This paper explores the nature of therapeutic action in a patient whose capacity for internalization was compromised. Drawing on and extending the work of Blatt and Behrends on the role of internalization in therapeutic action, the author presents the case of a patient whose defensive responses to the discontinuities in the therapeutic relationship, “experienced incompatibilities” in Blatt and Behrends’ model, complicated her ability to take in and make use of what the analyst offered. Elaborating on Blatt and Behrends’ understanding of the role of interpretation in therapeutic action, the author illustrates some technical approaches to working with patients who employ defenses aimed at thwarting internalization.