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The seeds of creativity have the potential to germinate and flourish within the rich, ambiguous and unsettling tapestry of the core dialectical tensions related to the central organizing dialectic, life and death, generated in the patient-analyst relating. The author introduces the concept of the ‘dialectical edge’ and describes it as the pivotal point in the dialectical struggle within these core dialectical dilemmas. This is a fluid, emotionally evocative threshold, where there is maximum potential for change, as well as for homeostatic stagnation. Drawing on Winnicott, the author illustrates how the presence of an edge within these dialectical dilemmas has the potential to open up into a creative, reflective space. He suggests that this, however, will depend on the therapist's capacity to contain/hold at this edge the arousing and intense affects—such as anxiety, dread, excitement and passion—that are inevitably generated at these pivotal relational moments. This will determine whether the patient will move forwards into the light of a creative, reflective, dialectical space, or backwards into collapsed, non-reflective darkness, where fluid oscillation is transformed into rigid ossification. The author uses a clinical example to illustrate these dialectical phenomena, with a special focus on two clinically relevant dialectics, i.e. ‘ritual versus spontaneity’ and ‘closeness versus separateness’.