political abuse of psychiatry in the soviet union political abuse of psychiatry in the soviet union there was systematic political abuse of psychiatry in the soviet union, based on the interpretation of political opposition or dissent as a psychiatric problem. it was called "psychopathological mechanisms" of dissent. politics of the soviet union leadership leaders president list vice president collective leadership state council presidential council communist party congress central committee history general secretary politburo secretariat orgburo legislature congress of soviets central executive committee supreme soviet soviet of the union soviet of nationalities presidium congress of people's deputies speaker 1989 legislative election governance constitution official names 1924 1936 1977 government ministries state committees cabinets premiership first deputy premier deputy premier administrator of affairs judiciary law supreme court military collegium people's court procurator general ideology soviet democracy marxism–leninism leninismstalinismkhrushchevism de-stalinization perestroika glasnost society economy agriculture consumer goods five-year plan kosygin reform new economic policy science and technology era of stagnation material balance planning transport war communism culture demographics education family phraseology religion repression censorship censorship of images great purge gulag system collectivization human rights ideological repression political abuse of psychiatry political repression population transfer propaganda suppressed research red terror soviet empire soviet union portal other countries psychiatry in russia and the ussr kgb (managing organ of psychiatry) mental health in russia political abuse in russia political abuse in the ussr campaign against psychiatric abuse working commission cases of political abuse struggle against political abuse serbsky center bekhterev psychoneurological institute independent psychiatric association sluggish schizophrenia sulfozinum psikhushka the serbsky central research institute for forensic psychiatry, also briefly called the serbsky institute (the part of its building in moscow) during the leadership of general secretary leonid brezhnev, psychiatry was used to disable and remove from society political opponents ("dissidents") who openly expressed beliefs that contradicted the official dogma. the term "philosophical intoxication", for instance, was widely applied to the mental disorders diagnosed when people disagreed with the country's communist leaders and, by referring to the writings of the founding fathers of marxism–leninism—karl marx, friedrich engels, and vladimir lenin—made them the target of criticism. article 58-10 of the stalin-era criminal code, "anti-soviet agitation", was to a considerable degree preserved in the new 1958 rsfsr criminal code as article 70 "anti-soviet agitation and propaganda". in 1967, a weaker law, article 190-1 "dissemination of fabrications known to be false, which defame the soviet political and social system", was added to the rsfsr criminal code. these laws were frequently applied in conjunction with the system of diagnosis for mental illness, developed by academician andrei snezhnevsky. together, they established a framework within which non-standard beliefs could easily be defined as a criminal offence and the basis, subsequently, for a psychiatric diagnosis. applying the diagnosis the "anti-soviet" political behavior of some individuals – being outspoken in their opposition to the authorities, demonstrating for reform, and writing critical books – were 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"). 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 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, and become involved in forbidden religious activities. in accordance with the doctrine of state atheism, the religious beliefs of prisoners, including those of well-educated former atheists who had become adherents of a religious faith, was considered to be a form of mental illness that required treatment. the kgb routinely sent dissenters to psychiatrists for diagnosis, in order to discredit dissidence as the product of unhealthy minds and to avoid the embarrassment caused by public trials. highly classified government documents that became available after the dissolution of the soviet union confirm that the authorities consciously used psychiatry as a tool to suppress dissent. according to the "commentary" to the post-soviet russian federation law on psychiatric care, individuals forced to undergo treatment in soviet psychiatric medical institutions were entitled to rehabilitation in accordance with the established procedure and could claim compensation. the russian federation acknowledged that before 1991 psychiatry had been used for political purposes and took responsibility for the victims of "political psychiatry." the political abuse of psychiatry in russia has continued, nevertheless, since the fall of the soviet union, and human rights activists may still face the threat of a psychiatric diagnosis for their legitimate civic and political activities. background definitions mass repressionin the soviet union economic repression collectivization dekulakization soviet famine of 1930–1933 ukraine kazakhstan political repression red terror purges of the communist party great purge gulag punitive psychiatry ideological repression religion 1917–1921 1921–1928 1928–1941 1958–1964 1975–1987 christianity islam judaism legislation science censorship images ethnic repression de-cossackization national operations of the nkvd population transfers 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 his book punitive medicine (1979) alexander podrabinek defined the term "punitive medicine", which is identified with "punitive psychiatry," 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 serve 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. as vladimir bukovsky and semyon gluzman wrote in their joint a manual on psychiatry for dissenters, "the soviet use of psychiatry as a punitive means is based upon the deliberate interpretation of dissent... as a psychiatric problem." an inherent capacity for abuse 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 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 1960s 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 classified threats to authority during periods of political disturbance and instability as a form of mental disease. in many countries, political prisoners are still sometimes confined and abused in mental institutions. in the soviet union, dissidents were often confined in psychiatric wards commonly called psikhushkas. psikhushka is the russian ironic diminutive for "psychiatric hospital". one of the first penal 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 precursor of the kgb) on the orders of lavrentiy beria, 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. under stalin, khrushchev and brezhnev as early as 1948, the soviet secret service took an interest in this area of medicine. one of those with overall responsibility for the soviet secret police, pre-war procurator general and state prosecutor, the deputy minister of foreign affairs andrey vyshinsky, was the first to order the use of psychiatry as a tool of repression. russian psychiatrist pyotr gannushkin 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. punitive psychiatry was not simply an inheritance from the stalin era, however, according to alexander etkind. the gulag, or chief administration for corrective labor camps, was an effective instrument of political repression. there was no compelling requirement to develop an alternative and more 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 the ussr mental health service conformed to the double standard in society, being represented by two distinct systems which co-existed peacefully for the most part, despite periodic conflicts between them: system one was that of punitive psychiatry. it directly served the authorities and those in power, and was headed by the moscow institute for forensic psychiatry named in honour of vladimir serbsky; system two was made up of elite, psychotherapeutically oriented clinics. it was headed by the leningrad psychoneurological institute named in memory of vladimir bekhterev. the hundreds of hospitals in the provinces combined elements of both systems. if someone was mentally ill then, they were sent to psychiatric hospitals and confined there until they died. if his mental health was uncertain but he was not constantly unwell, he and his kharakteristika were sent to a labour camp or to be shot. when allusions to socialist legality started to be made, it was decided to prosecute such people. soon it became apparent that putting people who gave anti-soviet speeches on trial only made matters worse for the regime. such individuals were no longer tried in court. instead they were given a psychiatric examination and declared insane. the joint session, october 1951 in the 1950s, the psychiatrists of the soviet union turned themselves into the medical arm of the gulag state. a precursor of 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, supposedly, to the great russian physiologist ivan pavlov, and alleged that several of the ussr's leading neuroscientists and psychiatrists of the time (among them grunya sukhareva, vasily gilyarovsky, raisa golant, aleksandr shmaryan, and mikhail gurevich) were guilty of practicing "anti-pavlovian, anti-marxist, idealistic reactionary" science, and this was damaging to soviet psychiatry. during the joint session, these eminent psychiatrists, motivated by fear, had to publicly admit that their scientific positions were erroneous and they also had to promise to conform to "pavlovian" doctrines. these public declarations of obedience proved insufficient. in the closing speech, andrei snezhnevsky, the lead author of the session's policy report, stated that the accused psychiatrists "have not disarmed themselves and continue to remain in the old anti-pavlovian positions", thereby causing "grave damage to the soviet psychiatric research and practice". the vice president of the ussr academy of medical sciences accused them of "diligently worshipping the dirty source of american pseudo-science". those who articulated these accusations at the joint session – among them irina strelchuk, vasily banshchikov, oleg kerbikov, and snezhnevsky – were distinguished by their careerist ambition and fear for their own positions. not surprisingly, many of them were promoted and appointed to leadership posts shortly after the session. the joint session also had a negative impact on several leading soviet academic neuroscientists, such as pyotr anokhin, aleksey speransky, lina stern, ivan beritashvili, and leon orbeli. they were labeled as anti-pavlovians, anti-materialists and reactionaries and subsequently they were dismissed from their positions. in addition to losing their