Revolutionizing Cuban Psychiatry: The Freud Wars, 1955–1970

Abstract

This article traces the battle over Freud within Cuban psychiatry from its pre-1959 origins through the "disappearance" of Freud by the early 1970s. It devotes particular attention to the visit of two Soviet psychiatrists to Cuba in the early 1960s as part of a broader campaign to promote Pavlov. The decade-long controversy over Freud responded to both theoretical and political concerns. If for some Freud represented political conservatism and theoretical mystification, Pavlov held out the promise of a dialectical materialist future. Meanwhile, other psychiatrists clung to psychodynamic perspectives, or at least the possibility of heterogeneity. The Freudians would end up on the losing side of this battle, with many departing Cuba over the course of the 1960s. But banishing Freud did not necessarily make for stalwart Pavlovians-or vanguard revolutionaries. Psychiatry would find itself relegated to a handmaiden position in the work of revolutionary mental engineering, with the government itself occupying the vanguard.

Beyond ideological platitudes: socialism and psychiatry in Eastern Europe

“…In practical terms, this development translated into attacks on those promoting both psychoanalysis (Miller, 1998;Etkind, 1997) and mental hygiene (Zajicek, 2014) in favour of somatic treatments that were understood as addressing the biological origins of psychiatric illness. The infamous Pavlov session of 1950 has been portrayed as a watershed moment in this regard (Windholz, 1997;Windholz, 1999), whereby the Pavlovian concept of mental illness as a problem resulting from higher cortical structures was firmly established, later being exported to (then) friendly nations, including China (Gao, 2015), Cuba (Lambe, 2017), Romania (Dobos, 2015) and others. At the same time, Marx's emphasis on the liberating potential of labour helped propel work therapy to a position of elevated importance within Soviet psychiatric hospitals (Sirotkina and Kokorina, 2015).…”

“…1 As of yet, no consensus has formed, and scholars seem split on exactly how central the ideological climate was to the unfolding of medical practices. On the one hand, some observers underscore the political nature of mental health care within this context; for example, they draw attention to the ways that certain types of therapeutic practices might be promoted or constrained because of their imagined relationship to Marxist ideals (Chehirian, 2017;Lambe, 2017) or suggest that diagnostic practices could be heavily informed by overarching desires to pathologize certain types of anti-socialist behaviour (Eghigian, 2004;Antic, 2016). By contrast, other observers have stressed that, although mental health care was of course not divorced from the political environment, we should be cautious about overemphasising the centrality of the state's preferred ideological discourse to its practice (Joravsky, 1989;Savelli, 2015).…”