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Although psychoanalytic psychology and Piagetian psychology share a developmental point of view, they have had relatively little impact on each other. One school, called "clinical-developmental psychology," has brought Piaget's theories closer to clinical theory and psychotherapy. The authors take two concepts important to psychoanalysis—"psychological boundaries" and "externalization"—and reinterpret them in a "clinical-developmental" framework around three cases, in hope of furthering the dialogue between psychoanalysis and Piagetian psychology. The relative scarcity of attempts to integrate these theories is due to Piaget's and his early followers' heavy emphasis on cognitive factors. The more recent social-cognitive theorists building on Piaget's theory are more interested in moral development and other clinical phenomena that may make dialogue possible. The authors sketch some of the recent developments in social-cognitive theory, identify some of the leading theorists, and introduce us to their own developmental stages. They next return to the concepts of boundaries and externalization and the related concept of projective identification, pointing out the clinical importance of and yet the lack of clarity about their meaning and exact mechanisms. These concepts seem to them to represent the intersection of ego psychology and object relations theory. They believe that psychoanalysis currently treats boundary phenomena as an exclusively early development issue, and self-object phenomena as only a quantitative, and not also qualitative, issue. A "clinical-developmental" point of view provides a "life span developmental" perspective that considers not only early life experiences, but also an ongoing self-other experience. Noam and Kegan present three case vignettes to help clarify their points. They suggest that concentrating on boundaries and externalization might lead to more fruitful dialogue between psychoanalysis and Piagetian psychology.