Ben is a slight, timid eight-year old boy who began having night terrors after a hospital admission in 2005 for gastro-enteritis. Ben would run out of his room and through the house, trembling and shaking his hands as if he had pins and needles, becoming extremely anxious and distraught if his parents tried to touch him. In 2007, a fire occurred in the semi-detached cottage next door, which spread rapidly to Ben's cottage. Ben was in bed at the time and he and his parents had to escape quickly. The house sustained a second fire one month later. Ben witnessed both fires, including the damage to the property and family possessions. The family were displaced for several months. Following their return, Ben's school reported uncharacteristic behaviour outbursts, which included incidents of kicking, biting or scratching and one episode of Ben 'stabbing' a friend in the hand, with a pencil. Ben was becoming withdrawn in the playground and reluctant to participate in group activities. He began to develop panic attacks during the day. He described people's heads appearing to grow larger or smaller, which terrified him.

Ben was referred in May 2008 by a consultant paediatrician at the county hospital. His parents selected Sarah and Robert who made up a family therapy team. In the first meeting, Ben decided with his parents and therapists help to 'chase Big and Small out of my life'. For this purpose permission was sought from school to carry a soft toy into class named Dogger that Ben had rescued from the house fire himself. The therapists briefed Dogger to report at future sessions on Ben's ability to manage Big and Small, at school and at home.

Panic had developed a clever way to keep Ben on the run and not himself, by insisting that Big and Small would come back and take over Ben's life if he talked about his distorted vision to others. So a system was evolved in which Ben, sometimes hiding among cushions, would speak what was in Dogger's mind to the other animals, who would then translate to Sarah and Robert. The therapists could then make guesses and suggestions which would be passed back up the line for response. A map was made of Big and Small's influence on Ben's life and ways in which he was fighting back. A diagram was constructed to show Ben's movements around the house during the night and the help he was obtaining by convincing his mother to sleep in a camp bed by the stairs.

The intervals during which Big and Small grew afraid to make their presence felt became longer and longer…three weeks, five weeks, eight…Ben started sleeping through the night and leaving his mother alone so that she was able to return to bed. Parents reported a much happier boy. He became more settled in class and no longer needed to rush out. In a session on their own, parents decided to change certain patterns of anxiety they held themselves. Father was busy developing a side of himself which was prone to laughter. Mother started a fulltime job which pulled her attention rather more away from her child. At the last session parents reported Ben's teacher as saying that he was now 'the one child he doesn't have to worry about in class'. Ben was much happier in himself and really enjoying school. Ben himself announced proudly to Sarah and Robert 'I have conquered Fear'.