This case is of particular interest for the study of the sources of anxiety and of symptom formation in a very young child who was taken into analysis at twenty-three months. The severe progressive symptomatology from seven months onwards following sudden weaning and enforced cleanliness training in a somewhat rejective maternal relationship

gives a clear picture of an acute primary disturbance. Temporary breaks with reality were precipitated by the inability to deal with sadistic pregenital elements, mainly oral. The birth of a brother at twenty-six months added night terrors and animal phobias to an already complex clinical picture. The function of the phobias in limiting the loss of reality and maintaining essential functions and relationships appeared clearly in the analysis. Similarly in the nightmares, the less guarded sadistic manifestations against the mother forced the child into waking to seek real maternal comfort. Both symptoms ensured a precarious hold on reality and prevented a lapse into paranoid or depressive psychosis.