This book is born out of the professional reality that contemporary psychoanalytic ideas are sadly absent in understanding the process of recovery of a severely mentally ill patient. The central idea behind this book is to apply theoretical concepts and clinical techniques from a particular psychoanalytic model to understanding the subjective state of mind of people with psychosis. This, along with accepted good practices in psychiatric care and well-founded research findings, provides a source of knowledge that I hope will be of help to everyone working in the real world of public sector provision of services for these patients. This has been a personal journey for me of hope and despair to a position of recovery to where this project has proved possible and is of demonstrable help to patients. This experience of the organisational psychic life of Threshold is not unlike the personal journey of personal therapy/analysis in the to and fro movement from the paranoid-schizoid and depressive positions (Segal, 1986), to the hoped for ultimate “psychic home” where concern for oneself and others eventually predominates in everyday intrapsychic and interpersonal life.