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In this complex and densely written paper, Meissner covers two related subjects: "normal" adolescent paranoia and the evaluation and treatment of rebellious, alienated late adolescents. He suggests that the "need for an enemy," with use of projection and denial and some resulting disturbance in reality testing, arises transiently in many adolescents as an aid in differentiating self from parents. With the rise in instinctual drives and a narcissistic overvaluation of the self comes the need to define the self by perceiving oneself as alienated from "the others," i.e., the parents and other authority figures. Meissner discusses the profound sense of alienation in some adolescents resulting from the confluence of the above-mentioned intrapsychic conflicts and feelings of intense dissatisfaction with values of parents and the ambient society. A case history is reviewed, and the author concludes with the plea that the therapist always keep in view both the intrapsychic and interactional factors at work in the psychopathology of such adolescents. The therapist should maintain a "ruthless," open objectivity in the therapy which enables the patient to sort out the distortions from within affecting his or her view of the world.