Lessons from history: the politics of psychiatry in the USSR

Abstract

The political-economic base of society affects every aspect of it, including nursing and psychiatry. This can be demonstrated by making a historical analysis of societies with different political-economic systems. Psychiatry in the USSR took a different form to psychiatry in the West. Differences included the diagnostic categories used and treatments employed. This can be investigated by examining accounts of clinical practice. Soviet psychiatry was also used for the systematic incarceration of political dissidents. Some commentators have drawn on the Soviet experience and used it to support an argument that psychiatry operates as a form of social control in the West as well as the USSR. This article shows how psychiatric abuse in the USSR was a historically specific response to a particular situation. Therefore some of the conclusions about Western psychiatry extrapolated from the Soviet experience are unsupportable. Whatever the role of psychiatry in the West, its mechanism is qualitatively different to that which existed in the USSR. In order to understand why Soviet medical workers were co-opted into the conscious abuse of psychiatry, it is essential to understand the specific nature of the USSR. This does not necessarily allow generalizations about Western psychiatry to be made from the Soviet experience. As psychiatric nurses, we can also learn from a particularly tragic period of psychiatry's history.