Carmen was four years old when she was referred for intensive psychotherapy after a diagnosis of autism. She was functioning at a very primitive level, with limited capacities for communication and relationships. She had a passionate nature and a profound intolerance of separateness. In this chapter I will focus on the first year of therapy in order to trace her development from a primitive form of relating to a genuine attachment to me, which brought in its wake all the conflicts that each of us have to negotiate in the course of ordinary development. Her central conflict was between being ruler of her world or joining the real world, which, in spite of herself, she found increasingly fascinating and beautiful, but one where she would be a mere subject like the rest of us. This is often a conflict for children with autism, but was particularly starkly revealed in the work with this child, whom I have called Carmen to give some indication of her fiery temperament.