For the past twenty-five years, I’ve worked as a psychoanalyst. I’ve treated patients in psychiatric hospitals, psychotherapy and forensic psychotherapy clinics, child and adolescent units, and private practice. I’ve seen children, adolescents and adults for consultation, referral and once-a-week psychotherapy. Most of my work, however, has been with adults in psychoanalysis – meeting with one person for fifty minutes, four or five times a week, over a number of years. I have spent more than 50,000 hours with patients. The substance of that work is the substance of this book.