The analysis of a case of ulcerative colitis in a sixteen-year-old male which included an interim episode of psychosis is related. The colitis was seen as an effort to expel the internalized bad object containing the sadistic part of himself that was felt to reside in the bowel. Experiencing emotions as physical sensations appeared to derive from a period when the infant experiences painful emotions so concretely that they are felt as physical sensations. This phase was apparently kept alive in part through failure of the mother to tolerate his emotions without withdrawal or recrimination. Five years after the beginning of treatment the patient was free of diarrhea except for occasional lapses, was living away from home, succeeding in his career, and maintaining physical improvement.