The diagnosis and treatment of psychosis has always been central to the identity of psychiatry and the public image of Mental Health Care. The divide between ‘neurosis’ and psychosis has also been a prominent subject in psychodynamic literature. In this talk the major models of psychosis will be discussed, including alternatives to the dominant Neo-Kraepelinian model. The psychoanalytic notion of a ‘psychotic core’ will be reviewed and critiqued. The case of Daniel Schreber (Freud) is discussed as an exemplar of the role of trauma in some presentations of psychosis. This is followed by other case examples that illustrate the importance of understanding the evolution of psychotic symptoms in the individual. The role of psychological treatments in psychosis, often overlooked, will be considered.