To be needy and helpless is one of the most dreaded experiences we are subjected to. If no one is available to hear our cries and to recognise and respond to our needs, we face the anxiety of abandonment and persecution. This fear relates to the helplessness and prolonged dependence of early infancy and is directly expressed through the need to fi nd and get through to an available object. The patient needs to reach and to make an impression on an object who is able to contain his anxieties – that is, one who is able to be emotionally responsive and able to understand rather than enact. When anxiety is high, the patient communicates his needs through projective identifi cation at a concrete level, and in analysis these concrete projections may make containment diffi cult since they provoke action rather than understanding.