More and more individuals with ego defects, severe object relations conflicts, affective turbulence, and unassimilated contradictions are seeking help from psychoanalysts and psychotherapists. Contributors to this book explore hereditary and constitutional factors, environmental influences and unconscious fantasies in the development of the psychotic core in such patients and provide guidance for psychoanalysts and psychotherapists to hear and therapeutically respond to these patients' uncanny ways of describing their internal worlds. This volume includes contributions by experienced clinicians from Europe and the United States, as well as case histories illustrating the transformation of the psychotic core and how these patients can develop healthier internal structures. The editors' introductory and closing summaries integrate knowledge dealing with especially difficult patients. By reading this book, psychoanalysts and therapists will be prepared to gain insights as newer neurobiological and psychological research findings become available and, hopefully, enthusiasm about working with individuals with "the seed of madness."