Political Abuse of Psychiatry in The Soviet Union - Background

Background

Political abuse of psychiatry is the misuse of psychiatric diagnosis, detention and treatment for the purposes of obstructing the fundamental human rights of certain groups and individuals in a society. It entails the certification and committal of citizens to psychiatric facilities based upon political rather than mental health-based criteria. Many authors, including psychiatrists, also use the terms "Soviet political psychiatry" or "punitive psychiatry" to refer to this phenomenon.

In the book Punitive Medicine by Alexander Podrabinek, the term "punitive medicine", which is identified with "punitive psychiatry," is defined as "a tool in the struggle against dissidents who cannot be punished by legal means." Punitive psychiatry is neither a discrete subject nor a psychiatric specialty but, rather, it is a disciplinary function arising within many applied sciences in totalitarian countries where members of a profession may feel themselves compelled to service the diktats of power. Psychiatric confinement of sane people is uniformly considered a particularly pernicious form of repression and Soviet punitive psychiatry was one of the key weapons of both illegal and legal repression.

Psychiatry possesses an inherent capacity for abuse that is greater than in other areas of medicine. The diagnosis of mental disease can give the state license to detain persons against their will and insist upon therapy both in the interest of the detainee and in the broader interests of society. In addition, receiving a psychiatric diagnosis can in itself be regarded as oppressive. In a monolithic state, psychiatry can be used to bypass standard legal procedures for establishing guilt or innocence and allow political incarceration without the ordinary odium attaching to such political trials. In the period from the 1960-s to 1986, the abuse of psychiatry for political purposes was reported to have been systematic in the Soviet Union and episodic in other Eastern European countries such as Romania, Hungary, Czechoslovakia, and Yugoslavia. The practice of incarceration of political dissidents in mental hospitals in Eastern Europe and the former USSR damaged the credibility of psychiatric practice in these states and entailed strong condemnation from the international community. Psychiatrists have been involved in human rights abuses in states across the world when the definitions of mental disease were expanded to include political disobedience. As scholars have long argued, governmental and medical institutions have at times coded threats to authority as mental disease during periods of political disturbance and instability. Nowadays, in many countries, political prisoners are still sometimes confined and abused in mental institutions.

In the Soviet Union dissidents were often confined in the so-called psikhushka, or psychiatric wards. Psikhushka is the Russian ironic diminutive for "mental hospital". One of the first psikhushkas was the Psychiatric Prison Hospital in the city of Kazan. In 1939 it was transferred to the control of the NKVD, the secret police and the precursor organization to the KGB, under the order of Lavrentiy Beria, who was the head of the NKVD. International human rights defenders such as Walter Reich have long recorded the methods by which Soviet psychiatrists in Psikhushka hospitals diagnosed schizophrenia in political dissenters. Western scholars examined no aspect of Soviet psychiatry as thoroughly as its involvement in the social control of political dissenters.

As early as 1948, the Soviet secret service took an interest in this area of medicine. It was one of the superiors of the Soviet secret police, Andrey Vyshinsky, who first ordered the use of psychiatry as a tool of repression. A system of political abuse of psychiatry was developed at the end of Joseph Stalin's regime. However, according to Alexander Etkind, punitive psychiatry was not simply an inheritance from the Stalinist era as the GULAG (the acronym for Chief Administration for Corrective Labor Camps, the penitentiary system in the Stalin years) was an effective instrument of political repression and there was no compelling requirement to develop an alternative and expensive psychiatric substitute. The abuse of psychiatry was a natural product of the later Soviet era. From the mid-1970s to the 1990s, the structure of mental health service conformed to the double standard in society, that of two separate systems which peacefully co-existed despite conflicts between them:

1. the first system was punitive psychiatry that straight served the institute of power and was led by the Moscow Institute for Forensic Psychiatry named after Vladimir Serbsky;
2. the second system was composed of elite, psychotherapeutically oriented clinics and was led by the Leningrad Psychoneurological Institute named after Vladimir Bekhterev.

The hundreds of hospitals in the provinces combined components of both systems.