In this reply I respond to Cambray’s introduction of the “self-organizing” and “emergent” qualities of telepathic communication, looking more closely at the relationship between dissociation and the emergence of telepathic phenomena. I highlight the creative aspect of such telepathic “intrusions,” viewing the clinician’s capacity for intuitive imagination as key to the emergence of telepathic material. In response to Eshel’s connection between the analyst’s “presence,” “absence,” and the patient’s unmet need for recognition, I examine the roles of co-construction and mutual dissociation in transference-countertransference enactments that generate uncanny phenomena. Verbal interpretation not always being the most viable mode of communication, “absence” can sometimes serve as a co-constructed, unconscious “solution” to the problem of multiple conflicting needs, holding a space for telepathic emergence to express the inexpressable.