It is necessary to distinguish between pathology caused by identifiable traumatic events and pathology caused by ongoing developmental interferences from external sources; the latter does not result in the degree of psychic paralysis and dysfunction that specific trauma causes. A literature review of trauma is given: the author supports Anna Freud's call for a specific definition of trauma— helplessness of the ego in the face of overwhelming stimulation. In treatment, the reality of the external event must be disentangled from the patient's related unconscious fantasies. The author also discusses the debate over whether or not the effects of trauma are fully resolvable; in this regard, specific difficulties, including proneness to various kinds of disavowals and acting out behaviors, are