Scientific Psychiatry in Stalin's Soviet Union: The Politics of Modern Medicine and the Struggle to Define “Pavlovian” Psychiatry, 1939--1953 (2009)
Zajicek, Benjamin (Author)
University of Chicago
Fitzpatrick, Sheila
Edition Details: Advisor: Fitzpatrick, Sheila
Physical Details: 508 pp.
Language: English
Pavlov's "theory of higher nervous activity" provided a language that both Soviet psychiatrists and non-psychiatrists could use to discuss the nature of the mind. Even after his death in 1936, Ivan Pavlov's theory was revered by the Bolshevik regime as a profoundly materialist theory that could be used to explain the mind. Soviet psychiatrists, however, could not agree on just what "Pavlovian" should mean or, indeed, how psychiatry should be practiced. The period that lasted from late 1930s to the early 1950s was a time of particularly intense debate because new technologies coming from Europe were incorporated into Soviet psychiatric practice. Between 1933 and 1938, psychiatrists in Germany, Austria, Switzerland and Portugal reported on experimental new methods including sleep therapy, insulin coma therapy, "psychosurgery" (lobotomy), and artificially induced epilepsy-like seizures, the so-called "shock therapies" (including Metrozol, insulin shock, and electroshock). These methods were brought to the Soviet Union between 1935 and 1938, and by 1939 Soviet psychiatric hospitals were beginning to adopt them as primary methods of treatment. Many Soviet psychiatrists hoped these methods would improve psychiatry's reputation by proving to the public that psychiatric hospitals were places of healing, not incarceration. Soviet psychiatrists found that methods like shock therapy were quite difficult to use. These treatments required equipment and drugs that were in short supply. More disturbingly, the new methods of treatment were poorly understood and often dangerous to use; some Soviet psychiatrists questioned whether they should be used at all. This challenge pushed psychiatrists to articulate their scientific and ethical assumptions about how and why treatments should be used in psychiatric practice. Some used Pavlov's theories to argue for more fundamental study of the brain. Using Pavlov's methods to understand the physical laws of thought, they argued, was the key to a truly scientific psychiatry. They were encouraged particularly by new technologies that enabled them to study brain structures and by new discoveries about the role of chemical neurotransmitters in the brain. In the near future, they believed, psychiatric practice would be governed by knowledge generated in the physiological laboratory. Other psychiatrists argued that the proper object of psychiatry was society, not the brain. To understand mental illness, psychiatrists should study how individuals adjusted to the world around them. They pointed to the psychological trauma they saw in soldiers during World War Two as evidence that mental illness was a normal response to a pathological environment. According to these advocates of a bio-social approach, psychiatric experts should be working to make everyday Soviet institutions into places that promoted mental health. Government officials in the post-WWII period were enthusiastic about this idea, and it briefly looked as if "mental hygiene" might flourish. This failed to happen, I argue, at least in part because Communist Party officials were uncomfortable about psychiatrists' claims to scientific expertise. The Communist Party itself claimed to have special knowledge about how to create a better society, and its members did not want their authority challenged, especially by experts claiming to speak with the authority science. The most high profile conflict between psychiatrists during the post-WWII period was over the use of lobotomy. In 1950, psychiatrists who opposed lobotomy successfully convinced Soviet officials that lobotomy was "un-Pavlovian." It was banned in December 1950. Advocates of the ban were motivated in part by scientific and ethical concerns, but they were also using lobotomy as a way to discredit their rivals within the profession. To do so they had to convince non-psychiatrists in the government and the Communist Party to support them, and they therefore reframed their arguments using the charged rhetoric of patriotism, dialectical-materialism, and thinly veiled anti-Semitism. The opponents of lobotomy were rather too successful in convincing Communist Party officials that anti-Pavlovian ideas needed to be rooted out of Soviet psychiatry. Between 1950 and 1953, psychiatrists in the USSR found themselves caught up in a campaign to remake their discipline on the basis of Pavlov's theory. Old methods of classifying psychiatric illnesses were to be abandoned, psychiatric hospitals were to be redesigned, and university research in psychiatry was to be relocated to the physiology laboratory. The campaign for Pavlovian psychiatry made it possible for psychiatrists to finally push through long-desired plans to rationalize of psychiatric hospitals. Furthermore, these changes dramatically increased the amount of clinical information being generated. Ironically, then, a campaign that had sought to subordinate psychiatrists to the Pavlovian laboratory actually ended up strengthening traditional clinical methods of psychiatric research. (Abstract shortened by UMI.)
...MoreDescription Cited in Diss. Abstr. Int. A 70/08 (2010). Pub. no. AAT 3369465.
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