In psychiatry signs and symptoms are observed and arranged into diagnostic patterns or clusters. The diagnosis is the ‘what’ of what is wrong with the patient. In order to plan effectively, we also need to know the whys and wherefores of his state. The understanding that we have of this is expressed in the psychodynamic formulation. In preparing it we draw upon our human capacity for understanding and empathy, our capacity to read the story of the other person's reactions.