Freud developed many of his theories and technique while attempting to help hysterical patients. This article approaches hysteria not just as a syndrome consisting of a group of signs and symptoms, but primarily as an inner world configuration that fuels object relations patterns. The internal world hysterical profile informs the transference/countertransference experience and the therapeutic process. I attempt to describe some of the technical problems psychoanalysts have to deal with while working with these patients. Hysterical object relations do not necessarily manifest themselves as somatic symptoms—epileptic-like, paralysis, blindness, etc.—even in patients that show the relational hysterical patterns. These object relations modes can appear in any analysis irrespective of the primary diagnostic conceptualization.