This article explores the application of mother–infant research and systems theory in treating children whose capacity to symbolize is severely impeded. Working with children who do not play or talk involves the creation of a transitional space to foster the development of their symbolic capacities and intersubjective relatedness. The clinical material examines the unfolding of the mother–infant patterned interaction, including ruptures without repair. Therapeutic action begins with the experience of imitation, state sharing, leading to the emergence of intersubjective relatedness. Self-with-other structures shift and transform as the child is provided with the new relational experience of finding himself or herself in the mind of the other. Ideas expressed may also apply to the treatment of silent adult patients.