This article sheds light on the concept of Nachträglichkeit as a basic psychoanalytic concept that not only contributes to the explanation of the dynamic evolution of traumatization but also may serve as a basic concept in the understanding of the creativity inherent in the transformative process towards curative psychic change. We will argue 1) that Freud’s concept of Nachträglichkeit can be seen in a broader perspective than as a way to understanding only the mechanism of the trauma. This will be done through a presentation of some fundamental and more recent viewpoints and interpretations of the concept; 2) that the concept of Nachträglichkeit as a complex dynamic causality of proactive and retroactive processes is a basic concept in the understanding of psychoanalytic practice as such; 3) that the dynamics of the curative effects of the psychoanalytic process may rely on the analyst’s ability to include conscious and unconscious creativity in the work with the repetitive aspects of Nachträglichkeit.