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Patients who make powerful, seemingly all-inclusive identifications with fictional characters are defined as "fictive personalities." The author cites as examples actors who seem consumed by the characters they play and people who identify with characters from literature. Theoretical understanding of this sort of personality is drawn from a combination of models and mechanisms including Helene Deutsch's "as if" personality, Harry Guntrip's schizoid emptiness, Anna Freud's "altruistic surrender," and Heinz Kohut's work on narcissism. The author gives several clinical examples. In one case the central issue was the patient's experiencing the real world as totally disappointing; all satisfactions were "confined to fantasy." She merely "played at" real world roles, such as being a mother. Emotionally, she drew her identity from heroines in favorite books. It is implied that this character style sprang from a rejecting family milieu which led her to prefer fantasy and books in order to ward off hurt and anger. Treatment required showing her repeatedly that she immersed herself in fantasy to ward off the fury provoked by the frustration of her requests for love. This seemed gradually to wean her from the total reliance on fictive fantasies for gratification and allowed her to seek love in the real world as well as to tolerate the narcissistic injury of real frustration.