CG," a 28-year-old graduate student, initially presented with complaints of depression, in response to social isolation and academic problems that had resulted in being placed on probation. Based on a history with non-nurturing parents who either neglected or physically abused him, CG had developed as an independent, interpersonally cut-off individual with a suspicious, paranoid view of the world, making initial therapeutic access to him quite challenging. Not surprisingly, in spite of a very

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... oblematic personal history, he had never before sought any kind of therapy, stating at intake that he was trying it as a "last resort." As the therapist, I employed a broadly defined, object-relations-focused, psychodynamic framework, with a particular emphasis upon balancing supportive versus insight-oriented modes of therapy. This balance turned out to be a key factor in developing an effective therapeutic relationship with this client and in helping him to move towards a more engaged and connected bond with his social world.