I would like to acknowledge the love and editorial guidance of my wife, Nancy McWilliams, who is “the best” of all superlatives, and without whose intelligence, radiant disposition, and belief in me this book might never have been written. I am grateful to Melanie Klein for what her writings taught me about the deeper regions of the human mind that shape psychosis. Her ideas are foundational in my thinking. I owe Sigmund Freud my profession and my livelihood. I thank the Psychoanalytic Association of New York. The training I received there is the foundation of my clinical identity. Despite his limitations, born of the insufficiencies of his own childhood, I am grateful to my father, whose delight in science showed me that the world can be quite an interesting place. He taught me practical things when I was a boy that helped prepare me for life. My relationship with my mother eventually taught me how real the distance between people can be, even among family members who live in close proximity, and even when an atmosphere of kindness prevails. She did her best. I wish she was less of a mystery to me.