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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 percert of it has been translated, vestern 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 even

by speaking out publicly against the practice, thereby courting a heavy jatl sentence, An exceptional situation obtains in one large city, where the practice 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 perveesion 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 syar tom 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 citizens who have lost trust in the integrity of all psychiatrists, regarding them as agents of an 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 these citizens do in fact need.

The last category of victim does not require further cormentary. As 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 this category in this period.

Recent examples include Vladimir Gershuni, a Moscow stonemason and self-taught intellectual, who was committed to a prison psychiatric hospital last April. Mir Gershuni had been similarly interned from 1969 to 197% 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 Foscow 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, te met the latter in Moscow and then corresponded with them for several years up to the time of his arrest last year. They found him

to be eminently 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 tae members of the Moscow-based "working 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 among the current victims from this group is te psychiatrist Anatoly Koryagin,

who, because of nis brave public stand, was sentenced in 1981 to 12 years o: imprisonment and exile. He has since been elected an Honorary sember 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 kedicine, 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 Commission" are Felix Serebrov, who has now gone nearly blind in a labour camp during the first three years of a nine-year term, and Irina Grivnina, who has just completed three years in exile, only to be subjected to new persecution 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 International

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

the PA at 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 Iran 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 had 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 PA voting for the USSR'S expulsion or suspension rose to nine, as these associations would wield half the votes 1r. the WPA's governing body, the ussa was now almost certain to be voted out in July. I Intensive Soviet lobbying of the assocbations 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 professional level to the political level (where it had been handled sometimes before, espec.

ially since 1981). The paliticians now had, in theory at least, tro o ptions.

First, political psychiatry could be quickly abolished - its leading
practitioners denoted and replaced by paychiatrists respected abroad; its
victing 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 operatos - especially when, as in this case,
it assential to lose as little additional international "face" as possible,

and therefore no public admission be made that anything done in the past fat 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.


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

observe how the VPA 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 exacerbate the situation, and wished to keep the door ajar for a future returri.

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 werded off any serious humiliation over the previous decade, World psychiatrists, 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 & 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 t

e them? And what would be the international consequences of not dismantling them?

To these questions the Kremlin policymakers, sobered by the shock, night 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 Rawnsley, 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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