As signaled in the title above, this
article is about women, ECT, and memory. Despite the fact that the memory loss
caused by ECT is greatly minimized by psychiatry to the point of downright denial,
it is fairly common knowledge at this point, at least among people who have
looked beyond the official ECT line, that one of the main and most devastating effects
of ECT is the destruction of memory (for an example of a standard denial
thereof, see, Abrams, 2002). Innumerable
shock survivors have testified to it (e.g., see https://coalitionagainstpsychiatricassault.wordpress.com/articles/);
and it is conclusively established by credible research (see Sackeim et al.,
2007 and Breggin, 1991). That noted, many of those who take in the reality of
ECT-created memory loss are aware of it largely in an abstract manner. As a statistic. As a fact supported by
research. If our memory is relatively in tact, we can forget how very integral
memory is to most every aspect of our daily lives. In this regard, I am grateful to the many ECT survivors who have
given testimony over the decades and whose words have made this destruction of
memory real in the way that statistics never could. Note, in this regard, this
sensitizing statement by survivor and author Linda Andre:
Imagine you wake
up tomorrow with your past missing….You may not be able to recognize your home
or know where your banks accounts are….You can’t remember your wedding or your
college education. Eventually you realize that years of your life have been
erased, never to return. Worse, you find that your daily memory and mental
abilities aren’t what they were before. (Andre, 2009, p. 1)
Now generally the memory loss that besets
ECT recipients is spoken of with little or no explicit reference made to
gender. In this article as in certain of the literature (e.g., Burstow, 2006),
on the other hand, gender is highlighted. My intent in this article is to hone on gender
per se, more specifically to shed light on how ECT, memory loss, and women’s
lives come together.
That noted, I am aware that some folk may
be wondering: But why are you writing about women specifically? Is not ECT, comparatively speaking, a
gender-neutral issue? To address that quickly, while both men and women are
unconscionable harmed by this procedure—and I in no way wish to minimize what
happens to men—as shown in Burstow (2015a and 2006), ECT and the lived reality
of it is not even close to gender- neutral. Throughout the history of ECT, two
to three times as many women as men have received electroshock. And as research
has established, they have generally received it because of a man signing for
it, often for behaviour seen as “inappropriate” for a woman, and this despite
the fact that the women themselves do not want it—hence feminists such as
myself theorizing it as a form of violence against women (Burstow, 2006). What
is up and above this, there is a gender-specific differential impact that needs
to be factored in.
The point is, yes, women are men both
suffer devastating memory impairment because of ECT—but not equally. A short
story to introduce you to this topic: When I was part of an organization that held
public hearings into shock in the 1980s, the fact that such a difference existed
was painfully apparent albeit no one commented on it. The point is, while men survivors
too were often horrendously affected, overwhelmingly, it was women survivors who
made reference to chunks of their lives as big as 5 to 20 years being totally
wiped out. By the same token, it was overwhelmingly women who would make
statements like, “That was fifteen years ago, and I still have to take notes
all day long just to get through the day.”
Which led me at the time to conjecture a gender-specific impact
differential. Decades later, the difference was confirmed by Sackeim et al. (2007)—the
largest study in ECT history. This study established at a level of statistical
significance that women’s memory is more impacted than men’s—a reality possibly
related to women’s lower seizure threshold. A particularly perverse statistic,
I would add, when you consider that it is the precisely the sex that is most
adversely affected by the procedure that is being singled out for it!
That noted, the difference with respect to
memory does not end here. The point is that we are all of us social beings,
that both men and women lead gendered lives. And so to understand the real
meaning of the destruction of people’s memory, whether the survivor be male or
female, we need to understand it in the context of those gendered lives. By way
of example—and this is just one among many different identities that could be drawn
on, for women are also lesbians, teachers, seniors in nursing homes—with women commonly
being in the role of wife and mother, to understand the meaning of that
destruction of memory, one very helpful lens through which to view ECT is precisely
the role of housewife and mother. Questions that we might ask in this regard include:
What happens between a mother and child when the mother cannot recall a good part
of the early years of her own child’s life?
When she is impaired in her ability to figure out how to be a mother?
What happens to a woman expected to be a housewife when she cannot remember any
of the everyday operations which allow her to navigate the very particular
world in which she finds herself?
With the intent of making this dimension
more “real” for people, what follows is an excerpt from a novel of mine in-progress
(currently under active consideration by a publisher) which delves into some of
these issues, takes up a number of these questions, fleshes out a character
whose post-ECT existence is deeply embedded in the social world of housewife
and mother. A few words by way of
introduction: The novel is called “The Other Mrs. Smith” and it is the
culmination of decades of research. The narrator is Naomi Smith (a totally fictional character). Once upon
a time, Naomi was a budding young filmmaker but having fall prey to psychiatry
shortly after giving birth, such avocations are no longer on her horizon. It is
now late August of 1973—approximately five months since her last shock
treatment. She is living with a husband named Earl (whom she has no memory of
ever marrying him, nor any appreciable pre-ECT memory of) and a baby daughter named
Ruth (of whom she has no pre-shock memory whatever). This is one and half years
after the birth of her daughter. For
several years now, she has been estranged from her family of origin, though she
has no idea why because she has no memory of the breakup. Her family of origin
consists of her mother, her father, and her twin sister Rose. Naomi is now living
in Toronto, has been ever since marrying, albeit she has no memory of ever
having moved here and no pre-shock memory of Toronto. She is a Jew originally
from Winnipeg (a city in Western Canada). Her husband Earl is an atheist
Christian, originally from Newfoundland (one of Canada’s Atlantic provinces). St.
Pukes, referred to in this excerpt, is the name the “patients” give to St.
Patrick-St. Andrew’s Mental Health Center (the fictional psychiatric
institution where Naomi received ECT). And Dominions is a local supermarket.
Excerpt
From Novel “The Other Mrs. Smith”
Fear—that was the common thread that wove its way
through my days, making them what they were.
I feared the growing frustration in Earl’s voice. I feared that I would not be able to find my
way into Ruthie’s heart. I feared that
my brain, my memory, my life were lying in tatters somewhere in a St. Puke’s
garbage bin. I feared that I would never
again be in the loving arms of the sister and parents that I so adored. I feared that all those years of hope and
study had come to naught, for no celluloid world would ever issue forth from my
shattered ship-wreck of a mind. I feared
the faces that I met—the ones that looked away embarrassed, the ones that
snickered, the ones that whispered to their children as I walked by. I feared myself for I knew not who I was nor
what terrible thing I had done to deserve such a punishment. But most of all, I feared existence itself—my
very being in the world—for the unvarnished truth is, I did not have the
wherewithal to be, to cope, to muddle through.
Poor Earl expected a wife
and mother, the family, indeed, needed a wife and mother; and me, I simply
could not function. At night, I would
tuck in my child and see her cringe and turn away, holding onto her doll for
dear life. Now if her daddy was not
right there, she would scream blue murder.
And there I would stand—useless—knowing full well that a mother with her
faculties in tact would have found a way in.
How come I am just fine with most vulnerable people on the ward and
absolutely clueless when it comes to my baby daughter?, I would ask. And Ruthie, if you are reading this, be
assured that not a day went by when I did not ask, when I did not long to be
the mother that you deserved. Then, my
heart heavy, I would crawl into bed with this stranger, even have sex with him,
though neither of us were under any illusion about my feeling what he so
desperately wanted me to feel. The Mrs.
Smith that I used to be, I would wonder, did she hunger for this man? Was she able to lift the pain from his heart?
#
It was a weekday morning, not unlike the ones that
came before, not unlike the ones to follow.
“Brnng…brnng,” went the
alarm.
“Time to get up,” urged
Earl, reaching over and turning it off.
I rose, quickly closed the
child’s gate, praying that Earl had not noticed. I rustled up breakfast, saw Earl hovering
over me. Gotenyu! Had I left a burner
on?
“Darling, don’t forget to
mail the letters,” he called out minutes later.
Then with a hurried peck on my cheek, he rushed out the front door.
Dreading the inevitable, I
put off the chore a good half hour. Then
I gritted my teeth, lifted up Ruthie, started scouring the streets in search of
the mail box. Where could it have gone? It was here yesterday. At long last, I passed a little green house,
a white picket fence at front. Shortly thereafter, I happened upon a
rectangular box. I dropped the letters
into what appeared to be a slot. Fine
and good. But how does one get
home? I whirled about, intent on
retracing my steps. Here was the little
green house with the white picket fence on my right. I passed it, scrupulously turned whenever the
street turned—but back I find myself in front of the little green house.
“Sir,” I call out to an
older man in Bermuda shorts ambling by, “could you give me directions to 532?”
“No 532 here. You must be looking for Palmerston
Avenue. This’s Palmerston Square.”
“So there’s two
Palmerstons?”
“Three,” he corrects,
chuckling. Then a curious look comes
over him. “Excuse me, but aren’t you the young woman who asked me this
yesterday?” he queries, eyeing me ever more keenly. “If this is a joke, young lady, it isn’t
funny.”
I apologize, back away
mortified, eventually find my way home.
With Ruthie hollering that she is hungry again, and the word “vacuum”
mysteriously coming to mind, I pull out what appears to be a Hoover. Then suddenly, suddenly, I remember. Groceries—God help me—I’m supposed to buy
groceries. Also, my daughter is
hungry.
I instantly stash the
vacuum in the hall closet, hoping that’s where it came from, then feed
Ruthie. Then once again the two of us
set out into the wilderness that is Toronto.
And once again, I search and search.
I pass a Victorian house. Vaguely
familiar. I come to a corner. A tall burly man in a police uniform is
positioned in the middle of the street directing traffic. Now somehow, his hand signals—if that’s what
they are—do not compute, but this time, I know better than to draw attention to
myself. I stand at the very edge of the
sidewalk, doing absolutely nothing as the policeman gazes my way. Who could get in trouble just by doing
nothing? Suddenly, a horn begins
honking. Then another, and another. The policeman stares right at me, while
waving his hands progressively quicker.
And now he approaches, his expression very like Earl’s.
“Lady, just whatchya
expecting me to do?” he asks. “Turn
green?”
Eventually, I catch sight
of the local Dominions, usher Ruthie safely through the door. And while I cannot make head or tail of my
grocery list, I recall that we are out of peas.
As luck will have it, I spot the right row, the right section of the
right row. With trepidation, I position
myself smack in the middle of the peas section.
I reach out my hand. Then I stand
in front of those hundreds of tins of peas utterly stymied. So many sizes, so many kinds—Libby’s,
Aylmer’s—how is a person to choose?
Beads of perspiration forming on my brow, I take a deep breath, grab a
tin at random, then hightail out of there as quickly as my legs will carry me.
Now I am half way out the
door when it dawns on me that I have not paid.
Also, that there is one other item that I simply have to pick up. Hoping that security is not on the way, I
reenter, make my way to the meat counter—and brace myself.
You see, pig, that turned
out to be a staple in the Smith household, and it utterly flummoxed me. Pork chops, ham, sausages, bacon,
Newfoundland steak—hell, being Jewish and electroshocked to boot—they all
seemed the same to me. Now Earl would
answer all my questions, would keep rattling off the different types, but try
to hold onto to them though I did, every name, every description would come
leaking out of my brain.
“So lady, what’s it today?”
asks the man in white behind the counter.
“A few pounds…a few
pounds…a few pounds of…of…that,” I stammer, pointing at something reddish.
Meat in hand, I head over
to the cashier, give the woman every ounce of lucre in my possession. Her eyebrow raised, she hands me back most of
my bills and several coins, together with what must be an itemized
receipt. I glance at it. Another blur.
Then I pick up my daughter because she is clearly tiring, and scurry
home.
“This’s just fine,” says
Earl, hours later, gobbling up a poor imitation of a dinner. But I can tell from his eyes that all of the
meshugas is wearing him down.
8:30 p.m., I tuck in
Ruthie, hear her scream for her father.
Then Earl and I sit and sit and sit in that living room. He tells me about his day, and I pretend to
be following. I tell him about mine, and
he pretends to be listening. “Missus,
it’s about that time again,” he eventually announces. I breathe a sigh of relief, take the pills,
observe him watching me.
At long last, the moment
that I have been waiting for arrives—I get to crawl into bed—that nice, warm,
comfortable bed—and call it a day. I
bury myself in the safety of the blankets, eager to fade into nothingness,
eager to forget. But now Earl, he’s
crawling on top of me. I instantly
spread my legs. Oh let him come
quickly!, I pray.
Finally, finally, I close
my eyes. I drift off, glimpse a better
place, a better time. It is our fourth
birthday, and attired in our new black tunics, Rose and I are blowing out the
candles. Now all four candles are out
and the two of us are smiling at each other, nestling into the recesses of each
other’s souls as only we can. “Mazel
tov,” chimes in my mother’s voice.
“Never mind with the mazel tov; Ida, give the girls cake,” pipes up dad. Even as I savour the first tantalizing
mouthful, a shrill sound shatters the stillness, and I awake with a start. Frantic, I cast my eyes about. I spot an alarm clock. I see a bump in the covers next to me. No!
No! It can’t be! Not here again!
And so the days went. How can we possibly keep this up?, I
wondered.
(from novel-in-progress, Burstow, 2015b)
This particular
passage, as you can see, focuses in on the abject terror of living in what is
now an alien world. In the process, it probes Naomi’s inability to perform the
everyday tasks integral to her life as housewife and mother, also the profound
injury to Naomi’s relationship with her child and husband.
I will comment no
further on the passage—for better the reader make their own discoveries. However,
I cannot leave the topic of the novel per se without commenting on the
experience of writing it: As author, putting myself in the head of an
electroshocked narrator struggling to tell a story, so much of which she simply
cannot remember was one of the most frustrating and humbling tasks that I have
ever taken on. Many a time I vowed to abandon the project once and for all
because the journey ahead felt just too daunting. Whenever I was on the brink
of “throwing in the towel,” however, I remembered that I always had the luxury
to put aside the double binds and frustrations related to ECT and return to a
life where memory is in tact—while shock survivors have no such option.
Then I would take
a deep breath, pick up my pen, and resume writing.
Closing
Remarks
I hope that this article has helped the
reader gain a deeper sense of the reality of ECT as lived. More particularly, I hope people walk away better able to
appreciate how the memory loss shatters lives and how that shattering invariably,
indeed, inevitably transpires on a gendered level. In ending, let me express an
even more ardently held wish—that some day soon we will be able to rid the
world of this atrocity. That said, as long as ECT is being unleashed on people and
as long as women and men survivors continue to have to navigate a world which has
in essence been stolen from them, I would invite readers to factor gender into
their understanding—for however poignant and sophisticated it may be, our grasp
of the ECT phenomenon is lacking otherwise.
References
Abrams, R. (2002). Electroconvulsive therapy (4th. ed.). New York: Oxford University
Press.
Andre, L. (2009). Doctors of deception: What they don’t want you to know about shock treatment.
New Brunswick, New Jersey: Rutgers University Press.
Breggin, P. (1991). Electroshock:
Scientific, ethical, and political issues. International
Journal of Risk and Safety in Medicine, 11,
5-40.
Burstow,
B. (2006). Electroshock as a form of violence against women. Violence Against Women, 12 (4), 372-392.
Burstow, B. (2015a). Psychiatry
and the business of madness: An ethical and epistemological accounting. New
York: Palgrave.
Burstow,
B. (2015b). The Other Mrs. Smith (a novel in progress).
Sackeim,
H., Prudic, J., Fuller, R., Kielp, J., Lavori, P., & Olfson, M. (2007). The
cognitive effects of electroconvulsive therapy in community settings. Neuropsychopharmacology, 32, 244-255.
