After 14 months…I returned home to a family I had no
memory of. I didn’t know how to be a mother to my young sons or a wife for my
husband. I had to learn my name, how to speak, do up buttons, brush my teeth
and so on. I didn’t even know my own parents, sisters, brothers. My social work
career and law aspirations vanished. (public
hearing testimony, ECT survivor Wendy Funk, from Coalition Against Psychiatric
Assault, tape 1, 2005)
The context of this article is ECT. ECT is
a medical procedure—correction, a
procedure deemed medical. The point
here is, despite the fact that it is administered in hospitals by people known
as doctors, by any normal understanding of the term, it cannot justifiably be termed
“medical” for such naming presupposes that something is medically wrong with
the person—and yet there is no proof whatever that such is the case with
prospective ECT recipients. That is, there is no edema, no cell deterioration, no
irregular readings, no inflammation. Moreover, it presupposes that said medical
problem is corrected by the “procedure”—when solid evidence establishes that on
the contrary, medical problems are thereby created where none existed before (for
details see Breggin, 1991).
That understood, what concretely is ECT? It
is an experimental treatment which involves passing sufficient electricity
through the brain to produce a grand mal seizure. How does it work? For most of
the history of ECT, doctors who promote it have answered this question with the
standard claim that they do not know how
it works—only that it works. The
latest claim is that they have at long last figured out the answer and that it works
by stimulating the production of new brain cells, all of which are healthy (e.g.,
Abrams, 2002). Are new brains cells indeed produced? Indeed, they are. However,
what professionals making such a claim fail to tell the public is that
overwhelmingly, ECT annihilates brain cells, that the brain cells thereby annihilated
were in fact perfectly healthy, and what new brain cells do appear (the
phenomenon is called “neurogenesis”) are irregular, the product of brain
damage, and are themselves accepted indicators of brain damage (see Zarubenko
et al., 2005, and Greenberg, 2007).
That noted, ECT has been proven conclusively
to cause extensive brain damage (see Zarubenko et al., 2005) and extensive and
enduring cognitive impairment—memory loss in particular (see Breggin 1991 and
Sackeim et al., 2007). Moreover, however the so-called therapeutic effect may
be theorized, it has been demonstrated to be no more effective than placebo (see,
for example, Ross, 2006). Now admittedly, there have been ample studies that report
effectiveness. As clearly demonstrated by Read and Bentall (2010) though, such
studies are inherently flawed, with, for example, no criterion of improvement
provided or improvement being predicated solely on the subjective opinion of caregivers.
Correspondingly, as research like Van Daalen-Smith’s (2011) suggests, there is
a dramatic mismatch between the subjective assessment of care-givers and
survivors’ self-assessment (what is apropos here, in the weeks following ECT,
Van Daalen-Smith interviewed both shock survivors and the nurses caring for
them. All of the shock survivors assessed their state as deteriorated, as
opposed to all of their nurses, who to a person assessed the condition of these
very same “patients” as improved). Additionally, and what is not surprising
given what has been revealed to date, as Breggin (1991) and Burstow (2015) have
demonstrated, there is a one-to-one ratio between the damage done and the
so-called therapeutic effect. An added reality which helps one ferret out the
truth of what is happening here is that ECT is overwhelmingly given to two particular
constituencies—women and the elderly (for a strong feminist and anti-ageist
analysis, see Burstow, 2006), albeit the largest and most extensive study in
ECT history (Sackeim et al., 2007) conclusively establishes that these are the very
groups that incur the greatest damage from the procedure.
If the best conducted research invalidates
the use of ECT—and as can be seen, it does—personal testimony is at least as damning.
Indeed, the history of shock is a history of survivor after survivor testifying
that their lives have been devastated, of survivors bearing witness to inability
to remember, to massive cognitive impairment, to inability to carry down even
the simplest of jobs (see Burstow, 2006). In short, the best scientific
evidence and survivor testimony concur. What do they show? That ECT is not just
slightly but profoundly damaging. That ECT is in essence a diminishment of the
person. That, in short, ECT is anything but a valid medical procedure. Now while
mounting evidence continues to pour in, these basic facts about ECT have long been
known. And yet the treatment continues unabated. Hence the call for abolition.
And hence the protests.
I have called this article “Protesting
ECT”. If ECT is the ultimate context of this article, the more immediate
context is indeed a protest. On May 16 2015—an international day of protest against
ECT is being held. In this respect, several months ago, a call was issued by
three survivors—Ted Chabasinski in
California, Mary Maddock in Ireland, and Debra Schwartzkopff in Oregon—inviting
survivors and their allies throughout the world to take part in an international
day of protest against electroshock (for details, see Chabasinski, 2015). This
article is leveraging the occasion of that protest to focus in on shock protest
more generally —its nature, why we should engage in it, what we get from it,
and in the process, it probes the still larger question of protest. Questions taken
up include: What exactly happens when people protest? What is a protest? Why is
it important to protest shock? In itself? In the context of psychiatry as a
whole? And what makes the action
currently being planned significant?
To begin with the obvious, it
is important to protest ECT precisely because, however it may be theorized or
intended, ECT is in its very essence injurious—that is, it is not simply incidentally
but is inherently injurious (the fact that it is being done in the name of help,
I would add, in no way alters the equation). What is called ECT “working”, to
put this another way, as can be seen, is precisely the effects of damage. Correspondingly,
not just the short but the long term effects are devastating. When people are
being subjected to brain damage, when people are being seriously impeded in
their ongoing ability to navigate their lives, when, as so often happens, the
memory of even those nearest and dearest is obliterated, when decades later people
still have to write notes incessantly to get through the day because of a
“procedure” to which they have been subjected, however commonplace or
cosmeticized what is happening may be, we are witnessing something violent,
something objectionable—that is, something
that calls out for protest. In saying this, note, I am making a moral
claim. At the same time, I am making an existential claim that goes to the
heart of what protest is about.
What is protest? If images of
marching in the streets come to mind—and for sure, these are examples of
protest—and you are tempted to say that it is a formal political challenge, let
me suggest, that at its core, it is far more basic than that. It is a
fundamental dimension of our being-in-the-world and of our being-with-others. In this respect, protest is a deeply
existential phenomenon. It is a way of saying “no”, of saying that “I won’t
tolerate this.” And note, from our earliest years, even as infants, we have a
human need to say “no” when something does not sit right. And indeed, saying
“no” at such times is part and parcel of our authentic being-with one another,
as it were, of our moral contract.
I am reminded here of the
film The Wild Child by François
Truffaut (see http://en.wikipedia.org/wiki/The_Wild_Child). In this film, as a
test, the scientist at one point punishes the human creature/child that he had
brought in from the wild, albeit well aware that the child had done nothing
wrong. What then happened? The child protested. The scientist was reassured at
seeing the protest. Leaving aside the inevitable question of the morality of
forcing “civilization” upon the child in the first place or even of conducting
such tests, why was the scientist reassured? Precisely because such protest
signified that the child grasped the basic human covenant which we have with
one another, knew that protest was called for, and responded accordingly.
Organized public protest such
as the one being planned for May 16 is a variant of this existential dynamic,
while turning protest into a collective action which binds people together while
reaching more concretely into the public. It is a way of asserting that “we”
(whoever the “we” may be) see what is happening as unacceptable; beyond this,
that we are joined together in asserting loud and clear that it is unacceptable;
moreover, we are appealing to others around us and/or those who may happen upon
our protest to see it similarly, to bear witness to something that it outside the
realm of what is tolerable, and we are demanding action. Given this latter
dimension especially, I would add, there is a clear moral appeal and moral
demand at the core of public protest.
I am aware of course that
there are people (and no, not movement people) who cannot imagine protesting
against those deemed helpers. I would suggest, though, if anything, the fact of
the designation just adds to the injury for it means that betrayal of trust is
involved. Correspondingly, when damage of such proportions is being done and,
indeed, done with no upside, when it is accompanied by systemic deception, moreover,
unleashed on vulnerable populations, irrespective of whether or not those
engaged in these actions are called helpers or are convinced that they are
doing good, why would one not protest?
To clear, I am in no way
suggesting that public protest is invariably the best strategy. This
notwithstanding, there is an upside to such action even in those instances when
in the short run, it appears to bring us no closer to our goals. And that
upside is precisely the witnessing engendered, together with the existential
and moral factors highlighted above. All of which makes anti-ECT protest intrinsically meaningful.
Now the fact that I am taking
this at least seemingly non-strategic position, I am aware, may surprise some,
for I am a staunch advocate of strategic activism (see, for example, Burstow,
2014a) and the direction being highlighted here appears to conflict with the
call for strategic activism. That noted, let me suggest that the strategic and
the existential/relational are not mutually exclusive. In this regard, one may
sometimes emphasize one dimension, sometimes the other, and at times one may be
able to bring them together. Correspondingly, what is more basic here, while tailoring
one’s activities strategically so that they serve our goals (read: morally
called-for goals) is an important value, so is standing up and being counted.
What is likewise relevant, even when it comes to the question of effectiveness
itself, straight line thinking does not always serve us, for we never know when
a mode of resistance that appears to have no impact will suddenly become a
“game-changer”—such is the power of the existential.
What does this boil down to? It
is important to protest shock whether or
not such protest can be reasonably judged as likely to be effective. What
relates to this, social protest with respect to recurring injury has a special significance
in that it is a means of keeping faith with people across time. In the case of
shock, it keeps faith with those who have been injured in the past. It keeps
faith with those currently being beset. And it keeps faith with the prospective
victims of the future— herein lies a commitment, however hard it may be to
bring it to fruition, to such concepts as “never again”.
To turn to the action at
hand, if protesting shock in general is important, this particular ECT
initiative is particularly important. Why? Because it was initiated by and to a
large extent is being organized by shock survivors themselves—and as such, is
first order protest (that is, protest by those centrally affected). Because
survivors and their allies are standing up together. Because it is part of the insurrection
of subjugated knowledge (“subjugated” knowledge is the disallowed knowledge of
the oppressed; see Foucault, 1980). Because it announces to the world that
survivors are a constituency that can no longer be ruled/overruled. Because of
the sheer size of it. It is significant in this regard that the action being
planned is by far the largest international protest against shock in history.
Note, twenty-eight cities had signed on when last I checked, and in no past international
protest has there been more than five (achieved in the Mother’s Day Protest
organized by Coalition Against Psychiatric Assault in 2011). What the sheer
size, together with the survivor and the global quality signifies is that there
is massive dissatisfaction with this this “treatment”, and there is a growing
commitment to resist. Correspondingly, it delivers a tangible message to the
public. What does it tell the public? No, ECT was not stopped years ago. No, it
is not the “improved” and benign
procedure of psychiatry’s messaging. No, it is not true that most people greatly
benefit from shock—in fact, quite the opposite. No, we will not be quiet about
it. And yes, there is an onus on you to
do something about it.
That said, while these are
primary reasons to protest ECT and while they are existential in nature, there
are also formidable non-existential reasons. Whether directly or indirectly,
some of these link up with the psychiatry abolitionist agenda. And it is here where
the question of strategy enters in.
The point is, while it is
important to protest regardless, strategic considerations themselves call for a
targeting of ECT. To concretize this, insofar as we want to make inroads in
reining in psychiatry, prioritizing a procedure that most psychiatrists
themselves refrain from employing and which the public to varying degrees fear
makes sense. Why? Because people know on some level that it is woefully misguided,
even if they do not admit to themselves that they know. Correspondingly, as something
that the general public inherently recognizes as violent, ECT can serve as a
symbol of the violent nature of psychiatry overall. That is, it can be employed
as a sensitizer, as an aid in making manifest what is now covert, and as such,
unrecognized. What relates to this and is likewise significant, insofar as an
attrition model of psychiatry abolition is followed, the abolition of ECT is an
obvious place to begin (for a discussion of psychiatry abolition and the
attrition model, see Burstow, 2014a and 2014b) Why? Again, precisely because
the violence is more obvious, precisely because most psychiatrists do not
practice it, moreover, because of all the fights facing our movement, arguably,
it is the fight that can be most readily won.
A different but likewise
strategic reason to prioritize anti-ECT protests relates back to the existential
point made earlier about the nature of public protests, more pointedly, about how
such processes existentially unite us as a “we” (for further elucidation on the
concept, see Sartre. 1946/1953). Whatever we call this movement against
psychiatry, whether it be “critical psychiatry”, “antipsychiatry”, “the mad
movement”, “the disability rights movement”, or “the survivor movement”, like
every other movement, it is beset by differences that pull its members apart. What
is of strategic significance about ECT is that our attitude toward ECT for the
most part draws us together. How so? Because overwhelmingly, movement people
recognize how utterly beyond the pale ECT is. Correspondingly, insofar as this
is the case, a focus on shock intensifies the cohesion inherent in protest
generally, and as such, shock protest can be a potent force for movement
building.
In
Summation
To return to the question
with which this query began, why should we be protesting ECT? To summarize, because
of what both shock and human protest are, as it were, “all about”; because shock
is so damaging as to be unacceptable; because in so protesting, we are expressed
our own humanity in the deepest sense of the term; because it involves bearing witness
to what screams out to be witnessed; because shock protest is something owed
those violated, whether the people violated be ourselves or others; because it
allows us to join together, to stand up together and be counted; because it is
a way of keeping faith with people have already been or might yet be subjected
to ECT; because such protest is part and parcel of the insurrection of
subjugated knowledge. These are reasons of relevance to everyone, that place
some degree of demand on everyone, and while no one can actively (capital “p”) Protest
every injustice, besides that this one is especially egregious, people can
always do something, however minimal, to register protest. Additionally, it
makes sense for adherents of antipsychiatry/critical psychiatry to both
actively protest and to prioritize shock protest not only for the moral/existential
reasons listed above and not only because this is our community (meaningful in
itself), but because doing so is strategic in that ECT acts as a symbol, because
such protest lays bare the covert nature of psychiatry generally, because it fits
with an abolition agenda, because it contributes to movement building.
That said, to
return to the context which occasioned this article: On May 16th 2015, at the instigation of shock survivors, people
across the world—from the US, to Canada, to Ireland, to Brazil, to Uruguay—will
be joined together in protest. I applaud all those who have taken up this task—who
are planning, making posters, blogging, talking to the press. I wish everyone the
best in their various efforts that day and, indeed, in all subsequent ECT
protests; and I encourage folk outside the antipsychiatry and critical
psychiatry fold to consider joining in. Note, if is it is a moral/existential calling,
it is also a mitzvah to stand up for justice, or to use feminist Kate Millet’s
descriptor for protests of this ilk (personal correspondence), to stand up for
the mind. Hopefully, the article has added a new dimension of understanding,
and, in the process, however modestly, contributed to the action and the cause.
Correspondingly, in the spirit of solidarity, in ending, as one human being to
another (read: one protestor to another), I leave you with a modified version
of the Anti-Shock Proclamation, which I penned in 2011.
Please feel free to draw on
it should you find it of any assistance to you, whether in this or in
subsequent protests:
The
Anti-Shock Proclamation
We
who care,
We
who are committed to decency,
We
who behold with horror the disrespect for human life around us,
We
who shudder at the knowledge
Of women whose memory has been turned into ember and ashes,
Of families brutally torn asunder by pulse waves or sine waves,
Of the elderly, whose final life reward is electrocution,
We who hold this fearful
knowledge can be silent no longer.
LEGISLATORS, on this day of
international protest, May 16 2015, we hold you directly accountable and call
on you to withdraw your authorization for electroshock.
FELLOW CITIZENS who think
this “practice” stopped decades ago, on this day of protest, May 16, 2015,
We tell you that the
carnage continues and that you too are responsible.
On this day of protest, May
16th 2015, as survivors and allies, we come together to raise our
voices in protest,
And we vow to return,
To return,
And return again
Until this abomination
Is no more.
(For more extensive analyses, see Burstow,
2015, Chapter Eight).
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