The case study describes the focal therapy of a 38-year-old child therapist whose ego defences were severely destabilized by the Gulf War. The dynamic background of the symptoms lay in an inner aggressive ego defence conflict in the presence of a self weakly cathected with aggression. The study shows why an ego critically aware of social reality must direct the process of interpretation more inwardly; on the other hand, with an ego that denies reality, the outer world must first be exposed in its structure-forming significance before the conflict can be re-internalized and worked through.