The author Nancy McWilliams describes her formative years and speculates on their impact on her approach to understanding and conceptualizing individual differences, personality organization, and personality disorders. Themes of moralism, marginality, feminism, and the questioning of authority emerge from her account of a personal history marked by recurrent losses and fears of loss. Her own qualities of personality, and her understanding of individuality generally, are construed in terms of themes, tensions, and polarities. These constructs are related to her approach to personality formulation and assessment, which is influenced by the clinical purposes to which such concepts can be applied. She emphasizes the importance of appreciating the interaction of different organizing motifs, seen from different angles of vision, and the coexistence of opposites in conceptualizing individuality and its clinical implications.