This paper revisits D. W. Winnicott's famous account of his patient Piggle to examine the profound nature of her response to the birth of her baby sister in the light of the concepts of object constancy and absence. The author speculates that recent scholarship revealing the mother's Holocaust family history enables us to hypothesise that Piggle's infancy might have been marked by her mother's psychic absence. This contributed to difficulties in the establishment of object constancy leaving her vulnerable to more extreme responses to later absences, such as at the birth of her sister. The focus of Winnicott's interpretations at an Oedipal level is critiqued as is the significance of the psychoanalysis-on-demand setting of the work.