This is a psychiatry textbook, but much more. Its gestation is 40 years of practice seeing, for the most part, the most difficult of patients. Yet I have sought to make it readable (and with some humor) and laden with personal observations. There are discussions of the major disorders, with plenty of clinical examples, always with an eye toward sharing something with you that is interesting or provocative--and often from a perspective not found in other reference works. I have also included chapters on a disorder or two that have not gotten their due and are not taught in most residency programs, but which every psychiatrist will see and need to understand. The section on medication discusses the compounds you will be using subjectively--what I like and dislike about each--with prescribing tips. Also included are some unusual chapters: for example, the ten most common mistakes psychiatrists make, five things every psychiatrist should read, on (medical) bureaucracies, and how the practice of psychiatry (and people in general) have changed over the decades. Finally, I have (with some discomfort) gone out of my way to detail clinical blunders I personally have made, with the goal of helping you avoid these unfortunate errors in the years to come. I approach this exercise as though I were a trusted supervisor, sharing my knowledge and opinions directly, honestly, and conversationally. The Different Guide to Clinical Psychiatry is exactly what I would have wanted to have on my own shelf 40 years ago--brought up to date, of course. H.L. Phelps, M.D.