The Pervasive Refusal Syndrome is a recently described syndrome of child psychiatric disorder. The theory of learned helplessness has an extensive research and treatment literature. We present the case of a 15-year-old girl with Pervasive Refusal Syndrome as an example of learned helplessness. The theory of learned helplessness is traced from its original descriptions to more recent formulations in which the behaviours of helplessness are linked to the loss of hope. The criteria of helplessness and the phenomenology of the Pervasive Refusal Syndrome are compared. The Pervasive Refusal Syndrome is a difficult condition to treat. The learned helplessness/hopelessness formulation provides a helpful theoretical paradigm within which to conceptualise phenomenology, aetiology and treatment.