Using a number of clinical examples, this paper advises that attempts at therapy are limited by the women's versions of reality in which the child, even when loved, is an object rather than a person to the mother. The countertransference as a reaction to this has been of anger on behalf of the infant, which makes it difficult to maintain a neutral caring of the mother. The killing of the child represents a partial suicide for the mother. Women who murder their children tend to experience the child as a part of their own inner worlds. When those inner worlds contain rage, abuse, and despair, the child becomes a container for whatever feelings the women cannot contain comfortably. The external pressures of the infant on the mother are then added to internal pressures of the infant perceived as persecuting the mother with disavowed aspects of herself. Any additional stress in this situation apparently precipitates the thought that these infants as persecutory objects must be killed. This culminates in premeditated murder, but in a robotic, unemotional state in which they have, at best, partial knowledge of the nature and wrongfulness of the act. Any therapy undertaken with these women must be conservative in its aims. The goals of therapy must be clear to the women and to others involved in her care. Therapy should not be viewed as a means of making the women into safe mothers. It can, however, allow the women space to explore the act and its meaning for them, even if some of these meanings leave the therapist with uncomfortable feelings in the countertransference.