The extraordinary case of Russian performance artist Pyotr Pavlensky: Psychopathology or contemporary art?

Abstract

This article examines the psychiatric and political issues surrounding the case of the controversial Russian performance artist Pyotr Pavlensky, who received a number of court-ordered psychiatric evaluations as part of the legal actions initiated subsequent to his political protest actions. The author presents the results of his own clinical investigation into Pavlensky’s case, arguing that previous diagnoses made by psychiatrists were unwarranted and unreasonable. This case draws the attention of experts to a problem: the need for more accurate criteria for the differentiation of behavioral disorders from behavior understood locally as socially-deviant. This issue is especially relevant during the assessment of the mental health of persons engaged in socially transgressive behavior which is explicitly framed as aesthetic and political action.

Keywords

behavioral disorders contemporary art diagnostics performance postmodernism psychopathology Pyotr Pavlensky

Introduction

Contemporary psychiatry has recently begun to face the challenges of the postmodern condition. Diagnostic principles that are at the basis of identifying psychiatric and behavioral abnormalities increasingly come into conflict with norms and values deemed acceptable in a variety of individual lifestyles and subcultures (Bracken & Thomas, 2001; Bryukhanov, 2013; Kecmanovic, 2009; Mendelevich, 2000, 2004; Musalek, 2008; Petho, 2008; Vlasova, 2014; Vygonsky, 2001; Whitley, 2008). While postmodern societies are tolerant of many forms of behavior that were unacceptable and even viewed as pathological in the past, psychiatry has sometimes been slow to integrate changes in public attitudes and norms.

These challenges are heightened by the parallel process widely described by sociologists and anthropologists as the “psychiatrization” or “medicalization” of everyday life (Conrad & Schneider, 1992). In a narrow sense, medicalization refers to the framing of any human condition or behavior as a medical problem, requiring intervention and solution (Boyazitova, 2007; Dobrorodny & Chernyak, 2012; Lekhtsiyer, 2006; Medvedeva, 2012; Michel, 2011). As medicalization expands to domains fraught with social ramifications, the process has notable effects on the daily clinical work of psychiatrists, and on the validity of reports of court-ordered medical exams, with significant consequences for so-called patients. Particular diagnostic challenges may emerge in settings where psychiatrists are asked to evaluate socially transgressive behavior that is explicitly framed as aesthetic and political action.¹

Over the past several years, we have found these issues playing out in particularly significant ways in the domain of psychiatry in Russia. It is in this regard that the case of performance artist Pyotr Pavlensky is worth examining in detail. Over the past several years Mr. Pavlensky’s “art actions” or performances have attracted wide public attention in Russia and elsewhere. Domestically, his actions have caused significant controversy, leading to several court orders for his psychiatric evaluation. The artist has oftentimes performed while naked in order to, as he put it, “protest against unfair government oppression of freedom of personal creative expression” (Beliaeva, 2016, n.p.). Mr. Pavlensky’s performances have included acts of self-harm, such as nailing his scrotum to the pavement, cutting his ear lobe, or sewing up his mouth. His colleagues, including leading art critics, artists, writers and journalists, have argued that Pavlensky is a talented artist and that his actions must be regarded as a form of contemporary art (Gusarova, 2013; Kandaurova, 2015; Stadnikov, 2014; Stolarov, 2015). For example, Aleksandr Skiperskikh, an expert in “protest discourse” in contemporary Russia, argues that Pavlensky’s behavior should be viewed as a political performance which is “an original and direct response to the actions of authorities, and which circumvents the framework of existing institutions and mechanisms specially created for this purpose” (2015, p. 34). However, from the point of view of the Russian government, members of the judiciary, and many laypeople, Pavlensky is a hooligan, an extremist, and someone in need of psychiatric help (Kandaurova, 2015; Lukina, 2015; Sergeyeva, 2015; Stadnikov, 2014).

The core of Pavlensky’s art practice is his performances which “turn streets and squares into canvas, and auditorium and stage merge, the audience can participate in the performance, and as a rule, become engaged without realizing it” (Nesterenko, 2015, n.p.). These performances are documented through photographs and video, which can subsequently be exhibited and viewed. Over the past few years Pavlensky has staged a number of politically-themed performances titled, respectively, “Stitch,” “Carcass,” “Fixation,” “Freedom,” “Separation,” and “Threat.”

In the performance “Stitch” (2012) Pavlensky protested the trial of the punk group Pussy Riot by stitching his own mouth closed with a thick thread and picketing alone for an hour and a half near the Kazan Cathedral in St. Petersburg, holding a sign which read, “Pussy Riot’s performance was a remake of Jesus Christ’s performance.”² “My stitched mouth became my personal transgression,” Pavlensky said, adding that “The trial of Pussy Riot deeply affected me. I considered it as an attack against art, and expected a dignified response from artists. But they only talked the talk. I stitched my mouth shut because the trial of Pussy Riot was a demand to shut up!” (Gusarova, 2013, n.p.). Pavlensky went on to say,

It was interesting to do some of these performances on government territory—so that the authorities wouldn’t like it, but also wouldn’t know what to do with you. I began to develop this theme and tried to create a metaphor with a minimum of tools, using my body. I was in a mental state of fearing that I won’t preserve my personality or capability of doing anything if I don’t respond to what was going on.

Pavlensky added that, “I don’t behave like that in regular life; I am a quiet person” (Gusarova, 2013, n.p.).

Pavlensky’s performance “Carcass” (2013) was staged outside the Legislative Assembly building in St. Petersburg. Pavlensky’s assistants placed his naked body, wrapped in a multilayered “cocoon” of barbed wire, at the building’s entrance where he lay still, not reacting to the comments or actions of passers-by. Police removed him from the barbed wire by cutting it away. His partner Oksana Shalygina declared that “the performance symbolizes the existence of a person in the repressive legal system where any movement causes a cruel judicial reaction digging into the individual’s body. This is a metaphor for animal submission, the ‘learned helplessness’ of a person impounded by the government machine” (Denisova, 2015a, n.p.). Shalygina further noted that the performance’s metaphor was immediately implemented in reality: “As soon as the barbed wire was literally cut away from the artist’s body, the same wire symbolically dug into his body in the form of policemen, emergency care personnel and field investigators” (Denisova, 2015a, n.p.).

Perhaps his most sensational performance, “Fixation” (2014) was staged in Red Square by the Kremlin’s walls. Naked, Pavlensky nailed his scrotum to the stone pavement. This is how he explained his performance: “A naked artist looking at his testicles nailed to the Kremlin cobblestones is a metaphor for apathy, political infantilism, and the fatalism of modern Russian society” (Beliaeva, 2016, n.p.). Pavlensky’s performance “Freedom” (2014) was staged at the Malo-Konyushennyi Bridge in St. Petersburg, and reflected what he called a “reconstruction of Kyiv’s Maidan” (Beliaeva, 2016). Pavlensky and his colleagues set afire tires and beat on metal sheets with sticks, creating what he called “sounds indicative of the Kyiv Maidan”³ (Beliaeva, 2016). The performance, in the words of organizers, was an expression of collective political liberation.

The performance “Separation” (2014) was staged at the fence of the Serbsky State Scientific Center for Social and Forensic Psychiatry, where Pavlensky cut off a part of his ear lobe.⁴ He explained it this way:

A knife separates the earlobe from the body. A concrete wall of psychiatry separates society from rational and crazy patients. By bringing back psychiatry for political purposes, the police apparatus retains its power to define the line between intelligence and craziness. A bureaucrat in whites, armed with psychiatric diagnoses, cuts from the society pieces that prevent him from setting up a monolithic diktat of mandatory norms. (Beliaeva, 2016, n.p.)

Pavlensky staged his performance titled “Threat” (2015) at the entrance of the FSB (Federal Security Service) at Lubyanskaya Square in Moscow, where he set the door afire and stood peacefully in front of it, holding in his hands a petrol can and awaiting his own arrest. The artist explained the essence of his performance this way:

The burning door of Lubyanka is a glove that society throws in the face of terrorist threat… Fear turns people into a clingy mass of separate bodies. The threat of inevitable violence hangs over each of those who is located within reach of monitoring devices overhearing their conversations, and within borders of passport control. (Beliaeva, 2016, n.p.)

Within artistic circles, these actions are understood as a form of performance art in which the actions of an artist or an artistic group, in a certain place and time, comprise a work of art. Unlike other forms of art, such as painting or sculpture, performance is characterized as any situation that includes four basic elements: time, place, the body of the performer, and the attitude of the artist and audience (Gnirenko, 2014; Sergeyeva, 2015). In describing his performances, Pavlensky argued that the “democratization of art has happened, and has led to many forms of art, for instance, classical paintings, losing their relevance. Artists began to search for new forms of expression” (Delphinov, 2015, n.p.). Writer and cultural critic Denis Dragunskiy, who highly values the artistry of Pavlensky’s performances, argues that “art does not mean only ‘likeness and beauty,’ but also ‘pain and disgust,’” adding that “[a]rt is always, even at decent times, a little bit of a shock” (2013, n.p.). Vladimir Nesterenko (2015) has raised the question of how distinct modern performance is, as an art form, from hooliganism, revolution, or uprising. In his words,

The borderline between art and hooliganism is located in the area of another person’s nose. If an artist waves his hands in dangerous proximity to someone’s nose, then it is a provocation. As soon as the first blow is made and blood starts to flow, the art ends. (Nesterenko, 2015, n.p.)

Pavlensky himself has stated on many occasions that “in all his performances no one was victimized except for himself—if the word ‘victim’ can be used at all” (Nesterenko, 2015, n.p.).

Pavlensky’s performance “Threat” provoked many comments—many of them negative—from outside the art world. For example, the director of the Moscow Helsinki Group, Lyudmilla Alexeeva, wrote, “I flatly condemn his action. If it is a performance, then it is an idiotic one. Imagine if the fire had prevented the evacuation of people inside the building, and they had families and children. What if those people burned to death? He needs to be examined by medical doctors. A normal person would never come with an idea of such a performance” (Lex, 2015, n.p.). In Eduard Limonov’s opinion,

Pavlensky is a successor to Herostratus and Malevich. He tried many times and finally succeeded. I consider it a certain demonstration of art perversion. It is produced as a performance, no doubt about it. In the past he crippled himself, and now he suddenly turned against the state. His motivation is exceptionally political and he has to be persecuted as a foreign saboteur. (Limonov, 2015, n.p.)

Pavlensky’s court-ordered psychiatric evaluation was said to be justified by the inappropriateness of his behavior (from the investigators’ point of view), on one hand, and on the other hand, by the fact that Pavlensky had been monitored by psychiatrists and given clinical psychiatric treatment in the past.

The issue of Pavlensky’s performances as relevant political comment and the need for his legal psychiatric evaluation was intertwined with investigators’ refusal to consider his performances as a form of art. Here is an excerpt from Pavlensky’s conversation with an investigator:

Investigator: … I have nothing against art. And our government has nothing against art. This is not the nineteen eighties any more. This is not the Soviet Union. However, you have to distinguish between art and illegal actions.

Pavlensky: In reality there is no borderline – “illegal actions” is just rhetoric in which they try to wrap art.

Investigator: Come on, stop talking about art, especially political art. Let’s not mix good art with shit.

Pavlensky: What do you mean by art?

Investigator: Art as part of life.

Pavlensky: Art is visual codes, that’s what we work with.

Investigator: Only you can consider this action to be art; all other people consider it an act of vandalism.

Pavlensky: Other people should be asked about it; there are many people and many opinions. The media have already agreed that this is a work of art. It is contextualization, the transfer of context in information and in a symbolic field. (Pavlevsky, 2014, n.p.)

Duma Deputy Vitaly Milonov (who at the time was a member of the Legislative Assembly of St. Petersburg) publicly expressed this about Pavlensky’s psychiatric health:

He needs to be treated [as a psychiatric patient], not to exhibit [as a performance artist.] The government and society must take good care of him because his actions demonstrate that he is dangerous. He harms himself—cuts his own ears, and tomorrow he will chop off his head. This is a relapse of suicidal syndrome or paranoia… Psychiatrists who refuse to diagnose his insanity, who are affected by modern trends, they have probably contracted the illness. It happens to psychiatrists that they become weird. (Sukhorukov, 2014, n.p.)

The Russian Minister of Culture Vladimir Medinsky agreed with this opinion, recommending that information about Pavlensky be added to the museum of medical and psychiatric history (Sneider, 2016).

As we describe in detail below, over the course of the several years during which he enacted his controversial performances, Pyotr Pavlensky was subject to a number of psychiatric evaluations, several of them court-ordered.

Case history and evaluation of Pyotr Pavlensky

The following account is primarily based on a clinical evaluation of Pyotr Pavlensky conducted by the author (with Pavlensky’s consent)⁵ on October 8, 2014, via Skype. During the evaluation Pavlensky was in St. Petersburg. Where necessary, the evaluation has been supplemented with reference to other published interviews and files from Pavlensky’s medical records.

Personal history and medical background

Born in Leningrad in 1984, Pavlensky’s early development was without any peculiarities. He started schooling when expected, was a good student, and participated in sports. In high school, he lost interest in his studies, frequently missed classes, and clashed with teachers. He switched from one school to another twice, then dropped out after the ninth grade, and subsequently passed the 11th grade through evening school. Starting at age 16, he episodically used psychoactive substances (hashish, cocaine, LSD, mushrooms), and used heroin for two years. In Pavlensky’s words, he “wanted to try all narcotics.” Since 2002, he has completely stopped using narcotics, remarking that he was “ending the narcotics experience and starting an educational one.” He worked as a laborer, and did not serve in the army.

Asked about his relationship with his parents, Pavlensky explained that he:

[N]ever had close contacts with my parents. I was an independent child. Till the age of 17 I spent a lot of time on the street, visited rave-clubs on weekends, [and] often was in trouble until I realized that it didn’t make sense to live like that, and [that] I needed to get in shape and evolve. My mother was a nurse at that time, but is now retired. She was always neutral about my interests, and we never discussed my performances. But my father directly influenced what I do now. He was a regular Soviet citizen—he kept a low profile, and did his best to keep comfortable relations with the state. He worked as a senior science specialist at a research institute, and when Perestroika began, he accepted it as a given. Peaceful, secure conditions were most important to him—he didn’t want any challenges. As a result, he became an alcoholic and died at the age of 49, choking on a piece of raw meat. I am grateful to him for that, really. It can be said that he sacrificed himself in order to show how you must not live. He is a symbol of human weakness to me. I often think how he would behave—and [in response,] act the other way around. All my performances are about overcoming myself and my fear of the system. (Levkovich, 2015, n.p.)

Psychiatrists first came into contact with Pavlensky in 2002 when he was 18, and he voluntarily admitted himself to a psychoneurological dispensary in St. Petersburg and underwent an in-patient examination and treatment there. During the admission he complained about emotional imbalance, irritability, excitability, insomnia, and nightmares. Pavlensky linked his mental problems to the effects of narcotics. He did not exhibit any psychotic disorders or suicidal thoughts. While an in-patient, he first quarreled with other patients for several days, and reacted with irritation to the medical staff’s criticism. Later he became calmer, his mood more stable, and he started to sleep better. He was at the in-patient facility for one month, and was diagnosed with an “Emotionally unstable personality disorder (ICD-10: F60.3), with poly-drug use in his medical history.” After he was discharged from the in-patient facility, his out-patient monitoring began. However, he has never been subject to regular medical check-ups.

In 2004, Pavlensky entered the St. Petersburg Stieglitz State Academy of Art and Design in the Faculty of Design, and in two years transferred to the Faculty of Monumental Art, simultaneously, studying at the School of Modern Art. He discontinued his studies at the Academy during his fifth year. He explained that even working on a graduate paper at an art school contradicted his beliefs about how to become a real artist. Since that time, he started to lecture and lead seminars on modern art. He was invited as a lecturer across Russia and abroad.

He has not legally married, but lives with his civil wife and partner Oksana Shalygina and their two young children. According to Shalygina, he “loves kids very much and spends time bringing them up.” His neighbors and relatives characterize him positively. Relatives describe him as “quiet, calm, polite and agreeable.” He does not smoke or use alcohol. He, his wife and children are vegetarians. The family’s apartment lacks practically any furniture and window curtains. The members of his family sleep on the floor, walls are scuffed, and there is no shower in the apartment (Denisova, 2015b). However, the apartment does not appear dirty or rundown.

Shalygina is Editor-in-Chief of the magazine “Political Propaganda” where she, along with Pavlensky, researches the phenomenon of “political art.” She also organizes her own art performances. Both Shalygina and Pavlensky deny the institution of marriage and monogamy in general. They both say that they have relations with other sex partners: “It is impossible to have a relationship based exclusively on sex, it is not interesting or fruitful and impedes work,” Pavlensky says, adding that “a person who shares our ideas and who is our friend can enter our close circle. We don’t use the notion of ‘family’ because it is a socio-political construct that means possession and rejection of freedom of will. We call it a ‘close circle’” (Denisova, 2015a, n.p.). Despite the couple’s free relationships, they, as he put it “can’t move beyond jealousy, even though it is a civilized person’s task to control it. Sex with other partners is not improper for us, trust is more important in relationships. But lies or hiding the truth – that is betrayal.” When Shalygina committed adultery, she voluntarily decided to punish herself by cutting off two parts of her pinky finger. “That was my price for betrayal,” she said. “Later I told Pyotr. He agreed with me. That was the way of restoring connection between action and word” (Denisova, 2015a, 2015b).

Both parents contribute equally to bringing up their children, as they put it “depending on who is available at this or that time.” The children are being home-schooled because their parents decided that it was viable. Shalygina says conventional school was “a waste of time” (Denisova, 2015b). Pavlensky explained that he didn’t want his kids to go to school because they are forced to wear uniforms, as he put it, “all are unified by pants and skirts of the same color. This is a vivid sign of growing totalitarianism” (Beliaeva, 2016; Buyanova, 2014).

During the decade after 2002, Pavlensky did not visit psychiatrists. Then, in March 2013, he returned to the psychoneurological dispensary with complaints that he felt uneasy, depressed, tense, and weak. He said he had been suffering from insomnia and a bad appetite since 2011, which he blamed on treatment for hepatitis C. He received treatment at the dispensary, but could not remember the names of medications.

In addition to this, between 2012 and 2014 Pavlensky underwent a series of psychiatric examinations subsequent to his performances. Some of these were part of the emergency medical procedure connected to his arrests and others were court-ordered attempts to assess his capacity to stand trial for various charges. For example, in July 2012 after his first performance “Stitch,” he was evaluated by a psychiatrist who concluded that, “the patient has correct orientation, without delirium or delusion. Without aggressive or suicidal tendencies. Self-aggression was demonstrative. Psychiatric diagnosis: healthy.”⁶ After the performance “Carcass” in May 2013, Pavlensky was evaluated by a doctor from an emergency psychiatric team. His condition was evaluated as “dangerous to the patient” and he was hospitalized for several hours at the diagnostic ward of the psychiatric clinic. He was released after consultation with psychiatrists who recommended out-patient treatment.

In November 2013, after his performance “Fixation,” Pavlensky was again evaluated by psychiatrists, and subjected to a comprehensive out-patient examination at the Serbsky. His psychiatric condition was described by the psychiatrist at the ward of the City Clinical Hospital this way: “It is hard to get any medical background, because he is affected by delirium.” That report noted that Pavlensky “protested against police oppression,” that he “considered himself an artist,” and declared that he “committed an action of artistic performance.” He was diagnosed with “emotional instability and immurement of personality.”

During the court-ordered psychiatric evaluation, psychiatrists noted that Pavlensky “[i]s correctly oriented in place, time and his own personality. Demonstrative. No psychotic symptoms (delirium or hallucinations). Critical and prognostic abilities are not impaired.” An expert psychologist noted that he “has retained all mnemonic processes. He correctly defines logical connections.” Based on that evaluation, experts concluded that “Pavlensky does not suffer from any psychiatric disorder or amentia, and shows signs of mixed personality impairment,” during the period of incriminating action, and “did not demonstrate any signs of temporary psychiatric disorder or other psychiatric impairment, and was capable of fully realizing the character and public danger of his actions and managing them.” Based on this analysis, it was concluded that he did not need to receive compulsory treatment according to Articles 97 and 99 of the Russian Criminal Code.

After Pavlensky’s performance “Freedom” in February 2014, investigative authorities requested an in-patient criminal psychiatric evaluation. However, it was not conducted. In October of the same year, after the performance “Separation,” Pavlensky was examined on three occasions by different psychiatrists, each of whom made a different diagnosis. One concluded that Pavlensky suffered from an “acute psychiatric disorder, undetermined.” Another diagnosed the artist as having “acute polymorphous psychotic impairment with self-aggressive behavior.” The third clinician determined that Pavlensky was afflicted by “self-injury… with demonstrative purpose.”

Psychiatric condition of the patient at the moment of evaluation

The author’s report on Pavlensky’s condition found:

Communicates willingly. During conversation is friendly, polite, and tactful. Calm, emotionally syntonic. Discusses openly, and with interest, questions connected with the “artistic performances,” that he is accused of doing in violation of the law. He describes in detail the cultural and artistic precedent created by other artists, when asked about motivation of his action in [the] Red Square and about the connection of that action to his dominant beliefs. He talks about avant-garde forms of modern art (performance, action art, Dadism, etc.). He underlines that he has colleagues who share his views of modern art. He also notes that the goal of this art form—confrontation and struggle with various standards, lack of freedom, restrictions, stereotypes—is of paramount importance to him as a person. During the discussion of these issues he talks emotionally but without exaltation or attention-seeking. No signs of demonstrativeness either. Notably increased sensitivity to questions about fairness and freedom.

The author’s diagnostic report on Pavlensky also stated that:

He is sure that his performance at Red Square and his other performances reached their desired results: attracting public attention to the theme of the lack of personal freedom [in Russia]. He is proud that he could implement his plan, contemplate everything and overcome all obstacles. He explained that his form of performance was adopted from the criminal environment. In penal colonies, prisoners often nail their scrotum to plank beds in protest against [the perceived] despotism of the authorities… The meaning of his performance should demonstrate to laypeople that “we all live in a global penitentiary zone.” At the same time, however, he does not express any concrete political preferences.… He demonstrates a high intellect and level of knowledge during the conversation. His thinking is logical, consistent, without signs of gaps, tangentiality or schizophasia.

He answered “No” to the question of whether he considers himself a psychiatric patient. He said that he had thought many times about “What is a psychiatric disorder?” and said that he knows people who need psychiatric help. He said that his main task during his performance called “Separation”… was to raise a question about the objectivity of psychiatry, stating “I cut off my ear lobe as Van Gogh [did]. After that he was declared insane and his bullying started. I think that influenced his decision to commit suicide. There is a very indicative historical example supporting that thesis. In the U.S. in the 19th century, there were such diagnoses as ‘drapetomania’ and ‘dysesthesia.’⁷ Psychiatrists studied runaway slaves and discovered that a desire to escape slavery was a psychiatric disorder, which was called drapetomania. And slaves’ urge to destroy products of their own labor they called dysesthesia. The question is raised, ‘In this context, where is psychiatry?’ It does not exist. It is a pseudoscientific explanation of isolation. A human being needs to be isolated so that he does not kill everyone, and he is isolated. The way psychiatry is now – it is just regime’s back-up block.”

He does not consider himself a maladjusted person, pointing to the fact that in real life with his family and friends, he is non-confrontational. There are no signs of a psychopathological disorder (delirium or hallucination). He is capable of attracting and paying attention normally. He remembers current and past events. No signs of asthenia.

Discussion of the clinical psychopathological evaluation

The report found that “[n]o signs of impairment of cognitive processes (impairment of perception, qualitative impairment of thinking, memory or intellect) and disorders of the affective sphere were identified during Pavlensky’s evaluation. Peculiarities of his behavior have been revealed that during his lifetime and incriminating periods led to outrageous actions which authorities considered to be violations of public order.”

Was Pavlensky’s behavior during his “performances” pathological? The opinions of psychiatrists differ on this point. Forensic psychiatrist Mikhail Vinogradov argues that:

This might be the case of a sluggish psychopathy-like schizophrenia, that from time to time leads to outbursts of inappropriate behavior. People like Pavlensky are dangerous to society, because one day they can overstep bounds and commit acts that are harmful to others, such as attacking someone or creating a situation leading to catastrophe, such as a car accident or something else. All his actions demonstrate that he is not healthy. (NSN, 2015, n.p.)

The so-called “Orthodox psychiatrist” Dmitrii Avdeev argued that

a deep deformity in the soul does not always result from a hard psychiatric disorder, for instance, schizophrenia. It could be, and likely is a pathology of personality. It used to be said about psychopathologies that they are “moral insanity,” “malice of the soul,” and “moral defectiveness.” Of course, this is illness of mind, but a very different one. Pavlensky is suffering from moral defectiveness. (“Pavlensky is sick”, 2014, n.p.)

The psychiatric diagnosis of emotionally unstable personality disorder (borderline personality disorder in DSM-5) requires justification. The diagnosis has the following clinical criteria (ICD-10, 1994): 1) An apparent tendency toward impulsive behavior, without regard for consequences in tandem with unstable mood; 2) diminished capability to plan; and 3) Bursts of intensive anger often leading to violence or “behavioral explosions.”⁸ Patients exhibiting these behaviors are easily provoked when their impulsive actions are criticized or prevented. There are two types of this personality disorder, and both include impulsivity and lack of self-control.

A comparison of Pavlensky’s behaviors during his performances shows that they do not coincide with any of the criteria. Pavlensky always carefully planned his performances and prepared for them in advance. He stated that “performances are produced” for several months. During that course of time, he “contemplates and accumulates many impressions in his mind before implementing them in one simple and laconic performance” (Mikhantyeva, 2015, n.p.). Pavlensky took an especially lengthy period and expended significant effort in preparing for the performance “Fixation”: he trained with a timer, studied anatomy on the Internet, and prepared the necessary equipment. Therefore, the author’s report concluded: “There are no grounds to claim that Pavlensky has signs of impulsivity. More than that, in everyday life he is characterized as a calm, quiet and balanced person, who is not inclined to aggression. It is also not possible to talk about his inability to plan and lack of understanding consequences of his actions.” Overall, the use of diagnostic criteria for personality disorders (ICD-10) to evaluate Pavlensky’s behavior does not produce evidence of any abnormal behavior. In this report, it was noted that Pavlensky does not exhibit a range of criteria associated with personality disorders.⁹

Conclusion

Based on our clinical evaluation of Pyotr Pavlensky, and our analysis of his “inappropriate” behavior, we argue that there are no grounds for diagnosing his behavior as clinically abnormal. The peculiarity of Pavlensky’s behavior must not be viewed exclusively as a psychiatric phenomenon. Indeed, other explanations can and must be found for this phenomenon. Performance art is not a fantasy, but a real form of contemporary art. Scholars of contemporary art have emphasized the continuities between performance and very long-standing traditions of creative production and even ritual (Popkova & Korolenko, 2014). Unfortunately, psychiatry—and especially the profession as it exists in Russia today—with its specific tools and long-standing views on normality and pathology, does not always take into consideration the role played by intentionally transgressive behavior or practice in contemporary art. In part, because of this, it unjustifiably characterises artistic behavior that does not fit established norms as pathological.

It is well-known that Soviet psychiatry quite often used psychiatric diagnoses as a way to explain the “antisocial behavior” of political dissidents. In the 1970s and 80s, dissidents were often punished with a diagnosis of “sluggish schizophrenia” (Lavretsky, 1998). This particular “diagnosis” is no longer used today. However, persons who have committed offenses that are considered notorious by the general public are still being labeled as mentally ill. They are often diagnosed with personality disorders instead of “sluggish schizophrenia.” But as was the case in the past, “inadequate behavior” remains the main justification for such diagnoses of mental disorder. Pyotr Pavlensky’s case fits this bill. The very fact that Pavlensky has been considered to suffer from a personality disorder completely stigmatizes him and devalues his artistic endeavors, even though he is not perceived as a “deranged person” who must be hospitalized.

In particular, we have found many contemporary psychiatrists in Russia to be obsessed with what has been called “pathography”—or biographical research on the lives and creative works of famous people that is driven by a search for hidden psychopathological motivations. Social scientists have described pathography as a tool of medical stigmatization (Sirotkina, 2011). It is important to note that in contemporary Russia there is practically no critique of the basic pathographic idea that specific aspects of an artistic work can be explained through their linkage to supposed psychiatric disorder (Sirotkina, 2011). Some psychiatrists have even declared that issues of creativity cannot be addressed without their expertise, and that “art itself is psychopathologic and psychopathology is one of the art forms” (Samokhvalov & Kuznetsov, 2015).¹⁰ Whatever other effects they might have, many Russian psychiatrists’ focus on such pathographic ideas helps to undermine the public credibility of psychiatry.

The particular case of the performance artist Pyotr Pavlensky draws our attention to the problem posed by the medicalization of public life, and psychiatry’s role in this problem. Psychiatry should not interfere in processes of political activism or in the changing styles of art, even at its extremes. The role that psychiatrists played in classifying Pavlensky’s actions as evidence of psychiatric disorder highlights the need for clear and convincing criteria for differentiating between clinical behavioral disorders and a wide range of intentionally socially-transgressive behaviors and practices.¹¹

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

Notes

Vladimir D. Mendelevich, MD, PhD, is Director of the Institute for Research of Problems of Mental Health and a Professor and Head of Department of Medical Psychology at Kazan State Medical University. He is editor-in-chief of Neurological Bulletin (journal of Bekhterev) and Psychopathology & Addiction Medicine. He has published more than 670 scientific articles and 60 books. Among the most popular and well-known are Psychiatric Propaedeutics, Medical Psychology, Psychology of Deviant Behavior, and Nevrozolology and Psychosomatic Medicine. His published works focus on behavioural and personality disorders, psychopathology, and addictions.

References

Beliaeva, A. (2016). Pyotr Pavlensky on Russian actionism. Moscow, Russia: Angedoniya. Retrieved from http://www.theartnewspaper.ru/posts/2549/ [In Russian].

Bespalov, V. (2015). Pyotr Pavlensky: From fire in fire. Retrieved from https://www.zaks.ru/pda/archive/view/146595 [In Russian].

Boyazitova, A. N. (2007). Medicalization as social process (Dissertation MD). Volgograd, Russia [In Russian].

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