Powerful unconscious countertransference attitudes occur in the treatment of psychotic children. There are certain frequent reactions which include: rescue fantasies and expectations for rapid improvement, leading to discouragement and pessimism; overidentification with the regressive behavior, aggression, or certain defenses such as projection and denial; over or under investment of libido in the treatment; discomfort in handling the primary process phenomena that may require extensive body contact; inability to tolerate the necessary symbioticlike relationship, which, once established, may cause difficulty in fostering separation-individuation; excessive anxiety in the therapist provoked by the child's massive anxiety. Dealing with these reactions in supervision is essential to the therapy of difficult cases.