The self-reproaches of a woman patient depressed almost to the point of psychosis were actually directed to members of her family. The precarious narcissistic balance of her ego was maintained by thinly disguised homosexual attachments; for example, she became engaged when one girl friend became psychotic and another was married. Various obsessions and reaction-formations acted as defenses against her intense penis envy and urethral sadism. To the patient femininity signified shame, humiliation, and abandonment; it also represented loss of mother, incest with father, and destruction by his penis. Selection of a love object was based on introjective identification with mother and narcissistic projection of herself into the object, accomplished by denial of sexual love and by a distorting idealization of the object.