This article addresses the question of how individuals construct their picture of reality and develop a sense of meaning in their lives. This question is pertinent to effecting and understanding change in the process of psychodynamic psychotherapy and psychoanalysis. Three themes are explored. The description and utilization of a particular form of clarification that is not described in the psychoanalytic literature is followed by an illustration of how this form of clarification creates order and cohesion in one's life. This is further developed by a discussion of how the philosophical concept of constructivism enriches this awareness. Patient anecdotes illustrate these themes.