This paper analyzes the life and the work of Dr. J.N. Rosen, who pioneered attempts to treat psychosis from a psychoanalytic standpoint at a time when conventional approaches advocated pharmacological and physical treatments. His psychotherapeutic technique, which became known as “direct analysis,” divided opinion among practitioners and later attracted a degree of notoriety as the result of several law suits following the deaths of patients under his care. This paper reviews the major publications on direct analysis, examines the events that brought it into contact with a hostile mass media, and reassesses the contribution of the approach to psychotherapy. With certain reservations, Rosen is adjudged to have been an outstanding clinician who pre-empted modern attitudes to the treatment of psychotic individuals, but the theoretical basis of his work, about which his closest collaborators were tellingly unable to fully agree, fails to provide an adequate account of how it helped those who were mentally ill.