to a meeting of the American Psychiatric Association (APA)
during its annual convention in Washington D.C. 1988
published in 1989 as the Foreword to a booklet of IAPUP with the title
“soviet psychiatric abuse in the gorbachev era” – robert van voren (ed.)
At the end of the sixties and the beginning of the seventies we received information and soon clear evidence, that in the USSR some dissidents were declared to be mentally ill and treated accordingly. The use of psychiatry for repressing, punishing and discrediting opponents became known worldwide. In 1972 the West German Psychiatrie Association, the Deutsche Gesellschaft für Psychiatrie und Nervenheilkunde, declared in a resolution:
‚Any abuse of psychiatric methods and facilities for ideological and political purposes is in contradiction to the ethical rules of the medical profession as well as to the principles of universally valid social ethics‘. This was one of the first reactions by a professional body, and was also supported by the leadership of the WPA. Since this declaration, however, only related to hypothetical cases of abuse, some regarded it as rather evasive. As a result of the efforts of many psychiatrists all over the world, stronger responses began to be made, eventually by the General Assembly of the WPA in 1977 and 1983 as well. We considered a clear stand to be necessary. Some colleagues, however, thought otherwise and they have been ready to use the tactic of evasion right up to now.
Deceit is the foundation of repression under the cover of mental health-care as well as the main instrument for its ‚justification‘. For years the Soviets denied psychiatric abuse despite all the evidence. And also this obvious lie was willingly accepted by many psychiatrists in western countries, including, sorry to say, my country. These colleagues, however, mostly preferred the milder, but no less false assertion, that the abuse was not sufficiently proven. They said, it’s too far away, and stressed the ambiguities which exist in psychiatric diagnoses. They simply passed over the abundant evidence.
But if on the one hand we heard that there was insufficient evidence, on the other hand, we heard the subject was already known to all and thus didn’t need any further attention. In 1988 WPA president Dr. Stefanis has used this argument to keep IAPUP’s contributions out of the WPA Regional Symposium held in October 1988 in Washington D.C.. We were also told that the issue is of little or no importance. The main task of psychiatrists is the promotion of their science. This ‚formidable‘ argument was usually combined with attempts to denigrate those, who, like us, deemed the matter to be very significant for the humane aims of psychiatry and for its scientific credibility. Our views and explanations had nothing to do with science, our opponents said, but were anti-communist; an argument first put forward by the abusers themselves, by Dr. Morozov, Dr. Vartanyan, etc.
More often, however, it was simply said that the whole question was being brought up for political motives alone. This argument appealed to the
aversion against all politics which is widespread among physicians, at least in Germany. Of course, it can contribute to privacy in the patient-doctor relationship, that physicians show restraint in public affairs. But this basically well-founded principle has always been ambiguous, too. For some colleagues it has served as an easy excuse to keep out of all struggles which had to be fought for human progress, liberty and justice. German doctors especially are said to have been educated to fulfill just their medical duties and not to get involved into what is called ‚dirty polities‘. In the opinion of serious observers their indifference, or rather, indolence towards polities has virtually contributed to the submissiveness of German doctors to authority, more especially to Hitler. Some of our eminent psychiatrists became pacemakers, even worse, executors of his most atrocious crimes.
The actions and omissions of doctors as weil as of everybody else, have a political context, whether it is admitted or not. I’m happy that there are countries where doctors obviously have a more natural attitude towards polities, where they take part in shaping the community, and where therefore psychiatrists were among the first to respond to the challenge of psychiatric abuse to a large extent. In my country, as I have mentioned already, I had been discouraged by the evasions, the distortions, the glossing over of the evils. So it was a great experience for me hearing the contributions of many from the floor during the Special Session on the Abuse of Psychiatry, arranged by the Americans at the World Congress of Psychiatry on 30 August 1977 in Honolulu. Wasn’t it there, where it was made evident that the majority of psychiatrists stand for right and truth and that they can never be turned into accomplices of political perfidy? Never before had I been so proud to belong to the professional group of psychiatrists as in that moment.
The problem of psychiatric abuse is not an inferior issue that has to be kept out of scientific conventions. As long as it exists it has to be on our agendas. Medical science is only scientific as long as it considers its effects on human beings. T 0 ignore some of these effects the way some representatives of the WPA have tried to do in the past and the present representatives, Dr. Stefanis and Dr. Schulsinger do nowadays, is creating almost a travesty of medical science. This science can only prosper if all those who contribute to it, can trust that they are all serving the interests of man. Science, international co-operation of scientists and the strengthening of a scientific association cannot be promoted by courting people who are notoriously involved in crimes.
It’s also a loss for a science if an area which undisputably belongs to it, is withdrawn from its consideration on an artificial pretext. Psychiatry involves the cultural, social and political spheres of human life more than any other medical discipline. So, how can it ignore a political sphere which is so cosely linked to it? Those of us who have studied the details of psychiatric abuse more thoroughly, have gained valuable experience for their own practice, too. Never and nowhere did the observation of human rights in psychiatry happen of its own accord. We psychiatrists have had to learn as we go along and we still have to learn. Science is an answer to challenges – that existing problems pose for the human mind. So, how can scientists not respond to such a challenge as psychiatrie abuse?
The leaders of the World Psychiatric Association dose their eyes to this this practice obstinately. Obviously, they are also not aware of the disgrace they are bringing upon our discipline. For example, in the German press, highly critical articles have appeared about how the issue of abuse is handled by these gentlemen. Unfortunately, we had to get used to the fact that some western psychiatrists prefer to associate with those who perpetuate this abuse, rather than with those who criticize it. By doing so, the representatives of the WPA also ignore the decisions of the majority of their members, as expressed in the General Assemblies of this association in 1977 and 1983. Now they are even trying to change the voting system of the association as the Soviets have demanded since Honolulu. Drafts of new Statutes and Bye-Laws are being circulated among WPA member-societies. According to these proposals the Americans, the British, all who have been defending psychiatric ethics over the years despite various tricky manoeuvres, would lose much of their voting power.
My esteemed colleagues, you should be aware of the fact, that all the efforts you made against the perversion of our science which have earned you the high respect of many of your colleagues worldwide, will be in vain, if you allow your influence within the WPA to be diminished. Now, especially, you and your colleagues in other countries who have opposed the abuse have every reason to defend your position. The ameliorations in this field so far have been achieved thanks to your interventions. Some long-term victims of abuse were released. New legal regulations have been produced. Perhaps we do not need to do very much more to stop this evil and obstruct those who are responsible for it. By adhering to the ethies of our profession, you will have laid the base for a lasting understanding among psychiatrists worldwide. So please do not weaken or surrender your stand nor the means to pursue your aims. Don’t abandon those who are still unjustly suffering in psychiatric wards nor your colleagues who share your medical ideals and the readiness to stand up for them.