Diagnosing Literary Genius: A Cultural History of Psychiatry in Russia, 1880-1930

3 Tolstoy and the Beginning of Psychotherapy in Russia

t h r e e Tolstoy and the Beginning of Psychotherapy in Russia A patient of sanguine temperament, from a quiet ward. The patient is obsessed by mania that German psychiatrists term Weltverbesserungswahn. His madness consists of believing that it is possible to change the life of others by a word. General symptoms: dissatisfaction with the existing order, accusation of everybody but himself, and an irritating talkativeness without paying attention to his listeners . Frequent transitions from anger and irritation to unnatural weepy sensitivity. Specific symptoms: doing unnecessary and inappropriate jobs: cleaning and cobbling shoes, mowing hay, and the like.Treatment: complete indifference of others to what he says; occupations that would absorb the patient’s spare energy. —Case Records of the Inhabitants of Yasnaya Polyana, Case record no. 1 (Lev Nikolaevich) In biographies and memoirs, Lev Nikolaevich Tolstoy’s (1828–1910) sound mind and robust health became almost emblematic. D. S. Merezhkovskii, in his influential essay L.Tolstoy and Dostoevsky (1902–3), juxtaposed Tolstoy’s “soundness” and Dostoevsky’s “sickness” as two spiritual poles;Stefan Zweig perceivedTolstoy as an embodiment of physical and spiritual strength.¹ Nonetheless , because of his untamed nature, Tolstoy’s sanity was questioned. His literature, philosophy, and everyday life went beyond any ordinarily conceivable standard and did not fit ready-made classifications.The issue became prominent especially when in the late 1870s Tolstoy, as his contemporaries perceived it, suddenly stopped writing belles lettres and began to philosophize .He provoked the anger of many opponents:the government held him to be a revolutionary; the Church excommunicated him for preaching his own version of Christianity; the radicals criticized him for not going far enough in opposing the regime;and literary circles reproached him for abandoning literature in favor of moralizing. As with Nikolai Gogol,psychiatrists followed the lead taken by critics and provided a medical diagnosis for Tolstoy ’s “disorder.” Yet, again as with Gogol, their views differed. Some perceived Tolstoy as neurotic, others argued that he possessed the supreme sanity of a genius. Tolstoy, in both word and deed, “fought back.” When his critics pronounced him insane, he pronounced the whole world “mad.” For many of his contemporaries, his criticisms of existing society and his positive teachings were more powerful than those of his opponents. Physicians, including psychiatrists,were not spared from feeling the effects of Tolstoy’s philosophy, literature, and reformed way of life. Some of them even used Tolstoy’s life philosophy in their own struggles with therapeutic nihilism and custodial psychiatry and in support of the introduction of psychotherapy and psychoanalysis . The social space in which psychotherapy developed, in Russia as elsewhere, was provided by private “nervous clinics” and “nervous sanatoria ,” which proliferated at the turn of the century. Though many of these institutions had a commercial purpose, some physicians saw nervous clinics and sanatoria as the places in which to practice a simple,industrious,and spiritual communal life in accordance with Tolstoy’s late ideals. Together with numerous followers of Tolstoy, psychiatrists penned tributes to the writer, praising him as “a great psychologist,” a master in the portrayal of psychological conflicts and their cure.“The purification of the soul,” which Tolstoy preached in his literary and philosophical work, became the creed of a new generation of psychotherapists.Through the career of Nikolai Osipov,a pioneer of psychotherapy and psychoanalysis in Russia, we can trace Tolstoy’s influence well into the 1930s,by which time many of that generation of psychiatrists had left the country and, like Osipov, lived and worked in exile. Tolstoy’s Neurosis When, in 1897, Cesare Lombroso arrived in Moscow for the Congress of Physicians, he asked Tolstoy’s permission to see him in Yasnaya Polyana.The Moscow authorities, however, made it clear that the government would not be pleased with a visit to the disfavored writer, so Lombroso had a converTolstoy and the Beginning of Psychotherapy in Russia 75 sation with the general charged to persuade him not to go.When Lombroso rejected all the arguments, the general made one last attempt, asking, “Don’t you know that Tolstoy’s head is not all right?” But Lombroso,as he reported, immediately turned the situation to his own benefit: “That is why I want to see him: I am a psychiatrist,” he said, to the general’s delight.² The official attitude towards Tolstoy worsened when the writer stopped...