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The subject is a nine-year-old-girl with overt aggression (rather than aggression liberated in the analysis). Her aggression and flamboyant acting out resulted from severe problems of self-esteem and had many pregenital aspects. The analyst attempted unsuccessfully to manage the aggression through interpretation and deflection, but it soon became clear that it had to be stopped or transformed if the analysis were to survive. Therefore, limits were set in the presence of a parent, the child's hitting and destructiveness changed to insults and screaming, and the analysis could proceed. Maenchen later became aware that she had been reluctant to set limits, believing that interpretation should be enough. But the aggressive acting out should have been stopped. Maenchen next describes a "borderline" girl whose psychoneurosis was superimposed on a disturbed ego structure. Although the analysis was stormy, it was the only treatment that would allow working through and modification of the archaic and disturbed aspects of her envy, separation problems, tyranny, victimization, exhibitionism, severe anxiety, and fear of losing control and disintegrating.