The central thesis of the paper – that the seriously disordered patient’s use of language is central to retrieving and containing split-off and dissociated aspects of mental life – is taken up in this discussion both with respect to its possible clinical utility and as a broader critique of contemporary trends in clinical theory. Certain questions are raised regarding the ambiguity inherent in our relation to language, the importance of shared perceptual and speech patterns in setting up a basis for linguistic communication, and the constant search for new ways to use words in the clinical situation.