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This paper attempts to demonstrate the value of an extended, psychoanalytically informed interview with seriously disturbed, including psychotic, patients. A careful initial exploration of the patient’s internal world and its links to external crises can act as a therapeutic intervention, an orientation towards an understandable explanation of the patient’s troubles and a basis for decisions regarding treatment plans. When the intra-psychic meaning of the psychotic patient’s anxieties is identified and understood, the patient is likely to feel contained and the conditions for a dialog with the non-psychotic personality of the patient are laid. Three examples of extended analytic interviews are given, each demonstrate increasing levels of complexity.