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Mentalization-based techniques constitute a promising component of treatment for children who suffer from severe psychopathologies and are less receptive to classical psychoanalytic child psychotherapy. This treatment approach, which focuses on identifying mental states in oneself and others, proves particularly useful in the treatment of children who have relational conflicts and tend to act out their difficulties. The authors present the clinical history and the psychotherapeutic process of a 9 year-old girl whose mother had a diagnosis of borderline personality disorder. They discuss the implications of this case for recent theory and research on mentalization and affect regulation. They discuss some therapeutic techniques the therapist adapted to the child’s treatment and had an impact on the evolution of the child’s ability to mentalize and regulate her affects.