We republish here a diary entry by Jane Haynes, a psychotherapist based in London who trained with R.D.Laing. Last spring, on a trip to St. Petersburg, Jane set out to investigate the opposition that medical psychiatry and psychotherapy face today in Russia from ‘quick fixes’ peddled by charlatans.
I am returning to St. Petersburg to give a series of lectures at the Eastern European Institute for Psychoanalytic Studies. My host is Mikhail Reshetnikov, an ex-military general and physician who persuaded Yeltsin to return psychoanalytic psychotherapy to an official status in the national medical curriculum after its demise by the Communists in 1927. Reshetnikov now presides over a stylish eighteenth century building on Bolshoy Prospect that Yeltsin gifted to him, which hosts a refurbished training institute replete with the largest psychodynamic library in Russia, a Dream Museum, and an annual intake of over 100 postgraduate students. Psychoanalysis was forcibly liquidated in the 1920’s and officially no forms of psychotherapy existed in Russia until 1975: neurosis was classified as a typical feature of the decadent West. By December 2000 there was one medical psychotherapist per one million people.
During this visit I intend to venture out from the ‘good city’ and find out whether it is true that even in the big cities like St. Petersburg and Moscow, medical psychotherapy falls far behind the collective national predilection to consult witches and mages and whether the Russian youth have become vulnerable to cults. Genuine healers come assorted and state accredited, along with all sorts of quacks and criminal charlatans, who use varied miasmatic techniques to brainwash their audiences into spending thousands of hard earned roubles for the promise of a quick fix. The Russian mentality – borne out of eternal struggle for survival – has become nationally addicted to the consoling idea of ‘a quick fix’. It seems that a new age occultism is fast becoming the religion for many Russian people. There are about 25,000 psychiatrists and psychotherapists in Russia versus 300,000 legally certified magicians and healers! There are more than one hundred state licensed schools for magicians throughout Russia.
In addition to an expanding occult industry the country is spawning more and more pseudo religious sects that are becoming increasingly irresistible to a floundering population, which is not yet skilled in the architecture of psychological individuation. Between the Russian Revolution, with its suppression of individuality, and Glasnost the average Russian had scant opportunity to develop a sense of personal agency or autonomy: the Russian personality is still adolescent in its explorations of subjectivity and the sources of self. Jesus of Siberia is not a national joke but a 42 year old prophet called Vissarion – a former policeman from Minusinsk – who claims to have 80,000 devoted followers, many of whom have followed him to an ecological settlement on an icy Siberian mountainside.
There are at least 500 different sects in Russia with well over one million followers of which the majority are young people. What disturbs – in particular – is that some of these so called new religions are commercial organisations with a ruthless focus on power rather than religion and a totalitarian mission of transforming the Russian psyche according to their own rules of political conformity.
Traditionally, Russia has been a country in which cults, correctly referred to as new religious movements, have flourished. Amongst the intelligentsia, pre-revolutionary society spawned Masonic rites, table raising séances, court orgies, theosophy and the phenomenon of Rasputin, another Siberian peasant. Rasputin, like Freud, was fascinated by hysteria and the powers of hypnosis. Freud applied himself to a theory of sexuality whilst Rasputin became an expert in sexual hypnosis. That was at the core of his impact on high society women, including the Tsarina, who were culturally susceptible to the mysterious arts of hysteria. Rasputin, like that other Siberian trickster, Vissarion, thought of himself as Christ and made others believe it as well. Both had innate origins in a cult which beckoned the Russian sexual revolution, the khlysty, a romantic sect that combined assiduous piety with sexual promiscuity. In their youth the future leaders of the Soviet intelligentsia, such as Gorky, Vladimir Mayakovsky and Lunacharsky were as influenced by Dionysian energies and Nietzsche’s vision of Superman as they were subsequently to be by Marx. In rural Russia magic and religion have always co-existed. Siberia, along with its mystical birches, has incubated generations of Shamans. Under Soviet rule it was rumoured that the KGB, scouring Russia for psychics to assist in their extra sensory perception researches, searched the forests and mountains of Siberia for mystics and children who displayed precocious psychic sensitivities. They forcibly recruited them into research projects for ‘Higher Nervous Activity’ at flagship research institutions like the Pavlov Institute in Moscow.
In a country that no longer knows what – or who – to believe in, whose people are floundering in an ideological void, there is an innate predisposition towards any authority that holds out the combined promise of prosperity and emotional containment.
Of particular relevance to my specific interests in Russian mental health is Scientology’s vast propaganda machine, which is fuelled by their generic hatred of clinical psychiatry. Of particular concern to Russian politicians should be the fact that their leafleted attacks and pamphlets carry truth in their squall. Russian psychiatric services are now at an all time low due to negligible budgets and the fact that state national insurance does not have any cover for mental health. Outside the major cities most of the acute psychiatric hospitals have reluctantly degenerated into primitive vehicles of restraint My medical colleagues tell me that in the provinces psychiatric hospitals are often deleted from the state budgets altogether. Many hospitals cannot afford modern pharmaceuticals and the older technologies like insulin, and the primitive equipment that is still being used for ECT are more likely to kill patients than cure them.
Officially banned, L. Ron Hubbard’s Church of Scientology is still alive and kicking in Peter’s great but confused city: it is alleged that its steely long arms have embraced senior Russian officials in both capital cities. Vladimir Agishev, director of SPB’s largest mental hospital has described how Scientologists disseminate huge quantities of leaflets attacking psychiatry as evil and the patients as prisoners. This is nothing new in terms of scientology’s politics but the consequences of its propaganda will be different in Russia where the current state of mental hospitals makes Chekhov’s shocking account of psychiatric care in Ward Six almost seem homely by comparison.
Arriving at my hotel the manager comes to greet me: This is my third visit this year and my eighth to his hotel. Good and bad news awaits me. The good news is that my room has been upgraded and the bad is that in the last week about forty guests have been mugged with varying levels of physical brutality. The muggings have not taken place down a cul de sac but outside the hotel whose boundaries are marked by private security and a legion of minders, who seem to turn a blind eye to everything except their bosses’ BMWs. The manager confides that it is the gypsies and that he is beginning to despair about the fate of his beautiful city, that several tour operators are threatening not to send future guests. The Astoria is one of the most beautiful hotels that I am acquainted with. Built in 1911 it was where Hitler planned to sign and celebrate his Russian victory. It is also where the revolutionary poet Eisenen slit his wrists and scrawled his dying name in blood on a banqueting wall.
Tomorrow I have plans to visit the Bekhterev Brain Institute that was established under Vladimir Bekhterev – another army general – in 1907. It was the august Bekhterev who first identified Rasputin as an expert in sexual hypnosis but his promising diagnostic perspicacity came to an untimely death after he was invited to give Stalin a consultation in 1927 and diagnosed paranoia. Surviving for only one day after this event, the Kremlin physicians diagnosed food poisoning! The Bechterev Institute is still privileged to be the country’s flagship of neurobiology and psychiatric research. After the emotional warmth, intellectual energy and aesthetic refinements of Professor Reshetnikov’s Institute, I am taken by surprise to arrive at a building, which has become so environmentally hostile that it has driven many patients to suicide and where only its most indefatigable psychiatrists have escaped, burn out.
My host Rada, Medical Director of the Outpatient Department of New Technologies, and President of the Russian Federation of Medical Psychotherapy: a man in his mid forties, with a prophetic beard that rivals his founder’s, and burning eyes, is one such triumph. Rada’s eyes, and professional devotion to finding ‘new clinical technologies’ – Russian’s are still addicted to technology – seem to me to be one of the few beacons of light and hope in a therapeutic space that has become as desolate as Sodom and Gomorrah. I find it hard to conceal my incredulity as he explains that included amongst the inpatient community there are affluent people who pay large sums of money to be here.
We pause outside a locked ward where a stern notice dictates to all inmates precisely the rations that they are allowed to bring along: all forms of salt, homemade preserves and pickles are, to my mind, illogically forbidden. As we enter I have a sensation of déjà vu: The windows are disfigured on the side with iron bars. The floor is discoloured and full of splinters. The place smells of sour cabbage, unsnuffed wicks, bed bugs and ammonia, and this picture of smells at first gives you the impression of having entered a menagerie. The words are Chekov’s but I feel as though I have walked backwards through a looking glass.
Originally the ward must have been designed to facilitate sedation through its naive deception that patients were accommodated in a country dacha, or turn of the century Swiss sanatorium. Ravaged by time and the absence of any budget for restoration, it has shrivelled into a crumbling set that has become the stage for an unintentional theatre of cruelty. Mere shades of their former three-dimensionality, personalities now wander aimlessly between nothing and less than nothing and I feel that I have entered an abode of the living dead. Most of these shadow-selves lie on their overcrowded bunks in heavily sedated and catatonic rows.
The ward psychiatrist makes a brief appearance from his internally locked office and explains, not without pride, that a policy change has been instituted whereby they no longer have any wards, just informal dormitories, but these are dormitories from hell. I still haven’t seen a nurse anywhere and I experience a sadness that extends beyond words. Whilst he is talking to me I am aware that a woman is booting his door in suspended agony, imploring entrance to discuss the fate of her suicidal adolescent. Unlike my host this ward psychiatrist, who sports a deaf ear, speaks immaculate English but his eyes are like cold fish; their only commonality exists in the animation of their cigarettes. Russian men, and they don’t even need to be psychiatrists, never seem to tire of making jokes about their addiction to smoking and its associations with oral deprivation at the Soviet Breast.
As I am led to another dormitory the psychiatrist explains that ‘These people are acute suicides and require a 24 hour watch’. Nobody there to watch them, still not a single nurse to be seen, nobody therapeutic anywhere; and besides these patients are definitely too sedated to move. The only redeeming feature is that the electro- convulsive therapy treatment room looks reassuringly non operational. One principal clinical difference between this flagship institute and the provinces must be that it still has a budget for twenty-four hour sedations.
It is no wonder that the ward psychiatrist has eyes as dead as fish, no wonder that in a society that pays its medical professors less than 200 dollars a month, he is in a crisis of existential despair. No wonder that no experiences of human suffering will ever surprise anyone who works, or tries to work here, again. No wonder at all that the Scientologists are onto a winning wicket with their anti-psychiatry pamphlets. Not at all surprising to any of my companions that I breathe a huge sigh of relief when that dreadful parody of a chalet door is unlocked again and I am reunited with Rada’s quizzical eyes and his offer of a constitutional lemon tea heavily laced with cognac. I am inspired that Russia still has philanthropically motivated doctors like Rada who, despite their profitable and thriving psycho-sexual private practices in the city’s’ centre, also continue to toil and trouble in this wasteland for a reformed vision of state mental health-care provision. As we prepare to depart Eliot’s words float into consciousness: ‘On Margate sands I can connect nothing with nothing’. This really is a world without connection.
On our way out of this baneful yet nationally prestigious institute – to which I have had privileged access – whose principal detail of aesthetic décor seems to be provided by a tracery of mice droppings, we stop at cluttered kiosk, such as you might find beside any metro station. This is the pharmacy and because medicines cost money it is attended to. It looks more like a wizard’s booth and prescriptions are clearly optional! When I ask whether the pharmacist has any Prozac for me Rada and Mikhail Reshetnikov laugh, light up, and shake their heads but they are the misinformed. Prozac she has indeed; just like vodka, cigarettes and software you can buy it cheap, even though it is a powerful mind altering drug which, when improperly imbibed, can transform depression into florid mania in a matter of hours.
The citizens of St. Petersburg make no secret of their distinction between the ‘good city’ and the ‘bad city’; tomorrow I am going to the Northern district of the ‘bad city’ to an old cinema to watch so called ‘folk healers’ perform. Remember, this is the country which, in the late ‘80s, an influential psychiatrist called Kashpirovsky transported himself into a populist hypnotist who managed to hold the nation in hypnotic thrall through the television screen.
I wake up to an autumn day that would make Wordsworth proud to be a Russian: the roads are silvered in a film of ice and my ears begin to freeze as soon as I enter St. Isaac’ Square to catch sight of a school crocodile wearing its homogeneity like an uniform. I realise that a sight of national physiognomy has become an anachronism in London where any large group of children come as assorted as Smarties. Almost all of my Russian friends found it hard to accept that my grandchildren are mixed race. Amongst the most liberal you often find that the African students – who were imported into Soviet universities – are still blamed for causing the Russian HIV epidemic, which will soon implode and explode the country’s inertia and denial into crisis. When I am in Russia my worst thought is that I will need to be hospitalised and require a blood transfusion.
Today, my translator and confidant, Lara is taking me across the city to visit a former Soviet cinema called Prometheus where we will witness the nationally esteemed folk healer Marina and her adept in crime hypnotise their audience into fiscal submission. More than a hundred, closer to two, old and not so old citizens are gathered in this derelict and unheated dump to be hypnotised into health. Soon the unbelievable will happen before my eyes as this patch-worked community offer up their hard won roubles in return for worthless talismans. I already have no doubt that this couple are neither mages nor folk healers but criminal charlatans who know how to work the collective mentality of a crowd of people whose lives have been scarred by famine, loss, sickness and multi-layered political betrayal. Most will have lost a son, or grandson – here or there – to one war, or another. But I am surprised by the absence of any attempt at presentation: they appear dressed by courtesy of a Russian equivalent of Primark. At the very least I had expected charisma with lashings of Russian soul and more smouldering eyes.
A rusty blaze of sound announces entry: there are no lighting effects, nothing to see except two drab individuals climbing onto the stage and receiving adulation and bouquets of flowers from arthritic men and women who struggle to be the first to offer their cellophaned tributes. Now I see a man and woman whose aura whiffs only of indifference and contempt. Without any attempt at folk habiliment – but lost in moth-eaten fur – the self-professed healer, Lady Marina begins to read her poetry. One ditty follows another until my embarrassed interpreter whispers ‘Frankly this is terrible poetry, let us leave’. I remind her that she didn’t bring me for the poetry but to witness a social phenomenon that happens all over Russia every day amongst a needy and neglected layer of the population which is still too confused to make a distinction between religion, cults, and collective hysteria. Marina’s companion, dressed in a polyester track suit, announces that he is the grandson of the great holy man Gramma Njura: not only can he cure his captive audience but he can also assist all the absent members of their families with his talismans. “Just like the great God Prometheus I can change your destiny.” This is something that no one in this audience, or maybe most of Russia, any longer believes that their politicians, doctors, military forces, scientists, or national security can do. Njura’s words carry seduction because their promise is of effortless gratification – the nationally longed for quick fix: rewards will be instant; or almost instant and no one needs to do anything at all because Njura possesses the spiritual key to a bio-energy to make all things possible. Energy, one should know, is the second most popular national word after technology. His rhetoric is dissolute: ‘If you haven’t heard from your grandson since he entered the army and left for Chechnya you need only sprinkle a few drops of holy water on his pillow and he will return by the end of the month.’ Sometimes they do! Most commonly as numbers.
The lights go out with a fearful hissing and we are plunged into a darkness that smells like more sour cabbage as the corrosive sounds of attempted sea rhythms now herald the climax of performance. Our polyester trickster Njura behests us to gather a citizen in our arms; to rub away grief and renew bio-energy. Rub! Rub harder and harder! The dark auditorium is alive with the electrical energy of strangers rubbing up a tornado of hysteria, delusion and denial. The light returns and I am amazed to see that the audience has been transformed: a group of cold and hungry strangers are looking towards their seducers with expectant eyes of the newborn. Can it really be so easy to hoodwink and seduce? Are these brave and resilient people who have born so much suffering, so much hunger, really going to bite the bait of illusion before my eyes? Surely such easy believers would prefer a church; but then I realise that prayer demands effort, uncertainty and patience to wait for that eternal reward and that there are no overnight guarantees on offer. In this ghastly cinema the illusion is not on the screen but in front of my eyes. Two greedy queues are forming on the stage and former hobblers appear quick on the hoof. One group are waiting to be blessed with poetry and holy water and the other group, already baptised in collective deceit, are frantically buying the talismans from the holy descendent of Gramma Njura.
The poet Osip Mandelshtam said that it was only in Russia that politicians thought that poets were worth killing. Come to think of it, during almost a century of the political suppression of agency and self, it was left to the poets to burn that counter- revolutionary candle of conscience and subjectivity. Anna Akhmatova, in her poem Requiem, which was banned until after her death, wrote: ‘Beyond the circle of the moon, I cry/Into the blizzards of the permafrost: Goodbye. Goodbye./ In those years only the dead smiled,/Glad to be at rest:’.
Can it only be in Russia – amongst the best educated people of the world – where physical existence literally depends on the acquisition of primitive survival skills, they can delude themselves that doggerel and water contain magic and bio-energetic energies that will bring back their lost boys from Never Never Land? Roubles are falling everywhere, just like the first snowflakes of the season that await me, as emotionally drained, but not financially ruined, we fall out of this corrupt atmosphere that now resounds to an Onegin chorus! During our long, ice blown walk to Lara’s home to eat blini and newly pickled mushrooms we calculate that in the course of one hour Marina and Gramma Njura probably filled their coffers to the equivalent of 1,500 US dollars, not bad for an hourly wage.
It is early evening by the time we return to the Institute for Psychoanalytic Studies and the building has warmed up; the austerity of its marble entry hall is complimented by crystal lighting. Startling nude studies recline the stairs and beckon towards the main teaching area as if to alert all those brave enough to enter that their task is to unmask psyche. The corridors are alive with the buzz of postgraduate students who have come on from their daytime employment. Fashionable looking individuals cluster out onto the pavement: despite the rigour of the freezing elements they all appear bright eyed and enthusiastic as they shed layers of outerwear and prepare to commit themselves to a seriously long evening of post- Freudian theory and applied psychoanalytic psychotherapy. Many of them are already employed as senior clinicians in mental health services, some are professors and others grown-children of the new affluent classes. Teaching is conducted in formal classrooms with blackboard and chalk.
It is only now – after the recorded events of the day – that I begin to realise how extraordinary the presence and philosophy of this thriving training institute EEPS is and how much its founder and rector, Mikhail Reshetnikov, has contributed to national psychological understanding in the last ten years. He is also a frequent traveller between Petersburg and the Kremlin where he is Consultant to the First Chamber of Russian Parliament. In November he was awarded the official title of Personality of the Year – along with the Nobel Prize winner and academician Jores Alpherov – for his services to the development of Russian psychoanalytic psychotherapy. As always in Russian politics you are either a national threat or absorbed into its mainstream: middle ground remains a neglected concept.
Later on, my lecture delivered, we warm up with vodka, obscured in a tsunami of exhaled cigar, beneath the inscrutable gaze of a lithograph of Freud’s Monday Club, while Mikhail Reshetnikov explains more to me. “I was never a conventional military man and my friends were surprised that I served for twenty-five years, but my primary contribution was to the psychology of trauma and terror. Then, I was invited by the Mayor of St. Petersburg, Anatoliy Sobchack, who was a very popular political leader, to work with him as the Chief of his Analytical Department which led on to my own idea to set up an independent institute. I was only interested if it was for the development of psychoanalytic studies. The idea just seemed to emerge out of a dream; it was 1991 and a period of intellectual intoxication: great ideas were in the air. However, when I said that I wanted to establish an institute of psychoanalysis, I was told that it was impossible. To begin with I had to compromise and it was established as the Institute of Medical and Psychological Problems and only later we changed its title to The Eastern European Institute for Psychoanalytic Studies. Fifteen years ago psychoanalysis was unknown to Russian medical psychotherapists and psychiatrists but now it would be impossible to have a psychotherapy conference without its presence as an academic discipline.”
Over dinner other colleagues explain to me that it is no longer the authorities that pose a threat to the expansion of psychoanalytic psychotherapy in Russia but the collective mentality, which has become addicted to the idea of ‘a quick fix’. Russians are weary of waiting and this contributes to a national predilection for magic and the seductive uniformity of cults where everyone knows what they must do next to maintain the promise of equilibrium. My colleagues express gratitude that I have strayed beyond the civilised confines of the Institute to see the nether belly of their city. They explain that they sometimes find it difficult to reconcile themselves to classical European techniques of psychoanalytic psychotherapy that were not sculpted out of a psychology of famine, and the other unique political pressures and crises of identity that a vast proportion of the Russian population – those who are neither the poorest nor richest citizens – are heir to. Growing more confident, these accomplished Russian professionals are also becoming determined to combine their desires for international clinical fertilisation with a distinctly Russian passport that will also address itself to the cultural specificities of the superstitious Russian psyche. It is inspiring for me to observe – each time I return – more and more graduate psychotherapists have set up shop in svelte clinical consultation centres.
Psychotherapy – under Reshetnikov’s influence – has already become a profitable and desirable profession with accredited qualifications that reflect European standards. Its skilled practitioners are still busy competing with national predilictions for occult alternatives that state registered quacksalvers continue to peddle but in St. Petersburg it is turning into the preferred treatment for alienated and impoverished professionals and the ‘New Russians’ alike.
I do not want to leave this extraordinary environment and go home. The only compensation is that I will stop smelling like the Russian equivalent of Galloise and will have to give up the appealing habit of cleaning my teeth in vodka.
Postscript, by Jane Haynes
I first went to Russia in 1994 as part of an official Jungian Training Programme set up by the Society of Analytical Psychology in London, and which operated under the aegis, but was not a part of, the Eastern European Institute of Psychoanalysis in SPB. I have never felt an official part of any organisation and indeed find the competing worlds of psychotherapy like the Tower of Babel, a confusion of authorities. My first lecture, which was given with the aid of a translator who became my friend, and is referred to as the companion in my essay was titled ‘Who is it that can tell me who I am?’ The Rector of the Institute happened to pass by the lecture room and decided to stay and listen. His response to the lecture, which has subsequently turned into a book, was to comment that for the first time in living history the Russian population had the opportunity to openly pursue Lear’s quest for ‘individuation’. As a result of this I was invited to join the consultant staff of the institute with the freedom to speak in a Jungian, Freudian, Bakhtin Dialogic, or any other ‘tongue’.