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In order to describe the contemporary transformations of psychiatry, we must borrow the methods of several different disciplines. The scientific dynamic of psychiatry must be described in order to show the progress of knowledge, with the help of epistemology and the history of science. And the evolution of practices and know-how must be described using sociology and the analysis of organizations and work. The social dimension of psychiatry makes it an object for the political, social, and human sciences. The sociological notion of a field is useful for describing changes in the scope of psychiatry. The changes in perspective brought about by psychiatry are expressed as changes in the anthropological conceptions of man, humanity, disease, and destiny. But the object of psychiatry is not neutral. Man, in his suffering, acts upon others, and his suffering has effects. Everyone’s humanity is involved in the suffering of each one of us, and the human being is transformed by this suffering. The demands made on psychiatry are overwhelming. Disappointment would be the rule were it not for the utopias and dystopias that abound in psychiatry, and manifest the creative tension of a social body seeking to escape the irreducible contradictions of human existence in its most dramatic forms.