I have met numerous individuals who have been electrocuted under the auspices of psychiatry and psychology, or psy. The treatment – electro-convulsive therapy (ECT) – is criticised by recipients and receives only occasional press coverage. In the days when I received calls from journalists asking about the state of psy, I would usually say: “You’re asking the wrong questions. You should be writing about ECT.” Invariably the response would come: “They don’t still do that, do they?”
ECT might be viewed as representative of much that occurs within the psy complex: it has harmed millions; it is based on suspect and ever-changing theoretical assumptions; research is carried out exclusively by those with vested interests in the results; it is most commonly used on those with little power, in the context of coercion and lack of consent; and health professionals are largely silent on the topic.
During ECT an electric current is passed through the brain, via electrodes, to induce seizure activity. The recipient is anaesthetised and muscle relaxants are given to prevent spasms. The original idea, to induce epileptic seizures (supposedly curative for people branded schizophrenic) has been long replaced by conflicting ideas about how ECT produces the desired effect, summarised by Peter Breggin as “brain damage”.
ECT is touted as “safe and effective” by Mind, the Royal College of Psychiatrists and others. It has the gloss of science – electricity, people in white coats – but this is an illusion. The wide variation in how ECT is used demonstrates that, in fact, it is based on the preferences and biases of local psychiatrists and researchers.
For example, in Greece and India ECT is administered to those diagnosed with schizophrenia, and elsewhere in the world to those diagnosed with anything from depression to autism. Banned in Italy, Holland and Germany for many years it is making a comeback throughout Europe. It is now only illegal to give ECT in Slovenia. Some US and Australian states have banned it for children under 14, leading some US ECT advocates to object to the fact children must now be taken across state borders in order to be legally electrocuted. In Turkey it is used as a torture with children as young as nine. In Nigeria it is given without anaesthetic, leading to fit-induced bone fracture.
The UK shows equal variation even within individual centres. For example, there is an 18-fold difference in the use of ECT between 11 adult psychiatric teams in a single Edinburgh teaching hospital. Unused in some NHS trusts, neighbouring areas use it weekly, particularly with women over 60. Award winning campaigner Bonnie Burstow sees this as part of a secret war against women. Many female recipients are surprisingly old. For example, 37 depressed patients 80 years of age or older were given ECT during a study at the Rhode Island Hospital in Providence. A one-year follow-up found 10 deaths among the ECT patients and one death among the 28 patients given only anti-depressants.
Despite a death rate estimated at 1-5 per cent and memory loss in more than 30 per cent of recipients, it is not unusual to find ECT described as “safe and effective”. The Greater Manchester West Mental Health NHS Trust website informs us that “ECT is used once medication, talking therapy, and other psychological and social supports are exhausted, and so adds another dimension to the recovery process”. Given the idiosyncratic nature of the use of ECT throughout the UK and the lack of support, this statement seems, at best, hopeful.
We know ECT is, for many, a lethal treatment. A small proportion of recipients claim it as a life-saver. As a procedure that has harmed millions over the last 75 years, it might be time to weigh the balance between the harm and the help before allowing its continued use.
Clinical Psychology: A Critical Examination by Craig Newnes and Children in Society: Politics, Policies and Interventions, edited by Craig Newnes, are available from PCCS Books (pccs-books.co.uk). Inscription, Diagnosis, Deception and the Mental Health Industry: How Psy Governs Us All by Craig Newnes is published by Palgrave Macmillan (palgrave.com)