At one time, I knew what psychiatrists should do and it was very satisfying. They should, so far as humanly possible, restore the mad and the distressed to sanity and tranquillity. Now things are less clear, and there are three main reasons for this. First, many of the incurably mad are distressed because they live in conditions of unspeakable social squalor which one does not have the power to relieve. Second, most of the curably distressed are cured by time or their GPs and we see only a small proportion of them. Third, many of the people referred to us have personality or alcohol problems for which, in most cases, no effective treatment can be given.