Oppenheim emphasizes the idea that imagination generates knowledge. Our sensory systems, like our higher cognitive functions, give the human brain knowledge to maintain the homeostatic balance required for survival and to enrich the sense of self required for agency. And, she suggests, imagination is a function of their doing so. Moreover, she explores the construct by which we apprehend the workings of imagination-fantasy-and considers in what the mental imagery that endows it consists, how fantasy may be transmitted transgenerationally, and how delusion can be an impediment to imagination while also being a product of it. Additionally, she likens psychoanalysis to the making of art as a process of acquiring knowledge and looks at creativity itself as a coming-to-know.

Throughout this book, there run several opposing threads. The first is that of the intra- and interpsychic psychoanalytic paradigms. This theoretical contrast bears on our understanding of aesthetic experience as sublimatory versus object relational and on our understanding of the construction of meaning. A second opposition resides in the notion of agency (with its implication of self-cohesion) which has everything to do with ego function and, seemingly, the usefulness of "unconscious fantasy," a cornerstone of psychoanalysis now thrown into question by the postmodern favoring of dissociation over repression and other mechanisms of defense. Last, but no less significant, is the contrast interwoven between the empiricism of neuroscience and the metaphysics of philosophical thought. Oppenheim's underlying effort is to explore the validity of these oppositions, which seem not to hold as steadfastly as we tend to suppose.