Abstract
While dynamic psychiatry in itself represents one of the great intellectual advances of the 19th and 20th centuries, it has neglected two areas of social change which are of importance for the therapeutic task. Changes in the position of men and women in Western civilization which give great decision power to women and impose a high degree of dependency on men are presented as pathology and ineffectively attacked by the setting of treatment goals which follow archaic models. Such goal setting burdens not only the patient but also the therapist with inappropriate assignments. The changing position of the United States from a spearhead of revolutionary idealism to a world power with essentially conservative interests has caused much conscious conflict among patients and therapists to which psychiatry has not yet responded as a mental health challenge. Here again, obsolete models interfere with the effectiveness of therapeutic goal setting.
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