The author links the basic sense of reality to the infant's first configuration of psychic existence framed by the mother's presence, i.e., to primary identification. It creates the preconditions necessary for the psychic representation of bodily excitations and sensations. It also makes a shared human understanding possible. The sense of reality is not, however, only based on this configuration, but it is also linked with vital bodily functions that receive by identification a vital narcissistic significance. The shattering of these meanings may lead to a serious collapse of the sense of reality. This viewpoint is illuminated by a clinical example. Another clinical case demonstrates the importance of primary identification in organising the psychosomatic matrix of psychic functioning. The sense of reality is seen as a continuous inner dialogue with reality, a dialogue that follows the mode of primary identification like an ascending spiral. The original frame of psychic representation will be rediscovered by the individual in new contexts and at new levels of understanding, as if it were occurring for the first time. The author analyses the obstacles related to the instinctual dangers of separation, castration and the loss of love that may obstruct this dialogue, concluding the paper by referring to the psychic integration of one's mortality, of which the body is the most intimate reminder.