[Reader-list] Madness in their methods...

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Madness in their methods

 
Vladimir Bukovsky was first arrested in 1963 for possession of anti-Soviet literature and interned in a special psychiatric hospital for 14 months. He spent years in and out of mental institutions and labour camps for his persistent opposition to the regime until his release and exile in 1976. 
Interview by Irena Maryniak. 
Q: You were twice subjected to compulsory psychiatric treatment in the 1960s, first in Leningrad's Special Psychiatric Hospital and then in 'ordinary' psychiatric clinics. What were the conditions of your internment and how did it affect you? 

Bukovsky: I was young and curious so I wasn't seriously intimidated, even though the chances of never getting out of hospital were high. But I didn't know that then. The special hospital was an overtly penal institution. The orderlies were criminals who had been designated to do time there. As far as they were concerned there were no rules, anything went. They could steal, beat or kill. The authorities never punished them, they put everything down to the patient's condition. If an orderly killed a patient, it was the patient who was to blame. 

Unofficial forms of punishment included injections and 'roll-ups'. I never had a 'roll-up', but it was an ugly thing to watch. They'd wrap wet canvas strips around the patient which shrank when they dried so that the victim lost consciousness. Then a nurse would come and loosen them. This could go on for any length of time. They called it 'restraint'; in fact it was torture. Some people suffocated and died. A young political I knew, Tolik Belyaev, was given this treatment because he had been reading after lights out. 

The punishment drug aminazine was widely used - in the early 1960s they had little else. They also gave sulfazine which was a solution of sulphur in peach oil, injected into muscle. It caused an abscess, high temperature and intense pain. In one section they gave insulin shocks, but we were spared those. Electric shocks were introduced later. They didn't have 
technology then. Subsequently, the range of available equipment grew much wider. 

They also administered the drug haloperidol. The idea was that it lowered the severity of the psychotic state by affecting neurotransmitters. An excess of dopamine induces a severe psychotic state and a low level of dopamine causes Parkinson's disease. They gave high doses of haloperidol to lower the dopamine level, and people got symptoms of Parkinson's.

All this made everything that came after seem much easier. When I was imprisoned, I found it quite simple to tolerate punishments like solitary confinement, cold or hunger. They didn't touch me. In prison you had colleagues, cell mates and limited rights. We used what we had. We went on hunger strike . . . In psychiatric hospitals there was nothing. 

Q: What about friendship? 

Bukovsky: We had that, but in those conditions there wasn't much we could do for one another. It was like a mischievous trick. You'd been diagnosed mentally ill. You were no longer responsible for yourself. You had no rights, even theoretically. 

I was fortunate in that our doctor was well over 70 and very experienced. If an orderly said that a patient had woken up and attacked him, he'd say: 'I've been working here 40 years and I've never seen a patient get aggressive. What did you do to him? You must have done something . . .' So in his section they never touched anyone. 

There was also a woman doctor who secretly helped us. She still lives in St Petersburg. She was an 'ascetic' in the Russian Orthodox sense of the word. She worked in mental hospitals to help people. She wouldn't let them punish us and helped to get us discharged. I kept in touch with her quietly after my release. She went on giving help, and was eventually caught and sacked. I lost sight of her after that. 

In 1991, I found her again, destitute, penniless, with no teeth. She was in a horrifying state. Her former patients now send her money from abroad. 

Q: What was the relationship between real patients and politica
er half of the patients in our section were healthy - it was considered a 'soft' section. In 'hard' sections the number of sane patients was very small. About 10% of all patients in Soviet psychiatric hospitals were politicals. A hospital might have 1,000 patients, of whom 100 would be mentally sound. Many of the others were multiple murderers; they might have killed in desperate circumstances. 

Q: How did ordinary and special hospitals differ? 

Bukovsky: People were sent to special hospitals following a court decision. There'd be a trial and if the investigation found you mentally irresponsible you'd be sent for compulsory treatment. But you could end up in an ordinary hospital on the basis of complaints from neighbours or relatives. People turned up fortuitously. Some had tried to commit suicide, others were merely thought to have attempted suicide. This was categorised as 'dangerous'. A potential suicide was dangerous to himself. 

Anyone who attempted suicide and survived had to submit to psychiatric treatment. You weren't supposed to commit suicide - it was seen as deviancy. In ordinary hospitals the percentage of people who were genuinely ill was high and most came of their own accord, through a doctor. The different sections were graded. There was a ward for the chronically ill who had been there for decades. There were also wards for alcoholics and drug addicts. 

Q: In To Build a Castle you describe how it felt to leave hospital and go back into what we think of as 'normal' life... 

Bukovsky: It was a reaction many people experience after release from imprisonment of any kind. The process of reintegration is intensely difficult. Getting used to prison is far easier. In extreme conditions you discover a greater capacity to adapt and react quickly. When you're freed you expect normality and there's no such thing. In prison you idealise life and freedom, it's like nostalgia for an imagined world. The mind embellishes what it wants. 

When you're released you perceive that things are quite dif
nt. It's a passage from one universe into another. You need time - and when you're set free you don't get that. There's a life to live, there's work, and people don't realise what's happening to you. It's as if you'd changed your skin. You walk around bare-skinned, highly sensitised. 

As a prisoner you're subjected to sensory deprivation. I remember the first thing that struck me when I came out of prison was colour. You're out of the habit of seeing colour - nothing coloured is permitted in prison. Even the strength of colour is painful and demands reintegration. It's also a time of rejection. You want solitude but you're in work, there's family, friends keep dropping in. 

You don't want that. If you're just out of psychiatric hospital it's twice as bad because of the psychological tension there. You're constantly wondering if you're normal. Even though you know you were diagnosed for political reasons you still watch yourself. Perhaps I am mad? Those big nobs in white coats with diplomas and professorial status decided I was. There must be something wrong. You keep analysing yourself, comparing yourself with others. It's an additional burden. 

Q: You must have thought a lot about mental illness and what it is. 

Bukovsky: I saw too much of it. I had the feeling it was like a technical fault, an engine running after something's seized up, or one of those old gramophone records that goes into permanent replay. No one has really understood schizophrenia yet. 

Q: It's ironic that Professor Andrei Snezhnevsky of Moscow's Serbsky Institute apparently thought he did. 

Bukovsky: The story of the struggle between the two Soviet schools of psychiatry, 'Moscow' and 'Leningrad', is well known. How different were they? Snezhnevsky dreamed up a new form of schizophrenia: 'sluggish' or 'creeping' schizophrenia. The idea was that schizophrenia can begin in early childhood as a result of psychological shock that evolves into clear symptoms only years later. The problem with this was that there were no objective
iteria. Living in the Soviet system it was virtually impossible not to be traumatised. Snezhnevsky saw potential schizophrenia from early childhood in everyone. 

You could show him anybody and he'd say 'schizophrenic'. I knew him quite well and I think part of him really believed it. But it was very convenient for the KGB. In any other country his views would have raised a laugh or prompted debate; he would never have dominated his field. Here he was useful without realising it. 

I don't think he understood it for a very long time, only towards the end. If they wanted someone diagnosed as mentally ill he'd do it. It was as simple as that. The Leningrad school was more traditional. They weren't intellectual giants, they were professional psychiatrists and didn't hold with all this nonsense. So if you were diagnosed with schizophrenia in Moscow and taken to Leningrad, they'd often say you were fine. 'And as to the future - who knows? We don't have a crystal ball.'

Sluchevsky - the leading Leningrad psychiatrist - was an old, highly intelligent and educated man. He regarded Snezhnevsky's theory as absurd. In the 1960s, he was very influential in Leningrad, so if they brought him a patient from Snezhnevsky he'd delete him from the list without a second look. This discrepancy explains a whole series of cases. The dissident Marxist-Leninist Pyotr Grigorenko was diagnosed twice as healthy and then taken to Moscow and diagnosed as mentally ill. It was a time of covert attack and counter-attack between these two schools of thought. 

But it ended soon enough because, with the support of the authorities, the Moscow school prevailed and became obligatory. 

Q: In the 1970s you collaborated with Semyon Gulman on A Manual on Psychiatry for Political Dissidents, which gave advice on how to deal with internment in psychiatric hospitals. Did you follow your own recommendation.

Bukovsky: Not always. Some of it came from experience, some was put in because Slava (Semyon) felt, as a psychiatrist, that it was necessa
 Some of it was intentionally malicious. A sort of joke to demonstrate the paradoxes of the situation. But it was useful; the advice is sound. People like us were quite unprepared. 

Q: You suggested that people should, if they had to, retract their beliefs. 

Bukovsky: We had to explain that there would be a dilemma. I can't advise anyone to deny their own views. I didn't do it myself. But people needed to know that there might be a moment when they would have to choose. They needed to be ready. After that, it was up to them. 

I was lucky. The doctor said to me: 'I expect you're pretending. I can't see any symptoms. How did you get in here?' 'You'd better ask them,' I said. He kept demonstrating that I was mentally sound, which wasn't what the authorities wanted to hear. So, in the end, they compromised: they said my condition had 'improved' and retired the doctor. 

I thought about what I might do, of course. You didn't usually get discharged from psychiatric hospitals unless you admitted your 'mistakes'. In the event, it proved simpler for them to let me out. But many others had to do it. If you had a family you were very vulnerable. But I had comparatively few Achilles heels and never had to make the choice. 

Q: What is happening in Russian psychiatry now? 

Bukovsky: Systematic abuse is over. The authorities have no interest in it, there's no demand. But occasional abuses occur, even in St Petersburg, and religious groups are sometimes still exposed. I recently received reports about regional authorities persecuting religious communes. 

The Moscow Patriarchate is often involved because it doesn't want competition, or needs a new church building, whatever. Sectarians are diagnosed as psychiatrically ill. It's convenient. They're taken away and there's more room for manoeuvre. These are localised cases. 

It doesn't happen in Moscow. There it's simpler and cheaper to kill people than to imprison or hospitalise them. Moscow is indifferent. This isn't the age of Andropov. Psychiatric diagnosis
nd the system. Today there are voluntary groups of psychiatrists who monitor what's happening. 

So incidents are publicised and a system can't be built up. You get isolated cases, but not a system. I suppose that can be considered a success. 

Q: What do you make of the Russian Psychiatric Society's estimate in April that, today, a third of Russians suffer psychological disorders? 

Bukovsky: Russia was traumatised by 73 years of communism followed by a sudden transition to capitalism. It's hard to find anyone who hasn't been personally traumatised. The new generation may be normal - time will tell. Many older people are psychologically broken. 

The experience of totalitarianism was immensely hard: total dependence and uncertainty, the arbitrary abuse of power. You had no idea what the authorities would do with you tomorrow. Even the existence of two conflicting channels of information was a trauma. I say that as a neurophysiologist. Radio, television, the press said one thing; life showed you something very different. It's a classic way of inducing trauma or neurosis. The way Russians escaped this discrepancy was to get drunk or tell jokes. 

There was a well-known anecdote in which a man goes into a hospital and demands to see an ear-eye specialist. They say to him: 'There's no such thing. There are ear, nose and throat specialists and eye specialists. What do you need an ear-eye specialist for?' 'I've got this problem, I don't see what I hear and I can't hear what I see.' 

Thousands of anecdotes were told in response to the lies people were fed, and to the internal, psychological conflicts this provoked. And then there was the hopelessness, the impossibility of getting out. It was deeply damaging for all those who lived through it.

Today people are still highly suspicious of one another. No one believes what they hear. There's always something behind it, and something beyond that - layer after layer like a matrioshka doll. That's how life was arranged. No one will ever do anything simply. You
reating 'market relations'. You won't get 'market relations' in Russia so long as people don't have a direct relationship with things, let alone with each other. 

Q: Shortly before your arrest, Nikita Khrushchev declared that everyone was happy with the communist system and that those who expressed dissatisfaction had to be mentally ill. Do you think the view that if you're in conflict with society you must be mad still carries weight in Russia? 

Bukovsky: Today's generation, the people we call 'Generation X', believe in total conformism. It's all they have: a reaction against the excessive idealism of their fathers and grandfathers. We were too idealistic and our children are conformists. There are similarities in Britain, especially now. It's even worse in the US. American society has a mob psychology. Ask for salt and you're an enemy of the people. 

In the West people don't know what historical experience has taught us in Russia: that conformism is dangerous. It's the foundation of totalitarianism. It was the same in Nazi Germany. Brecht writes a lot about conformism. There are always small groups of fanatics, but if a society is healthy enough it won't let them impose their madness on the rest. But a society predisposed to conformism will succumb.