This paper gives an account of the developments in the intensive psychotherapy of a seven-year-old boy with global development delay. It also describes the adaptations to technique and the changes in the setting that were required to support the work, which was undertaken in a special school. The importance of the regularity of sessions in helping to establish object constancy; physical and mental boundaries in relation to me/not me; inside and outside is also explored. A central theme of the paper is how close observation can inform the understanding of the emotional states of disabled children, particularly those with little language. The paper draws links between the early communications of mothers and infants and the therapeutic relationship, with reference to music therapy. It describes banging as a form of communication and traces the development of banging into more coherent nursery rhymes arguing that this development is an internalisation of the rhythm of the therapy and of the growing understanding between the child and therapist.