The New York Review of Books
March 18, 1982

Peter B. Reddaway

A defiant appeal to world psychiatrists has recently been smuggled to the West from a Russian labor camp in the Urals. The author, Dr. Anatoly Koryagin, is a Soviet psychiatrist who was given a twelve-year sentence last June for opposing the use of political psychiatry to lock up and torture dissidents. His analysis of the practice was published in April in Western medical journals. Now he calls for an international campaign.

Doctors have in fact taken an increasingly firm stand on the issue, notably in France, Britain, Canada, the US, Australia, and Switzerland. In June, for example, the matter was repeatedly raised at a world psychiatric congress in Sweden, where a campaign for Dr. Koryagin’s release was launched by the recently formed International Association on Political Use of Psychiatry. In July the British Medical Association passed a resolution strongly condemning the USSR, which was then unanimously endorsed by the World Medical Association. And a growing current of opinion in the World Psychiatric Association (WPA) holds that as the Soviets have ignored the association’s 1977 demand that they “renounce and expunge” the practice of political psychiatry, the only hope of achieving this end now lies in expelling them. This, the argument goes, would set a very unwelcome precedent for the Russians and force them at last into radical reforms.

On November 20 Britain’s Royal College of Psychiatrists set an example by voting to call on the WPA to expel the Soviet Union until such time as it “can show that the political abuse of psychiatry has been brought to an end.”

In his courageous appeal Dr. Koryagin, who is forty-three years old, firmly endorses this line. He also pays tribute to the Moscow “Working Commission,” which documented several hundred cases over four years, and for which he served as chief psychiatric consultant.

Here is the text in full:
 

Dear Colleagues,

I am writing to you from Soviet political labor camp no. 37, where the authorities have incarcerated me on the basis of a perfectly absurd, stereotyped charge of anti-Soviet agitation and propaganda.

As I did not at all have the intentions which the court arbitrarily attributed to me, I can only regard the judgment as an act of revenge against a specialist who has fulfilled his doctor’s duty by obeying the voice of conscience and not subordinating it to the purposes of the KGB. It is only because I examined some dissidents who had been persecuted through psychiatric means, and because I communicated the results of my investigations to the world community, that I was sentenced to seven years of imprisonment followed by five years of exile in a remote area.

Earlier, all the members of the Working Commission to Investigate the Use of Psychiatry for Political Purposes had also been sentenced.

Dear friends, let there be no doubt about the fact that the Soviet authorities have turned our most humane branch of medicine into an instrument for achieving a main aim of their internal policy—the suppression of dissent in our country. Psychiatry in the totalitarian Soviet state brings not only succor to the ill but also harm to the healthy.

The facts about the use of psychiatry to suppress dissidents in the USSR have now angered the world community for some years. At the world psychiatric congress in Honolulu in 1977 Soviet psychiatry was condemned as punitive. Since then, however, the dirty stain on its white coat has spread still further. Thousands of dissenters have spent time in psychiatric hospitals since then, and many with names that mean little to anyone are still there now.

Continuous criticism has forced the Soviet authorities to change their tactics somewhat. The main weight of psychiatric persecution, the scale of which has grown still more, has now been redirected to the provinces. Here the “success” of punitive psychiatrists is, as before, assured by the KGB and the Procuracy, while in the central institutions (e.g., the Serbsky Institute) the number being ruled mentally ill has been considerably reduced. In this way the authorities are trying to achieve their dual purpose: to suppress all dissent in the outlying areas of the country, and also to rehabilitate Soviet psychiatry in the eyes of the world community; the opinions of foreign colleagues are formed in the course of contacts with, after all, representatives of the central institutions.

Questions about the direct involvement of particular Soviet psychiatrists in the antihumane role which the Soviet authorities have assigned to their profession can be answered clearly. First among the guilty, without doubt, are those doctors who diagnose nonexistent illnesses in healthy people. But no less guilty are those leading psychiatrists of our country who—at the top administrative level—organize and facilitate the execution of this ugly policy.

Not surprisingly, the leaders of Soviet psychiatry do everything possible, and more, to conceal the shameful facts and to whitewash, at one go, both themselves and the KGB. A. Snezhnevsky, G. Morozov, E. Babayan, and others have “covered their names with glory” by making absurdly stupid statements at international forums and in the press, where they hold forth about “the attacks of bourgeois propaganda” and the “humanism” of Soviet psychiatry, while carefully not replying to questions about particular individuals whose cases have been documented by the Working Commission. They talk a lot about “medical confidentiality” while in fact shamelessly exploiting that principle in order to conceal a system based on the “creative” procedures of oppressors from psychiatry and the KGB.

Remember, colleagues, that all contacts with foreign psychiatrists are used by the leaders of Soviet psychiatry as a means to rehabilitate themselves. They widely and untiringly advertise such contacts, trying to convince everyone that they are accepted internationally not as violators of medical ethics and norms, but as colleagues and equal partners.

The importance of the USSR in the world is well known. Nonetheless, the interests of high policy and the natural desire for professional contacts should not weaken in any of us a feeling of common guilt and responsibility for the lives of those people who are suffering at the hands of psychiatrists. Their crippled health and careers call out for effective resistance: for constant, widespread, and public exposure of those responsible, and for boycotting them.

Is it tolerable that the World Psychiatric Association should have member societies from countries where psychiatry is assigned punitive functions? Is it ethical to have any professional contacts with the official psychiatric representatives of those countries? Has the time not come to form an international commission of psychiatrists on medical diagnosis, the effectiveness of whose action would be ensured by the states represented in the WPA? These and other questions could become subjects for debate in psychiatric forums if psychiatrists developed a widespread interest in resolving the problem of psychiatric oppression of dissenters in various countries.

Soviet politicians have always, and especially recently, trumpeted across the world their appeals to live in peace, friendship, and cooperation with others. It is, however, impossible to believe that politicians who keep their own people deprived of all rights and incarcerate critics in concentration camps and psychiatric prisons really care about the happiness of all peoples. Since the beginning of the Madrid conference on European security and cooperation in 1980, hundreds of Soviet dissenters have been imprisoned or interned in mental hospitals. The authorities have shown special hatred toward those who have exposed their repressive policy and tried to counter its implementation.

In my case the court ruled my activity to be “incompatible with the calling of a Soviet scientist” and demanded that I be deprived of my Doctor of Science degree. KGB officials tried to force me to renounce my views, subjecting me to exhausting interrogations for many hours and locking me up in a punishment cell. They also threatened me, saying that I would never be freed from captivity, that I would be reduced there “to a vegetable,” that I would never again be able to work as a doctor, and so on.

Now, in the camp, they deny me not only the chance to extend my professional range (through work in a new situation), but even to read specialist literature on psychiatry. Every line I write is inspected, letters are confiscated or delayed, and a meeting with my wife is barred.

Our professional duty demands of us that we care for others. I appeal to you, my colleagues, not for a moment to forget those who are now condemned to spend years in the nightmarish world of psychiatric wards, exhausting themselves in a debilitating struggle to preserve their psyches, a struggle against torturers armed with drugs—all because they have stood up for the rights and freedoms people need. To remember them and to do everything possible for their release is our obligation. Their fate is a reproach to our conscience, a challenge to our honor, a test of our commitment to compassion. We must brand, brand with shame, those who out of self-interest or antihumanitarian motives trample on the ideals of justice and on the doctor’s sacred oath.

    Your colleague,
    Psychiatrist A. Koryagin