I have tried to focus on several areas intimately linked with clinical work where ambiguities are sufficiently pronounced to disrupt the search for a cohesive framework—a common ground. Those areas include normal development, pathogenesis, the concept of the psychoanalytic process, and the nature of the therapeutic interaction. Analysts need a concept of normality to help sort their data; we need a classification of disorders to specify the domain of our treatment; we need a concept of process to categorize expected encumbrances to the cure; and we need perspectives about the therapeutic relationship to help specify the sources of the encumbrances. An excess of ambiguity in these areas compromises those needs and burdens productive discourse.