This paper explores the choice of psychoanalytic psychotherapy as treatment for an adolescent boy experiencing a psychotic breakdown. Comment is given on the value of the approach when psychosis is seen as defensive against the developmental imperatives of adolescence. This approach is contrasted with the masking of symptoms occurring with a pharmacological approach where the dynamic underlying the conflict is not available for exploration by the patient. The example of a 17-year-old boy is given, demonstrating the move from psychotic functioning, via the recognition of the separateness of the other, to neurotic functioning.