Shocked Tactics (Michelle Shocked)

Sunday Herald

THERE’S ONLY two things you don’t talk about in polite company – one is politics, the other is religion.” Michelle Shocked delivers her favourite line with a shrug that signals her intention to talk about faith, politics and little else. No-one has ever called her polite, but that’s how she likes it.

Shocked defined herself through confrontation the moment she ran away from her strict Mormon upbringing in East Texas to become a folk singer. Her rebellious streak landed her in mental hospitals, jail cells and homeless shelters in San Francisco. The cover of her debut album, Short Sharp Shocked, showed her being manhandled by riot police, a choke hold stifling her shout of protest. From the name down, she was outraged, appalled, and ready to fight.

She struggled against misappropriation of her music, taking her label to court and winning on the grounds that her contract amounted to slavery. She passionately condemned US foreign policy, speaking out against the invasion of Iraq back when it meant career suicide. She confounded the expectations of the music industry and her fans by refusing to stick with any one style, singing folk, blues, rock, gospel, swing, latino and Disney songs as the mood took her. She has no regrets.

Interviewing her is bracing, but never bland. “I find the question to be a particularly British type of journalistic tedium,” she tells me at one point, adding that she would like to put her hands around my throat and strangle me. “I really want to get to the soul of this, but you already have your questions. If you just want Q&A then I’ll give you answers, but don’t waste any more of my time. I’m trying to get to some heart matters here, man.”

Shocked is passing through New York on a tour to promote To Heaven U Ride, a live Sunday morning gospel set that she released on her own label, Mighty Sound, earlier this year. After a trip to a hat shop to get her trademark silk fedora professionally cleaned, we take tea at Starbucks. Shocked thinks that “people are hypocritical” in their attitudes to the corporate coffee chain, and in any case, she really likes the chai there. Knowing what your cuppa will taste like is important when you’re living out of a suitcase for weeks on end.

She pays with a gold American Express card, but times are evidently tight. She is staying at a grim hostel in Chelsea and travels from gig to gig in a small car barely big enough for her guitars and her three backing singers. “We wanted to go home with some money,” she says, “so the tour budget kept shrinking until we were sharing a room.”

Not that she is complaining. Shocked lived in enough squats and slept in enough doorways when she was young to know better than to get too comfortable with stardom when it arrived in the late-1980s. “I have never, ever, written songs to make money,” she says. “It’s something that I love to do. The fact that it becomes a recording is secondary.

“I’ve weeded out all the tourists by now. By now I probably have fans that I could put out a neo-Nazi album and they’d say, I sure didn’t see that one coming’. When you stop being cool, that’s when you can start calling people fans.”

Her gospel album comes with a “womanifesto” that begins: “Ask me about my religion. Of course no-one ever does.” But whether she is asked or not, the conversation returns again and again to her faith. Her political ideals, her feminism, her family relationships – all are expressed in the language of destiny and belief.

Fifteen years ago, Shocked was saved, at the charismatic Church Of God In Christ, close to her home in South Central Los Angeles. She went along for the singing, thinking that “this music would be so good if they’d just give that Jesus crap a rest”, but then, to continue the well-worn story, “stayed one Sunday too often”.

“When I made the altar call I was crying,” she says. “It’s almost like crawling across broken glass. The preacher said, This is the happiest day of your life’, but it took me a long time to understand.”

She soon joined the choir, as the only white woman in an African-American chorus, an occasional soloist with her own unofficial title: Sister Shocked. “My sister said, Chelle, you look like a grain of rice in a bag of chocolate chips’.”

Shocked was born Karen Michelle Johnson, in Dallas in 1962. After her parents divorced, when she was three years old, she was raised as the eldest of eight children by her mother and step-father, an “army brat” moving from base to base in the US and Germany. In her teens, the family returned to Kelsey – a one-church, one-store, one-cemetery town founded by Mormons in East Texas, in the middle of beautiful Bush-backing nowhere.

Her father, “Dollar” Bill Johnson, was a part-time musician who taught her blues and folk songs on weekends and holidays, but otherwise she was raised according to rigid Mormon dogma – no tea, no coffee, no fun on Sundays. “I was taught to be a racist. I believed God was racist,” she remembers. As soon as she was old enough, she ran away, ever further each time: to Dallas, to Austin, to San Francisco, to New York, to Amsterdam, to Rome.

In San Francisco, she was arrested at a squatter’s rights demonstration, given a shot of the now-discredited control drug Thorazine and taken to a psychiatric ward in handcuffs. Not long after she was released, she suffered a “psychotic episode” and was committed to a second mental hospital, in Texas, by her own mother.

After a month of therapy, medication and electric-shock treatment, her family’s health insurer declined to pay the bill and sent her home. This time, she left for good. She would not even speak to her mother for the next 25 years.

“I thought I had rejected religion whole qua, until I took the bad acid,” she says. “I was having apocalyptic, nihilistic visions that were part and parcel of the Mormon indoctrination of my youth. I was wandering around in the rapture. They got to me young and the more I tried to run, the more I tried to reject it. It became an antithesis to the thesis. I looked at my idealism, sincerity, passion and commitment and realised that the source of it all was a profound need for spiritual succour.”

Five years ago, she finally got back in touch with her family. “I’d already forgiven my mother many years prior but I just hadn’t had the courage to let her know. So I called her up. She was very gracious.”

That bond has been re-established, but some wounds remain raw. “I get reports that my sister is basically pretending she doesn’t know me,” Shocked says, with a tangible note of hurt in her voice. “She’s embarrassed to know me. They’re in East Texas and Bush plays really well there.”

The record that lifted her up, out of the squat scene, away from fiddle festivals and hardcore punk gigs, was the Texas Campfire Tapes. Englishman Pete Lawrence ran a tiny independent label, Cooking Vinyl. When he met Shocked at the Kerrville Folk Festival in Southern Texas, he was so entranced by her finger-picking guitar style, her beguiling voice, by turns pure and half-spoken, and her unselfconscious, storytelling lyrics that he asked if he could record her performing. He only had a Walkman, running low on batteries, but it would have to do.

Lawrence claimed to be a writer for Folk Roots magazine, but when he got back to Britain he released the set as a live bootleg without her permission. The collection of songs, punctuated with banter and laughter, with grasshoppers chirping loudly in the background, became the surprise hit of 1986. It topped the indie charts, got hours of airplay on Radio 2 and earned Shocked a major label deal, but it didn’t make her any less angry.

Oddly enough, To Heaven U Ride was never supposed to be released either. When Shocked performed at the Telluride Blues Festival in 2003 she had a clause in her contract that forbade organisers from taping her set. No-one told the team in the recording truck, so they taped her anyway.

Three years later, Shocked listened back to the performance and was impressed with what she heard. For an artist so determined to retain control over her music, who likens taking Mercury Records to court in the mid-1990s to David’s fight with Goliath; it was a confusing experience. Shocked is bitter that her wishes were ignored, but pleased with the results.

“This is about control of my destiny, which is very much in God’s hands,” she offers. “The fact that he may use bootleggers and pirates to guide that destiny is obviously something I don’t have a say in.”

At the live show in New York, Shocked’s rambling confessional stories threaten to eclipse the songs. Cover versions are chosen at the intersection of sacred and secular: Sister Rosetta Tharpe, The Band, The Staple Singers and Billie Holiday. Stripped of a rhythm section, it is up to Shocked to provide the intensity, while her backing singers fill out the sound.

One thing she does not talk about much, either on stage or in interviews, is her sexuality. In 1989, at the New Music Awards, when she beat Tracy Chapman, the Indigo Girls and Phranc to the title of “Best Female Singer or Group”, she accepted her trophy with a smile and an offhand comment: “This category should have been called Best Lesbian Vocalist’.”

A year later, she told Chicago’s OutLines magazine that “it would have made all the difference had I grown up knowing that the reason I didn’t fit in was because they hadn’t told me there were more categories to fit into”. She has remained a gay icon ever since, despite being married to music journalist and producer Bart Bull for a decade. “I have a lot of contradictions,” she says.

After her marriage disintegrated five years ago, Shocked fell “madly, passionately in love” with graphic artist David Willardson, whose Disney meets Pollock canvases are massively popular in Japan. They live in separate houses, a short drive apart in Los Angeles, and are working together on a collection of songs and paintings about iconic cultural figures: Audrey Hepburn, Frida Kahlo, Georgia O’Keefe and so on.

She has reconciled her sexuality with her faith, despite occasionally encountering conservative, homophobic attitudes within the church. When a visiting pastor preached that the Bible clearly defines homosexuality as a sin, she collared him afterwards and made her views known, but more generally she has accepted that it’s best to agree to disagree. “You cannot make a round peg like me fit into a square hole like organised religion,” she says, “but there’s lots of things that I can use.”

When Shocked opposed the invasion of Iraq with characteristic vehemence, the response from a section of her audience was “ridicule, hostility, outright rejection, people walking out of shows”. She also found that booking gigs was suddenly much harder than it used to be. However, the experience has not tempered her willingness to say the unsayable. She is happy to suggest that the USA deserves to be a terrorist target, for instance, paraphrasing an infamous Malcolm X quote in the process. “September 11 was just chickens coming home to roost,” she says. “The violence, the aggression, the inherent contradictions and the ultimate dysfunction of American society has led to this juncture.”

Her anti-authoritarian world view remains much the same as it was when she was younger. What has changed is the nature of her activism. This radical feminist, who never missed a chance to attack political oppression, sexism or racial intolerance, has now concluded that power and wealth have become so concentrated that prayer, not revolution, is the only option.

She says: “Folks, you’d better start praying like hell. This is truly gonna take a miracle to sort out. The good people had better start calling on a superpower to resolve this thing that is beyond human power. Look to Mahatma Gandhi, look to the Reverend Martin Luther King. They put the principle of non-violence to work. Power should not have ceded its authority without a bloody struggle, but it did.”

Shocked remains a professionally awkward customer who never backs down from a confrontation on principle. She last tussled with security guards earlier this year, on a Southwest Airlines flight, when a jobsworth steward flexing his post-September 11 powers wouldn’t let her sit on an exit row. “Move or I’ll call the cops,” he told her, so she refused, knowing she’d be thrown off the plane.

Is she more or less angry now that she is older and spiritually at peace? “Oh, I’m more angry, but I’m also more effective,” she says. “I’m still angry, but I have a few more skills, a few more credit cards, a few more contacts and a lot more experience.”

Shock Value

Electroconvulsive Therapy Saves Lives. But 70 Years After It First Gained Currency as a Treatment For Major Depression, ECT Continues to Court Controversy.

By Shirley Wang
Special to The Washington Post
Tuesday, July 24, 2007; HE01

Anthony Mauger woke up at 5 a.m. one morning nearly 10 years ago and heard a message in his head telling him to kill himself. He wrote a goodbye note to his wife, then jumped off the back deck of their Kensington home, falling the 14 feet hard enough to wake her with the sound of his thud.

The 66-year-old organic chemist succeeded only in smashing his knees and skull. After surgery at Suburban Hospital, he was transferred to Potomac Valley Nursing and Wellness Center in Rockville for intensive psychiatric care.

Mauger had been depressed for about six months, his wife, Inge, remembers. His sleep had been poor, and he was making strange claims that he could not go on vacation or walk. The slew of antidepressants Mauger tried made no difference. After four more months watching her husband deteriorate, Inge Mauger was desperate. “Nothing is happening,” she said to his psychiatrist. “Isn’t there anything you can do?”

“We can try ECT,” he replied.

Better known as shock therapy and seared into our collective consciousness as the involuntary procedure depicted in “One Flew Over the Cuckoo’s Nest,” electroconvulsive therapy remains a controversial treatment, often used, as in Mauger’s case, only after other treatments fail. Its popularity has waxed and waned in its 70-year history, but an estimated 100,000 Americans undergo ECT each year, according to a 1995 survey of more than 17,000 psychiatrists, and its use appears to be steady or increasing since then.

The number of treatments in California — one of the few states that have mandatory reporting — increased from about 13,000 to more than 20,000 between 1994 and 2004. Although the District, Maryland and Virginia do not require such reporting, Johns Hopkins Hospital treats about 125 people with ECT annually, a number that has not changed much recently, according to Irving Reti, head of Hopkins’s ECT unit; at Sheppard Pratt outside Baltimore, ECT physician Jack Vaeth says his service does about 60 treatments a week, an increase over the past decade.

While no one fully understands why ECT works, many psychiatrists believe that using an electric current to produce a “grand mal” — or generalized brain — seizure can “reboot” the brain when medications and psychotherapy fail. Just last week, a commentary in the Journal of the American Medical Association (JAMA) suggested that, despite its demonstrated effectiveness, ECT remains underused, primarily because of its stigmatized history.

The treatment is “miraculous” and “lifesaving,” say some patients and doctors, and yet the costs — primarily memory loss — can be significant. Many individuals who believe that ECT kept them alive when they were suicidal also urge caution about its use.

Mauger, as an older individual with “treatment-resistant” depression, is a fairly typical patient. Initially scared, he decided to try ECT weeks after his psychiatrist and wife first urged him to. By the seventh of his 12 treatments, he felt his depression lift.

“He sat up and said, ‘I’m not depressed anymore,’ ” his wife said. “I was amazed.”

His one relapse years later quickly responded to another course of treatment. “I am terrified of what would have become of me without ECT,” Mauger says.
A Long-Term Goal

An acute course of treatment usually comprises eight to 12 sessions, administered two or three times a week at a hospital. Studies show that more than 70 percent of severely depressed patients experience quick improvements. (About 50 to 60 percent respond to antidepressants.)

“ECT is hands-down, for the short term, our most effective treatment for depression,” says Harold Sackeim, professor of psychiatry and radiology at Columbia University.

However, only about half of patients remain well even six months after one course, if given no other treatment afterward. “Acutely helping someone out of a period of depression is very important,” says Sarah Lisanby, chairperson of the American Psychiatric Association Committee on ECT and Related Treatments. “But it’s not the end of the story. The goal is long-term treatment.”

That goal is a priority for researchers. The first randomized, controlled study of maintenance treatment following ECT, published in 2001, found that giving patients a combination of an antidepressant and a mood stabilizer significantly increased the chances that they would not relapse into major depression six months after having ECT.

More recently, a research group found that continuing to give ECT once a week to once a month for six months produced results similar to the combination medication treatment.

“We’re learning how to keep people well after ECT more than we knew before,” said Max Fink, professor emeritus of the Departments of Psychiatry and Neurology at Stony Brook University in New York, who wrote last week’s commentary in JAMA. “You can’t just stop.”
A 20-Minute Procedure

The ECT of today is not the shocking scene depicted in books and movies. The overwhelming majority of patients receive the treatment voluntarily. While I was a clinical psychology intern this year at Western Psychiatric Institute and Clinic in Pittsburgh, the head of the ECT program, Roger Haskett, arranged for my classmates and me to view ECT in action.

At Western, ECT is provided every weekday morning. Patients are wheeled one at a time into the ECT suite, lying on gurneys and in hospital gowns, much like patients about to get any other medical procedure. Many that morning were elderly and female, which is typical of the population that gets ECT, and most appeared calm.

They were given an intravenous anesthesia, which sent them to sleep within minutes. A muscle relaxant coursed through their entire bodies except for one foot, which was wrapped with a blood pressure cuff to keep the muscle relaxant out so the seizure movement could be observed. Five sensors were carefully attached to the patients’ foreheads to measure electrical brain activity, and their temples were cleaned and coated with conducting gel. The patients were also given oxygen, and a bite block was inserted into their mouths right before the electrodes were placed on their heads.

The anesthesiologist, psychiatrist and nurse then confirmed which procedure each patient would get — unilateral (both electrodes on the same side of the head) or bilateral (one electrode on each temple) — and what dosage of current.

The psychiatrist then placed the electrodes against the patient’s head, and the ECT machine sent a jolt of seizure-inducing current. Except for what appears to be a grimace — an automatic result of stimulation of the muscles that run along the sides of the face — and a tensing of the total body, ECT patients do not move during the procedure. There is no flailing about, apart from a slight twitching in the cuffed foot. Yet as a new observer, I found watching the experience a little jarring.

The setup is very efficient; each procedure takes about 20 minutes.
The Memory Issue

What bothers many patients afterward — and is at the core of the continuing controversy about ECT — is memory loss. Some are confused when they wake up; others complain that they cannot remember past events and have at least temporary trouble forming new memories.

Much research has focused on reducing that side effect, but patient experiences vary tremendously, and it is nearly impossible to predict the extent of memory difficulties in individuals, according to Frank Moscarillo, executive director of the Association for Convulsive Therapy, who has conducted ECT at Sibley Hospital since 1968.

Barbara Winkler, 46, of Kennewick, Wash., who had more than 90 sessions of ECT at Yakima Valley Memorial Hospital, cannot recall her wedding, which occurred during the period she was receiving ECT. “It probably saved my life initially,” Winkler said. “But the hardest part is probably the memory loss.”

Others, like Tom Hempel, 59, from Pittsburgh, see memory lapses as “inconveniences.” He jokes about “having an ECT moment.” “I know it was worth it,” he said.

Many in the ECT field say concentration and memory may also be compromised by depression. But it appears clear now that ECT can affect memory for much longer than the two to three weeks after which many physicians say most patients’ ability to remember will return to normal.

Some patients have pointed to inconsistency in information about side effects. Vermont state legislator Anne Donahue, 51, thinks they were not sufficiently emphasized before her first round of treatment in 1995, while the informed-consent form provided to her at a second hospital in 1996 was much more complete and easy to read.

“This is an incredibly vital and valuable treatment, but you have the right to know the risks,” Donahue said.

Although the overwhelming majority of ECT patients in the United States consent to the treatment, legislation governing involuntary ECT varies by state. The criteria are generally strict: A patient must be unable to make the decision, and they must be exhibiting dangerous behavior, such as not eating.

Also, there is no special license that a doctor needs to administer ECT in the United States. The American Psychiatric Association has issued practice guidelines, but in most states there is no regulatory body to see that practitioners adhere to those standards or to review the information on consent forms.

Nor is there any firm rule about when ECT is complete. Memory loss tends to get worse with more closely spaced treatments or larger doses of current, so doctors look for a plateau in improvement, when patients say they feel no additional benefit in symptoms.

“The desire to minimize memory loss while maximizing effectiveness is the holy grail,” said Steve Seiner, director of the ECT service at McLean Hospital in Belmont, Mass., one of the largest such programs in the country. “The goal of ECT is to get them back to their base line.” ·

Shirley Wang, who is completing an internship at Western Psychiatric Institute and Clinic at the University of Pittsburgh Medical Center, has a degree in clinical psychology

The body electric – Our son’s condition

Our son’s condition kept getting worse, and everything we tried to help him failed. Then we discovered there was one final option: Electroshock therapy.

By Ann Bauer
Jun. 19, 2007

At the age of 3, my older son withdrew, becoming sullen and cross-eyed overnight. He stopped speaking and lost the ability to follow directions, vanishing inside a body that only rocked and swayed and arched away from human touch.

Together with my then-husband, I coaxed this little boy back: reading him poetry, drilling him with flashcards, crawling the floor in circles at his side. And when he returned to us, recovering in a way most autistic children never do, I believed the worst thing that would ever happen to us was done.

So when — after more than a decade of progress — my son began to regress, I didn’t see it. I couldn’t. I called it depression, anxiety, teenage sloth. I didn’t realize the enormity of what was happening until my 18-year-old son could no longer climb a flight of stairs or tie his own shoes. Even then, it took us another year to figure out that he had a condition called autistic catatonia: a second withdrawal, even more cruel and dangerous than the first, which occurs on the far end of childhood.

About a month ago, I wrote a story about my son’s misdiagnosis of schizophrenia during that yearlong period, as well as his frightening response to a couple of commonly prescribed antipsychotic medications, Abilify and Geodon. I cited a New York Times article about psychiatrists in Minnesota (where we live) receiving kickbacks for prescribing exactly those drugs and went on to report that my ex-husband and I finally took our son to Mayo Clinic, where he was correctly diagnosed and appropriately treated. I told how doctors there admitted a mute and feral young man, working in choreographed teams to figure out exactly what he needed, magically finding the person inside and bringing him back again.

What I did not report was that they used electroconvulsive therapy (or ECT) in order to do so.

I had two reasons for omitting this information. First, the point of my original essay was to bring attention to the misuse of antipsychotic drugs in children, adolescents and people of all ages along the autistic spectrum; I believed including the information about ECT (also commonly known as shock treatment) would hijack the piece, drawing attention away from the issues of overprescription and autistic catatonia.

But also, frankly, I didn’t feel like going through a hailstorm of reader outrage and Frankenstein jokes. Because even after seeing the benefits of electroshock for myself, I remained ambivalent about the treatment, protective of my son and simply raw.

So why go public now? Because after that original essay was posted, I received literally hundreds of messages (in fact, I continue to receive them, all these weeks later), from readers who had children, brothers, sisters or friends suffering from something similar. And these people were desperate for answers: How was my son cured? Did it last? And where could they go to obtain the same treatment for their son, daughter, brother, sister or friend.

I was in the process of responding individually to each of these queries when I received a letter from Max Fink, the doctor who had referred us to Mayo — and whose book “Electroshock: Healing Mental Illness” I used to research ECT — asking me to set the record straight. “I recognize the tremendous stigma attached to this treatment,” it said. “But if you wish to help other parents of such adolescents, you should disclose the fact that, despite its stigma, electroshock is one of the most effective treatments in medicine; that it has been in use for more than 70 years; and that its benefit-to-risk ratio [for acute patients] is very favorable.”

Everything he wrote is true.

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Convulsive therapy was introduced to modern medicine in 1934 by the Hungarian neuropsychiatrist Ladislas Meduna. He had observed that delusional patients who suffered spontaneous seizures often were miraculously cured and developed a theory that mental illness and epilepsy were “antagonistic” conditions: Those with the first had a deficit of neuroglia (branched cells that form the network for communication between neurons), whereas those with the second had a surfeit. By inducing seizures with an injection of Metrazol, Meduna believed he could “grow” neuroglia in the addled brain, thereby reversing disease.

Proponents of ECT no longer believe this. In fact, they can’t say exactly why it works, only that it does, swiftly and consistently, in roughly 90 percent of catatonia cases, and 60-70 percent of patients with severe depression, mania and intractable psychosis. Recently, neurologists have begun recommending regular electroconvulsive therapy sessions for patients with movement disorders, such as Parkinson’s, saying that it minimizes tremors and reduces the need for drugs such as L-dopa, which has notoriously negative side effects. (ECT has proved ineffective, however, when used for dysthymia, anxiety, substance abuse and personality disorders.)

The prevailing theory today is that ECT somehow repairs and sensitizes various neurotransmitter receptors, such as the ones that bind to serotonin, dopamine, glutamate and cortisol. But the truth is, no one really knows.

“Think of it like rebooting the brain,” one clinician told me. “You don’t know exactly why your computer isn’t working, but if you shut it off and turn it back on, nine times out of 10, it’ll come back online and function just fine.”

This is small consolation on a chilly, blue morning in May, as I drive to Mayo before dawn and walk through the still-sleeping ward. Inside my son’s room I stand at his bedside, reading the form I’ve been handed, then take a deep breath and sign so the doctors who have assembled six-deep can take him to a surgical suite, put him under a “light” general anesthesia, attach electrodes to his temples, and shock him until he has a seizure. Under any other circumstances, this young man — 19 years old, of normal intelligence, and legally in charge of his own medical decisions — would not need parental consent. But here’s what it means to be clinically catatonic: Though he is burly and muscular, my son’s mind is spinning so fast his body has stopped functioning altogether and he cannot exert enough pressure to use a ballpoint pen. His signature at the bottom of the sheet is illegible.

After I have scrawled my name under his, I hand the paper to my ex-husband who does the same. Then we walk alongside the bed that is being wheeled with effort by two medical students into a large, bright theater. They talk excitedly as we walk: This is the first time they will observe an actual ECT treatment.

Just then, the female student glances in our direction. Her face softens. “We’ll take good care of him,” she says.

And I nod blindly, through stupid, angry tears.

Then my former husband and I stand against a wall while they coax our son onto a fancier gurney, one with long straps that they pull out to their full length and buckle snugly around him. We watch the anesthesiologist lean over his frozen form and slip a needle into his arm. And I remember the day of his tonsillectomy, 13 years ago, when we — still hopeful young parents — held him down, our hands meeting on his Winnie the Pooh gown, while someone lowered a rubber mask over his small face.

Suddenly, there is a problem. “They don’t belong in here!” a voice says, and we are hustled out, into a small waiting room where I sit uncomfortably across from the man to whom I was married for 14 years. “Don’t worry, it’ll be all right,” he says, in lieu of touching me. And again, I nod.

Twenty minutes later, the male medical student comes out to talk to us.

“Your son is fine, everything went well,” he says in a bright voice. “And you should know, we got a really good seizure using the very lowest level of current.”

“Is that better?” I ask. “What does that mean? Is less current safer, or a sign that he’s closer to the surface than we think?”

The boy’s eyes cloud and he looks suddenly bewildered. He pauses, then says, “Honestly, ma’am, I have no idea.”

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By the early 1940s, electrical current had replaced chemical agents to become the standard method for convulsive therapy. Ugo Cerletti and Lucio Bini, the Italian researchers who developed the protocol for “electroshock” by experimenting on animals, were nominated for (but did not receive) a Nobel Prize in medicine.

But ECT’s popularity plummeted briefly in the 1960s when drugs such as imipramine and chlorpromazine were introduced and deemed preferable by most doctors. And it dropped off again in the mid-’70s, when the film “One Flew Over the Cuckoo’s Nest” depicted electroshock as medicalized torture, used by venal healthcare workers to keep mental patients in line. Despite a series of movies and television shows that vilified the therapy — “Law and Order” even did an episode about ECT, called “Cruel and Unusual” — rates crept back up over the next several decades, mostly for patients with drug-resistant forms of mental illness. And by the mid-’90s (the most recent period from which statistics are available), about 100,000 people in the U.S. were being treated annually with ECT.

“One of the major reasons ECT is so controversial is because of the way it’s been portrayed in the media,” says Dr. Teresa Rummans, professor of psychiatry and the former medical director for ECT at Mayo Clinic. “Our challenge is to get people to consider this therapy as an option, despite the negative things they’ve seen in the movies. It’s not a panacea. But for certain people who can’t be helped any other way, it can be life changing, or life saving.”

Today, even anti-ECT activists admit the therapy sometimes works in cases where nothing else has. But there is a debate raging about whether the side effects of ECT — including memory loss and confusion — are temporary or, in the language of the medical establishment, “persistent.” Earlier this year, Harold Sackeim — a professor of psychiatry and radiology at Columbia University — published the results of a 25-year study in the journal Neuropsychopharmacology, confirming that ECT can cause permanent memory loss.

We didn’t turn to this treatment until it was the only option left and our son was so lost, overwhelmed and deluded that his quality of life was entirely gone. I remind myself of this. I’ve read and reread the quote from novelist William Styron — author of the visceral depression memoir “Darkness Visible” — after he underwent ECT in 2000: “I’m writing. I don’t sense any memory loss whatsoever … I would say that my memory is somewhat better than it might have been a year ago.” I remind myself that today electroconvulsive therapy is practiced not only by the Mayo Clinic but also by neurologists and psychiatrists in nearly every well-respected academic and teaching hospital in the country.

Still, I pray that this is not a terrible, irreversible mistake.

After his first treatment, my son is wheeled back to his room. I check him over, anticipating strap marks from where he strained upward during the convulsion, or burn marks on his temples. All I find is a white bandage on the crook of his arm, from where the IV needle went in. He sleeps the rest of the afternoon. When he awakens, he appears confused, but he is able to drink some water. The nurse asks him if he has a headache; he thinks for a few moments then signals “No.”

Drained, my ex and I drive back to Minneapolis together. We’ve told no one what we’d gone to Rochester to do, in fear that some distant relative with a Scientology bent might file an injunction to stop us. Now, the weight of this sits between us and we barely speak.

Eighteen hours later, my husband drives me back to Rochester. It is 10 a.m. on a Saturday. We walk onto the unit and while we are being checked for contraband (anything with a blade, a sharp edge, or a cord), my son ambles out of his room and smiles at us. He raises a hand. “Hey, good to see ya,” he says, and walks — not quickly, but purposefully — into the lounge where three other patients are sitting in front of the TV. “What are you watching?” we hear him ask one of the others.

My husband turns to me, eyes freakishly wide. “Holy cow,” he says, grabbing my hand. “Have you ever seen him move like that?”

And, of course, I have. But it was long ago: before I met this man, before my son became depressed and discouraged, before the catatonia set in.

Later that day, we play hearts and when my son shoots the moon [taking all the heart tricks, plus the queen of spades; a move that requires careful strategy and a straight face], he gathers up all the cards and crows the single word “Yes!” out loud.

It is an eerie, wonderful sound that doesn’t fade for me, even as we are riding home.

In “Flowers for Algernon,” the science fiction novella written by Daniel Keyes in 1959, a retarded janitor named Charlie Gordon undergoes brain surgery and is “cured.” His IQ rises from 68 to the genius range. Then the process begins to reverse and Charlie, now sober and worldly and able to read in several languages, must experience his own deterioration. In the final pages of the novel, after writing a scientific paper detailing the descent, he becomes once again a shambling, childlike man.

Bringing our son home from the hospital is something like this. After seven ECT sessions, he seems ready: still autistic — this is a lifelong condition that no current therapy will change — but clearheaded, affectionate, gentle and ready for real life. On the day of his arrival back home, he writes a new schedule, updates his calendar, washes his clothes. On the second day, he is a little shakier, more tentative; around dinnertime, he begins laughing joylessly, under his breath.

“I can feel the catatonia coming back,” he whispers to me late in the evening. “Please, help me. Make it stop.”

Day 3, he is supposed to return to work and he does, but his supervisor calls midway through the shift to say there is a problem: By the time I arrive, he is standing in place, swaying, tears streaming down his face. He cries for the next 17 hours, taking breaks only to eat, which he does in enormous quantity, telling us he’s trying to erase the sadness and bad thoughts. On Day 4, he pushes through the wall of me and his father, sobbing, saying he is leaving us and leaving his life, then walks away — a shaking, swooning mass topped with a backward baseball cap — into a steadily graying twilight.

Together with two police officers, a paramedic, and our respective spouses, we track him down and take him back to Mayo, where they determine he needs more ECT. This time, however, the response is not so immediate: He lies in his bed, lumpen and rank-smelling, his head lolling. It is only after the third treatment that my son is resurrected again. I call and he answers the phone in his old voice, telling me he’s feeling quite good now and would like to go home again soon. He remembers little of the four days between hospital stays but promises things will be different this time. Better.

That’s when the psychiatrist in charge of his case calls a meeting. We’ve reached a decision-making point, he says. ECT alone is effective but transient. Also, there are residual symptoms of the catatonia: tics, disordered thoughts, twilight around the edges of his mind. The best option is to continue with the ECT three times a week for the duration of his hospital stay and afterward, once or twice a week on an outpatient basis.

In addition, they’d like to try a drug that will bridge the treatments and sustain their effect.

Because our son has responded so badly to medications in the past, all four parents object. But we are told it is the only option, barring constant, lifelong ECT.

“Most people will need something to keep them well after their course of treatment,” says Dr. Rummans. “Electroconvulsive therapy resets the circuits and gets things working. But I think of it the same way as when someone has electroconversion for cardiac arrythmia: They still need medication or surgery afterward to maintain. The brain works similarly to the heart in this respect.”

Here’s what I know: Even given the potential risks and my distrust of its murky track record, ECT has brought my son back to life twice and I am suddenly more afraid of what will happen to him — that inevitable Charlie Gordon-like crumbling — if he is disconnected from the machines.

- – - – - – - – - – - -

It is Memorial Day weekend and our family urges us to get away. “You need to take a break from this,” my father tells me. “Go out of town for a couple days and we’ll take over at Mayo.”

My husband and I throw a change of clothes into a bag, climb onto our Triumph, and ride 12 hours through the Badlands and into the Black Hills. On the morning of the third day — our final one — we go to Bear Butte, the mountain just outside Sturgis, S.D., to which many Native Americans trace their spiritual roots.

We know that bikers have a reputation for desecrating this sacred place. So we are careful: touching nothing, taking nothing, leaving nothing behind.

It is a cool afternoon with clear skies but dampness that licks our cheeks and arms. We climb the rubbly laccolith through trees hung with colorful Indian tobacco ties, bits of cloth representing the six directions: north, south, east, west, above and Earth Mother. When the wind blows, they move like soundless bells.

As we near the top of Bear Butte, a storm gathers and I run ahead. I reach the wooden platform at the peak and stand in the center, watching black clouds scud like ships. Lightning cracks to the north of the mountain. Then, as if in answer, there is a flash from the south. I face east so I can watch both sides of the storm. Up here I am taller than the trees, the highest point between Rapid City and the Wyoming border, inviting one of the bolts to strike. Never has the power of electrical current seemed so clear and there is a part of me that wants to feel it, here in this hallowed place. I imagine the six directions have conspired to tell me something and I must listen, so I look toward the forked branches of light.

My husband arrives then, breathless, climbing the steps of the platform and coming toward me with his arms outstretched.

“Sit,” he orders. And I do. But I keep my head up, feeling the rain on my face and watching the flickering sky.

When antidepressants don’t work

Northwest Indiana Times
Feb 3 2007

PORTAGE | Barbara Layton’s depression had become so severe she had only the energy to sit in a rocking chair all day and slowly rock back and forth.

The Hobart native and Portage resident had suffered from depression since she was a teen. At age 21, she attempted suicide. But it wasn’t until she reached 40 that she was diagnosed with bipolar disorder.

Like most with the illnesses, she’d been treated with a cocktail of antidepressants. This time, however, they weren’t working.

Suicide again crossed her mind, but she didn’t have the energy to carry out the thought, Layton said.

Instead, after consulting with doctors and educating herself and family members, Layton agreed to undergo electroconvulsive therapy, or ECT, more commonly known as electro shock treatments.

After six treatments, Layton’s depression had eased sufficiently that she was released from the hospital and returned to her normal life. That was in 1998.

“It scared me to death,” she said of her initial reaction to the recommendation, but she knew she had to do something.

“It saved my life. It just saved my life, and it was quick,” said Layton, 57.

Layton, founder and executive director of the Porter County chapter of the National Alliance on Mental Illness, has been an advocate for the mentally ill for years.

She took it a step further last year by agreeing to be one of a dozen ECT patients portrayed in the book “Shock: The Healing Power of Electroconvulsive Therapy” by Kitty Dukakis, wife of former presidential candidate Michael Dukakis, and Larry Tye. She also was featured in the DVD documentary “Shock,” produced by AMS Production Group. Both are available through

The reason she agreed to go public on a national level was to continue her efforts to educate people about mental illness, she said. The book, which predominately features Dukakis’ battle with depression and use of ECT, and the DVD both take a look at the pros and cons of ECT.

“I wanted to help fight the stigma. I wanted people to recognize me as me and not as my illness. I am Barbara Layton, not a bipolar,” she said. “I’ve always been vocal about mental illness. There is a lot of stigma attached.”

Layton said her efforts have been to teach others that mental illnesses like hers are not a person’s “fault” and that depression is not something someone can simply “get over.” According to the National Institute of Mental Health, depression is the leading cause of disability for people ages 15 to 44.

ECT, while administered to 100,000 people annual in this country, is misunderstood, Layton said. The stigma behind the use of the treatments comes from the media, especially the portrayal of the therapy in films like “One Flew Over the Cuckoo’s Nest” and “Frances.” The procedures have changed in administering ECT and are depicted in the DVD.

“I’m very pleased with the video. It shows the pros and cons of ECT. If you’re contemplating this, it is a very good source,” she said, adding the video is objective and that stories are about successful and unsuccessful treatments.

“I want people to know it is safe. I want them to go into it (ECT) very educated and look at it long and hard. This is not for someone with a mild case of depression. It is for someone with a debilitating case who has gone through all the medications.”


The documentary “Shock” featuring Portage resident Barbara Layton is available at for $19.95. The book “Shock: The Healing Power of Electroconvulsive Therapy,” which also features Layton’s battle with depression and use of electro shock treatments, also is available at for $17.22.

The Baseball Player Who Used His Celebrity to Bring Mental Illness Out into the Open

The Baseball Player Who Used His Celebrity to Bring Mental Illness Out into the Open Royals and the Reich’ Reveals Fateful History of Nazi Princes

History News Network
Jan 15 2007

By Barron H. Lerner

Dr. Lerner is a historian and physician at Columbia University’s Mailman School of Public Health. This article draws on his new book, When Illness Goes Public: Celebrity Patients and How We Look at Medicine (Johns Hopkins, 2006).

In 1952, a major league baseball player did calisthenics and hula dances in the outfield and mocked pitchers when he got on base. When the team sent him to the minors, he climbed into the stands to lead cheers for himself, ran around wearing only an athletic supporter and sprayed home plate with a water pistol when an umpire called him out.

The player was Jimmy Piersall. His book, entitled “Fear Strikes Out,” helped to expose the realities of mental illness, a condition that had previously been a source of whispers and embarrassment. Interestingly, it was in Chicago that Piersall, then a member of the Boston Red Sox, first went public.

Born in Connecticut in 1929, Piersall excelled in baseball, football and basketball in high school. But his problems had already begun. He was incredibly high-strung and suffered from headaches.

The Red Sox took note of the high school phenom and signed him to a minor league contract in 1948. By 1952, his solid hitting and acrobatic play in the outfield made him a prime candidate for the major leagues.

However, the Red Sox originally chose to play Piersall at shortshop, something that upset him. As the season progressed, he acted more and more bizarrely.

Today, such behavior would probably quickly be diagnosed as pathological. But at the time, mental illness was very much in the closet. Families quietly sent sick relatives to large institutions where conditions were often terrible.

Finally, in July 1952, Piersall agreed to go to a private sanitarium. From there he was sent to Westborough State Hospital in Massachusetts.

After he was discharged as “recovered” two months later, Piersall pieced together what had happened. He had been diagnosed as having manic depression, now known as bipolar disorder, in which periods of excitability and high energy alternate with profound sadness. He had received both psychotherapy and electro-shock treatment, the latter of which had caused memory loss.

The Red Sox and their fans waited anxiously to see whether Piersall would play baseball again. And he did, rejoining the team as an outfielder in 1953.

Journalists covered Piersall’s story cautiously, pursuing few details. But in 1954, a Chicago man named Don Slovin, who ran a group called “Fight Against Fears,” convinced Piersall to tell his story on a local television show hosted by newspaper columnist Irv Kupcinet.

The response was dramatic. Piersall received letters from hundreds of Chicago residents with mental illness, one of whom thanked him for being “a source of inspiration to anyone who has gone through an experience similar to yours.”

This episode led to a two-part series in the Saturday Evening Post, entitled “They Called Me Crazy—And I Was!” and the subsequent publication of “Fear Strikes Out” in 1955, both of which brought Piersall’s story to the broad public. In these writings, coauthored with sportswriter Al Hirshberg, Piersall was quite frank, even discussing his shock therapy, which was commonly seen as barbaric.

With the release of a movie version of “Fear Strikes Out” in 1957, Piersall’s story achieved even more attention. Critics liked the film, admiring it for its honest portrayal of mental illness as a real disease that deserved treatment. Piersall also approved, although he chided Anthony Perkins, the actor who played him, for “throwing like a girl.”

Piersall did well until 1959, when he was traded to the Cleveland Indians. Unhappy with his new manager, he began to behave as he had in 1952, fighting with umpires and spraying bug repellant in the outfield.

Piersall insisted that his illness was not relapsing. The fans, who loved his antics during slow games, largely agreed. Perhaps his teammate Vic Power summarized the situation best. “He said he wasn’t crazy anymore,” Power said, “but he still was sick.”

After his retirement in 1967, Piersall became active in the Chicago baseball scene, hosting a sports talk show and broadcasting White Sox games on radio. Despite taking lithium, a pill that effectively treats manic depression, he continued to have emotional outbursts and fights with colleagues.

Ironically, over time, Piersall, who is now 77, has increasingly obscured aspects of his disease and treatment. For example, he has analogized mental illness to breaking a limb, an easily fixable medical problem. And he has stressed the role of self-help in curing psychological distress: “You can cure it, or you can lick it, if you want to.” Given the chronic, waxing and waning nature of most mental illnesses, these statements are misleading. And Piersall has developed a dim view of mental health professionals. Psychologists, he has said, “talk too much” and “do nothing.”

Still, Jimmy Piersall’s main legacy should be as someone who went public with his mental illness long before such revelations became fashionable. In so doing, he paved the way for athletes and others to deal with a serious medical problem openly and without shame.

Shock therapy revived as treatment for depression

By Elise Kleeman Staff Writer
Pasadena Star-News

PASADENA – Patricia Wedberg’s overwhelming depression arrived quietly and without cause.

In April, her family noticed she wasn’t herself and seemed tired and run down. In May, she lost her appetite. By the end of July she could no longer function at work. In mid-August she tried to take her own life by suffocation.

When September arrived, Wedberg said, “I was down to 90 pounds, skin and bones, and I was pacing around the house.”

“They put me on different things. I was on Prozac, and that seems to work for a lot of people, but it didn’t seem to work for me,” she said. “My husband was at his wit’s end.”

Fortunately for Wedberg, an article in Newsweek magazine about Kitty Dukakis’ book, “Shock,” caught her husband’s eye. In that book, Dukakis, wife of former Massachusetts governor and presidential candidate Michael Dukakis, talks about the treatment that rescued her from her own severe depression – electroconvulsive therapy, or ECT.

Wedberg’s husband took her to Huntington Hospital in Pasadena for treatment.

“I thank the doctors down there for saving my life,” she said last week from her home in Bishop, where she once again leads a happy and active life. “For me, ECT was the answer. I know it’s not for everyone, but it brought me back to life.”

“\ universally acknowledged to be the most effective treatment in serious depression,” said Charles Kellner, chief of psychiatry at University Hospital in Newark, N.J. Between 65 percent and 90 percent of patients see their depression lift completely after a course of treatment, he said.

But, Kellner said, it’s also “a very serious treatment that should be reserved for major illness.”

During electroconvulsive therapy, doctors administer anesthesia and heavy-duty muscle relaxants and, while the patient is asleep and immobile, send a small current through the front of the brain.

“We’re talking about enough electricity to light up a 60-watt bulb for about a second,” said Richard Meadows, a registered nurse who administers Huntington’s ECT program.

The short jolt sets off a wave of electrical chaos – a controlled grand mal seizure usually lasting 30 seconds to a minute.

Then everything returns to normal, and within 10 minutes of receiving the anesthesia, the patient wakes up. After about an hour and a half of monitored recovery time the patients – who are often treated on an outpatient basis – can go about their day.

Treatments are generally given three times a week until a patient’s depression lifts, which takes eight sessions on average, Kellner said.

“There’s no way this is the power of suggestion,” Meadows said. “They have appetite, they become engaging, they no longer have the depressing thoughts, the suicidal thoughts.”

At first the changes are subtle, but “usually five to six treatments and then they’ll make comments,” Meadows said. “One man told me `You know, I turned the corner at treatment number seven’ – they put a number on it.”

There are side effects, though – which range from mild headaches after the procedure to short term memory loss affecting weeks or months before the treatments.

Dukakis, wife of the 1988 Democratic presidential candidate Michael Dukakis, said she has no memory of the trip to France she took shortly before her first treatment five and a half years ago; Wedburg’s memory is spotty for a few months before ECT, and neither can remember the details of their hospital stays.

But for both of them, the trade-off was worth it.

“All I can say is I have a new life,” said Dukakis, who will speak at Huntington Hospital on Wednesday about her experience.

For many, ECT is still stigmatized, with some Web sites offering outreach for “ECT victims” and calling it “a crime against humanity.”

Much of that condemnation, doctors said, stems from its portrayal in the film “One Flew Over The Cuckoo’s Nest,” in which Jack Nicholson is reduced to a shuffling, drooling shell of himself after a painful shock contorts his body.

“Enough is enough – that was 1975,” Kellner said.

Hospitals that administer ECT are now strictly regulated, and careful monitoring and medication prevent patients from injury and pain.

And over the last five years, Kellner said, the tide has begun to turn.

“The fact that ECT remains an accepted treatment in every major psychiatric facility has become more widely known,” he said. “It’s pretty clear that ECT is making a comeback.”

Psychiatry’s electric evolution A new shock therapy or the same old charges?

San Francisco Chronicle

Dec 24 2006

Telling a friend I was starting Kitty Dukakis’ new book sparked a disagreement. Was it rubbing alcohol she used to drink? Or vanilla extract? A happy debate: We were both right.

One might be tempted to say Dukakis self-medicated by treating her storied long-term depression with booze and pills. But she had plenty of help from some of the country’s leading doctors, who enabled decades of her addiction to amphetamines.

Dukakis’ book, “Shock: The Healing Power of Electroconvulsive Therapy,” alternates what folks in Alcoholics Anonymous call a “drunk-a-logue” — Dukakis’ finely honed tale of a life punctuated by overdoses, blackouts and trips to treatment centers — with journalist Larry Tye’s history of electroconvulsive therapy, “psychiatry’s most controversial treatment.”

The Dukakis shining through these struggles with depression is warm, funny, vulnerable and considerably more engaging than her uptight husband of 43 years, former Massachusetts governor and 1988 presidential contender Michael Dukakis. Her description of unraveling under the media klieg lights is downright courageous.

Let’s face it, when celebrities get together to divvy up diseases, neither mental illness nor alcoholism often gets a taker. Appreciating the depths of Dukakis’ despair is the key to understanding why she would seek out the treatment that became her salvation and even promote it, even though it stole significant slices of her memory.

“Electroconvulsive therapy has opened a new reality for me. … It has given me a sense of control, of hope,” she writes.

Shock’s authors are on a mission to rescue this therapy from stigma that haunts it to this day, even as psychiatry has embraced it as a mainstream therapy and some 100,000 patients are said to undergo it each year in the United States.

It was an Italian neurologist, Ugo Cerletti, who determined that electric shocks could be used to “tame” mental patients by causing convulsions. Cerletti first determined the amount of electricity needed to induce a seizure, but not kill, a pig or a dog in a series of experiments that would give a PETA member a lifetime of nightmares.

He first made the leap to a human in 1938 when he administered 110 volts to a 39-year-old man who had been found wandering a train station in Milan, muttering incomprehensibly.

In the early decades of the therapy’s use, electrical shocks were administered to fully conscious patients. They lost consciousness, experiencing seizures and muscle spasms so violent as to routinely break bones. Confusion and memory loss was a common side effect.

To understand how such a brutal treatment gained sway in the 1940s and ’50s, it is worth noting that competing treatments included lobotomy, as well as other means intended to induce shock or coma as a therapy, such as insulin or the drug Metrazol.

But there was arrogance and sloppiness in its use, too. Doctors tried electroshock therapy on patients as young as 2 and as old as 102, seldom following them adequately or conducting proper clinical research, making it difficult to sort out the long-term impacts. Treatment was often given over patients’ objections or with scant attention to informed consent. The therapy became popular for treating schizophrenia, although, under more rigorous scrutiny, it was later determined not to be helpful.

Some doctors shocked with abandon, resorting to electroshock therapy for indications as questionable and slippery as “antisocial behavior,” “maladjustment” and homosexuality.

The use of shock for punishment rather than therapy also undermined its future.

Such was the case for the therapy’s most famous patient, albeit a fictional one. Randall Patrick McMurphy was the bete noir of Nurse Ratched in Ken Kesey’s 1962 novel, “One Flew Over the Cuckoo’s Nest.” The gruesome electroshock McMurphy received in “Cuckoo’s Nest” left the impression that he had been shocked into submission, but it was actually a lobotomy that reduced him to the catatonia seen at the movie’s end.

For Dukakis and Tye, that was your grandfather’s electroshock therapy. They say today’s version is neither an abomination nor a “Clockwork Orange” instrument of social control, but rather an invaluable treatment all too often denied to poor people and people of color.

Today, electroshock therapy is reserved for a more discreet set of circumstances. Depression is the most common indication, especially where antidepressant drugs and psychotherapy have failed and when suicide is a risk or psychosis and catatonia are complicating factors. Now, shocks are briefer; administering them on only one side of the brain is thought to spare memory. The patients receive anesthesia and muscle relaxants, and don’t remember undergoing what is a much calmer looking procedure.

Of course, one might wonder why a book seeking to destigmatize the practice is entitled “Shock” when modern practitioners prefer the “electroconvulsive therapy” of the subtitle.

“We debated it. Ultimately we decided it is the term most people recognize and understand. It might help sell the book and reach people in need. Sometimes embracing a stigmatized term is a way of deflating it,” said Tye in a recent phone interview.

“Shock” chronicles how the Bay Area was the crucible for much of the political debate over electroconvulsive therapy, profiling some of its harshest foes, Ted Chabasinski and Leonard Frank. They remain implacable critics of the procedure, even in its modern guise, maintaining that psychiatrists still understate long-term side effects, driven at least in part by a profit motive.

The debate fueled by California “psychiatric survivors” peaked in 1982, when they succeeded in placing electroshock therapy on the ballot in Berkeley. Residents voted 2-to-1 to ban the procedure within city limits, but the measure was quickly overturned in court.

Chabasinski, 69, a Berkeley attorney, is the very definition of a psychiatric survivor. A line on his Web bio summarizes his mental health experiences: “Shocked, Inpatient, Outpatient, Forced Treatment, Raped, Restraints, Tortured, Solitary Confinement.” With his natural mother incarcerated, Chabasinski was in foster care from birth. “The doctors had decided I was mentally ill before I was even born; hereditary views of mental illness were very much the fashion,” he said in a recent interview.

Chabasinski received electroshock therapy from Dr. Lauretta Bender at New York City’s Bellevue hospital in one of the first experiments involving children. He was 6 years old and would spend the next few years in what amounted to psychiatric solitary confinement.

Frank, 74, a longtime Pacific Heights resident, edits successful books of quotations for Random House. Born in Brooklyn, he landed in San Francisco after college and an Army stint. He was happy to hang out in North Beach and in no particular hurry to find a job. Distressed by his beatnik “lifestyle,” his parents had him involuntarily committed to a psychiatric hospital where he received 50 insulin coma treatments and 35 electroshocks in 1962 and 1963.

The impact on Frank’s memory was “like wiping a wet eraser on a chalkboard,” he said. He no longer remembered that JFK had been elected. More troublesome yet was the ablation of much of his Wharton School college education. Finally released from the hospital, “I decided I would spend my life fighting this,” he recounted in a recent interview in which he shared excerpts from his online “electroshock quotationary.”

Although Chabasinski and Frank and their fellow psychiatric survivors were unsuccessful in banning electroshock therapy, they were able to persuade California legislators to pass some of the strictest laws in the country regulating the practice.

Before administering the treatment in California, a psychiatrist must assert that other options have been exhausted. A second opinion must be secured from a physician who doesn’t use electroshock, and the episode must be reported to state authorities. Although “Shock” laments the California regulations as reducing the procedure’s availability throughout the state, one local practitioner embraces them.

Dr. Robert Dolgoff practices psychiatry at Alta Bates Summit Medical Center in Berkeley and teaches at UCSF. Much of his practice consists of referrals for electroconvulsive therapy.

“We are proud of what we do; we help incredibly vulnerable people,” said Dolgoff. His busy office is in the basement, not to hide it but because “that is the space we got.” Not all of the patients referred to Dolgoff for the treatment end up receiving it because he believes it is truly a measure of last resort.

“All of our patients have tried at least two drug regimens before coming to us for ECT. But it is much more typical for them to have tried four, five or six different drugs and still be suffering,” Dolgoff said.

Dolgoff acknowledges that some patients will experience memory loss for some of the time surrounding the procedure; discussing this risk is a key part of the informed consent process. But do extremely depressed patients have the wherewithal to weigh all the factors? “That is where the second opinion is helpful,” Dolgoff said. California also requires a court order for the therapy to be administered against a patient’s will.

Dolgoff said he rarely receives referrals for court-ordered electroconvulsive treatment, but when he does there is a good reason. “You have to understand that by this point patients are dying because they are so depressed that they are basically unwilling or unable to eat. ECT offers the prospect of a much more rapid turnaround than antidepressant drugs.”

Depressed OAP died after electric shock treatment

Dec 7 2006

By Gemma Collins
Berkshire Co UK

A FRAIL pensioner who battled with manic depression for 60 years, died after undergoing electric shock therapy at Reading’s Prospect Park Hospital.

Violet Dixon, 81, who suffered from Bipolar affective disorder was given Electroconvulsive Therapy after becoming so depressed and run down that staff feared she would die.

Mrs Dixon who lived with husband Victor in Compton near Newbury had been suffering from anxiety and depression since the 1940s and in the last three years had received several ECT treatments – which involves passing an electric charge through electrodes on her head to provoke a fit or a seizure.

A Reading inquest heard that in February, while sectioned under the Mental Health Act, Prospect Park staff felt she needed electric shock treatment because she was not responding to medication.

But after a second treatment, Mrs Dixon started vomiting, despite being anaesthetised and not having eaten for 24 hours.

She was rushed to the Royal Berkshire Hospital with Aspiration Pneumonia – caused by inhaling vomit – but died there the next day.

The post-mortem revealed that, unknown to her doctor at Prospect Park Hospital, Mrs Dixon had been suffering from an inflamed gall bladder.

Royal Berks anaesthetist Dr Gillian Harrison, who put Mrs Dixon under before her ECT, said: “These patients are mentally ill and often have other medical problems which are very difficult to tell when they won’t give you any history because they are so ill, and they won’t be compliant to medical tests.

“Mrs Dixon had been carefully examined, it was totally unexpected that she had bowel obstruction.”

Berkshire coroner Peter Bedford, recording a ‘narrative verdict’, said Mrs Dixon had undergone many previous ECT treatments without adverse effects.

He said gall stones had caused an undiagnosed gall bladder infection, and added: “This had caused an obstruction which led to severe gastric delay and in turn led to the sequence of events causing her death.”

Master of the Dark Arts

Ignored for decades, the twisted genius of Mervyn Peake is finally getting the attention it deserves

Dec 11, 2006

With a career encompassing 25 years that included five novels, a handful of plays and thousands of drawings, paintings and sketches, why isn’t Mervyn Peake a more celebrated English literary and artistic hero? A cult figure today, Peake is best known for Gormenghast, his bleak but compelling gothic fantasy trilogy published in the 1940s and ’50s about the hierarchy of a fictional castle, Gormenghast, and the Machiavellian machinations of its inhabitants. But he was also an accomplished illustrator, painter and war artist. “If somebody’s good at everything, then they’re never taken seriously, are they?” muses Chris Beetles, owner of the eponymous gallery in St. James’ in London that hosted a rare exhibition of Peake’s art in October.

It is precisely this failure to acknowledge Peake’s breadth of talent that Mervyn Peake: The Man and His Art, a new and comprehensive guide to his career, seeks to redress. In 1998, Peake’s son Sebastian met Alison Eldred, an avid collector of Peake’s artworks at Beetles’ gallery, and over dinner the new acquaintances decided to compile and edit a book which, says Sebastian, would show his father’s “eclecticism and breadth to a new generation.”

Though Peake’s talent is indisputable, the source of his marvelously twisted imagination is elusive. Unlike the early years of many masters of the macabre, Peake’s childhood was happy and contented. The son of a doctor with the London Missionary Society, Peake was born in Kuling, China, in 1911 and lived there until he was 11 years old. As a boy, he learned 600 basic Mandarin characters from a Chinese calligrapher, causing later observers to remark on the strange way he held his pen. After his family returned to England, Peake finished his education at Croydon School of Art and the Royal Academy Schools.

Early in his career, Peake became a documentary war artist during World War II. This experience appears to have pushed his world view and his art into a considerably darker realm. In June 1945, he was among the first British civilians to visit the liberated concentration camp at Belsen, Germany. Most of the former prisoners he saw there were too sick to be evacuated. The stark poems and drawings he made about these victims literally dying before his eyes are nearly too harrowing to bear. Returning to Britain, he finished the first Gormenghast book in 1946 and spent the next 20 years as a writer and illustrator, contributing art to the tales of the Brothers Grimm, Treasure Island and Dr. Jekyll & Mr. Hyde.

While his style is similar to American contemporary Edward Gorey, Peake’s bizarre sensibilities were less cruel. He enjoyed great critical acclaim as an artist during his career — he was commissioned by the Queen Mother to do illustrations for her grandson Prince Charles’ nursery in the 1950s — but he was largely ignored by the literary observers of the time. Kingsley Amis once called Peake “a bad fantasy writer of maverick status.”

This book shows just how wrong Amis and his cohorts were. The heavily illustrated tome punctuates examples of Peake’s art and excerpts of his writing with purely biographical chapters. Cartoonist Chris Riddell of the Observer Sunday newspaper, Lord of the Rings illustrator John Howe, and others who have been influenced by Peake contribute a range of essays and analysis as well.

Fantasy and science fiction author Michael Moorcock, who contributes an introduction to the book, says: “Peake is in the great tradition of idiosyncratic English writers. His poetry and fiction, like theirs is sui generis and, like his drawing and painting, reveals authentic genius.” Comic-book writer Alan ( Watchmen, Lost Girls) Moore calls Peake “probably one of the finest writers in the English language,” but says literary snobbery that considers fantasy a lesser art form has contributed to his neglect.

Already at an ebb in his career, Peake developed Parkinson’s disease in 1956. Despite attempts to improve his health with electroconvulsive therapy — in which high-voltage electricity is passed through the brain — he died in 1968 at the age of 57. His wife Maeve Gilmore, almost destitute after he died, went to the Tate Gallery to sell her husband’s body of work. She was offered £1,500 for the complete collection. Disgusted, she stormed out. If there is any justice, Mervyn Peake: The Man and His Art may well ensure that such snubs are not repeated.

Lou Reed: ‘I don’t believe in dressing up reality’

‘I don’t believe in dressing up reality’

Bernard Zuel
December 8, 2006
Syndey Morning Herald

To understand Lou Reed you could begin where he began: the works of American poet and author Delmore Schwartz and the novels of proto-grunge writer Hubert Selby jnr, author of Last Exit To Brooklyn and Requiem For A Dream.

By the time the Long Island-raised Reed met him at Syracuse University in the early 1960s, Schwartz was in the last years of his life and showing the effects of alcohol and drug abuse. He befriended the young English student, encouraging him to write naturally, to use the vernacular, a lesson that left its lasting mark via his early book, In Dreams Begin Responsibilities. Reed was to say later: “I read that in college and it changed my life forever. One of the greatest short stories ever written, five pages and not one polysyllabic word.”

At the same time Reed was developing a strong response to the realism of Selby’s portrayals of the American demi-monde, the hookers, hop-heads, the damaged war veterans. These weren’t imagined people, no matter what shocked critics and the comfortable middle class said. The effect was immense on Reed, who in his teens had been subjected to electroconvulsive therapy, ordered by his parents, who were disturbed by his developing homosexuality.

As he was to later say of his writing: “The idea behind it was to try and bring a novelist’s eye to it and, within the framework of rock and roll, to try to have that lyric there so somebody who enjoys being engaged on that level could have that and have the rock and roll, too – I don’t believe in dressing up reality. I don’t believe in using make-up to make things look smoother.”

When Reed began writing songs upon moving to New York in 1963, the material he wrote at the publishing house Pickwick Records was in stark contrast to the material he wrote at home. The private songs included Heroin and Waiting For The Man, two songs about the pleasures and deprivations of a drug user, later to appear on the albums of his group the Velvet Underground. Later, there would be songs about the transvestites and experimental artists who shared his downtown neighbourhood, songs about the prostitutes and underage runaways who were beaten at home and on the streets, songs about crippled relationships and weak human beings.

Welsh avant-garde musician John Cale, who met Reed at Pickwick where their almost instant bond led them to form the Velvets, said Reed’s songs weren’t necessarily autobiographical but “they gained their strength from first-person reportage”. Or, to steal a line from a Velvets song, “I’ll be your mirror/Reflect what you are, in case you don’t know”.

Suffering and degradation had long been staples of the blues, but it was rare in pop and rock. In the late ’60s, when the Velvets first played in San Francisco, their grimy, sometimes vicious tales were in sharp opposition to the hippie scene developing there and in London.

In the 1970s, as Reed’s solo career began, the lyrical and musical signposts were as jarring. In an interview with artist Julian Schnabel, who has designed the Berlin show coming to the Sydney Festival: “I’ve always been interested in emotion and transcendence – where do these things come from and what do you do with them when you have them?”

Even when Reed was aligned with the glam rock scene, hanging out with David Bowie, who produced his most successful solo album, Transformer, and sporting the androgynous look, he stood out. Rather than camp, there was about him the threat of the street tough giving off the “waves of fear” he sang about.

Musically, too, Reed wasn’t easily quantifiable by ordinary standards. From the start he’d noted and applied the assaulting noise and harsh, free jazz shapes of Pharaoh Saunders and Ornette Coleman. It was there in the sonic pummelling of the second Velvets album, White Light White Heat, and taken to extremes in 1975′s feedback-loaded Metal Machine Music. But he was just as capable of songs of almost ephemeral delicacy, such as Pale Blue Eyes , and haunting sadness, as in much of Berlin.

His career has been inconsistent and dotted with at most two dozen great songs, but Reed has rarely failed to provoke a response. “My primary thing has always been to spark an emotion in the listener that they might not be prepared for,” Reed said a few years ago. He has succeeded more often than most.

The Comeback of Electroshock Therapy

Nebraska TV
Thursday 12/07/06

Electroshock Therapy, now called Electroconvulsive Therapy or ECT, a surge of electricity to the brain, is still being used to treat severe depression. NTV talked to one patient who says he wouldn’t be alive today if it wasn’t for this controversial treatment.

“After my third suicide attempt, they mentioned ECT. It almost sounded like a last line of defense, said Kevin Karmazin, an ECT patient.

Kevin’s depression was serious. He was already on a cocktail of anti-depressants that wasn’t working.

“When I was manic I was out of control. I couldn’t sit still. I spent a lot of money and would often stay up for days in a row,” said Karmazin.

He says the pills created many adverse side effects.

“They just threw all this medicine at me. You didn’t know what side effect was caused by which pill,” said Karmazin.

But all that changed when he went through ECT.

“I was super nervous. But the next thing I remember, I’m waking up, and I’m like, ‘Are we done already?’ said Karmazin. “I felt refreshed and rejuvenated afterward … It’s been an all-good experience for me.”

Although Kevin has experienced some memory loss, a side-effect of ECT, he says it is worth it.

“If I would have known how much it would help me, I would have done it a long time ago,” said Karmazin.

Kevin’s story is not unique. Doctors are now saying that anti-depressants may not be as effective for serious depression. Patients may want to consider ECT.

“Any medication, the data shows, is not quite as good as ECT,” said Dr. Jasung Kim, a Psychiatrist M.D. at Bryan LGH Medical Center in Lincoln.

In fact, Kim says ECT may work better than traditional methods.

“It’s a more potent way to stimulate the brain, period. No medication can compete with ECT, that’s reality,” said Dr. Kim.

“I thank God they thought of doing this to me. I don’t know what else they could have done.”

It’s important to note that ECT is not right for everybody. Doctors say it is used as a last resort for serious depression. Some doctors will not even consider ECT, saying it is too invasive.

A beginning to forget

A beginning to forget
Mom writes a happy ending to battle with postpartum depression

Nov 26 2006

The birth of her only child is not even a blur to Carolyn Brink.

She doesn’t remember it at all.

In fact, she doesn’t remember the first few months of Zachary’s life. She was trapped in the depths of postpartum depression, a perilous condition made even more dangerous by an adverse reaction to the drugs prescribed to help her. She recalls almost nothing from that period except this:

” I came close to not being around,” she said. “I about killed myself.”

Brink’s story has a happy ending. She survived, her baby is fine and her family is strong. More than two years later, she feels back to her old self. A family friend recently published a book about her ordeal (“Mommies Cry Too: A Painful & Triumphant Story of Postpartum Depression,” by Carol S. Harcarik); reading it, Brink said, is “like reading a story that happened to someone else.”

Brink said she is willing to put herself in the public spotlight so she can help other women who experience postpartum depression.

“I had a great family, a great life and a successful career, and I was thrown into this ridiculous tailspin,” said Brink. “People can look at me and say, ‘If it could happen to her, it could happen to me.’ But they can also say, ‘She got better, I can get better.’

“I figure if I talk about it, maybe other people can have hope.”

Brink, 31, and her husband, De- mian, 34, moved to Richmond in 2002 from Minnesota. Both wound up working for The Martin Agency. Like most first-time parents, they eagerly anticipated the birth of their son, Zachary, in May 2004. The euphoria lasted until Zachary was placed in his mother’s arms for the first time shortly after his birth.

“I had in my mind what it was going to be like when she first saw him,” said Demian. “Tears, hugs, smiling.”

However, her reaction was oddly detached and distant. “Not that overflowing emotion I’ve come to expect and love about her,” he said.

When she returned home, Carolyn was anxious and panicky and wanted little to do with Zachary. She was almost catatonic at times. She said she’d made a terrible mistake by having a baby and that maybe she and Demian should put him up for adoption. Later, she spoke of suicide.

This from a person who by her admission is an overachieving “Type A” personality who had always tried to find the positive side of life and never harbored thoughts of killing herself.

“It was a long, hard struggle,” said Mary-Jane Kitchen, Carolyn’s mother, who lived in Wisconsin but stayed with her daughter, son-in-law and grandson through much of the nightmare. “Fortunately, throughout this whole thing, she was very open and honest about her feelings, even though it was really hard to listen to what she was saying. But because she was open and honest, it was easier for me to gauge where she was and how serious it was. If she hadn’t been so honest, I don’t know . . . ”

Only a few days after Zachary’s birth, Carolyn’s mother and husband sought medical help for her. At first, the prescription was relaxation techniques and more sleep. Then came medication. Then different antidepressants. Nothing worked for long, and she was getting worse. Finally, she underwent electroconvulsive treatments, which provided slight relief but no significant improvement.

Not knowing where to turn next, her father called a physician friend at the Mayo Clinic in Rochester, Minn. She checked in in September 2004, and her life turned for the better.

Using a test that was new at the time, doctors determined her body was slow to metabolize drugs, meaning the drugs she was taking weren’t being processed quickly enough and were, in effect, poisoning her. She was prescribed different medication and began to improve. She also underwent talk therapy and was home by mid-October.

She remembers little before Mayo — her Mayo doctors believe her loss of memory is related to the electroconvulsive treatments and may be temporary but she had her life back and soon came to a most fulfilling revelation: She is a good mother.

“It took a long time” to come to that realization, Carolyn said. Now, she’s looking forward to being a mother again. She and Demian have talked about having more children, and her doctors say with proper planning and a support system in place,she should make a better postpartum adjustment.

“It would be nice,” Carolyn said of providing a sibling for Zachary, “to be there from the beginning and have memories of it.”

Wherever God takes me

25th April 2006

Diocese of Oxford

Jo Harries says that life has taught her that God is a God of  surprises. ‘I often wonder what he has for me next’, she says. And no wonder – she had early dreams to be a medical missionary in Islamic countries, but instead became the wife of the Bishop of Oxford. Her career as a paediatrician has been halted by her own repeated
hospitalisations. But as Rebecca Paveley discovered, her sense of God’s presence and his purpose in her life is unfaltering.

I meet Jo Harries on a sunny, spring day in the house that is soon to be packed away and its keys handed back. The home shows no sign of the turmoil of packing that must be going on after the couple’s 19 year long stay there.

They have until June to leave and are moving back to their own house in Barnes, south London. I ask Jo what she will miss and she says, straight away, the garden. It is beautifully laid out, well-tended and large.

But though she is sad at leaving, she is already embracing the future. Born in Essex, she was brought up with God, prayer and church at the centre of family life.  ‘I have always been somebody who has had a sense of the presence of God. When I was a child my parents used to pray in the evenings with us and we went to church. I remember I didn’t like the smell of booze after the communion!’ she recalls.

As a child, she was allowed to choose one ‘ordinary’ book and one ‘Jesus’ book. ‘I loved the stories in the Jesus book,’ she says. But at 10, she was sent away to boarding school, where she was terribly unhappy at first, before going on to Benenden.

‘There too religion was very important to me. I  prepared for confirmation though I wasn’t absolutely sure I was ready for it but I did go ahead and get confirmed at 15 or 16 and I got a lot out of the early morning church services.’

After school and before taking up her place at Girton, Cambridge, she went to Florence for a few months and was, she says with a smile, ‘quite wild’ there. But by the time she was settled at Cambridge she was determined to be a medical missionary, joining a group of fellow Christians who met fortnightly to pray for and write to missionaries out in the field.

This was to remain her ambition for years to come. But an invite to a sailing club dinner set her life going in a very different direction. She didn’t take up the invitation straight away, and by the time she did the young man who had asked her had asked several others.

‘He was bewailing the fact at breakfast at his college, Selwyn, while he was sitting next to Richard [Harries]. Richard offered to help and take me. It was the day before the university lacrosse match and I didn’t play very well in it! We saw a lot of each other that summer term and fell in love really after the exams.

‘I had already booked to travel to Greece and Turkey and Persia to see some of the people we’d been praying for. When I told my father I wanted to marry Richard he said, what has that got to do with going to Persia? So I went, and sent long letters back.’

She felt confused about what her direction should be – marriage, or a career as a medical missionary. ‘I felt very much that I wanted to work with Muslim women but I felt I was also called to marry Richard and he didn’t feel called to work in Islamic countries. I was confused about what was right but decided it would all work out in the end so I went on with my medical training in London and lived with Richard’s parents while he went to Cuddesdon [theological college, near Oxford].

Jo’s visits up to Cuddesdon are remembered by other students for her flamboyant blue MGA motorcar, given to her by her family. While women weren’t allowed to stay at Cuddesdon, the fact Richard had a room in a farmhouse rather than in the college itself meant that Jo was able to visit regularly.

They married on St Peter’s Day 1963, while Richard was serving his title in London and she was working as a house officer in a hospital. But her life was to take a quite different turn, while she was still struggling with her earlier plans to become a medical missionary.

Their son Mark was born and Jo was struck with puerperal psychosis (the most severe form of postnatal depression). It took a while to be diagnosed and then she was in hospital for a long time and was given ECT, electroconvulsive therapy. The illness was devastating for her and for Richard.

Her baby son was in hospital with her, but she wasn’t allowed to see him. Since the first episode she has been sectioned several times, usually, she says, corresponding with a crisis.

Work was difficult and the ECT meant she had to ‘relearn everything’.

Daughter Clare was born a few years later, and fortunately the illness didn’t return. Jo stayed very much involved in Richard’s parish, despite her health problems, and has stayed active in parish and charitable activities throughout her time in Oxford.

She has also explored Tai Chi, which she says brings her into a ‘wonderful position of stillness’. She was told not to meditate after trying it once while on a clergy wives retreat and having a ‘white flash – a Hiroshima moment’.

Since moving to Oxford she has been involved in circle dancing, a form of sacred dancing, and has danced in Winchester Cathedral. Charitable work has dominated her time in the diocese and she has been involved with FLAME, the Mothers Union, the Family Nurturing Network and the Red Ribbon group amongst others, as well as environmental groups and those working for social justice, like Christian Concern for One World.

She has also travelled widely with Bishop Richard, including visits to Taize and recently to Kimberley and Kuruman, our twin diocese, with a group of parishioners from the Diocese.

She hasn’t worked for several years as she has had several stays in the Warneford Hospital.

‘I don’t know what God is going to give me next,’ she tells me. I’m sure everyone in the Oxford Diocese will hope it is health, and happiness, as she and Bishop Richard enter the next stage of their lives together.

William Styron, Unlikely Bard of Depression

William Styron, 1925-2006
Unlikely bard of depression.
By Nell Casey
Nov. 7, 2006

When I first met William Styron, in the summer of 2001, he was frail, barely back on his feet after a brutal bout with depression. I met him and his wife, Rose, at a bookstore where we read from Unholy Ghost, a collection of essays on depression I’d edited, and to which both Styrons had contributed. I was taken aback by Styron’s vulnerability. It was his ravaging sorrow that had brought us there, but still somehow his reputation as Famous Writer (and the few brusque phone conversations that preceded our meeting) had trumped his reputation as Depressed Person in my mind. As we talked, his hands gently trembled, and he spoke with a far-off quietness, as if his words were traveling from a great distance.

When Styron died last week of pneumonia at the age of 81, obituary writers scrambled to assess his literary achievements. But, while he was undoubtedly a brilliant and adventurous novelist, Darkness Visible, his concise, 84-page memoir of his own emotional descent, transformed him into a contemporary translator of the illness and, subsequently, an ardent mental-health advocate.

Styron disliked the term depression, calling it “a true wimp of a word for such a major illness.” Nonetheless, it was this word—and illness—that came to define the last third of his life. Darkness Visible began as a talk Styron gave in 1989 at a symposium on affective disorders sponsored by the Johns Hopkins School of Medicine. Later the same year, at the urging of Tina Brown, then the editor-in-chief of Vanity Fair, he published a longer version of the story in her magazine. In 1990, Random House published an expanded version of the essay as a book, and it became a national best seller.

Thus began Styron’s second act as a depressed person, for which he became, in his words, “reluctantly famous.” He eventually became a crusader as well, someone who faced up to the responsibility, once the course had been set, to continue the good work his book had begun. “Almost every day, Bill is in contact with fellow depression sufferers by mail or by phone,” Rose Styron wrote in 2001; she cited several instances when her husband, a person who cherished his privacy and solitude, skillfully counseled people who contacted him in the midst of their emotional crises.

Styron spoke at readings and on panels about his struggles—an experience that can feel like torture, describing your personal life with such frequency that it starts to taste like cardboard in your mouth. And yet he was consistently genuine and patient, devoting a good deal of his time to the many who approached him for help. It is little wonder Styron never published another novel after Darkness Visible came out.

Styron was certainly not the first celebrated writer to produce a personal account of his own emotional plunge. In 1936, for example, F. Scott Fitzgerald published three piercing essays about his spiritual depletion in Esquire, later collected in a book called The Crack-Up. But Styron described his illness with a distinct lyrical clarity. He offered up the secrets of his despair but also maintained a degree of formality—occasionally trading the word I for one, as in “one does not abandon, even briefly, one’s bed of nails but is attached wherever one goes.” This choice gave his words a sense of restraint but not withholding—an elegant high-wire act. In addition, he nimbly placed depression in historical and cultural context throughout, drawing from the work and lives of Albert Camus, Abbie Hoffman, and Ingmar Bergman, among others.

Styron also wrote with unusual gratitude about being hospitalized, sidestepping the stigma so often associated with spending time in an institution. “The hospital offers the mild, oddly gratifying trauma of sudden stabilization—” he wrote, “a transfer out of the too familiar surroundings of home, where all is anxiety and discord, into an orderly and benign detention where one’s only duty is to try to get well.”

And Styron’s timing was right. He shared his experience at a moment when a sizable audience was ready to receive it. In 1990, the public awareness of and tolerance for the illness was higher; Prozac had just begun to enter our minds—literally and figuratively—two years earlier. Darkness Visible ushered in an abundant era of depression writing. It’s funny to think that Styron paved the way for Marie Osmond (to choose one of the many who have recently offered their own accounts of depression), but perhaps his point in attending those many mental-health conferences was not just to demythologize the illness but also himself: The formidable writer was simply another sufferer in that setting.

Still, no good deed goes unpunished, and even Styron’s work had its critics. In 1997, the literary journal American Scholar published an essay called Depression: Darker Than Darkness by Joel P. Smith, a former vice president of Stanford University. He described his stay at a psychiatric hospital and the friendship he struck up with a fellow resident—who later committed suicide—named Clare. In it, Smith asks Clare to read Darkness Visible.

“She called it a ‘crock,’ ” wrote Smith. “She pointed out that Styron was depressed for a few months, not many years like us. What she actually said is that he had a ‘candy-ass’ depression. … [H]e did not have to rely on anti-depressant medication, much less rely on a radical remedy such as electroconvulsive therapy; his hospital stay was at a place which is as comfortable as they come; and, crucially, he was never alone. It rankles us, no matter what the virtues of Styron’s book may be, to feel he speaks for us.” (It is worth noting: Smith and I had a brief correspondence about the possibility of reprinting his essay—which I admire for its candor and style, if not its message here—in Unholy Ghost.)

This was a short piece in a small-circulation magazine; it was hardly a public lashing for Styron. Still, the sentiment was there—you haven’t suffered enough—and it is, to a larger degree, a problem with which many depressives must grapple. The illness is not always measurable by traditional medical standards; only the sufferer truly knows the severity of his own sadness, and therefore it can be hard to validate. Ironically, it is sometimes harder to prove the legitimacy of the illness to fellow depressives, some of whom resort to measuring their own pain in numbers of hospitalizations and electric shock treatments. It is disheartening, this jockeying for position as the most downtrodden. As one reader of Smith’s essay pointed out in a letter to the editor, “We don’t have to start pushing each other out of the nest.”

In the fall of 2002, I saw Styron once more at a mental-health conference. I was taken aback again, this time by his strength. He was a different man. Or maybe he was just the man he used to be. Either way, he was there: He had returned physically and emotionally.

In the closing of Darkness Visible, Styron worries that the more optimistic message of Dante’s Inferno has been lost with so much focus on the melancholy lines, “In the middle of the journey of our life/ I found myself in a dark wood,/ For I had lost the right path.” He then resurrects the forgotten part of that passage, “And so we came forth, and once again beheld the stars.” Perhaps now we should do the same for Styron—and also remember him for his courage in the face of terrifying affliction.

My Story by Julie Goodyear

By Clare Raymond
Oct. 30, 2006
Daily Mirror

I WAS motionless, lying face down on the pavement. There was grit in my mouth and blood dripping from my hands and my bare feet.

It was the sight of blood that saved me. I knew then that I needed help – needed a hospital. As I levered myself up from the kerbside, I heard screaming and shrank back, terrified, clapping both my hands over my ears.

Then I realised that my mouth was open, that it was me making those terrible piercing sounds.

But who was me? I didn’t know my name, didn’t know who I belonged to or where I lived.

How did I get from where I was that night to the lodge gate of the hospital, where the night porter lifted me up?

The next thing I remember is somebody screaming again and the porter’s voice saying: “There, there, love. You’re in good hands now.”

“Please stop the screaming,” I said, choking the words into his chest.

“That’s just what we’re going to do now,” a different disembodied voice replied, “and then you’ll have a good night’s sleep.”

Later, I learned that during those first two weeks they attached electrodes to my temples and gave me several rounds of ECT – electroconvulsive therapy.

Later still, I was informed I’d had “a complete nervous breakdown”.

Even in the midst of that mental anguish, I wanted to get back on the set of Coronation Street, I wanted to feel Bet Lynch’s wind beneath my wings, and fly off to that oasis where I always left Julie Goodyear – and all her troubles – behind.

It was 1973 and I was 31 when my nervous breakdown followed a second marriage that didn’t even survive the wedding day.

HAVING bundled me into the wedding car after the ceremony, the bridegroom left with the best man and returned to his mother’s apron strings.

Our guests, including most of the cast of Coronation Street, were all left waiting and the wedding reception hadn’t even got underway.

I had only been in Coronation Street for two years when, in 1972, I had the misfortune to meet Tony Rudman.

We met at the White Hart, a restaurant-cum-bar, near Heywood, Lancs.

When the courtship began, my mam was delighted, and my 12-year-old son Gary was thrilled, too.

A softly-spoken accountant, Rudman was being a hands-off gentleman then, so we were not having an affair, just enjoying each other’s company. Looking very determined one evening, he asked me to marry him and I said yes.

I was saying it for Gary to have a father figure as much as anything, and I hoped this would finally mean having some stability in our lives. Because Tony owned his bungalow, I thought it was only right that I should put half the amount it had been valued at into it. I also put my bank account into our joint names.

On the day of my wedding to Tony, lots of members of the cast were there, including Doris Speed, who played Annie Walker, and Pat Phoenix, who played Elsie Tanner.

It really was a big occasion and I was in a magnificent gold dress.

Things got off to a bad start because the vintage car that was taking me and my father to the church in Bury broke down – as if that wasn’t enough to create a feeling of foreboding, I discovered that my bouquet had been left on the bed in the bungalow.

When I finally arrived, I couldn’t believe the crowds. There were even several Saracen tanks because I’d been to Belfast in 1972 to do a moraleboosting visit to our troops.

It was like a royal occasion and knowing my son was about to sing with the choir while his mother was getting married brought a lump to my throat.

The service went without a hitch and as we made our way out of the church, arm in arm with my new husband, the crowds parted with a deafening roar and the Saracen tanks rumbled through.

I could now see that some of the soldiers had suffered terrible injuries since I’d met them in Ireland. One had lost an eye, several had limbs missing. It was a terrible shock. I felt I had to stop and have a special word with one or two of them.

That was when Tony’s hand tightened like a vice on my arm. Then I felt it move to the small of my back, followed by a discreet but hefty shove.

“Get in the car,” he hissed through clenched teeth. This was a face I didn’t recognise, wearing a vicious expression I’d never seen, but I still thought I must have misheard what he said. Wrong! As I looked up at him, bewildered, he repeated in another frenetic hiss: “Get in the damned car!” I was stunned. I had no idea what had happened to upset him and I couldn’t bear the idea of any of our guests knowing we were having a tiff. Was it the service? The tanks? The soldiers? The cast of Corrie? The fans?

I knew something was wrong and my first instinct was to get through the post-ceremony motions double quick so nobody would know. Tony waved all the photographers aside and beckoned the car, with its streamers of white ribbons, forward and hustled me into it. He wasn’t talking to me, his was face set like granite, his eyes staring straight ahead.

The moment we got to the reception, Tony leaped out of the car and, leaving me on my own, disappeared inside the building. When I entered, a smile painted on my face for the benefit of the waiting staff and a few people with cameras, he was nowhere to be seen. His mother had also disappeared.

Too late, then, I began to have suspicions. Maybe he wasn’t just being a gentleman when he made no attempt to nudge our relationship on to a more intimate basis. Perhaps he was terrified of consummating the wedding night? Maybe he was impotent but hadn’t the courage to tell me?

I was in such a state of shock I couldn’t even take it in, and I kept expecting him to reappear. He didn’t.

I think I gave one of the best performances of my life that day. Excuses were made for my missing bridegroom, the best man and his mother.

I was convinced he’d be back at the little bungalow waiting for me, feeling very sorry and sheepish, but he wasn’t.

The big treat, which I’d paid for myself, was a week’s honeymoon in Paris. We were due to go the next morning and I’d arranged for a car to collect us from the bungalow.

AT that stage I so wanted to put things right I was more than ready to make endless excuses for his behaviour.

I got into the car and drove to his mother’s house. There she was, his little mum who I’d grown so fond of, still wearing the suit I’d bought her for the wedding.

“Yes, what is it?” she barked, nothing like the woman I’d met so many times before.

“Is Tony in?”

“Yes, he is. And I’ve only just managed to get him off to sleep,” she replied and slammed the door in my face.

Dazed, I turned around, got into my Mini, and drove back to the bungalow. I stayed at my kitchen table for most of the week, only getting up to go to the loo. I was too ashamed to speak to anybody.

Tony Rudman had married me under false pretences for a reason I’ll never know. But he kept my half of the value of the bungalow and enjoyed using our joint bank account for a time. He never attempted to communicate with me after our wedding day. And, as I have now heard that he died some years ago, he won’t do so now.

Once I went back to work, it was a case of getting on with it amid all the usual post-wedding nudge-nudge wink-wink jokes of, “Good honeymoon, was it? Get any sleep? Eh…”

I played along with it. But when I got back from the studios it was brandy and soda time. I’d never drunk so much alcohol in my life.

ONE day when I wasn’t needed at the studios, I spent some time alone in the little bungalow with thoughts circling endlessly around my tortured mind.

Then, suddenly, it all came to a head. There was a white-out followed by red mist and everything blanked out. It was as if somebody had swung a lever and switched me off.

The next thing I remember was being dressed in a bloodied nightie in the street, somehow knowing that I had to get to the nearest hospital.

I was admitted to an NHS hospital first, then Granada got involved and I was moved from there to Cheadle Royal, a private clinic that specialised in mental health problems.

I spent four weeks there and one of the last questions the doctor asked me was, I thought, a very surprising one.

“Have you, by any chance, ever had a relationship with a woman, Julie?”

“What do you mean?” I replied, genuinely puzzled.

“A sexual relationship,” he answered.

“Good God no!” I replied, shocked.

But my next relationship was with a woman, I thought it was worth a try.

EXTRACTED by Clare Raymond from Just Julie by Julie Goodyear, published by Macmillan on November 3, £18.99.