The previous chapters have outlined some of the limitations of the biomedical approach to the experiences that are referred to as `psychosis'. In this chapter, I will expand on these limitations by contrasting the principles of psychiatry with those of the Hearing Voices Network. I will then discuss formulation as an alternative to the central tenet of biomedical psychiatry, diagnosis. Formulation, based on a shared understanding of personal meaning, can be seen as one of the best ways of promoting the principles of the hearing voices approach. It gives us a framework for seeing those who are distressed by voices or unusual beliefs as people with problems, not patients with illnesses.