This chapter illustrates the systemic interplays of developing ecological relationships across time that support a presenting problem(s) of a deaf individual It uses a case vignette as an example of the longitudinal patterns of ecological relationships that may occur during the development of a deaf individual who exhibits psychological difficulties within a hearing family. It is important to emphasize that this presentation is both pessimistic and limiting: It depicts one example of an ecosystem that is dysfunctional, and that therefore becomes a context for supporting presenting problem(s) within a particular deaf person. This attempt is not intended to describe the general course of development of a typical psychologically healthy deaf person or of a typical deaf person who is in need of psychological treatment. Rather, this mode of analysis, the longitudinal sketch from a systemic perspective, can be used by clinicians as a backdrop to guide their understanding of the particular system that they are treating.