A distilation of many year's work on a therapeutic millieu ward of the Maudsley Hospital, in which the psychotic patients were treated with an intergrated combination of psychiatric and pychological 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.