Lost Memories:
Shock Therapy Hindered Recovery, Kenora Man Says
by Jim Mosher
The Enterprise
July 20, 1997 ( Kenora, Ontario)
A Kenora man who says he endured almost 25
years of progressive memory loss, coupled with hallucinations and bouts of
confusion and depression, thinks the shock treatment he underwent may have
contributed to his troubles.
He says the routine use of shock treatment and
potentially hallucinatory medication to treat alcoholism and periods of mild
depression should be banned.
Jerry Gaudrain's first brush with psychiatry
and 'electroconvulsive therapy' (ECT or, more commonly, shock treatment) came
30 years ago, after he discovered his brother dead at their Kenora home.
Gaudrain (not his real name) says he fell
quickly into a deep and lasting depression after discovering his brother dead.
He began to drink a lot - not every day, but in large quantity during binges
that lasted several days. He became suicidal. Soon enough, he found himself in
a Kenora hospital where he was initially diagnosed as suffering from a mild
form of psychosis called reactive depression.
Doctors at Winnipeg General Hospital--now the
Health Sciences Centre--authorized shock treatment. That set Gaudrain, now 57
years old, on a course of treatment he believes kept him ill for 25
years.
"I'd be hearing voices," Gaudrain
said during a series of recent interviews in Kenora. "I'd see things. I
didn't want to live. I didn't know what I was talking about half the
time."
ECT is essentially an electrical stimulation of
the brain. It's used to induce cerebral seizures that disrupt normal electrical
activity in the brain. A patient is first given an intravenous anesthetic. Once
the patient is asleep, a muscle relaxant is administered intravenously and pure
oxygen is given through a face mask. An electrical stimulus is then briefly
applied to the scalp, causing seizure activity in the brain and mild muscle
contractions. The seizure usually lasts 30 seconds to one minute. The patient
is awake five to 20 minutes after the procedure.
Gaudrain says that instead of treating
alcoholism that was at the core of his suffering, psychiatrists in Winnipeg,
Kenora and Thunder Bay routinely ordered ECT to 'cure' his illness.
Gaudrain was prescribed a variety of drugs,
many of them known to induce hallucinations in small doses, among these
so-called psychotropic drugs and antidepressants such as Prozac, Librium and
lithium.
After more than 50 ECT treatments from 1967 to
his last in the summer of 1992, Gaudrain managed to take charge of his own
health. But it took a life-threatening car accident to change the course of his
life, he says.
Hospitalized on more than 75 occasions during
the 25-year course of his apparent illness, Gaudrain says he was routinely
released with a veritable pharmacopoeia of drugs prescribed. That surprises
Gaudrain now. He worked as a cab driver in Kenora. His doctor never told him
not to drive, he says.
"They'd just send me home with more
drugs," he said. "If you're alcoholic, why are they sending you home
with pills?"
'Voices' gone
Gaudrain says that since he's been drug and
alcohol free, the 'voices' that dogged him for a quarter century have
gone.
"It's a miracle I'm still alive," he
says of the many years of drug and electroconvulsive therapy. He says it took a
year to feel better after his accident five years ago on Redditt Road.
"But without the pills, the urge for
alcohol left," he says. "What really helped me was being referred to
an addiction counselor in 1992. That's something I needed."
Gaudrain has spent the last four years
attending a day self-help and peer support program.
An outreach worker with that program says
Goudrain's experience is far too common. "There are fewer places to file
people away," she said. "There are still people being caught in the
trap. They're getting this pill and shock routine. Maybe all these people need
is someone to talk to."
"I'm one of the fortunate ones,"
says Gaudrain today. "When I did get off the drugs and ECT, I just never
had the urge to drink."
He acknowledges that he did ask for ECT
treatments. "They had me so brainwashed. Now I just want to see ECT
banned."
While Gaudrain struggles to get his life back
together, there are some things that are simply irretrievable.
"There are so many things I can't
remember," he says now. "My family went through hell. They can't
believe I'm the same person."
"With the ECT and all the drugs, you walk
around like a zombie," he said. "I'm the one-in-a-million that comes
out of it."
Treatment considered part of the psychiatric
arsenal
Kenora psychiatrist Crosbie Watler acknowledges
electroconvulsive therapy(ECT) was inappropriately used in the past, but that's
no reason to turn away from its demonstrated therapeutic benefits.
"As we use it today, ECT is a very safe,
very effective and very well-researched treatment," Watler, chief of
psychiatry at Lake of the Woods District Hospital, said. "There are some
demons in the closet from decades ago, but we shouldn't throw out the baby out
with the bath water."
Dr. Watler says ECT is used at the Kenora
hospital because it can provide "a prompt, life-waving" treatment for
people who are in the throes of extreme depression, those who are suicidal, in
particular.
"ECT is a mainstream treatment in
psychiatry," Watler said. "In the '50s, '60s, and '70s, it was used
inappropriately. Bu over the last 15 years, the indicators for ECT have been
extremely well stated."
People at extreme risk of self-harm and those
suffering extreme forms of mania are among the candidates for the electrical
therapy.
"There's not been a single documented
case, with the way ECT is used currently, of brain damage," the Kenora
psychiatrist said, noting past ECT therapy was performed without oxygenation
(supplying oxygen to the brain) and with greater electrical current.
Treatments are now administered under general
anesthetic. Patients also receive a muscle relaxant to eliminate or reduce
muscle spasms and convulsions such as accompanied past treatments.
Watler is not alone in his profession.
Psychiatric associations in Canada and the United States endorse the treatment,
even though both groups acknowledge no one fully understands why ECT is
effective.
"The mechanism of action of ECT remains
uncertain, as do the mechanisms of antidepressant medications," says John
Lipsey, associate professor of psychiatry at Johns Hopkins School of Medicine
in Baltimore. "However, ECT remains an effective and often lifesaving
treatment for the most severely ill psychiatric patients. Eventually, it will
be replaced by more specific physical treatments so that induction of a
generalized seizure will no longer be necessary. In the meantime, the continued
careful use of ECT in selected cases is imperative to save lives and alleviate
suffering."
American psychiatrist calls shock
'barbaric
Psychiatrist and author Peter Breggin says
shock treatment is little more than electrical lobotomy. Breggin says
electroconvulsive therapy (ECT) causes brain damage - and, he says, most
psychiatrists know it.
"It's barbaric," Breggin said during
a recent telephone interview from his summer home in West Virginia. "It
causes brain damage. That was the argument used when it was first introduced in
1938. It was held as an electrical lobotomy."
Breggin has written more than a dozen popular
books about modern psychiatry including Toxic Psychiatry and Talking Back to
Prozac. In Toxic Psychiatry, he makes the claim that ECT is bad medicine, worse
when it's combined with drugs.
He says claims that ECT is safer now than when
it was first introduced are typical of the siege mentality of psychiatric
associations, which he claims always go to bat for whatever technique is in
fashion.
"They claim that it is safe, but there
have never been any follow-up studies," he said. "If you claim a
technique is safe, you have to show that with animal studies."
"To say that things are safer and better
now is not true," he continued. "They said that in the '50s about
lobotomies."
(Frontal lobotomies were a standard treatment
in the 1950s. A portion of the frontal lobe of the brain was removed, usually
by drawing it out through an eye socket. At the time, psychiatrists cited the
witnessed 'improvement' in previously combative patients. Neurological studies
later showed that the improvement resulted after some essential brain functions
were literally eliminated after the removal of the frontal lobe. The practice
has since been discontinued.)
Shock treatment is often combined with drug
therapy. That's hardly surprising to Breggin. "It shows you how inadequate
ECT is - they load you up with drugs," he said.
But Breggin appears to be out in left field -
at least out of step with his colleagues. Professional psychiatric
organizations have come out squarely behind ECT as a necessary and safe
treatment for acute depressive disorders.
The Canadian Psychiatric Association¹s
most recent position paper on the treatment notes that ECT remains "an
important part of the therapeutic armamentarium in contemporary
practice."
The CPA says ECT is a suitable treatment for
single episode or recurrent major depression, bipolar disorder and chronic
schizophrenia.
"For these disorders, there is either
overwhelming evidence in the literature attesting to the efficacy of ECT or a
consensus among experienced psychiatrists as to its effectiveness," the
CPA notes in its ECT position paper.
But the use of ECT to treat other disorders
should only be undertaken in "exceptional circumstances" because
"compelling evidence of the effectiveness of ECT in these circumstances is
lacking."
Breggin remains uncowed. He's convinced of the
barbarity of ECT. He says it takes away one's identity. It's hardly surprising
that ECT patients are more pliant and cooperative, he says. That witnessed
improvement is due, he claims, to brain damage.
In Toxic Psychiatry, he cites cases
where ECT was used to make a previously combative and disputive wife into a
docile and submissive 'perfect wife'. Breggin says there is reason to fear this
'social engineering'.
He says few psychiatrists are willing to speak
out against ECT. "It's simply not true that all psychiatrists agree with
the treatment," he said. "But I've been one of the few who has been
willing to take a stand."
A human rights atrocity: Activist
'psychiatric survivor' slams ECT
It's all been a "pack of lies".
That's how Don Weitz describes the selling of electroconvulsive therapy
(ECT).
Weitz describes himself as a proud psychiatric
survivor. Back in the 1950s, he did his times on psychiatric wards, where
'shrinks' used insulin shock therapy to force demons out of Weitz's
brain.
He calls ECT "a devastating
procedure" that should be discontinued. Weitz hosts a twice-a-week radio
program on CKLN-FM, an alternative radio station in Toronto. The program's
called 'Shrinkwrap' - and its focus is airing the experience of psychiatric
survivors, people who have abandoned the clinical approach in favour of
self-help through peer support.
"ECT is an atrocity masquerading as a
treatment," Weitz said in a telephone interview from Toronto. "Since
when is a seizure therapeutic? There's no such thing as a seizure that's
therapeutic in human beings."
Weitz says many people opt for shock treatment
because that's what their psychiatrist advises. That's fine, says Weitz. But
people must make decisions with all the information in front of them.
"If you hit people over the head and
they're stunned for the rest of their lives, that's fine if they're aware of
the consequences," he said. "But at least you should warn them.
That's not happening with ECT."
The media can also take the rap for failing to
adequately inform the public about the dangers of ECT, Weitz says. "Most
media stories just parrot the line laid down by the Canadian Psychiatric
Association," he said, adding people must be educated to understand the
potentially devastating consequences of the procedure.
"It's a very intrusive, damaging
procedure that shouldn't be continued," Weitz said.
A member of the Ontario Coalition to Stop
Electroshock, Weitz helped organize a hearing into ECT in the fall of 1995.
Weitz claims that of the 50 former ECT patients who described their post-ECT
experiences at the hearing, fully 49 said that they experienced memory loss and
other long-term effects. "But the Ontario government has refused to hold
public hearings," he said.
"ECT should be abolished," said
Weitz. "It's a human rights atrocity. There's no such thing as informed
consent. These so-called treatments invariably make people worse."
Instead of electric shocks and drug therapy,
psychiatry must work toward peer support and community involvement in the
healing process.
"In a community support group, people
suffering depression can really take off," he said. "It is an
extremely productive way to help people become healthy and whole again."
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