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In order not to overlap too much with other witnesses, I will limit my statement

to three aspects of the subject : its size and scope; the political context of the

USSR's enforced resignation from the world Psychiatric Association (MPA) in January

1983; and my thoughts on possible future trends in official policy.

The Soviet regime's practice of interning political and other critics in mental hospitals, and then, in most cases, giving them painful treatment with drugs, has,

since about 1960, been a countrywide, large-scale phenomenon. An enormous and diverse

Russian literature on the subject has now reached the West, where perhaps some ter per

cert of it has been translated, western studies, are now multiplying.

The practice is based on a close collaboration between the police authorities and

selected members of the psychiatric profession, the latter being regarded, like other

professions, as a branch of the civil service. A careful selectior. has to be made,

however, because although most Soviet psychiatrists have been trained in the dubious

psychiatric theory of Professor Snezhnevsky, which justifies the practice, and in no other, many of them instinctively sense that there is some thing wrong about the practice and try to avoid personal involvement in it. Moreover, a small but apparently growing

number resist it in various ways

by refusing to assess individual dissenters as

mentally ill, or by facilitating their early release, or by covertly supplying information

on local cases to the Soviet human rights movement, or



speaking out publicly against the practice, thereby courting a heavy jatl sentence,

An exceptional situation obtains in one large city, where the practive is virtually

non-existent, thanks to the known opposition of a powerful and prestigious local psychi

atrist. Yet other psychiatrists have emigrated or defected because of their distaste

for a fundamental pervepsion of medical ethics,

The system relies in the main on the domination of all Soviet forensic psychiatry

by Moscow's Serbsky Institute of General and Forensic Psychiatry, on the ready collaboration of a few socially or politically ambitious psychiatrists in each of the main psychiatric facilities, and on a number (seemingly small) of their colleagues who genuinely believe that criticism of government policy is a symptom of mental illness.

The victims of the system of psychiatric abuse can be divided into three main types

those who are incarcerated and treated in mental institutions even though they are

sane ; those who are imprisoned and otherwise persecuted because of their attempts to help these people and oppose politicized psychiatry; and many Soviet sitizens who have

the integrity of all psychiatrists, regarding them as agents of an

lost trust in

oppressive state rather than honourable healers of individuals' suffering, and therefore

rejecting their services and the aid and comfort which many of them would in fact provide, and which the citizens do in fact need.

The last category of victim does not require ?urthet corrmentary. hs regards the

first, for the period 1962 to 1983 Dr Bloch and I have documented the cases of 500 individuals against whom politically motivated abuse of psychiatry has certainly, or

almost certainly, been practised. However, this figure undoubtedly represents only a

small proportion - perhaps 5% of less - of all the victims in tris category in this


Recent examples include Vladimir Gershuni, a Moscow stonemason and self-taught intellectual, who was comunitted to a prison psychiatric hospital last April. Mor Gershuni had been similarly interned from 1969 to 1974 for his role in the founding of the Soviet human rights movement, and then briefly again in 1980, to prevent him talking to foreign visitors during the Moscow Olympic Games. This time the authorities objected to his participation in an unofficial typescript magazine and in a free trade union. He was ruled schizophrenic despite the extensive publicizing of a report by the well-known British psychiatrist Gerard Low-Beer, who examined him in Moscow in 1978 and found him mentally normal, and a striking personality.

Another recent case is that of Viktor Artsimovich, an historian who belonged to a

group of critically minded intellectuals in Tomsk, Mr

Artsimovich was labelled schizo

phrenic because, in the words of the psychiatric report, he "1. asks to emigrate; 2.

considers himself a notable personality; 3. does not have close friends, is introverted;

supposedly and 4. criticizes Marxism-Leninism." He also, suffered from "intoxication with philosophy". In reality, Mr Artsimovich was close friends with his group in Tomsk and also with

an American couple from St Louis, Missouri, le met the latter in Moscow and then corres

ponded with them for several years up to the time of his arrest last year. They found him

to be embnently sane, and his letters fully support this view.

The second category of victims of political psychiatry are indirect victims, but

none the less real for that. They are citizens who have been persecuted for their attempts

to oppose such psychiatry. Most notable among them are the members of the Moscow-based

"Jorking Commission to Investigate the Use of Psychiatry for Political Purposes", who

accomplished a prodigious amount of research and humanitarian work between 1977 and 1981.

jest known anong the current victims from this group is the psychiatrist Anatoly Koryagin, who, because of nis brave public stand, was sentenced in 1981 to 12 years of imprisonment

and exile. He has since been elected an Honorary member of the WPA, the American Psychi

atric Association and other such bodies. Another well-known case is the auxiliary doctor

Alexander Podrabinek, whose penetrating book on the whole subject, Punitive vedicine,

was published in the USA in 1979. Despite an international campaign for his release,

led by his relatives in this country, he has been held in captivity since 1978. Other excolleagues of his in the "Working Comunission" are Felix Serebrov, who has now gone nearly

blind in a labour camp during the first three years of a nine-pear term, and Irina

Grivnina, who has just completed three years in exile, only to be subjected to new perse

cution on her return to Moscow, This July she gave birth to a daughter. Now her husband

and she are experiencing.severe police pressure to leave their home and move far away

from Moscow. To date, this pressure has been reinforced by illegal threats to imprison

them if they refuse to go, and by a vicious beating-up of

her husband in their apartment

on August 24.

The Recent Political Context

Domestic and Internati anal

The international context in which Soviet psychiatric abuse was mainly debated from 1981 to 1983 was that of a movement by some national psychiatric associations, including those of the USA and Britain, aimed at expelling or suspending the USSR from

[blocks in formation]

the latter's world congress in Vienna in July 1983. The national associ

ations rightly took the view that ten years of quiet diplomacy, private conversations wi

Soviet official psychiatrists, and mild public protests, had produced no substantial

therefore change in the level of Soviet abuses, and that this approach had

failed. The

failure was not in fact surprising, as the Soviet spokesmen were, and still are, the

very psychiatrists who conduct and orchestrate the abuses, and who also have an iron grip on the whole psychiatric profession. To admit, even indirectly, to any mistakes would be, for them, political and professional suicide. The associations also noted the incriminating fact that in 1980-81 the highly esteemed Working Commission inad been

completely destroyed through arrests

with the active conni vance of the Soviet

psychiatric establishment.

In January 1983 the number of member associations of the WPA voting for the USSR'S expulsion or suspension rose to nine. As these associations would wield half the votes in the WPA's governing body, the USSR was now almost certain to be voted out in July. Intensive Sovket lobbying of the ass octations in an effort to change their position had been in progress for a year. As, however, they insisted on strict conditions for the Inspection visit to the USSR which the Soviets offered them, this lobbying was now abandoned. It would clearly be impossible to confuse, sidetrack or deceive their delegation - as had been done more or less successfully with previous delegations (notably those from the WPA in 1973, Austria in 1977, and Sweden in 1981).

In these circumstances the whole issue was undoubtedly referred up from the pro

Pessional level to the politicat level (where it had been handled sometimes before, espect

ially since 1981). The politicians now had, in theory at least, two options.

First, political psychiatry could be quickly abolished - its leading
practitioners denoted and replaced by paychiatrists respected abroad; ite
Victims released; Dr. Koryagin and his colleagues freed. This option
presented serious difficulties. To convince the many soeptics, the reforms
would have had to be conducted quickly and thoroughly. But this is not how
the Soviet bureaucracy normally operates especially when, as in this case,
1t essential to lose as little additional international "face" as possible,

and therefore no public admission be made that anything done in the past has been actually wrong. Morever, although the advent of the new Andropov leader

ship potentially facilitated the option of abolition, this leadership had not yet sufficiently consolidated its power for decisive, clear-cut reforms to be feasible.

second So the

option prompt resignation from WPA – was now. the only realistic one. This course, although profoundly humiliating, would avoid the even greater humiliation of Soviet expulsion in Vienna, amidst a blaze of publicity. It would remove one particular pressure - the necessity of responding to the WPA investigators. And it would provide a breathing-space - time in which to observe how the WPA and the world medical and political communities would react, time in which to review policy, and time in which if abolition of political psychiatry then seemed the best course

to conduct the abolition quietly, gradually and unobtrusively, prior to re-joining the WPA,

So the decision was quickly taken - under close supervision by the politicians to resign.

The politicians' public explanation of this decision was remarkably mild. A spokesman for the Health linistry explained that the USSR "disagreed with other member countries" over definitions and concepts of psychiatry, and that some IPA members took "a aon-objective approach" to psychiatric problems (The Times, 12 February). This mildness suggested that the politicians were anxious not to exacerbete the situation, and wished to keep the door ajar for a future return.

The above shows two things - the great importance attached by regime and psychiatrists alike to retaining international respectability; and their joint belief that this could still be done, in 1981-83, by the traditional methods of manoeuvrins, pressurizing and deception which had successfully confused the world medical community and warded off any serious humiliation over the previous decade. Horld paychiatrists, it was reckoned, would continue to shrink from any decisive action, just as the world's churches shrank from such action over Soviet persecution of religion, the world's physicists over suppression of Dr. Sakharov, and world governments over Soviet violation of human rights in general (even in such a suitable forum as the Conference on Security and Co-operation in Europe).

The final shattering of this assumption in January 1983 must have been felt in the Kremlin like a minor earthquake, It is sure to lead, and may already have led, to a searching review of policy. Who was responsible for maintaining the assumption when it was no longer valid? What precisely were the practices which provoked the West into such an unprecedentedly firm stand? Who was responsible for them? Are they really necessary for the future? If not, how big an operation would it be to dismantle them? And what would be the international consequences of not dismantling them?

To these questions the Kremlin policymakers, so bered by the shock, might well respond as follows:

"First and foremost, the political abuse of psychiatry is not an essential instrument of our rule. As the President of Britain's Royal College of Psychiatrists, Prof, Kenneth Ravnsley, has rightly said of us (The Times, 10 February), 'I don't really believe that this policy is vital to their interests. They could deal with dissidents in other ways if they wanted.' And indeed we do – we sack them, exile them, imprison them, deport them abroad, and so on.

"Second, the alarming precedent of our first de facto expulsion from an international body is likely to lead on to firmer action against us in other international forums, as Soviet psychiatry is increasingly seen as a new version of the Lysenkoism which destroyed our reputation in biology for a generation. And the trend could easily spread to other professional fields like physics, mathematics and the churches, where our vulnerability is already clear.

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