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Certain states of mind in a patient are difficult to remain with and tend to evoke defensive countertransference responses which, if enacted, obstruct therapeutic progress. The state of mind discussed in this paper is ‘adhesive identification’, a term that arose out of a conversation between Esther Bick and Donald Meltzer, when Bick said of certain patients: ‘They are sticky, they stick …’ The author presents an outline of ‘psychic skin’ defences (Bick, 1968, 1986; Briggs, A., 2002; Briggs, S., 1998; Mitrani, 2001; Turp, 2003) followed by a more detailed account of ‘adhesive identification’ (Meltzer, 1975). Cohen's (2003) work on countertransference and integrity, based on her experiences in a neonatal intensive care unit, is described. These resources are employed as a framework for thinking about countertransference enactments arising in psychoanalytic psychotherapy with an adult, adhesively attached patient. Extracts from a session with the patient, ‘Janine’, are presented and discussed. In conclusion, the author returns to the proposed links between integrity in the sense of thoughtfulness and respect and integrity in the sense of the felt experience of being in one piece within a skin boundary.