Reminiscences: 1938 and since

The author cites significant changes in the conduct of the psychiatric profession between the fourth and ninth decades of this century. Determinants of the changes included the impact of World War II, the National Mental Health Act of 1946, the evolution of multiple modes of psychotherapy, the move from a system of involuntary incarceration and treatment in public institutions to a voluntaristic and pluralistic system, the provision of public and private insurance support for office, outpatient, and inpatient psychiatric care, the resurgence of psychopharmacology, and the pursuit of research in biological and psychosocial fields. The social goals of the profession are also discussed.