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'Psychiatry, ' wrote Giliarovsky (one of the leading psychiatrists in the U.S.S.R.) some years ago, 'more than any field of medical science, reflects the social atmosphere in which it develops: it can be said that each epoch has its own kind of psychiatry.' A change in economic structure, he contended, affects the science of psychiatry, the methods of the psychiatrist, and the mind of the patient, each in distinctive ways. 'We can even see', said
Giliarovsky, 'in the very minds of our patients the reflections of profound social upheavals, the reflections of the class struggle in psychiatry. There has always been a general expectation among Soviet psychiatrists that something new and distinctive was bound to develop in their own science' (page 129)
This book is a conscientious and exhaustive report on these 'new and distinctive developments'. Dr. Wortis worked through the whole available Russian literature on psychiatry, and every one of his details is substantiated by an exact quotation. His book consequently can be considered as an authoritative source for the study of Russian psychiatry up to 1950. His approach, though not uncritical, is mainly sympathetic. Perhaps this is the reason why both he and his publisher had to write a kind of apology to preface the book.
The picture of Soviet psychiatry as it emerges from the reading of this book is puzzling indeed. On the one hand there are undeniable signal successes, such as the efficient dealing with the vast problem of criminality and delinquency after the devastations of the Civil War, the amazingly low figures of psychiatric morbidity, the elaborate and apparently competent service of rehabilitation of psychiatric patients, etc. On the other hand one is struck by the alarming superficiality of the case histories and the almost complete absence of psychotherapy in the Western sense, as revealed in this book.
One reason for this paradoxical situation is the present stage of Soviet theory about man's place in