What follows is the text of a talk presented at the sixth annual conference of the Affiliated Psychoanalytic Workgroups held in Omaha, Nebraska in September 2004. The APW began several years ago with the aim of providing lines of communication between otherwise disconnected Lacanian groups in the United States. The 2004 conference was hosted by the Centre for Psychotherapy and Psychoanalysis, Creighton University, Omaha. This centre was established four years ago and provides a locus of study and discussion for people coming from different perspectives and training in the fields of psychoanalysis and psychotherapy, including Lacanian and Kleinian. Originally suggested by Tom Svolos, the Centre has been supported with tremendous enthusiasm by Daniel Wison, Professor of Psychiatry in Creighton University, a self-confessed biological psychiatrist with a doctorate in anthropology.