Soviet ideologists once had a hard time accepting the fact that mental illness, which Communist theory blamed on capitalistic class exploitation, didn’t disappear in the new classless society. Even today, Russian psychiatry is anchored to a search for physical rather than psychic cures to mental disturbances. Practically speaking, Freud and his disciples, with their emphasis on long-range individual therapy, can have no real place in a health system devoted to fast, mass treatment. Instead, Ivan Pavlov, the Russian physiologist who pioneered the theory of the conditioned reflex, remains the accepted master, and psychiatric care depends heavily on a variety of machines and physio-therapeutic devices. Electricity is a popular treatment for everything from schizophrenia to insomnia.
Unsurprisingly, the primary therapy is work. All but the most severely ill are given some simple task to do at their bedsides. Those less afflicted are put to work at repetitive jobs such as making shoes or artificial flowers. A patient close to recovery might get employment in a special section of an ordinary factory outside, from which he would be expected to work his way back into society.
Alcoholism, the Soviet Union’s worst social problem, is treated as a public health challenge. Given a drug which makes liquor sickening, alcoholics are conditioned by a grueling Pavlovian sequence of drink-vomit-sleep. The Soviets claim a cure rate of 40%.