Tragical History Of Psychiatry During Comunist Dictatorship

TRAGICAL HISTORY OF PSYCHIATRY DURING COMUNISM Dr.I.C.CUCU,MD The paper refers to our Monograph PSYCHIATRY UNDER DICTATORSHIP,edited in 2005 The book appeared after 14 years of waiting,strugle with adversities and insurmountable obstacles and opposition against the truth of our psychiatric nomenclature , including the Romanian authorities. It was published on the Internet in many forums and having a share of over 300,000 visitors. Using psychiatry during communism as a political weapon is part of the tragic history of the Romanian in psychiatry, which generation today and especially the next generation should take knowledge. Using of psychiatry,communist political camp (Romania represented only one of these crimes communist metastaza) was done in a systematic way and had to premize theoretical basis and a good practice to put the point. Based on the study did have sought to see these mechanisms of a totalitarian state, became a real criminal organization, a field in which only a fascist state realized this successful performance. Viewers in terms of theory, as in other communist countries, in Romania, three structures have forced private dictatorship limetele in psychiatry: 1. The character of the totalitarian state; 2. Place occupied by ideology in all fields; 3. Visceral fear of regimen of not keeping their power and privileges. Thus, on the one hand, not individual rights, and was the only party which decidea, including one to consider the individual bishop, and on the other hand science, in our case psychiatry, was subject - not to say servitoarea -

ideology . But the psychiatrist that an international political opozant under pretext of schizophrenia or paranoia involvement in a conscious policy of the totalitarian state from which actually expect certain attitudes that will bring advantages. Apologets of "socialist psychiatry" explaned these "features" of their acts that the existence of disparities "essential" against "capitalist psychiatry", namely one that is practised in the West. This was the basis of rejection without discernment or scientific arguments concepts of psychological and sociological Roumanian psychiatry. Fundation of ideological political abuse in our psihiatry was based on several elements introduced by communist totalitarianism: 1.So called "socialist morality" and relationships as in the communist-totalitarian, 2. Theoretical postulats which was based on building "socialist psychiatry", which then became a psychiatric abuse and Allied of a totalitarian state. For communism, socialism was supposed to mean but a moral nine, namely Us principles that should be within the future. These principles were rezult after the communist ideology, based on studying marxist philosophy , whose concepts were over 150 years. "Moral principles" are not achieving grace of interior transformation of the individual in contact with "the most straight society", but conversely, the individual, artificially, had "correspond to" the principles of the philosopher now 150 years until the stage when he s would be called "new man". "Religion masses", as well as individual masificarea led to aberrant principles of law, such as: main aderence of the whole people to socialism, the superiority of socialism and implacabil running of any society to socialism. These aberrations called by the term "new principles" of socialist society have put science right in front of problems that mankind no longer knoun as psychiatric ethics had to be subordoned this Us to consider moral and political or

religious opposition as part of psyhopatology. Within this framework fall relations between psychiatry and politics dizident and politizante of theories that have served psychiatrists security and the communist party. It is a reality that socialism could only conformist aspire to normality. The "new moral", the affirmation of socialism infailibil and invincibil, made to implement the so-called repression "aseptic", that is a purely medical repression to hidea certain faces of the system of repression, thus succeeding to the Romanian carry psychiatry in the way of the largest mistification and violations of medical ethics. Three problems in this area we seem more important, psychiatry being deeply involved here: a. Communist social engineering; b. Instituţionalisation of lies and duble standard; c. Psychiatry have to transform into a maid regime and repressive communist system. If you have an individual religious faith or a particular political creed, this not only was not accepted by the communist society, but for the communist psychiatry they had become subjects of clinical diagnosis. Cohesion human friendship, confidence in protective figures, as would be the doctor for example, had to be systematically destroyed. Nothing needed to support the communist system. Institutionalisation in current life of lies and double standard.So, institutionalized system of lies in communism, followed by asiduitatea's defeat of normal repulsion and, as such, removing the main support of selfrespect, freedom of conscience and the dignity of the person. Why not, it would have been the situation and some psychiatrists who were put into service dictatorship. The entire existence in communist society was subject, of a double standard, and there is need to accept permanent difference between perception and reality of what had to say. In organizing a psychiatric abuse, communist apologets of psychiatry have used theoretical models overcome the scientific point of view, they ideologized as examples of

applying dialectical matherialism in psychiatry: a. A model purely biological - the medical model inherited from the classical German psychiatry from the beginning of this century, but which will be processed in marxist ideological manner. b. A carceral model of institution with psychiatric treatment rejection of psychological and sociological concepts in the field of therapy institutions and treatment. The model was taken, too, in the history of classical psychiatry (psychiatric asylum as an institution specifies the Middle Ages). POLITICAL IN ROUMANIAN PSYCHIATRIC Political psychiatric abuse is not so, because odios existed and even by its high frequency, but for the fact that in communist countries it was organized by state, thereby, has become a real "criminal organisation" involving civil officials (party activists, doctors as official organs of the repressive state, including Magistratura). Such organized crime by the state was not known in the history of humanity. 1. The practice of political psychiatric abuse a. Rol of psychiatrist in abuse Following the study that I undertook to us that arose following classification involving a specific gradation and accountability: 1. Psychiatrists who were as oficial of psychiatry (nomenclature) - in close collaboration with the securitatea and party organs - themselves occupying high positions in party leadership and in varying degrees and Securitatea. They are those who consciously organized repression in psychiatric theory and practice. 2. Disidents psychiatrist or opozants, very few (at least those I know), understood, but witout sustenemantl. They criticized sporadicly or systematic abuse or have started their own movement dezideologisation, informally or coverage, but all have criticized psychiatry official and exponents. 3. The mass of honest psychiatrists , but without interes and desinformated,adepts of "cage"psychology, paste often in colonial manner "teachers" in their geographical

area, for small advantages for administrative or a quiet life. The first group are few individuals, maybe a dozen, that communists they always assumed that "papuşniki" as called by Lenin, or rather as "Temporaly camarad." What was the motivation of this cooperation with the communist political system? From this point of view we could not disclose the following reasons: 1.Motivation ideological, honestical or opportunistic, faith in communist ideal and loyalty to the party. For these individuals to criticase the party or socialism can be a phenomenon of social inadaptabilitaty or even mental illness. For these reasons they will labeled the individuals subjected to "treatment" as suffering from schizophrenia or paranoia 2. Wish to promote business, which gives power and influence, meet their ambitions, benefits for a better life and often exceed the scope of their ambition in psychiatry, wanting to become ministers, deputies and even members of the Central Committee of communist party. 3. Qualification their policy has resulted in the naming functions, while the qualification was psychiatric subsidiary. For these reasons always had to renew their attachment evidence against the party and ideology. 4. The Party will promote only devoted cadre of confidence in the first line of psychiatry to facilitate its control and of Securitatea. In the first stage, the university in Soviet Union were absolutely necessary, because the attachment against the party asked that was definitely needed and proof of attachment against the Soviet Union. As a result of collaboration, the psychiatrist nomenclaturist received as a benefit to a maximum salary dimension, departures abroad, holiday villas, access to special shops, luxury goods and other payments made for services. For these reasons, some of them have become true apologets of communism and even international level, by the attitude of various psychiatric Congress. Disident psychiatrists were few as a number and have openly criticised the regime or prudencios, especially the use of psychiatry against disidents as political wepoint. Some have been severely punished , others bushed to emigrate, they have organized public processes and even

judiciar proceses. Especially those remaining in the country have been marginalized, have not been promoted, were taken right to publish. Other disidents were grouped in small groups more or less oficialisated and managed to have a certain activity in the press have published some works in its own. He paid a high price, but disidents they have assumed this risk. The process of disidenta "passive" was, too, one of the ways of fighting. Thus, many psychiatrists had an attitude and even soft "fraternisation" with dizidents hospitalisated, this being said many of the psychiatric disidents interned. The psychiatrists unactiv representing an absolute majority. Compromise their behavior was motivated by fear,using of denegation processes and rationalizing their atitude to avoid ethical problems. But fear and compromise caracterised in fact the entire population of the country and therefore this was an excuse for psychiatrists. The confirmist psychiatrists aware of the rules and convenients in communist Romanian society and knew that one wrong step was full of risks. Therefore, their first care was to avoid having to do with the dizidents, and if this could not be avoided, they blame on the "circumstances". Many have sought to respond to requests nomenclature by a tacit understanding over what it claimed. On the other hand, it was hard to believe that, as psychiatrists, the total could avoid the risk of having to do with the dizidents. Often, not avoid contact with them, could play a sharada the following manner: "I know that you are not sick psychological and that there must be interned you, but you thinking about what you suffered if you would give their hand and what harm you made me?” I can not do more, I supervise heads, but to know that I hate this imbroglio. Both are in the same boat. " b. The breadth and forms of abuse After studying the cases that we received, investigations conducted and documents reviewed, we could build the next grading psychiatric abuse that practiced in our contry: 1. Political hospitalisation had the highest frequency and

were the most harmful because this intimidated masses, hundred people healthy or at limit, including patients in remision for the years. Thus, in the psychiatric hospital, healthy individuals or marginal were interned , but in all cases, the common element was that to manq the possibility of using ocasion as political event for a demonstration against the hostile regime. 2. Actions illegal for political purposes from persons who had a mental illness. From this point of view, our research has identified the following categories: a. Diagnostics handled political reasons related to need hospitalization, such as schizophrenia, paranoia, etc.. The symptoms were more negative, the more it was clear that the patient "has no awareness of his disease." b.Neuroleptical treatment or electroshoc without medical reason. From time to time, prisoners of communist prisons or psychiatric hospitals reacive electroshocs or neuroleptic treatment, although this was not necessary. c. Psichiatric Units well-guarded, which exist at most of the county hospitals, but there were sections secured, completely isolated wards in which only the medical staff and officials with special arrangements had access. d. Specialized institutions, for "treatment" of some disidents. In Romania had this sad notoriety Hospital in Gataia especially in the 50s, hospitals Poiana Mare, P. Groza, Răducăneni, Bălăceanca. e. Abuse of diagnosis in pacients favour . A number of doctors argue that during communism have practiced false diagnostics to save patients from a bad situation that would be expected. It is a situation uncleared yet in terms of medical ethics and morality, especially that in all these cases the psychiatrist itself would be very much at risk. 3. The legislation as a factor encouraging the abuse was, too, an important thing. Legal structures of the years of dictatorship in Romania were designed in such a way that could facilitate psychiatric abuse. Indeed, abusive way are encouraged by laws relating to mental incapacity declaration of an individual. This is particularly evident in the Law no. 3 / 1978 which allows the seizure in case of medical emergency. Thus, the socalled medical emergencies were transformed into emergency order on the political and under detention on

grounds of illness. The law,Decret 12/1965 provide for the placement "hazard" on the basis of statements taken from neighbors or from family members, without an individual can appeal against these charges. Court judge in closed session without defense or provide evidence. Acusation could be made by relatives, friends, but also by the authorities. Similarly, Decret 313/1980 provides for the possibility of compulsory treatment at a single indication psychiatrist, who could easily be subjected to pressure authorities. Furthermore, if this decret, the entire action or deprivation of liberty of the individual body was delegated to health, while driving Securitatea shadow as a result of this criticism made of Decret 12/1965. 4. Statements sperjure politically motivated. A difficult problem is raised when the diagnosis is established on the basis of "evidence" that is involving different officials and who are present with their own version of the facts. 2. The processing of material studied Study detailed batch of cases that we held the record set in the following important issues, which will continue this: a. Admission abuse The first step in the political psychiatric abuse in the placement constituted abuse. Admission abuse occurred when dizidentul came into conflict with the communist political system and when securistul call on a psychiatrist to decide whether this behavior could be considered as abnormally. Since this opinion was given the status dizidentului change, it became a mentally ill who could apply the measures as forced admission, electroshocs, neuroleptics, contention measures. Normally, cases were brought to a psychiatrist in several ways: 1. Civil procedure with the placement direct "clean" to act of disident which the psychiatrist it turn into a phenomenon psihopatologic. In these situations could occur following categories: -- Dizidentul was given a deed, it was proved, arrested and

interned in the hospital and then undergo a psychiatric expert to confirm "mental disease". For this security could make a formal request, but most often brought to hospital dizident was sufficient to the psychiatrist conformist who understand to be done; -- Dizidentul was claimed by neighbours, relatives and even wife. It was called policy, dizident was led to the ward where the officer exposed his opinion and the person was carried to hospital against his will.; -- Kidnappings on the street, at work or home without arrest warrant. The person was carried psychiatric hospital without explanation and without a medical consultation beforehand. 2. Criminal procedure - when dizidentul was arrested for an alleged common law deed and transferred to psychiatric purposes "medical". 3. The procedure through which dizident was tried and convicted for acts alleged to be common law, but subsequently transferred from prison to hospital for mental diseases. b. The events which led to the placement What unites these abusive internations was that concerned citizens wished to exercise their rights guaranteed by the Constitution in peacefully (right to manifest, the right to faith, political creed, the petition), but organs of repression, serving purposes totalitarianism, have opposed free and peaceful exercise of these rights. Based on the study were able to systematise the main types of documents these internations. # Activities with a political nature. Communist Constitution does not formally opused exercise of the political activities of citizens. However, in practice any political activity, except those conducted by the party, were prohibited. Here are some examples of political motivation internărilor activities to defend human rights, the formation of trade union organizations or some hybrid parties from 3 to 4 members; critics verbal or written policy to address the Communist Party or leaders of party and state; criticarea violations of workers rights (wages, working hours, volunteer activities, etc.; showing slogans, printing show in which expresed critical opinions, read

some books or magazines banned by the authorities. # Insistent requests for emigration. Very many dizidents were interned for repeated attempts to pass the border and even for special insistence to emigrate. Too, the insistence to enter the embassies could be considered a mental illness. # Religious activities - the practice of religions other than in silence and worship premises was condemned as crime (religious propaganda), was regarded as a phenomenon psihopatologic - paranoia. Here we have entered, in particular, members of cults baptiste, adventiste, penticostale. Sometimes the placement could comprise an entire family. # The wording of petitions or memoranda may be considered as a mental illness. Although rarely answering system at memories and petitions, the nature poliltic were immediately sent to the Securitatea often is used and the gun in psychiatry. Lack of cooperation with security could be another reason for using in psychiatry. Often citizens who were interned were memories from a few days with psychiatric justification that they are making a short medical psychiatric, this being done to intimidate. c. The length of the internation In the cases studied by us length as in-pacient experienced highs and lows of the some day to a few years. There is a link between political reason and length. Most of dizidenţi were interned especially in short, on the occasion of events. Also, interned in psychiatric asilums the disidents were taken in secret places for the family, to hundreds of kilometers and thrated with neuroleptics and a so-called "psihoterapies" trying to wash the brainpower of these individuals. d. Place and the conditions of detention If psychiatric hospitals and special maintained their official appearance all the time in prison, psychiatric hospitals were normal aspect of an asilum, which in practice was almost identical. Super-aglomeration and lack basic hygiene.

The restrictions and censorship is in a drastic regime of correspondence, visits, receiving the package, the lack of permission to have some personal objects. Often, hospitals, the doctors agreed or not entitled to mail . Violence against the sick, care staff having virtually authorization to link patients, to make them electroşoc. Dizidenţii have complained especially despotism personnel, lack of skilled and harvesting it from among persons bran, common law prisoners, alcoolics, psychopats, former psychiatric pacients. Sometimes applied sadical phisical treatment. Often "detainees" had the feeling that the staff have the right of life and death upon them. If medical staff waching at least among patients, orderlies waching practically all the time, forming true clans, making it among them. Moral pressure and attempts to change political beliefs are exercied kept in special hospitals. Often such actions were as cover psychotherapy session. Among the main actions psychological note: -- Aberrant isolation in hospitals or in special exhibitions shake the key. At this add the prohibition of visits, animozităţile between psychiatrists and patients families.; -- The absence of any way of appeal or legal protection, censorship, permanent control over detened control its relations with other patients. In the psychiatric hospital staff does not officially have no legal obligation to make complaints to reach a prosecutor to patients, families and complaints were not taken into account; -- Hospitalization was indefinite duration, nor a dissident could not know how much will remain in hospital, only to surrender dizidenta was an argument to obtain the release. Not even those engaged in 12 or 313 decrets are not respect the right to review at 6 months. Promiscuitatea linked to the mixture of people age, degrees of special culture, mixing with real patients psihici. After discharge the patient was "dispensarizat, now under surveillance not only Security, but health bodies and territorial neuroleptizat ambulatory. For this reason, dizidentul declared "sick psychological" could be kidnapped at any home or on the street, without any formalities "the background".

e. Diagnosis The psychiatrists Romanian did not have access to Western literature and were trained only after psychiatric textbooks in the country, all edited by tartorii in psychiatry totalitarian and after indications "programming" of the directors or teachers. For these reasons, the psychiatric diagnosis in practice became a true farce simplistic and easily achieved. f. abuse of electro-therapy Dictatorships around the world have adopted this technique for torturing thr disidents. Within electroshok (ES) individual is put in a vital state of stress, a situation that simulates the imminent threat to life. g. Misuse of neuroleptice All dizidenţii of our lot did not have the right to choose the doctor who, in turn, does not have any duty to decline and identity. Neither the patient nor the family had no influence on the type of treatment applied. Usually, are very strong medicines used (haldol, clorpromazina, trifluoperazina, majeptilul) .. 3. Violation of the rights of patients Although dizidents were interned in psychiatric in different circumstances, they represent the common sens to exercise those freedoms known as basic human rights. He was talking mainly to written or oral expression, critical views on government practices, petitions against the authorities, participation in events neagreate officially belong to informal groups, participation in religious events, repeated attempts to emigrate, attempts to pass the border illegally . In many cases, dizidenţii always had been warned before, and that dizidentul not recognised it was sick because of "his lack of conscience of the disease." 4. The abuse as a form of torture Makes electroshoks as torture or syringe under the communists was an action directed by the state. There are

several criteria to determine if an act can be defined as torture (by Amnisty International): -- Severity of physical and psychological abuse; -- The fact that the act is premeditatedly; -- The formal involvement of the state; -- Ruling the act. Thus, the excessive use of ES is a form of torture that was used frequently. In this context enter and unjustified use of neuroleptics. None of the rights of a patient really has not been observed: hygiene standards, the right to refuse treatment or the person you administrază ensure security. Dizidents were mixed with real psychiatric patients and discipline to ensure being beaten, ES, overdose of neuroleptice, contention, restricting visits.