Electroshock

This is a revision of an article based on a speech I gave on this subject at the National Mind AGM, which resulted in a change in their policy with regard to ECT

Electroconvulsive Therapy (ECT) is given to over 20,000 people in the United Kingdom every year. About 70% of them are women. Over 2,000 of them are detained, non-consenting patients. Most people react with revulsion and horror to this treatment, but suppress their feelings because they feel that the men in the white coats must know what they're doing. I urge people to trust their own intuitions on this subject. They will find them quite in line with science.

When someone ends up in the loony bin, as a result of a psychotic breakdown - either because they've gone crazy or because they've become very low - it is of the essence of that breakdown that the person has had a communication breakdown with those around them which like anything - crazy or sane - that goes on in our minds, can be thought of in biological terms. People disintegrate - fall apart - a process which is at the same time mental and biological - but this a process - going to pieces in an environment which has become impossible to live in gives a chance for a re-organising process which is both mental and biological - a process in which interaction with other open-minded and empathic human beings can play a part.

Electroshock is not communication in the manner described above - it is obliteration. Instead of responding to someone's distress and confusion in a biologically appropriate manner - as one human to another - instead that distress and confusion is to be wiped away, ignored, suppressed.

What goes on in the mind corresponds to a biological view where electrical impulses are carried along nerve fibres (and by molecules called neurotransmitters) across gaps between one nerve cell and another.

All of these processes (as any biochemical process) take place in the body in the context of an overall structure of organisation, where every reaction carries out a necessary function in the life of the organism, and is regulated by homeodynamic mechanisms which stablise the internal milieu of the organism. A recent understanding (called the Santiago theory of cognition) sees all biological processes (even involving microorganisms) as cognitive processes and nervous systems as simply structures which organise this on a higher level. But the point about all this is that in the brain as throughout the organism, every molecule, every biochemical reaction, has its place within the highly integrated web of biological organisation.

Electroshock interacts with this delicate and highly organised system like an explosion - causing trillions of random biochemcial reactions which have no place in the body's highly organised system and are totally destructive to it. In place of the biologically organised system of communication, electricity from the grid carries no information whatsoever.

It is apparent that Electroshock, technically speaking, is brainwashing, reminiscent of Orwell's 1984. It is not an attempt to communicate with another human being in distress. One person has decided what should not be in someone else's mind and to obliterate it. The CIA explicitly recognised ECT's brainwashing function when they paid Ewan Cameron, professor of psychiatry in Montreal to experiment with intensive ECT as a brainwashing technique using innocent patients in the 50s and 60s.

What I have written above are simply rational deductions which any sensible person with a little scientific knowledge could make, but there is in fact a overwhelming amount of empirical research showing in detail the damage that ECT does. But in a way there is no need for it - I hope I have indicated above that arguing that ECT is therapeutic is like arguing that the moon is made of green cheese. It is also surprising that it exists at all, because most research into ECT has been carried out by its advocates. Much (though not all) of our research into this area we owe to books by dissident American psychiatrist Peter Breggin who has surveyed the evidence in "Electroshock, its Brain Disabling Effects" and "Toxic Psychiatry".

In the first part of the Electroshock book, Breggin details research proving brain damage from a wide range of sources - brain damage from (rather offensive) animal experiments, human autopsy studies, and in EEG (Electro Encephalograph) and neurological studies. Among other things this research showed violation of the blood-brain barrier and the degeneration and destruction of nerve cells on a massive scale. He cites 33 clinical and research studies confirming permanent mental dysfunction after ECT including anterograde (prior to ECT) and retrograde (after ECT) memory loss and mental impairment.

However, for me the most fascinating part of the book was the last chapters, where he uncovers some of the history of the subject. In particular, he shows that Electroshock was invented (in 1938), in a psychiatric climate where brain damage was considered quite acceptable to "cure mental illness" even at a cost of mental impairment. Psychosurgery, insulin shock and Metrozol, prevalent during this period, all caused brain damage. This was a bad period morally for psychiatry, where German psychiatrists pioneered the use of gas chambers to murder 100,000 mental patients before the SS borrowed the idea to gas the Jews, Reds, gays etc.

Right from the beginning, the efficacy of Electroshock was specifically attributed to the brain damage that it caused. This lasted up until a critical report in 1947 by the Group for the Advancement of Psychiatry in the US. Since then, advocates of ECT have denied it causes brain damage. It also becomes clear that it originated as a means of controlling patients and reducing them to a state of fear and docility and that this state of fear and docility was how its "efficacy" was defined. In recent years, of course, this kind of view can no longer be stated so blatantly.

The next point is the uncritical raising of the question "Does ECT work?" I am fond of replying to this "Fortunately it doesn't work too well." Perhaps it means that it calms people down, makes them "normal" at the cost of erasing the thoughts that caused them distress. Everyone in the world could be made "happy" and "normal" in this way. But would the human race still be human - or vegetables? Perhaps distress, depression, madness is an appropriate social response to a social situation, and action should be taken to change the social situation creating the distress, not to make the individual conform to it. Peter Breggin points out that the euphoria experienced by some patients is probably caused by brain damage, as euphoria is a common neurological symptom of brain damage. It is worth saying that giving ECT means that the psychiatrist can avoid trying to experience someone's distress, which cause distress to themselves.

The ultimate argument used in defense of ECT is that it is used to prevent people committing suicide or from dying of starvation and dehydration when they have stopped eating or drinking due to depression. Firstly the idea of someone having the legal right to prevent someone committing suicide is abhorrent to me. The idea of suicide is heart wrenching, but do we have any moral right to prevent someone committing suicide when we are not offering love or salvation in return? If someone is not eating or taking care of themselves, we can at any rate feed them or take care of them. If they refuse or cannot take food, they can be kept alive by means of an intra-venous line, or drip, as is used in countries where ECT is not used. This may involve tying someone down, which is not very pleasant, but we should not harm someone simply because we find them inconvenient. But of course, what we should be doing is asking why they want to commit suicide, or are in such a state, and to respond with love and compassion to that.

As regards consent to ECT, it is very easy for a psychiatrist to interpret any situation as life threatening if the patient refuses consent and the psychiatrist wants to shock them. Also I do not know to what extent consent can be described as voluntary when someone in a highly distressed state is being held against their will and put under a great deal of pressure to sign a consent form, with the threat of forceable treatment if they do not agree.

ECT poisons mental health care in this country. A willingness to use it is often expected of trainee and fully qualified psychiatrists and those who do not use it are viewed with fear and suspicion by their colleagues and often find it difficult to reach consultant status as a result. Nurses who refuse to administer it are sacked. A committment to ECT is more of a religious or ideological belief than a scientifically grounded one. This authoritarian, fearful and irrational culture as well as the obvious violence of the procedure, attracts completely the wrong kind of person into mental health care and discourages the right kind.