Louise and her dad come in for their weekly visit with looks on their faces which speaks to a traumatic event. Louise, age six, says “we have been through a lot,” in a way that conveys she does not want to tell me all of her news in one sentence. Although only six, she seems to want me to guess as to what might have happened to her. She is teasing me, in a playful way. Larry, her fifty-year old dad, chimes in, “we had a car accident.” Larry’s tone and body movements are different than usual; he is more tense and uptight. Louise jumps in, “we got to ride in a big truck,” she says with excitement for the novelty of riding in a tow truck. Larry, who is not the focus of the treatment, concerns me in his demeanor. He has the appearance of “shell shock,” I tell him. It is the look of stiffness and detachment. Louise, on the other hand, appears relaxed and happy. Louise has some behavioral problems at school, but through our work together, as Larry tells me, she has calmed down quite a bit. “I have to say I am concerned about you, Larry,” I say, trying to walk the fine line of expressing a clinical judgment to someone who has not consented to be my patient. “Yea, it was pretty scary. I had Louise in the car and I just can’t believe how close we were,” stopping his sentence right before he seemed about to say how close they were to dying. “I can certainly imagine how terrifying that is,” I say, understanding that the motor vehicle accident broke through Larry’s denial about the finite quality to our lives. I know the accident was recent and that with time, Larry is likely to restore his old defense mechanisms, but I want to tell him that if this “shell shock” quality does not go away, then he should seek professional consultation. I am not exactly sure how to say this, so I end up saying, “let’s meet next week without Louise and see where we are.” Traumas are openings for the re-working of internal structure, but first they create a numbness that speaks to future suffering when the numbness wears off. “I am glad Louise is doing better,” I say refocusing our work back to Louise, but still concerned about Larry. “Yea,” Larry says with a flatness that is uncharacteristic for him. We stop on that heavy note of flatness.