social functioning, his ability to adequately test the reality and so forth. in pekhterev's words, these speeches hit point-blank on the dissidents and revolutionaries, because all of them are poorly functioning in society, are hardly adapting to it either initially or after increasing requirements. they turn their inability to adapt themselves to society into the view that the company breaks step and only they know how to help the company restructure itself. the dissidents regard the cases of personal maladjustment as a proof of public ill-being. the more such cases, the easier it is to present their personal ill-being as public one. they bite the society's hand that feed them only because they are not given a right place in society. unlike the dissidents, the psychiatrists destroy the hardly formed defense attitude in the dissidents by regarding "public well-being" as personal one. the psychiatrists extract teeth from the dissidents, stating that they should not bite the feeding hand of society only because the tiny group of the dissidents feel bad being at their place. the psychiatrists claim the need to treat not society but the dissidents and seek to improve society by preserving and improving the mental health of its members. after reading the book institute of fools by viktor nekipelov, pekhterev concluded that allegations against the psychiatrists sounded from the lips of a negligible but vociferous part of inmates who when surfeiting themselves with cakes pretended to be sufferers. according to the response by robert van voren, pekhterev in his article condescendingly argues that the serbsky institute was not so bad place and that nekipelov exaggerates and slanders it, but pekhterev, by doing so, misses the main point: living conditions in the serbsky institute were not bad, those who passed through psychiatric examination there were in a certain sense "on holiday" in comparison with the living conditions of the gulag; and all the same, everyone was aware that the serbsky institute was more than the "gates of hell" from where people were sent to specialized psychiatric hospitals in chernyakhovsk, dnepropetrovsk, kazan, blagoveshchensk, and that is not all. their life was transformed to unimaginable horror with daily tortures by forced administration of drugs, beatings and other forms of punishment. many went crazy, could not endure what was happening to them, some even died during the "treatment" (for example, a miner from donetsk alexey nikitin). many books and memoirs are written about the life in the psychiatric gulag and every time when reading them a shiver seizes us. the soviet psychiatric terror in its brutality and targeting the mentally ill as the most vulnerable group of society had nothing on the nazi euthanasia programs. the punishment by placement in a mental hospital was as effective as imprisonment in mordovian concentration camps in breaking persons psychologically and physically. the recent history of the ussr should be given a wide publicity to immunize society against possible repetitions of the soviet practice of political abuse of psychiatry. the issue remains highly relevant. according to fedor kondratev, an expert of the serbsky center and supporter of snezhnevsky and his colleagues who developed the concept of sluggish schizophrenia in the 1960s, those arrested by the kgb under rsfsr criminal code article 70 ("anti-soviet agitation and propaganda"), 190-1 ("dissemination of knowingly false fabrications that defame the soviet state and social system") made up, in those years, the main group targeted by the period of using psychiatry for political purposes. it was they who began to be searched for "psychopathological mechanisms" and, therefore, mental illness which gave the grounds to recognize an accused person as mentally incompetent, to debar him from appearance and defence in court, and then to send him for compulsory treatment to a special psychiatric hospital of the ministry of internal affairs. the trouble (not guilt) of soviet psychiatric science was its theoretical overideologization as a result of the strict demand to severely preclude any deviations from the "exclusively scientific" concept of marxism–leninism. this showed, in particular, in the fact that soviet psychiatry under the totalitarian regime considered that penetrating the inner life of an ill person was flawed psychologization, existentionalization. in this connection, one did not admit the possibility that an individual can behave "in a different way than others do" not only because of his mental illness but on the ground alone of his moral sets consistently with his conscience. it entailed the consequence: if a person different from all others opposes the political system, one needs to search for "psychopathological mechanisms" of his dissent. even in cases when catamnesis confirmed the correctness of a diagnosis of schizophrenia, it did not always mean that mental disorders were the cause of dissent and, all the more, that one needed to administer compulsory treatment "for it" in special psychiatric hospitals. what seems essential is another fact that the mentally ill could oppose the totalitarianism as well, by no means due to their "psychopathological mechanisms", but as persons who, despite having the diagnosis of schizophrenia, retained moral civic landmarks. any ill person with schizophrenia could be a dissident if his conscience could not keep silent, kondratev says. according to st petersburg psychiatrist vladimir pshizov, with regard to punitive psychiatry, the nature of psychiatry is of such a sort that using psychiatrists against opponents of authorities is always tempting for the authorities, because it is seemingly possible not to take into account an opinion by the person who received a diagnosis. therefore, the issue will always remain relevant. while we do not have government policy of using psychiatry for repression, psychiatrists and former psychiatric nomenklatura retained the same on-the-spot reflexes. as ukrainian psychiatrist ada korotenko notes, the use of punitive psychiatry allowed of avoiding the judicial procedure during which the accused might declare the impossibility to speak publicly and the violation of their civil rights. making a psychiatric diagnosis is insecure and can be based on a preconception. moreover, while diagnosing mental illness, subjective fuzzy diagnostic criteria are involved as arguments. the lack of clear diagnostic criteria and clearly defined standards of diagnostics contributes to applying punitive psychiatry to vigorous and gifted citizens who disagree with authorities. at the same time, most psychiatrists incline to believe that such a misdiagnosis is less dangerous than not diagnosing mental illness. german psychiatrist hanfried helmchen says the uncertainty of diagnosis is prone to other than medical influence, e.g., political influence, as was the case with soviet dissenters who were stifled by a psychiatric diagnosis, especially that of "sluggish schizophrenia," in order to take them away from society in special psychiatric hospitals. according to russian psychologist dmitry leontev, punitive psychiatry in the soviet union was based on the assumption that only a madman can go against public dogma and seek for truth and justice. k. fulford, a. smirnov, and e. snow state: "an important vulnerability factor, therefore, for the abuse of psychiatry, is the subjective nature of the observations on which psychiatric diagnosis currently depends." the concerns about political abuse of psychiatry as a tactic of controlling dissent have been regularly voiced by american psychiatrist thomas szasz, and he mentioned that these authors, who correctly emphasized the value-laden nature of psychiatric diagnoses and the subjective character of psychiatric classifications, failed to accept the role of psychiatric power. musicologists, drama critics, art historians, and many other scholars also create their own subjective classifications; however, lacking state-legitimated power over persons, their classifications do not lead to anyone's being deprived of property, liberty, or life. for instance, plastic surgeon's classification of beauty is subjective, but the plastic surgeon cannot treat his or her patient without the patient's consent, therefore, there cannot be any political abuse of plastic surgery. the bedrock of political medicine is coercion masquerading as medical treatment. what transforms coercion into therapy are physicians diagnosing the person's condition an "illness," declaring the intervention they impose on the victim a "treatment," and legislators and judges legitimating these categorizations as "illnesses" and "treatments." in the same way, physician-eugenicists advocated killing certain disabled or ill persons as a form of treatment for both society and patient long before the nazis came to power. szasz argued that the spectacle of the western psychiatrists loudly condemning soviet colleagues for their abuse of professional standards was largely an exercise in hypocrisy. psychiatric abuse, such as people usually associated with practices in the former ussr, was connected not with the misuse of psychiatric diagnoses, but with the political power built into the social role of the psychiatrist in democratic and totalitarian societies alike. psychiatrically and legally fit subjects for involuntary mental hospitalization had always been "dissidents." it is the contents and contours of dissent that has changed. before the american civil war, dissent was constituted by being a negro and wanting to escape from slavery. in soviet russia, dissent was constituted by wanting to "reform" marxism or emigrate to escape from it. as szasz put it, "the classification by slave owners and slave traders of certain individuals as negroes was scientific, in the sense that whites were rarely classified as blacks. but that did not prevent the "abuse" of such racial classification, because (what we call) its abuse was, in fact, its use." the collaboration between psychiatry and government leads to what szasz calls the "therapeutic state", a system in which disapproved actions, thoughts, and emotions are repressed ("cured") through pseudomedical interventions. thus suicide, unconventional religious beliefs, racial bigotry, unhappiness, anxiety, shyness, sexual promiscuity, shoplifting, gambling, overeating, smoking, and illegal drug use are all considered symptoms or illnesses that need to be cured. as michael robertson and garry walter suppose, psychiatric power in practically all societies expands on the grounds of public safety, which, in the view of the leaders of the ussr, was best maintained by the repression of dissidence. according to gwen adshead, a british forensic psychotherapist at the broadmoor hospital, the question is what is meant by the word "abnormal." evidently it is possible for abnormal to be identified as "socially inappropriate." if that is the case, social and political dissent is turned into a symptom by the medical terminology, and thereby becomes an individual's personal problem, not a social matter. according to russian psychiatrist emmanuil gushansky, psychiatry is the only medical specialty in which the doctor is given the right to violence for the benefit of the patient. the application of violence must be based on the mental health law, must be as much as possible transparent and monitored by representatives of the interests of persons who are in need of involuntary examination and treatment. while being hospitalized in a psychiatric hospital for urgent indications, the patient should be accompanied by his relatives, witnesses, or other persons authorized to control the actions of doctors and law-enforcement agencies. otherwise, psychiatry becomes an obedient maid for administrative and governmental agencies and is deprived of its medical function. it is the police that must come to the aid of citizens and is responsible for their security. only later, after the appropriate legal measures for social protection have been taken, the psychiatrist must respond to the queries of law enforcement and judicial authorities by solving the issues of involuntary hospitalization, sanity, etc. in russia, all that goes by opposites. the psychiatrist is vested with punitive functions, is involved in involuntary hospitalization, the state machine hides behind his back, actually manipulating the doctor. the police are reluctant to investigate offences committed by the mentally ill. after receiving the information about their disease, the bodies of inquiry very often stop the investigation and do not bring it to the level of investigative actions. thereby psychiatry becomes a cloak for the course of justice and, by doing so, serves as a source for the rightlessness and stigmatization of both psychiatrists and persons with mental disorders. the negative attitude to psychiatrists is thereby supported by the state machine and is accompanied by the aggression against the doctors, which increases during the periods of social unrest. vladimir bukovsky, well known for his struggle against political abuse of psychiatry in the soviet union, explained that using psychiatry against dissidents was usable to the kgb because 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. "once they pump you with drugs, they can forget about