Human Rights and Psychiatry:
The Totalitarian Experience
The corruption of psychiatric practice that allowed Soviet doctors to institutionalize political dissidents with such specious diagnoses as "sluggish schizophrenia" will not completely disappear from Russian life until those who participated in it are dead, according to Dr. Semyon Gluzman, the celebrated Ukrainian human rights activist who delivered the ninth biennial Hoffman Memorial Lecture at the Law School February 15.
Dr. Gluzman himself was sentenced to a Soviet labor camp for seven years, and spent another three years in "internal exile," for his temerity in finding no evidence of mental illness in General Pytor Grigorenko, one of the most famous political dissidents of the Brezhnev era, who was condemned to a psychiatric hospital in order to silence his political opinions. The horrible fates of many dissidents, who were routinely injected with powerful mind-altering drugs and otherwise tortured, ostensibly to cure their anti-Soviet ideas, is now broadly documented, partly through the efforts of Dr. Gluzman.
The root of Soviet psychiatry's sins lies in the system of totalitarianism itself, Gluzman said, because of its philosophically materialist nature, which assumes that all things are empirically knowable and therefore can be engineered into new forms. In the totalitarian context, thinking differently is seen as being pathologically disordered. "Naked kings use psychiatry for doing away with boys who tell the truth," he said.
Despite international norms for the field, "Soviet psychiatry as a social institution, which was formed and functioned within the totalitarian system, could not but be totalitarian," he said. "This was inevitable because it is only a subsystem, whose characteristic features are predetermined. All major characteristics of the system will inevitably be present in its constituent parts -- the subsystems. This is a sociological law."
Soviet psychiatry found itself trapped between its therapeutic mission and the Soviet state's insistence on complete social control. Soviet psychiatrists typically were divorced from such moral norms and laws that inform practice in the West and mitigate the potential subjectivity of psychiatric diagnoses. He called Soviet law "decorative" and at all times subservient to the needs of ideology. The greater use of psychiatric excuses for confining dissidents grew as the Soviet state became less confident of its capacity to maintain social control after the death of Stalin, acccording to Gluzman.
Western pressure did contribute to ending abuses at the time of the Soviet Union's exhausted collapse in 1989, but Dr. Gluzman doubted that Western doctors fully appreciate the perverse nature of Soviet psychiatric reasoning.
Dr. Gluzman's lecture was arranged by Richard Bonnie, Director of the Institute of Law, Psychiatry and Public Policy. Professor Bonnie served on a 1989 American investigating team that interviewed patients and former patients hospitalized for committing political crimes and found clear evidence of abuse.