Ritvo views severe anxiety and symptom formation from the standpoint of impairment of the ego, especially in regard to judgment, reality testing, cognition, and defensive splitting. He describes a group of patients who were traumatized in the first two years of life and who were adversely affected by disturbances in the parent-child relationship, frequent somatic illnesses, and repeated, prolonged separations. Such patients are characterized by polymorphous-perverse sexual development. Two cases illustrate the thesis, giving special emphasis to activity as a coping mechanism which can be used by the child to reduce the noxious effects of an early childhood in which anxiety is unending.