In the Soviet Union, systematic political abuse of psychiatry took place; ; ; ; ; ; ; ; ; ; ; and was based on the interpretation of political dissent as a psychiatric problem.; It was called "psychopathological mechanisms" of dissent.
During the leadership of General Secretary Leonid Brezhnev, psychiatry was used as a tool to eliminate political opponents ("dissidents") who openly expressed beliefs that contradicted official dogma. The term "philosophical intoxication" was widely used to diagnose mental disorders in cases where people disagreed with leaders and made them the target of criticism that used the writings by Karl Marx, Friedrich Engels, and Vladimir Lenin. Article 58-10 of the Stalin Criminal Code—which as Article 70 had been shifted into the RSFSR Criminal Code of 1962—and Article 190-1 of the RSFSR Criminal Code along with the system of diagnosing mental illness, developed by academician Andrei Snezhnevsky, created the very preconditions under which non-standard beliefs could easily be transformed into a criminal case, and it, in its turn, into a psychiatric diagnosis. Anti-Soviet political behavior, in particular, being outspoken in opposition to the authorities, demonstrating for reform, writing books were defined in some persons as being simultaneously a criminal act (e.g., violation of Articles 70 or 190-1), a symptom (e.g., "delusion of reformism"), and a diagnosis (e.g., "sluggish schizophrenia").; Within the boundaries of the diagnostic category, the symptoms of pessimism, poor social adaptation and conflict with authorities were themselves sufficient for a formal diagnosis of "sluggish schizophrenia."
The psychiatric incarceration was conducted to suppress emigration, distribution of prohibited documents or books, participation in civil rights actions and demonstrations, and involvement in forbidden religious activity. The religious faith of prisoners, including well-educated former atheists who adopted a religion, was determined to be a form of mental illness that needed to be cured. The KGB routinely sent dissenters to psychiatrists for diagnosing to avoid embarrassing public trials and to discredit dissidence as the product of ill minds. Formerly highly classified extant documents from "Special file" of the Central Committee of the Communist Party of the Soviet Union published after the dissolution of the Soviet Union demonstrate that the authorities of the country quite consciously used psychiatry as a tool to suppress dissent.; ; ;
In the 1960s, a vigorous movement grew up protesting against abuse of psychiatry in the USSR. Political abuse of psychiatry in the Soviet Union was denounced in the course of the Congresses of the World Psychiatric Association in Mexico City (1971), Hawaii (1977), Vienna (1983) and Athens (1989). The campaign to terminate political abuse of psychiatry in the USSR was a key episode in the Cold War, inflicting irretrievable damage on the prestige of Soviet medicine. In 1971, Vladimir Bukovsky smuggled to the West a file of 150 pages documenting the political abuse of psychiatry, which he sent to The Times. The documents were photocopies of forensic reports on prominent Soviet dissidents. In January 1972, Bukovsky was convicted of spreading anti-Soviet propaganda under Criminal Code, mainly on the ground that he had, with anti-Soviet intention, circulated false reports about political dissenters. Action Group for the Defense of Human Rights in the USSR stated that Bukosky was arrested as a direct result of his appeal to world's psychiatrists, thereby suggesting that now they held his destiny in their hands. In 1974, Bukovsky and the incarcerated psychiatrist Semyon Gluzman wrote A Manual on Psychiatry for Dissidents, which provided potential future victims of political psychiatry with instructions on how to behave during inquest in order to avoid being diagnosed as mentally sick.
Political abuse of psychiatry in Russia continues after the fall of the Soviet Union; and threatens human rights activists with a psychiatric diagnosis.
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 exculpation 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 an emergency 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.; ;
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. Russian psychiatrist Pyotr Gannushkin also believed that in a class society, especially during the most severe class struggle, psychiatry was incapable of not being repressive.; 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 Stalin 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: 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; 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.
Soviet psychiatric abuse exposed
In the 1960s, a vigorous movement grew up protesting against abuse of psychiatry in the USSR. Since 1968, A Chronicle of Current Events, the main organ of Soviet human rights movement, has started publishing systematic information on how dissidents were being committed to psychiatric hospitals and forcibly, and often very painfully, treated with drugs. President of the Independent Psychiatric Association of Russia Yuri Savenko says psychiatric repression was obvious to his circle as early as 1968, and president of the Ukrainian Psychiatric Association Semyon Gluzman states no one of Soviet psychiatrists was going to reveal psychiatric repression until Gluzman revealed it in his report.Watch from 07.47 He was the author of An In Absentia Psychiatric Opinion on the Case of P.G. Grigorenko; ; otherwise known as An In Absentia Forensic-psychiatric Report on P.G. Grigorenko; this document started circulating in samizdat form in 1971; ; and was based on the medical record of Pyotr Grigorenko who spoke against the human rights abuses in the Soviet Union. Gluzman came to the conclusion that Grigorenko was mentally sane and had been taken to mental hospitals for political reasons. In the late 1970s and early 1980s, Gluzman was forced to serve seven years in labor camps and three years in Siberian exile for refusing to diagnose Grigorenko as having the mental illness.
In 1971, Vladimir Bukovsky smuggled to the West a file of 150 pages documenting the political abuse of psychiatry. The documents were photocopies of forensic reports on prominent Soviet dissidents. These documents were attended with a letter by Bukovsky requesting Western psychiatrists to explore the six cases documented in the file and tell whether these persons should be hospitalized or not. The documents were sent by Bukovsky to The Times and, when translated by The Working Group on the Internment of Dissenters in Medical Hospitals, were examined by forty-four psychiatrists from the Department of Psychiatry, Sheffield University. The psychiatrists described the documents in British Journal of Psychiatry of August 1971 and wrote a letter to The Times. In this letter published on 16 September 1971, they reported that four of the six dissidents manifested no signs or history of mental disease, and the other two had minor psychiatric problems many years ago, quite removed from the events related to their internment. The group of British psychiatrists concluded: "It seems to us that the diagnoses on the six people were made purely in consequence of actions in which they were exercising fundamental freedoms...". They recommended discussing the issue in the course of the forthcoming World Psychiatric Association (WPA) World Congress in Mexico in November 1971.
Congress in Mexico City
The Congress in Mexico City was held on 28 November — 4 December 1971. The statement of the forty-four British psychiatrists was circulated to the 7000 delegates in English, Spanish, and French. There were statements from the Soviet Human Rights Committee describing the part played by Snezhnevsky, a head of the Soviet delegation, in the Medvedev case. When speakers demanded that the Congress go on record against the confinement of dissidents in psychiatric hospitals, the Soviet delegation and Snezhnevsky instantly walked out. They said that they could not talk about the issue since the Congress lacked official interpretation into Russian. At this Congress, Western psychiatrists tried to censure their Soviet colleagues for the first time. But the charges of psychiatric abuse were new, the campaign was disorganized, and Snezhnevsky, who headed the Soviet delegation, remained unscathed. He said in rebuttal that the accusations were a "cold-war maneuver carried out at the hands of experts." The WPA General Secretary Denis Leigh said that the WPA was under no obligation to accept complaints from one member society directed against another member society, and he informed Snezhnevsky of the complaints and sent him the "Bukovsky Papers." Leigh proposed to constitute a committee for considering the ethical aspects of psychiatric practice, but also in this instance the issue of political abuse of psychiatry in the USSR was not mentioned.