This article describes the course of a psychotherapy with a depressed encopretic boy, using a psychoanalytic approach. The therapy was administered in a public welfare clinic in Israel. Based on an understanding of how the boy’s developmental needs had been neglected, an appropriate intervention programme was constructed and implemented. The principal insights determining the course pursued by the psychotherapist included the understanding acquired of the dysfunction and absences within the mother-child relationship during the boy’s early years, and the need for the therapist to provide corrective and containing maternal emotional experiences, together with insight regarding the repercussions on the boy’s emotional life. Additional understanding was gained about the role of the boy’s encopresis, which comprised a symptom, and seemed to be a response to the repressed, unmodulated regressive anger towards the internal maternal figure, owing to the parents’ difficulties in meeting the boy’s primary developmental needs.