An eclectic form of psychodynamic psychotherapy is presented to address the emotional problems of exceptionally and profoundly gifted adolescents and adults. The approach includes cognitive/behavioral techniques as well as psychologically informed mentoring, coaching, and advising. Once a psychodynamic formulation was established, it was used to guide all subsequent therapeutic interventions. Three phases of psychotherapy can be recognized. In the first phase, patients addressed their guilt about being exceptionally endowed. They elaborated and organized a personal vision for their giftedness and found an appropriate venue for its expression. In the second phase, patients modulated their need for complete autonomy so they could collaborate more effectively with the therapist and others. In the third phase, patients were able to integrate their extracognitive abilities with their superior intellect. They learned more mature methods of conflict resolution and were able to employ all aspects of their gifted endowment more effectively.