A frequent pattern of associations in the analyses of narcissistic patients seems to be the counterpart of the child's use of denial in fantasy to ward off feelings of weakness and insecurity. These patients have failed to master the latency task of developing tolerance for tension, frustration, and uncertainty. This tends to produce impasses in their treatment. An approach to this problem is outlined: it begins with focus on present-day problems of impulse control and failures of frustration tolerance. The aim is to awaken hope for the development of genuine self-control that had been abandoned in the postoedipal period.