Analysands whose conflicts are dominated by unconscious fantasies of being a superior exception present particular technical difficulties. These patients disavow transference wishes and distort their sense of time because they cannot tolerate dependence, longing, or vulnerability to frustration, aging, and death. The sense of exceptionality must be kept secret, lest the illusions fueling this conviction become apparent. The author links this phenomenon to an unloving childhood: adopting a pseudoadult identity, which rigidly stresses omnipotent control and autonomy, blocks out feelings of worthlessness and rage. Ladan discusses how the secret of exceptionality constitutes a central oedipal masturbation fantasy while defending against guilt and shame. She suggests that to help analysands gain a right to their emotional life, it may be necessary for the analyst to spell out the deprivations they have suffered. Finally, Ladan notes some typical countertransference-based collusions with the defense structure of exceptionality.