It had been my original intention to try to describe to this audience something of what it had meant to me, not personally but scientifically, to turn away from the analysis of the neuroses, after doing this for most of my time (although not exclusively) for some 35 years, and to plunge back into the problems with which we are confronted in a psychiatric hospital. Actually it has been one of the moving and illuminating experiences of my life. It has led me to reexamine all traditional assumptions about psychiatric and psychoanalytic classification, dynamics, training, and research. For various reasons I abandoned this plan and have turned to a more general topic, hoping that this will be of interest to this audience. This deals with the relationship of psychiatry in general, and of psychoanalytic psychiatry in particular, to the future of our Western culture of freedom.