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This case study of a child with aggressive behavior. Traditional therapy did not work but therapy was successful using an approach that encourages clinicians and patients to analyze symptoms not solely as internal problems but also as meaningful responses to external stress. Comment: Dialogic praxis: clinicians and their patients engage in bidirectional critical analysis and learning. Patient actions to change their social environments can themselves be therapeutic. For more information see: https://tinyurl.com/dialogicpraxis N Engl J Med 2020; 382:201-204    (retrieved Jan, 2020). There are currently 1090 pearls in the database. While every attempt has been made to ensure accuracy, mistakes can and do occur. Use databank at your own risk. All pearls © 2024 by the Internet Medical Association. Click Here to view more medical pearls.