THE PROFESSIONALIZATION OF RUSSIAN PSYCHIATRY: 1857-1911

This study is an historical sociological analysis of the professionalization of Russian psychiatrists during the late imperial period. It focuses upon the strategies adopted by psychiatrists in their attempt to gain control over the asylum and formal acknowledgment of their superior judgment in all matters pertaining to the diagnosis and management of insanity. It attempts further to account for their limited success in achieving those goals. Throughout the nineteenth century the situation of Russian psychiatrists differed little from that of their western colleagues. However, in the early twentieth century, public policy in Russia toward psychiatric institutions put drastic limitations on the implementation of the asylum solution and ultimately rendered the position of the psychiatric professional untenable. On the one hand, the asylum was rejected as the only solution to the problem of the chronic harmless insane. Most of the alternatives suggested would have placed mental patients in somatic hospitals. This development put psychiatrists in direct competition with nonpsychiatric physicians. On the other hand, as political threats to the Russian autocracy mounted, the asylum was blatantly incorporated into the tsarist network of police institutions. As a result the forms of physical and mechanical restraint usually associated with prisons were introduced on a large scale into the mental hospital. This effectively placed the psychiatric profession in a position of competition with the police. In contrast to their western counterparts, Russian psychiatrists faced significant competition from two sources: other social controllers and other physicians. They responded to this competition and to the new institutional arrangements which were thrust upon them by attempting to redefine their role. That endeavor was largely unsuccessful, a reflection of the weaknesses of their resources. The political radicalism of psychiatrists immediately prior to World War One was largely the result of their inability to resolve the dilemma delineated above and the internal structure of the profession. Events of 1905 forced psychiatrists of moderate political persuasions to choose between an older generation of politically reliable asylum directors, many of whom lacked training in psychiatry, and a group of youthful, articulate, scientifically trained professionals whose political views were more radical. Many sided with the latter, albeit initially on an issue that was only indirectly political. After 1905, actions taken by the government against psychiatrists and psychiatric institutions completed the politicization of the profession and ensured its movement into the camp of the opposition