The etiology of psychotic states is traced to dissociative elements in infantile emotional development, utilizing case examples from psychotherapeutic work with child and adult patients. A live infant observation is also reported, in which an infant manifests a dissociative reaction in the wake of a discrete trauma. Specific attention is devoted to the route of aggression in the psychotic case, as well as to the need of certain psychotic patients to find “stillness” in the treatment if there is to be hope for recovery. Issues relevant to the diagnostic classification of psychotic illness in children are also considered.