Postcard from a Padded Room: More on how Russia is Re-Weaponizing Psychiatry as Lever of Dictatorship

Filed under: Eastern Europe

La Russophobe has already reported three different times on the increasing weaponization of psychiatry in the neo-Soviet Union, and here through the good offices of her professional translator is yet a fourth terrifying installment in that saga, direct from the pages of Russia's opposition press.

The Abuse of Psychiatric Authority
Zoya Svetova
Yezhednevniy Zhurnal
June 22, 2007

At the end of May the Independent Psychiatric Association of Russia held a meeting in Moscow. Among the issues they discussed was the possibility or impossibility of a re-emergence in Russia of punitive psychiatry, the use of which against dissidents in the Soviet Union for many years covered Soviet psychiatrists in shame. This issue did not come up by accident. The introduction of censorship, political exiling, the use of the judicial system for settling scores with enemies, the appearance of political prisoners -- all of these elements of the Soviet totalitarian system have gradually migrated back into Russian authoritarianism. The full picture is lacking only punitive psychiatry. According to sociological polls, most of the residents of the country are satisfied with their lives. The rating of the current president is simply off the scales. And suddenly there appear these people who are unhappy with these highly-rated authorities -- they do not agree with them. Something is not right. Something is wrong with them. Could it be they're sick?

The head of the Independent Psychiatric Association of Russia, Yuri Savenko, assesses that "the authorities have not yet given the signal, but the appearance of the Law on Extremist Activities, which can be interpreted rather broadly, along with the inevitable appearance among protest-minded citizens of a certain percentage of people with so-called personality disorders, is likely to lead to some people being placed in psychiatric hospitals." The problem is exacerbated by the fact that among professional psychiatrists there has never been the necessary assessment of the prevalence of punitive psychiatry in Soviet times.

Repentance for psychiatric repressions was expressed at the beginning of the 1990's by the Director of the Serbskiy Institute, T.B. Dmitriyev, as was loudly broadcast to audiences in the West, and to Vladimir Bukovskiy, as described it in his book "The Moscow Process" (1996). But in Russia it was spoken of only unofficially, without "excessive noise." Now, just ten years later, the very fact of the abuse of psychiatry has been categorically denied. And many psychiatrists continue to believe that there was nothing wrong with forced hospitalization of dissenters. One still encounters the view among some doctors that "putting anti-Soviet activists in the hospital saved them from being sent to the Zone" [TN: a.k.a., the Gulags].

Never Write a Letter to a Duma Deputy or Psychiatrist

Is it easy or difficult nowadays to forcibly hospitalize a "difficult" person?

The Law on Psychiatric Care regulates hospitalization fairly strictly, especially when it is done without the consent of the patient. Involuntary hospitalization is still allowed only in certain circumstances, such as when there is an indication of serious psychiatric disorder, which would pose a direct danger to the patient and those around him, or if the patient is helpless, or if remaining without medical care would result in a worsening of the patient's condition. But the case of one resident of Moscow (we'll call her "Elena") seems to me a worrying symptom. Elena is not an oppositionist. She does not go to the March of Those Who Disagree. She is simply a non-standard person. And due to certain circumstances she turned out to be "difficult" for a fairly high-ranking official. And for this she suffered.

Psychiatric diagnosis is a somewhat delicate matter. In diagnosing one and the same patient, the opinions of doctors can vary widely. What one doctor may see as an indication of illness, another may consider a "borderline condition", which does not pose a threat to either the patient or those around him.

"Obviously, this was an unfortunate experiment," says Elena today, evaluating what happened to her. "I had always liked strong, self-confident, action-oriented women. Among those I took an interest in was the Duma Deputy Svetlana Savitskaya. I found her home phone number and called her with a request for her email address, so I could send her a certain political text. Savitskaya reacted to my call somewhat strangely: She said she was going to file a complaint with the police or have me committed to an insane asylum. She said that I was keeping her from sleeping and working. I later decided to give her a copy of a book by George Soros, 'The Bubble of American Supremacy.' I thought that all patriotic fundamentalists should read this book. Along with the book I passed a disk of Tibetan music to the female guard on duty at the entrance to Savitskaya's home. I then called Savitskaya to make sure she had gotten my book. Once again she was very unhappy with my phone call." Elena was unperturbed, and next tried to deliver her political text to the Deputy in person. The "political text" contained some articles by well-known journalists, as well as Elena’s personal thoughts about the intelligence services and the role of Joseph Stalin in Russian history. Elena went through the entrance to Savitskaya's building and rang her doorbell. Savitskaya did not open her door, but called the guards, and they ejected the unwanted guest from the Deputy's building.

Could the behavior of our heroine be considered that of a person who was abnormal, aggressive, or presented a danger to society? No. Her behavior was odd, annoying, but nothing more than that.

Then Elena wrote a letter to the director of the Serbskiy Institute, Tatyana Dmitrieva, whose appearance on television Elena had much enjoyed. Elena decided that Dmitrieva could help her understand herself and give "an evaluation of the behavior of Savitskaya." After giving a detailed description of her interactions with the Deputy, Elena waited for a reply from the psychiatrist Dmitrieva. At Dmitrieva's request, the Deputy Director of the Center, Zurab Keklidze, answered the young woman as follows: ". . . in accordance with the charter documents, the Federal State Office of the V.P. Serbskiy State Scientific Center for Social and Judicial Psychiatry is not empowered to give an opinion (express an evaluative opinion) in either verbal or written form on the activities of any entity or person. Therefore, unfortunately, T.B. Dmitrieva cannot respond to your request."

Elena still tried several times to send emails to Dmitrieva and called her at home. Eventually, Tatyana Dmitrieva complained to the police, and Elena was visited by a police officer from the local precinct who sought to find out why she would not leave the Director alone. No criminal case was ever brought against her. But a short while later Elena found herself in a psychiatric hospital. She had come to a lecture by Dmitrieva and, attempting to talk with her, lunged at her car.

Hospitalization "By Phonecall"

Dmitrieva's driver called for a "psychiatric ambulance." After talking with Elena, the doctors refused to hospitalize her. A second ambulance team also refused to hospitalize her. "I explained my actions to the doctors," recalls Elena. "One of them told me that Dmitrieva had called the Moscow City chief psychiatrist. Then a third ambulance arrived, and they took me to the hospital." There Elena was placed in the "acute section," in a ward with a dozen seriously ill women. The next morning, in a meeting with a doctor, Elena said that she did not consent to remaining at the hospital. After two or three days, a court convened. "They told me that I had to stay in the hospital, or else my condition would worsen. They gave me antidepressants. Later various doctors and consultants came. I asked them to release me. But they kept putting it off. The most unpleasant thing was not knowing when I would ever be allowed to go home. I was afraid that I would lose my job. The first two weeks I was in a ward with 16 people. I couldn't talk with any of them. It was horrible for me to even to look at them."

Elena spent two and a half months at the hospital. Professor Aleksandr Gofman, a doctor who is well-regarded in his profession, believes that it was unnecessary to hospitalize Elena. "It should have been sufficient to treat her as an outpatient, explain to her that if she did not do as she said she would do, she would have to be hospitalized. But by her behavior, she did break the law. She could have been held criminally responsible for interfering in the work of an official functionary, for entering into an occupied domicile. And for disturbing a person’s peace, calling them on the telephone," he explained. Another psychiatrist, Professor Vladimir Rotshteyn said, "Tatyana Dmitrieva receives hundreds of letters like this every day. And, as a rule, she does not answer them. A person who receives no answer usually stops writing. Hence, one cannot condemn Dmitrieva for being frightened." He is certain that "hospitalization was good for Elena."

The head of the Independent Psychiatric Association of Russia, Yuriy Svenko categorically disagrees: "This woman was forcibly hospitalized without sufficient reason." Only the third 'psychiatric ambulance' team, which included a doctor who worked at the Serbskiy Institute, agreed to hospitalize Elena. She should not have been detained at the hospital for so long." Savenko believes that the doctors who decided against releasing Elena from in-patient status were pawns of "divided loyalties." On the one hand, they had taken the Hippocratic Oath, and were obliged to serve their patient, but on the other they were obliged to obey a senior official, in this case the chief psychiatrist of the Ministry of Health, who happened to be one and the same T.B. Dmitrieva.

"Every experienced psychiatrist has at various times attracted the attention of mentally ill people. This can in fact be quite dangerous," continues Savenko. "So Dimitrieva's first reaction was natural. But her failure to take into account the opinion of a consultant-professor, and then a second, and then a third, to say nothing of the opinions of the doctors at the hospital, clearly shows the extent to which professional ethics and the rule of law are observed by the country's head of judicial psychiatry, who is also the sole leader and chief psychiatrist in the ministry. Such occurrences are not a rarity, but are carefully hushed up. Transparency in this case occurred thanks to the work of journalists and a fortunate confluence of circumstances. Hence, my arrival at the hospital was the final drop needed for the release of Elena, shortly before the end of the three-month period after which she would have lost her job, at which she does quite well. Her worshipping of Dmitrieva on the television was transformed into a stubborn desire to sue her in court. She approached our Association with a request for legal assistance in this. The fact that we were able to talk her out of a trial is more than enough proof that her behavior had no characteristics mental illness. Of course, a trial would have been very notorious. But we give priority to the individual futures of those who turn to us for assistance."

Elena still has a bad taste from her stay in the psychiatric hospital. “None of the professors could explain my behavior. They simply said that there was no severe disorder, but there was depression. But no one would explain to me what sort of psychological problems I had and what I could do to get over them. I was there for two and a half months, and for nothing. So what was the point of sending me there for treatment? I needed a psychoanalyst, not psychotropic pills, which caused side effects in me, and worsened my depression. The question I asked Dmitrieva, as a leading specialist, how to explain my behavior, remains unanswered."

This story is not only about how easy it is to get a non-standard, unusual person committed to a psychiatric hospital. It is also a story about indifference and intolerance.

Our parliamentary deputies and bureaucrats - worst of all, our government medical professionals -- have forgotten how to get along with private citizens. They are deathly afraid of them. It is easier for them to brush off a person who wants to talk with them, simpler to declare them crazy, than to pay attention to someone who is asking for just a minute of their precious bureaucratic time.

Here is what Elena wrote in her letter to Deputy Svetlana Savitskaya: "Tolerance should be taught beginning in kindergarten, in the schools and colleges. One must have constant discussions about any theme. The main idea should be to instruct children in the field of argument. So that every person from childhood on is predisposed to conduct arguments and the search for information . . ."

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