Tag Archives: ECT

Shock “Treatment” Is Not Safe and Provides Little If Any Benefit

DELICATE THINGS REQUIRE DELICATE HANDLING

When I was a teenager, one of my hobbies was making small transistor radios.  It sounds complicated, but is well within the reach of an average 15-year-old.  You get some magazine articles, learn how to read a circuit, and learn how to use a soldering iron.

A transistor is a small device – about half the size of a pencil eraser – with three wires coming out of it.  In building a radio receiver, the transistors have to be soldered to other devices which are in turn soldered to other devices, etc…  The soldering iron is plugged into a wall outlet, but no mains electricity reaches the tip of the iron.  However, tiny eddy currents can circulate in the tip, and although they are only of the order of milliamps, they can burn a transistor in seconds.  What you have to do is unplug the iron from the socket, make the joint with the tip’s retained heat, and then replug the iron to have it ready for the next joint.  The point being that delicate things require delicate handling, and that electricity can be very destructive.

About the same time, an adult I knew told me that he had recently had shock “treatment.”  I had noticed that he had seemed different.  I asked him what it was like.  “Awful,” he said, shaking his head.  I didn’t ask for any details, and he didn’t elaborate.  I did some reading, and discovered that the procedure involved applying high voltage across the temples which sent a strong electric current through the brain.  I thought about my transistors, and about the delicacy and complexity of the human brain.

In college I heard a number of psychiatrists say that shock “treatment” was very effective for depression, and was perfectly safe.  They also mentioned that the therapeutic effect occurred because the electric current caused a seizure.  They talked vaguely about the current “breaking up” dysfunctional neural circuits and allowing them to “reconnect” in more functional ways, and conceded that for many individuals, repeated “treatments” were needed, sometimes for years, to maintain the benefits.

I had seen a young girl (let’s call her June) have a seizure once in her front yard.  I was about four.  June was lying on the ground and being cared for by her mother and another adult.  I was walking past on the sidewalk with my mother, whom I noticed was in tears.  I had but the vaguest understanding of what was going on, but I definitely got the impression that seizures (or “fits” as we called them then) were not good.  In later years I learned that real doctors go to extraordinary lengths to prevent seizures, precisely because they are so damaging to the brain.

In the early years of my career I often heard that shock “treatment” was both effective and safe.  But I never shook the lessons from the transistors and from June.  It seemed to me that shock “treatment” was a bit like using a jack-hammer to fine-tune a piece of electronic equipment.  The likelihood of improvement seemed low; the likelihood of serious damage seemed high.  I looked for studies that demonstrated efficacy and safety but found very little.

THE TRUTH ABOUT SHOCK “TREATMENT:” DANGEROUS AND INEFFECTIVE

I recently came across a book called Doctors of Deception by Linda Andre.  It’s very compelling reading, and I strongly recommend it to anyone who has an interest in the topic.  Linda received shock “treatment” (now called electroconvulsive therapy) in her mid-twenties.  Prior to that she had been a successful photojournalist with an IQ of 156.  After the shock “treatment” her IQ had dropped to 118, and she had:

“Deficits in executive functioning, cognitive flexibility, abstract thinking, planning… Difficulties with higher level cognitive processes…Significant decrease in her attentional and organizational abilities…severe enough to undermine her ability to work…Results clearly indicative of brain injury secondary to ECT… (p. 9)

Prior to the “treatment” Linda had apparently not been informed of any of these risks.  Most of the book is devoted to her subsequent attempts to highlight the risks (and minimal benefits) of shock “treatment” and to have truly informed consent made mandatory.  She decries in detail the collusive relationship between the shock doctors, the FDA, and the machine manufacturers, and the entire scenario is strikingly similar to the corrupt and corrupting pharma-psychiatry alliance with which we are all familiar.  The PR job that the shock faction have done makes the tobacco industry look like a bunch of ham-fisted schoolchildren.  The shock doctors’ message, fully bought by the media, is – we’re doctors, we know what we’re doing; these other people are crazy – you can’t believe what they say.

But the message that “they” communicate clearly from the pages of Linda’s book is consistent:  gains from shock “treatment” are minimal and transient; damage is severe and lasting.

There’s other reading on the topic.  Peter Breggin, MD, of course, has been an ardent foe for years.  You can read one of his articles here.

John Breeding, PhD, a Texas psychologist, has been an active opponent of ECT for the past 20 years.  You can find his website here.

Fred Baughman, MD, an eminent neurologist, writing in 2011, had this to say about ECT:

“Throughout the more than 3 decades of my neurological practice I have encountered patients treated with ECT who had permanent erasures of parts of their memory.  Think of the extent of memory loss not immediately evident in these and in all patients.  For their own selfish reasons, psychiatrists may wish to call ECT and such end-results ‘therapeutic’ but they never achieve anything but to diminish adaptability in the broadest sense and cannot be called ‘therapeutic or medically justifiable.”

Probably the definitive work on shock “treatment” from the scientific perspective is a 2010 article by John Read and Richard Bentall:  The effectiveness of electroconvulsive therapy: A literature review.  The study is a systematic review of the research on ECT from the ’40s through the present.  Their conclusion is startlingly frank:

“Given the strong evidence … of persistent and, for some, permanent brain dysfunction, primarily evidenced in the form of retrograde and anterograde amnesia, and the evidence of a slight but significant increased risk of death, the cost-benefit analysis for ECT is so poor that its use cannot be scientifically justified.”

Formal studies, randomized control trials, and meta-analyses are, of course, the yardstick for truth in any science, including the human sciences.  But the human sciences are unique in that the object of the study is not rocks or electricity or light – but human beings – people.  And although I’ve always been, and still am, a big believer in the need for and the value of research, I also think it’s critical in our work to recognize and listen to the input of individual people.

ASK THE VICTIMS

In this context, I have come across a truly remarkable article by Lucy Johnstone, PhD.  It’s called Adverse psychological effects of ECT, and was published in the Journal of Mental Health in 1999.  Here’s the abstract.

“Although it is known that a proportion of people find ECT distressing to receive, these adverse psychological reactions are little understood. Twenty people who reported having found ECT upsetting were interviewed about their experiences in detail. A variety of themes emerged, including feelings of fear, shame and humiliation, worthlessness and helplessness, and a sense of having been abused and assaulted. This had reinforced existing problems and led to distrust of psychiatric staff. Few had felt able to tell professionals of the strength of their reactions, implying a possible hidden pool of trauma. Implications for the practice of ECT are discussed.”

But the paper also reports verbatim what the “treated” individuals said.  Here are some quotes:

“They asked me if I would agree to it, but they did say if I refused they’d go ahead with it anyway…being forced to stay there is bad enough but being forced to have something that you don’t want is ten times worse, so I did agree, yes.”

“I thought maybe second time around it’ll be much easier and I won’t feel so scared and terrified, but it was just the same, if not a bit more.”

“Afterwards I felt as if I’d been battered…I was just incapacitated, body and mind, like a heap of scrunched-up bones.”

“It was the whole treatment, being carted off I felt like a slave, taken away to this little room and put on a bed. No control, it was awful.”

“It was like I was a non-person and it didn’t matter what anybody did to me.”

“It felt like I had been got at, yes, bashed, abused, as if my brain had been abused. It did feel like an assault.”

“People would come up to me in the street that knew me and would tell me how they knew me and I had no recollection of them at all…very frightening.”

“In a very bizarre sort of way, because the treatment and the abuse was so terrible, it made me come to my senses. I’ve got to get my act together, I’ve got to help myself.”

“Well, it deadens your brain, doesn’t it? That’s what it does.”

There are pages more; a tragic and heart-rending catalog of abuse.

THE “THERAPEUTIC” EFFECT

After shock “treatment,” many individuals present fewer management problems and also say that they feel better.  These benefits are usually short-lived, but they constitute the basis for the fiction that ECT is a safe and effective “treatment” for severe depression.

In the early days of shock “treatment” the proponents were more honest about the brain damage, and in fact stated very clearly that it was this very damage that produced the “beneficial” effect.  Here are some quotes:

“I believe there have to be organic changes or organic disturbances in the physiology of the brain for the cure [with electric convulsive therapy] to take place. I think the disturbance in memory is probably an integral part of the recovery process. I think it may be true that these people have for the time being at any rate more intelligence than they can handle and that the reduction of intelligence is an important factor in the curative process. I say this without cynicism. The fact is that some of the very best cures that one gets are in those individuals whom one reduces almost to amentia.” Abraham Myerson (U.S. electroshock psychiatrist), June 1942 [The Electroshock Quotationary]

 “This brings us for a moment to a discussion of the brain damage produced by electroshock…. Is a certain amount of brain damage not necessary in this type of treatment? Frontal lobotomy indicates that improvement takes place by a definite damage of certain parts of the brain.”  Paul H. Hoch (Hungarian-born U.S. electroshock psychiatrist), “Discussion and Concluding Remarks,” Journal of Personality, vol. 17, 1948.  [The Electroshock Quotationary]

“From the data available, it is probable that the biochemical basis of convulsive therapy is similar to that of craniocerebral trauma…” Max Fink, MD, psychiatrist, in 1958 (quoted in Doctors of Deception by Linda Andre, p 49)

“After a few sessions of ECT the symptoms are those of moderate cerebral contusion, and further enthusiastic use of ECT may result in the patient functioning at a subhuman level…. In all cases the ECT “response” is due to the concussion-type, or more serious, effect of ECT. The patient “forgets” his symptoms because the brain damage destroys memory traces in the brain, and the patient has to pay for this by a reduction in mental capacity of varying degree.  Sidney Sament (U.S. neurologist), letter to Clinical Psychiatry News, March 1983. [The Electroshock Quotationary]

In addition, it is very well known in neurology circles that one of the side effects of severe brain injury is a short-lived sense of euphoria!

As is the case with psychoactive drugs, the putative therapeutic effect is identical to the toxic effect.  In the immediate aftermath of shock “treatment” people don’t feel depressed because they have lost the ability to feel much of anything.  They don’t present management problems, because they are rendered almost incapable of any kind of executive action; they don’t remember past traumatic events, because their memories have been obliterated.  Sometimes these deficits remit somewhat over time, sometimes not.  But with repeated “maintenance” exposure, the damage becomes extensive and more or less permanent.

Imagine if rheumatologists amputated people’s legs to cure knee joint deterioration.  It would definitely work!

In his wonderful novel Galapagos, Kurt Vonnegut, with tongue firmly in cheek, laments the fact that the human brain is simply too big.  He attributes all our woes, all our counter-productive fretting, all our dysfunctional behavior, to this simple anatomical fact, and looks forward to the day when the inexorable adjustments of natural selection will have corrected this aberration.

But you don’t have to wait for evolution.  We have shock “treatment”!!   It’s in a “hospital” near you – right now.

Isn’t it time that this “treatment” went the way of spinning chairs and insulin coma “therapy”?