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The author presents a scholarly and thorough review of the attempts by psychoanalysts to treat psychotic patients, from Freud to the present. Freud was pessimistic about the therapeutic results of analysis with psychotic patients because they could not establish the transference necessary for successful work, i.e., they suffered from a 'narcissistic neurosis'. Abraham was more optimistic and reported that manic depressive patients could establish a transference and respond to psychoanalytic help. Rosenfeld discusses every psychoanalytic author of note who has worked with psychotic patients. He points out that they tend to fall into two groups as far as treatment philosophy is concerned. The first group sees the patient's narcissism as caused by early environmental deficiency; the therapist's task is to provide the patient with a 'new and better mother'. Fromm-Reichmann (early) and Winnicott are representatives of this viewpoint. Waelder, Jacobson, and Federn also deviate markedly from a classical analytic stance with psychotic patients; they maintain a primarily positive transference and use it to help 'sublimate the patient's narcissism'. The second group treats psychotic patients from the usual analytic position with only very minor modifications. This group is heavily influenced by Melanie Klein and includes Segal, Bion, and Rosenfeld.