This article presents a clinical theory of healthy and pathological child development. I offer the hypothesis that persistent emotional and behavioral problems in childhood and adolescence are caused by painful emotions that remain active in the mind of the child—a bad feeling that does not go away. Over time, troubled children have become discouraged. Their discouragement has most often developed in the context of ongoing pathogenic family relationships—vicious cycles of frequent criticism, punishment, or lack of understanding on the part of parents and increasing defiance, resentment, and withdrawal on the part of children. Successful therapy arrests this malignant process. Children learn (as they do in healthy emotional development) that they will not always feel this way, at least not in the same way they do now. We then begin to turn vicious cycles into positive cycles—to strengthen in our child and adolescent patients a more encouraging, less critical inner dialogue and a new sense of what is possible in their lives.