Sonia is a case study of a little girl who presented at age 2 years, 10 months for temper tantrums that drove her parents crazy. Gradually, her doll play revealed a preoccupation with the genital difference and explicit references to her “lost penis,” accompanied by frank urogenital sensations. This play, as well as bedtime anxiety, led to our understanding the extent to which she was absorbed in symptomatic masturbatory behavior that, in turn, was interfering with her development and spoke to the need for more intensive treatment. In the course of her ensuing analysis, which began at age 4, we uncovered the multiple meanings and secondary gains embedded in her masturbatory behavior and accompanying fantasies. Furthermore, over time, we uncovered evidence of a learning difference that had contributed substantially both to her sense of defectiveness and to her ability to master learning about her body and about her affects.