In this commentary, I discuss two papers, one by Sandra Silverman and one by Maureen Murphy, each in different ways charting the challenges and possibilities in work where the analyst's subjectivity and the patient's cross or merge in demanding, sometimes tragic, sometimes brutally difficult ways. I consider the role of shame and mourning in the analyst's work to contain material with patients in profound distress and in important identificatory links to the analyst. I explore the demands on the analyst in these extreme situations and the dilemmas around analytic self care, a process I argue that is insufficiently theorized.