In the psychoanalytic setting, patients can develop a strong reaction to the therapeutic opportunity to gain new knowledge about themselves. This reaction to knowledge is manifested in the patient by walling it off, splitting it off, or attacking it and erasing it from one's internal experience. The avoidance of knowledge can be the result of various phantasy states that bring on defensive postures. Knowledge can be experienced as a persecutory threat to be avoided and defended against. Knowledge can also elicit depressive concerns of loss and separation. Issues of dependence and autonomy can be equated with knowledge and therefore learning must be warded off. As a result of any or all of these internal threats, the ego can instigate a moratorium on thinking and creativity, a shutdown on feeling, thinking, and learning. As will be shown in the case material, wanting to know can be offset by a greater defensive need to not know. Through projective identification cycles, knowledge is placed into the analyst and experienced as dangerous, unobtainable, or a gift one deserves to be given rather than earned. The patient in the case example demonstrates a more paranoid experience of knowledge and a more paranoid avoidance of learning and change. When paranoid phantasies drive the patient to destroy object-relational links between self and analyst, the transference becomes colored with the phantasy of knowledge being equal to dangerous dependence that leads to destruction of either self or object. Therefore, curiosity and learning are to be avoided. Change is no longer a safe option. Psychic change can only occur when past and current knowledge are allowed to be part of the ego's selfobject world. In other words, Psychic change is possible when the ego is less restrictive and open to new selfobject experience. Therefore, the ego must tolerate conflicted feelings and thoughts about the self and others for knowledge to be allowable and accessible. This is the core struggle for many patients and must be identified through interpretation of transference and phantasy for gradual working through to become a viable possibility.