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quid be gratefullion to my suggestrder, in very

I would like to suggest to the State Department that we have a unique psychological moment, in view of the airline incident, which is so palpably simple and visible and comprehensible to a child of 4, to issue a very carefully documented, but very easily understandable report, a white paper on the use of psychiatry by the Soviet Union as an instrument of control and terror and suppression.

I would be grateful, Mr. Chairman, if Secretary Fairbanks were to give me his reaction to my suggestion and the likelihood that the State Department, in very short order, in very short order to take advantage of the timeliness, issue such a document.

Mr. FAIRBANKS. Let me begin by saying that I believe that you are profoundly correct in linking together the callous Soviet action against the Korean Airlines Flight 007 with the long practice of psychiatric abuse, with the Soviet use of chemical warfare against innocent indigenous people who are civilians, and other practices of a similar character.

I absolutely agree with you that this is a crucial time to try to rethink and try to better comprehend the reasons for the pervasive callousness of the Soviet regime, its disregard of human life and of ordinarily accepted standards of humanity and decency. I think, for Americans, who are decent and who look for decency around the world, it is very hard to comprehend what kind of traits of character can lead to this kind of action.

As Robert Conquest once noted it was easy to believe that there were many different kinds of people and different kinds of regimes in the world when some people wore turbans, and other people wore periwigs, and so forth. In our world where everyone wears suits and ties, it is easy to be lulled into the belief that there are no fundamental differences of human attitudes. In the Korean Airlines atrocity, and the use of psychiatric abuse, we see that there really are, and we must understand this better.

I am grateful to you for the idea that the U.S. Government should issue a special report on psychiatric abuse, and we will certainly look into the possibility of doing that. It could be a valuable contribution to the understanding of the issue.

I think that what Amnesty International and Freedom House have done on this is of very high quality in itself. In some respects, it would be hard for us to do better. But it is a valuable suggestion. Mr. LANTOS. Thank you, Mr. Chairman. Mr. YATRON. Thank you, Mr. Lantos. Mr. Leach.

Mr. LEACH. Mr. Secretary, can you indicate if there are any antiSemitic implications in the misuse of psychiatry in the Soviet Union?

Mr. FAIRBANKS. It is a question I have not specifically thought about. There has been, as you know, a recurrence and reintensification of anti-Semitism in the Soviet Union within the last year as marked by the organization of an Anti-Zionist Committee of Soviet Society, the publication of anti-Semitic statements in the newspapers, and so forth.

Mr. LEACH. What I am getting at is, is there any indication that a cross-section of those that we think are submitted to psychiatric abuse for political reasons is disproportionately Jewish?

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Mr. FAIRBANKS. I don't have a sense of that, though the people who know the hundreds of cases in greater detail might be able to answer better.

I think it is the case that Soviet persecution of dissidents has always hit Soviet Jews to a somewhat disproportionate degree, perhaps because they are more exposed than many other Soviet nationalities to persecution by the government, more vulnerable. In that sense, it wouldn't surprise me if Jews are to a disproportionate degree victims of psychiatric abuse, but I have no specific reason to see a difference between psychiatric abuse and other techniques of Soviet persecution in that regard.

Mr. LEACH. Among professional psychiatrists in the Soviet Union, do you have any sense of what percentage participate in this kind of government psychiatry and for what reasons? Do you have any sense for the motivation?

Mr. FAIRBANKS. I could not answer as well as a dissident who compiled a sort of handbook, for other dissidents, of Soviet psychiatry and of the types of psychiatrists who exist, which can be found in the book by Reddaway and Bloch on Soviet psychiatric abuse.

There are a number of different types of psychiatrists distinguished there, some of whom are men of honor who will have nothing to do with this. Others are people who can do nothing about it. A few are, as we know, simply working for the police, just as there are members of the secret police within a vast range of professions in the Soviet Union who see their primary loyalty to the state repressive apparatus rather than to their profession.

I believe that that is a very small part of the psychiatric profession in the Soviet Union. Yet, the Soviet psychiatric profession as a whole can't help but be touched by this base practice. You see here the consequence of the fact that in the Soviet Union, the government owns everything, and operates virtually every profession. In the United States there cannot be psychiatric abuses of the Soviet type because psychiatrists are in business either for themselves or for a great range of decentralized local, State, or Federal Government institutions, and no one approach or no abuse that authority would want to introduce could be spread throughout the whole structure, whereas in the Soviet Union it is very easy to do that as a result of state control of the system.

We do know that it is used to persecute not only dissidents, but simply people who come and, from the authorities' point of view, pester them with complaints about bureaucracy, people who think their taxes are too high, and that type of thing. So it is a very pervasive problem in the Soviet psychiatric world, I think.

Mr. LEACH. Thank you very much.
Mr. YATRON. Thank you, Mr. Leach.

Secretary Fairbanks, has the Soviet systematic misuse of the medical profession spread to other Communist countries, such as in Eastern Europe, or Cuba?

Mr. FAIRBANKS. As with psychiatric abuse in general, the very nature of this form of persecution means that the information we have on it is rather elusive because it avoids public trials and other things that create records which are accessible to the public.

The American Psychiatric Association has a number of recent complaints from Yugoslavia, one from Czechoslovakia, some from

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Rumania. Early in the 1970's, I believe that there were complaints also from East Germany, Poland, and Hungary, if I am not mistaken. So I think psychiatric abuse is concentrated overwhelmingly in the Soviet Union, but secondarily in countries that have been earlier or later under Soviet influence, and that is not an accident.

The reports I spoke of are ones that the U.S. Government doesn't have enough information presently to confirm or deny. We are certainly concerned and we are looking into it.

Mr. YATRON. Again, I want to thank you for some of the other statements that you made earlier, because I think that it helps to put the problem of psychiatric abuse to its historical context.

You cite an Amnesty International report on psychiatric abuse in your statement. In general, how accurate and how useful does the Department find Amnesty International reports?

Mr. FAIRBANKS. On this issue, I would have to say that they have been quite complete and accurate as far as we are able to judge.

Mr. YATRON. Can you tell me what measures the administration and the State Department are taking to call to the attention of the Soviet Government the American public's concern regarding the issue of psychiatric abuse in the Soviet Union?

Mr. FAIRBANKS. I should say, first of all, that we regard this as one of the most grave violations that the Soviet Union engages in, and we give it a very high priority in attempting to work against it. We have condemned Soviet psychiatric abuse both in public fora, such as the U.N. General Assembly, the CSCE Review Conference, the 1982 Human Rights Report, which you have probably seen, and in private exchanges.

As you know, this administration, particularly recently, has given a very high priority to discussion of human rights problems in bilateral exchanges with the Soviet Union, and you can assume that no area of Soviet human rights violations is excluded from the concerns we express on those occasions.

Mr. YATRON. Thank you very much, Mr. Secretary, for being here with us today. We appreciate it very much.

Our next four witnesses will appear as a panel.

Dr. Harold Visotsky is chairman of the Committee on International Abuse of Psychiatry and Psychiatrists, American Psychiatric Association, and director of the Institute of Psychiatry at Northwestern University.

Dr. Walter Reich is a research psychiatrist and program director, the National Institutes of Health, member of the American Psychiatric Association's task force on human rights, and former fellow of the Kennan Institute for Russian Studies at the Woodrow Wilson Center.

Dr. Boris Zoubok is on the staff at the Four Winds Hospital, an Instructor in psychiatry at Columbia University, and a former Soviet psychiatrist.

And finally, Mr. Peter Reddaway is a fellow at the Kennan Institute of Advanced Russian Studies at the Woodrow Wilson Center, and a senior lecturer in the London School of Economics.

Gentlemen, I would like each of you to keep your opening remarks to no longer than 10 minutes, if possible. Then we will give the other members an opportunity to ask questions.

Dr. Visotsky, why don't we start with you.

STATEMENT OF HAROLD VISOTSKY, M.D., CHAIRMAN, COMMIT

TEE ON INTERNATIONAL ABUSE OF PSYCHIATRY AND PSYCHI. ATRISTS, AMERICAN PSYCHIATRIC ASSOCIATION, AND DIRECTOR, INSTITUTE OF PSYCHIATRY, NORTHWESTERN UNIVERSITY

Dr. VISOTSKY. Mr. Chairman, members of the Subcommittee on Human Rights and International Organizations, I am Dr. Harold Visotsky, and I want to thank you for the opportunity to testify on the subject of psychiatric abuse.

The American Psychiatric Association (APA) represents some 28,000 psychiatrists from the United States and abroad, and has for years expressed its opposition to the abuse of psychiatry wherever it may occur. The APA has a committee on international abuse of psychiatry and psychiatrists which I presently chair, as well as a Committee on Abuse and Misuse of Psychiatry in the United States which deals with any complaints brought forth relating to this country. Both of these committees review cases of alleged abuse of psychiatry.

The International Committee on Abuse has reviewed complaints in a number of different countries, but as you heard the overwhelming majority of cases which are sent to us relate to the Soviet Union.

Other distinguished individuals presenting testimony today on this panel will inform you of the grim facts of this systematic form of abuse of our profession in the Soviet Union. I would, however, like to focus on the actions by the American Psychiatric Association and the results of these actions.

The APA Committee on International Abuse of Psychiatry and Psychiatrists has written hundreds of letters to the Soviet Union on behalf of certain individuals. We have written to authorities of the Soviet Government, and to patients themselves. We have written to the families of patients, and to the psychiatrists who are treating these patients. Never have we received a response from the authorities, and only indirectly do we hear from the families of patients.

In addition the APA Board of Trustees referred over 20 cases to the World Psychiatric Association (WPA] for further investigation by their committee to review alleged abuses of psychiatry for political purposes. A number of these cases were sent to the All Union Society of Neuropathologists and Psychiatrists of the U.S.S.R. for clarification and response. When months and months went by and the WPA had received no response from our Soviet colleagues, the APA as well as a number of other psychiatric associations around the world passsed a resolution which stated:

If the All Union Society of Neuropathologists and Psychiatrists of the U.S.S.R. does not adequately respond to the inquiries by the World Psychiatric Association on cases of alleged abuse of psychiatry by April 1, 1983, the All Union Society should be suspended from membership in the World Psychiatry Association until such time as these abuses come to an end.

The Royal College of Psychiatrists in Great Britain as well as other societies passed a stronger resolution indicating that the All Union Society should be expelled from the World Psychiatric Association. These resolutions were to be voted on at the General Assembly of the World Psychiatric Association which met in July in Vienna, at the time of the VII World Congress of Psychiatry.

In the meantime, the All Union Society of the U.S.S.R. did begin to respond to the referrals of the WPA Review Committee cases. They submitted histories on seven cases in all to the WPA. There was discussion between the chairman of the All Union Society and the officials of the World Psychiatry Association about the possibility of a multinational delegation visiting the Soviet Union to discuss these issues more fully.

There were a number of details to be worked out about this trip, but our Soviet colleagues indicated that they would contact the Ministry of Health regarding visas for this delegation. These discussions were abruptly cut-off during the meeting in January 1983 when the Soviet psychiatrists were called back to Moscow. A few days thereafter, the All Union Society resigned from the World Psychiatry Association, claiming that the organization has become too political. We have a copy of the correspondence for you.

The American Psychiatric Association has been working with other organizations in the hope of bringing enough collective pressure to bear to end this practice of using psychiatry to suppress dissent in the Soviet Union. Our efforts with the U.S. State Department resulted in the All Union Society stating that “a U.S. Government body is actively interfering with the work of national, nongovernmental organizations, and indirectly, in the work of the World Psychiatry Association.”

The General Assembly of the World Psychiatry Association addressed the issue of alleged abuse of psychiatry in the Soviet Union by passing, 174 votes for, 18 against, and 27 abstentions, a resolution put forward by the president of the Royal College of Psychiatrists of Great Britain which stated:

The World Psychiatry Association would welcome the return of the All Union Society of Neuropathologists and Psychiatrists of the USSR to membership in the Association, but would expect sincere cooperation beforehand of amelioration of the political use of psychiatry in the Soviet Union.'

In addition, the General Assembly passed a resolution making Dr. Anatoly Koryagin an honorary individual member of the World Psychiatry Association for "demonstrating in the struggle against the perversion of psychiatry for nonmedical purposes, professional conscience, courage and devotion to duty, all in exceptional measure." Dr. Koryagin has been imprisoned since February 13, 1981, for speaking out against the practice of the use of psychiatry for political purposes in the Soviet Union.

We do regret that the All Union Society of Neuropathologists and Psychiatrists of the U.S.S.R. has resigned from the World Psychiatry Association, and that the societies of Czechoslovakia, Bulgaria, and Cuba have followed them. I believe that we have lost a viable means through the World Psychiatry Association of helping concerned psychiatrists within those nation to seek reforms in the use of their profession.

It is my hope and the hope of the American Psychiatric Association that a way will be found to continue discussions with our colleagues in those countries. However, we cannot continue to collaborate with the Soviet professional society until there is acknowledg

See appendixes to Mr. Visotsky's prepared statement.

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