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Deconstructing the emotional relationship between patient and therapist is certainly a formidable task. Using research results from experimental social psychology, psychophysiology, and developmental psychology, this essay focuses on the automatic processes of mimicry, emotional synchrony, and physiological synchrony—all preludes to empathy. For the therapist to achieve an empathic posture, however, she must also imagine the perspective of the patient. Furthermore, to broaden and sharpen her empathic lens, she must tune in to the ubiquitous current of nonverbal communication that is part and parcel of the interactive treatment process. For these reasons, imagery proves to be a crucial element in the transition from simple attunement to empathy. A clinical vignette and a neuroscience perspective on image formation help illustrate the relationship between emotional contagion and imagery. It is suggested that there is a reciprocal relationship between the emotional ambience cocreated by the two participants and image formation. Sensorial images aid in the detection of gross emotional states as well as in the nuancing of their intensity. Affective ambience, on the other hand, seems to affect the selection of one particular image versus another.