A child that was analyzed from four years of age to nine returned for brief visits at age twelve, nineteen, thirty; and at fifty for a more sustained analytic engagement. He reported new dreams on each return visit. Given this contact with him for almost fifty years it has been possible to reflect on the progression of his dreams over five decades. While it is clear that dreams do reflect developmental challenges there is also a remarkable continuity of genetic themes that can be identified. While dreams do reflect different phases of development, to be sure, the persistence of initial genetic conflicts are not only reflected in symptoms and character structure but in the dream work’s artistry as well, as latent content is transformed so creatively into its manifest disguises. It is this striking continuity of original genetic themes, first exposed in the child analysis, that runs like the unconscious musical drone of a ground bass throughout the first fifty years of the symphonic life of one individual, that I wish to focus on.