Reflex. The images themselves seem to come reflexively. The clinician’s percussion hammer bouncing off of the knee. A startled infant. I hadn’t thought much about the idea of the reflex. At least not since the fifth grade, when I had unsuccessfully tried to condition four white laboratory mice to respond either to the sound of a bell or a flashing light, for a science fair. (Actually the conditioning had worked well, at least in the relative calm of my home. But when subjected to the glare of the school’s fluorescent lights and the poking fingers of countless elementary-school children, the mice cowered in the corners of their cages).
Some twenty years later I was conducting fieldwork with addiction specialists and their patients in St. Petersburg for my dissertation in anthropology. It seemed like everyone was talking about reflexes. There was the idea of the “expended vomiting reflex” – once used as a symptom to diagnose chronic alcoholism. There was “conditional-reflex therapy” – widely used during the Soviet period to combat alcoholism. This method was especially striking. It involved using apomorphine to condition patients to experience a physical aversion to alcohol, and was usually carried out in large groups, a suitable economy of scale for large hospitals and penal institutions. One physician I worked with described the groups, which were thought to bolster the conditioning effect of the procedure, as a Rabelaisian subversion of the ideal Soviet collective: “Give everyone a swab [of alcohol] to smell, inject everyone, and everyone pukes, all in a choir—a Communist choir!” There were other, more casual references to reflexes as well.
All of this talk of reflexes struck me at first as oddly anachronistic. Ubiquitous images of Pavlov and his dogs came to mind. And yes, these were generally references to diagnostic categories and methods that had fallen into disuse. Indeed there were physicians, proponents of evidence-based medicine, who depicted the whole of Russian addiction medicine as a relic, a kind of clinical “world on the wane.” Yet the more I traced the notion of “the reflex” back through the history of Soviet and Russian science and medicine, the less it seemed like what the Bolsheviks (in reference to alcoholism and other vices) called a “survival” of the previous “mode of production.” Instead, I began to see a set of scientific, clinical and popular ideas and debates about reflexes as implicit in many of the other contours of the post-Soviet addiction clinic.
* * *
As Georges Canguilhem reminds us, the “image that suggested the word ‘reflex,’ [is] that of a light ray’s reflection by a mirror…”[i] Well into the 19th century, the word was widely used to mean “a reflection of light or heat” – (the OED quotes Thomas Carlyle writing in 1843, “The illimitable Ocean, tinting all things with its eternal hues and reflexes”). The image connotes the operation of a physical law, or at least the automaticity of an established mechanism running its course. To contemporary ears the reflex suggests a response that is not just unconsidered but unthinking. Knee-jerk. Automatic. Curiously, the unthinking response is the very antithesis of reflex’s cognate concepts, which also hinge on the image of mirrored light: “reflection,” “reflective,” and its cousins favored by social scientists, “reflexive” and “reflexivity.” Unlike reflex, these suggest a deliberate turning in on oneself.
Not only do the tensions between these meanings of “reflect” make it a poetically rich term (mined most recently and to great effect by Arcade Fire), they have also shaped the development of the concept of the reflex. During the 18th century philosophers and scientists disagreed both over the potential role of consciousness in reflex action as well as over whether it should be understood as mechanistic (i.e. a physical law), or as metaphysical (i.e. teleologically motivated by some vital force).
By the turn of the 19th century, Canguilhem writes, the reflex was generally conceptualized in neither of these ways. Not so much an isolated organ’s mechanical response to a stimulus, the reflex came to be seen as “an already coordinated movement determined in part by stimuli in a certain part of the organism and in part by the organism’s global state.”[ii] In these terms, reflex movement “was a form of behavior, the reaction of an organic whole to a change in its relationship to the environment.”[iii] Conceived as having the potential to link psyche and soma (whether or not that meant reducing one to the other), the notion of the reflex and reflex action was prominent in many late 19th and early 20th century Euro-American discussions of consciousness and volition. During an age when ideas about non-intentional human action – and its socio-political meanings – both fascinated and disturbed many scholars (think Le Bon, Tarde, suggestion, and crowd theories), the concept of the reflex (and the broader physiological frameworks of which it was a part) suggested a model of personhood that was both materially grounded and available to scientific intervention.
Precisely for these reasons, reflex theories took on a particularly strong political set of meanings in the Russian Empire. The publication of Ivan Sechenov’s Reflexes of the Brain: An Attempt to Introduce Physiological Foundations for Psychic Processes in 1863 prompted an early association in the popular imagination of the Russian intelligentsia between materialist physiology and political radicalism, soon popularized by literary depictions in Chernyshevsky’s What is to be Done? and Turgenev’s Fathers and Sons. Political thinkers and activists saw in the new physiology a materialist reductionism with the potential to undercut Orthodoxy, a central pillar of Tsarist autocracy, as well as a utopian narrative about the transformational power of science.[iv]
Flash forward more than half a century to the early 1920s. The Bolsheviks are in power and the reflex, as Irina Sirotkina writes, has become “a fashionable word, a cultural idiom and part of the revolutionary discourse.”[v] She notes the compatibility between the reflex as a materialist idea and “the ideologists of the Revolution” who sough “a tangible instrument for reshaping human nature.”[vi] While there were various reflex theories circulating among psychologists and physiologists, it was the theories of Ivan Pavlov that received the greatest official praise. In 1924 Nikolai Bukharin, at the time the Party’s chief ideologist, described his theories as a “weapon from the iron arsenal of materialism.”[vii] Pavlov’s teachings were also popularized in text and film – including this 1926 documentary, “The Mechanics of the Brain,” one of the first by the noted Soviet film director Vsevolod Pudovkin:
Pavlov had first described his famous “conditional reflex” while conducting the research on digestive physiology, which earned him a Nobel Prize in 1904.[viii] As Daniel Todes has chronicled, the research depended on a particular experimental setup – in particular, the “dog technology,” (animals with salivary, intestinal and gastric fistulas) which allowed Pavlov’s assistants to measure the reactions of living digestive and nervous systems to various stimuli.[ix] In most of his early work on the physiology of digestion Pavlov had followed the example of 19th century physiologists like Claude Bernard, black-boxing the “psychic element” (or what he called the “psychic secretion”) in animal behavior. However, when a series of experiments suggested that the “psychic secretion” was playing a key role in the laboratory dogs’ salivary responses to stimuli Pavlov recruited several researchers with expertise in biologically-grounded psychology and psychiatry to help investigate. It was these researchers who eventually proposed relabeling the “psychic secretion” as “association,” “habitual reflex” or “reflex from a distance.”[x] Pavlov settled on “conditional reflex,” as Todes puts it, because of the “‘conditionality’ of the relationship between stimulus and response.”[xi]
In the conceptual system developed on the basis of these early experiments, the conditional reflex became the atom, the “elemental unit” of psychological phenomena – which Pavlov called “higher nervous activity.” Pavlov described the nervous system as a telephone switchboard, using a metaphor meant to convey the system’s flexibility, but which also resonated with the resolute technophilia of the time. In subsequent work Pavlov was generally careful in translating his insights from work on animal models to human beings, who were distinguished by the presence of a “second signal system” of symbolic representation and rational thought.[xii] Yet, as Todes writes, this research was “increasingly informed by a metaphorical relationship between excitation (which Pavlov equated with freedom) and inhibition (which he equated with discipline), a metaphor that acquired force and meaning from Pavlov’s life experience, particularly his response to the Bolshevik seizure of power and its aftermath.”[xiii]
While praised by Bolshevik officials, during the early 1920s many Soviet psychologists and physiologists contested Pavlov’s theories. Lev Vygotsky famously quipped that “a human being is not at all a skin sack [a sausage] filled with reflexes, and the brain is not a hotel for a series of conditioned reflexes accidentally stopping in.”[xiv] Others like physiologist Evgenii Bernshtein critiqued Pavlov’s reflex theory on the basis of observations of human beings in natural settings.[xv] And Leningrad psychiatrist and neurologist Vladimir Bekhterev promoted his own competing theory which he called “reflexology” (more or less unrelated to the variety that involves therapeutic foot massage).[xvi]
Such debate became rarer in the late 1920s, when Stalin and other Party leaders began the project of creating a cadre of “red” specialists whose primary allegiance would be to the party-state.[xvii] Throughout the following decades Pavlov’s theory was promoted in increasingly forceful terms among experts in psychiatry, psychology and physiology at the expense of other schools of thought. In late 1936 approaches to psychiatry as “mental hygiene” – which focused on social and familial conditions and advocated for psychosocial and prevention-oriented interventions – were declared anathema.[xviii] Finally, Pavlov’s doctrine was declared the objective foundation for the Soviet sciences of the mind and brain at a series of conferences on physiology, psychiatry and psychology held between 1950 and 1951 (the so-called Pavlov sessions).[xix] Soviet leaders of the 1920s had interpreted Pavlov’s theory as way of “dialectically” linking understandings of human beings as historical actors with a science of humans as material beings. By the dawn of the Cold War Pavlov served another purpose, as part of an ongoing critique of psychoanalysis – which became seen not only as a form of bourgeois idealism—as it had been since the 1920s—but also as an emblem of US imperialism and capitalism.[xx]
It was during this period that conditional-reflex therapy for alcoholism had been developed and that a diagnostic language focused on reflexes had emerged in the clinic. And although a resurgence of research and scholarship on psychology and consciousness took place during the post-Stalin years, these therapeutic and diagnostic tools took on an institutional life of their own.[xxi] They did not remain unchanged and yet they persisted, as Ludwik Fleck wrote of past scientific concepts “in accepted concepts, in the presentation of problems, in the syllabus of formal education, in everyday life, as well as in language and institutions.”[xxii]
And so while these methods of treatment and diagnostic categories had long been abandoned by the time I started fieldwork in St. Petersburg, remembered largely as indices of an imagined late Soviet past, they also remained implicit in other therapies and clinical practices. Indeed, many of the physicians I worked with seemed to conceptualize their patients as “organisms in the clinic,” but not simply as amoral and precognitive bodies, or as bundles of reflexes and malleable affects. Nor did they vault dualisms to enact some synthesis of mind and body. Rather, both they and patients alike drew familiar distinctions between their putative selves (or those of their patients) and something—some material thing—that could be acted on and through–“my body,” “my brain,” “my organism”—albeit in partial, shifting, incomplete and self-contradictory ways.
According to the OED, two centuries before “reflex” became a physiological term, it was used to signify both the “reflection of light” and the act of reflection or meditation. So it would only be particularly appropriate to end by asking whether my own attention to the reflex, my reading or seeing it in these encounters was conditioned primed shaped by the overdetermined role which Pavlov has played in histories of Russian biological sciences or by my own interest in theories that cut across distinctions between the biological and the psycho-social. Perhaps. Or maybe it was just the memory of those four frightened laboratory mice.
Eugene Raikhel is a cultural and medical anthropologist in the Department of Comparative Human Development at the University of Chicago. He is editor of Somatosphere and co-editor (with William Garriott) of Addiction Trajectories.
[i] p.184, Canguilhem, Georges. “The concept of reflex.” In Delaporte, François, ed. A vital rationalist: Selected writings from Georges Canguilhem. Zone Books, 1994.
[ii] p. 201, Canguilhem, “The concept of reflex.”
[iv] Joravsky, David. Russian psychology: A critical history. London: Blackwell, 1989.
[v] p.71 Sirotkina, Irina. “The Ubiquitous Reflex and Its Critics in Post‐Revolutionary Russia.” Berichte zur Wissenschaftsgeschichte 32.1 (2009): 70-81.
[vii] Quoted in Sirotkina, “The Ubiquitous Reflex,” p.71; as well as Joravsky, Russian Psychology. Pavlov’s own relationship with the Bolsheviks was extremely complicated; he moved from a frank antagonism to the regime in 1917, to a mutually accommodating relationship during the 1920s, and finally to a rapprochement before his death in 1936, remaining committed above all to scientism and a conservative patriotism. See Todes, Daniel P. “Pavlov and the Bolsheviks.” History and philosophy of the life sciences 17.3 (1995): 379-418.
[viii] The Russian term “uslovnyi” is typically translated into English as “conditioned,” but historians of science have argued that “conditional” is closer to Pavlov’s meaning – as the rest of this paragraph explains.
[ix] pp.93-101 Todes, Daniel Philip. Pavlov’s physiology factory: Experiment, interpretation, laboratory enterprise. JHU Press, 2002.
[x] pp.217-254 Todes, Pavlov’s physiology factory.
[xi] p. 246 Todes, Pavlov’s physiology factory.
[xii] Joravsky, Russian Psychology; Todes, “Pavlov and the Bolsheviks.”
[xiii] p. 352 Todes, Pavlov’s physiology factory. See also: Smith, Roger “The meaning of “inhibition” and the discourse of order.” Science in Context 5.2 (1992): 237-263.
[xiv] Quoted in Smith, Roger. Between Mind and Nature: A History of Psychology. Reaktion Books, 2013. p.230. Also quoted in Sirotkina, “The Ubiquitous Reflex,”
[xv] Sirotkina, “The Ubiquitous Reflex.” In the post-Stalin period Bernshtein would become a pioneer of cybernetics in Soviet physiology, arguing with orthodox Pavlovians that the computer, rather than the telephone switchboard, was the appropriate, non-mechanistic metaphor for the human nervous system. See: Gerovitch, Slava. “Love-Hate for Man-Machine Metaphors in Soviet Physiology: From Pavlov to “Physiological Cybernetics”.” Science in context 15.02 (2002): 339-374.
[xvi] Strickland, Lloyd, and Tzvetanka Dobreva-Martinova. “Theory and context: Bekhterev’s” Collective Reflexology.”.” Problems of theoretical psychology 6 (1996): 254.
[xvii] During this period, known as the Great Break (marked by the start of massive industrialization projects and the collectivization of agriculture in the late 1920s), Stalin and other Party leaders sharply departed from an earlier conciliatory policy towards professionals and initiated a program of cultural revolution intended to create a new class of Soviet (non-bourgeois) specialists whose orientation was meant to coincide with those of the party-state. Fitzpatrick, Sheila. The cultural front: Power and culture in revolutionary Russia. Cornell University Press, 1992.
[xviii] Zajicek, Benjamin. Scientific psychiatry in Stalin’s Soviet Union: The politics of modern medicine and the struggle to define ‘Pavlovian’ psychiatry, 1939–1953, Unpublished Ph.D. Thesis, University of Chicago, Chicago. 2009.
[xix] Ibid. Zajicek shows that far from silencing debate in psychiatry, the language of Pavlovian theory was used by the partisans of different positions in debates about disease ontology and about the proper relationship between the laboratory and the clinic in producing medical knowledge.
[xx] p.117 Miller, Martin. Freud and the Bolsheviks: Psychoanalysis in imperial Russia and the Soviet Union. Yale University Press, 1998. See also: Etkind, Alexander, Eros of the impossible: The history of psychoanalysis in Russia. Westview Press, 1997.
[xxi] Between the 1940s and 1980s in the Soviet Union, conditional reflex therapy was the recommended mode of clinical treatment for alcoholism, given pride of place in textbooks as a first-line therapy for use after detoxification and mandated as a treatment for alcoholism in penal institutions. As Benjamin Zajicek has argued, “Pavlovian clinical techniques… produc[ed] useful results because they provided hospital administrators with new ways of rationalizing their hospitals and disciplining their patients,” p. 63.. Zajicek, Scientific psychiatry in Stalin’s Soviet Union. See also Shtereva, L. V. 1980. Klinika i lechenie alkogolizma [The treatment of alcoholism]. Leningrad: “Meditsina,” Leningradskoe otd-nie; Babayan, Eduard A and M Kh Gonopolsky. 1985. Textbook on alcoholism and drug abuse in the Soviet Union. New York: International Universities Press.
[xxii] p.20 Fleck, Ludwik. Genesis and development of a scientific fact. University of Chicago Press, 1981.