Yes, the Tide is Turning Against Psychiatry

The suggestion embedded in this article’s title seems counter-intuitive. How could the tide be turning on psychiatry when the institution has never been so strong? And indeed indicators of its growing strength and tenacity are all around us. The exporting of its model to the global south via the World Bank, the emergence of outpatient committal, the explosion of funding for psychiatric research (see Burstow, 2015). Correspondingly, daily are there calls for most aggressive “detection” and “treatment”  (e.g., Jeffrey Lieberman, 2015). And the mainstream press has never been more closed to truly foundational critiques. That acknowledged, let me suggest that such intensification is common when an old system is in the early days of crumbling.

Of course, intensification itself is hardly an indicator that a reversal is at hand. So how would we know? Examples of possible indicators are: Ever growing critiques from inside and outside the profession, growing discomfort with “anomalies” (in essence, the indicators of a paradigm shift spelt out by Kuhn, 1962). Established moral authorities making unprecedented negative pronouncements about the current state of affairs. The surfacing of more and more tales of corruption and fraud. The rising up of those subjected to it. Each of these signs and more we are experiencing now with psychiatry -- hardly conclusive individually, but taken together, convincing portents of a societal shift.

While psychiatric anomalies have always been with us, note, never have they been so visible. Even as we hear calls for the early detention and treatment of “mental illness” to prevent school shootings, for instance, we discover that the majority of the shooters were on psychiatric drugs. Correspondingly, as the system pushes western ways of handling “schizophrenia” on the rest of the world, World Health Organization studies conclude that the countries with the highest rates of “recovery” are those without the “benefit” of  modern “treatment” (see Robert Whitaker, 2010). As for the dissatisfaction experienced by people in the psychiatric and related professions, just check out the speakers at the 2015 conference of the International Society for Ethical Psychiatry and Psychology (http://psychintegrity.org/plenary-talks/), and you will quickly get a sense of it. Telling likewise is what happened in the years leading up to the release of DSM-5. While their goal, of course, was not "changing” but rather “saving” the current paradigm, well in advance of DSM-5’s release, in what was a historically unprecedented move, the two previous taskforce chairs, Robert Spitzer (2009) and Allen Frances (2009), each came out with hard-hitting critiques of what their colleagues were doing, describing it as once bad science and an exercise in subterfuge—critiques echoed, I’d add, to an unparalleled degree by mainstream media. At the same time, a plethora of radical survivor groups have sprung up. And sites dedicated to deconstructing psychiatry are legion (e.g. madinamerica.com and endofshock.com).

By the same token, proofs of fraudulent trials and fraudulent claims of discoveries abound. Witness David Healey’s (2009) unearthing of the systematic “cooking” of drug trials. Witness the exposés on the Breggin site (http://www.breggin.com/). And note the publishing this year of a book which clearly establishes that the American Psychiatric Association has intentionally misled the public throughout its history -- about “mental illness” being a proven brain disease, for example, about the efficacy of the drugs (Whitaker and Cosgrove, 2015).

Even as these developments unfold, major international organizations have cast doubt on psychiatry both morally and scientifically. Take the aforementioned World Health Organization’s studies. And what is particularly suggestive, in its role as moral compass, two different instruments of the United Nations have declared involuntary neurolepticization a form of torture. Moreover, trace the practical implications of the recently minted Convention on the Rights of People with Disabilities and it becomes clear that it positions a key modus operandi of psychiatry everywhere -- involuntary treatment -- as a human rights violation (a victory, I might add, for which the vintage work of groups like the Center for the Human Rights of Users and Survivors of Psychiatry must largely be credited; for details, see Minkowitz, 2014). All of which, note, paves the way for the current survivor-led campaign to rescind involuntary committal laws throughout North America.

Another salient indicator comes from non-psychiatric medical practitioners and students, for quiet though they remain about it, cogent evidence suggests that their opinion of psychiatry has plummeted. A major study written up by H. Stuart et al. (2015) involving 1057 non-psychiatric medical teaching faculty in 15 countries, for example, shows that the vast majority hold a highly negative view of psychiatry. They find psychiatrists, for instance, too powerful, “unscientific,” and “illogical.” Correspondingly, there is currently a formidable decline in the percentage of medical residents open to specializing in psychiatry. In the UK, for example (once a psychiatric hotbed), less than 5% of medical students choose to enter psychiatry (see Read, 2015).

Indeed, psychiatrists are aware of their faltering reputation. And in what is an unprecedented move, in January of this year a major psychiatric journal (Acta Psychiatrica Scandinavica) devoted a special issue to psychiatry’s “image problem” (Vol. 131; see http://onlinelibrary.wiley.com/doi/10.1111/acps.2014.131.issue-1/issuetoc), with leading figures in psychiatry weighing in -- e.g., current and former presidents of the European Psychiatric Association and the current president of the World Psychiatric Association. What the very existence of this special issue seems to suggest is that so bad is the public image that the upper echelons of the industry are taking alarm. Correspondingly, their response is how regimes of ruling commonly respond when their seemingly unquestionable authority begins to slip away -- for example, portraying themselves as victims and blaming everyone else. Bhugra (2015), current president of the World Psychiatric Association, for instance, lays the blame on the “anti-psychiatry media” -- ironic, given the enormity of the media’s support.

That noted, if the tide is turning – and, as shown, it is -- the question is how far? And what form will the change take? At the moment, despite critiques which demonstrate psychiatry’s utter invalidity, the primary discourse is reformist. This news is worse than it appears, for throughout the centuries, in the long run, reform agendas have only served psychiatry. Temporarily, for sure, they create a modicum of improvement, like with “moral management.” Nonetheless, as shown by Burstow (2014), each and every tempering of psychiatry under a reform agenda has culminated in the return of biological psychiatry with a vengeance. As such, despite good intentions—and I am in no way doubting the intentions and hard work of most of the people involved -- all “reformism” ultimately succeeds in doing is losing the momentum.

That said, at this point, many movement people are keenly aware of this dynamic. Correspondingly, we are seeing a renewed interest in psychiatry abolition, especially versions committed to societal rebuilding. The reception which I have been receiving among psychiatric survivors – and survivors, after all, is where the resurgence of subjugated knowledge must come from -- is suggestive in this regard.

Significantly, up until a few years ago, there was but muted interest in psychiatry abolition within survivor circles. What I am seeing now, conversely, is an abundance of posts of the ilk “If antipsychiatry is what Bonnie says it as, then I am antipsychiatry.” Additionally, more and more antipsychiatry websites are popping up. The point is, antipsychiatry -- and not just any type but one of a visionary nature -- is markedly on the rise.

And indeed, a visionary antipsychiatry is precisely psychiatry’s worst nightmare—hence the current barring of foundational critiques by the mainstream media and hence psychiatry’s worried references to “antipsychiatry.” Simple reform, as history shows, is inevitably coopted. And critique alone can easily be dismissed. A true revolution -- one involving reclamation -- is a whole different matter.

In ending, let me invite those in the Toronto area interested in continuing this conversation to come to my book launch on September 18 (5:30, Floor 12, 252 Bloor West). And more generally, let me ask all readers: Is a coercive, invalid, and damaging “system” really the best we can do? What makes setting our sights on but tempering it and/or but adding “alternatives” the “practical” option?

And now that the tide is turning, what can the average citizen do so that this time round, we as a society do not “squander” the moment?

(for this and related articles, see http://bizomadness.blogspot.ca).

References

Bhugra, D. (2015). To be or not to be a psychiatrist? Acta Psychiatrica Scandinavica, 131, 4-5.

Burstow, B. (2014). Liberal “mental health” reform: A fail-proof way to fail. Mad In America. November 17 (http://www.madinamerica.com/2014/11/liberal-mental-health-reform-fail-proof-way-fail/)

Burstow, B. (2015). Psychiatry and the business of madness. New York: Palgrave Macmillan.

Frances, Allen (2009). A warning sign on the road to DSM-V. Psychiatric Times. June 26 (http://www.psychiatrictimes.com/articles/warning-sign-road-dsm-v-beware-its-unintended-consequences).

Healey, D. (2009). Psychiatric drugs explained. London: Elsevier.

Kuhn, Thomas (1962). The structure of scientific revolutions. Chicago: University of Chicago Press.

Lieberman, J. (2015). How to halt the violence. The New York Times. August 28  (http://www.nytimes.com/2015/08/29/opinion/how-to-halt-the-violence-treat-mental-illness.html?smid=fb-share).

Minkowitz, T. (2014). Convention on the rights of people with disabilities and liberation from psychiatric oppression. In Bonnie Burstow, Brenda LeFrançois, and Shaindl Diamond (Eds.). Psychiatry disrupted (pp. 129-144). Montreal: McGill-Queen’s University Press.

Read, J. (2015). Saving psychiatry from itself. Acta Psychiatrica Scandinavica, 131, 11-12.

Spitzer, R. (2009). DSM transparency: Fact or rhetoric. Psychiatric Times. March 6 (http://www.psychiatrictimes.com/articles/dsm-v-transparency-fact-or-rhetoric).

Stewart, H. et al. (2015). Images of psychiatry and psychiatrists. Acta Psychiatrica Scandinavica, 131, 21-28.

Whitaker, R. (2010). Anatomy of an epidemic. New York: Broadway Paperbacks.

Whitaker, R. and Cosgrove L. (2015). Psychiatry under the influence. New York: Palgrave Macmillan.

What is The Bonnie Burstow Blog All About?: Getting A Sense of the Territory

[my first blog on Rabble, with whom I also maintain a blogsite. For the original publication of this article, see http://rabble.ca/blogs/bloggers/bonnie-burstow/2015/08/what-bonnie-burstow-blog-all-about-getting-sense-territory
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As I sit down to draft the first of what will hopefully be a long series of articles for Rabble.ca, I am aware that I am carving out a very new type of space; and so an introduction of sorts is in order. So what is this new space about? The clue is in the title. 

All words in the title of the blog site are pointers, signaling what to expect. On a relatively simple level, The Bonnie Burstow Blog is antipsychiatry. At the same time, the positioning of the phrase "Toward a World with Commons" announces that the blog is concerned with piecing together a vision of a better society that we might jointly build together—one based on such values as sharing, mutuality, equality, participatory governance, freedom. Does the society being envisioning include services for those with emotional difficulties (people currently deemed "mentally ill")?  Absolutely, and an abundance thereof but not services "managed" by "experts" -- for rule by experts, however benign individual experts may be, is part of what has landed us in the current morass.

So what kind of articles might you find? Articles that demonstrate psychiatry’s invalidity and the harm it does, which makes visible the ideological circularity and how psychiatry functions as a regime of ruling, that illustrate the tie-in with other forms of oppression (e.g., sexism and racism). Articles that explore non-psychiatric community-oriented approaches to helping people, which, for example, delve into participatory ways of resolving conflict, while attending to the well being and safety of everyone. Articles on how to create a society where people can thrive, where there is greater acceptance of difference, which is less alienated/alienating. In this regard, the "commoning" of services are likely to figure particularly prominently, for it is precisely what we create together as opposed to what is bestowed upon us where I would suggest that the promise lies.

That said, my suspicion is that at that this point, most readers are to varying degrees in agreement with expanding the social commons. I suspect as well that many are uneasy about the enormous power of psychiatry, also by its relentless pursuit of ever more markets. This withstanding, I suspect as well that most are convinced that even though it ought to be reined in, that psychiatry has a legitimate place in the scheme of things, for however important the social is, it is believed, we are, after all, talking about bone fide illnesses for which some measure of "medical treatment" is in order. That is, there are "diseases" here for which substances like psychiatric drugs are necessary. Such are the beliefs of most people. And for the most  part, such are what people are socialized to believe.

In the interests of helping readers begin grappling with this common set of beliefs right from the start (and please excuse the objectivizing language) let me introduce some relevant "myths" and "facts":

MYTH/PSYCHIATRIC CLAIM:

Minds can be ill, hence the validity of the concept "mental" illness.

FACT:

Minds are activities of bodies and can no more be ill than other activities like "running" can be -- also an activity of the body. Only an organ (the brain, for example), can be the site of an illness.

MYTH/ CLAIM:

It has been proven that "mental illnesses" are bone fide brain diseases.

FACT:

While claims about proof are repeatedly made, none of the phenomena framed as "mental illnesses" have been shown to be a "brain illness." Not even "schizophrenia" (see in this regard, Burstow, 2015 and Robert Whitaker, 2002).

MYTH/ CLAIM:

Chemical imbalances have been established for most "mental illnesses."

FACT:

Not a single chemical imbalance has ever been found for a single "mental illness."

MYTH/ CLAIM:

Even if there are no chemical imbalances, there are other physical indicators of "mental illnesses."

FACT:  Not a single physical abnormality has been found for a single "mental illness."

MYTH/ CLAIM:

Psychiatric drugs correct chemical imbalances.

FACT:

Not only is there no proof of this, there is incontrovertible proof that psychiatric drugs, rather, routinely create chemical imbalances. In the process brain damage commonly occurs, much of it irreversible (see Peter Breggin, 1991).

MYTH/ CLAIM:

Psychiatry, like other branches of medicine, proceeds via a painstaking process of scientific discovery.

FACT: 

Psychiatry does not "discover" "illnesses" but proclaims them, sometimes via the mechanism of a vote, much like one votes for a candidate in an election (itself an indicator of the inherently political nature of what is transpiring -- for note, no one votes on whether or not tuberculosis is a disease). For a window onto how this disease-making process actually works, see Stuart Kirk and Herb Kutchins (1992). 

MYTH/ CLAIM: The "mentally ill" are dangerous, hence need to be controlled.

FACT: What evidence shows is that people deemed mentally ill are no more dangerous than the average person. Correspondingly, despite the panic that is whipped up whenever harm is done by someone deemed mentally ill, people so deemed are typically far less dangerous to others than others are to "them", with state-authorized "helpers" posing a special problem (see Burstow, 2015).

MYTH/CLAIM:

Horrific developments like the mass school shootings would have been prevented had only these shooters been on psychiatric drugs.

FACT:

A "side effect" of the drugs (the antidepressants and the stimulants especially) is that they can badly impair judgment and give rise to a kind of intoxication named "intoxication anosognosia." That said, while each major school shooting has culminated in a call for youth to be systematically screened for "mental illnesses," then put on psychiatric drugs as "needed," the frightening reality is that the vast majority of the school shooters were on a therapeutic dosage of either antidepressants or stimulants at the time of the shooting -- a factor which would appear to be causal (see Breggin, 2000 and 2008). What is being taken as the solution, that is, is actually one of the causes.

MYTH/ CLAIM:

New modified ECT (electroshock) minimally is safe and effective.

FACT: There is nothing new about modified shock, for it has been with us since the 1950s. Correspondingly, as researchers like Collin Ross (2006) and Howard Sackeim et al. (2007) respectively demonstrate, after six weeks no form of ECT outperforms placebo, and all result in substantial, often overwhelming cognitive impairment.

MYTH/ CLAIM: Psychiatry serves the public good.

-- Ah, but that is precisely the crux of the matter.

The point is, it is transparently the case that psychiatry permeates every facet of society, fashions how we think about things, how we deal with one another--and the contention of this blog is that is that besides that it is void of foundation, it is highly deleterious. We have a historically unprecedented number of people hooked on mind-altering drugs and brain-damaged. We have a veritable epidemic of iatrogenic (doctor-caused) diseases. We have childhood itself treated like a disease. And we have a regime that in its own way threatens the freedom of everyone.

That noted, the purpose of this blog is to help us move beyond the hegemony that has bit by bit been build up around this institution. It is about unmasking psychiatry, as it were, and promoting an "turn-about." It is about finding ways that we as members of communities can take back our power to govern ourselves and begin grappling with societal problems in a benign, participatory, caring, egalitarian, and non-coercive way. Ultimately, it is about finding ways to value and incorporate the unique wisdom and gifts of everyone.

For those intrigued, please continue to check out this blog. Correspondingly, in preparation for the challenging journey ahead -- and it will be challenging -- I would end this article by inviting readers to do three things: Whatever your beliefs about psychiatry:

1)    Try using everyday terms for the distress you see around you, including your own, that is, letting go of institutional terms and getting back to what you actually see, hear, feel (examples of institutional terms are "mental illness," "schizophrenia," "hallucination," "medication," "symptoms"). 

2)    Think of people that you know that are alienated or distressed and ask yourself -- and them: What changes in society might help them feel less distraught, less alienated, more part of the social fabric?

3)    Dare to imagine a more benign, egalitarian, respectful, and participatory world.

References

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

Breggin, P. (2008). Medication madness. New York: St. Martins.

Breggin, P. (2000). Reclaiming our children. Cambridge: Perseus Books.

Burstow, B. (2015). Psychiatry and the business of madness. New York: Palgrave Macmillan.

Kirk, S. and Kutchins, H. (1997). Making us crazy: The myth of the reliability of the DSM. New York: The Free Press.

Ross, R  (2006). The sham ECT literature and what it tells us. Ethical Human Psychology and Psychiatry, 8, 17-28.

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.  

What Do We Owe When a Shock Survivor Dies?: On the Death of Sue Clark-Wittenberg

On August 7, 2015, prominent ECT survivor and antipsychiatry activist Sue Clark-Wittenberg died. That day, I sent the following message to members of Coalition Against Psychiatric Assault (of which Sue was one), also to my Facebook friends:

It is with profound sadness that I am writing to let everyone know that Sue Clark Wittenberg has just died, but hours ago . . . Everyone who knows anything about Sue knows that she has been an enormously important person in the community of people battling shock. A shock survivor since she was 17, Sue has fought against ECT for decades and decades, with fierce determination. She received an award from CAPA a few years ago for a lifetime of work combating psychiatry . . . May her memory be as a blessing. (personal correspondence)

A few hours after posting this, I began thinking about the loss of ECT survivor Leonard Roy Frank, that magnificent ECT warrior, famous for his activism and scholarship (e.g., Frank, 1975/1978), who likewise passed away this year. I was honoured to be one of those who memorialized Leonard. Then I found myself worrying who would memorialize Sue. Shortly, thereafter, to my relief, tributes on Facebook began pouring in.

That noted, in that moment of uncertainty, when I did not know whether or not people would rise to the occasion in response to Sue’s death, a curiously existential question came to me, which question, in part, motivated this article: What do we owe to shock survivors when they die? Whether they are extremely famous like Leonard, legendary but in more limited circles like Sue, or people leading comparatively obscure lives? Whether they were activists or folk who never became involved in a single social movement?  Whether they went on to do wonderful things like Sue or Leonard or simply went about their lives? What do we owe to each and every one of them?

One answer to this question which I would like to advance is that we owe them what we owe everyone who underwent an atrocity that is ongoing, that is being visited on others daily—doing something about that atrocity. Given, as shown by Breggin (2008) and Burstow (2015), shock is anything but a legitimate medical procedure, given that it is profoundly damaging, what we owe is doing everything in our power to rid the world of the “treatment” so that never again is it visited on anyone. Every time a survivor dies, it is minimally an opportune moment to renew our commitment and our pledge to both bring an end to this treatment and to build a world where brain-damaging people in the name of help would be unthinkable.

There is something else that we owe them as well, something of a more personal nature—and it is this that I will be honing in on in this article. We owe holding their experiences in our memory. Indeed we owe something of this ilk to everyone subjected to  ongoing atrocity, but the onus is all the more pressing here given that this “treatment” is precisely about the destruction of memory. More generally, we owe them taking very seriously the disjuncture that happened to them, however long ago—and all that this disjuncture points to. To be clear, the ethical imperative which I am referencing here is  of both a commemorative and witnessing nature for sure but likewise of a pedagogic nature. The point is that insofar as these stories can be used to conscience-raise, we help make them something beyond just the senseless tragedy which they otherwise are. A work of transformation, I would add, which the survivor takes upon themselves each and every time that they do us the courtesy of bearing testimony.

Which brings us to the Sue Clark electroshock story. The key questions taken up in this article are: What does Sue’s ECT story highlight? Exemplify? Teach us?

Sue’s Story and its Significance

Who was Sue Clark in the years before ECT? She was a very bright child, with a powerful instinct for survival.  She was also a child who had been subjected to ongoing abuse most of her life (see Burstow, 1994 and 2002, and Inquiry into Psychiatry, 2005).  

 Sue first ended up in a psychiatric institution as a teenager. How and why? Initially, she ran away from an abusive home, with that abuse at one point including sexual abuse. Now homeless, she began missing classes at school. She was soon summoned to speak to the school psychologist, who had concerns about her “absenteeism”. Upon hearing Sue’s story, the school psychologist observed that Sue needed help and suggested an appointment at the Royal Ottawa Hospital.

What can we learn from the story thus far? That at that time, minimally, there was insufficient support for abused children. What is also highlighted is the treacherous connection between school and psychiatry. Note that Sue did not have a “mental health problem”. Her “problem” was that she was being abused—and help in ending the abuse and creating safety—this was the kind of assistance that would have been useful. Instead the school psychologist began the process of redefining Sue’s problem as “mental” and turning her into a “mental patient”. What is highlighted here is at once the psychiatric transformation of social problems into personal diseases and the implication of schools in that transformation.

It was at this moment that Sue’s life as she knew it truly began to fall apart. One of the first acts of the institution was to create a “family meeting”. At the meeting, Sue courageously introduced the issue of the abuse. According to Sue, the family responded, “Oh no, we never abused Sue.” (see Burstow, 1994) Whereupon, the abuse as Sue had lived it was discounted, or put this another way, was turned into a “symptom”.

What truths about psychiatry’s mode of operating does the nature of the family meeting bring to light? That once a redefinition has occurred, the newly minted “psychiatric patient” has little credibility compared to everyone else. Indeed, the further at odds their story is with the ones of those around them, including those being identified as abusers, the more dire the mental illness that is likely to be assumed.

What happened to Sue after that? Having entered the Royal Ottawa voluntarily, she quickly found herself involuntary. States Sue, “Right away I was given heavy doses of tranquilizers. I had no coordination as I walked down the hall and had to cling to the walls.”(Inquiry into Psychiatry, 2015) In essence they drugged her into a stupor while refusing to let her go. All of which points to the brutality and the coercive of the “care” given long before ECT became part of her lived reality.

Upon being released, she went to live with her abusive family. Why? Because she had nowhere else to go and no one so much as mentioned a single resource that she might access—a reality which again points to the negligence of the “care” afforded the young.

More hospitalizations and more infringements of rights followed. Horrified by the daily infringement of her rights and understandably in despair over the turn her life had taken, one day while under lock and key at the Royal Ottawa, this increasingly desperate teenager tried to hang herself.

Obviously the question that any thinking person responsible for her care should have asked at this point was: Why did this youth resort to such a desperate measure? How are we failing this person? What this part of the story highlights is that questions of this nature are never asked. Instead, the institution continued to interpret what was happening through the frame which they had adopted from the start. To wit, her trying to kill herself, in their understanding, could mean only one thing—that her “mental disorder” was “deteriorating” and so more aggressive treatment was warranted. Whereupon, she was transferred to Brockville Psychiatric Hospital. And it is here where ECT entered in.

Once at Brockville, Sue was “informed” that she was going to be given ECT. This was a moment of absolute terror for her. She protested, stating that she feared what ECT would do to her. She was told that her worries were needless, that ECT is safe and effective— responses which, as we all know, highlight the misinformation which pervades the ECT industry (see Andre, 2009 and Burstow, 2015). What happened next?  Something that epitomizes at once power-over, indifference to people’s wishes, violence, and trauma. ECT was physically forced upon Sue, this I would add, despite the enormity and indeed transparency of her objection to it. In this regard, Sue tells us: 

On the morning of my electroshock therapy, I yelled and screamed as loud as I could, I bit the staff and I kicked them . . . but no one came to my rescue, no one helped me . . .  Eventually the staff forced me into the ECT room . . .  I yelled to the staff that I did not want ECT . . . No one listened . . . It was a traumatizing experience that haunts me to this day. A rubber band was wrapped around my forehead and a rubber mallet put between my teeth. Then the psychiatrist turned on the shock machine and zapped me with electricity through the brain. (Inquiry Into Psychiatry, 2005)

While of course not all ECT administration involves people kicking and screaming in protest, what this story writes large is that everything about ECT is violent. That the entire experience is traumatizing. A reality which is all the more horrific when you factor in what allowed this to transpire in the first place—besides the avarice and the grandiosity of the ECT industry, a obvious distrust of youth, a dismissal of people’s words, rights, choices, a willful disregard for very real circumstances of people’s lives, an arrogance of massive proportion, and what minimally looks like callousness.

 What has happened here? A young woman was abused at home. She was persuaded to seek help only to be imprisoned and otherwise abused by the so-called helping institution. Moreover, she was singled out for a experimental treatment that was already known to be brain-damaging (see Breggin, 1979).

Now people reading the literature on the efficacy of ECT with suicide might consider the choice of ECT appropriate in this instance. But here not only the senselessness of psychiatry but the groundlessness of official ECT claims are highlighted. Besides the fact that there was a simple solution to what was now seen as Sue’s “suicidality”—listening to her and stopping abusing her—the point is, as documented in Burstow (2015) and Breggin (2008) just as ECT has no efficacy in general, it has no efficacy whatever with “suicide”. That said, insofar as we are trying to figure out what the story so far has to teach us, there is one additional dimension to factor in, albeit one less obvious.  

Step back and look at what is happening at this juncture and what led up to it. The adult male is forcing ECT on the female youth. This is adultism and indeed child abuse at the extreme. What is perhaps less obvious to some, though, it is also sexism. The woman’s story, significantly, is disbelieved. It is assumed that “the woman” needs ECT. And, note, the statistics on gender are clear: Throughout the entire history of shock, two to three times as many as women as men receive ECT irrespective of whether or not they are deemed “suicidal”. For a possible explanation of why, I would draw attention to this historical statement by shock promoter Abraham Myerson:

I believe there have to be organic changes or organic disturbances in the physiology of the brain for the cure to take place.  These people have for the time being at any rate more intelligence than they can handle . . . and the reduction of intelligence is an important factor in the curative process. (quoted from Breggin, 1979, pp. 142-143)

Given the statistics, it is clear that the people covered by Myerson’s term “these people” are largely women, and that on some level, the reduction of women’s intelligence is being deemed acceptable, and beyond that, desirable.

To make a more general statement about gender here (though this part is not so clear), Sue might not have been abused to this extent had she been male—certainly, was less likely to be sexually abused, given what we know of sexual abuse. Had she been abused to this extent, she was less likely have landed in a psychiatric facility. And had she landed in psychiatric facility—and here the statistics are irrefutable—she would have been far less likely to be subjected to ECT. What is relevant in this last regard, throughout the history of electroshock, irrespective of diagnosis, women have received ECT two to three times as often as men (for an example of a current statistic, see Weitz, 2009).

How many “treatments” did Sue end up having? Five. All against her wishes. All brutal. Why so few? Because a physical “complication” entered in, forcing them to stop. 

What happened after that highlights additional realities about shock. From that period hence, Sue was someone who suffered from major memory and cognitive impairment, The hospital had done its “job”, and now she was forced to live her life with the consequences. Which for all intents and purposes boils down to this: Whatever her original dreams may have been—becoming a philosopher, having a regular job—thanks to a purported “safe and effective treatment”, all such options were now nullified.

And here one further fundamental truth about ECT is highlighted—how little it takes for massive damage to happen. Sue, note, had five treatments only—a very low number.  While ECT advocates sometimes suggest that trying a few treatments could not hurt—the consequences for Sue, as for legions of others, demonstrate otherwise. 

The point is no matter how many shock are given or what type of shock is used, the memory loss can be enormous. Nor does it self-correct. The memory loss is not, that is, as promoters like Fink (1979 and 2009) are so fond of claiming, minor and transient.

Flash forward: For the rest of her life, Sue had to take notes all day long just to keep track of what was happening. “I’ll be talking to you today,” she stated in my video, “and tomorrow, it’ll be hard for me to recall . . . our conversation.” (Burstow, 1994).  She further stated 11 years later:

I have a difficult time remembering things from hour to hour, let alone from day to day. I forget to mark things down in my date book and I have forgotten appointments, meetings, trips, conferences, and the list goes on. People come up to me to this day and say, “Do you remember me—and I don’t know who they are. I can’t remember some of my neighbours’ names who I see on a daily basis . . . You can’t get a job when you can’t remember. You can’t go to school to get a good education if you can’t remember anything . . . Marking things down doesn’t even help me much for I forget where I wrote the things down. (Inquiry into Psychiatry, 2005)

A reality, I would add, which not only points to the damaging nature of this treatment—which it surely does—but once again points to the gender dynamic. In this regard, Sackeim et al. (2007) conducted the large study in ECT history and they established at a level of statistical significance that women administered ECT become more cognitively impaired that men, with inability to recall details of their lives particularly pronounced.

In summary, what Sue’s story reveals and reveals powerfully is the damaging nature of ECT particularly and psychiatry in general, psychiatry as an inherently oppressive and inherently dishonest institution, the foundationlessness of ECT as a “treatment”; the destruction of self that is part and parcel of ECT; psychiatry’s erasure of the social nature of people’s problems; and the dearth of real help for people in difficult predicaments. It likewise sheds light on the degree of social buy-in into psychiatry, with psychiatry’s cooptation of our educational system especially highlighted. And last but hardly least, it sheds light on the role played by sexism and ageism. 

That said, what we can learn from Sue’s life hardly stops here. Sue’s life likewise offers us a glimpse into a very different reality. And I could not end this article without also focusing in on it. The damage done to Sue was horrific and beyond dispute. The point, however, is, as philosopher Jean-Paul Sartre (1943/1956) put it decades ago, we can always make something of what has been made of us—and indeed Sue did—and did so brilliantly and with panache.

Albeit while persistently having to take notes all day long—and to be clear, these  dire effects never subsided—after consulting with a few of us when in her early 20s, Sue went on to become a fearless antipsychiatry activist and one of the world’s foremost advocates against ECT. In the end, as those of us who have had the privilege of knowing this remarkable woman are well aware, Sue led a highly meaningful live—a life of commitment, humanity, generosity, and integrity—and in the process, besides accomplishing much, she became a critical part of the social justice landscape and an inspiration to those around her. She demonstrated against ECT tirelessly. She meticulously highlighted what the research actually shows. She created numerous myth-fact sheets. She was co-founder along with her husband Steve of the enormously important International Campaign to Ban Electroshock (ICBE) and she managed its website (see https://intcamp.wordpress.com/). She wrote poems about ECT. She created and disseminated petitions. She networked with other activists and with legislators and scholars across the world. She made deputations. And she created her own whistle blower hotline.

 And whenever a hearing was happening, a video being made, there was Sue offering thrillingly frank testimony, never missing an opportunity to draw on her own experience to expose and teach. She also pointed the way, not only insisting on the importance of ending ECT but also of targeting the state.

In this last regard, to end this article the only way that I could imagine it ending, with a quote from the fearless, the outspoken Sue Clark-Wittenberg—here is Sue at her quintessential best, mincing no words, and announcing to everyone that ECT is torture in which the State itself is complicit:

All the therapy in the world is not going to erase the scars of being dragged into a room, having a band on your head, and having your brains fried. People say there’s no torture in Canada. That’s pure bullshit.  And excuse my language. There is torture being paid for by the Ministry of Health. (quoted from Burstow, 1994)

In the end, what words better than her own to show who this remarkable woman was?  And what words better than hers to commemorate her? 

(for this and other related articles, see http://www.bizomadness.blogspot.ca).

References

Andre, L. (2009). Doctors of deception. New Brunswick, New Jersey: Rutgers University Press.

Breggin, P. (1979). Electroshock: It’s brain-disabling effects. New York: Springer.

Breggin, P. (2008). Brain-damaging treatments in psychiatry. New York: Springer.

Burstow, B. (2015). Psychiatry and the business of madness: An ethical and epistemological accounting. New York: Palgrave Macmillan.

Burstow, B. (1994). When women end up in those horrible places. Video. Burstow: Toronto.

Fink, M. (1979). Convulsive therapy. New York: Raven.

Fink, M. (2009). Electroconvulsive therapy. New York: Oxford University Press.

Frank, L. (1975/1978). The history of shock treatment. San Francisco: Network Against Psychiatric Assault.

Inquiry into Psychiatry (2005). Retrieved August 9 2015 from https://coalitionagainstpsychiatricassault.wordpress.com/articles/personal-narratives/

Sackeim, H. et al. (2007). The cognitive effects of electroconvulsive therapy in community settings. Neuropsychopharmacology, 32, 244-255.

Sartre, J-P (1943/1956) Being and nothingness (Hazel Barnes, Trans.) New York: Pocket Books.

Weitz, D. (2009). ECT statistics 2008. Unpublished statistics released under Freedom of Information. Austin.

Women, ECT, and Memory

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.