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This article thoroughly discusses the differences and similarities in Freud's and Piaget's thinking, focusing on the problem of epistemology. As an example of similarity, both Freud and Piaget were intrigued by the phenomenon of not knowing what was knowable. The author also points to deficiencies in each of their systems and urges that these deficiencies be corrected in psychoanalysis. He describes in detail the differences in their understanding or conceptualization of the unconscious. Whereas Piaget suggested that there was an intermediate mode of thinking which existed between primary and secondary process, this was omitted in Freud's concepts. There is an interesting section dealing with the differentiation between egocentric children and what might be called narcissistic children. The former are those who cannot differentiate themselves from the world—they are the world; the latter love only themselves. These two processes go on simultaneously in the course of maturation. Another example of how Freud and Piaget approach a problem along different lines and yet arrive at similar conclusions is in the area of the development of the conscience. A pervasive theme in the paper is the comparison of cognitive and affective approaches and the different ways these are dealt with by Freud and Piaget. The author makes a plea for a discipline in which both cognitive and affective approaches can be broadened and deepened, thus allowing the observer to view the patient from a much fuller perspective.