The psychiatrist and political dissidents.

Healthy dissidence is part of the stuff of politics but when does health break down into ill health and how does that ill health manifest itself? In violence, street riots, anarchism, terrorism, revolution, civil war, or in forms of deviant thought and behavior that may be regarded as manifestations of mental illness? The term dissenter came into being in 1639 to describe individuals who separated themselves from the Established Church of England and for three centuries the religious connotation was generally accepted. Dissent was a matter for the churches, although it was well recognized over this period that dissent might at times overstep the boundaries of reality and become a form of "religious mania" requiring the assistance of the psychiatrist. Delusions of a religious nature were remarkably common in an age of religious fervor and of religious doubt but I am not aware that the psychiatrists of the period were accused of using their subject to incarcerate what may easily have been regarded by the public as religious dissenters. It was to be over three hundred years before the psychiatrist became involved with religious dissent. You, in this country, are more familiar with this matter than most of us outside the United States. My own first contact with one particular group was made at the VI World Congress of Psychiatry in 1977 in Hawaii when, as Secretary General of the World Psychiatric Association, I was approached to speak against the sinister role of psychiatry in the opposition to such groups. Previously I had been hounded by members of another group at one of our regional meetings, although later informed that I had been "pardoned for my crimes" by an American fellow group. Contemporaneously with the emergence of the psychiatrist in relation to religious dissent, over the last twenty years the psychiatrist allegedly has assumed an even more sinister role politically. The growth in the use of psychological warfare and its success during World War II and the startling effects of the thought-reform techniques used on prisoners of war in Korea led to a surge of military interest in the use of the psychiatrist in situations other than his or her traditional role as a doctor, preventing or healing mental disturbance. A new era began in which he or she was to be employed in dealing with the political dissidents who had taken up violent struggle in their cause the terrorist or freedom fighter the adjective depending on one's allegiances. The themes and techniques of sensory deprivation and of Pavlovian psychology were now applied, particularly to interrogation procedures. This was, as it were, the acute situation, aimed at extracting information as quickly and as expeditiously as possible from a suspected dissident, ending once the information had been obtained. But about the