This paper addresses the diagnosis and treatment of clients whose lives are constricted, and whose relationships are characterized by adaptations to the needs of others. This life style is believed to be the result of very early adaptations to pathological parental needs which interfered with psychosocial development and identity formation. It is suggested that Winnicott's theory of ego distortion in terms of True and False Self provides a useful conceptual framework for diagnosis and treatment of such cases. His theory is presented, followed by a case report, illustrating the application of these principles.