Oberndorf and Eisendorfer present the case history of a woman seventy-eight years old who has had a condition diagnosed as psychoneurosis for the past seventy years. The illness has been characterized by crippling phobias and compulsively determined acts, which have been disturbing enough to necessitate institutionalization on at least four occasions. The onset was at the age of six, when, following a period of excessive masturbation and resultant guilt, she developed a fear of fire and a compulsion to listen to fire engines. The history indicates an inability to make a successful heterosexual adjustment, and a persistent dependency on her mother.