization and Psychotherapy.” Such individuals frequently experience therapeutic encounters as threatening because they fear renewed traumatization. They are thus typically restricted in their capacity to build a trustful relationship. In his study, Varvin focuses on a mentalization disturbance resulting from trauma, and draws on case vignettes to support his attempt to develop an approach to the treatment of these patients. Of special historical significance here is the setting, which must encourage a process of historicization, permitting the contextualization of hitherto inadequately symbolized experiences.