Francesca Colzani’s rich report of her sensitive work with Elisa highlights the therapist’s struggle with the issue of the exercise of power and authority bearing on the patient’s choices. It is suggested that sometimes the analyst poses her dilemma in dichotomous terms, choosing, in effect, between coercion and passivity. Also, it is argued that moral choices can be obscured by a turn to medicalization, diagnosis and treatment, of the patient’s “condition.” An alternative is proposed in which the analyst may offer constructive suggestions imbued with her subjectivity—her experience of conflict and uncertainty—leaving Elisa room for the exercise of her own responsible agency. In finding her own voice, the analyst may awaken selves or aspects of self of the patient that might otherwise remain dormant, potentially to her detriment. An example of an interpretation of projective identification, with self-disclosure on the analyst’s part, is proposed that might encourage collaborative reflection on a seemingly dissociative dimension of Elisa’s way of being and relating.