I have described aspects of a short analysis of a 10-year-old girl who presented with symptoms which could indicate a psychotic organization. Her psychotic-type anxieties did not increase in the year, in fact her symptoms decreased and her anxieties became less acute. A more manic type of defensive structure became apparent as Laura used denial and omnipotence to deal with anxiety-producing situations. The defences prevented her from integrating her experiences and distinguishing those of her internal world from the external environment. In addition, the external environment played its part in making it difficult for Laura to trust a sane and reliable world.