Sterility and suggestion: Minor psychotherapy in the Soviet Union, 1956–1985

Abstract

This article explores the concept of minor or general psychotherapy championed by physicians seeking to popularise psychotherapy in the post-Stalin Soviet Union. Understood as a set of skills and principles meant to guide behaviour towards and around patients, this form of psychotherapy was portrayed as indispensable for physicians of all specialities as well as for all personnel of medical institutions. This article shows how, as a result of Soviet teaching on the power of suggestion to influence human organisms, every interaction with patients was conceptualised as a form of psychotherapy, leading to the embrace of placebo as a legitimate form of therapy, and to the blurring of the boundary between therapy and other activities in the clinic. The principles of minor psychotherapy reveal a concept of psychotherapy that is much wider, and rooted in different priorities, than the dominant understanding of this type of treatment found in Western Europe and North America. This article addresses the ethical principles implicit in the Soviet perspective, demonstrating that despite fighting against the uncaring and dismissive attitude of other physicians, Soviet psychotherapists remained rooted in the paternalistic tradition. Finally, it traces the efforts to establish minor psychotherapy as standard practice in medical institutions, which, like many other plans and ambitions of Soviet psychotherapists, were constrained by a lack of resources in the healthcare system.