What is the BizOMadness Blog?

This blog is devoted to raising critical awareness of psychiatry generally. It is likewise devoted to the antipsychiatry research projects, publications, and related activities of Dr. Bonnie Burstow. Especially foregrounded are The Psychiatry Project, The Madness Project, and "Psychiatry and the Business of Madness". Related to one another, The Psychiatry Project and The Madness Project involve hundreds of interviews, a dozen focus groups, analysis of several hundred documents and their activation, and dedicated periods of institutional observation. The culmination of both as well as of decades of related interviews and activities is "Psychiatry and the Business of Madness" (timely updates on its publication will be provided)--a cutting edge book in which psychiatry is investigated from multiple angles and which begins to tackle the inevitable question: So if we get rid of psychiatry, where do we go from there?

For the Events page to find events related to this research or this book, see
http://bizomadnessevents.blogspot.ca/

To check out reviews of Psychiatry and the Business of Madness and related publications, see http://bizomadnessreviews.blogspot.ca/

Tuesday, December 5, 2017

Naomi as “Every-Woman”: The Other Mrs. Smith

The Other Mrs. Smith by Bonnie Burstow
Inanna Publications, 2017
447 pages.

In late October, my novel The Other Mrs. Smith—a novel centred on electroshock—was published. The fact that the release of such a novel was newsworthy became evident shortly after its launch. I was approached by CTV National News Channel for an interview (http://www.ctvnews.ca/video?clipId=1270212) But days later, I was approached by Amy Pitt for an interview. What follows is the edited version of the second interview; I invite the reader to peruse and ponder it:

AP: This novel traces the life experiences of one highly successful woman who falls prey to electroshock. What inspired you to write it? 

BB: In the early 1980s, I was part of group that held hearings into electroshock. And those hearings were an incredible eye-opener. I had known people who has been subjected to electroshock, but the few I knew were men. And so while I had certainly seen terrible damage—nothing like what I witnessed from the legions of women at this hearing. The extent of the memory and other losses was horrifying. And that was the start of my becoming highly involved in the fight to ban electroshock. What followed were decades of research, articles, and activism. Now at one point in the mid 80s, it looked like we had the electroshock industry on the ropes. Then we lost the interest of the press and the public and never got it back. Anyway, after decades of research and activism, I remembered the power of art and embarked on this novel. Could a novel, if powerful enough, lead to a public outcry against shock?, I wondered. So what was my inspiration? Very real people and the very real damage done to them.

AP: Primarily, you wrote it from the perspective of Naomi, the protagonist, who suffers from enormous memory loss. How did you go about writing a novel from the perspective of someone who can’t remember much of anything?

BB: That was the struggle; and that, the gambit. As I was keenly aware, all instructions on how to write novels warn you against writing from the first person where the person has been severely damaged or traumatized. And I could totally see why. Nonetheless, I knew from the get-go that this was the only way to do it if the reader was to end up really understanding. So I took the plunge.  Decided to write it from inside the head of a brain-damaged narrator. And indeed, writing from the first person virtually forced me into her perspective.

AP: Did you have to employ any special strategies to tell the story?

BB: Well there was no problem getting into her head—none, for I had been making common cause with shock survivors for decades. The issue was: How was she to tell a story when she cannot remember? Also, how do I ensure that reader does not get drowned  in her problems? What did I do? I started employing two devices early on in the project.  One was to switch back and forth between pre-shock days—when her memory was good—and her post-shock life. The second was to invent point-of-view characters and allow the novel to occasionally drift into the third person narrative from their points of view—for that way we could learn the odd thing that we that we needed to know but that Naomi was in no position to tell us. Those were the two main devices. But even doing that did not come close to addressing the biggest problem facing me. The point is, narrating a novel primarily from within the head of someone who could not remember her story was crazy-making for I kept running into dead ends. Anyway, a couple of years into the project, I decided: I can’t take this any more. I want my life back. And I can get my life back. All I have to do is stop writing this novel. Then it hit me like a thunderbolt: Yes, I can’t get my life back. But shock survivors cannot get their lives back. Which means that I have to continue and to do it well.  Herein lie the moral imperative. And once I took that in, I solved problem after problem. And in the process, the novel grew richer and  richer.

AP: I get that. Let me ask you something somewhat different. They say that all writing is autographical. Where’s Bonnie in this?

BB: Besides the concern over shock? Like the protagonist, I spent most of my life in two cities—Toronto and Winnipeg. Now Naomi loves Winnipeg, not Toronto, and I’m the opposite. So I asked myself, if you loved Winnipeg, what would you love about it? Also I found myself drawing on the type of arguments that my best friend and I have when I scripted quarrels between Naomi and her sister. One way or another, your life always flows into the fiction that you write, and in the absence of that, you just cannot write anything deep.

AP: I’ve heard you refer to this as very much a Canadian novel. How so?

BB: Two Canadian cities come alive in the novel, Toronto and Winnipeg—especially Winnipeg. We are led to shiver at the cold Winnipeg winter. We are introduced to the legendary flooding of the Red River. Aspects of Canadian history—the Winnipeg General Strike, for instance—are frequently referenced. We experience Kensington Market in its heyday. We get a taste of Newfoundland. So, yes, this is quintessentially Canadian. Let me just add, it is at the same time a Turtle Island novel, if I may call it that. An Indigenous theme runs throughout. We witness the oppression of Indigenous people. We make the acquaintance of a remarkable Indigenous man named “Jack”. And we see Indigenous wisdom. When Naomi does not know what to do, she calls to mind Jack—and suddenly, she knows.

AP: Which reminds me, this novel has a huge rich cast of well developed characters. Who’s your favourite and why?

BB: Hands down, Naomi. That said, if I were to choose another, it would be Ger. Ger is a trans man. He is also the kindest and most sensitive soul in the novel—the sort of guy we would all dearly love to have as a friend. And we see him thoughtfully make the connection between his struggles and those of other oppressed people. And then there is his uncanny eye. He realizes early on that there is a secret lurking between the lines in some writing of Naomi’s known as Black Binder Number Three. But let me ask, Amy:  Who’s your favourite?

AP: One of the many characters that I love is Naomi’s father. His kindness, his spirituality, his open-mindedness, his connection with nature. My favourite scene is when he takes the girls outside to feed the birds. It reminds me of my own father. You know, we can all identify with your characters, for they link up one way or another with our own lives. Okay, a more literary question: How’s this novel different from the other famous novel about electroshock—One Flew Over the Cuckoo’s Nest?

BB: Let me say from the outset, that Kesey’s is a truly terrific novel for Kesey is an exceptional writer. At the same time, his novel does not provide either an intricate or an accurate depiction of electroshock. On one level, we are left with the impression that electroshock mainly befalls men, when two to three times as many women as men are shocked. Moreover, women are way more damaged by it. Nor is there any exploration of the damage done. Now it is a fascinating novel, but I would have to add, it is also a sexist novel. The primary adversary in One Flew Over the Cuckoo’s Nest is Big Nurse—a woman, in other words, not the patriarchal figures who actually have the power. By contrast, in The Other Mrs. Smith I lay bare the reality of electroshock. In other words, my novel is once experiential, true-to-life, and what goes along with this, a feminist novel. I was trying to show what happens to women in this patriarchal society and what happens to women with electroshock—the sheer violence against women involved.

To move beyond the question of Kesey, you know, every woman survivor that I have ever known—and I’ve literally known hundreds—have overlapping stories to tell. Which leads me to this point: While the character Naomi is very individual, there is a way in which some version of what befalls her not only has befallen many women, but beyond that, could happen to any woman. You know, the morality plays mounted in the Middle Ages typically contained a character called “Everyman”. And, as unique as Naomi is, what we gradually come to realize, if I may coin a term, is that Naomi is “Every-Woman”. What happened to her happened ultimately for no reason other than that she is a woman. So we see the plight of Every-Woman in Naomi. We also see the wondrous strength of Every-Woman. A testament in itself to the beauty of the human spirit.

AP: Yes, we do indeed see her heroically and brilliantly rebuild a life. Bonnie, congratulations on writing an exceptional novel. You have written a highly lyrical novel. You have provided a sobering account with such grace and tenderness that it speaks to the paradox of what it means to be human. There is something here for everyone.

BB: Humour, pathos, ingenuity, comraderie, activism, mystery, insight.

AP: All and all, a stunning work of art. And I imagine many people will be itching to dip into it over the holidays. So one more question: Where can one pick it up?
BB: From libraries. From the publisher’s website (https://www.inanna.ca/catalog/other-mrs-smith/), from Amazon. Also, from local bookstores. For example, in Toronto, Book City on the Danforth has the equivalent of signed copies.

AP: Good to hear. Congratulations again.

Sunday, November 19, 2017

Creeping Fascism: The Universities’ “Unfit to Study” Policies


I am being put on medical leave by my college due to a number of long standing mental health issues…. I am . . . devastated….I have nowhere to go.” (private correspondence, October 30, 2017)

I was declared “unfit to study” by my college over a year ago. It took the ground out from under me; and I doubt that I will ever get back my life. Dr. Burstow, how can they just do things like this to people? (private correspondence, November 6, 2016)

These are excerpts from two of the many letters that I have received over the last couple of years from students who have left their respective universities involuntarily. Called “mandatory leave” the students subjected to these measures are categorized as “unfit the study”, and such policies are sweeping the globe, with the UK demonstrably taking the lead. Examples of UK universities that have adopted “unfit to study” policies are Oxford, Bradford, Bristol, Brunel, Cardiff, Leeds, London, Reading, and Queen’s University Belfast (see http://www.idras.ac.uk/designing-a-better-system-for-dealing-with-complaints/is-there-a-dispute/fit-to-study-dealing-with-problem-students/). Many universities in North America have similarly adopted them, and the most prestigious university in Canada—University of Toronto—appears to be poised to pass just a policy.

So what exactly are these policies? How are we to understand them? And as people concerned about human rights, decency, and social justice, what should we be doing about them?

On a simple level, they are provisions whereby the university administration can compel a university student to take a “leave of absence”. While the university’s code of conduct is frequently cited, breaking the code of conduct is neither a necessary nor sufficient condition to be placed on mandatory leave. What is pivotal is the university being uncomfortable with the student—oh yes, and that magical term “mental illness”.

Being of danger to self or other is generally how this is understood, though thrown into the mix as well are what would appear to be primarily academic considerations. The policy currently being actively considered by University of Toronto, for example, reads (http://www.governingcouncil.lamp4.utoronto.ca/wp-content/uploads/2017/09/a1005-6i-2017-2018ab.pdf):

The threshold for intervention encompasses two potential scenarios:

Scenario 1: A Student’s behaviour imposes a risk of harm to self or others . . .
Scenario 2: While not posing a risk of harm to self or other as described in Scenario 1, the Student is unable to engage in the activities required to pursue an education at the University not withstanding accommodations.

Scenario 2 is curious, for it appears to preclude at least one possible obvious explanation which is that either the services are insufficient or the university is fostering a toxic or less than accepting environment that is taking its toll on students (e.g., rigid rules, snap tests, the systematic ignoring of the impact that life circumstances inevitably have, a lack of openness to people who think or act differently or not as those around them expect).  One has to wonder why this does not occur to administrators? One also has to ask, how failures generated in part by the university itself have been miraculously transformed into a “health” or to be more precise “mental health” issue besetting the student? More generally, what we seem to be seeing here is a grab-all category which allows universities to get rid of students viewed as troublesome or otherwise not up to the mark. As these expulsions are defined as temporary, they appear benign to the administrators. The problem is that they circumvent choice; they ignore circumstances, they invisibilize the university’s own role in what is happening; they take negotiation out of the hands of both students and faculty; they deeply stigmatize the students subjected to them, and they utterly disrupt the student’s life.

To see how the two scenarios described in U. of T.’s proposed policy work together—it is situations like the one depicted in scenario 1 which allow the policy in its entirety to be seen as about “mental illness” and which is the essence of what most universities appear to have in mind. Note the strategic use of words here like “harm to self or others”— words that echo the phrases found in involuntary committal protocols (see Burstow, 2015). In turn, scenario 2 widens the net, thereby enabling more people to be caught up by the policy. To put this another way, Scenario 1 defines how we are to understand the policy while Scenario Two greatly expands its application.

To briefly cover a few other aspects of these policies, typically, an intricate procedure is spelt out which needs to be followed, with the procedure generally involving assessments by “mental health professionals”. An appeal process is likewise spelt out. And invariably, the mandated leave is described as not punitive but as a kindness to the student. Suicide is sometimes explicitly mentioned and indeed, the students most commonly subjected to the provisions are ones deemed “suicidal” and/or anxious. That said, window dressing aside, what are we actually encountering here?

On one level, we are encountering a profound human rights violation. It is one thing to remove students from their course of study on the grounds of them breaking the university’s rules of conduct—not that expulsion should ever be the default mode. It is quite another to throw them out on the grounds of being mentally ill. We are likewise encountering expediency. The university has an obligation to accommodate and provide service to students experiencing difficulty. The situation which the policy in essence sets up is minimal accommodation happening with the university thereby saving money—for if you kick out students whom you regard as high maintenance, you save a great deal of money on services. By the same token, a pathologization is happening, which similarly saves the university money. Note in this regard that instead of the university, for example, being faced with having to actually do something about the fact that it is creating an environment that leads to students becoming anxious and depressed, the university is identifying the students themselves—and only the students—as the problem and configuring “their problem” as grounds for mandatory leave—hence, the university need not take stock of how it is operating. At the same time, the policy is both actively drawing on and perpetuating stereotypes. The point here is, as has been repeatedly demonstrated, the so-called “mentally ill” are no more violent than anyone else (see Burstow, 2015). Correspondingly, we are seeing ableism and a human rights violation, moreover, a violation of other civil rights, including the right to an education. We are likewise seeing the universities intrude on personal matters which in the final analysis are none of their business.  Once again, as I have repeatedly stated elsewhere (e.g., see https://www.madinamerica.com/2016/04/75895/), while we might dearly wish for people to stay alive. people have a right to kill themselves.  Moreover, they have a right to think and act differently. We are additionally seeing a conduit into the psychiatric system being established both initially (note, in this regard,  “mental health services” are framed as something to try first, that is before a student is put on “mandatory leave”) and in the long run.  On top of which we are seeing a woeful lack of insight and abject cruelty, whether intended or not.

In this regard, the majority of students that are subjected to such policies never return to school or at very least, not to the school that has cast them out.  As numerous emails which I have received suggest, they are humiliated and traumatized by what has happened. Moreover, they typically find themselves at a loss, for they have been robbed of the routines on which they rely, of their way of coping, often of their housing, in short, of the life they have built.

Question: Why would anyone expect that banishing a “depressed” or “suicidal” person from our midst would do anything other than make them more depressed? More isolated? More “suicidal”?

If these policies are a disaster on the personal level—and for the most part they are—they are every bit as disastrous on the systemic level—and we need to keep our eye on this.  What is happening here is institutionalized sanism. Moreover, what is happening is nothing less than an extension of psychiatric rule into the operation of the university. “Mental health services”, which as most readers know, are themselves dangerous and can seriously harm—are being foisted on students.  Psychiatry—not students and faculty—will be deciding who gets to be university learners. And psychiatry to a large part will be dictating who gets to return after the students have been turfed out (it goes without saying that only those who have “availed themselves” of “mental health services” have much of a chance). 

There are very clear winners and losers here. So who wins? Psychiatry of course and by extension the entire mental health industry win for they are thereby colonizing yet another area and thereby securing yet another stream of steady “customers”. And who loses? Pathologized people, the vulnerable, indeed, all students at any risk of being subjected to these measures—and who isn’t? While most academics seem strangely unaware of this, I would add, academia also loses—and at that, profoundly. The point is, what is in effect being accomplished by these measures is the ceding of an important part of the governing of the university to the “mental health industry”. More generally still, society overall loses, for in enacting and applying such policies, we are marginalizing and harming large segments of our populace.

Is this really what we want for our universities? Is this really what we want for society?

The story which I am telling here, of course, clashes in significant ways with the official university narrative, that being a story of progress and of generosity. Which brings us to a series of myths and facts:

Myth: Mandatory leave policies benefit the students subjected to them.
Fact: Evidence shows that the students are not benefited. Rather the students in question are profoundly harmed.  

Myth: There are built-in safety mechanisms like the right to appeal that makes these policies reasonable, for students can always contest the mandatory expulsion.
Fact: The majority of the students are so overwhelmed that they never appeal. Correspondingly, as with issues of involuntary admission to a psychiatric institution, those who appeal almost never win, for the deck is stacked against them (see Burstow, 2015).  Moreover, why should anyone be faced in the first place with such stigma, with such a profound assault on their dignity and liberty? 

Myth: Other students feel unsafe with “these students” around.
Fact: Insofar as this is the case, that is a reason to engage in consciousness-raising, to take measures to counter sanism—not a reason to reinforce sanism by casting people out.

Myth: Were it not for mandatory leave measures, the “mentally ill” who break rules would be banned permanently.
Fact: Let’s not kid ourselves. That, for the most part, is what with these measures accomplish. Moreover, there is no law in any land compelling university administrations to remove students for any period of time who break rules. This is a university invention.  And the university quite simply needs to find more creative and more humane ways to deal with conflict. What adds insult to injury, the issue of whether or not someone is ‘mentally ill” is a “red herring”, is at very best irrelevant for rule-breaking and violence have no intrinsic connection with so-called “mental illness”.

Myth: Mandatory leave is a measure of last resort. It goes along with added support so that more students can stay in school.
Fact: While all administrations who adopt such policies make claims of this ilk, there is no evidence whatever that such practices function as measures of last resort. The point is that universities who have introduced such measures have historically not increased their services. In fact, most have cut back on their services. Which leads one to ask: Could not the desire to spend less on services actually one of primary motivations for introducing such measures? On top of which, the services offered are not just “offered”. There are forced on student and are a way of controlling students. Additionally, as already specified, so much of what is “offered” is incredibly harmful (see Breggin, 1991 and Burstow, 2015).

Nor is this all that is wrong with “unfit to study” policies.

On yet another level—and we fail to recognize this level to our peril—this expansion of psychiatric rule into academia is itself part of a larger and truly worrisome trend. Significantly, just as psychiatric ruling is being used to remove students from school, it is likewise being used to purge the “helping professions” of members that in any way trouble their colleagues. In this regard, being/being deemed “mentally ill” is progressively being seen as a sign of “professional incompetence” with mental illness discourse being leveraged to drive what are often perfectly capable social workers and nurses (especially those of colour) out of their professions (for a detailed analysis of this growing practice, see Chapman, Poole, Azevedo, and Ballen, 2016).

How does this happen? Each of the regulated professions have colleges or other similar bodies associated with them with which members must be in good standing if they are to continue practicing. The policies mandated by these colleges specify that for person to be a member in good standing they must be “competent to practice ” and the policies explicitly allow for the removal of members found to be “incompetent”. Now with mental status progressively dictating how competence is understood, a member’s colleagues, a member’s supervisor, and others in their workplace are progressively on the look-out for signs of “mental illness”.

A nurse’s confidentiality having been broached in that her supervisor mentioned to others that she was once diagnosed as bipolar, the nurse begins to be treated differently, whereupon she becomes noticeably uncomfortable with her colleagues. A social worker seems distraught one day when talking to some of her less than helpful other team members.  A precarious worker at some point is spotted in tears—and who does not know that precarity makes one’s life harder? All this can and indeed has served as ammunition to level against them, to deem them mentally ill and so incompetent and to deprive them of the right to practice. What makes matters worse, as shown by Chapmen, Poole, Azevedo, and Ballen, 2016, people of colour are in special jeopardy of having these policies applied to them.

Further insight into this worrisome trend can be gleaned by looking at the language employed. To whit, just as vulnerable students seen as mentally ill and accordingly thrown out of the university are called “unfit to study”, social workers and nurses thrown out of their profession on “mental health” grounds are called “unfit to practice.” 

There is a historical echo here that is unmistakable. While I am well aware that people applying these policies are not intending this echo and would indeed be shocked at the suggestion of it, as a Jew and as an authority on the Holocaust, on anti-Semitism, and on fascism, I cannot but notice that  “unfit to study” and “unfit to practice” are on a continuum with “unfit to live”—or, to use the more common designation “life unworthy of life” (see https://en.wikipedia.org/wiki/Life_unworthy_of_life)--a concept that ushered in the systemic murder of Jews, mental patients, and others during the Nazi era, with the eradication of the “mental patients” significantly, coming first, paving the way for the others.  (For one of the earliest and most influential articulations of this fascist concept, see Binding and Hoche,1920; for an analysis of what came of it, see Lifton, 1986).

Now to be clear, I am in no way equating these measures or indeed in any way comparing them—for the differences are enormous. Nor am I imputing what might be called “intent”.  However, I am suggesting that they exist on a continuum. I am likewise suggesting that with this extension of psychiatric rule into areas like academia and into professions like social work and nursing (both, not coincidentally, “regulated professions”), what we are witnessing is creeping fascism—hence the title of this piece.  

Alas, it is all too easy for the fascistic nature of such measures to go undetected for it is not the blatant fascism that we hear about on the streets in Charlottesville.  It is not hatred. It is rather, to coin a phrase, “respectable fascism”.  Indeed, it bears all the marks of being kindly as well as responsibly intended. All the more reason we need to be on the alert.

What other groups will society start trying to control this way? What new modes of surveillance, control, and exclusion will be put into place?  These are larger questions that are beyond the auspice of what can be handled in this article, but as society progressively goes down this path, they are important to keep in mind.

That said, to hone in once again specifically on what is happening to students, so what can we do?

One thing we can do is rally students to mobilize their colleagues and the general public to sign petitions to stop these practices, to mount teach-in for students and others on the issue (both of which actions I currently involved in at University of Toronto). When taking part in any such activity, it is important to challenge sanism, to prepare myth/fact sheets, to systematically make visible the contradictions, and to help people see beyond the rhetoric of the university, or to put this another way, beyond the rhetoric of psychiatry—would that they were not currently overlapping so! Other actions that can be taken include legal challenges (for we are witnessing human rights violations here), the mounting of university-wide demonstrations, the insistence on real (and of course voluntary) services.  

On a broader and more philosophic level, we need to educate around sanism. More broadly speaking still, if we are help society arrive at a place where such policies would be unthinkable, we need to integrate what I have called “mad literacy” into school curriculums from the early grades onward (for details on what this might like, see Burstow, 2015, Chapter Nine). We need people growing up knowing that that there are many different ways of thinking and acting—rather than one right way. And we need them to be able to follow and value what is currently dismissed as “crazy”.

On an equally philosophical level, we need to help others recognize fascist thought when they see it or creeping fascism will inevitably continue. On a more basic level, students and faculty need to proceed from vision. More generally, we all of us need to defend freedom, know what it means to be in community, and everyone who cares about human rights and social justice need to announce unambiguously: We stand for inclusivity and accommodation. We stand for real community. We stand for learning from one another. And we affirm together: No one is “unfit to study”.

Make no mistake about—there is a huge fight ahead of us. Allies that can be meaningfully turned to in the fight ahead include psychiatric survivors and their allies, the autistic community, student unions, students from every sector of the university, progressive educators, progressive university staff, disability rights groups, lawyers, activists, advocates, ombudsmen, politicians, religious leaders, organizations of on-side parents. 

The task before us, as I see it, is to assemble as many allies as possible, to build a broad-based coalition, and not to cease in our labour until a) such policies are stuck down; b) university environments are safe for students, c) adequate accommodation is happening; and d) the oppression known as sanism becomes understood and instances of it are transparently treated as unacceptable—even when these arise from university governance  itself. To be clear, while of course the actions of some students may legitimately be seen as a problem by university administrators, this reality is no way justifies sanist and otherwise oppressive policies and processes.

In ending, to touch base once again on exclusionary policies more broadly, beginning with what is currently happening to besieged professionals, by the same token, while individual social workers or nurses may well be incompetent and best not be employed for any number of reasons (e.g., they are woefully hegemonic, lacking in skill, or just plain insensitive), as Chapman, Poole, Azevedo, and Ballen (2016) so astutely put it, “the human experience pathologized as ‘mental illness’” is decidedly not among these. Correspondingly, in accordance with the same principle, while there are people who should not be parenting, perhaps because they are abusive, perhaps because they are negligent, being saddled with a psychiatric diagnosis is likewise not among these.

The point here is that where marginalization, exclusion, and control on the basis of putative “mental illness” is happening and/or is starting to happen in any arena, or to any designated group—and who’s to say that university administrators won’t be next?—we need to oppose the institutionalized oppression and to stand in solidarity with those under siege. Just as we must do so with respect to students. Just as we must oppose “involuntary treatment” and incarceration more generally.

How else are we going to build a better world?

References

Binding, K. and Hoche, A. (1920).  Die Friegabe der Vernichtung Lebensunwerten. Lebens. Leipzig: F. Meiner.

Breggin, P. (1991). Toxic psychiatry. New York: St. Martins Press.

Burstow, B. (2016). Psychiatry and the Business of Madness. New York: Palgrave.

Chapman, C. Poole, J., Azevedo, J., and Ballen, R. (2016). A kind of collective freezing out.  In B. Burstow (Ed). Psychiatry Interrogated (pp. 21-40). New York: Palgrave.


Lifton, R. (1986). The Nazi Doctors. New York: Harper and Row.

Thursday, October 26, 2017

Ending ECT: From a Lawsuit to a Novel—The Moment is Now!

Eyes peer at me, then quickly look away.
Because they are afraid.
Because they sense the humiliation.
Because they know not what else to do.
Stretchers in front of me. Stretchers behind me.
Some poor soul being dragged where none of us want to go.

Who would have thought that a single shriek could fill the universe? (from Burstow, 2017—The Other Mrs. Smith; https://www.amazon.ca/Other-Mrs-Smith-Bonnie-Burstow/dp/1771334215/ref=sr_1_1?ie=UTF8&qid=1508451818&sr=8-1&keywords=the+other+mrs.+smith

In the midst of flagrant professional mispresentation of ECT, this article provides hard-hitting and accurate information about the “psychiatric treatment” known as electroshock (ECT).  What goes along with this, this article is a call to arms. Quite simply, the time has come for a frontal assault on the ECT industry and on the professionals associated with it.  The time has come to rid society of this barbaric “treatment” altogether. 

Naturally, it would make no sense to call for the end to a “treatment” unless clearly it was first and foremost profoundly injurious. So…

What are the Salient Facts about Electroshock?

There are so many horrific facts about ECT that it would take several articles to list them all. In a nutshell, however, some of the most pressing of these are:

·      ECT is a putative “treatment” involving the application of sufficient electricity to the brain to produce a grand mal (Whitaker, 2002, and Breggin, 1991). A relevant point here is that every other branch of medicine moves mountains to prevent grand mal seizures because of the damage which results. By contrast, psychiatry is purposely perpetrating grand male seizures, at the same time denying the damage in question.
·      ECT is inherently brain-damaging, with damage arising from both the seizure and the electricity (see Breggin, 1991).
·      ECT always causes memory loss, much of it extensive and permanent—both loss of memories from before the shock (retrograde amnesia) and inability to remember new facts (anterograde amnesia) (see Burstow, 2015),
·      Contrary to what the shock proponents claim, not a single form of ECT gets around the problems of brain-damage and memory loss. What does the largest study in electroshock history show—and this to a degree of statistic significance?  Despite the standard reference to new and improved, every single mode of ECT damages and creates memory loss (see Sackeim et. al, 2007).
·      As thousands of courageous ECT survivors have testified over the decades, most shock survivors are greatly impeded in their ability to navigate life as a result of this putative “benign treatment”. A typical day for a frighteningly large number is having to take notes all day long for otherwise, by the time the day has ended, they will have no way of knowing what has happened. More generally, an abundance of survivors routinely forget people in their lives, cannot remember facts, ways of proceeding, details, are stuck having to settle for a simplistic job despite having prepared for something very different, for gone are many of the skills that they have spent a lifetime acquiring (see ECT survivor testimony at https://coalitionagainstpsychiatricassault.wordpress.com/articles/personal-narratives/)
·      Electroshock is overwhelmingly an attack on women. In this regard: Two to three times as many women as men are subjected to electroshock. The psychiatric rationale for this difference is that electroshock helps with depression and women are more depressed than man. The truth, however, is, women are given electroshock two to three times as often as men irrespective of diagnosis. What is likewise significant, the very people who are targeted for shock (women) are the ones typically most damaged by it (see Burstow, 2006).
·      The rational for delivering this terrible blow to the mind and to the integrity of one’s being is that ECT allegedly prevents suicide.  The truth is that does not lower the suicide rate (Black et al.,1989).  In fact, a study by Munk-Olsen, et al., 2007, suggests instead that in the days after the “treatment”, it actually raises the risk of suicide.
·      Electroshock is not effective even by the psychiatry’s self-serving measures of effectiveness. As decades and decades of studies show, within six weeks electroshock is no more effective than placebo (for an extensive meta-analysis of the various effectiveness studies, see Ross, 2006).

In short, people are being permanently damaged —for nothing!  Virtually nothing! Hence the call to arms.

What Makes This a Good Time to Combat Shock?

A good time to mobilize on any issue is when you can detect movement on it—which is exactly where we are at this juncture. The point is, after decades of us activists largely spinning our wheels around shock, in the last half year, the attack on shock has been gaining real momentum. What are we seeing?—major law suits, legislative intervention, an uncompromising novel that truly lays bare the reality of shock: All reasons to seize the moment.

The Law Suit(s)

The leading legal action is in California. And it is a class action lawsuit against the manufacturers of shock machines. The filers of the motion are DK Law Group. The major defendants are the giant shock machine manufacturers MECTA Corporation and Somatics—and yes, these are giants! The allegations are: negligence, failure to warn, and loss of consortium. Anyone can join the class action who have sustained injury in California any time from May of 1982 onward as a result of the negligence of the shock manufacturers (for further details, including how to get involved, see David Karen, 2017). 

Significantly while this action is restricted to California, DK Law Group is committed to helping law firms in other states file similar cases. And interest is growing in having comparable suits world-wide. 

Herein lies a promising new direction and a momentum that we have not seen before.

I would just add: A Canadian law firm as well is actively considering launching a class action lawsuit, but unfortunately it would be open only to Canadians subjected to electroshock in the last 2 years (clearly an attempt to stay within the statute of limitations). What is promising, nonetheless, the conversation is happening.

The Pennsylvania Motion:

A promising development has likewise materialized in Pennsylvania. In short, a bill has been introduced by state representatives Stephen Kinsey and Tom Murt to prohibit the use of electroshock on children. A fortuitous initiative which could reverse the current targeting of children and youth.

Ways to Contribute to the Momentum Identified to Date:

Targeted ways to contribute to the current momentum, include a) taking part in or otherwise supporting the lawsuits and bills currently under way, and b) doing the footwork necessary to bring about similar suits and similar laws in additional jurisdictions. Obviously still other ways are speak-outs, demonstrations, and educationals.


A Different Kind Development: And a Special Opportunity: The Novel The Other Mrs. Smith

When we think of defeating shock, we quite rightly think of law suits and legislative interventions—all of which is necessary and all which is good. We also think of demonstrations and speak-outs—also good. Alas, though, we tend to overlook the enormous power of art. Art is magical, opens up a public space for understanding and transformation. Points can be made that otherwise allude. Art moves and educates, and can stir the public to protest. Correspondingly, if demonstrations or speak-outs sufficed to stir public indignation against shock, we would have won the battle against shock long ago. And has a development happened here as well—something that can add to the current momentum? In a word “yes”. Enter the new novel The Other Mrs. Smith—and in the interests of full disclosure, to be clear, I am the author.

 The blurb on the cover of The Other Mrs. Smith is as good an initial introduction to this novel as any. It reads:

This novel traces the life experiences of a once highly successful woman who falls prey to electroshock and subsequently struggles to piece back together her life. Naomi suffers enormous memory loss; additionally, an estrangement from her family of origin that she has no way to wrap her mind around. The novel begins with her wandering the corridor of St. Patricks-St Andrews Mental Health Centre (St. Pukes) faced with the seemingly impossible challenge of coming to terms with the damage done her, as well uncovering the hidden details of her life. It moves back and forth between a relatively happy childhood in the legendary north-end Winnipeg of the mid-1900s and post-ECT adulthood in Toronto. An exceptionally kind man named Ger who befriends Naomi comes to suspect that important pieces of the puzzle of what befell her lurk beneath the surface of writing in a binder of hers, which comes to be known as Black Binder Number Three. What Naomi progressively comes to do, often with Ger's help and just as often with the help of a very different and eerily similar sister named Rose, is find ways to do justice to her life and to the various people in it. Filled with a vast array of colourful and insightful characters from a variety of communities—Toronto¹s Kensington Market of the 1970s, the 1970's trans community, north-end Winnipeg Jewry, and the ingenious and frequently hilarious mad community—this novel sensitizes us to the horror of electroshock, takes us to new levels in our understanding of what it means to be human, and, in the process, leads us to question the very concept of normalcy. 

This is an engaging novel with broad appeal. At the same time, it drives home the horror of shock in a way not seen in fiction before. We see the effects of this “treatment” play out over the span of the heroine’s life. We see the effects on the next generation.  And we come to know the reality of shock from the inside—not just the outside—for the novel is narrated in the first person by a fictional shock survivor. Moreover, the sexist nature of this “treatment” is inescapable.

How I came to write this novel, I would add, is itself informative. I was part of the big 1980s push to abolish shock. Now there were moments back then when it looked as if us activists were on the verge of winning. Then I saw us totally lose the momentum. For the next several decades, like others in the struggle, I continued to push for the abolition of shock with very little promising materializing, when one day the idea of writing an ECT-centred novel narrated in the first person occurred to me. Now I knew that a first person narrative about someone badly harmed contravenes the inherited wisdom of what is possible to pull off in a work of fiction, but in short, I decided to do pursue this seemingly impossible project anyway. 

Soon after making this decision, I phoned Toronto shock survivor and long time activist Carla McKague and told her what I was doing. “For God’s sake, Bonnie, do it,” she insisted. “We have never had anything like this. What you are describing is a novel that the movement direly needs.”

Whereupon, I threw my heart and soul into this project for the next two years. However, problem after problem kept materializing. And I soon realized why a novel of this sort had been declared something that should not be tried. What emerged was often overwhelming and just as often confusing.

Anyway, the time came when I again called Carla to tell her that I was going to have to stop for it just wasn’t working.  Her answer was, “Bonnie, don’t stop. The movement, it absolutely needs this novel.” And understanding her point only to well, back to the drawing boards I went.

Two years later and after considerable work, again I felt the urgent need to stop—this time not so much because it was not working, though there were problems of this nature too, but because it was just too hard, just too agonizing.  What went along with this, there was an enigma at the very centre of the project: Namely, while I myself could tell Naomi’s story, the fictional narrator into whose head I had placed myself was often at a loss how to tell it precisely because of the memory impairment, precisely because of the damage done to her by shock. 

A related issue is that there were moments when I felt that I could not endure another second of being inside the head of someone whose memory was this impaired. To put this another way, I did not want to have to keep facing dead end after dead end. How wonderful it would be to get my life back!, I found myself thinking.  And to get it back, all I really had to do is give up writing this novel. Now for a brief moment there, that is precisely what I determined to do—when suddenly the realization struck me like a thunderbolt. 

Yes, of course, I could get my life back. But those of you who are shock survivors, you do not have the same option, do you? That is, you do not have the luxury to get your lives back. And if you can’t do it, then neither should I. Herein lay the moral imperative.

It took me almost ten years to complete this novel and to land a publisher, but the longer I worked at it, the better, the richer, more fulsome the novel became, what is particularly telling, with the very difficulties that had originally led to me declare the writing of this novel an impossibility being exactly what allowed this novel to become rich, multi-levelled, and potent.  In fact, soon it was evident not just to me but to everyone around me that what had emerged was nothing short of “dynamite”.

Fast forward. The novel is now out, and yes, my sense is that it genuinely has the power to motivate the public—it is that sensitizing, that powerful--but only if it is widely read. Hence my own current campaign.

If after reading the novel, you too become convinced of the importance of ensuring that this novel is widely read, here are some ways that you can help:

1)    Write a review on Amazon.com or Amazon.ca and encourage others to do the same  (if over 100 of these materialize, the novel will indeed start to take off).
2)    Follow me on twitter and re-tweet the quotations from the novel that I post.
3)    Resend messages that I post about it on Facebook.
4)    Email information about the novel to friends, post it to listservs; write blurbs about it on Facebook, on your blogsite, on your personal webpage.
5)    Write a full scale review for a major publication.
6)    Give it as birthday and Christmas presents to your loved ones—and do remember, Christmas is just around the corner.
7)    If you are part of a book club, look into getting The Other Mrs. Smith on the agenda.
8)    Put in a request for your local library to purchase a copy; also hook up with women’s and trans centres in your area and encourage them to have copy on hand. 
9)    In any demos and other actions that you mount in support of the current move against electroshock—and I hope these will be legion—do consider reading a passage from the novel.
10) Get in touch with literary and media figures that you may know with the goal of interesting them.

In Ending

This article has provided a brief summary of what is wrong with electroshock and why it should be abolished. It has clarified what makes this an optimal moment to act while articulating the momentum that is building. And in the process, it is has introduced you to current actions to which you might contribute—a ground-breaking class action law suit, a legislative bill that could help to safeguard our children, and finally, a novel (The Other Mrs. Smith) that has the potential to do heavy lifting for us. 

That said, to end this article as it began, with a quotation from the novel, what follows are the opening words of the fictional heroine Naomi, ushering you into the world of what was I call the novel The Other Mrs. Smith and what she calls her “memoire”:

My name is Naomi, Nomi for short. Not two years ago I was at a public meeting in Toronto where an aged woman looked everyone straight in the eye and asked, “After all our years of service, is this what we have to look forward to?” Two months later, a far younger woman who is ever so precious to me called with an urgent request. “Write about everything,” she pleaded. “Do it for whoever—yourself, me, others at risk. Just do it.” Hence this curious journey on which we are embarking.    
Now in the sweep of literature, there have been many unusual, one might even say “oddball” narrators—corpses, the cross on which Jesus Christ hung, even—and I kid you not—a fish. By these standards, I am a fairly everyday narrator, for as best I can make out, I am neither the holy rood nor any kind of fish—well, leastways not since I last checked. What I am is a sixty-five-year-old activist with holes in my head and a whopper of a memory problem. And that is the crux of the matter. But enough said.
This is one of those stories, you see, best left to unfold on its own. Like a surprise autumn sunset. Like a murder at dawn. I would only point out that there are depths here to plumb, truths to probe. Step into my world, additionally, and you will quickly find yourself rubbing shoulders with a vast array of some of the most endearing and fascinating souls that a person could hope to meet—some housed like Gerald, some from the streets like my buddy Jack who could always roll the meanest cigarette in Turtle Island. Ah, but all in good time.
     Now I could begin almost anywhere—when I discovered the films of Ingmar Bergman, when I fuckin’ rediscovered the films of Ingmar Bergman—but if I am to trust in that old Spenser formula, “where it most concerneth me,” there is really only one place to begin: When I first started crawling out of the void. When those glimmers of consciousness first came upon me in the opening days of March 1973….

[For this article and other Burstow articles, see http://bizomadness.blogspot.ca/]

REFERENCES:

Black, D. et al (1989). Does electroshock influence mortality in depressives? Annals of Psychiatry, I, 165-173.
Breggin, P. (1991). Toxic psychiatry. New York: St. Martin’s Press.
Burstow, B (2006). Electroshock as a form of violence against women, Violence Against Women, Vol. 12, No. 4, 2006: pp. 372-392
Burstow, B. (2015) Psychiatry and the business of madness. New York: Palgrave.
Burstow, B. (2017). The other Mrs. Smith.  Toronto: Inanna Publications (https://www.inanna.ca/catalog/other-mrs-smith/).
Karen, David (2017). Electroshock Therapy Class Action Filed (see https://www.madinamerica.com/2017/10/electroconvulsive-therapy-class-action/).
Munk-Olsen, T., Laursen, T., Videbech, P., Mortensen, P., & Rosenberg, R. (2007). All-cause mortality among recipients of electroconvulsive therapy. British Journal of Psychiatry, 190, 435-439.
Ross, C. (2006). The sham ECT literature. Ethical Human Psychiatry and Psychology, 8, 17-26.
Sackeim, H. et al. (2007). The cognitive effects of electroconvulsive therapy in community settings. Neuropsychopharmacology, 32, 244-255.

Whitaker, R. (2002). Mad in America. New York: Perseus Books.