Byline: Ajai. Singh Introduction While each one of us has his own special concerns and would like to give his own take on what he considers the task before psychiatry today, I want to highlight some critical areas for your consideration which are likely to be common concerns for us all. I divide them into five tasks to be performed, four of them of concern to all psychiatrists everywhere and a fifth of special concern to Indian psychiatrists and psychiatry. The First Task: Speak To A Wider Audience About Positive Contributions Of Psychiatry Just do a Google/Yahoo/MSN search on ' Psychiatry',' Positive Aspects of Psychiatry', 'Anti-Psychiatry'. You will get a lot of matter to browse. Please do. It will be an eye-opener. While you will get to read matter on positive contributions of the branch, quite a lot of it would be about negative aspects of psychiatry, how it is useless and dangerous, how it harms and is an infringement on human rights, free will etc, how barbaric is ECT treatment, how dangerous are its medications etc. It goes on and on and on. And while you and I sit in our consulting rooms and our OPDs and our seminars and conferences and committees and task forces, debating this and that issue and ostensibly working for patient welfare and therapeutic advancement in psychiatry, a major part of the world around remains unimpressed and keeps ranting about the ill-effects of our branch. Psychiatry and its critics There is something about psychiatry that attracts the most vehement protests. No other branch of medicine sees such vilification heaped on it. And yet, those who are in the system know they are doing the best thing possible for their patients/clients. And it is the one system that is most open in discussing what needs to be improved about it. While many other systems of medicine would dismiss most protests with a shrug, psychiatry is one branch that considers ethical, conceptual and foundational issues, sometimes almost to the point of becoming paralysed for action due to this. Every psychiatrist knows the benefits of ECT in selected patients. Every psychiatrist knows how psychopharmacology has revolutionised patient care. The grateful patients who have been saved from suicide, who get rid of their delusions/ anxieties/phobias/depressions to lead a productive life, whose inter-personal and intra-personal problems have been resolved with psychotherapy - all these are so very well known in psychiatric practice. And yet the vilification of the branch continues. Of course not all of anti-psychiatry has been useless and only vitriol. One can understand the contributions it has made to mental health consumerism. And it has added enlighteningly provocative critiques to 'establishment' psychiatry in the form of thinkers like Michel Foucault in France, R. D. Laing in Great Britain, Thomas Szasz in the United States and Franco Basaglia in Italy.[sup] [1] It essentially champions personal reality and freedom and that is a laudable approach. But it also opposes any attempt at a definition of normalcy that, according to it, the establishment of psychiatry tries to 'impose' on nonconformists and society at large. Here it transgresses its legitimate domain, for a definition of normalcy is essential, although difficult, as is a definition of the abnormal. And every non-conformism is not legitimate. That which confronts social prejudices and stereotypy is; but that which tries to legitimize people's disease and resultant distress, suffering and anguish in the name of non-conformity, isn't what we label as psychiatric disorders falls in the latter category. Moreover, the inability to precisely define a certain phenomena, as for example the difference between normal and abnormal, does not mean it does not exist. It only requires a more clear-cut delineation, which researchers need to work over more diligently. Studies on normality need greater emphasis than is their lot at present. …