Saturday, March 12, 2011

The Gulag

Dinah is away this week so Roy and I are filling in. Here's a quick blog post (more to come). I stumbled over the Center for History and New Media web site this morning and found a video tour of an old Soviet gulag. In addition to the video, there's an accompanying audio tour (in Russian, with an English text translation). The camp is better than most, from what I gathered from the description, because it eventually housed formerly high-ranking prisoners. The thing that struck me most was this comment by the tour guide, about transfers out of the gulag to other facilities:

"If one could leave a camp or a jail, a mental institution meant a life sentence, because the effect of mind-altering drugs could not be reversed."
I wonder how many tourists have gone away from that tour thinking that psychiatrists are equivalent to political persecutors. I've seen this attitude about psychiatric medications reflected in some legal opinions here in the United States as well, thankfully in cases a couple decades old, but present nonetheless---the idea that psychiatric medications are "mind-altering" rather than "mind-correcting."

Of course, there are people who have been hurt by psychiatric medications or who feel that they have been permanently damaged by them and I'm not dismissing or ignoring those experiences. I was just struck by the international nature of the stigma about meds.


Dinah said...


ClinkShrink said...

Done! You commented while I was uploading.

Aren't you gone yet? I can't cover for you until you leave! :)

Dinah said...

You're not "covering" because it's your blog too! You're blogging on your blog.

No, I'm not gone.

Alison Cummins said...

Isn't the issue for Soviet political prisoners that people who were not unwell were given drugs? And that given the state of psychiatric drugs, were being given pretty crude stuff?

Anonymous said...

I suppose I am not surprised by the international stigma, given the strong stigma against such drugs in this country. I work with people who discuss all sorts of medical problems - high blood pressure, high cholesterol, etc. (Clearly we all spend too much time together at work, but that's a separate issue). Those medications are acceptable, apparently. I suspect if I said I take lithium for biopolar, that would end the conversation -- and my career (lawyer).

Anonymous said...

Well psychiatry does have a history of being in coercion with corrupt states to maintain the regime. It also has a history of maintaining the status quo,cultural norms, biases and prejudices of any society in which it finds itself. Perhaps the profession should ask itself if it truly can be trusted with the well being of others and how much of that distrust has actually been earned.

Anonymous said...

"I wonder how many tourists have gone away from that tour thinking that psychiatrists are equivalent to political persecutors."

I would be surprised if anyone voluntarily seeks psych care in Russia after their history of abuses there.


Roy said...

I'm sure that in some countries (Russia, China) psychiatrists are pressured to to what the state wants them to do, even if there is no true mental illness.

ClinkShrink said...

Alison: Yes, healthy people were treated involuntarily there and this lead the World Psychiatric Association to oust Soviet psychiatrists for a time.

Anon #1: I've never understood the rather harsh stance of the bar association toward psych meds.

Anon #2: Agreed, history should not be forgotten. Thus, this blog post.

Anon #3: Or in Iraq now either, given that during the Saddam regime all psychiatrists worked for the military.

Anonymous said...


When cases like this one keeping popping up, the image of psychiatrists as political prosecutors is not going to disappear.

To summarize, Alison Hymes had a kidney transplant in 2008 which was due to long term effects of lithium. Unfortunately, she developed psychiatric side effects as the result of taking steroids. It goes her back on the psychiatric treadmill which has now led to her facing a 6 month involuntary stay at the state hospital.

Oh, and she is being forced to cold turkey Klonopin.

As for medications being mind correcting vs. mind altering, it depends on a person's perspective.

Let me repost what I wrote on this blog by Pat Deegan which I think sums up the issue perfectly.


You are getting better ***** Your cure is disabling me
Your symptoms are gone**** My symptoms no longer bother you
You are more in control**** Haloperidol is controlling me
You are stable **** I can't think or feel
You are functioning again **** My life is without meaning or passion

Anonymous said...

I have had my mind corrected at times when there was nothing in need of correction other than a system that uses drugs when a few words with a decent human being would have done the trick. I am not against the judicious use of drugs but they are abused even today by doctors in so called good hospitals as a form of social control and as a way to let everyone know who the boss is. We live the Gulag in some respects so it doesn't seem so surprising as you seem to find it.

Anonymous said...

Clink - this is Anon 1 - the theory of the bar is that people with psychiatric illnesses are unable to effectively treat their clients, unless the illness is under control. The same is true of alcoholism and drug addicition, and the bar encourages treatment of all of them. I've never seen statistics on which is more likely to lead to disbarrment, or non-admittance in the first place.

I think the difference with psychiatric medications/illnesses stems more from society's overall bias in that regard; treating physical ailments is ocnsidered quite different from treating psychiatric ones. And, alcoholism, and to a lesser degree drug addition, are seen as things that happen to perfectly respectable people who have something go wrong in their lives or who are under too much stress. Lots of lawyer alcoholics out there. Drugs are a bit 1980s. Mental illness is something that happens to mentally ill people, not perfectly respectable people - or at least that is the sense I get. Depression is probably somewhat more accepted these days than other mental illnessses, as long as it is short-lived and tied to some event (death of a spouse, divorce, etc).

Anonymous said...

sorry - effectively "serve" their clients - freudian slip

Anonymous said...

What the last Anonymous said is very true. In my state, there is a state bar sponsored Lawyer's Assistance Program, founded by one of the most respected lawyers in the state. I've been to their programs as part of my Continuing Legal Education/Professionalism requirements. In the program, judges and lawyers talk about their past drug and alcohol use, and how they got clean. But though they purport to help mentally ill lawyers, there are no lawyers that will publicly stand up at these programs to discuss it. I mean no criticism of the Lawyers Assistance Program; it's a fine program that has helped many, many people. I just want to point out that all these lawyers and judges speaking at the CLE's make it almost respectable to be a former alcoholic or addict. But not one person will stand up and publicly admit mental illness. The stigma is too strong.

Sarebear said...

Is there something awful about cold-turkeying clonazepam? I've done it several times before. It's eventually been prescribed again as part of my regimen, but not because I was addicted to it or anything like that, nor to alleviate any kind of withdrawal . . .maybe don't tell me. If I don't know, maybe that's why I don't have effects from doing it. If that makes sense. Lol.

Retriever said...

I think one reason many people (especially bipolar and schizophrenic people) view shrinks with suspicion in this country (and not just in Russia) is that the meds often primarily benefit the people around the patient more than the patient themself. In other words, the meds may bring down a gloriously manic person who unnerves their friends and family, may stop them having a wonderful spending spree and wild love life, which distressed their loved ones but was wild fun for them.

Atypicals and mood stabilizers which deaden feeling and make a person gain weight and take away energy and feelings of creativity make a person more law-abiding and compliant, more likely to go to work, clean house, pay their bills, keep their medical appointments. All things that are desirable from the standpoint of the people around the patient, but that the patient may find dull as ditchwater themself.

In addition, I saw by direct observation over some 40 years the cumulative effects of massive doses of various psychiatric drugs on my mother. Dozens of hospitalizations, every treatment known to man in America, SOuth America and England for bipolar disorder w rapid cycling. Her meds not only gave her tardive dyskinesia, but destroyed her memory, shortened her attention span, damaged her ability to think, and made her dull witted. And this was true even when she went off her meds (in other words, it wasn't becaue of heavy doses of, say, depakote and/or zyprexa). It's possible some of the 1950s and 1960s treatments were to blame (higher dose ECT than now, older neuroleptics, and some of the weirder things they may have tried.

I've also wondered if stopping and starting so many meds wasn't part of the problem.

Anonymous said...


Sorry, I am going to post why you shouldn't cold turkey benzos or any psych med for that matter. If you have done it without problems in the past, consider yourself very lucky. Anyway, here is the link to the manual by Heather Ashton, who is considered a top expert on withdrawing from Benzos.

Abrupt or over-rapid withdrawal, especially from high dosage, can give rise to severe symptoms (convulsions, psychotic reactions, acute anxiety states) and may increase the risk of protracted withdrawal symptoms.

She lists them on this site:

As an FYI, the only quibble I have with Professor Ashton is I think her suggested Benzo taper is too fast as it is 10% of current dose every 2 weeks. I think it should be about every 4 weeks.

But compared to most professionals tapering schedule, her two week one looks quite reasonable.

Anonymous said...


Another take on the people you initially described is they might feel the way that Pat Deegan felt regarding her perception of the meds vs. the psychiatrist's.

As far as current anti psychotics, I know someone who has stayed on her med regime and her rewards are diabetes, high cholesterol, and high blood pressure plus having to deal with obesity.

She also has the other issues you mentioned.

So no, I don't think the current meds are any better side effect wise.


Anonymous said...

sarabear: cold turkey klonopin can lead to seizures. not a good idea.

i am old enough to have taken all the old antipsychotics and to have been switched to the atypicals. i do not prefer the atypicals. psych says well the older drugs will give you TD. But everywhere I read about the risks of the newer drugs in elderly patients.No elderly yet but with all the side effects of the these quels and prexas and so on I don't see that I will live to such a ripe old age. No wonder we go off our meds all the time. Everyone complains that bipolar people go off their meds because they are bipolar. Sorry but no we go off for logical reasons.And then right back on when we really really have to.

Sarebear said...

How come none of my doctors ever bothered to tell me that? YIKES.

Anonymous said...

In reading this post, it did make me wonder about psychiatry in Russia today. With such a history of abuse there, even if they turned over a new leaf under the post soviet regime people tend to have long memories about stuff like that.

I am a little disturbed by the rationalizations for abuse that some people are willing to make (i.e. the journal article below is case in point -


Anonymous said...

Hi Leslie,

You might be interested in this article which mentions the author of the pdf link you provided, Richard Bonnie. You will see that it isn't surprising that he wrote what he did.

I find his attitude scary and frightening but then again, I shouldn't be surprised.

By the way, Alison Hymes, whose case I talked about previously is mentioned on this link.

As an aside, she was released from her mental health commitment to her home. Writing emails does pay off.

Anyway, that article is another reason why psychiatry will continue to have a negative image as consisting of political prosecutors.

Milo said...

I am just glad that I was not the only one who didn't like anti-psychotics.

Dinah said...

Isn't it time for a new post?