A group of exceptionally gifted adolescents between the ages of 14 and 25 were each treated in individual psychotherapy over the course of a number of years. They were referred for symptoms of anxiety, depression, self-destructive behavior, and underachievement. Each phase of their gifted development was accompanied by particular anxieties and conflicts. In adolescence they developed a powerful personal vision, a sense of destiny, and a charismatic personality. Their inability to resolve conflicts about these particular gifted traits led to their most dramatic forms of underachievement and self-destructive behavior.