Because illness-bearers, our patients, come to us not just with diagnoses but with their dreams and character. In dreams lie cherished fears and desires. Character is the precipitate of our material and social being – genes, developmental experiences, choices, relationship patterns, strengths and weaknesses. We are largely unaware of these deep structures that constitute the self. Psychoanalysis provides a language for describing the development of character and for reading dreams. The psychiatrist versed in that language can converse with their patients about how they came to be who they are, and how best to cope with the adversities of mental illness.