An interpretive strategy, based on current infant research, is described that facilitates engagement with emotionally constricted patients who appear to form little attachment to their analysts. Relevant research is reviewed and clinical material is presented to illustrate the presence of highly restrictive early modes of self- and mutual regulation organized in childhood and minimally transformed through later experience. These nonverbal presymbolic forms of relating constitute adult versions of the early interaction structures that protected the infant from trauma and continue to be used by patients to avoid retraumatization. How these configurations appear in the transference and can be reorganized in the analytic relationship is also detailed.