In this chapter the author provides a case study of Anthony, treated for both attention deficit hyperactivity disorder (ADHD) and Asperger syndrome. When Anthony came with his parents for an initial consultation with the author he was sixteen years old. His mother gave the author a report of a psychological evaluation of Anthony had undergone eight years earlier when he was in second grade. Despite his anxiety about the testing, Anthony’s performance on the IQ test was in the superior range for visual spatial organization, in the high average range for verbal comprehension and in the average range for working memory and processing speed. After that comprehensive evaluation, it was clear that Anthony was a very bright and appealing adolescent who fully met diagnostic criteria for ADHD of the combined type. From his earliest years Anthony had a significant problem with how he viewed himself.