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The psychoanalyst treating primitively organized people has to be primitive and porous enough to carry the projections and enter into a seemingly undifferentiated envelope to establish contact. Like a member of a dysfunctional couple, he or she must evolve a separate skin so that language has the clout of bridge, rather than discharge. In this way, the analyst is trying to provide a distinct outcome to the formerly thwarted separation–individuation journey and in so doing functions simultaneously as a leading out and identificatory other. Language is only trusted when one trusts that living in one's own skin will not result in annihilation of self or other.
Inevitable breakdowns and failure of attunement occur in any treatment. An undiscovered countertransferential conflict can open up creative space, rather than ossify unresolved painful conflicts into stultified reenactments of sadomasochistic exchange. In two cases, feeling mortified, “Why couldn't I have known this sooner; how could I have done this?” the author finds that honest handling of such exposures marked the beginning of opening of creative space rather than a continuation of futile repetition.