A college student with a lifelong speech blockage so severe that he could not be treated by psychotherapy based on dialogue was able, after 42 sessions of systematic desensitization, to speak fluently. As soon as his speech permitted, while therapy was still in progress, a diagnostic study was undertaken. The results suggested that cognitive activity, attitudes, and behavior directly related to the symptom were consistent with psycholanalytic hypotheses on the personality dynamics of stutterers. Yet although the symptom appeared to be an integral part of a widely ramified personality disturbance, it could be removed without any attempt being made to alter other aspects of personality function. The implications of these paradoxical findings are discussed, with emphasis on stuttering, but also as they relate to understanding and treating neurosis generally.