During the clinical dialogue with some of the most severely troubled psychiatric patients, in those moments when the patient’s state of mind is deeply shattered, it is vital to preserve the intersubjectivity of the experience from sinking into reciprocal withdrawal of attention and understanding. Empirical evidence and clinical reflections stemming from attachment theory might be of great assistance to psychotherapists engaged in the diffi-cult task of maintaining an empathic understanding of their patients’ states of mind when, during the clinical dialogue, they become fragmented and imbued with contradictory, dramatic emotions such as those indicated by quick shifts between expressions of hope and expressions of rage, sorrow, and fright.