Dr Carveth begins by describing the difference between the narcissistically based superego from the object-oriented conscience. He sees the former as culturally derived and the latter as biologically given. We discuss how in the clinical situation persecutory guilt, i.e., superego, may often be emphasized to defend against the vulnerabilities associated with loving and being loved. We consider the use and overuse of the concept of trauma in contrast to intrapsychic conflict, and he distinguishes between empathy and sympathy. He shares his view that the edges of our political parties are imbued with the self-certainty born from the paranoid position. Ultimately, he concludes, "I'm not afraid that analysis will disappear – people who have problems with their soul will seek out soul doctors."