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The Concept of Analytic Contact. Defining Psychoanalytic Treatment. Clinical Reality and the Concept of Analytic Contact. The Kleinian Interpretation: Bringing Theory into a Clinical Stance. Projective Identification, Everyday Life, and the Analytic Situation. Caution and Reluctance Concerning Psychological Engagement. Reality, Phantasy, and the Fragile of Analytic Contact. The Analyst as Translator: Speaking the Unspoken. The Patient’s Desire to be Parented Void of Growth or Change. Drugs, Mutilation, and Psychic Fragmentation: Is Analytic Contact Still Possible? Addictions. Psychic Mutilation and the Struggle for Integration. Fragmented Attachments. Clinical Reality, Psychoanalysis, and the Utility of Analytic Contact. Loss. Looking at Films for Perspective on Structural Change. Psychoanalysis or Psychotherapy: Shifting the Debate to a Clinical Focus. Summary. Bibliography.