The current situation in Soviet psychiatry needs a surrealist to describe it. On the one hand, an increasing number of Soviet journals have been forthrightly saying what Soviet dissidents and Western observers have said for almost twenty years. This is that abuses of psychiatry for political reasons—including the confinement of political dissidents in psychiatric institutions—have taken place in the USSR on a large scale for decades, violating the Hippocratic oath and causing enormous human suffering. Many of the confined dissidents, for example, were gratuitously injected with the drug Sulphazine, which, without having any medical benefits, induces a high fever and also excruciating pain in the area of the injection. Second, some of these journals point out that abuses, though much reduced in scale, continue to occur.
On the other hand, the leading officials of Soviet psychiatry and also, on occasion, the politicians who employ them, put forward a completely different picture. They say, or at least imply, that no such abuses have ever occurred, or—a slight variant—that a few mistakes occurred in the past as a result of psychiatrists being overcautious and producing “hyperdiagnoses,” but that now such mistakes cannot occur, thanks to new legislation and administrative reforms. The officials who are in charge of Soviet psychiatry also continue three long-established practices: they continue to try to manipulate foreign psychiatric organizations and delegations; they put obstacles in the way of those victims of abuse who seek psychiatric “rehabilitation” or justice through the courts; and they try to discredit critics of these abuses in the Soviet Union.
The two worlds occupied by the critical journals and the Soviet officials are radically different. The US psychiatric delegation that visited the USSR earlier this year, of which I was a member, was made aware of the difference when it moved back and forth between them, and the contrast is reflected in our report.1 In the first world, which includes liberal journalists, psychiatrists outside the bureaucracy, and dissidents, our talks about psychiatric abuses were useful and uninhibited. But when we stepped through the looking glass into the second world, which had organized our official program and made sure that it included only approved doctors, dialogue was either impossible or so tortuous as to be exhausting and most of the time unproductive. Since the Soviet side could not acknowledge the basic facts, our talks lacked a common language and could often proceed only through circumlocutions and hints.
Why does such a dualistic situation exist? The answer is simple: since early 1987, the officials who have for many years been in charge of psychiatry have been fighting to preserve their power during the period of perestroika. Perestroika is a comprehensive program which aims to bring efficiency and integrity to the economy, society, and politics in the USSR. In most fields, reform is well underway, and many of the old leaders have been retired, disgraced, or even jailed. In psychiatry, even though perestroika has been needed for reasons of foreign as well as domestic policy, the leading officials are still hanging on. The Foreign Ministry has been pressing for the reform of psychiatry because it has been working for nearly three years to improve the human rights image of the USSR in the West, and psychiatric abuse has been one of the ugliest blemishes on that image.
However, the psychiatric officials know that if they were to allow serious reform, it would soon sweep them away. They have long presided over a branch of medicine that, in addition to harboring violators of the most basic medical ethics, is also inefficient, scientifically backward and even obscurantist, expensive to the state, and, to judge by Soviet press reports, at least as corrupt as most of the rest of Soviet medicine.
For this reason, reform in Soviet psychiatry has so far been limited in its announced aims and even more limited in its practice. True, the most visible cases of abuse—cases known in the West of political dissidents who are forcibly kept in psychiatric hospitals—have now been largely removed by the convenient device of having them suddenly declared cured and releasing them. During the last two years, some one hundred have been sent home. But the system by which dissidents are persecuted by psychiatric means remains in place, and we also receive new information that some dissidents who were previously unknown abroad remain interned, and that new internments are sporadically occurring.
Just as important, if a repressive leader were to replace Gorbachev, and if a crackdown on reformers and dissidents of the type recently seen in China were to take place—developments that could occur during the next few years—then the system could start “processing” large numbers of victims without difficulty. The US delegation gained insight into this system because we were allowed to see many more patients, records, and institutions than have been accessible to other foreign visitors in the past. But this unprecedented opportunity will not necessarily be repeated and it has not stopped the system from functioning.
Since last summer a dozen or so articles have appeared in the Soviet press that have frankly discussed the use of psychiatry to silence political dissidents.2 On June 28, for example, a particularly revealing case was described in the government paper Izvestia. Nothing was previously known in the West about the victim, Yu. I. Sobolev, a former director of a timber yard in the Ulyanovsk region on the middle Volga who was critical of official policies, even though he has been confined in a hospital three times for political dissent, and has spent a total of a year and a half as, in effect, a political prisoner. Although a psychiatrist had diagnosed him as psychotic with a “depressive-paranoid syndrome” and ordered that he be confined, he was found by the hospital that admitted him after diagnosis, and by the reporter, to be normal. The circumstances of Sobolev’s third internment in March 1989 were described to the Izvestia reporter with unusual candor by a deputy police chief in the Ulyanovsk region. Three weeks before the elections to the Congress of People’s Deputies last March, he told the reporter,
I was phoned by the First Secretary of the Nikolayevka District Party Committee, V.A. Panasenko, who said that at a candidate’s election meeting Sobolev had been putting forward some sort of undesirable ideas. He said that Sobolev must be taken out of circulation. I phoned the psychiatrist V. Kamalov and explained the situation. He said he’d write an order for hospitalization.
Dr. Kamalov, the report continued, “admits that he consigned to compulsory treatment in a mental hospital a man who was not on the psychiatric register, and whom he had never even set eyes on.” Kamalov’s self-serving comment was: “What is one to do, if one is given an order?”
The answer to this question is that many Soviet psychiatrists faced with the same situation have, without doing anything heroic, found ways of avoiding complicity in a professional and juridical crime.
The most significant aspect of the case, however, is the casual, routine way in which compulsory confinement was arranged—at a time when officials of the Ministries of Health and Foreign Affairs had long been telling foreigners in private that such practices had stopped. Such assurances were designed to back up public statements that legislation passed in 1988 had radically improved the protection of patients from possible abuses, and that the new law would allow patients with grievances to have their cases reviewed and to engage legal counsel to defend them against unjust hospitalization. But it was already clear that the assurances by the Soviet ministries that the compulsory confinement of healthy dissidents had stopped were not true, because news of a score of new political internments during 1988 and 1989 had reached the West. However, the victims in these cases had not been sent to the hospital as a result of a criminal prosecution but were put there, as Sobolev was, by an administrative order signed by a doctor; and they were soon discharged. It was therefore possible to believe that these cases of confinement might be local aberrations that would soon come to an end.
The Sobolev case, along with other evidence, tends to confirm my suspicion that secret instructions have probably been issued by officials in Moscow to local authorities telling them (a) to avoid criminal commitments in political cases, and (b) if news of a local case of civil or administrative commitment leaks out, to have the person released. In other words, such instructions—and we can so far only speculate about them—are probably not intended to eliminate political abuse altogether, but to prevent the continuing, more infrequent, use of psychiatric repression from causing problems for the USSR’s foreign policy.
A somewhat similar case is that of the Ukrainian dissident Anatoly Ilchenko, whom members of the US delegation examined in March. He showed no symptoms that would have justified putting him in a hospital, and he was immediately released. In this case the local authorities in the Ukraine had been more careless. They had overlooked the fact that Ilchenko’s name, though not well known, had in fact been reported earlier in the West in connection with a previous internment in a psychiatric hospital for dissident activities.
Another article in the Soviet press, by the journalist Leonid Zagalsky,3 is notable for being the first to call for the resignation of three longstanding top executives of the system of political abuse of psychiatry—Dr. Georgy Morozov, Dr. Marat Vartanyan, and Dr. Alexander Churkin. Dr. Churkin, the chief psychiatrist of the Ministry of Health, played a prominent part in arranging the visit of the US psychiatric delegation. Also, in May of this year he was invited, by a group of American psychiatrists who did not trouble to look into his credentials, to take part as an honored guest at the annual convention of the American Psychiatric Association (which, as an association, takes a strong position against Soviet psychiatric abuse). I shall have more to say about him and his colleagues below.
Zagalsky’s article begins by documenting the dirty and crowded conditions and demoralized atmosphere of Soviet mental hospitals. A hospital in Adzharia, for example, had no plumbing or toilets and stank so horribly that it was, he reported, “a rare bird” that dared to fly over it. He also tells how he accompanied an earlier American group to Moscow’s Serbsky Institute for General and Forensic Psychiatry, and how they were carefully kept away from the depressing sight of the wards—a sight which was “not suitable for weak-nerved Americans.” Only hardened Soviets could “endure such a spectacle.” This institute is the apex of the system of psychiatric abuse, and has labeled as insane hundreds of dissidents such as Vladimir Bukovsky and General Petro Grigorenko.
Zagalsky then discusses how Soviet psychiatry “started to serve politics” during the 1950s. Early on, as in the well-known case of the biologist Zhores Medvedev, who was confined to a mental hospital near Moscow in 1970, it was sometimes possible for established intellectuals to get a victim released quickly. But this soon became difficult since victims were locked up for “long years” and “those who interceded for them faced the threat of serious punishment.” Thus the foreign criticism that led in 1983 to the USSR’s resignation from the World Psychiatric Association (WPA) was, in Zagalsky’s view, fully justified. He appears to doubt whether the Soviet application to be readmitted will be approved at the WPA’s congress in Athens this October. Certainly his article strongly implies that Soviet psychiatry has not yet earned the right to readmission.
One reason it has not done so is the continuing power of Churkin, Morozov, and Vartanyan, who, Zagalsky writes, hold in their hands “all the reins” of Soviet psychiatry. Churkin has been chief psychiatrist of the Ministry of Health for more than a decade—a term that makes clear “what role he played in dissident cases…all these years.” Zagalsky quotes disapprovingly Churkin’s views on the recent visit by American psychiatrists. When asked what would happen if the Americans examined hospitalized dissidents and reached conclusions different from the Soviet diagnoses, Churkin replied: “They have a right to their opinion. But it will not change the subsequent treatment of the patient.”
Churkin, Morozov, and Vartanyan are servile officials, Zagalsky goes on, “people of the past.”
A vast quantity of facts about the abuse of psychiatry and its use for political purposes testifies incontrovertibly to the guilt of the leaders of this branch of medicine. It is with their connivance that healthy people were sent to mental hospitals, and the reputations and whole lives of these people ineradicably damaged.
“If,” Zagalsky continues,
even one human life has been wrecked through one’s own fault, one should resign. This is what people do in societies claiming to be civilized, if their actions have been discredited in the view of public opinion.
In this case, however, “no one has resigned.” The officials claim, Zagalsky writes, that “psychiatry has changed so much that now no one will ever be put in a mental hospital without strict criteria being met.” He comments: “We’ll wait and see.” He ends his article by recounting the details of several cases similar to Sobolev’s, and he shows how the mental health legislation of 1988 has been undermined by Ministry of Health directives. The result, in his opinion, is that “as in the past” no one is safe from arbitrary hospitalization and excruciating treatment with the drug Sulphazine.
Zagalsky implies, I believe rightly, that no radical change can occur in Soviet psychiatry so long as its present leaders remain in power. Apart from their abuse of psychiatry, their deception and manipulation of Western psychiatrists for many years have shown them to be unscrupulous. This has been documented at length, particularly in two books jointly written by Sidney Bloch and myself,4 and the facts we presented have not been challenged. More recently, Dr. Vartanyan’s record of plagiarism, corruption, and general viciousness has been described in an open letter by a courageous longtime colleague of his, Dr. Viktor Gindilis.5 Gindilis points out that Vartanyan’s record was so scandalous that the Communist party’s disciplinary committee felt impelled, in 1985-86, to investigate him. The committee “officially confirmed that he had grossly abused his official position and violated the norms of scientific ethics.” However, because of “powerful pressure from the forces protecting Vartanyan,” he was eventually let off with an “administrative reprimand.” Worse still, his close relationship with Dr. Evgeny Chazov, the minister of health and his chief protector, later led to his promotion as director of the All-Union Research Center for Mental Health.
The militancy and power of the conservative psychiatric establishment were also revealed last October when Dr. Nikolai Zharikov was appointed president of the reorganized Soviet Society of Psychiatrists and Narcologists. For several decades Zharikov has been a close associate of Georgy Morozov, the director for thirty-two years of the Serbsky Institute. Not surprisingly, his record is dismal. In 1973, for example, he ruled that the dissident activist Yuri Shikhanovich, who was widely known in Moscow as one of the sanest and most humane of people, was psychotic. That a man like Zharikov is now leading the Soviet Society’s efforts to gain readmission to the World Psychiatric Association suggests a disturbing confidence that the association can be easily manipulated.6
Further evidence of the untrustworthiness of administrators came to light during the US delegation’s trip, and some of it is described in the delegation’s report. In Kazan, for example, two young psychiatrists who had just started telling members of our group what had been concealed from us during our visit to the Kazan Special Psychiatric Hospital (SPH) were quickly frog-marched out of our hotel by the deputy director of the hospital, Dr. Nail Idrisov. A number of patients in the Kazan and Chernyakhovsk Special Psychiatric Hospitals told us, secretly, that they had been warned they would be punished if they spoke to us negatively about the hospitals. All this simply reflected the position of the psychiatric authorities in Moscow, who had evidently been forced by the Kremlin to go along with our visit, but were still determined to manipulate its outcome as much as possible.
More recently, the same kind of deception and furtiveness that prevented us from freely discussing the issues with the official psychiatrists whom we met also occurred in the new USSR Supreme Soviet, when the minister of health, Evgeny Chazov, was asked by a member whether psychiatric abuse had been ended. (Such questioning is part of the newly instituted confirmation hearings in the Soviet Union’s recently elected legislature.) Chazov avoided replying directly, but said that the 1988 legislation I have mentioned provided a guarantee against abuses, that the Special Psychiatric Hospitals had been transferred from the authority of the Ministry of Internal Affairs (MVD) to that of the Ministry of Health, and that recent psychiatric delegations from abroad had not been able to name a single person currently held in mental hospitals because of his beliefs.7
The disingenuousness of this reply is not surprising, since Dr. Chazov is closely associated with Dr. Vartanyan. He has worked in the Ministry of Health for twenty years, and it is likely that if the lid is ever blown off Soviet psychiatry, he would risk disgrace along with Vartanyan and the others. But the deviousness of his reply is nevertheless worth noting. First, the 1988 legislation and related Ministry of Health directives have been shown by Soviet lawyers as well as by Zagalsky and several foreign commentators to be seriously defective; moreover most patients have not even been told about the new systems of appeal and review that are now available to them on paper. Our report makes the same points.
Second, the transfer of the Special Psychiatric Hospitals to the jurisdiction of the Ministry of Health is only a very partial one. As our report makes clear, the transfer allows the Ministry of Internal Affairs to continue to have a strong influence over the Special Psychiatric Hospitals, since this ministry still employs—directly or indirectly—the key medical and security professionals in them. Third, in referring to foreign psychiatric delegations Chazov deceptively omitted to mention (a) that our delegation had, in March, found no reason why five hospitalized dissidents whom it examined should be confined; (b) that we had found other patients in hospitals we visited whose cases were at least partly political or religious, and who appeared, if only on short acquaintance, not to need confinement (for example, at Kazan, the religious believer Valentina Shakina, a physicist from Moscow); and (c) that medically unjustified commitments of dissidents were still occurring, such as that of Sobolev, a fact that had just been reported by Izvestia, the main publication of the government to which Chazov himself belonged. Finally, Chazov’s reply did not admit that the political abuse to which the questioner referred had ever occurred.
Even on purely factual matters, health officials are often untrustworthy, for example, in their statements about the national psychiatric register—a list of hospitalized patients and of discharged patients who are indefinitely subject to compulsory recall for examination until they are removed from the register. It recently came to light that Churkin’s claim in early 1988 that there were then 5.5 million citizens on the register is incorrect.8 According to the journal Ogonek the state statistics committee gives a figure of 10.2 million for the same date.9 (Churkin announced in 1988 that the government intended to remove 30 percent of the supposed 5.5 million from the register during the next two years.)
The US delegation of twenty people, plus six interpreters, consisted mainly of psychiatrists, but also included lawyers and specialists on human rights. Its main work was to examine twenty-seven Soviet citizens currently or recently hospitalized for reasons suspected of being non-medical, and to make visits to two Special Psychiatric Hospitals in Kazan and Chernyakhovsk, where well-known dissidents like Natalya Gorbanevskaya and General Grigorenko had been held, and, for comparative purposes, to two Ordinary Psychiatric Hospitals (OPHs) in Vilnius and Kaunas. The Special Psychiatric Hospitals are officially reserved for cases requiring a high degree of security, i.e., cases in which the patients may be dangerous to themselves or others.
We named the hospitals we wished to visit only a week before we arrived, while the names of the forty-eight people we hoped to examine were given to Moscow two months in advance. During these two months a score of those we named were hastily released, and we ended up examining twelve recently released people, and fifteen who were still in Special Psychiatric Hospitals. Teams of half a dozen Americans examined each of the twenty-seven people for an entire day, studied their records, and in most cases were also able to talk to his relatives and to Soviet psychiatrists. The teams recorded most of the examinations on audiotape and videotape.
We concluded that none of the twelve people recently released had been mentally ill, although three had minor personality problems such as hypomania or mild cognitive impairment. They had all been confined in hospitals and treated for reasons evidently related to their political or religious dissent, rather than for genuine psychiatric conditions. Of the fifteen still in a hospital, the team concluded that five showed no signs of having been mentally ill. Ten were diagnosed as having psychiatric conditions such as paranoid schizophrenia and delusional disorder, and a few of these were dangerous. Except for the latter, none of them, according to the psychiatrists who saw them, should have been hospitalized. Before we arrived, human rights groups such as Helsinki Watch had information suggesting that four of the ten were suffering from mental illnesses. The question the groups wanted answered about each of the ten people was whether any mental condition he had made him physically dangerous, either to others or to himself. If it did not, and if there were no other valid medical reasons for confining him, then compulsory hospitalization and treatment could only be described as politically motivated abuse of psychiatry. This proved to be the case with six out of the ten.
As regards the two Special Psychiatric Hospitals I visited, the prospects for change seemed to me better in the hospital at Chernyakhovsk than the one at Kazan, partly because the Chernyakhovsk administration was making considerable progress in reducing the numbers of people being treated, but more especially because the administrators had been newly promoted and therefore, in contrast to Kazan’s, were less burdened by a need to justify past practices.
In reality, as I have suggested, the transfer of the Special Psychiatric Hospitals from the Ministry of Internal Affairs to the Ministry of Health does not seem very genuine. The doctors, in fact, are still Ministry of Internal Affairs officers, even though they receive Ministry of Health directives, and the guard units are still wholly under the Ministry of Internal Affairs. At Chernayakhovsk the Ministry of Internal Affairs officer at the hospital refused to give me permission to look inside a watchtower.
Trying to find out if the KGB still maintains a presence in the Special Psychiatric Hospitals, I interviewed in Kazan Major Nikolai Vdovenko, the head of the “Special Department,” the official who has traditionally been the KGB’s representative in each hospital. He became flustered when I asked him if he worked for the KGB, but, after looking, as if for guidance, at Lieutenant Colonel Rail Valitov, the head of the hospital, they both said no, he reported only to Valitov. Moreover, Vdovenko said, he had never worked for the KGB. However, since the only photograph on the wall of his office was of Felix Dzerzhinsky, the founder of the KGB, I suspect he and Valitov were lying.
A further obstacle to reform in the Special Psychiatric Hospitals is that in comparison to the powerful Ministry of Internal Affairs, the main officials responsible for monitoring the possible abuses in these hospitals, the regional chief psychiatrists of the Ministry of Health, appear to be in a weak position. The regional chief responsible for monitoring the Chernyakhovsk hospital, for example, was a young man of about thirty who had just finished his graduate studies in Leningrad. He seemed a decent man, but had no administrative experience and was too junior in status to carry much weight within the hospital.
The problem of brutality in the Special Psychiatric Hospitals is acute. At Chernyakhovsk, for example, many inmates complained to us about the cruelty of one Dr. Dmitri Podryachikov, with whom I talked twice at some length. My conversations led me to believe that he did in fact regularly intimidate patients by shouting at them and sometimes by having them severely beaten by orderlies. One patient told me that he had almost died from a beating administered on Dr. Podryachikov’s orders and in his presence, and several witnesses confirmed that this had happened. Later two of the doctor’s colleagues indicated that they shared my impression of him.
Two doctors clearly lied to us, both Dr. Valitov at Kazan, as noted above, and also Dr. Anatoly Pchelovodov at Chernyakhovsk, who told us that Sulphazine had not been used there for many years, when the head of his Special Psychiatric Hospital openly admitted to me that it was still being used.
The revised laws of 1988 concerning psychiatry have been in force for a year, but they have not had much effect. Ninety percent of the Special Psychiatric Hospital inmates I met had never heard of them, and no one knew their provisions. Some hospital psychiatrists themselves admitted not knowing about them, and none that I met was eager to discuss them. At Kazan, a bulletin board headed “New Developments in Legislation” carried no material more recent than 1983.
No patient who knew of the new laws put hope in their helping him, for example, to get a diagnosis changed, or to obtain a lawyer who might be able to appeal against the injustices that, in many cases, he felt he had suffered from the legal system, either between arrest and trial, or after compulsory hospitalization. When a Kazan patient complained to us about such injustices, Dr. Valitov admitted that the hospital “unfortunately has no personnel to help patients with such matters.” It was as if the new laws scarcely existed.
The Soviet reply to the report of the US delegation is conciliatory in tone. The psychiatric section calls the report
a valuable and useful document, since a “view from outside” enables Soviet psychiatrists to assess anew the processes occurring in Soviet psychiatry, and to map out ways of overcoming those negative phenomena that still exist.
However, the anonymous writers paint a rosier picture than the facts warrant, both of current trends in Soviet psychiatry and of the usefulness of the official psychiatric discussions with Soviet psychiatrists that took place during our visit.
Their purpose seems clear. They want to improve the chances of Soviet psychiatry being readmitted to the World Psychiatric Association by creating an exaggerated impression of reforms in psychiatry and of willingness to discuss issues openly and frankly. Two months after the publication of the report and the Soviet reply in the US, however, they have yet to appear in the USSR. If they did the false optimism of the Soviet reply would risk being exposed by the liberal press.
How much change has occurred, then, in Soviet psychiatry, and what prospects exist for further change? In my view, a timid start has been made on reforms, but it has been imposed on a resistant, hostile, and defensive Ministry of Health by politicians who have sometimes been able to mobilize journalists and lawyers and a few maverick psychiatrists in their support. The prospects for further change seem uncertain and limited, as long as Vartanyan, Morozov, Chazov, Zharikov, and Churkin remain the key officials in charge. All the knowledgeable independent witnesses who have spoken out publicly or privately regard the psychiatric system as being in bad shape, and our visit provided much evidence to the same effect. I had no sense that there is strong momentum or enthusiasm for change except perhaps within a few of the best Ordinary Psychiatric Hospitals such as the one I visited at Vilnius in Lithuania where patients were getting attentive if mostly old-fashioned care and the occupational therapy was varied and imaginative; and in Vilnius the changes are limited to what can be accomplished locally.
In all hospitals there is as yet no general policy of removing unsuitable staff members. Only part of the evidence on psychiatric abuses that has been collected by Soviet journalists and lawyers has been allowed to be printed. The Ministry of Health is clearly doing its best to block the publication of such information and reports, and when it fails to do so, it either ignores them or reacts with hostility. And no one seemed confident that the Ministry of Health would increase the funds available for psychiatric services as a whole. The chronic shortage of funds is suggested by the fact that local churches have been officially invited to supply volunteers to work in psychiatric hospital wards (see illustration on page 56).
The debased psychiatric establishment can thus be said to be holding the line and fighting hard against reform—often with success. In my view, though, if the five chief officials I have mentioned were to be removed or transferred to teaching posts, this would be the major development that could easily lead to real reform in Soviet psychiatry, as has already occurred in other spheres of Soviet life. With these men gone, I believe that political abuses could soon be ended and authoritatively condemned, and at least some safeguards against their re-emergence might be developed.
The worst contribution we in the West could make to the reform of Soviet psychiatry, in my view, would be to soften our criticism for diplomatic reasons. The best would be to be frank and direct, just as countless people are about the short-comings of American psychiatry.
If serious changes were really taking place in Soviet psychiatry, both the US report and the Soviet reply would have been published in the USSR, and the Novosti news agency would not have circulated an article implying that the US group had approved most of what it found and that US-Soviet cooperation was blooming.10 The system of political abuse would have been publicly denounced by psychiatric and political leaders. The new laws of 1988 would be widely known in the Special Psychiatric Hospitals. The twenty or so Soviet psychiatrists officially charged with corruption would have been sentenced, and others like Vartanyan and Churkin who have been publicly accused of corruption would have been investigated. These two, as well as Morozov, Chazov, and others, would at least have been dismissed or sent into retirement for their active or complicitous roles in the conduct of political psychiatry. Dr. Anatoly Koryagin and Dr. Semyon Gluzman, the heroic psychiatrists who were imprisoned for long terms for their efforts to expose the repressive psychiatric system, would have been honored by Soviet psychiatry for their commitment to truth. And Koryagin would, like Alexander Solzhenitsyn, have been officially asked to return home from exile abroad. But none of these things has happened.
During the last year or so, dissidents like Alexander Podrabinek have taken the view that Soviet readmission to the World Psychiatric Association would be premature.11 This view has now been argued by Dr. Semyon Gluzman in a letter to Western colleagues. In his eloquent, philosophical, and constructive appeal he writes:
I don’t understand…how one can accept back into the World Psychiatric Association people who tortured in the past and do not acknowledge it today.12
The people who would return to the association would not be
the thousands of ordinary Soviet psychiatrists who saw it all and understood it all, but were afraid to protest, but rather the false scientists and hangmen, the stained ones, those without a conscience, the incompetent ones.
Dr. Gluzman is right. If the USSR does return now, “the false scientists and hangmen” would be strengthened and the liberal reformists will be weakened. If, however, it is not readmitted, the opposite would happen.
—September 14, 1989
October 12, 1989
See Report of the US Delegation to Assess Recent Changes in Soviet Psychiatry, to Assistant Secretary of State for Human Rights and Humanitarian Affairs, US Department of State (July 12, 1989), 117 pages. Issued simultaneously was a “Preliminary Soviet Response” to the report, consisting of seven pages of psychiatric comment by anonymous official psychiatrists and fourteen pages of commentary on legal problems in psychiatry by two lawyers. ↩
Among those not discussed here are articles in Literaturnaya gazeta (May 31, 1989), Znamya, No. 7 (1988), Uchitelskaya gazeta (November 19, 1988), Meditsinskaya gazeta (May 21, 1989), and Ogonek, No. 29 (July 15–22, 1989). ↩
Literaturnaya gazeta, June 28, 1989. ↩
See Psychiatric Terror: The Abuse of Psychiatry in the Soviet Union (Basic Books, 1977); and Soviet Psychiatric Abuse: The Shadow Over World Psychiatry (Westview Press, 1985). ↩
This remarkably bold, 2,000-word letter has been written up at greater length in the medical and scientific press, notably in Nature, Vol. 337 (February 16, 1989), and The Lancet (February 18, 1989). A full translation is in my possession. ↩
The late I.F. Stone documented in The New York Review (December 22, 1988) evidence from last fall of active efforts by some WPA leaders, notably President Costas Stefanis of Greece, to help the Soviets gain readmission. Since then, the evidence has mounted, and involves especially the WPA’s secretary-general, Doctor Fini Schulfinger of Denmark. See details in the Information Bulletin of the International Association on the Political Use of Psychiatry (IAPUP, Post Box 3754, 1001 AN Amsterdam, Holland), No. 20 (February 1989), pp. 1–15, and No. 21 (May 1989), pp. 1–6. Further information has just appeared in a book edited by Robert van Voren: Soviet Psychiatric Abuse in the Gorbachev Era (IAPUP, Amsterdam, 1989), Chapters 3 and 6. The contributors to this timely book are Anatoly Koryagin, Alexander Podrabinek, Robert van Voren, Christine Shaw, Sidney Bloch, Friedrich Weinberger, and Peter Reddaway. ↩
TASS report, July 10, 1989. ↩
One of the occasions on which Churkin gave this figure was in an interview with Andrea Bonanni in Corriere della Sera (April 5, 1988). ↩
Ogonek, No. 16 (April 15–22, 1989), p. 24. ↩
Article by Eleanora Gorbunova, Novosti Press Agency (August 4, 1989). ↩
See, for example, Alexander Podrabinek, “Soviet Psychiatry: A Message from Moscow,” in The New York Review (December 8, 1988). ↩
The full text appears in the book Doctor Semyon Gluzman on Soviet Totalitarian Psychiatry, published in August 1989 by IAPUP (see note 6 above). ↩