Psychiatric Abuses Once Led to Cold War Confrontation

In 1964, Pytor Grigorenko, a high-ranking Soviet military general and hero of World War II, was committed to psychiatric hospitalization by Soviet psychiatrists in the wake of Grigorenko's vigorous criticism of human-rights abuses in the Soviet Union.

In time, news of the general's confinement came to the attention of a Ukrainian psychiatrist named Semyon Gluzman, M.D., a connection that would prove critical, according to Robert van Voren, a Dutch human-rights activist and author of a book published this year, Cold War in Psychiatry: Human Factors, Secret Actors.

“Gluzman was a young Kiev psychiatrist who had contacts with dissident circles in his hometown,” van Voren told Psychiatric News. “Gluzman read [Grigorenko's] file and came to the conclusion that the man was not suffering from any mental disorder and that his incarceration had been for political reasons. Gluzman's report found its way to the KGB, and he was arrested and sentenced to 10 years in camp and exile.”

Fast forward to 1977 when APA recognized Gluzman's courage by making him a distinguished fellow of the Association. The same year saw the publication of Psychiatric Terror, a book by Peter Reddaway, a British political scientist specializing in the U.S.S.R., and British psychiatrist Sidney Bloch, M.D., documenting Soviet abuses of psychiatry to detain and control political dissidents.

Reddaway and Bloch received APA's Guttmacher Award for their work in 1978.

The events would prove to be a watershed in Cold War politics, one that would eventually draw Western psychiatry into a confrontation with the Soviets. The story of that confrontation constitutes a small epic involving high diplomacy and a cast of international characters pitting science and medical ethics against what many regard as a uniquely lurid feature of modern totalitarianism: the use of psychiatric diagnoses, in some cases augmented by the use of drugs, to stigmatize and contain political dissent.

The 1977 meeting of the World Psychiatric Association (WPA) in Honolulu resulted in a statement describing the rights of psychiatric patients and denouncing political abuses of the profession. Six years later the Soviets withdrew from the WPA, under threat of expulsion, and in 1989 the confrontation culminated in a remarkable visit by American psychiatrists led by the U.S. State Department and the National Institute of Mental Health in which the American delegation personally interviewed individuals believed to be incarcerated in psychiatric hospitals for their political activity.

It was a confrontation that would raise the international profile of American psychiatry and APA. It would also prove formative in the development of ethics regarding the interface of psychiatry and the law in America (see Rift Changed U.S. Psychiatry). And it would serve as a subplot in the eventual unraveling and dissolution of the Soviet Union.

Central to APA's involvement was the figure of Melvin Sabshin, M.D., who served as medical director from 1974 to 1997. He was a staunch advocate for an international presence for APA (see Sabshin's Past Led Him to Historic Crossroads) and during his tenure established the Office of International Affairs under the leadership of Ellen Mercer.

Past APA President and Trustee Lawrence Hartmann, M.D., a longtime advocate for human rights in psychiatry, remembers Sabshin's leadership as “quiet, diplomatic, but persistent” in the confrontation with Soviet abuses.

And van Voren recalled Sabshin as an invaluable ally in his role on the executive committee of the WPA. “He was a specialist in conflict resolution and was able to build bridges,” he told Psychiatric News. “I think his role in promoting human rights in mental health, strengthening the forces for an ethical psychiatry, and combating abuses by developing a generally accepted psychiatric nosology cannot be underestimated.”