There was systematic political abuse of psychiatry in the Soviet Union, based on the interpretation of political opposition or dissent as a psychiatric problem, rather than a social, political, or material one.
The extent of this abuse depended on the time period. It started in the late 1940s and was systemic in the 1960s to the mid-1980s.
The Criminal Code was applied in conjunction with the system of diagnosis for mental illness developed by Andrei Snezhnevsky to establish a framework within which non-standard beliefs could easily be defined as criminal offences and subsequently be the basis for a psychiatric diagnosis. Diagnoses such as "sluggish schizophrenia" or "political intoxication" were applied to dissenters, who were then incarcerated in psychiatric wards with poor living conditions.
Psychiatry allowed Soviet authorities to bypass standard legal procedures and avoid the odium attached to political trials. Dissidence was also thus discredited as the result of unhealthy minds.
At least 20,000 dissenters were put in psychiatric hospitals for political crimes. Russia is still impacted by Soviet political abuse of psychiatry.
Definition 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.;
Punitive psychiatry is based upon "the deliberate interpretation of dissent [...] as a psychiatric problem". It entails the exculpation and committal of citizens to psychiatric facilities based upon political rather than mental health-based criteria.
Punitive psychiatry is neither a distinct subject nor a psychiatric specialty. It is the result of members of the psychiatric profession serving the state's will in matters of repression – a phenomenon that happens in the applied sciences of many totalitarian countries.
Mechanisms Motives 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 is itself oppressive.
Punitive medicine (punitive psychiatry) is used to repress dissidents that cannot be punished by legal means. Psychiatry can be used to bypass standard legal procedures for establishing guilt or innocence and allow political incarceration without the ordinary odium attached to such political trials.
Psychiatric power in practically all societies expands on the grounds of public safety, which, in the USSR, was best maintained by the repression of dissidence. The definition of danger was radically extended by the Soviet criminal system to cover "political" as well as customary physical types of "danger".
Sending dissenters to psychiatrists also discredited dissidence as the product of unhealthy minds.
Diagnosis Forensic psychiatrists were asked to examine offenders whose mental state was considered abnormal by the investigating officers. People could also be hospitalized on the request of their headman, their relatives or a district psychiatrist.
Dissidents were almost always examined at the Serbsky Central Research Institute for Forensic Psychiatry in Moscow, where they were subjected to a forensic-psychiatric expert evaluation. Patients could also be examined by prison doctors or at clinics.
The "anti-Soviet" political behavior of some individuals was defined simultaneously as criminal acts (e.g., a violation of Articles 70 or 190–1), symptoms of mental illness (e.g., "delusion of reformism"), and susceptible to a ready-made diagnosis (e.g., "sluggish schizophrenia"; , "political intoxication" or "philosophical intoxication"). The explanation of dissent as a psychiatric problem was called "psychopathological mechanisms" of dissent.
The accused had no right of appeal. The right was given to their relatives or other interested persons, who were not allowed to nominate psychiatrists to evaluate the patient. All psychiatrists were considered equally credible before the law and fully independent.
The political abuse of psychiatry in the USSR arose from the conception that opponents of the Soviet regime were sick since there was no other logical reason to oppose the best sociopolitical system.
Types of persecuted dissidence The psychiatric incarceration of certain individuals was prompted by their attempts to emigrate, to distribute or possess prohibited documents or books, to participate in civil rights protests and demonstrations, to be involved in forbidden religious activities and to write critical books. +Victims of soviet psychiatric abuse, by group, per share of dissidents repressed by psychiatryGroupShare (%)Advocates of human rights or democratization~50%Nationalists~10%Would-be emigrants~20%Religious believers~15%Citizens inconvenient to the authorities~5%
Classification of mental disorders
Political abuse of psychiatry in the Soviet Union was facilitated by the fact that the national classification included categories that could be employed to label dissenters, who could then be forcibly incarcerated and medicated.
Andrei Snezhnevsky developed a novel classification of mental disorders with an original set of diagnostic criteria. Despite a number of its controversial premises, Snezhnevsky's hypothesis immediately acquired the status of dogma, in line with the traditions of then Soviet science. This dogma was later overcome in other disciplines but firmly stuck in psychiatry.
"Philosophical intoxication", for instance, was widely applied when people disagreed with nomenklatura or party leadership, or criticized sanctioned political philosophies, theory or the theoreticians who conceived them. When the dissidents were themselves communists, they were also accused of "revisionism".
Andrei Snezhnevsky was essentially responsible for the Soviet concept of schizophrenia with a "sluggish type" manifestation by "reformerism" including other symptoms. It was the most prominently diagnosis used in cases of dissidents. It could be applied to nearly any behavior deemed abnormal or asocial. Pessimism, poor social adaptation and conflict with authorities were themselves sufficient for a formal diagnosis of "sluggish schizophrenia".
According to most scholars, psychiatrists involved in the development of sluggish schizophrenia were following directives from the Communist Party and the secret service, and were well aware of its eventual political uses. Nevertheless, for many Soviet psychiatrists, "sluggish schizophrenia" was a logical explanation for the behavior of critics who seemed willing to jeopardize their happiness, family, and career for a reformist conviction that was so divergent from the prevailing social and political orthodoxy.
Incarceration
In the Soviet Union, dissidents were often confined in psychiatric wards commonly called psikhushkas. One of the first penal psikhushkas was the Psychiatric Prison Hospital in Kazan,A Chronicle of Current Events No 10, 31 October 1969 — 10.10 "The Kazan Special Psychiatric Hospital". which in 1939 was transferred to the NKVD's control on the orders of Beria.
Many dissidents were sent to regular psychiatric hospitals, which were unhygienic, overcrowded and often ran by drunks and sadists. Dissidents who were considered more dangerous were sent to "special psychiatric hospitals", which were run by the MVD and were alike to prisons.
There, they would be subjected to forced administration of drugs, beatings electric shocks, lumbar punctures and other forms of treatment or punishment. Many went crazy and some died during treatment. Patients had no rights and were entirely dependent on the psychiatrists' wills. They were only protected by rules put in place by legal and medical departments.
Hospitalization did not have an end date, and, as a result, there were cases when dissidents were kept in psychiatric prison hospitals for 10 or even 15 years. The duration of the treatment was chosen entirely by the psychiatrist. Dissidents would be freed once they recanted their previous convictions and admitted that mental illness had caused them to criticize the Soviet system.
History
During Stalin's regime (1948–1953)
As early as 1948, the Soviet secret service took an interest in psychiatry. A system of political abuse of psychiatry was developed at the end of Joseph Stalin's regime. The use of psychiatry as a political weapon was ordered by Andrey Vyshinsky, a chief of the secret police.
Punitive psychiatry was not simply an inheritance from the Stalin era, however. The Gulag was already an effective instrument of political repression. There was no compelling reason to develop a more expensive substitute such as punitive psychiatry.
The USSR did not have legislative acts regulating psychiatry until 1988 as the patient was seen as a burden to society.
The Joint Session (October 1951) A precursor to later abuses in psychiatry in the Soviet Union, the "Joint Session" of the USSR Academy of Medical Sciences and the Board of the All-Union Neurological and Psychiatric Association took place from 10 to 15 October 1951. The event was dedicated to the Russian physiologist Ivan Pavlov.
During the session, it was alleged that several of the USSR's leading neuroscientists and psychiatrists of the time were guilty of practicing "anti-Pavlovian, anti-Marxist, idealistic [and] reactionary" science, much to Soviet psychiatry's detriment. These eminent psychiatrists had to publicly recant their scientific positions and promise to conform to "Pavlovian" doctrines.
Several leading Soviet academic neuroscientists were labeled as anti-Pavlovians, anti-materialists and reactionaries and were subsequently dismissed from their positions. Some of these scientists were also imprisoned and tortured. The Joint Session ravaged research in neuroscience and psychiatry for years to come, which came to be dominated by pseudo-science.
Following the Pavlovian session and the Joint Session, Snezhnevky's school became predominant. It was given monopoly over psychiatry in 1950 – an important factor in the rise of political psychiatry. Motivated by Snezhnevky, Soviet doctors devised a "Pavlovian theory of schizophrenia" and increasingly applied this diagnostic category to political dissidents.
During Khrushchev's regime (1953–1964) The campaign to declare political opponents mentally sick and commit dissenters to mental hospitals began in the late 1950s and early 1960s. Nikita Khrushchev asserted that it was impossible for members of a socialist society to be anti-socialist. Whenever dissidence could not be justified as a provocation of imperialism or a legacy of the past, they were labelled as the product of mental illness.
By the end of the 1950s, confinement to psychiatric institutions had become the most common method to punish leaders of the political opposition.
The atmosphere at the Serbsky Institute in Moscow altered almost overnight when Daniil Lunts took over as head of the Fourth Department (otherwise known as the Political Department). Psychiatric departments had previously been regarded as a 'refuge' against being dispatched to the Gulag. The first reports of dissenters being hospitalized on non-medical grounds date from the early 1960s, not long after Georgy Morozov was appointed director of the Serbsky Institute.
Struggle against abuse