In this paper we have attempted a tentative delineation of particular superego elements which may be involved in the production of 'pseudo-narcissistic' psychopathology, that is to say, a disturbance which superficially appears to be a narcissistic personality disturbance but which is fundamentally based on neurotic conflict. Using a framework of superego constituents and superego functions, aspects from the analysis of a man with profound difficulties in self-esteem regulation were examined to highlight his intrasystemic conflict—a conflict of ideals. Some possible explanations were offered, taking into account the persistence of early stages in the development of the superego and of difficulties in the resolution of oedipal conflicts. This work is offered as an example of a way in which the psychoanalytic treatment process can contribute to knowledge of early psychic structure formation and development.