Life in this country has been dangerous for and cruel to its black citizens for 400 years. In this chapter, I introduce the subject of the book and provide an explanation of and rationale for my historical/psychoanalytic approach to clinical work, and how this approach is especially important working with African American psychotherapy patients. After surveying the development of psychoanalytic thinking about massive trauma and its effects on its individual survivors, I describe the specific historic and geographical backgrounds of the black patients who will provide the clinical material for the book: mostly children of the Great Migration, born in the Bay Area between 1940 and 1970, mostly blue-collar workers, and mostly women. I also briefly discuss my own particular white identity and the role it plays in the dynamics of these cases, as well as a short history of African American life in Oakland, CA, where most of the people depicted in the book live. I follow the chapter with a dramatis personae in which I give a capsule description of each of the seven clients whose vignettes appear throughout the book.