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Dostoyevsky's Brothers Karamazov as essential psychiatric text – psychiatry in literature

Published online by Cambridge University Press:  21 March 2019

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Copyright © The Royal College of Psychiatrists 2019 

Dostoyevsky's The Brothers Karamazov is generally considered one of the greatest works of the 19th Century. It was Freud's favourite novel, embodying his contention that parricide is a universal human – or at least male – wish, and that its associated guilt lies at the root of the religious impulse. For bipolar Virginia Woolf, Dostoyevsky ‘alone among writers has the power of reconstructing those most swift and complicated states of mind’.

Despite its iconic status, Brothers Karamazov is a complex assembly of styles, stories and genres – whodunnit, the science-versus-religion debate, epilepsy symptomatology, chauvinistic celebration of the Russian spirit, courtroom drama and forensic psychiatry dilemma. The story centres around four brothers and the murder of their ‘sensualist’, neglectful and much-married father, Fyodor. Each brother embodies states of mind with which psychiatrists need to be familiar. Despite the prosecutor's dismissal of an insanity (or ‘aberration’) defence, Dmitri surely suffers from a mood disorder. He is subject to bouts of manic activity, is often violent, hypersexual, profligately spends money (his own and other peoples'), constantly changes his mind and, unable to differentiate wish from action, confesses to a crime he hasn't committed.

His half-brother Ivan, ultra-rationalist, existentialist prototype (much admired by Camus and Sartre) annunciates the book's principal themes: (a) without God, ‘are all things possible?’ and (b) ‘everyone wishes their father dead’. Ivan is the intertextual ‘author’ of the famous Grand Inquisitor section in which the worldly torturer explains that a contemporary Christ would have to be liquidated. Ivan is mostly cut off from his feelings but, delirious from infection, he hallucinates a Devil-Avatar with whom he has a prolonged and profound dialogue about the nature and necessity of evil.

The third son, Smerkyadov, Fyodor's ‘natural’ child, is, as we would now say, ‘on the spectrum’: clever and calculating, interpersonally challenged and (spoiler coming) self-confessedly the murderer.

The fourth son and the book's hero is the saint-like proto-therapist Alyosha. Alyosha's honesty, composure and empathy are examples to all in the helping professions. His guru is Father Zosima, an all-accepting, all–forgiving libertarian monk, whose humanity and cheerfulness counterbalance the novel's unremitting dark themes.

There is also a host of vivid minor characters. Kolya, the precocious adolescent, all brilliance and self-doubt; Lisa, the self-harming teenage girl in love with Alyosha; Ratikin the scheming proto-Marxist intellectual, a step away from the oncoming Russian terrorism; a pompous Moscow doctor, all self-importance, avarice and denigration of local services; eloquent lawyers for the prosecution and defence.

Brothers Karamazov was written in the aftermath of Dostoyevsky's 3-year-old son's death from epilepsy. The book is suffused with a sense of loss and grief. Its exploration of father–son relationships – Alyosha and Zosima, Fyodor and his sons, the Pope and his flock, God himself – speaks to our contemporary problematic masculinities. (By contrast, Dostoyevsky is notoriously weak at depicting women: Brothers Karamazov's main female characters are little more than caricatures: Katarina, hell-hath-no-fury rejected lover and tart-with-a-heart Grushenka.)

The book concludes with the poignant funeral of Kola's playmate, Ilusha. Alyosha, father-like, enjoins the boy's assembled school friends to transcend their loss: ‘… some good sacred memory preserved from childhood is the best education. If a man carries many such memories with him into life, he is safe to the end of his days, and if one has only one good memory left in one's heart, even that may sometime be the means of saving us’. Innocence, love, reciprocity, relationship: Brothers Karamazov offers lessons in true resilience which our target-obsessed, ahistorical culture – psychiatry not excepted – needs urgently to relearn.

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