Abstract
Human culture is viewed historically as passing through three great stages, from savagery through barbarism to civilization, the transitions being stimulated, first, by the Agricultural Revolution and, later, by the Urban Revolution. The class structure appears with the stage of civilization and is the social response to the changed conditions of residence resulting chiefly from the rise of the city.
The psychological characteristics responsible for the passage of culture from savagery to civilization, those resulting from the capacity for instinctual renunciation, are found mainly within the upper classes of a society. From this springs the differences between the social classes with regard to character formation, types of mental disorder, and motivation and capacity for personal change. This cultural variability, in interaction with a similar variability of psychiatric nosology and criteria of “cure”, requires the abandonment of the traditional view of mental disorder as “illness” and of mutative intervention as “treatment”.