Early in 1983, the All-Union Society of Psychiatrists and Neuropathologists, the national association of Soviet psychiatrists, announced that it was quitting the World Psychiatric Association. It was widely viewed as a preemptive move: The Soviets had been censured at the last international congress for the systematic abuse of psychiatry for political purposes -- specifically for using vague diagnostic categories to confine and punish dissident citizens -- and a campaign was under way in the United States and in England to suspend or expel the Soviet psychiatrists from the world body.
In "The Mind Palace," novelist Steve R. Pieczenik has borrowed these facts about the misuse of Soviet psychiatry and transformed them into an intriguing element of plot. Indeed, Pieczenik, a psychiatrist himself and a former State Department official, has borrowed freely from what is known about current Soviet psychiatry. He has taken Kashchenko Psychiatric Hospital, a prestigious Moscow research hospital, and placed at its head a preeminent psychiatric theoretician, here called Dimitry Zoubok, the originator of the diagnostic system that is causing the Soviets so much trouble.
Western critics are arguing that one of Zoubok's diagnostic categories, called "sluggish schizophrenia," lends itself to political abuse; it is a mild, vaguely defined illness, the symptoms of which might include nonconformity, "reformism" or anti-Soviet activity. As a result of this criticism, an intense research effort is under way, headed by biological psychiatrist Alexsandr Borisov, to find a medical test that will prove conclusively the validity of Zoubok's diagnostic scheme.
All of this is pretty much the actual state of affairs in Soviet psychiatry today, which is not to suggest that Pieczenik is a mere reporter. He recognizes considerable ambiguity in the facts, and he puts that ambiguity to good use here in crafting a compelling tale of political gamesmanship. Borisov has made a successful career as a clinician and researcher, but he has become something of a psychiatric imperialist who sees human minds as nothing more than material for his research; he has already killed more than one hapless patient in his overzealous effort to demonstrate the effectiveness of his dubious insulin coma therapy.
All of this changes when Natalya Nikitchenko, a beautiful and willful actress and wife of a high Soviet official, is admitted to his care at Kashchenko, diagnosed by Zoubok as a sluggish schizophrenic. Is she? She is argumentative, manipulative, bohemian in her life style. And she is paranoid -- unless the delightfully malignant Leonid Donskoi of the KGB is really out to get her. And she is clearly delusional, because if not it means that Anatoly Sukhumi, the immensely popular general secretary of the Communist Party, has been murdered.
These are the questions Borisov sets out to answer, and in doing so he becomes entangled in a political power struggle involving the highest level of government. He becomes entangled, too, in a close self-examination, and in place of the conditioned Soviet citizen he thought he was he finds an unpredictable spirit, one capable of falling in love with the hysterical Natalya, planning an ingenious escape and evading pursuers from Moscow to Tbilisi.
The cultural trappings that provide the background for this action will be familiar to fans of the genre: the cramped housing, the ubiquitous paranoia, the black market, icons, alcoholism. Pieczenik knows his territory, and in the tradition of Martin Cruz Smith's "Gorky Park," he brings it to life. But Pieczenik's added strength is his insight into the riddle of Soviet psychiatry and into the peculiar psychology at work in a closed society.