Case material, disguised for confidentiality, is used to show the way interpretations are made from the Modern Kleinian therapy approach and how these interpretations evolve during the course of a session and throughout treatment. Issues of focus on defense and/or internal phantasy conflict are discussed and the centrality of projective identification and phantasy are then illustrated. In detailed clinical reports, the patient’s internal object relational struggles are highlighted, explored, and challenged with supportive interpretation. This includes a focus on transference, countertransference, and containment.