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In this discussion of Philip Ringstrom’s provocative paper (this issue), I attempt to elaborate on several concepts: the role of “something” and “nothing” in psychoanalytic treatment, the problematic nature of the search for truth, the dialectic of aliveness and deadness, and the inevitability of improvisation in the pursuit of aliveness in the crucible of treatment. I also enumerate several transference–countertransference vulnerabilities inherent in improvisation.