Efforts to treat hyperaggressive children frequently break down in a manner which reinforces the feeling that these children are beyond the reach of psychotherapeutic intervention. This study was undertaken in an attempt to elucidate the essential nature of the psychopathology of these children in order to provide a better foundation for the therapeutic enterprise. One finding was that much of their violent behavior is related to underlying narcissistic vulnerability, one facet of which is here termed the disregarded self. Much of the child's aggressive, antisocial behavior can be understood as an attempt to cope with and defiend against the hurt, the anger, and the anxiety associated with this aspect of self-structure. Origins of the disregarded self are considered from a psychodynamic perspective integrating child-rearing, sociocultural, and psychobiological factors. The implications of this concept for individual psychotherapy and milieu treatment are discussed.