Our body image is subject to distortion throughout the lifespan. People often deny or minimize the body's deterioration. However, with advancing age the individual has the capacity to mourn losses and incorporate or integrate bodily changes. Early remnants of body image tend to be retained, and may become conscious in dreams, illness, or regressive states. In pathological states, body image is psychically frozen. This article proposes that disturbances in body image and time, which are often interrelated, may reflect an enduring unconscious fantasy associated with trauma and/or intrapsychic conflict. A clinical vignette examines a disturbance in body image and time, its pathogenesis, impact on character, object relatedness, and work, along with transference and counter-transference issues. It addresses challenges that all individuals face in maintaining a realistic, healthy body image and sense of time. Neuroscientific research enriches a psychoanalytic perspective.