In this account of the analysis of a four-year-old girl I have tried to describe the pathological outcome of the interaction of her high capacities with the extreme demands of her environment. Emma's precocious ego development facilitated the intensification of defense against instinctual wishes; various ego functions were drawn into the service of defense, notably intellectual functioning and reality testing, which were used to preserve a rigid distinction between approved adult behavior, allowed to be "real," and despised infantile wishes and feelings, all relegated to the realm of fantasy and "pretend."

The work of analysis helped to resolve pregenital conflicts and thereby decrease the blanket imposition of rigid defenses. By the end of her treatment Emma was fully established in the age-adequate oedipal phase and was able to acknowledge her own intense feelings.