Children suffering major burn injury were studied; four case vignettes are presented. Significant factors that emerged included unconscious motivation and early parent loss in some parents of burned children, an unexpected finding. Positive factors for survival were coping mechanisms of denial, withdrawal, splitting of the ego, somatic responses (hypertension, ulcers, and "seizures"), and hope in parents and/or staff. Follow-up revealed better adjustment than anticipated. The authors urge psychiatric involvement in the burned child and offer possible explanations of past neglect.