This is a response to the discussions of the case presented by this author. Responding to the discussions has allowed the author to pull together her own ideas about the case as well as about the work we do. The author sees Sheldon (Shelly) Bach's view of sadomasochism as a particular type of object relationship as informing her own point of view. Next comes a discussion centering on Steven (Steve) H. Knoblauch's emphasizing the importance of the internal symbolic world of the patient. The author makes the point that understanding the level of differentiation of the internal objects in the patient's representational world is important in thinking about the types and timing of interventions the analyst makes; for example, those which Mary-Joan Gerson describes in her comments. Finally, the author addresses Sue Grand's response, especially her emphasis on the importance of siblings in our patients’ histories and the resulting sibling transferences to the analyst.