The Need for Positive Alternatives to Psychiatry's Brain-Damaging Approaches
Why ElectroConvulsive 'therapy' is bad for your brain - as if the term itself didn't tell you.
COMMENT 6 - POWER & OPPRESSION **** EXAMINATION - FROM MICHEL FOUCAULT
Just in the last week in the UK, MIND issued a report
on ECT. There was a review in the Guardian. There is a self-help
group called ECT Anonymous, 14 Western Avenue, Riddleston,
Keighley, West Yorks, BD20 5DJ. I know people who had their heads
smashed against the windscreen in car crashes, and felt fine
after a couple of weeks. I`m (almost) surprised psychiatrists
haven`t tried it as a cure for depression.
Have you ever wondered why people who have had their brains shot
through with high voltage by a psychiatrist will tell you that it
'worked` and that they feel much better now thankyou doctor. It
could be, couldn`t it, something to do with them not wanting it
to happen again?
Ian Parker - Discourse Unit,Bolton Institute, Deane Road ,Bolton
BL3 5AB UK - email: I.A.Parker@Bolton.ac.uk
Years ago, when I was working at NPI at the U. of
Michigan Hospital, I was director of a research project that
compared the effects of bilateral ECT with unilateral ECT. Dr.
Raymond Waggoner, the Dept. Chair, had obtained a research grant
to bring Dr. Stanley Cannicott over from England to demonstrate a
bilateral technique he had developed. Cannicott had found that by
inducing the seizure in the non-dominant hemisphere the pts
recovered from the treatment very quickly with no loss of memory.
This was especially valuable for physicians, accountants,
professors and others who rely on memory for their work. We set
up test and control groups in psychiatric hospitals in the Ann
Arbor area. The results established beyond the .01 level that
patients receiving traditional bilaterally induced ECT showed
organic impairment while the unilateral pts did not.
Early one Monday morning I let myself into the locked adult
female ward of a private hospital. As I walked down the hall, a
woman I hadn't seen before rushed up to me. She was about 50,
dark complexion, black hair with some gray, looked matronly. She
said "Please help me. I'm not supposed to be here! My
husband and son put me here! Please help me."
"I have no authority to do anything here," I told her.
"Why are you here in the mental hospital?"
"My husband put me here. I said I would divorce him. I
warned him before to stop being bossy. He always bossed me
around. He came home from work Friday and was bossy again. I got
mad. The last straw. I yelled and screamed at him. I said, 'Get
out! Leave me alone. I divorce you!' He yelled at my oldest son
to get the car out. He grabbed me and said I am crazy to divorce
him. He wrestled me to the car. He threw me on the floor and held
me down. He ordered my son to drive me to this place. Please help
me! I'm not crazy. My husband, he's crazy. They won't let me
telephone. I can't call friends or my sister. Please help."
Two aides came over. They took hold of her arms and led her into
a small lounge where all the patients were held during shock
treatments. An aide said to me "She's a bad one. Tried to
escape twice this weekend. Made it out to the lawn once. Nothing
but trouble, saying she's not crazy. Stirring up the
patients."
When the "Shock Team" arrived in the ward dayroom the
nurse called for the woman first. The aides led her toward the
treatment table. She began to struggle. She yelled "No! What
are you doing to me?"
"You need treatment for your illness," the psychiatrist
said.
"I'm not crazy! I don't want treatment!" Five aides,
all husky, wrestled her onto the table and held her down. The
psychiatrist injected the muscle relaxant into her arm. "No!
I don't want treatment!" The nurse pressed the rubber strip
with the two electrodes down tight over her forehead. "You
need this treatment, "the psychiatrist said. "You are
mentally ill." "No! I'm not crazy!" I saw the
psychiatrist turn the dials to increase the voltage and the
duration of the shock. He turned back to her and smiled. The last
thing she heard before he pressed the button was his voice
insisting, "You are mentally ill."I watched the
convulsions rack her body. It was at this same hospital only a
few days before, that I had been in an elevator with one of the
other psychiatrists who owned the hospital and had this
conversation:
He asked "How is the research going?"
I said "We're getting significant results. The data support
the unilateral technique. There's no brain damage and the
depressions are lifting. Have you asked the nurses and aides for
their reactions? They're amazed at the difference. And when I go
in to do my memory test, some of the bilateral patients plead
with me to be allowed to have the 'good kind.'"
"I've seen all that," he said. "But
franklyŠ" He looked around even though we were alone in
the elevator. He leaned close and whispered, "ŠI make
some of my patients brain damaged on purpose. They aren't so
resistant to directions that way. They follow my orders better
when they're confused and dependent."
What shocked me the most was that when I talked about these
experiences with a psychiatry instructor back at NPI, he wasn't
surprised or alarmed. Psychiatrists know that these things happen
and remain silent about it. Go find out for yourself, Ian, if you
dare. Find out why psychiatry is the only medical specialty that
must have police protection from its ex-patients when it holds
conferences.
Al Siebert - e-mail: asiebert@thrivenet.com - a thriving story of the month at the THRIVEnet website: http://www.thrivenet.com/
About 20 years ago John Friedberg, M.D., a neurology
resident in a California hospital, became increasingly dismayed
at all the evidence documenting neurological and organic damage
caused by ECT. He attempted to change the system from within by
writing a professional research article that he presented to the
psychiatry department. The result was that he was fired from his
position, declared mentally ill, and told he needed treatment.
Friedberg wrote a book titled "Shock Treatment is Not Good
For Your Brain," Glide Publications, 1976. Chapter three,
"The Evidence Against Electroconvulsive Therapy," has a
footnote that says "This chapter is a revision of the paper
that got me fired. It is intentionally detailed and meticulously
referenced to assure as watertight a case as possible against
ECT."
Al Siebert
When Leonard Roy Frank was 30 years old he started on
a spiritual quest. His parents became so disturbed by what he was
saying, feeling, and thinking they had him committed. He was
forced, against his will, to submit to an intense series of ECT
and insulin coma that left him with permanent memory loss.
Because of that experience, he dedicated himself to preventing
the same thing from happening to others and has worked to
eliminate ECT for over thirty years. Frank is very bright,
articulate, and thorough. In 1978 he published what is now a
classic book, The History of Shock Treatment. This is not likely
to be in any psychiatric or clinical psychology library, but it
is loaded with excellent documentation. I telephoned him to see
if he still has copies. He does. The price is $14 plus $3 for
P&H. His address is 2300 Webster Street, San Francisco, CA
94115. A more recent, short version of his perspectives on ECT is
in an article titled "Electroshock: Death, Brain Damage,
Memory Loss, and Brainwashing" in Challenging the
Therapeutic State: Critical Perspectives on Psychiatry and the
Mental Health System, a special issue of The Journal of Mind and
Behavior, Editor David Cohen, Volume 11, Numbers 3 and 4, Summer
and Autumn, 1990. Frank's arguments against ECT also appear in a
chapter titled "Should ECT Be Prohibited?" in a book
titled Controversial Issues in Mental Health, Edited by S.A. Kirk
and S.D. Einbinder, Allyn and Bacon, 1994.
Al Siebert
(1995). The minor issue of electroconvulsive therapy. Nature
Medicine, 1 ,199-200.
ECT was first applied to human patients in Italy
following a fortuitous observation that restless and frantic
animals being led to the slaughterhouse were rendered calm and
manageable following application of a stunning bolt of electrical
current. ... However, use of the treatment is not restricted to
desperate cases. Nor is it restricted to consenting patients.
Last year, in the United Kingdom, an average of four or five
treatments were administered to approximately 22,000 psychiatric
patients and APPROXIMATELY 2,000 PATIENTS DID NOT CONSENT TO THE
PROCEDURE.* ... Other patients are told that IF THEY DO NOT
CONSENT THEY WILL BE 'SECTIONED' or made the subject of a mental
health order. In the United Kingdom it is possible to use Mental
Health Legislation to confine patients who are clinically deemed
to be a danger to themselves or others and to compel such
treatment as may be recommended by two consultant psychiatrists
and endorsed by a mental health board. Others who have undergone
compulsory or coercive ECT talk of being assaulted or broken down
in a routine and legalized clinical abuse. Even more worrying is
the use of ECT on children.... I have ... heard of a 14-year-old
rape victim who was treated with ECT against both her and her
parents wishes. This girl suffered from a classical post
traumatic stress disorder, which would respond to a combination
of safe milieu and psychotherapy. A RECENT BRITISH STUDY REVEALED
THAT 60 CHILDREN UNDER 16 YEARS OF AGE HAVE BEEN TREATED WITH ECT
IN THE PAST DECADE, ALTHOUGH MANY CONSIDER THIS AN
UNDERESTIMATE.* ... (P)atients have experienced inadequate
anaesthesia and have therefore been conscious, but incapable of
signalling their conscious state ... ECT also has more routine
side effects, the most common of which is memory loss, often
accompanied by an inability to properly integrate new
information. ....Poor training, poor equipment, poor consent
procedures and poor preparation of patients have all continued.
(199) .... Under these circumstances the question of treating
children with ECT is a particularly serious concern. I know of no
condition in the field of psychiatry of the young that requires
ECT rather than an alternative treatment. It is of major concern
that THE GROWING CHILD'S BRAIN MIGHT BE IRREVERSIBLY DAMAGED BY
THE REPEATED PASSAGE OF AN ELECTRICAL CURRENT. THERE HAS BEEN NO
RESEARCH THAT HAS SPECIFICALLY ADDRESSED THE QUESTION OF WHETHER
YOUNG
BRAINS CAN SAFELY TOLERATE THIS ASSAULT. And this, for a
procedure that is so poorly understood that it is next to
impossible to provide reliable information before asking for
consent. .... In the United Kingdom, The National Association for
Mental Health has called for a ban on the use of ECT in children
under 18 years and a ban on all compulsory use of ECT. I would
extend that to all patients who are unable to provide consent due
to their mental state. Most importantly, without a well-organized
and funded national audit we may never learn under what
circumstances ECT is and is not effective and whether the
clinical successes are won at the expense of the patients (sic)
memory and integrity My own opinion is that this scrutiny would
reveal that the procedure is now redundant and far too costly in
human terms. It is noteworthy that PSYCHIATRISTS IN HOLLAND AND
GERMANY HAVE BANNED ECT.
The abuses perpetrated upon individuals in these extracts about ECT rightly provoke indignation, anger and repulsion in readers who may never have considered that such things happen in our ‘caring’ society, in hospitals, between doctors and the patients they pretend to be ‘caring’ about.
It is useful to put such abuses in another perspective by considering the power mechanisms of control, surveillance and punishment at other more pervasive levels - at levels which impinge upon all of you everyday. To encourage you to reflect on this, have a look at the following observations of Michel Foucault on the mechanism of the ‘examination’ - something which we all undergo in many different situations in our daily living - in the form of interviews for jobs; being inducted into a military organization; going for an appointment to see your family doctor or going to hospital; undertaking school or university examinations; etc.
Foucault provokes some important reflections on the way that power and knowledge is intertwined to reduce persons to controllable ‘objects’ - to depersonalise and to degrade.
The Examination
"The examination combines the techniques of an observing hierarchy and those of a normalising judgement. It is a normalising gaze, a surveillance that makes it possible to qualify, to classify and to punish. It establishes over individuals a visibility through which one differentiates them and judges them. That is why, in all the mechanisms of discipline, the examination is highly ritualised. In it are combined the ceremony of power and the form of the experiment, the deployment of force and the establishment of truth. At the heart of the procedure of discipline, it manifests the subjection of those who are perceived as objects and the objectification of those who are subjected. The superimposition of the power relations and knowledge relations assumes in the examination all its visible brilliance. ....
One often speaks of the ideology that the human ‘sciences’ bring with them, in either discreet or prolix manner. But does their very technology, this tiny operational schema that has become so widespread [from psychiatry to pedagogy, from the diagnosis of diseases to the hiring of labour], this familiar method of the examination, implement, within a single mechanism, power relations that make it possible to extract and constitute knowledge? ....
One of the essential conditions for the epistemological ‘thaw’ of medicine at the end of the eighteenth century was the organisation of the hospital as an ‘examining’ apparatus. The ritual of the visit was its most obvious form. ....The old form of inspection, irregular and rapid, was transformed into a regular observation that placed the patient in a situation of almost perpetual examination. ....
The examination introduced a whole mechanism that linked to a certain type of the formation of knowledge a certain form of the exercise of power.
1. The examination transferred the economy of visibility into the exercise of power. Traditionally, power was what was seen, what was shown, and what was manifested and, paradoxically, found the principles of its force in the movement by which it deployed that force. ....
Disciplinary power, on the other hand, is exercised through its invisibility; at the same time it imposes on those whom it subjects a principle of compulsory visibility. In discipline, it is the subjects who have to be seen. Their visibility assures the hold of the power that is exercised over them. It is the fact of being constantly seen, of being able always to be seen, that maintains the disciplined individual in his subjection. And the examination is the technique by which power, instead of emitting the signs of its potency, instead of imposing its mark on its subjects, holds them in a mechanism of objectification. In this space of domination, disciplinary power manifests its potency, essentially, by arranging objects. The examination is, as it were, the ceremony of this objectification. ....
Discipline, however, had its own type of ceremony. It was not the triumph, but the review, the ‘parade’, an ostentatious form of the examination. In it the ‘subjects’ were presented as ‘objects’ to the observation of a power that was manifested only by its gaze. They did not receive directly the image of the sovereign power; they only felt its effects - in replica, as it were - on their bodies, which had become precisely legible and docile. ....
‘Very good’, Grand Duke Mikhail once remarked of a regiment, after having kept it for one hour presenting arms, ‘only they breathe’.
2. The examination also introduces individuality into the field of documentation. The examination leaves behind it a whole meticulous archive constituted in terms of bodies and days. The examination that places individuals in a field of surveillance also situates them in a network of writing; it engages them in a whole mass of documents that capture and fix them. The procedures of examination were accompanied at the same time by a system of intense registration and of documentary accumulation. A ‘power of writing’ was constituted as an essential part in the mechanisms of discipline. ....
3. The examination surrounded by all its documentary techniques, makes each individual a ‘case’. A ‘case’ which at one and the same time constitutes an object for a branch of knowledge and a hold for a branch of power. The case is no longer, as in casuistry or jurisprudence, a set of circumstances defining an act and capable of modifying the application of a rule; it is the individual as he may be described, judged, measured, compared with others, in his very individuality; and it is also the individual who has to be trained or corrected, classified, normalised, excluded, etc. ....
The disciplinary methods ...lowered the threshold of describable individuality, and made of this description a means of control and a method of domination. It is no longer a monument for future memory, but a document for possible use. And this new describability is all the more marked in that the disciplinary framework is a strict one; the child, the patient, the madman, the prisoner, were to become, with increasing ease...the object of individual descriptions and biographical accounts. This turning of real lives into writing is no longer a procedure of hero-isation; it functions as a procedure of objectification and subjugation. ....
The examination as the fixing, at once ritual and ‘scientific’, of individual differences, as the pinning down of each individual in his own particularity ... clearly indicates the appearance of a new modality of power in which each individual receives as his status his own individuality, and in which he is linked by his status to the features, the measurements, the gaps, the ‘marks’ that characterise him and make him a ‘case’.
Finally, the examination is at the centre of the procedures that constitute the individual as effect and object of power, as effect and object of knowledge. It is the examination which by combining hierarchical surveillance and normalising judgement, assures the greater disciplinary functions of distribution and classification, maximum extraction of forces and time, continuous genetic accumulation, optimum combination of aptitudes and, thereby, the fabrication of cellular, organic, genetic and combinatory individuality. With it are ritualised those disciplines that may be characterised in a word by saying that they are a modality of power for which individual difference is relevant. ....
The individual is no doubt the fictitious atom of an ‘ideological’ representation of society; but he is also a reality fabricated by this specific technology of power that I have called ‘discipline’. We must cease once and for all to describe the effects of power in negative terms; it ‘excludes’, it ‘represses’, it ‘censors’, it ‘abstracts’, it ‘masks’, it ‘conceals’.
In fact, power produces; it produces reality; it produces domains of objects and rituals of truth. The individual and the knowledge that may be gained of him belong to this production. "
Extracts from Michel Foucault. [1982]. Discipline and Punish: The Birth of the Prison. p.p.184-194. England: Peregrine Books.
[1] Juli - My interest in mental health is as a consumer/survivor. I consider myself both of those. A survivor because I've survived some horrific abuse at the hands of the system.
I won't go into the abuse I've seen and experienced. I'm sure it will come out later. I've survived it, and it's made me determined to work in psychiatric rights. I'm involved in the KL vs. Edgar et al lawsuit (their star witness) in Illinois brought by the ACLU against Illinois for its horrid state psych hospitals. And they said "Cuckoo's Nest" was a thing of the past. Ha.
I'm also a survivor of ECT...and I've got lots to say on the
subject. I was coerced into ECT myself two and a half years ago.
My then-shrink gave me a choice....have ECT or hit the road. Even
though his treatments were not working, I felt dependent on him,
and was terrified of being without a doctor. Later, I learned
that there were many more medications to try. He just didn't give
them a chance. And ECT is a large (and more profitable) part of
his practice.
I have spent the last two years, since my own disastrous
experience with ECT, researching the treatment and industry, and
talking with thousands of ECT recipients. Coercion is very real,
as is a lack of trying other methods before resorting to ECT.Look
at the California stats, and see how many elderly are getting it.
There's a big jump once patients turn 65...because Medicare pays
for it. Stats in the other states are the same.
Juli
Never doubt that a small group of thoughtful, committed citizens
can change the world, indeed, it is the only thing that ever
has...Margaret Mead
Shocked! Home Page: http://www.i1.net/~juli/shocked.html
I Must Be Mental! http://www.i1.net/~juli/mental.html
Be sure to read the following
article at the "Shocked" web site Juli Lawrence
created.
ECT: Sham Statistics, the Myth of Convulsive Therapy, and
the Case for Consumer Misinformation. by Douglas G. Cameron The
Journal of Mind and Behavior. Winter and Spring 1994, Vol. 15,
Nos. 1 and 2, Pages 177-198.
Also be sure to read "Does Electroconvulsive Therapy
Prevent Suicide?" from Convulsive Therapy Journal.
This study showed that ECT does NOT have an effect on suicide
rates. The authors of the study called its results
"disappointing."
[2] web: http://www.efn.org/~dendron
David Oaks, co-coordinator Support Coalition International 454 Willamette, Suite 216 PO Box 11284 Eugene, OR 97440-3484 USA e-mail: dendron@efn.org - web: http://www.efn.org/~dendron
[3] American anti-psychiatry info - Pseudoscience, Psychobabble, and Psychology
http://academic.uofs.edu/student/rmr7/links.html
[4] English Anti-Psychiatry site
http://ourworld.compuserve.com/homepages/Duncan_Double/
[5] Psychological Activism
http://www.carleton.ca/~rthibode/activism.html
[6] Of Related Interest - DOE Human Radiation Experiments Home Page
[7] DENDRITE alert on human rights in psychiatry March 23, 1997 - please redistribute
from Support Coalition - dendron@efn.org
[8] Al Siebert, Ph.D. Author of *The Survivor Personality* . Read a thriving story of the month at the THRIVEnet website: http://www.thrivenet.com/.
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