This article is a therapist review of the process that occurred during a systematic case study of psychotherapy with 'Martha', a female client who presented with depression, anxiety, alexithymia and dismissive/avoidant attachment style.Assessment, diagnosis of the client and treatment direction is described, followed by a detailed account of the therapeutic process through 12 sessions and 2 posttherapy interviews. Analysis team results are summarised, indicating support for the therapist's identification of issues during the process of the therapy. Particular attention is paid by the analysis team two points of rupture and repair, with pragmatic evaluation confirming that the relational struggles between therapist and client seemed pivotal in generating positive change.