As reported at Tech Central Station [by Irwin Savodnik]
The old Soviet psychiatry subscribed to a harsh biological determinism. The psychiatric physician was an absolute authority while the patient's words mattered little more than raindrops at sea. That the patient might have something to add to the doctor's assessment of him made little sense since the origin of his difficulties was thought to be a disordered biology that had to be set right. The idea of a person was quaint but irrelevant.
Part of Soviet psychiatry involved the well-known use of psychiatry as an instrument for political ends. Indeed, there were few other ends in the system. The brothers Zhores and Roy Medvedev offer a shocking, though typical, picture of what things were like in the Stalinist era. In the Soviet scheme of things, political dissent was interpreted as a psychiatric disorder, a difficulty in reality testing, which justified confinement in a mental hospital. Such niceties as due process, length of stay and an appeals process meant nothing. In a state where individual freedom was a bourgeois myth, there was no need to respect basic human rights.
Today in Russia, there are patient protections against involuntary psychiatric hospitalization similar to those in the United States. While some may argue that unwilling confinement is always wrong, such hard-core legislation recognizes the freedom of the individual, which represents a radical change from the pre-Gorbachev era. [...] The great irony is that American psychiatry is moving in exactly the opposite direction. In the past 30 years, the overriding ideology of American psychiatry has shifted to a biological model. Psychopharmacology has become its therapeutic backbone.
The problem, however, is that this model doesn't tolerate free agency. It views psychiatric problems -- moral problems, really -- as medical ones, just as Soviet psychiatry did. It has become more prominent in the courts as the hefty influence of medical diagnoses has replaced the literary-like "assessments" of psychoanalysts. Always, the emphasis is on relieving the individual of moral responsibility. Interpersonal problems, family conflicts, sexual malaise, even shyness, have become medical problems.
So, as the Soviet system came undone and its psychiatrists freed themselves from the confines of a strangulating ideology, American psychiatrists have embraced uncritically the same narrow vision. But as the Soviet example demonstrates with distressing clarity, a conception of people as little more than biochemical bundles fails to address those aspects of ourselves that make us human -- the moral and esthetic dimensions of our lives about which chemical equations have little to say.
[Edited from a longer article]
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