"Masses & Mainstream" on Soviet psychiatry (circa 1950)

Doyle Saylor djsaylor at SPAMprimenet.com
Sun Jun 4 17:56:47 MDT 2000

Title: Re: "Masses & Mainstream" on Soviet psychiatry (circa 1950)
Greetings Comrades,
   Where James Farmelant quotes from the old magazine article in Masses &
Mainstream, I thought I might elaborate on the theme of disability in this
article.  There several parts to the article which caught my attention.  First,
at that time the writer emphasized that Soviet psychiatry rejected Freudian
psychology.  I think that is ironic given the continued influence of Freud on
Post Modernists in the English speaking countries.  
>From James Farmelant,
However, one piece that attracted my attention is George Stewart's review of the
book *Soviet Psychiatry* by Joseph Wortis  in the Spetember 1950 issue, which
Joseph Wortis,
..."First, on the general trend of Soviet psychiatry.  The Soviet psychiatrist
is essentially a materialist and an environmentalist.  There is no room in his
conceptual storehouse for instinctual drives, innate abilities or purely "psychological"
explanations of human behavior.  As A.N. Leontiev puts it:
   ". . . Only the anatomical and physical traits of the organism are innate.    These
traits do not in themselves determine directly one's abilities; abilities are
formed only in the process of development of appropriate activities.  Consequently,
they are dependent on the concrete
conditions which make a give activity possible."...
..."A second problem of quite general interest is, of course, the attitude of
Soviet psychiatry to psychoanalysis, particularly the Freudian doctrines which
today dominate in American psychiatry.  It should not be news that Soviet
psychiatrists are sharply critical of psychoanalysis, regarding its theories as
reactionary and obscurantist and its therapeutic methods as wasteful of time and
relatively ineffective. "
The point I would make here though is about how such a focus "medicalizes"
mental disability.  A psychiatrist is an expert on a subject matter.  And I am
sure that in the Soviet Union they would have also shown how someone depressed
participates in their system of health care, but disability does not consist
solely of being about health care.  Rather, given successful methods of therapy,
a mentally disabled person has to be a part of society as a whole.
To be oriented against Individualism (as bourgeois culture creates it) can be
rather obscure in content in such circumstances for someone who never lived in
that Soviet culture.  I think there is way to bring home what that means from
our viewpoint here by looking at what I am driving at with respect to mental
disability outside the concept of medical solutions to mental problems.
Let us start with the autonomous individual of the Bourgeois Enlightenment, the
person who in public life helps determine the social contract, as opposed to
someone who was subject to the king or queen's will.  The autonomous individual
breaks down as a concept of real people when we have to include in society
mentally disabled people.  For example, medication to help reduce symptoms costs
money in order for people to function within the requirements of the current
social system.  We of course don't really know much about the standards that
argues for, because we have so little clarity about human consciousness, but
medications help people to function better than if they simply were left alone.
So medications are vital to access to the system in Capitalist society, and
decent health care is necessary for someone to have access.  On the other hand
what is the profit in that for big business?  We might take away profit as the
defining criteria of health care then we must face that a disabled person cannot
be autonomous without meds, and without meds cannot participate and therefore
that defines what a community means by belonging.  Very clearly then
individualism as a theory depends upon an ideal of human mental life which very
obviously does not hold without society providing the means of access to that
ideal theoretical structure of participation.
So the demand for access for disabled people means a fundamental look at what
society as a whole must provide for disabled people to function "independently"
in the community.  Independence means being able to function outside medical
care facilities in the rest of society.  Where medicalization fails to get at
this problem is that a person who is disabled must be a part of the whole, and
that can neither be understood as how individuals function in that whole (the
super disabled person who succeeds by trying hard), nor as how medical doctors
theorize mental illness to "cure" the problem.  The medical doctor can only be
expert in a narrow range, and yet the disabled person does not live a life in
the hospital.   And that disabled person has friends, a need to work, a need to
participate in whatever comes their way.
The disabled person is in fact doing what the rest of working people do, which
is creating a social network around themselves which meets their needs.  That
network is not a cookie cutter framework, but dynamically differs from other
individuals whose needs vary from that persons also.  Or said another way,
statistically disabled people are at least 20% of the human population, and the
social system already functions without many people being autonomous (rich
enough to get all societies support) at all.  Yet those same people have
profound directions they might orient the social system were their presence felt
by the social structure.  What I am saying is that since disabilty is invisible,
we simply don't often get it what the implications of inclusion really leads us
to seek.
Someone by themselves enmeshed in severe mental disability cannot hope to change
that for themselves.  But a system that really does walk the walk, talk the
talk, will want to include everyone in the social fabric.  Thus individualism
would die, since the reason to exclude people has been faced and dealt with and
the recognition that various disabilities are the most difficult of all the
forms of oppression in this system to deal with motivates the development of
social structure.  This is of course a variant upon the class issue of the need
for unemployment in capitalism in order for the economy to function profitably.
Doyle Saylor

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