I review the virtues and limitations of the narrative paradigm in contemporary clinical practice. I contrast ‘episodic’ and ‘diachronic’ forms of life, the former characterised by no particular predisposition to see one’s life in narrative terms and the tendency to experience oneself fragmentarily. After highlighting a progressive decline of storytelling in the current socio-cultural scenario, I show how a number of conditions (borderline-type personality and identity development in adolescence) are marked by reduced ability to organise narratively one’s own experiences. I emphasize a mismatch between the episodic and fragmentary phenomena characterizing these conditions and the prevailing opinion among clinicians belonging to academic culture that values instead the narrative paradigm. In the training of the clinicians, in addition to the necessary skills related to the diagnostic framing of the patient’s symptoms, and in addition to narrative competence, the capacity to embrace all that is fragmentary (that is, what at face value escapes diagnosis and narration) is necessary. I corroborate the approach with a theory taken from contemporary art criticism called ‘aesthetics of post-production’ and its capacity to re-signify the meaning of fragments by recontextualizing them. The personal ‘knots’ in the patient’s experience can be preserved and enhanced only through fragment-oriented listening.