The movement called Institutional Psychotherapy is grounded in the ongoing effort to install the necessary conditions of possibility for the liberation of the clinic from alienation. To care for psychotic and other suffering people, we need to create a supportive transferential field in which the human encounter is essential. This touches the Real and makes possible, in a moment of crisis, a transformation of the position of the Subject. The Collective, the pathic sculpting of the space-between-people, allows for the emergence of the singular, the unexpected, the impossible. The starting point of this article is the author’s experience in the psychiatric clinic of La Borde (France). Through a number of concrete examples and critical moments, it hopes to show the interweaving of the elaboration of conceptual tools and the therapeutic situation within an institution.