This article offers a narrative description of a challenging psychotherapeutic process from the vantage point of the author’s subjective experience. The treatment process, which evoked extreme states of fear and shame, ultimately culminating in a physical collapse, is considered from a self psychological perspective as well as a neo-Kleinian perspective. Projective identification, viewed herein as a bidirectional phenomenon, is considered in terms of its potential to expand and enrich our understanding of certain forms of selfobject transferences. Various iterations of coalescence and disjunction between the therapist and the patient are described, which reveal the dismantling and uniting influences of fear, shame, and destructuralization during the therapeutic process.