As a result of psychotic crises, Vincent Van Gogh was hospitalized several times from December 1888 to May 1890. The author focuses on Van Gogh’s intense intrapsychic struggle during this critical time. The article discusses how his paintings not only reflected his struggle but also enabled him, for a time, to stave off the hopelessness & despair that eventually overwhelmed him, culminating in his suicide. After reviewing possible factors in the artist’s illness, the author agrees with others that the most persuasive explanation involves epileptic underpinnings. (38 refs.)