In this paper I examine absence—absence as an internal relationship, absence as an enactment, absences characteristic of psychotherapy, absence as a theory, and absence as something people do to each other, including patients, therapists, families, and societies. To illustrate these ideas, I discuss my work with Gemma. When absence enters our relationship in a very present way, the powerful emotions that absence eludes come alive for us. Forced to confront my own absences, I begin doing a better job of holding her in mind, which ultimately helps her to hold me in mind and make better use of me.