ABSTRACT
The complementary capacities of participating and observing are required of both patient and therapist in the clinical encounter. This chapter takes up those capacities in terms of the ability to play. Clinical presentations by James M. Herzog are used to show how both patient and analyst play and what happens when the patient is unable to play. The definition of play distinguishes it from lived reality – what Herzog calls its reversibility. That is, to be able to play, one must be able to leave reality and return to it. If either capacity is compromised, the distinction collapses, with profound clinical consequences.
