Madness is the colloquial and sometimes derogatory term used to describe insanity: the fragmented and chaotic state of mind of the person who becomes detached from the consensual view of reality. In the first instance, the mental health care system has to provide a setting where madness and anxieties about madness can be managed safely by empathic and thoughtful staff. In many ways this is a natural process that takes place in the encounter between patient and mental health professional. However, in this book I argue that good mental health care—and treatment—needs to go beyond this important first step, by trying to understand the relationship between patients’ presentations and their personalities. Indeed, highly disturbed patients need to be cared for by mental health professionals who are interested in and committed to understanding the meaning behind the presenting problem. Recovery will depend upon patients’ ability to reclaim their capacity for psychological thought and insight.