This chapter is concerned with the relationship between imagination, communicative musicality, intersubjectivity, and therapeutic practice. It begins with a personal account of the history of the theory of Communicative Musicality, tracing its origins in the domains of psychology and psychobiology (including the study of child development), psychiatry, and the neuroscience of emotion, with particular reference to the work of Colwyn Trevarthen, Daniel Stern, and Jaak Panksepp. There is discussion of the relationship between phenomenology and intersubjectivity, beginning with Husserl and Heidegger, and leading toward the work of Daniel Stern and the importance of the idea of the “present moment” in both psychotherapy and everyday human relationships. The chapter goes on to describe how the theory of communicative musicality and related psychology, psychobiology, psychiatry and neuroscience have influenced therapeutic creative work with children who are victims of conflict. There is discussion of the pathology of PTSD, including dysregulation of the autonomic nervous system, endocrine systems, movement repertoires and breathing, and the potential for communicative musicality to help alleviate both mental and physiological symptoms. The chapter ends with an example of work with imagination, communicative musicality, intersubjectivity, and therapeutic practice in the field, with Syrian refugee children in the Beqaa Valley, Lebanon.