This chapter discusses art and science of psychotherapy writing, about the importance of case studies in writers’ work and about the special challenges that arise in writing them. Trauma turns a person's life upside down: the door to chaos is thrown wide open. Furthermore, it is in the nature of trauma to resist representation. The question of confidentiality can be a source of additional complications where a patient has been subject to traumatic events or situations of an unusual and highly specific nature. Every case study is a raid on the inarticulate. A conversation between a practitioner and patient is as complex and messy as any other conversation. Since a factual description of the trauma would be likely to identify Declan not only to family and friends but also to anyone who had read the newspaper report, it was evident from the start that the details of the trauma would have to be changed.