Friday, April 10, 2009

Psychiatry In Russia: A View From 1955

BOULDER, Colorado -- In 1955, American filmmaker Albert Maysles traveled to the Soviet Union to document their practice of psychiatry. He produced a short film about his trip, Psychiatry in Russia, which was aired on American television the following year:

The most striking difference that Maysles notes between Russian and Western psychiatric practice is the former's reliance on Pavlovian theory, which does not emphasize psychoanalysis and talking therapy as much as the Freudian psychology predominantly in use in the United States at the time. Obviously, much in the film should be taken with a grain of salt - while most Soviet mental health professionals were undoubtedly conscientious and caring, their statistics on the low incidence of mental illness and the success of treatment are highly exaggerated. That said, American psychiatry at the time was in large measure barbaric, inhumane, and damaging to many patients. Lobotomies were still in wide use in the US in 1955, while the Soviet Union had banned the practice five years previous.

Maysles' film misses another important aspect of Soviet psychiatry, though his amateur foray could hardly be expected to capture one of the most oppressive practices of the Soviet state - committing political dissidents to mental institutions. The practice became widespread towards the end of Stalin's rule in 1953, and subsequent regimes, especially that of Brezhnev, used the practice to muzzle and incarcerate hundreds, if not thousands, of political opponents. The favorite stock diagnosis was "sluggishly-progressing schizophrenia," which had no symptoms other than the inability to function peaceably and obediently in Soviet society. Fighting for "truth and justice" was considered a sign of extreme paranoia, and even the failure to believe in Marxist ideology was labeled a form of psychosis.

Unfortunately, the practice is not unheard of in contemporary Russia. In 2007, journalist and opposition activist Larisa Arap wrote an article about sexual abuse and other vile mistreatment of children at a mental health facility in the Murmansk Region. After the story was published, Arap was detained by police while visiting another hospital for a personal appointment. Hospital staff then drugged her and committed her against her will to a mental facility. Medical staff moved her to another hospital in the city of Murmansk and refused to give any information to her family about her condition or even her whereabouts. Finally, she was released after being held for 46 days, during which time she was repeatedly beaten, drugged, and force fed after she went on a five-day hunger strike to protest her detention. She was only discharged on the condition that she agree to continued out-patient psychiatric care, and Russian courts have repeatedly upheld her detention as legal.

In February of this year, the Russian Constitutional Court ruled that it was illegal to involuntarily commit patients without a court order, which could only be issued with a recommendation from a court-appointed expert. Like so many decisions by the Russian courts, it is unlikely that this one will be fully and forcefully implemented by the government. Because this incident was not an isolated one, nor was it the work of a few corrupt and deranged individuals. So little of the Soviet state has been dismantled in Russia, and the security services employ many of the same coercive practices that they did in communist times. Add to a police force wholly untrained in the ways of democratic law enforcement (the emphasis there should be on the law) a political leadership born of that very same coercive apparatus, and you get a society in which medicine, which is meant to heal people, is used as a political weapon.

Maysles is still alive and well, and he is currently working on a documentary about the affair of Menahem Mendel Bailis, entitled Scapegoat on Trial. Bailis was a Russian Jew who was accused of murdering a 13-year-old boy to use his blood to make matzoh in 1913, and it was the last of the so-called "blood libel" trials against Jews in Europe.

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