Martin was a child who, from infancy, lagged in all his developmental milestones. Those difficulties were compounded by intermittent hearing loss and poor speech. His defective synthetic function, his inability to verbalize, and his narcissistic vulnerability made it necessary for his therapist to find preverbal ways of connecting with him in their exclusive one-to-one relationship. While he was easily overwhelmed with anxiety, he also was highly motivated to succeed. He recognized that therapy was a process which could help him reduce tension and strengthen his ego and improve his performance. He had to learn how to master anxiety and to understand his sense of humiliation in order to improve his speech.

As verbalization improved and his practical skills became autonomous, he became less dependent on his therapist for auxiliary