The totalitarian government in Soviet Russia invented a mental illness to lock up resisters
‘Sluggish schizophrenia’ was a dangerous diagnosis
You had to be crazy to oppose Communism in Russia. Or if you weren’t, the Soviet state medical system made sure you were at least classified that way.
In 1963, Russian poet Joseph Brodsky was seized and sent to a mental institution. At his trial the following year, authorities charged the 24-year-old with “social parasitism” and called him a “pseudo-poet in velveteen trousers.” He had failed to “fulfill his constitutional duty to work honestly for the good of the motherland.”
“Who has recognized you as a poet? Who has enrolled you in the ranks of poets?” asked the judge.
“No one,” Brodsky replied. “Who enrolled me in the ranks of the human race?”
Brodsky was committed to a mental institution for examination, where he spent three weeks. Hospital workers pumped him with tranquilizers and repeatedly woke him during the night. He was given cold baths and wrapped in wet canvas that shrank and cut his skin while drying.
Years later when Brodsky was being considered for exile, officials examined his mental health records. They consulted leading Soviet psychiatrist Andrei Snezhnevsky, who, without personal examination, diagnosed Brodsky with “sluggishly progressing schizophrenia.” The poet was “not a valuable person at all and may be let go.”
In fact, Snezhnevsky had invented “sluggish schizophrenia” as a political tool for oppressing anti-Soviet dissenters. Any anti-state behavior—such as opposition to one’s superiors or overvaluing one’s importance—could indicate mental illness. The logic was simple: If anyone opposed the Soviet state, he was mentally ill, as there was no logical reason to oppose the finest socio-political system in the world.
In a speech, Soviet leader Nikita Khrushchev said, “A crime is a deviation from the generally recognized standards of behavior frequently caused by mental disorder…To those who might start calling for opposition to Communism on this basis, we can say that…clearly the mental state of such people is not normal.”
Symptoms of sluggish schizophrenia came in the form of “reform delusions,” “struggles for the truth,” “a heightened sense of self-esteem,” and “perseverance.” People with sluggish schizophrenia often seemed functional or experienced only slight neuroses, but Snezhnevsky argued that was the very nature of the disease: its mild symptoms only progressed with time.
By design, sluggish schizophrenia’s broad definition encompassed all manner of typical human behavior, and mass diagnosis would serve to intimidate the resistance.
People who distributed anti-state literature, organized political activities, or defended the rights of the disabled were immediate targets, according to the Journal of the American Academy of Psychiatry and the Law. In fact, the KGB tipped off psychiatrists with the names of dissidents in order to avoid public trial and to vilify opposition as mental illness. Dissidents were incarcerated in mental institutions without any medical justification. Under Soviet law, if such persons were found nonimputable, they could be placed in maximum security hospitals, also called “special hospitals” or “mad house jails” (in Russian, psikhushka, or little psych wards).
There they were given compulsory treatment, which in some cases meant high doses of antipsychotic drugs by injection. Doctors administered sulfazine, believed to enhance treatment responses to neuroleptic medication, but which could cause pain, fever, and immobility. Other patients were put into insulin-induced comas. They lived in spaces as small as two-square meters, sometimes with physical restraints and in total isolation. Many patients shared beds or slept on floors in dilapidated prison wards built during tsarist times.
The government called it treatment, a means to return to “normal” life. But normal life in the Soviet Union meant uncontested service to country.
Before long, the Soviet Department of Science and Education reported that the number of people in need of psychiatric help had grown from 2 million in 1966 to 3.7 million in 1971. In the 1980s, the Soviet Union diagnosed three times as many schizophrenic patients as the U.S., and twice as many as West Germany, Austria, and Japan. Moscow had the highest prevalence of schizophrenia of any city in the world.
In Soviet Russia, a diagnosis of schizophrenia meant serious legal consequences (aside from potential incarceration). Patients were not allowed a driver’s license; they could neither serve in the military nor hold leadership positions; they were not permitted to travel abroad.
The Soviet Union diagnosed sluggish schizophrenia into the late 1980s, by which time the World Psychiatric Association had denounced the country’s political abuse of psychiatry as a human rights issue. Yet Snezhnevsky continued to defend his practices until he died in 1987.
In an interview that same year with Soviet newspaper Komsomolskaya Pravda, psychiatrists Marat Vartanyan and Andrei Mukhin explained their definition of mental illness: “When a person is obsessively occupied with something. If you discuss another subject with him, he is a normal person who is healthy, and who may be your superior in intelligence, knowledge, and eloquence. But as soon as you mention his favorite subject, his pathological obsessions flare up wildly,” Vartanyan explained, adding that hundreds of people were hospitalized according to this definition. Mukhin said this was because “they disseminate their pathological reformist ideas among the masses.” A few months later, the paper listed among the symptoms of psychiatric illness “an exceptional interest in philosophical systems, religion, and art.”
By then, people like Brodsky, who would later win the Nobel Prize for literature, and nuclear physicist Andrei Sakharov, who would later win the Nobel Peace Prize, had been forced into mental hospitals for their vocal resistance to Soviet authoritarianism. The writer Vladimir Bukovsky spent 12 years in prisons, labor camps, and psychiatric hospitals. Fellow dissenter Jaures Medvedev wrote, “It is time to think clearly: the incarceration of free-thinking healthy people in mad-houses is spiritual murder: it is a variation of the gas chamber, but even more cruel: the torture of the people being killed is more malicious and more prolonged.”
The diagnoses of mental illness slowed in 1991 when the Soviet Union fell apart and president Mikhail Gorbachev led Russia out of Communist rule.
But in the early 2000s, coercive treatment began to stir once more. “Punitive psychiatry, so-called ‘police’ psychiatry, is alive and well,” Yury Savenko, president of Russia’s Independent Psychiatric Association, said in 2007. And in 2012, the Psychiatry: National Manual once again added “delusion of reformism” as a symptom of mental disorder.
Power by diagnosis is back.
