If Moon square Neptune sits in your natal chart, you've known this state since you were very small, even if you never put a name to it. Other people's feelings come into you as though they were your own. You walk into a room and you can tell, before a word is spoken, who has fallen out with whom. You listen to a piece of music and weep where everyone else just nods along. You look into someone's eyes and you understand more about them than they've told you — and more, sometimes, than they know about themselves.
On one side, that's a richness. On the other, it's a very expensive ability, because it's as if you have no separate skin. The line between "this is my feeling" and "this came from outside" is blurred almost all the time. As a child you may have fallen ill on the back of stress, had anxious dreams, been frightened by things the other children never noticed at all. Often, in families like these, there was a mother who was emotionally complicated. Not necessarily a bad mother — just a very sensitive, anxious, sometimes dependent one, who would sometimes vanish so deeply into her own feelings that the child was left without an emotional anchor and learnt to read her mood simply to predict how the day would go.
In adult life the aspect gives a character that's hard to sum up in a single word. From the surface you might be all sorts of different people, but on the inside there is always a little more of you than you let show. Tight schedules are difficult, because your energy rises and falls for reasons you can't always trace. Saying no is hard, because someone else's pain registers far too clearly. You take on what isn't yours to carry, then burn out, then blame yourself for the burnout — a tidy little loop that can run for years before you spot it.
Creative ability is almost always present with this square; the only real question is whether you've found a channel for it. A great many owners of this aspect write, paint, play, photograph, work in psychology or work with the body. For them, creativity isn't a hobby, it's a way of processing an overflow of feeling. Where there's no channel, that overflow goes inward instead, and that's when the patches arrive — apathy, anxiety, the sense of having "run out of strength for no reason at all".
Then there's the separate theme of illusions. This square is wonderfully good at inventing people and then believing in the invention. You can fall in love with someone you barely know and quietly build them a whole personality they don't actually possess. You can trust someone who hasn't earned it, because you feel a kindred soul in them, and that feeling can't be checked against logic. You can pity someone who is coping perfectly well on their own, while failing to notice your own exhaustion. Healthy work with this square begins exactly here: you stop automatically believing every emotion the moment it arrives, and you learn to test it instead.
The relationship with this aspect shifts as you age. Before thirty it tends to deliver vivid romantic episodes, stretches of immersion in art or spiritual practice, sometimes a brush with dependence. After thirty a more grown-up attitude to your own sensitivity usually arrives: you stop being embarrassed by it, but you also stop over-using it. By forty, many people find a form in which that fineness becomes a profession or a steady source of meaning. Some go into therapy as a client first and a practitioner later. Some begin to write, or to teach. Some find a partner who respects the rhythm and doesn't rush them.
The central task of Moon square Neptune in the natal chart is to learn to tell yourself apart from the space around you without losing your ability to feel that space at all. This runs against the usual either-or logic — "either you feel, or you defend yourself". In truth, both are possible at once. When you build your boundaries not out of armour but out of a clear "I know what's mine and what isn't", the aspect stops being a problem and turns into a rare resource that very few people carry. To see exactly how it plays out for you — the signs your Moon and Neptune sit in, the houses involved, the other planets wired into the square — the whole chart has to be read together; "I've got Moon square Neptune" on its own only takes you so far.