Analysis, comments
17.12.2002
Psychiatry’s painful past resurfaces

The question is not whether Col. Yuri Budanov killed 18-year-old Elza Kungayeva in a Chechen village on March 27, 2000. He has long since admitted to that.

But for more than two years, Russia’s military justice system has been paralyzed by the case, unable to decide on Budanov’s culpability for a sensational crime that could undermine the government’s pledge to pursue the brutal Chechen war and its uncertain commitment to stopping the human rights abuses that have resulted.

Stuck on the matter of Budanov’s guilt, the state has turned to a familiar partner from Soviet times, a psychiatric profession that for decades followed orders to camouflage political problems behind the opaque curtain of mental illness. In doing so, however, officials have resurrected questions about psychiatry’s shameful past in the Soviet Union — and its highly politicized present.

Twice now, Budanov has been sent for evaluation to Moscow’s Serbsky Institute for Social and Forensic Psychiatry, a little-changed artifact of the Soviet system. Earlier this year, a panel at the institute overturned previous evaluations of Budanov to conclude that he had been temporarily insane at the time of the killing, and therefore not responsible for his actions.

That controversial finding has opened a broad evaluation of the Serbsky Institute’s fitness as an independent judge of mental competence. Now, a showdown on the issue is approaching. On Monday, the court is scheduled to announce the findings from Budanov’s latest psychiatric evaluation — ordered after the public furor caused by his temporary insanity diagnosis. The hearing has been repeatedly delayed, most recently because of a «technical» flaw discovered last month in the paperwork submitted by the Serbsky Institute, which routinely conducts more than 2,500 court-ordered evaluations each year.

Meanwhile, the case is awakening ugly memories. For years, Serbsky held political dissidents in the same wards where Budanov has been kept, dazing them with psychotropic drugs, subjecting them to fake diagnoses and forcing them to sit through inquisitions on their sanity whose outcomes had been predetermined by the KGB.

When the military court first ordered Serbsky to test Budanov, the panel conducting the inquiry was led by Tamara Pechernikova, the doctor who condemned poet Natalya Gorbanevskaya for protesting the 1968 Soviet invasion of Czechoslovakia. When that evaluation of Budanov was criticized, the court next appointed a commission that included Georgi Morozov, the former Serbsky director who had sat on many of the committees that declared prominent dissidents insane in the 1970s and 1980s.

«Practically nothing has changed. They have no shame at the institute about their role with the Communists," said Yuri Savenko, head of the Independent Psychiatric Association of Russia. «They are the same people, and they do not want to apologize for all their actions in the past."

The first and so far only case of a Russian officer publicly charged with a crime against a Chechen civilian began when Budanov and his men rushed into the village of Tangi-Chu late one night. Budanov dragged Kungayeva from her home, claiming he later killed her in a rage because he believed she was a sniper. Her family says she was raped and murdered by Budanov in a drunken rampage.

At first, Budanov was denounced by top military officials and appeared likely to be quickly condemned in a case that would show the West Russia’s commitment to human rights. But a year later, Defense Minister Sergei Ivanov said he «felt» for Budanov, and public opinion polls showed huge margins of support for him.

Before the trial began in February 2001, Budanov had been sent twice for psychiatric evaluation at military hospitals. Both times he was found mentally competent. But with the trial at a seeming impasse last year, the military tribunal turned to the Serbsky Institute.

This May, the institute’s findings appeared to offer the state an easy way out of its dilemma: The panel headed by Pechernikova concluded that Budanov was temporarily insane at the time of the killing and not responsible for his actions.

Outcry was swift. Independent psychiatrists such as Savenko wrote scathing attacks on the medical reasoning behind the evaluation. Serbsky’s Soviet history was resurrected in the press. The report on Budanov, said an adviser to the Kungayev family, Emil Gushansky, is «a relapse to using psychiatry as a prostitute."

The military appeared to respond, ordering a last-minute replacement of the prosecutor. The new prosecutor demanded another evaluation to replace the one his predecessor had praised. On July 3, the military judge agreed.

But once again, Serbsky’s past became the issue, when Morozov, the institute’s longtime Soviet-era director, and two other Serbsky veterans were named to the commission. To Serbsky’s critics, Morozov represented all that had gone wrong in Soviet psychiatry. «He’s a symbolic figure for all of the abuses," Savenko said in August.

Just a few days later, it was announced that Morozov had quit the Budanov panel. The new evaluation was completed by Serbsky in late September, though its findings have yet to be released. The public hearing scheduled for Monday has already been postponed twice.

Budanov spent more than two months at Serbsky this summer, held behind the high white wall that separates the institute from a quiet side street in Moscow’s Old Arbat neighborhood. He had pledged in court not to cooperate with the doctors, but later decided to talk to them.

«A professor spoke to me and asked questions," Budanov later told a Russian newspaper in answers to written questions. «I told him, if a person had been to war, later on was in prison, after that at a mental hospital, later on again in jail, the mental hospital. . . . So I asked him if an ordinary person could endure all of that. He replied in the negative. I said, ’So I just live.’ "

Budanov and his team say they are convinced the latest Serbsky evaluation will go against him. But they have also defended Serbsky when its history is recalled.

«They are still considered to be the best specialists. Why shouldn’t we trust them just because a long time ago they choked somebody? Why should we look that far back?» said his attorney, Anatoly Mukhin.

Alexander Solzhenitsyn, the Soviet dissident and Nobel Prize-winning author, once wrote, «The incarceration of free-thinking healthy people in madhouses is spiritual murder." In the West, the debate about Soviet misuse of psychiatry formed a centerpiece of human rights campaigns, eventually forcing the Soviet Union to withdraw in disgrace from the World Psychiatric Congress.

Founded in 1921, the Serbsky Institute played a leading role in such abuses. By the 1960s, Serbsky was famous for pioneering a diagnosis that complied with the KGB’s wishes to condemn mentally healthy dissidents. It was called «slow-developing schizophrenia," and it provided convenient evidence of insanity in someone without obvious symptoms. Signs of the disease included «stubbornness and inflexibility of convictions» and «reformist delusions."

The Serbsky Institute disavowed the diagnosis after the collapse of the Soviet Union, saying there was no such disease. There are laws today protecting the rights of Russia’s mental patients and seeming to limit Serbsky’s powers. But critics say the institute has merely evolved to suit changing times without genuinely reforming.

«The system is the same, the mentality is the same," said Alexander Podrabinik, a one-time Soviet dissident. In 1977, he wrote «Punitive Medicine," a secretly distributed work of samizdat documenting the horrors of the Soviet psychiatric system. For writing the book, he was exiled to Siberia for five years. Later, he received 31/2 years in prison camp — because the book was translated into English.

The doctor who testified at his trial was Pechernikova, the same doctor who headed the first commission on Budanov.

No one knows how many political prisoners passed through the Serbsky Institute. Podrabinik said his research found as many as 2,000 dissidents had been sent there between the mid-1960s and the mid-1970s, while the institute has admitted to holding only about 400.

Vyacheslav Igrunov, a reformist member of the Russian parliament, remembers being sent to Serbsky in 1975 after psychiatrists at a hospital in Odessa found him to be mentally competent. He had been arrested for disseminating «anti-state» reading material.

«The KGB didn’t want to agree with that diagnosis, so they sent me to Serbsky," he recalled recently. After two months, a Serbsky commission headed by Pechernikova found him insane.

Gen. Pyotr Grigorenko, who turned against Soviet power after the invasion of Czechoslovakia, was immortalized in Report 59/S of the Serbsky Institute in 1969, which determined that he was insane because he «was unshakably convinced of the rightness of his actions» and twisted by «reformist ideas."

In his prison diary, Grigorenko recounted his time at Serbsky. «Of course," he wrote, «if it is only a person who bows submissively before any arbitrary act of the bureaucrats that is considered a normal Soviet person, then I am ’abnormal.’ I am not capable of such submissiveness, no matter how or how much I may be beaten up."

The man who headed the panel that evaluated Grigorenko was Morozov.

«It’s not right to personalize evil," said Morozov’s friend, Alexander Goffman, a professor of psychiatry. «They were limited at Serbsky and couldn’t do what they wanted to do. All modern psychiatry was forbidden. They had to stick to official ideology."

The Serbsky Institute’s current director, Tatyana Dmitriyeva, has little patience for revisiting the past.

«I cannot say that all of the dissidents — 100 percent — were not insane," Dmitriyeva said. «Many of them have different psychiatric disorders."

Dmitriyeva has been a fixture at Serbsky since the mid-1970s. In 1990, as the political winds shifted, she replaced Morozov in the top job. Today, she seems alternately outraged at and dismissive of the criticism the Budanov case has stirred up. Speaking in a waiting room off Serbsky’s entrance hall — she refused to give a reporter permission to enter the institute — Dmitriyeva complained repeatedly about inappropriate «political pressure» on the institute during the Budanov case. But none of it, she hastened to add, was from the government. It was all from the press and the public.

As for the dissidents, her view is eerily similar to the logic described by Grigorenko. Essentially, she said, the dissidents were crazy by Soviet standards, since only a madman would place his life at such risk by defying the state.

«There were social standards, norms of behavior," she said. «When a person walked away from these norms, any person would point and say he’s insane. People reacted [by believing] only an insane person can protest what is going on in the country."

Today, Serbsky doctors are still validating the insanity of enemies of the state. This summer, former Russian diplomat Platon Obukhov convicted of spying for Britain, was found to be mentally ill by Serbsky specialists. Serbsky also tested captured Chechen warlord Salman Raduyev, finding him sane despite several head wounds rumored to have affected his thinking.

Alina Vitukhnovskaya’s is another example of the kind of case that was supposed to have disappeared from Serbsky with the end of the Soviet Union.

A young poet with a flair for the controversial, she ran afoul of the Federal Security Service, the domestic successor to the KGB, in 1994 and was charged with drug possession. After six months in jail, she was taken to Serbsky. «I was terrified," she said recently. «I knew what they did to political dissidents, their history of cooperating with the KGB."

The first evaluation concluded that she was sane, and Vitukhnovskaya was sent back to jail for six more months, then released. The Federal Security Service arrested her again on the drug possession charge two years later, plus a new charge that she was «acting with the purpose of trying to destroy the secret service of Russia." Again, she was sent to Serbsky.

To her attorney, Vitukhnovskaya’s case and the others he has shepherded through Serbsky show how little has changed.

«If they didn’t tell me it’s the Russian Federation now, I wouldn’t know there was any difference at Serbsky Institute from Soviet times," said the attorney, Karen Nersisyan. «Serbsky is not an organ of medicine. It’s an organ of power."

The Washington Post

 
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