Intellectual perestroika and Russian neuropsychology.

During a recent visit to Russia, I learned that Alexander Luria's laboratory is still very active. The 9 doctorate level psychologists, led by Tatiana V. Akhutina, pursue an "in­ tuitive ... artful and qualitative" approach to syndrome analysis (Homskaya, in press). I was surprised to find, however, that there has been a competing approach to neuropsychology in Russia since the 1920s. During my visit to the Bekhterev Institute for Psychiatry and Medical Psychology at St. Petersburg, it was brought to my attention by the three neuropsychol­ ogists at the Institute that complete acceptance of Luria's method at the Institute had never been achieved. They and their predecessors had developed a quantitative ap­ proach to brain dysfunction evaluation partially based on the theories of Bekhterev (Health Ministry, 1989). The question of why this psychometric approach is not known outside the former Soviet Union is an interesting one. The Bekhterev Institute has not enjoyed the politi­ cal support of the more centrally located and politically correct laboratory of Luria. However, to imply that Luria did not suffer from political control would be incorrect. Indeed, Luria narrowly escaped incarceration; after he left the Genetic Institute all professional members of that organization were jailed. However, he managed to avoid further major political complications (Homskaya, in press). Bekhterev, in contrast, was much less politically cor­ rect. It is well known in Russia that Bekhterev was Sta­ lin's neurologist and psychiatrist during his ascension to power in the Communist Party. Recent evidence discov­ ered by Popov (1992), now head of the Bekhterev Insti­ tute, suggests that Bekhterev may have been poisoned by Stalin. On the morning of December 23, 1927, Bekhterev examined Stalin. Later that afternoon, at the gathering of the first meeting of the All Union Federation of Neu­ rologists and Psychiatrists, Bekhterev made allusion to having just examined a "paranoiac," though no specific mention of Stalin was made. Later that evening while watching the Bolshoi Ballet, he consumed two "specially" made ice creams. Within hours, Bekhterev was dead. Since that time, not only the center of political but in­ tellectual power has been Moscow. The Communist Party required that all published materials meet specific ideol­ ogy and that certain schools of thought were more fa­ vored than others. At the 1936 Congress of Psychology, the government formally proclaimed that psychometric tests were not supportive of Marxist philosophy and, therefore, would be not be used in the Soviet Union. The focus on this commentary is not to detract from the importance of Luria. However, intellectual peres­ troika has clearly shown that Soviet or Russian neuropsy­ chology encompasses more than Luria's work. The two extremes in neuropsychological evaluation have been tra­ ditionally considered to be the North American and So­ viet approaches. In reality, the approaches developed in Bekhterev's and Luria's laboratories appear as diametri­ cally opposed. Historians of the discipline may have been hasty in relying on the works of Luria and the seminal ar­ ticle by Majovksi and Luria (1977) to arrive at an incor­ rect understanding of Russian neuropsychology.