Are psychiatric and neurodevelopmental conditions fundamentally epigenetic disorders? The answer to this question may shape the next generation of clinical science related to psychopathology.1 The genetic metaphor for developmental psychopathology has long been considered inadequate for the complex dynamics of human development.2 However, the rise of behavioral epigenetics3 has amplified the possibility of an actionable paradigm that effectively integrates genetic liability and an environmental modulation of developmental trajectories. If the epigenetic perspective proves to be productive, it would open up not only new treatments but also new preventive approaches that reach the earliest days and months of life.