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The paper explores psychiatry’s responses to the twentieth-century socio-political currents in Latvia by focusing on social objectives, clinical ideologies, and institutional contexts of Soviet mental health care. The tradition of German biological psychiatry in which Baltic psychiatrists had been trained blended well with the materialistic monism of Soviet psychoneurology. Pavlov’s teaching of the second signal system was well suited to Soviet ideological needs: speech stimuli were seen as a vehicle for moulding the individual’s mind. The transformation in diagnostic practices during the 1970s and 1980s reflected the demise of optimism about the capacity of the self to model itself to the needs of the society. Latvian psychiatry was prepared to embrace more individualistic and pessimistic theories of the self. [ABSTRACT FROM PUBLISHER]