Patients, with some measure of unconscious hope and dread, seek vitalizing objects. These objects, which represent interactional processes, provide persons with subjective and intersubjective experiences of being alive and real. This article proposes that a constitutional structure of vitality, which is initially nonpropositional and preconceptual, is projected onto objects, rituals, and persons. Ideally this provides persons with subjective and intersubjective organizations and meanings of being alive and real. The development, transformation, and expansion of these organizations and experiences are contingent on the complex interplay of trusted significant figures, primary and secondary transitional phenomena, and the person's constitutional capacities. Patients often display varying degrees of constricted abilities to make use of shared objects to feel alive and real. A goal of therapy is facilitating the patient's capacity to risk creating, projecting onto, and making use of socially shared phenomena for more diverse and expansive organizations and meanings of feeling alive and real.