The question is how to construct such an interpretive environment outside of an inpatient setting. Quaytman and Sharfstein’s quarter-way house seems useful, but many institutions create a continuum of care with discontinuous staffing and therapy. With every change of program, patients also experience changes in nursing and other clinical staff, doctors, treatment teams, and peer groups. It is extraordinarily difficult to build and staff competently an interpretive community where the patient can find the integration she needs without providing concomitant continuity of the psychotherapy, marital treatment, and milieu intervention. Given the patient’s rapid shifts toward projection in all of these contexts, her inner and outer worlds must be worked with together—by clinicians trained in this specialized work and in communication with each other. In the hypothetical case, the crucial moment comes when the patient withdraws a negative projection from another patient. This follows her move from inpatient treatment to outpatient to quarter-way house. We wonder about the capacity of rapidly shifting settings to help patients use each other this way as well as how lasting such an internalization can be. In fact, even in the hypothetical case, there is ongoing evidence that the patient’s projections simply shift into her marriage, which falls apart as she considers supervised apartment living. This follows almost a year of treatment.