Peter Gøtzsche, MD, an extraordinary physician and researcher, talks with me about the self-deception and denial rampant in psychiatry as we ask, “How can our colleagues behave in this way?” We look at the mountain of money, power and authority looming over our reform efforts and ask, “How can we succeed?” A heartfelt conversation about the disaster of modern psychiatry and our personal and professional efforts to come to grips with it. We look at the plight of patients whose doctors do not listen to them and indeed the plight of psychiatrists seemingly compelled to do harm regardless of the truth and any efforts to stop them. This is the final in a marvelous series of four consecutive conversations with Peter about the state of psychiatry and what can be done about it, available on prn.fm and on breggin.com. I can think of no better introduction to psychiatric reform than listening to these four dialogues.