Langworthy presents his experiences with the psychotherapy of four patients with blepharospasm and/or facial tics in an attempt to delineate factors in common between them. He found that all these patients have strong obsessive perfectionistic trends and are much concerned with problems involving giving and receiving. The symptoms all developed suddenly and in response to rejection by an emotionally significant person. The author divides the treatment situation into three successive phases, the first that of 'getting acquainted', the second that of challenging the essential emotional problems, and