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Certain patients who present with clear obsessions and compulsions seem so frantically immersed in their symptoms that a diagnosis of obsessive-compulsive character disorder proves neither completely descriptive nor clinically helpful. Such patients cannot be treated in the ordinary psychoanalytic fashion, since these obsessions and compulsions, which may originally have developed as psychoneurotic symptoms, now serve to protect the individual from a graver disturbance by serving the important intrapsychic function of distracting attention from intolerable preconscious material. Thus, it is often better to consider such patients as having "pseudo-neurotic schizophrenia" or "obsessive psychosis." Attempts to clarify the anxieties, defenses, or wishes contained within the presenting symptomatology may prove fruitless or even dangerous. The author suggests that conceptualizing the distracting functions of the patient's obsessions makes it possible to maintain a dynamic view of the disorder which can point the way to an interpretive approach. Technically, it may be necessary to confront these patients with the notion that they are distracting themselves from frightening thoughts which are in fact available to them and to address directly the reasons for the avoidance. This approach is evidently different from the one usually employed with neurotic patients. In a very detailed case presentation, Renik illustrates the clinical application of this formulation. When he focused his interpretive approach upon threatening preconscious thoughts, the patient's obsessive-compulsive symptoms were replaced in the sessions by conscious, violent sadistic fantasies. When, as treatment progressed, the patient became able to tolerate these threatening ideas, the obsessions and compulsions disappeared. It was possible to make explicit the danger the patient had felt in having his preconscious fantasies become conscious: he had feared that he might act on them.