May I let my voice be a clarion call. I will use these words for justice. I will use these words for truth. And humour.

Wednesday, May 16, 2007

 

Did you know 100k US citizens receive Electro-Convulsive Therapy annually?

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I didn't know that until I read about it in a local paper "The Street Sheet," published by and for the homeless community in the bay area. Many people in the homeless community suffer greatly from mental health issues, and are often either undertreated or untreated. In addition to articles written by mental health activist
Leonard Roy Frank (the author of the piece linked above, and several other b00ks, including a quotationary put out by Random House), they had in-depth articles/interviews with journalist/author Robert Whitaker on the nature of the nationwide problems associated with antidepressants and antipsychotics, their marketing pressure, ineffectiveness, and the danger they actually produce in patients.

Almost needless to say, I'm against ECT as a treatment and as a torture. There are much better ways of treating mental health problems, and it seems to still exist primarily as a tool of social control. I think that as humanity grows to be more aware of how the human brains work, they may find that introducing electricity to the brain can be effective, and they will also discover that ECT introduces the brain to a destructive process with the subtleties of a kiloton-sized bomb, when really what could be best would be small fine-tuned intricately-timed millivolt charges at precise locations. I guess we'll see, but I'd imagine there is already a lot of headway being made with respect to electrochemical neuroconnectivity, right?

WELL-KNOWN ELECTROSHOCK PATIENTS
Some of the better-known people who have undergone electroshock treatment include
French philosopher Louis Althusser, French playwright and actor Antonin Artaud, actor
Clara Bow, writer and poet Richard Brautigan, television personality Dick Cavett, Kitty
Dukakis (Massachusetts governor Michael Dukakis’s wife), Missouri senator and
(briefly) 1972 Democratic Party vice presidential nominee Thomas Eagleton, writer
Ralph Ellison, actor Frances Farmer, New Zealand writer Janet Frame, singer Connie
Francis, singer and actor Judy Garland, Naomi Ginsberg (Allen Ginsberg’s mother),
Australian pianist David Helfgott, writer Ernest Hemingway, Russian-born U.S. pianist
Vladimir Horowitz, Irish poet Pat Ingoldsby, poet Bob Kaufman, musician Roland
Kohloff, Olga Koklova (Pablo Picasso’s first wife), writer Seymour Krim, British actor
Vivien Leigh, pianist and actor Oscar Levant, poet Robert Lowell, British humorist Spike
Milligan, composer Paul Moravec, physician and writer Sherwin Nuland, actor Jennifer
O’Neill, English writer and illustrator Mervyn Peake, baseball player Jimmy Pearsall,
writer Robert Pirsig, poet Sylvia Plath, composer Cole Porter, poet and lyricist Dory
Previn, songwriter and performer Lou Reed, singer/actor and human rights leader Paul
Robeson, French fashion designer Yves Saint-Laurent, writer Andrew Solomon, writer
William Styron, actor Gene Tierney, songwriter and performer Townes Van Zandt,
physician Mark Vonnegut (Kurt Vonnegut’s son), poet John Wieners, Rose Williams
(Tennessee Williams’s sister), British writer Simon Winchester, CIA official Frank
Wisner, Australian singer Stevie Wright, and singer Tammy Wynette.



A LONG list of telling quotes from the 155-page article (based on historical quotations on ECT) linked above:

'[Regarding the first ECT experiment, performed on a subject found by police wandering around a railway station] “Two large electrodes were applied to the frontoparietal regions, and I decided to start cautiously with a low-intensity current of 80 volts for 0.2 seconds. As soon as the current was introduced, the patient reacted with a jolt and his body muscles stiffened:
then he fell back on the bed without loss of consciousness. He started to sing abruptly
at the top of his voice, then he quieted down. Naturally, we, who were conducting the
experiment, were under great emotional strain and felt that we had already taken
quite a risk.
“Nevertheless, it was quite evident to all of us that we had been using a too low
voltage. It was proposed that we should allow the patient to have some rest and repeat
the experiment the next day. All at once, the patient, who evidently had been following
the conversation, said clearly and solemnly, without his usual gibberish: ‘Not another
one! It’s deadly!’”
The next day, despite the subject’s plea, Cerletti administered a stronger shock which
caused a seizure. Thus “the first experiment of induced electric convulsions in man”
(Cerletti’s words) was carried out against the will of the subject with no one’s
authorization other than that of the person conducting the experiment.'

"1957-1961 — Husbands might wish to have their wives forget the emotional troubles,
including marital strife, which precipitated hospitalization. Mr. Karr [a pseudonym]
commented on his wife’s long-term memory loss as proof of her successful cure by ECT,
saying that her memory was still gone, especially for the period when she felt ill, and
that “they did a good job there.” These husbands used their wives’ memory loss to
establish their own definitions of past situations in the marital relationship....
Mr. Karr... expressed pleasure to the research interviewer that electroshock therapy
had made his wife forget her hostile outbursts against him in the pre-hospital period."

"A few days after being released from the Mayo Clinic following a second electroshock series in 1961, Hemingway killed himself with a shotgun blast to the head at the age of 61. Several years later, Howard P. Rome, his Mayo Clinic psychiatrist, was elected president of the American Psychiatric Association."

"You are strapped to a table, shaped, ironically, like a cross, with a crown of electric
sparks in place of the thorns. You are touched on each side of the head with wires. Zap!
Five cents’ worth of electricity through the brain and you are jointly administered
therapy and a punishment for your hostile go-to-hell behavior, on top of being put out of
everyone’s way for six hours to three days..."

"When I was young, I wanted to be a priest and I guess that was the dream
of my childhood, and I went into a seminary at the age of 16 and later went to novitiate.
And one day I woke up in a hospital. And on my medical records it said that I was a
catatonic schizophrenic and that therefore they gave me electroshock treatment. The
treatment itself was horrendous.
I remember two of them from my medical records which stated that I had 17 of them.
I remember being strapped down, totally powerless, electrodes being applied to my
head, injection of drugs, and a hum starting to appear inside my head, increasing in
volume till my whole head vibrated, and finally at the last moment it was like a crack,
like a gunshot, which blew me into nonexistence.
Coming to and not knowing who I was or where I was. An incredible fog. That was
horrendous, and I remember the last treatment that I had. I told the psychiatrist when I
was lying on the table, “I don’t want this treatment, I am afraid of it, it is horrendous, it
kills me, it’s very painful.”
And he said, “There is no pain. We give you a drug and there is no pain. Don’t be so
childish, don’t be a baby about it. Just relax and take the drug.” And that was such a
[pause] demeaning... [ellipsis in original]. I was even denied the ability to say that my
experience is that I feel pain in this treatment, that I am being a baby... [ellipsis in
original]. He is the expert. He has this credential. He went to school and studied this. He
has been certified by the state. But I am the person going through this, and I have no
credibility...."

"I am 49 years old today. I accept my age only because
my birth certificate validates the time, day, and the place of my birth. In reality, my
reality, I am 23. I have no memory of existing prior to October 1963, and the
recollections I do have of events of the following years until 1966 are fuzzy and few....
Dr. Cameron’s “brainwashing” experiments wiped my brain clean of every experience
I had ever known....
My parents were introduced to me that winter of 1963/64. Of course, I did not know
them. The children came back from wherever they had been living. I had no idea who
they were, and I certainly had no sense of what a “mother” was. They were all “older”
than I; the oldest could read and write — their mother could not...."

"Terrified, having seen the price for disobedience (for I had defied the psychiatrists by
not resuming my role), I tried hard now to be “good.” The carpeted floors and pastel
walls showed me one of my choices; the vacant stares and shuffling gaits of the patients
returning each morning from the shock room showed the other. Again the lesson:
conformity or punishment!"

"she was one that
really rebelled. I don’t know if she knew what it was before, but she had seen people and
you don’t see people get it, but you see them before and after and you see the difference.
Q. Anybody else attempt to fight back in any way?
A. I don’t think so. You know, you learn to play the game. But sometimes I thought, I
wonder if I got better they’d stop doing it. So I’d say, “Boy, I sure feel good today,” and
they’d say, “Oh, that’s great, they’re helping you so much.” So I thought, well, maybe if I
don’t do any better. [And I’d say,] “God, I feel terrible,” so they go, “That’s okay, the next
one will take care of it.” You can’t win really. I think they’d set up before how many I was
going to get. And after twenty she [the nurse] stopped and said, “Well, you’ve had your
twenty.” So I don’t think it would have mattered if I had done really bad or done really
well."

"[The old personality] was dead. Destroyed by order of the court, enforced by the
transmission of high-voltage alternating current through the lobes of his brain.
Approximately 800 mills of amperage at durations of 0.5 to 1.5 seconds had been
applied on twenty-eight consecutive occasions, in a process known technologically as
“Annihilation ECS” [ECT]. A whole personality had been liquidated without a trace in a
technologically faultless act that has defined our relationship ever since. I have never
met him. Never will."

"All your two-bit psychiatrists
Are giving you electroshock
They said, they’d let you live at home with mom and dad
Instead of mental hospitals
But every time you tried to read a b00k [note from joel: i change the oo's to 00's, so that this and other posts don't show up in a "b00k + list" search of my blog.]
You couldn’t get to page 17
‘cause you forgot where you were
So you couldn’t even read."

"I have been a registered nurse for 13 years and I’ve been a psychiatric nurse for
the past five....
I have seen the shock doctor try out all kinds of drugs, mixing them and using them
in such a way that the patient would get worse. Worse. And then the doctor [would have
97
a case for using] ECT as “all else has failed.” Often, if a lot of anticholinergic drugs are
given at once, the patient can go into a worse state and it’s called an anticholinergic
psychosis. I have seen him do this several times with different patients. It can be made
to look in the chart that ECT is the last resort.
I have seen consults with other psychiatrists which are required by law, signed and
written up when the patient was in the process of being put under anesthesia. This is
clearly illegal.
Patients are badgered to consent to another series after the first series is finished. At
this point they are often confused and do not remember how many treatments they have
had. Can this be legal informed consent?
Patients are often given a soft sell and not told of the possibilities of irreversible brain
damage. Thus, they cannot truly make an informed consent."

"At one time I tried to file for Social Security. I could not remember places I worked or
years. My mother tells me I was always good with dates, years, etc, not no more. I can’t
do any math, I’ve been tutored and helped and it won’t sink in. I can read a page in a
b00k and look up and not have any recollection of what I read. I have lost my ability to
learn and better myself....
I’d also like to tell you that since the ECT I lost my first husband, I have hardly any
memory of him, we were married 10 years."

"One advantage in the use of this treatment as far as hospital staff is concerned is
that the effect of successive shock treatments makes the patient more and more
confused, regressed, compliant, and — above all — forgetful, until the patient no longer
remembers that he is fighting his hospitalization and the use of electroshock treatment.
If there is any question whether the patient meets the criteria for commitment, several
shocks later all doubts will have disappeared as the patient becomes increasingly more
disoriented and confused."

"For the last 15 years or so, nobody has been speaking about electroshock in
Switzerland. Even among professionals, except for the ECT psychiatrists themselves,
there is hardly any knowledge about the current practice of this “treatment.” During the
1970s, psychiatrists noisily declared that electroshock was a very effective treatment,
especially for depressed people. This “beneficial treatment” then fell into disrepute and
for a while there were in real terms fewer people being electroshocked. Psychiatrists
attributed this to a dishonest press campaign carried out by critics of psychiatry.
Starting around 1985, however, and with little public awareness, the number of people
being electroshocked began to rise and has continued rising ever since. One might speak
of the silent comeback of electroshock.
There are good reasons for this silence: most people think of cruelty, torture and
electrocution when they hear the word electroshock. Nearly everyone feels horror and
dread when they imagine someone being administered electroshocks. The same must be
true for psychiatrists, at least before they begin their specialized training. It is during
this training that they learn to suppress their feelings more and more. This results in the
gap between themselves and their patients becoming larger and larger. This gap
separates not only the sane and the insane, the normal and the abnormal, but also the
powerful and the powerless. This gap enables psychiatrists (and other people) to project
everything in themselves that is disturbing and frightening, everything they dislike
about themselves, onto the so-called mad people where it can be dealt with by any
means they choose, including deception and violence. This blaming of others prevents
empathy, understanding, and appreciation of the truth that we are all creatures of value
— equal value.
Violence has always been a remedy, a false remedy, against fear. The powerful are
especially fearful of those they cannot control. In modern society, the “lunatic” is
emblematic of all the uncontrollables. Psychiatrists have developed the tools of control,
145
really weapons of violence passed off as medical treatments. With these tools they are
able to control, manipulate and destroy to a greater or lesser extent the intellectual and
emotional capacities of the uncontrollables, now fixed with stigmatizing psychiatric
labels, and so reduce their own fears and at the same time satisfy their sadistic impulses.
The true nature of electroshock becomes obvious when one considers that outside of
psychiatry applying electricity to any part of a human body is immediately perceived as
a method of torture."

"Women are subjected to electroshock 2 to 3 times as often as men. To cite as
examples statistics from different eras and locations, a 1974 study of electroshock in
Massachusetts reported in Grosser (1975) revealed that 69% of those shocked were
women. By the same token, figures released under the Freedom of Information Act
(Weitz, 2001) show that for the year 1999-2000 in Ontario, Canada, 71% of the patients
given ECT in provincial psychiatric institutions were women.... Another statistic that
seems relevant is that approximately 95% of all shock doctors are male (Grobe, 1995).
Factor in these statistics and a frightening and indeed antiwoman picture of ECT
emerges: Overwhelmingly, it is women’s brains and lives that are being violated by
shock. Overwhelmingly, it is women’s brains, memory, and intellectual functioning
that are seen as dispensable. Insofar as people are being terrorized, punished, and
controlled, overwhelmingly those people are women. And what is likely not coincidental,
almost all the people making the determinations and wreaking the damage are men....
[At public hearings] woman after woman maintained that despite the rationales used,
the real purpose of the electroshock was social control. Cognitive impairment or
memory loss was frequently identified as the means. The implicit rationale is: What
cannot be remembered cannot be repeated or acted on.
ECT appears to be effective in the way abuse is always effective: by inspiring fear of
further violation."


lyrics: Belly's version of "Have You Ever Been Experienced?"


chant/prayer/mantra: Surrender. Be at one. Pull.


pax hominibus,
joel

Comments:
On the one hand, many of the worst abuses of ECT as a therapy happened in the past, before ethics review boards came into existence. On the other hand, it's still used, which is horrifying. I agree that our understandings of how the brain works must be advancing rapidly. However, as far as I have seen, this hasn't led to equivalent advances in mental health treatment. I sincerely hope that it will in the future.

When it comes to handling the worst, most incapacitating forms of mental illness, medical professionals still have very few tools at their disposal. Presumably, this would be the reason given for the continued use of ECT. But I think it would be good to consider whether this is ever an ethical treatment.

To the extent that it might be used as a very last resort, and the damage and trauma it produces might be considered less detrimental than the ongoing mental condition being treated, then it might be okay. But I would suggest that the process by which it is decided to be a better alternative than the illness itself should be examined with utmost care.

For a good theoretical grounding for your discussion of social control, be sure to read Foucault, especially Discipline and Punish and The Birth of the Clinic (in case you haven't already). Upsetting stuff, especially when you consider the unequal application of these forms of social control on women and members of the lowest economic class.
 
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