A distillation of many years’ work on a therapeutic milieu ward of the Maudsley Hospital, in which psychotic patients were treated with an integral combination of psychiatric and psychological care anchored in the use of advanced psychoanalytic concepts of psychosis. Compelling clinical material is reproduced to help illuminate the meaning of illnesses such as paranoid schizophrenia, catatonia, psychotic anorexia and manic-depression. Several depth interviews by the author, an authority on the application of psycho-analytic thought to the problems of psychosis are reproduced for the first time.