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Psychiatry, Violence, and the Soviet Project of Transformation: A Micro-History of the Perm΄ Psycho-Neurological School-Sanatorium

Published online by Cambridge University Press:  10 July 2018

Abstract

This article analyzes the interactions of medical experts, minor patients, and parents in a child psychiatric institution that operated in the Soviet city of Perm΄ between 1926 and 1929. Through a micro-history of this institution, the author raises questions about the nature of violence within the realm of psychiatric care, demonstrating the multidimensional flow of power within a particular institutional setting and adding complexity to our understanding of the asylum writ large. At the same time, the article engages the question of violence in Soviet society at the end of the NEP, suggesting that the historical actors involved in the Perm΄ institution used violence as a means to explain the crisis of their time.

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Articles
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Copyright © Association for Slavic, East European, and Eurasian Studies 2018 

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References

1. “Protokol organizatsionnago sobraniia obshchestva izucheniia i bor΄by s detskoi defektivnost΄iu i besprizornost΄iu ot 29-go avgusta 1923 g.,” preserved in the Archive of the Russian Academy of Education (Arkhiv Rossiiskoi Akademii Obrazovaniia, hereafter RAO), f. 139, d. 238, ll. 1–6. See also Kashchenko, V.P. and Murashev, G.V., Iskliuchitel΄nye deti: Ikh izuchenie i vospitanie (Moscow, 1926)Google Scholar. In making this argument Vsevolod Kashchenko might have been inspired by the work of his brother Petr Kashchenko, who during the war had managed an organization devoted to collecting statistics of psychiatric casualties. See Sirotkina, Irina, “Toward a Soviet Psychiatry: War and the Organization of Mental Health Care in Revolutionary Russia,” in Bernstein, Frances L., Burton, Christopher, and Healey, Dan, eds., Soviet Medicine: Culture, Practice, and Science (DeKalb, 2010), 2948Google Scholar.

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9. Holquist, Peter, “Violent Russia, Deadly Marxism? Russia in the Epoch of Violence, 1905–1921,” Kritika: Explorations in Russian and Eurasian History 4, no. 3 (Summer 2003): 627–52Google Scholar, here 650. See also Laura Engelstein's commentary, “Weapon of the Weak (Apologies to James Scott): Violence in Russian History,” Kritika: Explorations in Russian and Eurasian History, 679–93; Holquist, Peter, Making War, Forging Revolution: Russia's Continuum of Crisis, 1914–1921 (Cambridge, Mass., 2002)Google Scholar; and Sanborn, Joshua A, Drafting the Russian Nation: Military Conscription, Total War and Mass Politics, 1905–1925 (DeKalb, 2003)Google Scholar.

10. Ball, Alan M., And Now My Soul is Hardened: Abandoned Children in Soviet Russia, 1918–1930 (Berkeley, 1994)CrossRefGoogle Scholar; Caroli, Dorena, L'enfance abandonée et délinquante dans la Russie soviétique (1917–1937) (Paris, 2004)Google Scholar; Kelly, Catriona, Children's World: Growing Up in Russia, 1890–1991 (New Haven, 2007)Google Scholar.

11. Jacqueline Lee Friedlander, “Psychiatrists and Crisis in Russia, 1880–1917” (PhD diss., University of California Berkeley, 2007); Sirotkina, “Toward a Soviet Psychiatry;” and Dufaud, Grégory, ‘“Un retour aux anciennes maisons de fous”? Réformer les institutions psychiatriques en Russie soviétique (1918–1928),” Revue historique, 660, no. 4 (October 2011): 878–81Google Scholar.

12. Gorsuch, Anne E., Youth in Revolutionary Russia: Enthusiasts, Bohemians, Delinquents (Bloomington, 2000)Google Scholar; and Zajicek, Benjamin, “Soviet Madness: Nervousness, Mild Schizophrenia, and the Professional Jurisdiction of Psychiatry in the USSR, 1918–1936,” Ab Imperio, no. 4 (2014), 167–94Google Scholar.

13. On the limited applicability of Foucault to Russia and the Soviet Union see, in particular, Engelstein, Laura, “Combined Underdevelopment: Discipline and the Law in Imperial and Soviet Russia,” American Historical Review 98, no. 2 (April 1993): 338–53Google Scholar; and Reich, Rebecca, “Inside the Psychiatric Word: Diagnosis and Self-Definition in the Late Soviet Period,” in Slavic Review 73, no. 3 (Fall 2014): 563–84Google Scholar. On the complex partnership between medical experts and Soviet authorities in articulating projects for medicalization, see also the essays in the collection Soviet Medicine, esp. Frances Bernstein, Christopher Burton, and Dan Healey, “Introduction,” 5–26. It is also worth remarking here that, unlike the newly formed Soviet regime, governments in interwar western Europe did not put the medical treatment of mental illness entirely in the hands of the state. European political parties of various persuasions did set up a few state-subsidized services, but until the mid-1940s they mostly encouraged a mixed economy of child psychiatric care.

14. Galmarini-Kabala, Maria Cristina, The Right to Be Helped: Deviance, Entitlement, and the Soviet Moral Order (DeKalb, 2016)Google Scholar; and Galmarini, Maria Cristina, “Moral΄no defektivnyi, prestupnik ili psikhicheskii bol΄noi? Detskie povedencheskie deviatsii i sovetskie distsipliniruiushchie praktiki: 1935–1957,” in Kukulin, Il΄ia, Maiofis, Mariia, and Safronov, Petr, eds., Ostrova utopii: Pedagogicheskoe i sotsial΄noe proektirovanie poslevoennoi shkoly (1940-1980-e) (Moscow, 2015), 107–51Google Scholar.

15. Sirotkina, Irina, Diagnosing Literary Genius: A Cultural History of Psychiatry in Russia, 1880–1930 (Baltimore, 2002)Google Scholar; and Benjamin Zajicek, “Scientific Psychiatry in Stalin's Soviet Union: The Politics of Modern Medicine and the Struggle to Define ‘Pavlovian’ Psychiatry, 1939–1953” (Ph.D. diss., University of Chicago, 2009).

16. Zajicek, “Scientific Psychiatry in Stalin's Soviet Union,” 19.

17. There is a definite qualitative difference between the act of hitting a child in the face and that of producing a diagnosis. As Lennard J. Davis has written, “medical diagnosis is the bedrock of any attempt to understand disease, but it is not without its problems.” Davis, Lennard J., The End of Normal: Identity in a Biocultural Era (Ann Harbor, 2013), 82Google Scholar. Diagnoses are fundamental steps toward the effective cure of various forms of mental illness. Yet, they are also forms of authoritative scientific knowledge that change “how we think of ourselves, the possibilities that are open to us, the kinds of people that we take ourselves and our fellows to be.” Hacking, Ian, Mad Travelers: Reflections on the Reality of Transient Mental Illness (Charlottesville, 1998), 10Google Scholar.

18. Sirotkina, Irina and Kokorina, Marina, “The Dialectics of Labour in a Psychiatric Ward: Work Therapy in the Kaschenko Hospital,” in Savelli, Mat and Marks, Sarah, eds., Psychiatry in Communist Europe (Houndmills UK, 2015), 2749Google Scholar; Dufaud, “Un retour aux anciennes maisons de fous?”; Zajicek, “Soviet Madness.”

19. Gosudarstvennyi Arkhiv Permskogo Kraia (State Archive of Perm΄ Region, hereafter GAPK), f. 132, op. 1, d. 257, l. 177 and l. 62.

20. Ibid. This perspective on children's mental dysfunctions echoed popular and scientific theories of the time that established close links between nervousness and insanity. See Kashchenko, V.P. and Murashev, G.V., “Pedologiia iskliuchitel΄nogo detstva,” in Kalashnikov, Aleksei Georgievich and Epshtein, Moisei Solomonovich, eds., Pedagogicheskaia entsiklopediia (Moscow, 1927), 1:191214Google Scholar. See also Bernstein, Frances, The Dictatorship of Sex: Lifestyle Advice for the Soviet Masses (DeKalb, 2007), 8289Google Scholar; and Morrissey, Susan K., “The Economy of Nerves: Health, Commercial Culture, and the Self in Late Imperial Russia,” Slavic Review 69, no. 3 (Fall 2010): 645–75Google Scholar. On the history of the term “psychopathy” in Germany see Eghigian, “A Drifting Concept for an Unruly Menace.”

21. GAPK, f. 132, op. 1, d. 137, l. 10.

22. On degeneration see Beer, Daniel, Renovating Russia: The Human Sciences and the Fate of Liberal Modernity, 1880–1930 (Ithaca, 2008)Google Scholar. On the debates between those who stressed the role of social forces and those who privileged biology as explanations for deviant behavior see Kenneth M. Pinnow, “Cutting and Counting: Forensic Medicine as a Science of Society in Bolshevik Russia, 1920–29,” in Hoffmann, David L. and Kotsonis, Yanni, eds., Russian Modernity: Politics, Knowledge, Practices (New York, 2000), 115–37Google Scholar; Gorsuch, Youth in Revolutionary Russia, 158–60; and Friedlander, “Psychiatrists and Crisis in Russia.” Russian child psychiatrists and defectologists did not develop their ideas about this complex problem in a uniform manner. Among the defectologists there was a strong divergence of opinions about the extent to which Pavlov's theory of reflexes could be applied to behaviorally deviant children. Kashchenko and Putnin saw a direct relation between stimuli and reactions; Zalkind combined Pavlovian reflexology with psychoanalysis; and Vygotskii tended to reject reflexology. See Caroli, “Deti-invalidy.”

23. GAPK, f. 132, op. 1, d. 137, no list numbering.

24. GAPK, f. 132, op. 1, d. 137, no list numbering.

25. GAPK, f. 132, op. 1, d. 257, l. 62.

26. Ibid., d. 257, l. 62.

27. Ibid., l. 36.

28. Solomon, Susan Gross, “The Limits of Government Patronage of Sciences: Social Hygiene and the Soviet State, 1920–1930,” Social History of Medicine 3, no. 3 (December 1990): 405–35Google Scholar; idem, “Social Hygiene and Soviet Public Health, 1921–1930,” in Susan Gross Solomon and John F. Hutchinson, eds., Health and Society in Revolutionary Russia, 175–99; Pinnow, “Cutting and Counting;” and Hoffmann, David L., Cultivating the Masses: Modern State Practices and Soviet Socialism, 1914–1939 (Ithaca, 2011)Google Scholar, chapter 2.

29. GAPK, f. 132, op. 1, d. 257, ll. 132–133; l. 105; and ll. 58–61. On bed-wetting as a symptom of emotional trauma for British psychiatrists see Wheatcroft, Worth Saving: Disabled Children during the Second World War (Manchester, 2013), 121–22Google Scholar.

30. Putnin's scientific references on the topic of holistic diagnosis included the works of well-known psychiatrists of the time such as the Russian Grigorii Ivanovich Rossolimo and the Frenchmen Alfred Binet and Théodore Simon. Holistic approaches were also widespread in American psychiatry of the time. See Rosenberg, C.E., “Holism in Twentieth-Century Medicine,” in Lawrence, Christopher and Weisz, George, eds., Greater Than the Parts: Holism in Biomedicine, 1920–1950 (New York, 1998), 335–55Google Scholar.

31. GAPK, f. 132, op. 1, d. 257, l. 128 (Putnin's examination report on the Kaiurin brothers, dated February 1929). Putnin also recommended speech therapy.

32. On work therapy in Soviet psychiatric hospitals see Sirotkina and Kokorina, “The Dialectics of Labour.” An important collection of essays on patient work in mental institutions in different parts of the world is Ernst, Waltraud, ed. Work, Psychiatry and Society, c. 1750–2015 (Manchester, 2016)CrossRefGoogle Scholar. On the role of labor education in German special pedagogy see Osten, Philipp, “Photographing Disabled Children in Imperial and Weimar Germany,” Cultural and Social History 7, no. 4 (2010): 511–31Google Scholar. Of course, regular Soviet schools also incorporated the value of work. They emphasized “life-skill” curricula and included workshops for arts and crafts as well as vocational training. See Kelly, Children's World, esp. Chapters 5 and 6; Holmes, Larry E., The Kremlin and the Schoolhouse: Reforming Education in Soviet Russia, 1917–1931 (Bloomington, 1991)Google Scholar; and Fitzpatrick, Sheila, Education and Social Mobility in the Soviet Union, 1921–1934 (Cambridge, Eng., 1979)Google Scholar.

33. GAPK, f. 132, op. 1, d. 137, l. 11 (February 17, 1927).

34. Madison, Bernice Q., Social Welfare in the Soviet Union (Stanford, 1968), 139–46Google Scholar; Iarskaia-Smirnova, Elena, Class and Gender in Russian Welfare Policies: Soviet Legacies and Contemporary Challenges (Gothenburg, 2011), 3942Google Scholar; and Galmarini-Kabala, The Right to Be Helped.

35. GAPK, f. 132, op. 1, d. 257, l. 188.

36. Ibid., l. 131.

37. Ibidem. The School-Sanatorium's library included 150 books and subscribed to several periodicals.

38. Ibid., l. 168 and l. 127.

39. Ibid., l. 184.

40. Gorsuch, Youth in Revolutionary Russia.

41. Hoffmann, Cultivating the Masses.

42. GAPK, f. 132, op. 1, d. 137, no list number. All the documents concerning this episode are archived together in this delo without numbering of the single papers. These documents include written statements left by the staff, the letters written by the two children, reports of the meetings of doctors and teachers, reports compiled personally by Putnin, the official reports drafted by the external investigators sent by the Commissariats of Health and Education, and the correspondence about this scandal exchanged between the School-Sanatorium, the Tagil and Perm΄ sections of the Commissariat of Health, the oblast-level Procuracy, and the children's parents.

43. Dufaud, “Un retour aux anciennes maisons de fous?,” 893–94.

44. Meeting of the doctors and pedagogues working in the School-Sanatorium on February 12, 1927. GAPK, f. 132, op. 1, d. 137, no list number.

45. Ibid.

46. I am not interested here in the epistemological question whether the word of inmates can be believed and who has the authority to decide. Rather, I follow James Trent's methodological suggestion that scandals and investigations within psychiatric institutions provide researchers with “an unusual glimpse at the underside of institutional life” and balance the positive accounts usually compiled by the superintendents. Trent, James W., Inventing the Feeble Mind: A History of Intellectual Disability in the United States (Oxford, 2017)Google Scholar, at 118.

47. GAPK, f. 132, op. 1, d. 257, l. 62.

48. GAPK, f. 132, op. 1, d. 137, no list numbering (Zhan Genrikovich Putnin at the Meeting of the doctors and pedagogues working in the School-Sanatorium on February 12, 1927).

49. Ibid.

50. GAPK, f. 132, op. 1, d. 137, no list numbering (Report of the investigation commission of the local People's Commissariat of Health and People's Commissariat of Education).

51. Michaels, Paula A., Lamaze: An International History (Oxford University Press, 2014)Google Scholar.

52. GAPK, f. 132, op. 1, d. 137, no list numbering (Letters to the oblast section of the Commissariat of Health).

53. GAPK, f. 132, op. 1, d. 137, no list numbering (Zhan Genrikovich Putnin, April 1927).

54. Ibid.

55. Ibid., d. 257, l. 83

56. Ibid., ll. 69–68; l. 135; and l. 184. At that time, the staff of the School-Sanatorium consisted of around twenty people including doctors-psychiatrists, teachers and wardens, nurses, administrators, accountants, cooks, nannies, and janitors. In terms of staff composition and system of referral, the Perm΄ School-Sanatorium closely resembled the British child guidance clinics of the 1930s. See Wheatcroft, Worth Saving, 119.

57. GAPK, f. 132, op. 1, d. 257, l. 132. In 1928–29, a certain Professor Shumkov used the psychically sick children visiting this ambulatory to conduct research on the question of inherited alcoholism. Ibid., l. 132; ll. 69–68.

58. Ibid., l. 132.

59. In August 1928, out of eighty-three children residing in the Perm΄ Institute of Social Re-Education, fifty-five were recidivist thieves, six had committed only one theft, fifteen were “hooligans,” and seven apparently joined the colony voluntarily. GAPK, f. 118, op.1, d. 215, l. 90.

60. Ibid., ll. 79–89.

61. GAPK, f. 132, op. 1, d. 257, ll. 133–34. During an assembly of teachers and doctors on April 13, 1928, Putnin's colleagues agreed that proximity to the Institute of Social Re-Education hindered the educational work conducted in the School-Sanatorium. Ibid., ll. 68–69.

62. On “outpatient psychiatry” see Dufaud, Grégory and Rzesnitzek, Lara, “Soviet Psychiatry through the Prism of Circulation: The Case of Outpatient Psychiatry in the Interwar Period,” Kritika: Explorations in Russian and Eurasian History 17, no. 4 (Fall 2016): 781803Google Scholar; and Joravsky, Russian Psychology, 422–23.

63. GAPK, f. 132, op. 1, d. 257, ll. 133–34.

64. Ibid., l. 134. Father's letter to the School-Sanatorium.

65. In addition to Mr. Okloto'’ letter cited above, see also a letter written by a single mother to an agency called Children's Social Inspection (Detskaia sotsial΄naia inspektsiia) on May 31, 1923. GAPK, f. 23, op. 1, d. 138, l. 102. In fin-de-siècle France, adult vagrancy was connected to degeneracy and medicalized as a mental disease called “ambulatory automatism.” As a mental disorder, writes Hacking, “it exculpated acts performed by traveling or in transit.” Hacking, Mad Travelers, 71.

66. Ball, And Now My Soul is Hardened; Caroli, L'enfance abandonée; Kelly, Children's World.

67. See McCagg, “The Origins of Defectology”; Caroli, “Bambini anormali”; Malofeev, Spetsial΄noe obrazovanie v meniaiushchemsia mire; and Etkind, Eros of the Impossible.

68. These diary entries appear in the archival record in the form of fragments collected in one single document. We do not know who made this compilation and what were the selection criteria. It is also impossible to identify their authors. However, the practice to keep a diary was not unique to the Perm΄ School-Sanatorium. Teachers working in reception points for orphaned and neglected children were also encouraged to record their pedagogical observations in diaries. See Koroleva, V.M., “Organizatsiia i razvitie uchebno-vospitatel΄nykh uchrezhdenii dlia sotsial΄no zapushchennykh detei i podrostkov v 20-e gody,” in Rotenberg, V.A., ed., Voprosy istorii pedagogiki v SSSR i za rubezhom: Sbornik trudov (Moscow, 1974), 131–50Google Scholar, esp. 139.

69. GAPK, f. 132, op. 1, d. 257, l. 177.

70. Ibid.

71. Ibid.

72. Ibid.

73. Ibid.

74. Gorsuch, Youth in Revolutionary Russia, 153.

75. GAPK, f. 132, op. 1, d. 257, l. 70. None of the journals talked about the violence perpetrated by the teachers on the children. However, one diary entry revealed the possibility of deviant conduct among the teachers. It was a brief comment about a summer day when all the teachers got drunk.

76. On boundary confusion for people labeled as “abnormal” see also Donna Haraway, “The Promises of Monsters: A Regenerative Politics for Inappropriate/d Others,” in Lawrence Grossberg, Cary Nelson, and Paula А. Treichler, eds., Cultural Studies (New York, 1992), 295–337.

77. GAPK, f. 132, op. 1, d. 257, l. 62.

78. Zalkind, A.B., “Deti, sotsial΄no-vybitye iz kolei,” Na putiakh k novoi shkole no. 10–12 (1924):1725Google Scholar, here 17. For more examples of Soviet psychiatrists’ criticism of the environment as the source of disorders see also Dufaud and Rzesnitzek, “Soviet Psychiatry through the Prism of Circulation.”

79. Pinnow, Kenneth Martin, “Violence against the Collective Self and the Problem of Social Integration in Early Bolshevik Russia,” Kritika: Explorations in Russian and Eurasian History 4, no. 3 (Summer 2003): 653–77Google Scholar.

80. Galmarini-Kabala, The Right to Be Helped, chapter 4.

81. Quoted in Malofeev, Nikolai N., Spetsial΄noe obrazovanie v meniaiushchemsia mire: Rossiia. Vol. 2 (Moscow, 2013), 202Google Scholar.

82. Zajicek, “Soviet Madness”; and Galmarini-Kabala, The Right to Be Helped, chapter 5.