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The following symptoms often occur together: inability to learn, to know, to correlate facts or to understand except by rote, and inability to assimilate and utilize knowledge as, for example, in abstract thinking. This symptom complex is closely correlated with the inability to accept the existence of the vagina because it cannot be seen. A body image that excludes knowledge of the apertures has certain effects on the ego. Four cases are presented, one in detail, to illustrate this phenomenon. A difficulty in object relations results from the inability to assimilate the presence of the vagina, and there is impairment of the ability to assimilate knowledge. A disturbed, isolated, fragmented body image, never properly integrated into the ego, also results. Because existence of the vagina cannot be deduced, there occurs inhibition of deductive reasoning, and because the body image remains disconnected and disjointed, there is disconnected speech and body language. In fine, these patients cannot believe in or have true knowledge about anything. A good review of the literature correlates these observations with views on ego development.