This article examines a family therapy case involving a woman who was violent to her children and partner where conscious and unconscious paranoid beliefs were manifested in projective identification and sadomasochistic liaisons between the children and/or partner. I will illustrate how apparent social appropriateness covered up an extremely disturbed personal relationship. I will explore how this paranoid and perverse relationship arises from the use of a particular type of defensive organisation. This is characterised by a mostly narcissistic and unyielding defence, namely projective identification, which functions to help the patient avoid knowing about her aggression and anxiety by avoiding connection with other people and with reality.