Inherently intense motor impulses in infancy may accumulate and, in the absence of opportunities for discharge, cause feelings of helpless rage and the experience of one's own impulses as dangerous. Similarly, frustration of inherently intense oral dependence may lead to unbearable stress, refusal to eat, and eventually to rejection of reciprocal relations with the world. Thus, the first active mode of receptive contact with reality, given this predisposition, can constitute the first rejection of reality. In such cases infantile narcissism with omnipotence and a sense of 'there is time for everything' may alternate with impotence, depersonalization, and enraged nihilistic withdrawal causing profound inhibition of thinking and sexual activity, and rejection of reality.