Psychoanalysis with women patients over thirty, who seek marriage and children as a goal, can pose particular problems. Lieberman criticizes the position that an unwanted single status is the result of neurotic conflict. She states that this problem may not be just intrapsychic; reality factors are important and must also be addressed. Three clinical examples are given, and transference, countertransference, resistance, and defense are examined. Lieberman postulates and describes a "singles syndrome." She concludes that when intrapsychic change occurs as a result of treatment, one may hope that external reality will change; however, one can lead a full life without marriage.