(In her book Midday [Polden] Natalya Gorbanevskaya includes the following account by P.G. Grigorenko. It is published here in abbreviated form.)
The idea of special psychiatric hospitals is not in itself without merit, but as for the way this idea is implemented in our country, there is nothing more criminal or inhuman.
The method of dealing with objectionable persons by adjudging them insane and confining them to psychiatric hospitals for lengthy periods or even for their whole life is as old as the very idea of the ‘madman’. Even taking this into account, progressive people have long fought to institute controls concerning the treatment of psychiatric patients. They have also fought so that people who have committed crimes while of unsound mind should not be subject to criminal punishment, but be sent for psychiatric treatment. The distinguished Russian psychiatrists Bekhterev and Serbsky fought for this also. Soviet legislation went far towards meeting the demands of progressive people. But the trouble is that the whole thing has since been completely removed from public scrutiny and placed under the control of a specially chosen apparatus. Doctors for psychiatric hospitals are appointed by special selection processes in which their medical qualifications are of secondary importance and other qualities have precedence, the main one being the ability to knuckle under and suppress their medical ‘ego’.
We must start our discussion by asking whether the people who find their way into the special hospitals are always real mental patients, or whether the prerequisites for repressive injustice are built into the system. A person is sent to the notorious Serbsky Institute of Forensic Psychiatry on the order of an investigator. This institute nominally comes under the Soviet Ministry of Health, but I myself, on more than one occasion, have seen Professor Lunts, the head of the department diagnosing me, arrive at work in the uniform of a KGB colonel. True, he always came into the department in his white coat. I have also seen other doctors of this institute in KGB uniform. But the exact relation between the KGB men and the Ministry of Health I have not managed to ascertain. People say that only one department is under KGB control —the one which diagnoses political cases. I am inclined to think that the influence of the KGB — and it is a decisive influence —extends over the whole of the institute’s work. But even if what people say is true, the question arises: can the psychiatric diagnosis of political cases be objective if both the KGB investigators and the medical experts are subordinate to one and the same person, and, what is more, are bound by military-style discipline?
I will recount what I have seen myself. I arrived in the second (political) department of the Serbsky Institute on 12 March 1964.1 had not previously even heard of such a method of repression existing in our time as the declaration of a healthy man to be of unsound mind; I was unaware that this ‘Chaadayevan’ system [Commentary 11] existed in our country. I realized it only when I myself was presented with a committal order for a psychiatric investigation.
Having read the order, I looked at the investigator and asked: ‘Well, so you’ve found a way out of your dilemma, have you?’ The investigator, greatly embarrassed, started assuring me that the investigation would continue after the medical examination, and an indictment would be drawn up. I felt there would be no more investigation, and that a mental hospital was my lot for the rest of my life.
In the department I was taken to there were eleven people. From what I imagined the examination to be like, I tried to predict what diagnosis awaited each of them. Even without medical training it was clear that the only one of us who was mentally abnormal was Tolya Yedamenko, but he, according to my prediction, would end up in an ordinary camp. The madhouse, in my opinion, awaited three of us: myself, Pavel Borovik (an accountant from Kaliningrad) and Denis Grigorev (an electrician from Volgograd). The investigation against all three of us had yielded nothing and there was no foreseeable chance of finding anything.
All the others ought, in my opinion, to be found normal, although some of them were acting the idiot very skilfully, feigning pathological conditions. I had doubts about one, Yury Grimm, a Moscow crane-driver who had circulated leaflets bearing a caricature of Khrushchev. To him I said: ‘If you don’t recant, it’ll be the madhouse for you, if you do — a camp.’ (An investigator was visiting him several times a week, trying to persuade him to recant and promising him all sorts of wonderful things.) Yury did ‘recant’ and got three years in a strict-regime camp.
Grimm’s case testifies in the best possible way to the fact that the Serbsky Institute is simply a subordinate organ of the investigation authorities. Both the investigator and the doctor spoke to Yury about one thing only —recanting. Moreover the doctor was a worse bully than the investigator, painting a vivid picture of how Grimm would be shut away for ever among ‘loonies’ if he did not recant.
In Leningrad too I met people who had landed in a psychiatric hospital without being mentally ill. I was especially saddened by the tragic case of engineer Pyotr Alekseyevich Lysak. Because he had spoken at a student meeting against the expulsion for political reasons of a number of students, he had landed in a psychiatric hospital and, at the time of my arrival, had already been there for seven years. Bitter anger at this wild injustice, at his ruined life, had permeated his being, and he would write complaints daily, which, naturally, never reached their destination, but found their way into his hospital file and were used as an excuse for further ‘treatment’ (people who do not admit their illness are not usually discharged from special psychiatric hospitals). I tried to drum this truth into his head. During one such conversation, I said in irritation: ‘Your reasoning is so unreal that I’m beginning to doubt your normality.’ He stopped all of a sudden, looked at me with an expression I shall remember to the day of my death, and asked in a barely audible voice and a tone of bitter reproach: ‘Do you really think that a man can spend seven years in here and still remain normal?’
Here is the very essence of the inhuman system of compulsory treatment. The whole horror of the position of a healthy man who finds himself in conditions like these lies in the fact that he himself begins to realize that in time he will become like those who surround him.
My military training, and maybe the iron constitution which my parents passed on to me, enabled me to learn quickly to insulate myself from my surroundings, and my internment in hospital passed without doing any particular harm to my psyche. The one thing I cannot forget, the thing that sometimes wakes me up at night, is a wild nocturnal cry mixed with the hollow sound of shattered glass. From that I could not insulate myself. Evidently during sleep one’s nerves have no defence mechanism against such stimuli. But I can imagine what a man must go through who is receptive to everything around him through his highly strung nervous system, and whose defence mechanisms are not as well developed as mine.
Even if cases of people finding their way into these establishments were few and far between, even then every such case ought to be subject to the most thorough investigation with maximum publicity. But these cases are not accidents; they occur systematically. Moreover, the system is widely practised. I have said that within as little as one month, while I was being diagnosed, the Serbsky Institute promoted three healthy people to the ranks of madness and sent one undoubtedly abnormal man to a camp. The latter process is also part of the system. I only realized this after reading A. Marchenko’s book My Testimony. Mentally sick people are necessary in the camps in order to make life even more unbearable for the healthy.
In the Leningrad Special Hospital I met a young man who was interesting to talk to. He had landed up there in the following way: he had been arrested for petty theft and would possibly have been released without being brought to trial if it had not suddenly occurred to the investigator that with this man’s help he could round off a certain ‘dead’ case – a murder case which had never been cleared up. They did not require very much of the arrested man: he was to testify that at the moment when the murder was committed, one of his friends had been in the village where it took place. The man knew that this was untrue and refused to testify. The investigator then said: ‘Aha, so you don’t want to assist the investigation? … Well then, I’ll lock you up in a place where you’ll remember me for the rest of your life.’ And he sent him for a psychiatric examination. The diagnosis team declared him to be of unsound mind. The young man was lucky. In the hospital his doctor happened to be an honest man, who was able to get the findings of the diagnosis team annulled. But it took him six years to do it. As a rule it is impossible to have a diagnosis annulled, because the diagnosis is given on many occasions by repeated medical commissions, and can be revoked only with the consent of the doctor who gave the initial diagnosis.
For a healthy man, the atmosphere which surrounds him in a mental hospital is terrible, and no less terrible are his complete lack of rights and his helplessness. The ‘patient’ in a special psychiatric hospital does not even enjoy the miserable rights of the camp prisoner. He has no human rights at all. You can do anything you like to him, and no one will object. No one will defend him, and none of his complaints will ever reach the outside world. His only remaining hope is an honest doctor.
But I assert that a system in which the only hope is someone’s honesty is absolutely worthless.
The atmosphere of the madhouse, the complete lack of rights and the absence of any real possibility of regaining one’s freedom—these are the terrifying facts which everyone who lands in a special psychiatric hospital has to face.
Radical changes must be fought for in the diagnosis system and the conditions in which patients are kept in special psychiatric hospitals; the public must be given the right to exercise some real control over the conditions of confinement and the treatment of patients in these establishments.