This book is a narrative in dialogue form in which the author, now an octogenarian who is a psychiatrist, psychoanalyst, and a PhD in philosophy, describes his intellectual evolution from a published laboratory researcher to engagement in the full-time clinical teaching and practice of psychoanalysis, psychodynamic psychotherapy, and philosophy. He reviews the development of his ideas through his many publications and offers commentary on the nature of the origin, environment, and content of his thinking at the time each of these were written, also referring to his voluminous diaries.

This serves as a running report on the changing fashions in the field of psychiatry, psychoanalysis, and philosophy over the past sixty-five years, along with the author's opinions about the nature and source of these changes. The book is divided into five parts, arranged chronologically from 1953 to the present time.