I have spent my professional career working with people with severe mental illnesses, leading clinical teams dedicated to helping this patient population, and conducting research and training younger clinicians and researchers to establish meaningful connections and seek interpretable biological findings reflecting core pathologic changes. For the first twenty years (1982-2002) I worked as a consultant at Manteno and Elgin Mental Health Centers, going weekly to meet with staff and patients, with an initial aim of deciphering my own responses and discomfort (i.e. 'praecox feeling') in order to develop the ability to communicate with severely psychotic patients. I learned that the vast majority of patients could make meaningful connections, though in some it was more like interpreting poetry and in others the connection evaporated as soon as the interaction ceased. It was here that I also became aware of the life-threatening water intoxication that caused repeated transfers to area intensive care units because of seizures and coma. In response, I decided to complete a NIH-sponsored fellowship in neuroendocrinology, which enabled me to begin studies into the pathophysiology of the water imbalance and to develop effective preventitive measures for water intoxication. The fact that I was simultaneously drawn to undertstanding the phenomenologic experiences and humanity of psychotic patients and finding a way to prevent a life-threatening medical problem and determine its mechanism captures a fair amount of what motivates me. In the 1990s, I began leading a clinic research team at Illinois State Psychiatric Institute where I was able to collaborate with basic neuroscientists developing an animal model of the water imbalance in psychotic patients. At ISPI, we also conducted the second and third phases of studies into the pathophysiology of the water imbalance and began to probe its relationship with the underlying psychotic disorder. I was able to apply what I had learned at Manteno and Elgin to gain patients' cooperation in undergoing lengthy, tedious research protocols. Like the first phase studies which were completed at the University of Chicago, these studies were conducted in clinical research centers, and indeed our work formed a core study of the first General Medical Clinical Research Center at the University of Illinois Medical Center. It was also here that I began to study the neural underpinnings of the deficit in prepulse inhibition that is perhaps the most widely studied ‘biomarker’ of severe mental illness, which unlike other putative biomarkers, involves a relatively well-characterized neural circuit. During this period I continued to run the after-care program for patients with severe mental illness at University of Chicago, teaching scores of medical students and residents that they too could establish rewarding relationships with, and support, persons suffering from chronic psychosis. In 2009 I moved from University of Chicago to Northwestern, pursuing the same clinical and research agendas. Around 2015, I began working with an outpatient clinic research program that was studying persons with first episode psychosis. Our role was primarily to provide clinical services to these patients while they were undergoing research studies. Working with Kevin Murphy, a social worker who had spent much of his career with this population, it became apparent we could help many of these people 'reverse course', and resume their development toward young adulthood. It is from this experience that Kevin and I started the Recovery from Early Psychosis Program (REPP) in 2017.