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.