Hope and despair are antonyms that describe a person's emotional state, determine whether one receives a psychiatric label, and whether one experiences others as potentially loving or threatening. Patients come to the therapist, bereft of a sense of self-esteem and personal potency, seeking the gift of hope which the therapist, who treasures life, is uniquely qualified to give. The cultivation of hope and the abolition of despair are prime ingredients in psychotherapy, yet have received little attention in the therapeutic literature. This article examines the nature and origin of hope and despair.