This is the first book to address the history of psychiatry under Communism in Central and Eastern Europe. In ten chapters the authors compare in a rich diversity of options of psychiatric treatment, cultural and ethnical distinctions, and competition within the East-European psychiatric field. They illustrate a new understanding of research and its interplay between ideology, politics and psychiatry. The contributors debate forms of psychiatric treatment like occupational therapy, shock therapy and antipsychotic treatment. As the articles show, global culture wars and political systems in the 20th century had strong influence on the historical view of psychiatry. The chapters demonstrate that there was substantial political pressure on medical research and professionals. A major advantage of this publication is that each chapter deals with a different geographical area. So instead of counter-narratives, the stereotype of a monolithic Soviet history is divided into several focuses: communist Hungary, Czechoslovakia, Romania, Bulgaria, the Soviet Union or Yugoslavia. The interested reader will find precious remarks to aspects concerning the USSR, even though one notices minor gaps such as the lack of a particular contribution on Albania or Poland.
The topics explored in the book show a certain tension between the centre and periphery. Some papers concentrate on several institutions, like the essay on Russian work therapy in the Kaschenko Hospital, which analyses the influence of political forces in the USSR in connection with the power of individual healthcare experts, while other essays examine large areas like the entire USSR. Several chapters highlight especially relevant and innovative interpretive approaches. For instance, Alisher Latypov's informative survey of the construction of 'narcomania in Central Asia' demonstrates that in the Soviet construction of this psychiatric disease category, drug addiction was portrayed as a 'regional problem' of Tashkent and Ashkhabad (pp.74f.). In this context, native physicians were declared as retrograde cultural relicts, and their use of opiates was considered rather to cause the problem than to contain it. As Latypov ascertains, this affirmed the view of the superiority of Soviet Russia and vindicated the centralisation and cultural influence over peripheral regions.
The pioneering chapter attends to psychopharmaceutical medicalisation in East and West German. Volker Hess examines the introduction of psychoactive agents into East German psychiatry and the following standardisation and production of drugs such as chlorpromazine. Hess contents a 'magical triangle' (p.154) of industry, state and science, and illustrates how the post-war period saw networking between scientific societies, and exchange of research knowledge and pharmacological materials between FRG and GDR. The author argues that after the building of the wall in 1961, there was a slowdown of scientific innovation in the GDR.
The chapter by Sarah Marks examines the take-up of environmentalism and development of ecological aetiologies of mental health in Czechoslovakia from the late 1950s to the 1970s. Mat Savelli's contribution to this volume explores the psychiatric discussion over drug use, abuse and addiction in communist Yugoslavia. The chapter suggests that the later moral panic over drug use could be understood as part of a longer trend, but does not investigate further the political changes and how these influenced the psychiatric care. The article of Melinda Kovai offers an insight into the relationship and debates between the medical and the Party. As a case study, it analyses the history of the Hungarian Institute of Psychiatry and Neurology from 1945 to 1968 and the influence of the political shifts on doctor-patient interactions. Corina Dobos's chapter analyses the development of Pavlovian psychiatry in Romania. It deals with the emergence of 'asthenic neurosis' as a major preoccupation of psychiatrists in the communist Romania. Finally, Benjamin Zajicek examines the insulin-shock-therapy as a predominant method of treatment for schizophrenia in the USSR until the early 1960s that 'came to be seen as an effective, modern and distinctly Soviet treatment' (p.51). The author emphasises institutional and social aspects relating to the construction of therapeutic effectiveness.
This publication underlines a need for addressing the topic of mental health in the context of European Communism. The editors emphasize that studying transnational links between East-European countries 'provides a novel perspective for understanding not only 'Communist Psychiatry' but also the global development of ideas relating to mental health' (p.19). The publication contributes to the wider fields of medical history, to the history of Communism and not least of Europe. In addition, the book offers a variety of research themes and contexts and is a significant contribution to the social history of medicine. The volume edited by Marks and Savelli create a diverse and complicated picture of a psychiatric care system of the former Eastern Bloc. The study deconstructs a predominant totalitarian interpretation frame and embeds the history of psychiatry in Communism in a broader context.