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This paper deals with character and behavior in relation to some of the social and economic realities of today’s world. These realities include the fragmentation of previously stable social structures; massive migrations from rural areas into cities unable to accommodate them; the uneven destruction of centuries-old caste and class barriers; the alignment of power-wielding groups along racial, religious or other ethnic lines; and the unprecedented transmission of information and desires by pictorial and auditory means to semiliterate peoples without the techniques for satisfying their newly acquired wishes. These changes do more than force the abandonment of old interpersonal guideposts. They encourage conflict-laden identifications with aspects of a new culture, or with social groupings, in which the individual concerned is not allowed full membership. They focus our attention on the exclusion of important population segments or of social subsystems from complete participation in the culture of the larger societies to which they belong. The pursuit of this theme, the impact of cultural exclusion on character and illness, requires a constant interweaving of social and psychiatric ways of thinking about human behavior. Perhaps the best known

The rapid strides made by psychiatry in the past few decades and the permeation of the psychiatric attitude into other fields have been noteworthy developments. It is difficult to reconcile these advances with the comparatively slight changes in the general social, and legal attitudes towards the mentally ill. One of the outstanding anachronisms is the continued use of the concept of “insanity” for commitment and other legal procedures. Although there is a general repugnance and vagueness about the use of the term “insanity,” it continues in the statutes of most of the states and is apparently looked upon as a definite entity. Certainly physicians are called upon daily to testify to the existence of such a condition before patients are admitted to hospitals for treatment or judgment passed in certain legal procedures. To dismiss insanity as a legal concept, as William A. White,’ Zilboorg2 and other psychiatrists have done, brings about a rebuke from legal authorities. In 1911 a committee of the American Bar Association published a report on this question in which it is stated: “As criminal responsibility is a purely legal question, so insanity is a medical one which must be answered by the physician.”8 This has never been revised. In this introductory paper the writer proposes to discuss the development of the concept of “insanity” from historical, social, legal and psychiatric points of view, and to bring up for consideration some of the factors that help to account for the backwardness of social and legal attitudes towards the mentally ill. The term “insanity” condensed from “insanity of mind” came into popular usage in England in the i7th century. It gradually replaced such terms as “madness,” “lunacy,” “imbecility,” etc., in medical and legal writings. “Insanity” covered all forms of mental disturbance other than those due to outstanding congenital defect

A session ofthe annual meeting ofthe A merican Psychiatric Association in Dallas, Tex. , on May 2, 1972 (a joint panel with the A merican A cademy of Psychoanalysis), was devoted to “ Changing Styles in Psychiatric Syndromes.” The participants were: John L. Schimel, M.D. , Associate Director, William Alanson White Psychoanalytic Institute, New York City, and Chairman ofthe Committee on Programs. A merican A cademy of Psychoanalysis. Leon Salzman, M. D. , Deputy Director, Bronx State Hospital, and Clinical Professor ofPsychiatry, Albert Einstein College ofMedicine, New York City. Paul Chodoff M. D. , Clinical Professor of Psychiatry, George Washington University Medical School, Washington, D.C. Roy R. Grinker, Sr. , M. D. , Director, Institutefor Psychosomatic Research and Training, Michael Reese Hospital and Medical Center, Chicago, and Professor of Psychiatry, Pritzker School of Medicine, University of Chicago. Otto A. Will, Jr., M.D., Medical Director, A usten Riggs Center, Stockbridge, Mass. Their papers are abstracted below.

The study of the relationship between culture and personality has been one of the major interests of social anthropologists, sociologists, and social psychologists for two decades. Significant contributions have been made by all three sciences. Nevertheless it is still in a confused and controversial state. This arises from the divergent formulations of the problem, each formulation springing from the implicit and explicit postulates of the particular scientist, which again arises from the historical development of his own science. Of recent years, however, there has developed the possibility of an approach that may become acceptable to a large number of social scientists of all the disciplines concerned. It is intended in this brief paper to make a restatement of this particular approach in the hope that discussion may further clarify it. An oversimplified statement of what might now be called the traditional approach is that there are individuals, that these individuals live in society and, growing up in his society, each individual’s process of development is influenced by the culture of the society of which he is a member. The resultant product, in the individual’s behaviour, we label personality. Thus, it is said, the development of each personality results from all his experiences, including his interaction with other individuals. Thus, further, there is a cultural component in each personality, but also there are individual components. In this scheme, the role of the sociologist and of the social anthropologist is to study this social component of personality, leaving it to the psychologist to study the totality of personality and the individual differences. Culture and society thus interact with personality, and one of the meeting grounds of the van