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slow death in slave-labor camps. A characteristic of this period was the unpredictability of the terror. So many innocent people were caught up in the process of terror that it was impossible to know whether a given kind of conduct would result in punishment.

After the death of Stalin, and particularly after 1956, conditions became vastly better in the Soviet Union. There was no longer mass terror against the population, and the law was administered in a less arbitrary way. A dissident subculture grew up within the Soviet Union which was able to pursue opinions independently of the regime, within narrow limits. But, ironically, it is only in the post-Stalin era, when successive Soviet governments have sought to convince both domestic and foreign opinion that they had brought an end to the Stalin heritage, and were no longer holding political prisoners, that psychiatric abuse has become a major instrument of repression. From the regime's point of view, psychiatric commitment is a convenient instrument of policy. It enables Soviet authorities to substitute psychiatrists' judgment for sentencing in a trial, or to avoid a trial altogether. It enables the government to keep dissidents incarcerated for an indefinite length of time. And, of course, it enables the regime to claim that Soviet citizens who express dissatisfaction with the system are simply mentally ill.

The advantages of psychiatric abuse for the Soviet leadership are worth further examination. The USSR has laws against dissidence which the leadership can use very freely; for instance the law against anti-Soviet agitation and propaganda. But even totalitarian laws are a restriction on autocratic rule. And, on the other hand, sentences on obviously political charges are an embarrassment to a regime which no longer wishes to appear Stalinist. In these circumstances methods of dispensing with normal trials are very attractive. Sending dissidents to psychiatric hospitals achieves this end. Moreoyer, since confinement in mental hospitals is not limited to a definite term, this technique enables Soviet officials to move into a realm of almost unlimited administrative discretion or whim. It is a technique that perverts medicine in order to destroy law.

The diagnoses of dissidents by Soviet psychiatrists make clear the replacement of legal standards by arbitrary whim. The dissident Edward Kuznetzov, for example, was diagnosed as suffering from "schizophrenia", because, "He asserts that there is no such thing as a communist moral code, and that credit for its creation should go to the Bible." Similarly, the dissident Vladimir Borisov was diagnosed as suffering from "a disturbed sense of orientation and on incorrect interpretation of his surroundings. Thus, he takes the hospital for a concentration camp and the doctors for sadists."

This sequence of events shows the complexity of de-Stalinization in the USSR. Overall, conditions are much better. But some Soviet dissidents are subjected to terrors not used in the Stalin period, as part of the very attempt to conceal or legitimize surviving elements of Stalinism in the Soviet regime.

To give the distinguished members of this committee an idea of what psychiatric abuse entails, let me quote from a document entitled "Prisoners of Conscience in the + U.S.S.R.: Their Treatment and Conditions," issued by Amnesty International in 1980. The document states:

.. The drugs most commonly used on dissenters are

the powerful tranquilizers (commonly referred to

as neuroleptic drugs)...
... Each of these drugs can cause serious negative

side effects. A characteristic negative side-effect,
and the one which victims regard as the greatest
threat to their sanity, is the "Parkinsonism" or
"Extra-Pyramidal Derangement" often induced by
these drugs. This side-effect is characterized by

muscular rigidity, paucity and slowness of body movement, physical restlessness and constant desire to change the body's position.

Another type of psychiatric treatment to which dissenters have often subjected is insulin shock therapy. This method consists of adminstering increasing doses of insulin over a period of days. The dosage is increased until the subject goes into "Hypoglycaemic Coma" and shock. A course of insulin shock therapy in Soviet psychiatric hospitals usually consists of 25 or 30 such shocks...

The drug sulfazin was at one time used in a number of
countries for treating schizophrenia and other ailments
in certain circumstances but has generally gone out of
use long ago because it was shown not to be useful.
However, sulfazin caused great physical discomfort -
raging fever so intense that the patient is virtually
incapacitated for up to three days after an injection.
Most former inmates of Soviet psychiatric hospitals who
have been in a position to give an account of their
conditions of incarceration have reported that sulfazin
is regularly used as a punishment for violation of
discipline, with the victims sometimes being subjected
to injections of it every day for several days. As
with the other treatments mentioned above, the medical
personnel administering this drug have often done do
without proper assessment of whether the subject was

physically able to stand the treatment. Soviet psychiatric abuse is a form of punishment that must be particularly terrifying to those undergoing it. It uses not the crude stength of the bully, but the entire vast storehouse of resources of modern medicine to affect its victims. And it uses those vastresources not simply to wound, to humiliate, or to force confessions, but to intrude into the most hidden recesses of the whole personality. This is what victims of Soviet psychiatric abuse cannot but fear: that the drugs, and the rest of the treatment, will change their

entire personality. After all, the diagnosis implies that an effort will be made to change their personality, because it regards political opinions not merely as opinions but as indications of a pervasive personality disorder, a psychosis.

Most human rights violations attempt to compel only an outward compliance with repressive government. Psychiatric abuse goes beyond that; it attempts to touch the very springs of thinking and feeling. So this is a peculiarly totalitarian type of human rights violation. Most of the horrors which are inflicted by man on man extend through a great range of political regimes, but this one is more distinctive. The very notion that mental health can be identified with holding specific political opinions belongs to the political culture of totalitarianism.

Unfortunately, we have no firm data regarding the total number of peopole undergoing such abuse - and given the closed number of Soviet society, no such information is likely to be forthcoming. Recently, however, Ms. Ludmilla Thorne, Director of the Center for Appeals for Freedom at Freedom House, conducted a study of the case histories of some 1,110 Soviet political prisoners where detailed information had been compiled. She concluded that some 215 people - 19% - are currently in Soviet psychiatric institutions. If we assume - as Andrei Sakharov and others have suggested - that there are about 10,000 political prisoners throughout the Soviet Union, and if we further assume that some 19% of these are in mental institutions, that means that there are about 1,900 victims of psychiatric abuse in the Soviet Union today. However, as Ms. Thorne would be the first to admit, this is only a very rough estimate.

In any event, the existence of psychiatric abuse in the Soviet Union is sufficiently widespread to have provoked international condemnation. In 1977, the world Psychiatric Association, which consists of professional psychiatric groups

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from 65 nations, voted to censure the Soviet Union for politically-
motivated abuses of psychiatry and also set up a Committee to Review
Alleged Abuses of Psychiatry for political Purposes. The Soviet
Union's withdrawal from the world Psychiatric Organization earlier
this year, immediately prior to a meeting in which a number of
Western delegations planned to examine its record of psychiatric
abuse, indicates both that many countries feel concern over
these Soviet human rights violations and that the Soviets are
unwilling to meet those concerns through any sort of constructive
behavior.

The government of the United States deeply deplores the
pervasive use of psychiatric "treatment" as an instrument of
political repression. We have repeatedly condemned this
flagrant human rights abuse in the Madrid CSCE Review Conference
and before the U.N. Human Rights Commission. We will continue
to work in every appropriate way to alleviate the plight of
Soviet citizens deprived of their liberty, and subjected to cruel
and inhumane punishment, for the "crime" of seeking to exercise
their elementary human rights in a totalitarian society.

Mr. YATRON. Thank you, Mr. Fairbanks, for your statement.
Mr. Lantos.
Mr. LANTOS. I just have a couple of questions.

I want to commend Secretary Fairbanks for a very excellent statement.

Most people view psychiatry with awe and noncomprehension. I believe that the Department of State, in the wake of the recent events, has a unique opportunity, and I am inclined to think a unique obligation, to issue a white paper, understandable to a lay public, on the use of psychiatry as one control device of the Soviet totalitarian state.

I would like to suggest to you, Mr. Secretary, and ask your opinion-I expect to have lunch today with Secretary Shultz where I will raise this issue with him-how your Bureau views the possibility that in view of the outrage of the American people at the Korean Air Line incident, in view of the fact that a whole new generation of Americans is now learning, through the use of terror and force in Afghanistan, the oppression of the people in Poland, the use of chemical weapons in the Far East, but the use of psychiatry. is perhaps the most insidiously diabolical Soviet technique which is being used to terrorize potential dissident and to punish people who dare express views contrary to those of the Soviet

regime.

After all, the 269 innocent civilians met their death in a matter of minutes, but the inmates of Soviet psychiatric institutions, and the inmates of Soviet psychiatric prisons suffer a gradual and progressive dismantling of their personalities by the most cruel and disruptive and inhumane tactics.

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