Psychotherapy has gained wide acceptance as a primary treatment for nonpsychotic psychological disorders but has yet to find the same acceptance in the treatment of psychosis. One reason for this is the idea that schizophrenia is a genetically determined brain disease unlikely to respond to psychological treatments. A second reason is the difficulty most people have in relating the symptoms of psychosis such as hallucinations and delusions to their own mental processes. This paper relates the manifestations of psychosis to ordinary mental life, and describes how psychotic symptoms arise as meaningful expressions of unbearable psychological pain in the aftermath of adverse life events.