Russia 1991-1995

My first invitation to Russia came in 1991. After the International Symposium for the Psychotherapy of Schizophrenia in Stockholm, Sweden, I traveled to Russia, to present my work to the professional community in three cities. I arrived just after the attempted coup and did workshops in Moscow, Simferopol (a city near the Black Sea and part of the Crimea) and St. Petersburg. In all, I did a total of nine day workshops, three in each of the cities. The reaction was good, even though the audiences had a fair number of those professionals, who were advocates of medication as the only treatment method of worth. One can imagine the lively exchange that took place between those who believed that psychotherapy has an important place in treatment.

In the following years including 1995, I went from the most commonly visited areas to cities that foreigners were never allowed to enter, such as Chelyabinsk (the Russians built the atom bomb there) and Ekaterinburg (the last Czar and his family were assassinated there) in the Urals. Novosibirsk, Novokuznestk, Krasnoyarsk and Achinsk in Siberia. Also I was invited to do workshops in Khaborosk, Valadivostok (a large nael base), Nahodka, and Ussirissk in the Far Eastern part of the country. I have been to Russia five times, for professional purposes, staying for a month to two months each trip.

I have done workshops from one to seven days and in some of the cities my wife Ann and I were able to seed the basics of psychosocial principles of treatment, spending a month at a time in some of the cities. In these efforts, psychotherapy was emphasized as an important part of a contiguous treatment program. It appears to me that psychotherapy is not enough of a part of an integrated treatment approach in other popular and recognized programs with schizophrenic patients and with the seriously disturbed mentally ill.

It’s been an exciting and professionally rewarding experience for a number of reasons. I dealt with those skeptical professionals, by demonstrating methods, active methods of psychotherapy with Russian patients through an interpreter. I was able to make rapid contact this way with many patients.

This did indeed stimulate the interest of psychotherapists, who had been greatly restricted by the biological influences and they became increasingly responsive to the potential for making corrective behavioral changes with the long term mentally ill patient.

However, I need to point out those professionals who are firmly embedded in the belief that there is no hope for those very sick human beings and that the only treatment of any worth is the physical methods are not unlike professionals of similar leavings in all countries.

Russian hospitals are large. The typical hospital houses 500 patients. Of course they are over crowded, however, even worse, so many of the professional staff are steeped in apathy. Many are insensitive in their treatment approach. They are resentful of their heavy case loads and their low level of pay, which is understandable.

However, I was able to experience the pleasure of working with eager and curious professionals who intensified their psychotherapeutic efforts and were able to break free of some of the older physical methods of treatment. Many expressed a sense of renewed hope and are doing productive work with psychotherapy aas their treatment of choice.

I have seen some changes since 1991 and I am hopeful that more professionals will join the ranks of those psychotherapists, who are working hard to develop better health care delivery systems under the most difficult of circumstances.

Overcoming language and cultural barriers by working with Russian patients through an interpreter has been very important in demonstrating the effectiveness of attitude in the psychotherapeutic process. Hope and optimism are critically important in establishing that basic relationship between two human beings that prepares the patient for treatment.

The hard work that I and my wife Ann did in Russia has built a bridge that we hope to continue crossing as long as we can be of use. Also, we should not forget that no country has developed an optimum treatment approach to those patients who are so very often not approached because of the seriousness of their mental illness. We will continue our work with this population wherever we can.