The author attempts an analysis of some of the socio-cultural elements which have marked the birth of (modern?) psychiatry and which have consequently influenced the education, identity and ethical values of the practitioner who choses to become a psychiatrist. The author draws attention to the problem of the psychiatrist's autonomy by stressing the important relationship between autonomy (or lack of autonomy) and the dominant political ideologies. Such relationship appears more clearly when the psychiatrist uncritically accepts to become "the psychiatric expert" in criminal and civil law, suicide, sex, death, etc., in other words, whenever accepting the role of "managerial technician". It is evident that the psychiatrist cannot renounce the social responsibilities which fall upon him because of his understanding and analysis of human behaviour, but it is also evident that a redefinition of the psychiatrist's role in society is called for. Such a re-definition will be possible only by the permanent exercise of self-criticism, honesty towards oneself, moral integrity and the capacity to differentiate between true autonomy and the illusion of autonomy when operating in the name of an official psychiatry which is often also a vehicle for the enforcement of a political ideology.