The published psychological literature on the developmental milestone that is the doctoral dissertation emphasizes either psychological interpretations or practical strategies as ways to help, each often failing to note the critical importance of the other. Clinicians need to understand underlying psychological issues that may complicate the dissertation-writing process, including particular difficulties that can arise for first-generation college students and other nontraditional students. Interpretation of unconscious conflicts is possible and sometimes critical even in brief treatments. Conversely, pragmatic techniques can help move students from paralysis into constructive action when interpretations do not. Case examples are offered throughout.