In March 1971, a French human-rights organization released to the Western press
150 pages of documents said to be the photocopied forensic reports on six citizens of
the Soviet Union being held involuntarily in psychiatric hospitals.
Accompanying the documents was a letter addressed to Western psychiatrists. As
reported by Peter Reddaway and Sidney Bloch, M.D., in their 1978 book,
Psychiatric Terror, the letter read, in part: "In recent
years in our country a number of court orders have been made involving the placing in
psychiatric hospitals ... of people who in the opinion of their friends and relatives are
The letter noted that the six individuals were "well known for their
initiatives in defense of civil rights in the Soviet Union" and contained a
specific request to psychiatrists: Did the forensic reports describe evidence of mental
illness sufficient to warrant incarceration?
The letter was signed by Vladimir Bukovsky, a biophysicist and human-rights
activist who had himself been incarcerated; the documents were compiled by a small group
of underground activists in Moscow. It was a dramatic breakthrough and one of the first
glimpses the Western world had of a fledgling human-rights movement that had begun to
emerge in the Soviet Union, including a group who formed the Working Commission to
Investigate the Use of Psychiatry for Political Purposes.
Reddaway, at the time a political science professor at the London School of
Economics, recalled that the dissidents in Moscow in the early 1960s had adopted the
tactic of taking Soviet law at face value to protect their right to protest.
"They would point out that they were only exercising the rights afforded
under the Soviet constitution," he told Psychiatric News.
"It sounds simple, but in many cases it worked because the authorities were not
sure how to handle the dissident movement.
"One of the responses the authorities developed was to argue that because
there could be no flaws in a socialist society, the only explanation for the dissidents'
behavior was a distorted view of reality," Reddaway said. "On a small
scale at first, but increasingly throughout the 1960s and 1970s, they began to put the
early Soviet dissidents into psychiatric hospitals. Sometimes they did this through
administrative means without a trial, placing individuals in mental hospitals, and in
other instances [the dissidents] had a trial in which they were examined by a
psychiatrist who would do what the authorities demanded."
The "Bukovsky papers" were among the first substantiated
evidence of the practice of using psychiatric incarceration to detain political
dissidents—a practice that, as recorded by Reddaway, was used sporadically
as early as the Stalin period, but in time became a systematic response to political
dissent. And it was a practice that would eventually arouse Western psychiatric
opinion and lead to a confrontation between APA—and other Western
psychiatric organizations—and the Soviet All-Union Society of Psychiatrists
The confrontation resulted in a statement by the World Psychiatric
Association in 1977 denouncing political abuse of the profession and later in the
withdrawal of the All-Union Society from the world body under threat of expulsion
(see Soviets Left WPA
Under Expulsion Threat). In 1989 the face-off culminated in a
remarkable visit by American psychiatrists led by the U.S. State Department in which
the American delegation interviewed individuals believed to be incarcerated in
psychiatric hospitals due to political activity.
But movement by Western psychiatry was hesitant at first, and Reddaway and
others acquainted with the period described a fitful process—a slow
accretion of evidence, the surreptitious establishment of a network of contacts
within and outside of the Soviet Union, widening publicity for the dissidents' cause
and about the nature of psychiatric abuse, and only later the mobilization of
professional and organizational protest.
This epic story is told in a new book, Cold War in Psychiatry: Human
Factors, Secret Actors, published this year by Dutch human-rights
activist Robert van Voren, and in two volumes by Reddaway and British psychiatrist
Sidney Bloch, M.D. (The first, Psychiatric Terror, earned Reddaway
and Bloch APA's Manfred S. Guttmacher Award in 1978. Their second book,
Soviet Psychiatric Abuse: The Shadow Over World Psychiatry, was
published in 1985.)
At APA, a crucial development was the arrival of Melvin Sabshin, M.D., as
medical director in 1974. Sabshin brought with him an international perspective and
a commitment to the development in the United States of a more rigorously scientific
psychiatric nosology—as opposed to ideological or theoretical
approaches—that made effective confrontation with the Soviets possible
(Psychiatric News, November 5).
During Sabshin's tenure, APA's Board of Trustees, with the strong
recommendation of the Council on International Affairs, established the Committee on
International Abuse of Psychiatry. Sabshin hired world traveler Ellen Mercer, who
served as staff liaison to the committee and later as director of APA's Office of
International Affairs when it was formed in 1982.
Reddaway was appointed a consultant to the committee and van Voren served
informally as an advisor to Mercer (van Voren had befriended Bukovsky after the
latter was released from the Soviet Union in an exchange for Chilean communist
leader Luis Corvalan in December 1976). With the help of Reddaway and van Voren's
contacts in the Soviet dissident community, the committee began to make contact with
incarcerated individuals, their family members, and official Soviet psychiatry.
The strategy was straightforward and modeled on the practice of Amnesty
International: the committee wrote letters.
"Cases would come to us through various channels but mostly from the
Moscow Working Commission," Mercer recalled in an interview with
Psychiatric News. "We would send letters to the
prisoners, their families, and to the institutions where they were incarcerated. We
didn't always have their family members' contact information, but we would write to
them if we did.
"The content of the letters was less important than the fact that
they were on APA letterhead and had the name of the individual in the
letter," she said. "We would always say something like, ‘It
has come to our attention that _____ has been incarcerated in ________________
hospital allegedly for nonmedical reasons. We would appreciate your sharing with us
the reason the person is there and whatever other information is
Incarcerated individuals were not always strictly political dissidents
protesting human-rights abuses, but included members of disparate national groups
seeking independence, as well as members of religious sects, including the Russian
Orthodox Church and Protestant denominations, and Jews seeking to emigrate to Israel
or the West.
Some of the cases also involved psychiatrists who refused to cooperate with
KGB authorities in detaining individuals. Among these were two—Semyon
Gluzman, M.D., and Anatoly Koryagin, M.D.—on whose behalf APA was vocal.
Gluzman had early on protested the incarceration of Pytor Grigorenko, a Soviet World
War II hero, and earned for his courage seven years in a forced-labor camp and three
years in exile. Gluzman was later made a distinguished life fellow of APA, and in
1982 he returned to Kiev and later became a leader of Ukrainian psychiatry.
Koryagin was a consultant to the Moscow Working Commission to Investigate
the Use of Psychiatry for Political Purposes and wrote an article in the April 11,
1981, The Lancet titled "Unwilling Prisoners." A
footnote to that article stated that earlier that same year, Koryagin had been
arrested and charged with "anti-Soviet agitation." After serving
time in prison, he was exiled to Switzerland and later returned to the Soviet
APA's letters rarely, if ever, received a response, but the communication
served notice to Soviet officialdom that the world was watching.
And it had an effect. Mercer recalled that in a meeting with dissidents at
the American Embassy in Moscow in 1989, prior to the visit of American psychiatrists
led by the State Department, many stated that the publicity had saved their
"We know from people who were released that they received much
better treatment because of the letters than those who did not come to the attention
of people and organizations in the West," Mercer said. "And,
usually, they had no idea how and why they were noticed and others were
Reddaway agreed. "The dissidents themselves firmly believed the more
foreign pressure the better, and if someone was released, they all felt the pressure
had played an important part," he said. "I have studied official
documents in the Soviet archives, including minutes from meetings of the Politburo,
and it is obvious that Soviet authorities at high levels paid close attention to
foreign responses to these cases."
In the third article of this series, Psychiatric News
will look back on the 1989 visit of American psychiatrists to the