The author reflects on his work with a child patient struggling with affect regulation, loss, and his adoption through a detailed process account of the treatment with a focus on the therapist’s inner dialogue in relation to the child’s play and words—how each affects the other. Drawing from his personal use of clinical theory stemming from multiple theoretical influences, the author shows how his associations, identifications, and tentative formulations inform his work and how the various transference/countertransference matrices influence his inner dialogue. Attention is paid to the movement from the therapist as an object within the patient’s closed system to a system that gradually becomes more open, in which the patient is able to take in the therapist’s own person as they come upon various ways to communicate and build a narrative together.