The mental hospital directs its explicit diagnostic and treatment efforts to the pathology of the patient. Simultaneously, if less deliberately, the hospital contributes to reorganization of the pattern of relationships previously esta~blished between the patient and his intimates. These changes are rarely the subject of systematic inquiry and conceptualization. They commend themselves to attention, nonetheless. First: The occasion for hospitalization is social as well as clinical, it includes a breakdown of a prior interpersonal accommodation between the patient and his community as well a,s a breakdown of his intrapersonal mechanisms of defense> 2, ~ An implicit but crucial task of the mental hospital, then, if the patient is ever to be released to a viable community context, is to assist in the repair of the social breakdown or in the establishment of a new setting in which he may resume his extramural life. ~ Second: Any changes in the pattern of relationships within the patient's family will influence the direction of psychic reorganization. The most commonly studied change is that in which the family "closes ranks" behind the hospitalized patient; '~, 6 but as will be seen, a variety of other changes occur and significantly influence the patient's reorganization. Finally: The adjustment tasks and possibilities that the patient encounters after release are concretely determined by t.he interpersonal setting to. whic,h he returns. ~ Does hospitalization tend to restore the relational status q~o ante, thus confronting the patient with a pathological situation similar to that in which his illness developed ? Or does hospitalization favor reorganizations of family life which pose new possibilities, new dangers, or new limitations for the released patient? These considerations have led the authors to analyze the effects of hospitalization on relatively enduring pat.terns of integration