This article addresses the long-term disturbances in the psychological functioning of abused children from the perspective of self psychology and intersubjectivity theory. From these viewpoints, the symptomatology displayed by abused children is conceptualized as the product of derailments in self-development and impairments in affect regulation, resulting from chronic failures in caregiver attunement. Implications for treatment are discussed, and a case is provided to illustrate the points made.