Psychiatric Terror: How Soviet Psychiatry Is Used to Suppress Dissent
In the Soviet Union today, Marxist and psychiatric ideologues work together efficiently, even smoothly. This is a fairly recent development. During the power struggles of the 1920s and the mass purges of the 1930s, there was no need for the Kremlin’s self-proclaimed Marxists to summon assistance from psychiatrists. In Stalin’s time, his enemies, real or imaginary, were subjected to mock trials, then shot or locked up for good; there was no inclination to call them crazy. The Soviet ideological system had its convenient designations of “bourgeois” or “capitalist” or “reactionary,” which were quite enough. The NKVD ran its own psychiatric hospital in the 1940s, but a substantial number of those confined in it were political prisoners who were obviously in bad shape psychologically—plagued by hallucinations, delusions, etc. The Russian poet Naum Korzhavin told Sidney Bloch, a psychiatrist, and Peter Reddaway, a political scientist, both English and co-authors of Psychiatric Terror, that up until “1948 at least, the practice of placing healthy people in mental hospitals was not malicious in intent but benevolent.”
Korzhavin should know. He was arrested that year and thrown in a Soviet “forensic psychiatry” hospital for writing “anti-Soviet” poems. He believes he was shielded there by members of the staff, who knew only too well that the alternative for him was Stalin’s labor camps. Eventually he was deprived of his psychiatric sanctuary and sent to Siberia. Indeed, in the late 1940s, elements of Stalin’s bureaucracy were worried that psychiatrists were letting a few “renegades” or “traitors” off too easily—pampering them in hospitals when they belonged in labor camps. A new group of sterner psychiatrists was given power whose task it was to emphasize the difference between mental and political deviance and, in the event of any uncertainty or blurring, to favor the latter.
To be sure, in the early 1950s, before Stalin died in 1953, there were isolated instances of psychiatric abuse of a political nature—the confinement to a mental hospital of a person who had offended the state authorities. But doctors were not ordered to deal systematically with political dissidents—to call them crazy. Nor did they suggest or demand confession and recantation as part of a cure. Dissenters were not pressured to say: yes, I was out of my mind when I (allegedly, needless to say) said this or did that. Stalin, who believed various doctors were conspiring to be rid of him, was not about to entrust his major obsession, the liquidation of various “enemies,” to a group of psychiatrists.
On May 24, 1959, Pravda carried some remarks by Khrushchev on the communist world of the future. What would it be like when the “permanent revolution” had, at last, achieved its central objectives? Would there be a new kind of human being, living a radically different kind of personal and social life? Khrushchev was not an unqualified optimist, and he had a degree of candor that may have been responsible for his abrupt demise. There might still be trouble, he admitted, in the fully realized communist society. He spelled out one kind: “A crime is a deviation from the generally recognized standards of behavior, frequently caused by mental disorder.” There would always be, alas, what he went on to call “disease” and “nervous disorders.” And those so afflicted would, inevitably, do things that are unwarranted and deserve rebuke or worse. They would commit “offenses which are characteristic of people with abnormal minds.” Some of those people would, of course, turn on the world around them, try to criticize it, when in fact they are themselves in trouble, but are unable, or unwilling, to appreciate that such is the case. The Soviet leader was both philosophically resigned and admonishing:
To those who might in the future start calling for opposition to Communism on this “basis,” we can say that now, too, there are people who fight against Communism…but clearly the mental state of such people is not normal.
During the 1960s, and up to the present moment, the Soviet government has done its best to deal with the sad anomaly—mental anguish in the midst of a developing utopia—which Chairman Khrushchev indicated to be a continuing trial for communism. By 1971 the West had begun to learn rather a lot about the willingness of Russia’s bureaucrats and psychiatrists to fight social deviance head on, so to speak, along the lines suggested by the outspoken Khrushchev. Ward 7, an autobiographical book by Valery Tarsis (1965), could perhaps be dismissed as a somewhat overwrought account. Written in vivid, emotional prose, the book was the first full-length account of psychiatric punishment. Tarsis was a short story writer, a translator, a prolific essayist. Perhaps he was a cranky, all too articulate intellectual who, even if he wasn’t actually insane, had made a nuisance of himself in various ways—and so been locked up.
The authors of Psychiatric Terror say that Tarsis may well have made “some emotionally based exaggerations.” He was, however, to be proved a rather sober participant-observer. His description of the way psychiatrists work on political prisoners in an effort to get them to change their opinions has been echoed repeatedly by others, including Soviet psychiatrists themselves. One of them, Dr. Marina Voikhanskaya, now lives in England, and another, Dr. Semyon Gluzman, has himself been arrested and sent to prison, after having refused to work in a “special” mental hospital where, he knew, people not by any means insane were locked up because of their political views.
In 1971, at the World Congress of Psychiatry held in Mexico City, an effort was made by a number of Western psychiatrists, especially British and Canadian ones, to bring the matter before their colleagues, in the hope of obtaining a strong condemnation of Soviet political psychiatry, the nature of which by then had been amply documented. Case after case of persecution of dissidents in psychiatric hospitals was reported through personal statements, court proceedings, official records, carefully worded appeals by Russian citizens active in the human rights movement. I.F. Stone, in these pages (February 10, 1972), told what came of such efforts: nothing. The Russians were outraged and threatened to walk out of the Mexico City conference. They had strong allies in the leadership of the Congress—Western psychiatrists who had their own reasons to look the other way or stand fast in the defense of each nation’s obligation to mind its own business. This was the time of so-called “détente,” and English and American professional men and women had just begun visiting and receiving visits from their counterparts in the Soviet Union.
Since then the West has received from Russia one report after another of psychiatric abuse in the interests of political control. Valery Chalidze, a Moscow-born physicist, published in 1975 To Defend These Rights, a thorough survey of the various ways dissent is curbed in Eastern Europe, including medical and psychiatric punishment: enforced hospitalization, the use of drugs, electro-convulsive “therapy,” insulin shock, the gamut of other “interventions” doctors have at their disposal. In England, where psychiatrists have been notably outspoken about the behavior of their Russian colleagues, a Working Group on the Internment of Dissenters in Mental Hospitals has been established, and periodic news bulletins or reports are issued. A Committee of French Psychiatrists Against the Political Uses of Psychiatry has done likewise: it publishes lists of prisoners, with information about their lives, their current situations. Certain American psychiatrists, too, have made strong protests in local medical and psychiatric societies and through the American Psychiatric Association, which in recent months has faced up unequivocally to Soviet practices. The Association has condemned psychiatric punishment outright, and urged an international committee of inspection, aimed at uncovering the use of psychiatry anywhere for political repression.
The book Psychiatric Terror, published just before the sixth World Congress was to meet this past August in Honolulu, made it especially difficult for doctors from all over the world to look the other way. They could no longer claim, for example: we are scientists, and ought not to be involved in sticky matters of international politics; or we are physicians, and require extensive interviews with those hospitalized—clinical evidence, not hearsay stories or propaganda. (No Westerners, needless to say, have been able to obtain free access to the hospitals where dissidents are confined.)
Reddaway and Bloch supply plenty of evidence. Their book is introduced by Vladimir Bukovsky, who has in his relatively short life spent eleven years in Soviet psychiatric hospitals and prison camps—and, recently, an hour or two in the White House, conversing with Vice President Mondale. Bukovsky gets to the heart of the matter quickly. He wonders whether anyone in the West can really understand what it means to live (never mind speak up critically) in a world where a given ideology has control of a totalitarian political apparatus. “Theories and conclusions,” he points out, don’t “develop out of the raw material of life, but, on the contrary, the raw material of everyday life is created to fit in with the ruling theory.”
The “ruling theory” Bukovsky refers to can exert dominion over “life” itself—crush differing viewpoints, insinuate its assumptions into schools, offices, factories, courtrooms, and, of course, hospitals. Life, in Bukovsky’s tersely penetrating phrase, “does not develop freely, but is ‘interpreted’ by the party”: the reigning millenarian ideologues who have the final say on what constitutes “reality,” what constitutes deviance. But is not such a judgment, in concrete everyday clinical instances, the doctor’s? Bukovsky’s answer is: “The Soviet psychiatrist is a part of the Soviet system. He cannot say, ‘I find no symptoms of illness in this person.’ He cannot reach his conclusions inductively, he must follow the prescribed deductive method.”
The authors of Psychiatric Terror provide ten appendices, including a description of a Soviet mental hospital by a psychiatrist, a verbatim record of two psychiatric interrogations of political dissenters, and a fifty-page “register” of dozens of people who have been confined to mental hospitals because they have said or written words deemed “anti-Soviet.” The register offers personal information about each man or woman, and a brief summary of the “case.”
But the book contains more than a series of life histories suddenly and arbitrarily turned into case histories. Bloch and Reddaway are aware that psychiatry generally lends itself readily to political abuse. At the very start of their book, and without reference to the Soviet Union, they remark that “the nature of psychiatry is such that the potential for its improper use is greater than in any other field of medicine.” They draw on well-known psychiatric critics, such as Thomas Szasz and R.D. Laing, without going as far as those two in connecting psychiatric diagnostic categories with conventional social judgments. They give a brief history of Soviet psychiatry, showing how it has been strongly influenced by Pavlov’s experimental work in conditioning and research on learning.
For the most part, however, they describe Soviet psychiatric abuse, the justification for which does not follow from the theories of Pavlov or any other psychiatrists whose principles deserve respect. They explain how the procedures of civil commitment to mental institutions are devised to accommodate the desires of bureaucrats or the police rather than those of families, neighbors, or friends. The criminal commitment procedures are similarly bent, if not completely twisted. In the hospitals, frightened, intimidated, humiliated men and women struggle for long stretches against the effects of various drugs or electricity. Always near at hand are psychiatrists who act as judges, accusers, and sometimes tormentors. A useful historical description at the end of the book offers a little hope; we are reminded that an increasingly strong opposition to psychiatric abuse, among other repressive activities of the Soviet state, has developed both within Russia and in the West. The Russians, ever sensitive to their reputation abroad, seem willing to reduce at least some repressive activities that lead to worldwide censure. It remains true that if all psychiatric abuses were ended tomorrow, the labor camps would still be around. Knowing that, the authors concentrate on a specific task—to lay before Western readers the elements of a particular kind of “terror.”