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Home , Narcology, Psychiatrist

INTERVIEW

AN INTERVIEW WITH PROF. DR. POLISCHUK IS IN DANGER OF DEHUMANIZATION

Interview and Translation by Ekin Sönmez, Yasin Çalış

Thank you for this introduction. Now let me ask you some questions about psychiatric practice during the Soviet Union and that of today. We can start with the general aspects. Could you brief us about how psychi- atric care was organized in the Soviet Union? In the Soviet Union, there was a coherent step-by-step organization of psychiatric care, which consisted of a relevant subdivision in the Ministry of Health, the Chief - cial, municipal psychiatric and dispensaries. TherePsychiatrist’s was a linkOffice between and a network hospitals of and regional, dispensaries. provin There were psychosomatic and somato-psychiatric hospitals, psychiatric units in polyclinics, sanatoriums Photo 1. Prof. Polischuk in front of Moscow Institute of Psychiatric for psychoneurological disorders, psychoneurological Research homes for chronic patients and the disabled.

On behalf of the Neural Mechanisms and Brain Section Was there a professional and/or legal framework for of the Academy of Science and Enlightenment (BAA), the provision of prevention and prote- we had an interview with Professor Yuri Polischuk, who ction services? worked as a in the Soviet Union and later The professional and legal framework for the provision on in the Russian Federation. Professor Polischuk spo- of services for the prevention and protection of mental ke about the well-organized psychiatric services in the disorders and the mental well-being of the population Soviet Union and explained various approaches of the - time on mental disorders, in comparison with today’s tees of Citizens’ Rights in the Provision of Psychiatric psychiatry. We thank him on behalf of the Academy of Care,was defined the Code by theof Professional Act on Psychiatric Ethics Carefor , and Guaran Science and Enlightenment (BAA). and the ethical committees of psychiatric institutions.

Dear Prof. Polischuk, thank you for accepting our in- Thank you. Now we can move on to some specific qu- terview request. First of all, I would like to ask you estions. Let me start with the disorders. It to introduce yourself and your institution for our re- is well-known that the fight against different types of aders? was an important issue in the USSR. Could Yuri Iosifovich Polischuk, born in 1934, , Doctor of Me- you elaborate on that? What kind of treatment and dical Sciences, Professor. I am the Chief Researcher of services were provided in this regard? the Moscow Research Institute of Psychiatry - branch The narcological services in the USSR were extensive, of “V. P. Serbsky Scientific Research Center for Psychiatry which included narcological psychiatrists and specia- and ” of the Russian Ministry of Health. lists in narcology. There was a narcology department in the Ministry of Health headed by the chief narcologist. Did you work as a psychiatrist in the Soviet Union? The Institute of Narcology as well as narcological hos- What was your position at that time? pitals and dispensaries were established. So-called “so- - ber-ups” were functioning to assist patients who were tal in Chernigov (Ukraine). Then I started as a junior re- in deep intoxication and withdrawal. Treatment and searcherAt first I worked at the Institute as a psychiatrist of Psychiatry at a psychiatricof the Academy hospi of employment facilities were established for the invo- Medical Sciences in Moscow, worked there until 1968. luntary treatment of alcohol and addicts. A range Since then I have been working as a senior researcher, of treatment methods were used: Hypno-suggestive as the head of the Department of Old Age Mental Patho- logy at the Moscow Research Institute of Psychiatry. For , “coding” method, combined psychopharmaco- therapytherapy, aimed conditional at suppressing reflex therapy, pathological emotional attraction stress to Society of Psychiatrists. addictive , aversive therapy aimed at sensitizing 15 years, I had been the chief scientific secretary of the

alcoholic patients, as well as detoxification methods.

246 Could you tell us about facilities as mostly come from Western sources among others. well? Was there a leading school of psychotherapy What is your opinion on this issue? You worked in the in the Soviet Union, or was there a variety of schools Soviet Union, what is your personal opinion about the- available? se allegations? The leading school of psychotherapy was personal-o- Personally I have not encountered any case of political riented (reconstructive) psychotherapy, based on the abuse of psychiatry, except for some restrictions of the theory of relationships between the individual and the mentally ill during mass festive processions. If there had been any political abuses of psychiatry, they were on the teachings of Ivan P. Pavlov was widely used. Vari- isolated and controversial cases, which were later gre- antssocial of environment. suggestive psychotherapy, Conditional reflex , behavioral based atly exaggerated by the media. psychotherapy and various types of art therapy were also used.

We know that the approach of the Soviet Union towar- ds was public-health oriented and sociali- zed. Could you tell us about the rehabilitation servi- ces for chronic mental disorders? For instance, was it possible for someone to work had he/she a ? Theoretical and practical aspects of social and labor re- habilitation of mentally ill people were actively develo- ped by T. A. Geyer and D. E. Melekhov in the USSR. The indications and contraindications for different types of Photo 2. Prof. Polischuk in a TV programme. labor and activities in case of schizophrenia and other We have a few last questions about today’s psychi- mental disorders were developed. The social and labor atry. You have witnessed both periods and two dif- prognosis of mental disorders were studied, the metho- ferent systems. What do you think were the main dology of social and labor expertise was developed by differences between these two systems in terms of an institute specially created for this task. psychiatry? Stigma is another important aspect of psychiatric di- Russian psychiatry today, in the era of globalization, has sorders. Can we speak about a special effort related borrowed a lot from Western psychiatry: It has moved to overcoming the stigmatization of mentally ill peop- le in the Soviet Union? How did society interact with introduced a large arsenal of psychopharmacological psychiatric patients? medicationsto the international into medical classification practice, masteredof mental many disorders, Wes- - tern psychotherapeutic and psychometric methods. sues related to the stigmatization of the mentally ill, as However, at the same time, it seems to me that the tra- wellIn the as Soviet to measures Union, tosufficient overcome attention stigmatization. was paid Speci to is- ditions of tracing subtle clinical and psychopathological - details and clinical and anamnestic research of mentally ned in a special law on “Psychiatric Care and Guarantees disordered people are being lost, the coherent, holistic offic Citizens’ measures Rights in this in directionits provision were”, as formulated well as in the and “ Codedefi approach to the mentally ill is being lost. of Professional Ethics for Psychiatrists”. Ethical commit- tees have been established at psychiatric institutions. How do you, as a psychiatrist, interpret the changes When necessary, state institutions and human rights that have taken place over the years? organizations also intervened to protect the constituti- onal rights of mentally ill persons. mental disorders with the help of modern methods and techniques,I think, while the striving vision for and the understanding complete objectification of the perso of- How did Soviet psychiatrists view the psychiatry in nality of the suffering patient is lost. There is underesti- the West? mation and neglect of the subject to subject relationship Soviet psychiatrists were interested in the achievements between the doctor and the patient, ignoring the under- of Western psychiatry and sought to expand contacts lying mental patterns, which can largely determine the with foreign psychiatrists. However, due to ideological nature of the course of the disease and its outcomes. reasons, a critical attitude towards some theoretical po- Finally, psychiatrists do not pay much attention to pa- sitions and foundations of Western psychiatry (Freud’s tients’ inner psychic realm, which is the core and basis , Binswanger and Jasper’s existential of his/her personality. Here lies the danger of further analysis, neothomism, pragmatism, personalism) was dehumanization of psychiatry. maintained. Thank you for this unique opportunity. There are widespread allegations of political abuse of I would like to thank you. psychiatry during the Soviet Union. These allegations

MADDE, DIYALEKTIK VE TOPLUM | CILT 3 | SAYI 3 247