Sunday, March 20, 2011

The Problems with ECT

   The history of electroconvulsive or electric shock therapy began in 1938 in Italy when two Italian psychiatrists, Ugo Cerletti and Lucio Bini, were visiting a slaughterhouse.  They watched the butchers shock the pigs with electrodes hooked up to wall current in order that they would become more docile before being slaughtered.  This practice gave them the idea that perhaps they could do this to their human patients in order to help become more docile as well. 
   Since its inception in the late 1930s, electroconvulsive therapy (ECT) has never been subjected to testing for Food and Drug Administration (FDA) approval in regard to safety and effectiveness. In 1979 the FDA classified ECT devices as demonstrating "an unreasonable risk of illness or injury" [9]. This would have required animal testing and additional evidence for safety.
   Under heavy criticism from organized psychiatry and ECT advocates, the FDA panel then recommended reclassifying the treatment as safe for depressed patients [3, 9]. However, the panel also recommended delaying the approval process until engineering safety standards could be established for the machines. 1
   What used to be called electroshock or electric shock treatment (EST) is now usually called "electroconvulsive therapy", often abbreviated ECT.  The term is misleading, because ECT is not a form of therapy, despite the claims of its supporters.  ECT causes brain damage, memory loss, and diminished intelligence.  An article in the March 25, 1993 New England Journal of Medicine says "ELECTROCONVULSIVE therapy is widely used to treat certain psychiatric disorders, particularly major depression" (p. 839).  The March 26, 1990 issue of Newsweek magazine reports that "electroconvulsive therapy (ECT) ... is enjoying a resurgence.  ...  an estimated 30,000 to 50,000 Americans now receive shock therapy each year" (p. 44).  Other recent estimates go as high as 100,000 per year.
     In his textbook Psychiatry for Medical Students, Robert J. Waldinger, M.D., states "ECT's mechanism of action is not known.  ...  As with the other somatic therapies in psychiatry, we do not know the mechanism by which ECT exerts its therapeutic effects". 2 Psychiatrists claim unhappiness or so-called depression is sometimes caused by unknown biological abnormalities in the brain.  They say by some unknown mode of action ECT cures these unknown biological abnormalities.  There is no good evidence for these claims.  Other than by causing mental disorientation and memory loss, ECT does not help eliminate the unhappy feeling called depression.  This is true even though currently unhappiness or "depression" is the only "condition" for which ECT is a recognized "therapy".  Indeed, rather than eliminating depression, the memory loss and lost mental ability caused by ECT has caused some subjected to ECT so much anguish they have committed suicide after receiving the "treatment". The fact is that the mechanism of action of ECT is similar to that of psychotropic drugs. 3
     ECT consists of electricity being passed through the brain with a force of from 70 to 400 volts and amperage of from 200 mill amperes to 1.6 amperes (1600 mill amperes).  The electric shock is administered for as little as a fraction of a second to as long as several seconds.  The electrodes are placed on each side of the head at about the temples, or sometimes on the front and back of one side of the head so the electricity will pass through just the left or right side of the brain (which is called "unilateral" ECT).  Some psychiatrists falsely claim ECT consists of a very small amount of electricity being passed through the brain.  In fact, the 70 to 400 volts and 200 to 1600 mill amperes used in ECT is quite powerful.  The power applied in ECT is typically as great as that found in the wall sockets in your home.  It could kill the "patient" if the current were not limited to the head.  The electricity in ECT is so powerful it can burn the skin on the head where the electrodes are placed.  Because of this, psychiatrists use electrode jelly, also called conductive gel, to prevent skin burns from the electricity.  The electricity going through the brain causes seizures so powerful the so-called patients receiving this so-called therapy have broken their own bones during the seizures.  To prevent this, a muscle paralyzing drug is administered immediately before the so-called treatment.  Of course, the worst part of ECT is brain damage, not broken bones.
    Electricity is only one of several ways psychiatrists have induced seizures in people for supposedly therapeutic purposes.  According to psychiatrists, seizures induced by chemicals or gas inhalants are just as effective, psychiatrically speaking, as ECT.  In September 1977 issue of the American Journal of Psychiatry, psychiatry professor Max Fink, M.D. wrote: "Seizures may also be induced by an anesthetic inhalant, flurothyl, with no electrical currents, and these treatments are as effective as ECT" (p. 992).  On the same page he said seizures induced by injecting a drug, pentylenetetrazol (Metrazol), into the bloodstream have therapeutic effects equal to seizures induced with ECT.
     It's interesting, to say the least, that any of these three very different seizure producing agents - flurothyl gas inhaled through a gas mask, Metrazol injected with a hypodermic needle, or electricity passed through the head - could be equally psychiatrically "therapeutic".  Psychiatrists say that it is the seizure that is "therapeutic", not the method of inducing the seizure.  But why would seizures induced by any of these three very different methods be equally "therapeutic"?
     One theory is they are all equally horrifying to the victim (the "patient") who receives the "treatment". In his book Against Therapy, published in 1988, psychoanalyst Jeffrey Masson, Ph.D., asks: "Why do psychiatrists torture people and call it electroshock therapy?" 4 In his book Battle for the Mind: A Physiology of Conversion and Brain-Washing, William Sargant said "The history of psychiatric treatment shows, indeed, that from time immemorial attempts have been made to cure mental disorders by the use of physiological shocks, frights, and various chemical agents; and such means have always yielded brilliant results in certain types of patient". 5 In his book Breakdown, psychologist Stuart Sutherland points out that in his observations ECT "was widely dreaded", and he says "there are many reports from patients likening the atmosphere in hospital on days when ECT was to be administered to that of a prison on the day of an execution".6
     Defenders of ECT say that because of the addition of anesthesia to make the procedure painless, the horribleness of ECT is entirely a thing of the past.  This argument misses the point.  It is the mental disorientation, the memory loss, the lost mental ability, the realization after awaking from the "therapy" that the essence of one's very self is being destroyed by the "treatment" that induces the terror - not only or even primarily physical suffering.  ECT, or electroshock, strikes to the core personality and is terrifying for this reason.  Lothar B. Kalinowski, M.D., and Paul H. Hoch, M.D., stated in their book Shock Treatments, Psychosurgery, and Other Somatic Treatments in Psychiatry: "Fear of ECT; however, is a greater problem than was originally realized.  This refers to a fear which develops or increases only after a certain number of treatments.  It is different than the fear which the patient, unacquainted with the treatment, has prior to the first application. ... 'The agonizing experience of the shattered self' is the most convincing explanation for the late fear of the treatment". 7 One way ECT achieves its effects is the victims of this supposed therapy change their behavior, display of emotion, and expressed ideas for the purpose of avoiding being tortured and destroyed by the "therapy".  Refusing to take ECT doesn't always work, because ECT is often administered against the "patient's" will.  In The Powers of Psychiatry, Emory University Professor Jonas Robitscher, J.D., M.D., said "Organized psychiatry continues to oppose any restrictions by statute, regulation, or court case on its 'right' to give shock to involuntary and unwilling patients." 8 At this point, only one state, Wisconsin, prohibits all involuntary administration of ECT.
    Since the "patient's" fear of ECT is one of the things that makes ECT "work", psychiatrists often get results by merely threatening people with ECT.  As psychiatrist Peter R. Breggin, M.D., wrote in his book Electroshock: It's Brain Disabling Effects: "For patients who witness these [brain disabling] effects without themselves undergoing ECT, the effect of ECT is nonetheless intimidating.  They do everything in their power to cooperate in order to avoid a similar fate." 9
     Another way ECT achieves its effects is by damaging the brain.  In the words of Lee Coleman, M.D., a psychiatrist: "The rationale for electroshock was formerly couched in psychoanalytic terms, with punitive superegos sometimes requiring repeated shocks of 110 volts for appeasement.  Only then could guilt be assuaged and discontent be relieved.  It is much more common now to hear equally absurd neurophysiological explanations, this time the idea being that these electrical assaults somehow rearrange brain chemistry for the better.  Most theorists readily agree, however, that these are speculations; in fact, they seem to take a certain satisfaction in shock treatment's supposedly unknown mode of action. ... The truth is; however, that electroshock 'works' by a mechanism that is simple, straightforward, and understood by many of those who have undergone it and anyone else who truly wanted to find out.  Unfortunately, the advocates of electroshock (particularly those who administer it) refuse to recognize what it does, because to do so would make them feel bad.  Electroshock works by damaging the brain.  Proponents insist that this damage is negligible and transient - a contention that is disputed by many who have been subjected to the procedure.  Furthermore, its advocates want to see this damage as a 'side effect.' In fact, the changes one sees when electroshock is administered are completely consistent with any acute brain injury, such as a blow to the head from a hammer.  In essence, what happens is that the individual is dazed, confused, and disoriented, and therefore cannot remember or appreciate current problems.  The shocks are then continued for a few weeks (sometimes several times a day) to make the procedure 'take,' that is, to damage the brain sufficiently so that the individual will not remember, at least for several months, the problems that led to his being shocked in the first place.  The greater the brain damage, the more likely that certain memories and abilities will never return.  Thus memory loss and confusion secondary to brain injury are not side effects of electroshock; they are the means by which families (perhaps unwittingly) and psychiatrists sometimes choose to deal with troubled and troublesome persons.  Many of us would question such a dubious means of obliterating, rather than dealing with, emotional distress" (From the Introduction, The History of Shock Treatment, edited by L. R. Frank, p. xiii.)
    Advocates of ECT falsely claim there is no evidence of brain damage from ECT.  For example, in his book Overcoming Depression, Dr. Andrew Stanway, a British physician, says "People often worry that ECT might be damaging their brain in some way but there is no evidence of this" (p.184).
    In fact, it didn't take long after ECT was invented in 1938 for autopsy studies revealing ECT-caused brain damage to begin appearing in medical journals.  This brain damage includes cerebral hemorrhages (abnormal bleeding), edema (excessive accumulation of fluid), cortical atrophy (shrinkage of the cerebral cortex, or outer layers of the brain), dilated perivascular spaces in the brain, fibrosis (thickening and scarring), gliosis (growth of abnormal tissue), and rarefied and partially destroyed brain tissue. 10
    Commenting on the extent of physical brain damage caused by electroconvulsive "therapy", Karl Pribram, Ph.D., head of Stanford University's Neuropsychology Laboratory, once said: "I'd rather have a small lobotomy than a series of electroconvulsive shock. ... I just know what the brain looks like after a series of shocks, and it's not very pleasant to look at." 11 Dr. Sidney Sament, a neurologist, describes ECT this way: "Electroconvulsive therapy in effect may be defined as a controlled type of brain damage produced by electrical means.  No doubt some psychiatric symptoms are eliminated ... but this is at the expense of brain damage." 12 Although he is a defender of ECT, Duke University psychiatry professor Richard D. Weiner, M.D., Ph.D., has admitted that "the data as a whole must be considered consistent with the occurrence of frontal atrophy following ECT."  13 By "frontal atrophy" he means atrophy (reduced size) of the frontal lobes of the brain, the frontal lobes being the parts believed to be responsible for higher mental functions.  The frontal lobes get most of the electricity in ECT.  Dr. Weiner also admits "Breggin's statement that ECT always produces an acute organic brain syndrome is correct." 14 Organic brain syndrome is organic brain disease.
    Psychological testing of those who have had ECT also indicates ECT causes permanent brain damage.  For example, in an article in the British Journal of Psychiatry, three psychologists said "The ECT patients' performance was also found to be inferior on the WAIS [Wechsler Adult Intelligence Scale]" and "The ECT patients' inferior Bender-Gestalt performance does suggest that ECT causes permanent brain damage" (Donald I. Templer, Ph.D., et al., "Cognitive Functioning and Degree of Psychosis in Schizophrenics given many Electroconvulsive Treatments" Brit. J. Psychiatry, Vol. 123 (1973), p. 441 at pp. 442, 443).
    In The Exercise Prescription for Depression and Anxiety, psychology professor Keith W. Johnsgard, Ph.D., says "Some who receive ECT appear to suffer both serious and permanent memory loss." 15 A woman who had ECT described these effects ECT had on her memory: "I don't remember things I never wanted to forget - important things - like my wedding day and who was there.  A friend took me back to the church where I had my wedding, and it had no meaning to me" (quoted in: Peter R. Breggin, M.D., Electroshock: It's Brain Disabling Effects, p. 36).  Professional people who have sought treatment for depression and had ECT have lost a lifetime of professional knowledge and skill to this so-called therapy. In one state, Texas, a state law requires those considering ECT be warned about ECT causes memory loss.  But in most states those undergoing ECT voluntarily do so without any warning of the brain damage and associated memory loss and intellectual impairment to which they are about to be subjected - the psychiatrist suggesting ECT usually being the person least likely to give this warning.
   ECT advocates sometimes claim the addition of anesthesia, a muscle paralyzing drug, and oxygenation (making the “patient” breath air or 100% oxygen) prevents ECT-caused brain damage.  But neither anesthesia nor muscle paralyzing drugs nor breathing oxygen stop what the electricity does to the brain.  Autopsy studies, EEGs, and observation of those who have received ECT indicate those given ECT with anesthesia, a muscle paralyzing drug, and forced breathing of air or oxygen experience the same brain damage, memory loss, and intellectual impairment as those given ECT without these modifications.
     Some ECT advocates say the newer brief pulse ECT devices cause less harm than the sine-wave ECT devices that predominated until the 1980s.  In contrast, one prominent ECT supporter, psychiatry professor Richard D. Weiner, M.D., Ph.D., cites studies that "demonstrated sine wave and bidirectional pulse stimuli produced equivalent amnestic changes" (Behavioral & Brain Sciences, March 1984, p. 18).  According to Chicago Medical School psychiatry professor Richard Abrams, M.D., in Electroconvulsive Therapy, 400 volts is a typical peak voltage produced by the newer brief-pulse ECT devices.16 This is more than double the highest voltages produced by the older sine-wave machines, suggesting the newer brief-pulse ECT devices do greater harm.
    Claims that the new "unilateral" ECT in which the electricity is run through only one side of the head is less damaging are also false.  The idea is to spare the parts of the brain responsible for verbal and mathematical skills (non-emotional, computer-like intellectual functions).  These functions are believed to be located in what is misleadingly called the dominant side of the brain.  One problem is the difficulty of determining which side of the brain this is in any particular individual.  In most people it is the left side, but in some it is the right side, so psychiatrists sometimes inadvertently shock the side of the brain they are trying to spare.  The side of the brain intended to get the electricity in unilateral ECT is deceptively called the non-dominant side.  This supposedly non-dominant side of the brain is primarily responsible for our emotionality and sexuality, artistic, creative, and musical ability, visual and spatial perception, athletic ability, unconscious mental functions, and some aspects of memory.  In the words of neurology professor Oliver Sacks, it is "of the most fundamental importance" because it provides "the physical foundations of the persona, the self" without which "we become computer-like" (The Man Who Mistook His Wife for a Hat and Other Clinical Tales, pp. 5, 20).  The side of the brain electroshocked in supposedly non-dominant hemisphere unilateral ECT is at least as important to us as the other parts of our brains.
   Psychiatrists who use ECT are violating their Hippocratic Oath to not harm patients and are guilty of a form of health care quackery.  Unfortunately, most psychiatrists have administered ECT, and government has failed to live up to its responsibility to protect us from this harmful and irrational "treatment".  It is therefore left to you to protect yourself and your loved ones from quackery such as ECT by keeping yourself and your loved ones away from practitioners who use it.
   There have numerous accounts of patients having their teeth knocked out, breaking bones, breaking their spine, or suffering from internal organ damage as a result of being restrained during an induced seizure.  These are the types of results one would get from torturing someone, rather than providing a medical “treatment”. 
                                                            End Notes

1)    Peter R. Breggin “The FDA Should Test the Safety of ECT Machines” International Journal of Risk & Safety in Medicine 22 (2010) 89-92
2)    Robert J. Waldinger Psychiatry for Medical Students (Washington, D.C.: APA, 1997), pp. 120 and 389
3)    Jeremiah R. Grosse “The Truth About Mental Illness”
4)    Jeffrey Masson Against Therapy: Emotional Tyranny and the Myth of Psychological Healing (NY: Flamingo Publications, 1992), p. xv
5)    William Sargant Battle of the Mind: A Physiology of Conversion and Brain-Washing (NY: Malor Books, 1997), p. 82
6)    Stuart Sutherland Breakdown (NY: Oxford University Press, 1998) p.196
7)    Lothar B. Kalinowski and Paul H. Hoch Shock Treatments, Psychosurgery, and Other Somatic Treatments in Psychiatry (NY: Grune & Stratton, 1946), p. 133
8)    Jonas Robitscher The Powers of Psychiatry (NY: Houghton Mifflin, 1980), p. 279
9)    Peter R. Breggin Electroshock: Its Brain Disabling Effects (NY: Springer Publishing, 1979), p. 173
10) Refer to Beggin Electroshock
11) Karl Pribram APA Monitor Sept.-Oct. 1974, pp. 9-10
12) Sidney Sament Clinical Psychiatry News, March 1983, p. 4
13) Richard D. Weiner Behavioral and Brain Sciences, March 1984, p.8
14) Weiner, p. 42
15) Keith W. Johnsgard The Exercise Prescription for Depression and Anxiety (NY: Plenum Press, 1989), p. 88
16) Richard Abrams Electroconvulsive Therapy (NY: Oxford University Press, 1997), p. 113
17) Weiner, p. 8
Richard Abrams Electroconvulsive Therapy (NY: Oxford University Press, 1997)
Peter R. Breggin Electroshock: Its Brain Disabling Effects (NY: Springer Publishing, 1979)
Peter R. Breggin “The FDA Should Test the Safety of ECT Machines” International Journal of Risk & Safety in Medicine 22 (2010)
Jeremiah R. Grosse “The Truth about Mental Illness”
Keith W. Johnsgard The Exercise Prescription for Depression and Anxiety (NY: Plenum Press, 1989)
Lothar B. Kalinowski and Paul H. Hoch Shock Treatments, Psychosurgery, and Other Somatic Treatments in Psychiatry (NY: Grune & Stratton, 1946)
Jeffrey Masson Against Therapy: Emotional Tyranny and the Myth of Psychological Healing (NY: Flamingo Publications, 1992)
Karl Pribram APA Monitor Sept.-Oct. 1974
Jonas Robitscher The Powers of Psychiatry (NY: Houghton Mifflin, 1980)
Sidney Sament Clinical Psychiatry News, March 1983
William Sargant Battle of the Mind: A Physiology of Conversion and Brain-Washing (NY: Malor Books, 1997)
Lawrence Stevens “Psychiatry’s Electroconvulsive Shock Treatment: A Crime against Humanity”
Stuart Sutherland Breakdown (NY: Oxford University Press, 1998)
Robert J. Waldinger Psychiatry for Medical Students (Washington, D.C.: APA, 1997)
Richard D. Weiner Behavioral and Brain Sciences, March 1984


Anonymous said...

what do you think of transcranial direct current stimulation(tdcs)?

Robert S. Grosse said...

I will do some research into this method of treatment and make a determination.