Soap guru overcomes shock and shock-induced blindness to “save the world with soap”

Dr. Bronner attempts to save the world with soap
By Molly Snyder Edler

OnMilwaukee.com
Oct. 26, 2006

“If we ever advertised, I would have a billboard reading ‘Our soap makes your crotch tingle,’” jokes Ralph Bronner, vice president of Dr. Bronner’s Magic Soaps, a 60-year-old company based in Escondido, California.

But Ralph, who lives in Menomonee Falls, doesn’t advertise. Instead, he promotes his family’s business in unconventional ways. He and his wife road trip across the country with cases of soap, stopping at health fairs and natural food stores. Also, he interviews frequently with journalists, and articles about his company have appeared in the Chicago Tribune, The Washington Post, Fortune.com and Vogue, among many others.

Ralph inherited his anti-advertising philosophy and free spirit from his eccentric father Emmanuel Bronner — AKA “Dr. Bronner” — who started the business in the ’40s.

Although “Dr. Bronner” never attended a university, he earned a “soapmaster’s degree” — basically a completed apprenticeship — and declared himself a doctor of soap. Over the years, he also referred to himself as “The Pope of Soap” and “Rabbi E.H. Bronner.”

Dr. Bronner was from an Orthodox Jewish family, and much of the company’s vision and philosophy were born out of devastation from the Holocaust. Dr. Bronner believed that humans are all from the same divine source and often he printed the words “All-One!” on his bottles of soap.

Dr. Bronner was also a pioneer in the environmentalist movement, and today, the company is still ecologically friendly and socially conscious. The company donated a rain forest territory worth $1.4 million to the Boy’s and Girl’s Club for a camp. They also give over 10 percent of profits annually to a slew of non-profit organizations, use only natural ingredients (including hemp), never test their products on animals and offer fantastic wages and benefits to their employees.

The soap, available in liquid or bar form, comes in a variety of scents, including peppermint (which, for the record, does make things rather tingly “down there”), almond, tree tea oil, lavender and rose. It can be used on skin, hair, teeth, floors, cars, pets and as mosquito repellent, denture cleanser, athlete’s foot medicine and diaper deodorizer.

Over the years, rumors have surfaced claiming that the soap can be used as a douche and as birth control, but Bronner says the company doesn’t recommend these practices.

The Dr. Bronner product line expanded over the past few years. New products include Dr. Bronner’s & Sun Dog’s Magic lotions, lip balms and tattoo balms, and a line called Gertrude & Bronner’s Magic Alpsnack energy bars.

Dr. Bronner started the soap company in the late ’40s, but the business didn’t begin to gel until the late ’60s when Haight Ashbury hippies discovered the soap through word-of-mouth advertising. Hippies embraced the product because it was simple, natural and inexpensive, and because the label quoted poets, spiritual leaders and other visionaries.

The label, crammed with more than 3,000 words of copy and not a single graphic, looks more like a page torn from a book rather than a product label. Dr. Bronner used the label as his personal soapbox (no pun intended) to promote his ideas of environmental protection, peace, global unity and one-love/one-God.

Originally, Ralph was a non-believer in Dr. Bronner’s labels that quote a diverse group of people, including Jesus, Oprah Winfrey and Carl Sagan. He thought the label was aesthetically unpleasing and that no one would read it. He also thought the product needed a catchier name than “Dr. Bronner’s.”

“I thought he should call the soap ‘Mint Glow,’” Ralph says.

Prior to the computer age, Dr. Bronner coerced Ralph to type the labels on typewriters, sometimes just to change a single word. Although the labels were a source of frustration for Ralph, he is sentimental about them today. In the late ’90s, when Dr. Bronner was dying of Parkinson’s Disease, Ralph spoke all 3,123 words of the peppermint label onto a cassette and gave it to his dying father.

“He called me and said, ‘Did I write all of this?’ and I said ‘Yes, Dad. You did.’”

Ralph has not changed a single word on the labels since his father died in March of 1997.

Dr. Bronner was born Emmanuel Heilbronner (he later dropped the “Heil” to disassociate his name from the phrase “Heil, Hitler!”) to a family of German soap makers in 1908. He moved to Milwaukee in 1930 and married Paula Wolfart in 1933. They had three children: Ellen, James and Ralph.

Aside from being a fourth generation soap maker, Emmanuel was a visionary obsessed. He gave speeches, handed out flyers and sent 200 telegrams to President Roosevelt demanding “Peace on earth through one God!”

Despite his peaceful ideas and harmless nature, a bizarre event quickly changed Dr. Bronner’s life for the worse. In 1945, Chicago police found a man nailed to a cross under an elevated train track, and the man claimed he was dying for “Dr. Bronner’s peace plan.” Although Bronner did not know this man or what he meant by “peace plan,” he was arrested and committed to a mental hospital in Elgin, Ill.

Emmanuel underwent six months of manual labor and electric shock treatment (which caused the blindness he suffered for the last 30 years of his life). Finally, on his third attempt, Dr. Bronner escaped from the institution after stealing $20. However, he didn’t return to his family in Milwaukee, rather went to California where he started his soap company out of a Los Angeles hotel. Meanwhile, Ralph and his siblings lost their mother to an illness and lived in more than a dozen foster homes.

“Creative geniuses don’t always make good fathers,” says Ralph. “I don’t think Mozart would’ve stopped writing a symphony to take his kid to the park.”

Despite the strained relationship with his father, Ralph has grown to appreciate the man who spent most of his life running a soap company while wearing a leopard skin bathing suit. Ralph now understands that the soap was simply a way for his passionate father to spread his message to hopefully improve the planet he called “Spaceship Earth.”

“Dad used to say ‘Everybody, Jew or Gentile, uses soap,’ and he’s right. I’d hate to be downwind from someone who didn’t,” says Ralph.

Some say the therapy is inhumane. Others say it has saved their lives

By John David Sutter
The Oklahoman

Oct. 2, 2006

Michele Rodriguez-Ryland thinks about suicide every day – sometimes constantly.

And if not for the 175 times she’s had medically administered electric shocks sent through her brain, she says her unyielding depression would have killed her by now.

“It’s like going outside in the sunlight, you know, colors look brighter, people seem friendlier,” she said of the electroconvulsive therapy, also called ECT or shock therapy, she’s chosen to receive. “I just feel like I wanna go out and do everything. And this is after just a few hours before, feeling like I wanted to kill myself. I mean, that’s quite a radical transition.”

The controversial treatment – mostly used to dull intractable cases of severe and prolonged depression when drugs and therapy fail – appears to be making a comeback from its stigmatized past.

In Oklahoma City, Dr. Shreekumar Vinekar, a professor of psychiatry and behavioral science at the University of Oklahoma College of Medicine, said he now administers the treatment to about twice the number of patients he did 10 years ago – up from about 250 treatments per year to an estimated 500 now.

National and Oklahoma statistics on the treatment are not collected. But Dr. Charles H. Kellner, chairman of the department of psychiatry at the New Jersey Medical School-UMDNJ, a leader in the field, said ECT use is “definitely increasing. It’s going up several percent a year, definitely. I don’t think there’s much question about that.”

Some say the treatment has become destigmatized. Others say patients are simply more aware that it’s an option.

The increase comes in spite of risks, including memory loss.

But for those with depression like Rodriguez-Ryland’s that doesn’t respond to anti-depression medications, or doesn’t respond quickly enough to avoid crisis, psychiatrists have long backed keeping ECT available.

They say modifications have made the treatment a safe and effective option – worth the risks.

How it works
Exactly how ECT works is not understood, but its power is thought to be in the seizures it induces.

Patients are wired to two electrodes placed on their forehead. While under general anesthesia, a series of shocks, lasting usually no more than 6 seconds each, are pumped into the brain. This induces seizures, which are thought to reboot or reset brain chemistry.

Patients are given muscle relaxers before ECT treatments, otherwise they would convulse and maybe get injured.

The procedure takes 10 to 15 minutes.

Rodriguez-Ryland said the first time she underwent ECT she felt terrified, miserable, hopeless. Since then, she has come to know her doctor and anesthesiologists and looks forward to ECT.

She only can receive up to three treatments per week. She goes back for one any time she feels like she can’t go on living otherwise.

Memory loss
Rodriguez-Ryland and others experience memory loss, which they link, at least in part, to their shock treatments.

Rodriguez-Ryland parks in the same, empty section of the Wal-Mart parking lot every time she goes, so she’ll remember where her car is. She uses visual markers to put places she might otherwise forget in a memorable context.

She says doctors have told her severe depression causes her memory loss, not the shocks. But she thinks it may be both. Her memory returns, and it’s a risk she’s willing to take for the benefits.

She said she has tried to kill herself about 30 times. The first attempt was at age 10. She says ECT saved her life.

Tina Boyle says a series of ECT treatments ruined hers.

After shock therapy, she lost almost all recollection of her family. She used stacks of photo albums to refresh her memory but says she will never be the same. “I feel like I’m short-circuiting,” she said.

She and her family members say the memory loss started after her shock therapy. Her children quit their jobs to take care of her for a time. She stays in her south Oklahoma City apartment most all the time, for fear she’ll forget how to get home.

Boyle’s memory loss may not be related to her shock therapy. She has other mental health conditions.

Her psychiatrist declined to comment on her case, despite Boyle’s willingness to sign legal release forms necessary for him to do so. Medical records from 2002 provided by Boyle show she received ECT treatment.

Future
Rodriguez-Ryland hopes more people become aware of shock therapy so that they can discuss the option with their psychiatrists.

She is still very depressed.

But she has enrolled in graduate school at OU, with the hopes of writing a book about her experiences with ECT.

The body electric

Sep. 28, 2006
The State

The body electric
What’s more shocking — that electroconvulsive therapy is still around, or that some doctors and patients say it really works?
By LINDA H. LAMB

It’s a humid, overcast morning when Marcia Hudson heads to the hospital for a treatment most people would be surprised to know still exists.

Reclining on a gurney with white cloths tucked around her, she will be rolled into a bright room at Palmetto Health Baptist. She will chat with the doctors and nurses attending her. She will be sedated and have electrodes attached near her temples.

When she’s asleep, a doctor will press a button and for a fraction of a second, an electrical stimulus will pass into her brain.

Yes, electroconvulsive therapy or ECT — formerly known as electroshock — does still exist. About 100,000 patients will have these treatments in the United States this year, including more than 385 in South Carolina.

If you’re already picturing a horror movie, or “One Flew Over the Cuckoo’s Nest,” you might be surprised to know Hudson calls ECT “a blessing” that helped her conquer crippling depression when nothing else worked.

“I was feeling hopeless, totally hopeless,” said Hudson, 62, of Laurens County.

While struggling in the aftermath of her stepson’s suicide, she became immobilized by sadness and anxiety.

“I just could not function,” she said. “I felt numb, I couldn’t think, couldn’t put one foot ahead of another.”

The antidepressant medications that help many people were not helping her, and she felt that talk therapy was a dead end. That’s why she sought out ECT early this year. Despite some resulting problems with her short-term memory, she credits the treatments with helping her feel balanced and creative again.

“I think it’s an option that people don’t know about,” she said.

STILL CONTROVERSIAL

Doctors who use ECT say that for some people — especially older patients who are severely depressed — it’s an option that can save lives. They say the treatments have changed significantly over the years thanks to improved techniques, smaller jolts of electricity and the use of anesthesia and muscle-relaxing medications.

There’s even a new celebrity testimonial to the benefits of ECT: Kitty Dukakis, wife of the former Democratic presidential candidate, has written a book about how ECT saved her from decades of depression (“Shock: The healing power of electroconvulsive therapy”).

But that doesn’t mean the subject is no longer controversial.

Juli Lawrence, 46, says ECT did not cure the depression she developed while dealing with job troubles and a difficult divorce. Worst of all, she said she’s still trying to cope with cognitive problems following the treatments, which she had in 1994.

“The one thing that really stands out is that some of my math abilities have disappeared,” she said. “Math has always been something I loved and I was exceptional at.”

Now she can’t balance her checkbook, said Lawrence, who lives on Long Island, N.Y., and operates a Web site critical of ECT (www.ect.org).

Another former ECT patient, Andy Behrman, was bemused to find himself an ECT poster boy after writing a 1999 New York Times essay about how it helped him regain control of a life ravaged by bipolar illness. When he wrote a verbally hyperactive book about his experiences, he titled it “Electroboy: A Memoir of Mania.”

Behrman credits ECT with breaking his manic cycle. He’d been living in fast-forward, hopping planes from his Manhattan home to London or Tokyo on a whim, spending money like crazy and eventually getting into legal trouble. Now, at 44, he lives in Los Angeles and is happily working on a movie based on his book.

Electroconvulsive therapy “was a last resort for me — 37 medications had failed me,” he said. But his 19 ECT treatments caused confusion and memory lapses he found frightening and humiliating.

“Electroboy” said he doubts he would have ECT again.

“I don’t know any patient who hasn’t suffered from some pretty serious confusion and memory loss,” he said.

NOT THE FIRST OPTION

On the other hand, who wants to cherish memories of being paralyzed in dark depression, or being obsessed with thoughts of suicide? Up to 15 percent of seriously depressed people end up killing themselves, according to the National Institutes of Health.

Some patients say brief periods of confusion, even memory gaps that persist for years, are a worthwhile tradeoff for the ability to go back to living their lives.

“The people who are selected for ECT today are those who are significantly, suicidally depressed,” said Dr. Kenneth Huggins, a psychiatrist who administers treatments for Hudson and others at Palmetto Health Baptist.

“We don’t take a person who is depressed and give them ECT to start with,” he said.

Typically, Huggins said, doctors will try various medications and therapies for patients who are sad, anxious or depressed. ECT might be considered if patients seem perilously close to suicide, have a serious reaction to medication, or are so ravaged by depression that they cannot take care of themselves.

“ECT has saved my life a few times in the last three years,” said Kathleen Kain, 48, of Columbia.

“Psychiatric medications are great, but my body can’t tolerate them because I get severe side effects,” she said.

Kain, trained as an engineering scientist, has struggled with bipolar illness for years and currently is on disability. She said she has attempted suicide half a dozen times. She thinks “horror stories” about ECT keep patients from trying it.

Another Columbia woman, who asked that her name not be used, fears she would be stigmatized in her government job if people knew she had had electroconvulsive therapy. But the treatments jolted her out of two decades of depression, she said.

“About four years ago, I just kind of lost it,” she said. “I called my doctor and said, ‘Get me a room at the hospital; I’m on my way.’

“After 10 days in the hospital, I came home and I sat on the couch for two and a half months. I just stared at the TV. I didn’t go anyplace but the doctor. I withdrew.”

She had tried medications, group therapy and psychoanalysis. Finally, she agreed to try ECT. Now she is back at work, coping with some short-term memory loss by making notes to herself.

“I did that before, but I do it more now,” she said with a laugh.

“The fatigue is gone; (I) can think … it’s like all of a sudden, a light went on.”

‘CUCKOO’S NEST’

Huggins, who teaches a course on electroconvulsive therapy at the University of South Carolina School of Medicine, said ECT was developed in the 1930s.

Doctors had observed that when epileptics had seizures, or when people had fever-related seizures, depression symptoms often improved. They tried triggering seizures with electric current for a similar effect.

“Your brain is an electrical organ in delicate balance,” Huggins said, adding that it’s not clear why ECT may help depressed patients. He thinks the best theory is that the stimulus triggers release of brain chemical that functions as a powerful antidepressant.

According to the 1999 Surgeon General’s Report on Mental Health, no controlled study has shown any other treatment to be superior to ECT for depression. However, it fell out of favor for several reasons, Huggins said.

One is that before psychiatric drugs, ECT was tried for all kinds of mental disorders — and in most cases, it didn’t help.

Also, patients suffered serious memory loss and brutal seizures. Some patients convulsed so violently that they broke bones, Huggins said.

Actor Jack Nicholson in the Oscar-winning, 1975 “Cuckoo’s Nest” grimaces painfully during an electroshock treatment.

“He did a great job. That is exactly the way it looked, back in the ’50s,” Huggins said.

View the film carefully and you’ll notice Nicholson’s character is affected little by his ECT. But at the end of the movie, he’s had a surgical procedure called a lobotomy that leaves him completely senseless. Interestingly, people remember that horrifying image and associate it with ECT.

“That was probably one of the most influential movies in the history of psychiatry,” said Dr. Milton J. Foust Jr. of the Medical University of South Carolina.

Besides the two Palmetto Health hospitals in Columbia, MUSC in Charleston is the only other place in the state where ECT is administered.

Foust said negative media portrayals of ECT run counter to his observations at MUSC, especially of gravely depressed, older patients. “Those kind of patients respond exquisitely well to ECT,” often showing great improvement after only a few treatments, he said.

The brief pulse of electrical current is as little as one-third as powerful as what was used decades ago. With the use of anesthesia and muscle relaxants, the only sign of a seizure might be a slightly twitching hand or toe and the printout of an EEG (electroencephalogram, which measures brain activity).

Resulting memory loss “typically is not going to have any serious effect on the person’s ability to function,” said Foust, an assistant professor of psychiatry.

The National Institute of Mental Health says lasting memory problems are less troublesome than in the past, but advises patients to weigh the benefits and risks carefully before having ECT.

Patients usually receive eight to 12 treatments, two or three a week. Initially some receive the treatments while hospitalized. Hudson and Kain receive outpatient “maintenance” treatments.

More than 100 patients receive ECT in Charleston each year, about 225 a year at Palmetto Health Baptist and 60 at Palmetto Health Richland.

DECLINE AND COMEBACK

Use of ECT declined with the emergence of anti-psychotic drugs and antidepressants in the 1950s. According to medical journals, the treatment has made a bit of a comeback in recent years. But positive accounts of ECT have been controversial, such as Martha Manning’s 1994 book “Undercurrents: A therapist’s reckoning with her own depression.”

“Nobody bats an eye when electricity is delivered to a stalled heart … But try talking about the same thing with the brain, and it’s no miracle,” Manning wrote. “Suddenly, words like torture and mind control populate the descriptions.”

Some experts believe other forms of brain stimulation will replace ECT to treat the 15-20 percent of depressed people who do not respond to medications and psychotherapy.

Proto, the magazine of Harvard University-connected Massachusetts General Hospital, recently touted “less shocking alternatives” of vagus nerve stimulation, transcranial magnetic stimulation and deep brain stimulation. It proclaimed cheerily that these treatments are “sure signs that electroconvulsive therapy has flown the cuckoo’s nest.”

But Dr. Mark George, a renowned brain researcher at MUSC, noted that two of those techniques involve surgery and none of them are widely available. Though very promising, they are not appropriate for an emergency in which a depressed person is not eating or is suicidal, he said.

George said research is being done at MUSC and elsewhere to try to bypass or limit the cognitive problems of ECT — for example, to deliver energy inducing a seizure without passing through the part of the brain that affects memory.

“I don’t think ECT will ever fall into disuse, not in the next 10 to 15 years, for sure,” George said.

“ECT, with all its problems, is still a lifesaver.”

Reach Lamb at (803) 771-8454.

ABOUT ECT

Electroconvulsive therapy, or ECT, formerly was called electroshock or shock treatment.

• For most patients, medications for mental illness are more likely to be used than ECT.

• Studies show ECT can be highly effective for severe depression, some psychotic states and mania.

• A brief pulse of electric current passed through one or two electrodes causes a generalized brain seizure.

• Possible risks from ECT include confusion, memory loss, headache, hypotension (a type of low blood pressure), rapid heartbeat and allergic reaction to anesthesia.

• Cost of a typical course of ECT (eight to 12 treatments) is about $10,000 to $17,000, usually covered by insurance.

• To view a video presentation of one woman’s experience with ECT, visit www.mayoclinic.com/health/electroconvulsivetherapy/MH00022.

SOURCES: Surgeon General’s report, National Institutes of Health

Shock Therapy Loses Some of Its Shock Value

September 19, 2006
New York Times
By JANE E. BRODY

For an older woman I know who was suffering from “implacable depression” that refused to yield to any medications, electroconvulsive therapy — popularly called shock therapy — was a lifesaver. And Kitty Dukakis, wife of the former governor of Massachusetts and 1988 Democratic presidential nominee, says ECT, as doctors call it, gave her back her life, which had been rendered nearly unlivable by unrelenting despair and the alcohol she used to assuage it.Neither woman has experienced the most common side effect of ECT: memory disruption, though Mrs. Dukakis recalls nothing of a five-day trip to Paris she took after her treatment.

The television host Dick Cavett, who also had the treatment, wrote in People magazine, “In my case, ECT was miraculous.”

Mr. Cavett added, “It was like a magic wand.”

But for a man I know who was suicidally depressed and given ECT as a last resort, it did nothing to relieve his depression but destroyed some of his long-term memory.

Such differences in effectiveness and side effects are not unusual in medicine and psychiatry, and they are not played down in a new book called “Shock,” which Mrs. Dukakis wrote with Larry Tye, a former Boston Globe reporter. The book, in which Mrs. Dukakis details her experience with depression and ECT, explores the history, effectiveness and downsides of this nearly 70-year-old treatment, a remedy that has been repeatedly portrayed in film and literature as barbaric, inhuman, even torturous.

Few people seem to know that ECT has undergone significant changes in recent decades, placing it more in line with widely accepted treatments like those used to restart a stopped heart or to correct an abnormal heart rhythm. After a rather precipitous decline in the 1960’s when effective antidepressant drugs became available, ECT since the 1980’s has experienced something of a comeback, and is used primarily in these circumstances:

• When rapid reversal of a severe or suicidal depression is needed.

• When depression is complicated by psychosis or catatonia.

• When antidepressants and psychotherapy fail to alleviate a crippling depression.

• When antidepressants cannot safely be used, such as during pregnancy.

• When mania or bipolar disorder do not respond to drug therapy.

Though there is no official count, experts estimate that more than 100,000 patients undergo ECT each year in the United States.

ECT was developed in the 1930’s by an Italian neurologist, Ugo Cerletti, who “tamed” difficult mental patients with electric shocks to the brain after noting that such shocks given to hogs before slaughter rendered them unconscious but did not kill them. In its first decades of use, ECT was administered to fully conscious patients, causing them to lose consciousness and experience violent seizures and uncontrolled muscle movements that sometimes broke bones. It was sometimes used in patients without their consent, or at least without informed consent.

And while evidence for its effectiveness did not extend much beyond depression, for a time ECT was applied to patients with all kinds of emotional disturbances, including schizophrenia. It was also widely used in mental hospitals to punish or sedate difficult patients, as was graphically depicted by Jack Nicholson in the movie “One Flew Over the Cuckoo’s Nest.”

Some people may also recall that Ernest Hemingway, who suffered from life-long and often self-medicated depression, committed suicide in 1961 shortly after undergoing ECT. He had told his biographer: “Well, what is the sense of ruining my head and erasing my memory, which is my capital, and putting me out of business? It was a brilliant cure, but we lost the patient.”

A Modified Treatment

Though the impression of ECT left in the public mind by such films and writings persists, ECT today is a far more refined and limited therapy. Most important, perhaps, is the use of anesthesia and muscle relaxants before administering the shock, which causes a 30-second convulsion in the brain without the accompanying movements. Thus, there is no physical damage. The pretreatment also leaves no memory of the therapy itself.

The amount of current used today is lower and the pulse of electricity much shorter — about two seconds — reducing the risk of post-treatment confusion and memory disruption. While memory losses still occur in some patients, now the most serious risk associated with ECT is that of anesthesia.

Most patients require a series of six to eight treatments, delivered over several weeks. As my friend discovered, however, it is not universally effective. About three-fourths of patients are relieved of their debilitating symptoms at least temporarily. The remaining one-quarter are not helped, and some may be harmed.

Despite its long history, no one knows how ECT works to ease depression and mania. There is some evidence that it reorders the release of neurotransmitters, favoring an increase of substances like serotonin, which counters depression. Some experts view it as a pacemaker for the brain that disrupts negative circuitry.

The beauty of ECT is the speed with which it works. Antidepressants can take as long as six weeks to relieve serious depression. Mrs. Dukakis reported that she had begun to feel better after the first in an initial series of five outpatient ECT treatments given over a two-week period.

A Stopgap Measure

But — and this is a big but — ECT is not a cure for depression. It is more like a stopgap measure that brings patients to a point where other approaches, including antidepressants and cognitive behavioral therapy, can work to stave off relapses. Although some ECT patients never relapse, most are like Mrs. Dukakis, who over the course of four years has come back for seven more rounds of ECT. She explained that while she used to deny the early signs of a recurring depression, she now calls her doctor “as soon as I spot the gathering clouds.”

“ECT has wiped away that foreboding,” she wrote, and “given me a sense of control, of hope.” It has also helped her get off antidepressants, which had side effects like bowel, sexual and sleep disturbances and an inability to experience “the full range of my feelings.”

ECT should not be administered without the patient’s (or the patient’s surrogate’s) fully informed consent, which includes consideration of all possible side effects. The most common side effects are headache, muscle soreness and confusion shortly after the procedure, as well as short-term memory loss, which usually improves over a period of days to months.

But according to the American Psychiatric Association, there is no evidence that ECT causes brain damage. Abuse of the procedure has declined strikingly. Today fewer than 2 percent of patients hospitalized in psychiatric facilities in New York State receive ECT. Properly used, it can be lifesaving.

Though there is not nearly the money to be made from ECT that there is in selling antidepressants, work on improvements continues. Modern ECT is sometimes delivered to only one side of the brain, reducing the chances of memory deficits.

Another new approach uses a magnetically induced current that can be aimed at specific regions of the brain, possibly altering them permanently. An advantage of this treatment, however, is that it does not require the use of anesthesia.

The First Lady’s Shocking Story

Her battle with depression is well known, but in her new book, Shock, Kitty Dukakis, with help from award-winning medical journalist Larry Tye, shares how controversial shock therapy treatments may have saved her life.

It is June 20, 2001, Michael’s and my 38th wedding anniversary. It also is the end of my fourth month of depression, my crisis period. I’m normally a person with enormous enthusiasm for and interest in the world. All that is just missing now. Fun or enjoyment are things I cannot even imagine. I don’t speak to my kids on the phone, or to my sister. I do keep up with Dad, but he calls me more than I do him. The last two people I want worrying about me are my father, who is too old and dear, and my husband, who has had to worry for far too long. I have run out of options and I don’t want to drink.

These are the times when I am most vulnerable. Having a drink is the only way of bringing me away from the horrendous feelings I am having about myself. It starts out as a glass or two of wine. It generally ends up with vodka. The alcohol is like an amnesiac, it is able to take me away from the darkness. Last night I was so afraid I was going to drink that I had them check me in here at Massachusetts General Hospital.

Today I am going to try the only thing left: electro-convulsive therapy.

Michael and I have reason to be anxious. His older brother, Stelian Panos Dukakis, had ECT back in 1951, in what I think of as the treatment’s Dark Ages. Stelian had had a mental breakdown. One day he tossed a pile of sleeping pills in his mouth. They gave him ECT along with insulin coma treatments, which was a combination they often used at the time. Stelian never really was the same person. He had a zombielike look that melted the heart of everyone who knew and loved him.

Neither Michael nor I knew they still were doing electroconvulsive therapy before my doctors showed us a video on it three years ago and explained how the treatment had been transformed. We knew that if the time came again when we were desperate for a solution – some kind of positive action – we would try it. That time is now. Yesterday they admitted me to the hospital under the name Jane Dee, a pseudonym they use as a courtesy to protect my privacy after my 12 years as first lady of Massachusetts and Michael’s long campaign for president in 1988. Today, as I lie here waiting for my treatment, the image of One Flew Over the Cuckoo’s Nest flashes through my mind. Getting ECT will make me a full-fl edged member of the mental health family. What am I doing?

I am the first patient of the morning. No one else is around. They clip to my finger a device that measures the oxygen in my blood. They stick a bunch of electrical leads on my legs, arms, and over my heart. The anesthesiologist comes over and says, “I’m going to give you a shot of sodium pentothal. You’ll be asleep within seconds.” I am lying down. He says to think of something bright and cheerful. I think about Michael and our anniversary.

It was the medical madness of an earlier era, a remedy forever equated with thrashing limbs and obliterated memories.

Now, at the same Harvard teaching hospital that Kitty Dukakis gets her treatment, 20 patients a week volunteer for shock therapy. All are tormented by depression too deep to defy or another disabling disease of the mind, and all, like Kitty, are counting on 20 volts of electricity to jolt their brains back into equilibrium. Muscle relaxant ensures that the only signal of their seizure will be a twitch of the toe; anesthesia guarantees they will not remember that paralysis or anything else leading to the convulsion. Scores more line up for similar sessions at two dozen other hospitals across the state. Even at nearby McLean, one of America’s most exalted citadels of psychiatry, 50 patients a week are transfused with enough current to kindle a 60-watt bulb and, if the procedure is true to its well-established form, vanquish the demons of the moment.

In Massachusetts as in the rest of the nation the evidence is unmistakable: ECT is back.

A procedure pioneered in the 1930s that seemed on the edge of extinction just a generation ago is being performed today at medical centers large and small, on patients staying in the hospital and on a growing number who simply show up an hour before treatment and leave an hour after. More than 100,000 Americans a year get ECT for ailments ranging from mania to catatonia, with 10 to 20 times that many worldwide. Electroconvulsive therapy is now as ordinary as hysterectomy and twice as common as knee replacement surgery. And it all is happening just enough out of sight that it has taken many medical professionals by surprise. Madness no more, electric shock is quietly being resurrected as a restorative wonder that someday could rank right up there with penicillin and Prozac.

How one of the most reviled psychiatric procedures is fast becoming one of its mainstays is an astounding yet untold chapter of American medical history. It is a narrative that begins with an epidemic of mental illness that has stubbornly resisted a cure, and a handful of doctors who have equally stubbornly refused to give up on a remedy that most had banished as barbaric. Researchers still have not filled in the puzzle of how or why ECT provides relief, although the proof is compelling that it does, faster and more surely than drugs or talk therapy. Questions also remain about the price that shock patients pay in memories lost, in rare cases permanently, and whether such risks can be minimized or eliminated entirely. The rise, fall, and rise again of ECT thus remains an epic without an ending, as practitioners and potential patients alike wait to see if hopes for success are sustained and it can come back all the way.

Barbara Collins-Layton could not wait. Like millions of Americans, the retired banker suffers serious depression, and has since childhood. Her bathroom vanity was beginning to look like pharmacy, stocked with Risperdal, Zyprexa, Lamictal, and other psychotropic drugs that once worked but did no longer. Her desk was cluttered with crumpled bills from therapists. It had gotten to where she would wake in the morning and make a beeline for the living room and her rocking chair. Forward and back. All day long for six long weeks. While she rocked, her 3-year-old adopted son whispered: “Did I make mommy sick?” Collins-Layton finally went to her psychiatrist and pleaded, “I can’t do this any longer. I can’t live in this state of mind.” He suggested ECT.

Looking back six years later, Collins-Layton, now 56, realizes how radical a treatment ECT is. Was I afraid to get electricity to my brain?” she asks. “Hell, yes!” She knows there are questions still unanswered, like whether her lost memories will return. “But it made me function again,” Collins-Layton explains from her home in Portage, Indiana. “You don’t function sitting in a rocking chair. I didn’t shower. I couldn’t cook. couldn’t take care of my family. It takes a while with ECT. I had like six treatments. But when I came home from the hospital I was functioning again. ECT gave me my life back.”

Next thing I know I am waking up. I am back on an upper floor of Mass. General, in the unit where I slept last night. I feel lightheaded, groggy, the way you do when anesthesia is wearing off . I vaguely recall the anesthesiologist having had me count to 10, but I never got beyond three or four. I remember Dr. Charlie Welch and his ECT team but am not sure whether not I got the treatment. One clue is a slight headache. Another is the goo on my hair, where they must have attached the electrodes.

There is one more sign that I did in fact have my first session of seizure therapy: I feel good – I feel alive.

Michael is standing there as I struggle to keep my eyes open, and I give him a big grin. That surprises him right away. After a bit more dozing I am awake for good, and get dressed. Michael takes me to the car. I have been warned not to expect too much from any single ECT treatment, especially my first. But I already can detect difference. Feeling this good is truly amazing given where I am coming from, which is a very dark place that has lasted a very long time. As we head home to Brookline, I remember that it is our anniversary. I turn Michael and say, “Let’s go out for dinner tonight!” asks, “What?” I say, “I’m serious. Let’s do it!”

Michael and I did eat out at a restaurant that night, remaking an anniversary I wanted to forget into one I will remember always. I was back at the hospital on an outpatient basis the next two weeks for four more treatments. After the second one I went to the hairdresser, then a dinner party, and watched the Red Sox on TV.

Love it or hate it. That is the way things have been with ECT since the 1960s. There are two camps, at war. One labels the treatment the best in psychiatry and says it is vastly underused. The other brands it brain-damaging and insists it be banned. Both argue their positions with a righteousness and pertinacity reminiscent of third rail issues like abortion and evolution. Both say it is their way or no way.

Now comes Anne Donahue and her middle way. The Republican lawmaker from Vermont entered the world of ECT a decade ago, when she came home for a breather from overseeing programs for runaway kids in New York and Los Angeles. She started teaching, and playing a game during her commutes on the interstate: “I dared myself how long I could close my eyes before panicking and opening them. It was not a direct attempt at suicide, but I wanted to have a terrible car accident so I would be taken care of. People would realize how desperately I needed help.”

She confided in a friend, who convinced her to go to the hospital. That led to a series of hospitalizations and medication trials to treat the depression she had been suffering since the mid-1980s. When they failed, her doctors convinced her to try ECT. She got 33 treatments in all in 1995 and 1996.

Her ECT was a triumph and a miscarriage. The treatment was able “to break the stranglehold of a seemingly intractable and severe depression.” It saved her mental health and her very life. But it sliced into the life she had lived starting a full six years before her ECT. Memories from the year before treatment have not come back at all, those from two to four years before are hit-and-miss. Donahue is philosophical about the trade-off, comparing herself to a “cancer victim who must choose the horrible side effects of chemotherapy over certain death to the disease.”

Most ex-patients would stop there, focusing on their personal recoveries. Holding things in is not Donahue’s way. So she pressed hospitals and state regulators in Vermont to agree to one of America’s strictest informed-consent requirements for ECT. She filed a malpractice suit against the teaching hospital in New Hampshire where she got her treatment, agreeing to a settlement under which it adopted Vermont’s consent form and created a more candid video for prospective patients. She ended up as a reviewer of the American Psychiatric Association’s latest book on ECT, and in 2002 was elected to the Vermont House of Representatives.

In the process, she has become a pariah. ECT critics cannot stomach the good things she says about the therapy, including that she would have it again. Boosters are at least as disdainful, suggesting that because her memory loss is worse than most, she must be imagining it. The truth is that the Vermont legislator represents a substantial minority of ECT patients who applaud what the treatment did for them but bemoan what it did to them. Even those who cheerlead for ECT generally have some complications to report, just as many who are bitterly opposed acknowledge that ECT did some good for them or someone they know.

It is not just patients who are eager to find middle ground in the ECT debate, but a growing number of psychiatrists. They know that ECT is one of their profession’s most effective remedies but also know that too many patients suffer side effects. They are adjusting techniques in ways that demonstrably minimize those losses, in the process doing battle with fellow doctors who insist that attempts to lessen its impact on memory will lessen its impact on disease.

Donahue is working with those patients and doctors to carve out a compromise, one that reforms the treatment rather than sees the status quo as immutable or seeks to ban it. “I was being told from all the research that my experience of loss doesn’t exist. Yet I know without question what happened to me,” she explains. “I also was discovering this opposite view that said, ‘This deliberate and knowing fraud on innocent psychiatric patients who are having their brains destroyed by the evil kingdom.’ I am not the kind of person who can believe that, either. I don’t believe in massive conspiracies.”

It is not an exaggeration to say that electroconvulsive therapy has opened a new reality for me. I used to deny when a depressive episode was coming on. knew how much it would hurt, how long the darkness would last. Now I know there is something that will work and work quickly. It takes away the anticipation and the fear. I also used to be unable to shake the dread even when I was feeling good, because I knew the bad feelings would return. ECT has wiped away that foreboding. It has given me a sense of control, of hope.

That does not mean I look forward to the treatments. Who would? But when I lie down, I know that within seconds I’ll be asleep – and that this process going to make me better. I also know that like many patients today, I can go home after each treatment rather than stay overnight in the hospital.

I have had seven more sets of ECT since the first in 2001. All my treatments have been unilateral, which means the electrodes go on just one side of my head in positions aimed at minimizing memory loss. The same concern led them to gradually lower the intensity of the stimulus they give me, to a level the doctors say one-10th of what Stelian Dukakis probably got in the 1950s. I generally need treatment every seven or eight months, my timeline for depression returning.

A nun who contacted me after a story on my ECT appeared in the newspaper described how afraid she had been to have ECT. She said, “This is the way would feel going in for a root canal.” As for me, I hate fillings, and don’t like to go to the dentist, period. I happened to have had a root canal not long before my first electroconvulsive therapy. In some ways ECT is less traumatic for me than going to the dentist, and certainly less frightening than the root canal. Lots of doctors say I am crazy for thinking something like that, but I don’t think negatively about the treatment.

Kitty Dukakis recounts ECT in new book

MSNBC.com
‘I Feel Good, I Feel Alive’
In a new book, Kitty Dukakis credits electroconvulsive therapy for relieving her famously disabling depression.
By Kitty Dukakis
Newsweek

Sept. 18, 2006 issue – As many as 100,000 people in the United States each year receive electroconvulsive therapy, a treatment that has improved dramatically since it was first used in the 1930s. On the advice of her doctors, Kitty Dukakis started ECT treatment in 2001 after suffering for decades from severe depression, substance-abuse problems and hospitalizations. Here, Dukakis’s firsthand account.

Next thing I know I am waking up. I am on an upper floor of Massachusetts General Hospital, in the unit where I slept last night. I feel lightheaded, groggy, the way you do when anesthesia is wearing off and you are floating between sleep and wakefulness. I vaguely recall the anesthesiologist having had me count to 10, but I never got beyond three or four. I am not sure I got the treatment. One clue is a slight headache. Another is the goo in my hair, where they must have attached the electrodes.

There is one more sign that I did in fact have my first session of seizure therapy: I feel good—I feel alive.

Michael is standing there next to the nurse as I struggle to keep my eyes open, and I give him a big grin. That surprises him right away. As we head home to Brookline, I remember that it is our anniversary. Our 38th. I turn to Michael and say, “Let’s go out for dinner tonight!” He asks, “What?” I say, “I’m serious. Let’s do it!”

Michael and I did eat out at a restaurant that night, making an anniversary I wanted to forget into one I will remember always. I was back at the hospital on an outpatient basis the next two weeks for four more treatments. After the second one I went to the hairdresser, then a dinner party and watched the Red Sox on TV.

I have had eight sets of ECT since 2001. It is not an exaggeration to say that electroconvulsive therapy has opened a new reality for me. I used to deny when a depressive episode was coming on, to myself and to others. Now I call my doctor, Charlie Welch, as soon as I spot the gathering clouds. As important, ECT has gotten me off antidepressants. I withdrew slowly, with help from my doctors. Since I have been off I know the full range of my feelings. I get into the car now and put on music, the classical station. I sometimes cry because it conjures up feelings of my dad, who died on March 29, 2003, and was a conductor of the Boston Pops. Once I went off antidepressants, I finally could grieve.

ECT has even helped with talk therapy, strange as that may sound. I had been with Roger Weiss, my therapist, for five or six years. After ECT, I was able to work on issues that I couldn’t before, with him and on my own. I stopped smoking 15 months ago and feel terrific about that. I am working on my road rage, which is especially challenging every winter when we head to L.A. and start driving those confounding freeways. I am even addressing what my kids call my sense of entitlement. They kid me for behaving like the “queen bee.” It is not ECT per se that is curing me of those bad habits. It is staying well enough for long enough that I can start looking at behaviors I want to change. Why, for instance, do I always introduce myself by my last name as well as my first? Kara, Andrea and John say I am seeking the recognition that comes with the name Dukakis. Whether they are right or not, it was impossible to acknowledge they might be when I was depressed.

Memory loss is ECT’s most feared side effect. It is what the public hears about most often and what critics complain about most loudly. I believe anyone who says her ability to remember has been permanently damaged, and that big chunks of her life were lost. Who would make up something like that? On the other hand, most ECT patients I know have had milder memory problems, and some have had none. As for the situation I know best, mine, the memory issues are real but manageable.

Things I lose generally come back. Other memories I prefer to lose, including those about the depression I was suffering. But there are some memories—of meetings I have attended, people’s homes I have visited—that I don’t want to lose but I can’t help it. They generally involve things I did two weeks before and two weeks after ECT. Often they are just wiped out.

I forget telephone numbers, including ones I dial all the time. I sometimes don’t know where I am supposed to go or at what time. What embarrasses me most is forgetting people’s names. I live in a political world. My remembering someone may only be mildly important to them, but it is really important to me. After ECT I still go to receptions, dinners and other public events, with Michael or on my own, but I generally am not on my game. I sometimes forget commitments I make to help people. I tell a refugee from Cambodia that I will call the State Department on his behalf. I tell a friend of a friend that I know just the surgeon for her, or a lawyer, or a psychiatrist. Then I don’t make the call or get back to them with the name. Promising it, then not doing it because I don’t remember, is terrible. They must think I’m a ditz, or maybe insincere.

I have learned ways to partly compensate for whatever loss I still experience. I call my sister Jinny, Michael and my kids, asking what my niece Betsy’s phone number is, what we did yesterday and what we are planning to do tomorrow. I apologize prior to asking. I wonder when they are going to run out of patience with “Kitty being Kitty.” I hate losing memories, which means losing control over my past and my mind, but the control ECT gives me over my disabling depression is worth this relatively minor cost. It just is.

From “Shock” by Kitty Dukakis and Larry Tye. To be published by Avery, a division of Penguin Group (USA). © 2006 by Kitty Dukakis and Larry Tye.

A transformation to treasure

A transformation to treasure
Would you agree to electroconvulsive therapy?

September 05, 2006
By Amber Smith
Health & Fitness editor
The Post Standard

It was an average summer weekday, after a routine doctor’s appointment, at an ordinary restaurant on Erie Boulevard. Debbie Ahearn was dining with her 82-year-old mother.

It was a meal, a moment, she will never forget.

Her mother ordered from the menu, then began talking about the weather.

Debbie Ahearn burst into tears.

“When you get a person back to life, you treasure the little things,” she says, recounting that afternoon through tears even weeks later.

Ahearn’s mother, Frances Ahearn, of Baldwinsville, had Parkinson’s disease for six years when, about a year ago, she started becoming anxious and obsessive. Over several months, she spiraled into depression, with hallucinations and paranoia. She was in and out of emergency rooms and psychiatric hospitals. She stopped walking, stopped eating, stopped speaking and stopped recognizing Ahearn. She was near death, doctors agreed, when Ahearn went against her mother’s stated wishes and asked them to try shock therapy.

Today you wouldn’t know it.

“Now she is walking with her walker. She’s laughing. She’s making jokes. She’s eating. She’s gotten back to life,” Ahearn says from her mother’s room at Park Terrace at Radisson, an assisted living center.

The electroconvulsive therapy Frances Ahearn underwent is, technically, the same treatment depicted in “One Flew Over a Cuckoo’s Nest.” Only, patients today must consent to the therapy, and it isn’t used to control behavior. Patients are sedated with anesthesia and muscle relaxants, and they’re provided oxygen during the treatment.

Dr. Roger Levine, who oversees psychiatry for St. Joseph’s Hospital Health Center in Syracuse, says the ensuing seizures are usually mild, with patients only slightly moving hands and feet. “You sort of change the balance of all those neurotransmitters,” he says of what happens in the brain. “It’s actually the most effective treatment there is.”

Shock therapy is used to treat severe depression and other mental illnesses. It was developed in the 1930s but stopped being used so much after antidepressants hit the market. Levine says it helps many people, not by curing their depression but by getting them out of bad episodes.

Frances Ahearn doesn’t remember much of her ordeal.

“I remember the one treatment I got. I remember the doctor putting those (electrodes) on me, but that’s it,” she says.

Ahearn, also of Baldwinsville, remembers doctors proposing shock therapy in April. Her mother was at St. Joseph’s, hallucinating. Sometimes Ahearn would go along with her mother’s hallucinations, and sometimes she would spend hours trying to help her differentiate what was real from the tricks of her mind.

At one point, “she fell limp in my arms,” Ahearn recalls. “She told me she was going to die. It was one of the most scariest moments in my life.”

She stopped eating and curled up in bed. “She was basically, without realizing it, committing suicide. Her refusal of food and medicine was jeopardizing her life.

“She still had that paranoia where she thought people were trying to poison her. She thought cameras were around and people were trying to kill us. She had horrible hallucinations about what would happen to her.

The doctors told Ahearn: “If this continues, you have to realize that her organs will start shutting down.”

She researched shock therapy, then signed consent for her mother to have the treatment. The first of five was done June 13.

Ahearn didn’t notice big changes in her mother after the first couple of treatments. Frances Ahearn recognized her daughter again, and she was able to sit in a chair, but that was all. The big improvements were visible after the subsequent treatments.

“I saw her in her deepest, darkest, basically dying days,” Ahearn says. “The transition is absolutely amazing. It’s a second chance at life, that’s what it is.”

Robert Pirsig: Still Zen after all these years

Robert Pirsig: Still Zen after all these years
Author’s 500-page novel Lila about to be reissued
He defined an era with Motorcycle memoir in 1974
Aug. 12, 2006

Toronto Star

Robert Pirsig has a bone to pick with philosophers. As his era-defining memoir Zen and the Art of Motorcycle Maintenance levitated up the bestseller lists in 1974, all he heard from them was grumbling.

This story of a father-son motorcycle trip across America was just a skeleton of a philosophy, they said. What exactly was this “metaphysics of quality” he kept talking about? And who was he to tell them about it?

Seventeen years later Pirsig gave his answer and it came in the form of a 500-page novel, Lila: An Inquiry into Morals. Now, at last, the thinkers of the world had something to tinker with. Their response? “Silence. They have just given me zero support and great hostility,” Pirsig says on the eve of the novel’s reissue in Britain.

“It’s just they don’t say anything.” Now, Pirsig believes that he has one last shot at explaining his philosophy to the public, and if it means coming out of seclusion, so be it.

Sitting in a hotel suite overlooking the Charles River in Boston, a meditation mat at his feet, his wife Wendy at his side, New England’s second-most reclusive novelist does not appear to have sweated much over his celebrity.

At the age of 77, Pirsig is a white-haired, bandy-legged old coot. Years at sea and on the road have given his face a sun-blasted quality. His voice is strong and clear, but when he takes out a pen and paper to demonstrate a concept, his hands shake.

“As I see these two books,” Pirsig says, drawing an oval on a notepad, “there is a Zen circle. You start here with Zen,” he says, marking an X, “and then you go here to enlightenment, that’s what’s called 180 Zen.

“Then you go back to where you started from — that’s 360 Zen — and the world is exactly as it was when you left it.” Pirsig sits back and lets that sink in, then adds: “Well, I felt that Zen and the Art of Motorcycle Maintenance was the journey out, and Lila was this trip back.”

This might explain why Lila was not as universally adored as its predecessor. Zen was a serious feelgood book, a modern day “Thoreau,” written by a man who had been through the wringer, but emerged having identified a better way to live.

It was also as picturesque a tour of western America as one could find between two covers. Lila is an almost noir-like novel about a writer who falls in love with a former prostitute. As they float down a brooding river toward New York City, the writer — whose name is Phaedrus, the name Pirsig gave his insane alter ego in Zen — muses on her nature and on the metaphysics of quality (MOQ).

The novel is structured like a river with many locks — each stage a new level of Pirsig’s philosophy. The mental work it takes to measure these ideas explains why Lila has sold 600,000 copies, hardly a failure, but nowhere near the 4 to 6 million of Zen.

There are two types of Quality, as Pirsig sees it, Dynamic and Static.

“Without dynamic quality an organism cannot grow,” he explained in an essay. “But without static quality an organism cannot last.”

While it became a cultural cliché to say that we have moved beyond good and evil, Pirsig believes just the opposite — and he believes that the MOQ can be a useful tool in bringing order to a chaotic world.

“You know the structure of the MOQ,” he says, bringing out the pad again. “Static quality can be divided into intellectual, social, biological and inorganic realms. Any attempt by a lower order to overcome a higher order represents evil. So those forces which prohibit intellectual freedom are evil according to the MOQ.”

Pirsig’s insistence on the existence of evil has a painful personal note. In November 1979, his son Chris was stabbed to death in a robbery outside the San Francisco Zen Center. He was two weeks shy of his 23rd birthday. Pirsig was living on a houseboat in England at the time. He came home for the funeral, and wrote a moving epilogue about his son — the child at the heart of Zen — and it has been printed in every edition since.

This loss can be felt in Lila and might explain why it took Pirsig almost two decades to write it. “One reviewer said that the shadow of Pirsig’s son’s death seems to hang over this entire book,” Pirsig says, looking bewildered. “I had no idea that was true at the time, but now I see in retrospect. I was very gloomy.”

Born in 1928 in Minneapolis, Minn., Pirsig was a gifted child, whose IQ was measured at 170 when he was 9.

His father was a law professor who studied in England, so Pirsig learned to read and write in England. He returned to Minnesota and entered grade school so young that he was picked on. He entered university at the age of 15, flunked out, then served in the Korean War, coming home with an interest in philosophy. He eventually finished his degree and went on to get a graduate degree in oriental philosophy from Benares Hindu University in India. And here’s where the drifting begins. Pirsig returned to the U.S. in the 1950s and began to study journalism.

To make a living he began technical writing and doing some editing at a university newspaper where he met his first wife. For 20 years they would move around, Pirsig doing odd jobs, raising their two kids.

Without knowing it, he had begun a kind of internal philosophical quest, but the heat of his intellectual searching pushed him over the edge.

In 1960, he began the first of a series of hospital treatments for mental illness. Pirsig’s father obtained a court order to commit him to a hospital where he received electro-convulsive shock therapy. It seemed to work, but Pirsig maintains that he was not insane. “I never thought I was crazy.”

Pirsig took to writing as a life raft. In 1965 he bought a motorcycle, and in 1967 began what he thought would just be a few essays on motorcycle maintenance but the book grew into a fully fledged project.

In 1968 he wrote to 122 publishers offering sample chapters. Only one wrote back. This was enough encouragement for him. He rented a room at a flophouse and would go there from midnight until 6 a.m. to write, then he would go to work.

“When I talk about compulsion in that book,” Pirsig says, “that’s what I mean. I was compelled to write that book.”

Pirsig admits that this regimen had as much to do with his ambitions as with “problems at home,” as he calls them. When the book finally became a bestseller, Pirsig felt he needed to get away. He and his wife bought a yacht and planned to travel the world. Instead they divorced.

Pirsig’s response was to keep moving, and it was in this fashion that he met his second wife, Wendy Kimball, and they started a life of travel together.

That same year Pirsig’s son was murdered. He has moved forward. He and Wendy had a daughter, Nell, in 1980.

The success of Zen has afforded Pirsig and his wife “a very nice life,” he admits, and he doesn’t want to appear ungrateful for this gift. But he says that it is not for his sake that he wants Lila to be read. “I think this philosophy could address a lot of the problems we have in the world today,” he says, leaning forward. “Just so long as people know about it.”

Last Resort Therapy

Last Resort Therapy


The Record (Bergen County, NJ)

10-25-2005
Jennifer Hughes

CORRECTION: An article about electroshock treatments that appeared in the Oct. 25 Health section incorrectly reported the name of the founder of the Committee for Truth in Psychiatry. The group was founded by Marilyn Rice. (PUBLISHED THURSDAY, NOVEMBER 10, 2005, PAGE A02.)

When most people think of electroshock therapy, they picture Jack Nicholson writhing in agony on a gurney in “One Flew Over the Cuckoo’s Nest,” but “Jane” has never seen the film.

The 52-year-old doctor from Morris County, reluctantly agreed to ECT (the procedure is now called electroconvulsive therapy) in February after her 30-year battle with manic depression had reached its terrible crescendo.

Medications no longer worked and the cocktail of drugs brought nighttime insomnia and daytime drowsiness. Tremors shook her hands, she gained 50 pounds, and her sex life evaporated.

“I don’t like to think about it, but I was really suicidal,” said Jane, whose mother is institutionalized with severe depression. Since then, she has had 16 treatments at University Hospital in Newark and said her lifelong depression has lifted.

“It basically saved my life,” she said.

ECT, which causes a grand mal seizure, has changed since its early days, when even proponents agree it was used on too many patients, in painful procedures. Now, patients who receive ECT are given anesthesia and muscle relaxants, which prevent broken bones and muscle injuries. The amount of electricity in most ECT treatments is about 800 milliamps, about one-fifth the power you would feel if you were shocked through your wall socket, doctors said.

Many psychiatrists admit memory loss is a serious potential side effect of ECT, but the treatment is often the last resort, when medications don’t work, for people who are severely depressed.

“ECT is the gold standard by which all anti-depression treatments are judged,” said Dr. Charles Kellner, who treated Jane. “It works better and faster than any other treatment.”

At Englewood Hospital and Medical Center, Dr. Charles Blackinton said those referred for ECT often can’t take drugs because of medical conditions or can’t tolerate the side effects.

“People are no longer willing to put up with partially remitted depression,” said Blackinton, who has been doing ECT at the hospital since 1964.

But while ads for anti-depressants are commonplace on TV, ECT has not escaped its association with psychiatry’s dark ages. Jane asked to remain anonymous because of the stigma.

ECT also has not shed its vocal critics, who insist success rates are overblown, that memory loss from ECT is more widespread than reported and that it is often irreversible.

“Neurologists are trying to prevent seizures because of the bad things that they do to the brain, while psychiatrists go out of their way to produce seizures,” said Dr. Peter Sterling, professor of neuroscience at the University of Pennsylvania School of Medicine. “It doesn’t make any sense to me.”

Despite the fact that ECT has been used in the United States for more than 50 years, no one knows exactly how it works or how many patients receive it each year.

The American Psychiatric Association estimates 100,000 patients get ECT annually – but doctors admit the figure is merely a guess because no government agency or outside group monitors or tracks ECT nationwide.

Englewood Hospital has seen a rise in ECT patients; from 142 in 2003 to 168 for the first eight months of 2005. At the University Hospital, which has had an ECT program for 2 1/2 years, about 26 patients have undergone ECT each year, including some who came from as far away as California.

While several states have laws that require reporting information on ECT patients, New Jersey does not.

Linda Andre, a freelance writer in New York City, founded the Committee for Truth in Psychiatry in 1984 to cope with her negative reaction to ECT.

She said she was coerced into ECT by family members. She said she has no memory of ever being depressed and that the treatment wiped out five years of memories.

“Your life is erased like it never happened. … It can be very difficult to live your life after that,” she said. Andre said her group has about 500 members nationwide, and all of them have experienced severe side effects from ECT.

She said she often hears former patients say doctors don’t adequately explain side effects and push people into the treatment.

One of the biggest hurdles Jane had to overcome before she agreed to ECT was the fact that her doctor couldn’t explain how it worked.

“I’m a scientist,” she said. “That was very hard for me to accept.”

It is not the electricity but rather the seizure caused by ECT’s current that is believed to be the key, said Kellner. One theory is that when the body releases neurotransmitters to “turn off” the seizure, those are the same brain chemicals that naturally help alleviate depression.

Backing up that theory is the fact that many of the most recent and most effective anti-depression drugs were first developed as anti-convulsants, Kellner said.

Dozens of studies have been done on ECT’s effectiveness with a wide range of success rates.

* In a 2005 study, 85 percent of patients reported a remission in their depression during ECT treatments and within a week of the course’s conclusion.

* Another study, from 2004, reported between 30 and 46 percent of patients interviewed within days of ECT reported that their depression had lifted.

* A 2001 study found that without follow-up medication, depression returned in 85 percent of patients within six months. Only 39 percent reported a relapse if they had medications.

ECT is a short-term solution, said researcher Dr. Vaughn McCall, editor of the Journal of ECT and the president of the Association for Convulsive Therapy, which has about 400 members worldwide.

“The first thing you have to do with a patient is disabuse them of the idea that this is a cure,” McCall said.

Just because ECT helps only in the short term does not mean it should be discounted, argued Kellner.

“If someone kills themselves because they couldn’t get well in the short term, then it doesn’t matter what would have worked in the long term,” he said.

ECT can pull a patient from the depths of a life-threatening depression quickly and long enough to allow time for medications to work, to find a proper cocktail, or to allow for a natural lifting of depression, McCall said. In some cases, patients rely on a “maintenance” ECT – having the treatments spread out for years.

“There’s no good answer for why drugs sometimes work after ECT when they didn’t work before,” said Englewood’s Blackinton.

Dr. Peter Breggin, author of the book “Toxic Psychiatry,” is likely the most well-known critic of ECT. He said the reason some patients show an improvement after ECT is precisely because of the damage caused to the brain.

“Patients are too numb, bewildered and confused to be anything, let alone depressed,” he said.

The other major hot button issue of ECT is memory loss. Supporters of ECT say memory loss is usually not permanent or extensive and generally involves impersonal memories like names of places.

“There are some reports of people with much more profound memory loss … we don’t understand why this happens, but it is quite rare,” said Kellner.

Critics say studies are tailored to weed out severe cases, and there is not enough follow-up on patients to give a real understanding of effects.

“All the studies are done by shock docs,” said Breggin. “I’d discount anything they have to say.”

In one study from 1986, patients wrote down an inventory of personal information and memories before ECT treatment and were asked the same questions again post-ECT.

Those with bilateral ECT – when electrodes are placed on both sides of the head – had forgotten about 30 to 40 percent of the information. Patients in a control group who did not have ECT forgot about 15 to 20 percent of the information.

Because of the problems with memory loss, researchers are looking for ways to induce seizures, or create similar brain chemistry, without electricity.

One way is through magnetic stimulation, which produces seizures in a more localized, specific part of the brain, said Dr. Sarah Lisanby, a researcher and practicing physician at Columbia University. Another technique is called Vargus Nerve Stimulation, which uses a small device implanted in the body that stimulates a nerve running through the neck to the brain.

One of Sterling’s arguments against ECT comes from how researchers are trying to promote these new treatments.

“In order to promote them, they’re pointing out the damage caused by ECT, the fact that it is safer than ECT, even though they had denied for years that ECT caused damage,” he said.

Lisanby noted that while ECT can have serious side effects, so do psychiatric medications.

“I’d like to see us as a field do a better job of communicating more accurate information about the benefits and risks of ECT as compared to other treatments,” she said. “I think that could help combat some of the stigma and lack of information on what ECT is.”

(SIDEBAR, page F01)

What the procedure entails

Most patients who have ECT have a course of therapy that includes six to 12 treatments, starting with three times a week.

* A patient who is referred for ECT undergoes a physical exam to ensure there is no neurological problem that could be causing depressive symptoms. Blood tests and spinal X-rays are taken to ensure the patient can tolerate the anesthesia and seizure caused by ECT.

* Doctors explain to the patient and family members side effects, including memory loss and cognitive difficulties. They are advised to have someone help at home after treatments, to refrain from driving, and to avoid major decisions.

* At the hospital, monitors are placed on the patient to track blood pressure, heart rate, oxygen content and brain waves. Gauze is inserted into the person’s mouth to prevent tooth damage. A general anesthetic is administered, and the ECT electrodes are placed on the scalp. In bilateral ECT, one is placed on each temple; in unilateral ECT, the electrode is placed on the top of the head near the right side.

* The electrical pulse lasts from half a second to eight seconds, and the patient undergoes a grand mal seizure, which can last from 25 seconds to 90 seconds. In many cases, because of the muscle relaxant given, the patient’s body barely moves.

* Once the patients awaken, usually after less than 10 minutes, they remain in a recovery area until they can be driven home or return to a psychiatric unit of a hospital.

Source: Dr. Charles Blackinton, Englewood Hospital

ELECTROSHOCK: A CRIME AGAINST THE SPIRIT

Spring 2002 (pp.63-71)
Ethical Human Sciences and Services: An International Journal of Critical Inquiry

This is another exquisite article by my friend Leonard Roy Frank.

Download pdf: ELECTROSHOCK: A CRIME AGAINST THE SPIRIT

Shocking Treatment

Electroconvulsive therapy is enjoying a comeback, and though practitioners claim it’s now safe and effective, others insist it still causes permanent damage

BY TOM LYONS
Eye Magazine
October 2000

It is 8:15am, and the Electroconvulsive Therapy (ECT) room at the Queen Street Mental Health Centre is open for business. A man in his 40s sits in the waiting area. In a few minutes he will be injected with an anesthetic, a sedative and a muscle relaxant. Oxygen will be administered while the relaxant partially paralyzes his lungs. Two electrodes will be attached to his skull, delivering a brief electric current that will induce a grand mal seizure lasting 20 to 90 seconds. After 10 minutes or so he will awaken in a state of confusion and be wheeled back to his ward.

Theoretically, this treatment, which typically consists of six to 12 convulsions spaced out at a rate of three per week, provides a brief cure (up to a month) for severe depression.

Dr. Barry Martin, head of the ECT service at the newly amalgamated Centre for Addiction and Mental Health — which includes the Queen Street Mental Health Centre, the Clarke Institute of Psychiatry, the Addiction Research Foundation and the Donwood Institute — says ECT is necessary to treat intractable mental illnesses like severe depression, especially when there is a risk of suicide, and insists that improvements in ECT practice have reduced the dangers associated with early shock treatments.

“When it is administered according to contemporary standards of psychiatric and anesthesia practice, it is an extremely safe and effective procedure,” he says. “It’s been in widespread clinical use since the late 1930s. There have been improvements in the procedure that have made it much more safe and acceptable to patients by reducing some of the side effects and risks of physical injury.

“The other thing to keep in mind is that it is the most effective antidepressant available — it helps a large proportion of patients who are not responsive to antidepressant medications.”

But some people who have received ECT since it was “modified” with anesthetic, sedatives, oxygen and muscle relaxants are not so sure. Keith Welch, head of the Queen Street Patients’ Council, received 53 electroshock treatments for severe depression in the mid-’70s, and says they permanently damaged his memory and erased two years of his life. After waking up in a panic after his 53rd session, he’d had enough.

“I grabbed the doctor and said, ‘You give me one more treatment, you’re going to have to give me the electric chair, because I’ll kill you,’” he says.

Still, Welch says his memory losses are minor compared to those of other patients. “One can’t remember his mother or father, or whether he’s got a sister. He didn’t know how many treatments he received.

“Most lose memory, sometimes for a short period, sometimes for a long period,” he adds. “What makes me mad is that each treatment kills brain cells. And how’s that going to help the patient? Some people have been there for 30, 40 years. They could never get ‘em functioning outside anymore.”

For the time being, however, it is doctors’ rather than patients’ advocates’ views that prevail. Although anti-ECT protests, legal challenges, a Toronto Board of Health moratorium, a provincial review committee and intensive media coverage led to a dramatic reduction in the number of ECT treatments given in Ontario in the ’80s, the numbers are climbing steadily back upward. In 1986-87, there were 10,362 per year, down from 39,501 in 1973-74. In 1993-94, however, the number had risen to 11,360, and by 1997-98 it was 16,028. Nationally, the use of ECT has doubled in the past decade.

But has ECT fundamentally changed? Anti-ECT doctors like John Friedberg, Peter Stirling, Peter Breggin and Robert Morgan point out that the modifications touted as new were actually introduced in the 1940s and had become routine by the ’60s, and that despite the modifications, numerous studies indicate the persistence of long-term memory loss.

Moreover, opponents argue that while anesthesia and muscle relaxants reduce the risk of bone fractures during the convulsion, they do not change the essential nature of ECT itself, which is, simply, the passage of an electrical current — typically 100 to 150 volts — through the brain. It is for this reason that ECT opponents argue that the numerous studies from the ’40s and ’50s that found evidence of ECT-produced amnesia and brain damage are still relevant.

In fact, ECT opponents argue that contemporary modified shock treatments are often more dangerous than those of the past, because more powerful electrical currents must be used to overcome the seizure thresholds in patients who have been anesthetized and sedated.

Similarly, the use of “milder” forms of ECT, like low-voltage non-dominant “unilateral” ECT (given to the right, non-verbal hemisphere of the brain) produce such “inadequate” seizures that the procedure often has to be repeated or replaced with regular bilateral ECT.

Dissenting doctors have had little need to convince patients that ECT can cause permanent memory deficits. “I lost four years of my education,” estimates Mel Starkman, 58, a former history teacher who received 38 shock treatments for depression in North York’s Branson Hospital between 1966 and 1968. “And I’ve had to read books over again.”

Wendy Funk, 42, a former law student and social worker in Alberta, says that after receiving 43 shock treatments for depression in 1989-91, she lost the memory of virtually her entire life prior to the treatments. “After 14 months, I couldn’t speak or walk,” she says. “I managed to say thank you, and they figured I was cured.”

Upon her release, Funk had to be reintroduced to her husband and children. Ten years later, her memories have not returned, and she has launched a lawsuit against the Alberta government and the doctor who treated her.

Wayne Lax, 60, a retired taxi driver in Kenora, Ont., received over 80 shock treatments for alcoholism and depression between 1967 and 1992. Lax says he has virtually no recall of those 25 years, which he has since been trying to reconstruct from hospital files, photographs and the recollections of friends, family and other ex-patients.

“I thought I was in hospital 12 times, and it ended up that I had 108 admissions. I can’t remember half my life because of electroshock,” says Lax, who, like Funk, is suing his doctor.

Juli Lawrence, 39, a health writer in St. Louis, estimates she lost two years of her memory after a series of ECTs in 1994. “I’m lucky I didn’t lose my childhood,” says Lawrence, who went on to create , a website that disseminates information on electroshock.

Even the supposedly harmless unilateral ECTs evidently produce memory impairment, albeit of a different type — for visual and spatial rather than verbal data. A 25-year-old Toronto woman says she lost her sense of place after receiving eight unilateral and one bilateral ECT treatment earlier this year.

“I had memorized the TTC stations from Finch all the way around,” she says. “When I got out of the hospital, I had no memory. I had to look at the map. Slowly, it started coming back, but there is some stuff I don’t remember still.”

Although the complaints of patients and anti-ECT doctors are dismissed by ECT advocates, they have been given more credence by mainstream health bodies. The U.S. Food and Drug Administration recently announced that ECT may cause brain damage and permanent memory loss. And last year, the American Psychiatric Association — which has vigorously supported ECT — upgraded its 1990 guess that only a “very small” percentage of ECT patients suffer permanent memory loss to the more generally accepted estimate that “many” do.

ECT practitioners insist that such reports are rare, however, and that there is no need to warn patients about permanent memory loss. “I don’t believe that’s true, so I don’t say that,” explains Dr. Joel Jefferies, a staff psychiatrist at the Clarke, who adds that many of the patients who complain about memory losses may be suffering from memory impairment caused by age, depression or medication.

Yet anti-ECT doctors note that many of the studies that found evidence of ECT-produced amnesia were controlled for such factors. The patients themselves likewise believe that complete annihilation of memory produced by ECT is readily distinguishable from the side effects of drugs.

“There is some medication that’ll make you lose your memory,” says Welch. “But the shock treatment does the biggest damage.”

Martin contends that since ECT is useful in treating people with severe depression who are at risk of suicide, its benefits outweigh its risks. But there is no proof that ECT reduces the incidence of suicide, as Martin concedes, just as there is no proof that it cures depression by correcting a chemical imbalance in the brain, a point Martin likewise grants.

Why, then, is ECT still in use? One reason is that it’s a product of the very era its advocates try to distance themselves from: the dark ages of lobotomies and insulin shock. Invented in 1938 in a slaughterhouse in fascist Italy, ECT was never subjected to the safety trials that any new drug or treatment has to undergo today. Rather, it was “grandfathered” into use. When the FDA tried to reclassify shock machines in 1979 to make them subject to safety testing, the ECT lobby protested, touching off a 20-year battle, with the FDA caught in the middle.

As for why ECT use has been increasing, shock opponents say the answer is simple: money. A 1996 Washington Post article exposed the fact that the leading ECT expert in the States, Richard Abrams, owns one of the country’s two shock-machine companies — Somatics, Inc. — a detail he had failed to mention in his textbook and journal articles. And ECT opponents point out that virtually all pro-ECT research is written by psychiatrists who make a substantial living from providing it. A 1996 article in Psychiatric Times actually advised psychiatrists to take up a lucrative ECT practice to overcome the threat to their income posed by the new “managed care” companies. More tellingly, a study in Texas — one of the few states with strict ECT reporting laws — found that ECT use jumped almost 400 per cent between 64- and 65-year-old women, the only plausible explanation being that the 65-year-olds are eligible for Medicare.

Canada, of course, has universal health insurance, but the patterns of use here have nonetheless closely followed profit-driven trends in the States. Here, as in America, the typical ECT recipient is an elderly woman suffering from “geriatric depression.”

Asked about the trend, Dr. Martin says: “ECT is extremely effective for those severe affective disorders which occur in the elderly patient. Paradoxically, a course of ECT may be more easily tolerated than a course of antidepressant medication.”

But ECT opponents, like medical writer and ex-shock recipient Leonard Frank, argue that psychiatrists “are underestimating the dangers of using ECT on the elderly.”

Frank cites Impastato’s 1957 study of 254 ECT-related deaths, which found that “the death rate among elderly persons [was] five times higher than the overall death rate,” and adds that later studies also found high rates of heart complications and death among elderly ECT patients.

Indeed, ECT opponents claim elderly women are being targeted precisely because they are fragile and unlikely to resist. But there is no guarantee that even the most determined protests will bring about change. “It’s hard for activists to have any long-lasting effect, because this is a procedure the medical establishment wants to keep,” says Dr. Bonnie Burstow, co-founder of the now-disbanded Coalition to Stop Electroshock Treatment, which staged over 40 protests in Toronto throughout the ’80s.

Still, Welch says the Patients’ Council is planning another demonstration against ECT — the first in Toronto in a decade — because they fear that if they say nothing, its use will increase even more rapidly.

“Sometimes you’re sitting in the [patients'] mall, and you see people going through on a wheelchair, right out of it,” says Welch. “And you know they’re coming back from shock treatments. How can anybody do that to another person? I’ve thrown that up at the nurses. ‘Well, it’s doing some good,’ they say. ‘Can you prove it?’ ‘No.’ I said, ‘Then don’t do it.’”

Former patient still suffering

USA Today Series
12-06-1995

Former patient still suffering

Delores McQueen of Lincoln, Calif., received shock treatment in 1993 at CPC Heritage Oaks Hospital in Sacramento. Her bill: $18,000.

“I wouldn’t have minded so much if it had done any good,” says McQueen, who still suffers from deep depression.

McQueen, who has fought depression much of her life, suffered a relapse after her sister died. She was hospitalized and even slashed her wrists in a suicide attempt.

Her psychiatrist recommended shock therapy. She received more than 20 shocks.

McQueen says shock destroyed large parts of her memory:

She couldn’t remember the names of her children.

She got lost driving once-familiar hometown streets.

She forgot how to ride horses, which she’d once trained and showed.

She couldn’t remember family hunting and fishing trips.

She didn’t know who her old friends were, even when they greeted her at the mall.

She couldn’t remember information she’d just read.

“I was assured the problem was short-term, but my memory hasn’t come back. I’m convinced now that it’s gone for good,” she says.

Doctors told her that depression was responsible for the memory loss. “But I’ve had depression for a long time and hadn’t had memory problems,” McQueen says.

After leaving the hospital, McQueen kept getting shock treatment. The treatment was leaving her confused. She also doubted it was helping her depression. But she was reluctant to go against her doctor’s recommendation.

With her church group, she prayed for God to tell her whether to keep getting shocks.

In November 1993, the hospital called to postpone a treatment.

“I took that as a sign from God,” she says. “When they called to reschedule, I said, `No more.’”

By Dennis Cauchon, USA TODAY

For one girl, treatment and success

USA Today Series
12-06-1995

For one girl, treatment and success

Valerie seemed like a happy, well-adjusted 8-year-old when she went to summer camp for a week in 1993.

She was popular at school. She got excellent grades. She worked hard to please people.

But when Valerie came home from camp, she was withdrawn. She cried. She was hard on herself, always worrying that she was being bad. She kept saying, “I don’t feel like myself.”

Her parents – who asked that the family’s last name not be used because they feared Valerie’s name would later turn up in a computer database, possibly stigmatizing her – took her to a psychiatrist at the University of Iowa College of Medicine. The doctor put Valerie on 20 milligrams a day of Paxil, a newly released anti-depressant.

A week later, Valerie was worse. She began hitting herself with her fists. She ate less. She spoke in whispers and became so overly compliant that she asked permission to do the simplest tasks.

Valerie was hospitalized in a psychiatric ward. Her daily dose of Paxil was increased to 30 milligrams, then 40 milligrams. Still, she got worse.

She became bedridden and rigid. She had to be fed through a tube.

After a month, she was taken off Paxil and put on Haldol, then nortriptyline, bethanechol and Ativan – all anti-psychotic drugs.

Yet she remained largely silent and emotionless.

“No medicines seemed to work,” said her mother, Deb, who, like Valerie’s father, is a dentist in Iowa City, Iowa. “She went downhill faster and faster.”

The psychiatrists suggested electroconvulsive therapy, commonly called shock therapy or ECT.

“By the time we got to ECT as an option, I begged to have it done,” Deb says.

Valerie was shocked 19 times, once every Monday, Wednesday and Friday morning for about six weeks. She got a two-second electrical jolt each time. Her brain seizures averaged 52 seconds.

Doctors first noticed improvement after the eighth shock. But Valerie’s parents didn’t see it.

“After eight treatments, I said, ‘What are we doing to this little girl?’ ” Deb recalls. “But we had no good options left.”

After the 11th shock, Valerie’s parents noticed a change. Their daughter seemed more alert.

After the 12th treatment, Valerie’s dog was smuggled in against hospital rules. Bugsy, a Boston terrier, jumped onto Valerie’s lap and lovingly licked the girl’s face.

Valerie smiled.

Sitting in a wheelchair, she hugged and petted her dog.

“To this day, she credits the dog with curing her,” says her mother.

After her 13th shock, Valerie had a party and ate three slices of pizza.

“It was a miracle,” Deb says.

The last four shocks were done to the right side of her head – not the front, where they cause more disorientation – because Valerie was acting confused and uninhibited, telling toilet jokes.

“She probably would’ve gotten better on her own at some point,” says Valerie’s psychiatrist, Beth Cizaldo. “But that could have meant losing a year of life in the middle of elementary school. That was an unacceptable trade-off.”

“I credit ECT with saving my daughter’s life,” Deb says.

Deb thinks it can help other children, too, and she’s telling that to other parents.

“Last night, I spent an hour on the phone with someone who’s 12-year-old boy is undergoing ECT. He’s only had three. I said, ‘Don’t blame yourself. This will work.’ ”

It’s still unclear what caused Valerie’s decline in the first place.

The adults couldn’t find evidence of anything traumatic, such as molestation, at summer camp.

Paxil’s safety and effectiveness in children hasn’t been established. But the doctor doesn’t think Paxil caused her decline: Catatonia hadn’t been a reported side effect. However, stupor and lack of emotion have been infrequently reported side effects.

Also, Valerie was having hormonal changes at the time, which foreshadowed early puberty.

Her parents wondered if they were to blame.

They admit to being hard-driving perfectionists who expect a lot of themselves, Valerie and her younger brother. Deb talks rapid-fire, bustling with energy and vibrancy. She successfully defended her doctoral dissertation recently.

“I’ve asked, ‘Did we put the stress on our young girl? ” Deb says. Some mental illness runs in Deb’s family: a sibling spent seven months in a psychiatric hospital at age 10 but recovered and is now a successful physician.

Students welcomed Valerie back at school. Her parents and doctors lectured the children at school about her illness and the shock treatment.

Valerie, now 10, says she’s doing OK: “I get mad at my brother and those kind of things, but I feel pretty good.” She likes school, gymnastics, roller blades and “hard-down dirty soccer.”

She loves the doctors and nurses who treated her, but says she remembers only three things about the hospital: her dog and two other patients.

“This kid, Jarvis, always made me laugh,” Valerie says. “Anything he did, even the way he took a step, was funny. And this kid, Andrew, who was deaf, we did sign language together.”

She has no memory at all of summer camp in 1993.

Valerie caught up with her school work in two weeks: “I work hard.” She still gets A’s.

But she scored slightly lower on the standardized Iowa aptitude test, her mother says. She concentrates a little less well than before.

And Valerie sometimes laughs at odd things or doesn’t seem fully engaged. She takes 20 milligrams of Prozac a day. “She’s still a sensitive little girl,” her mother says.

By Dennis Cauchon, USA TODAY

Memory loss prompts woman to stop treatment

USA Today Series
12-06-1995

Memory loss prompts woman to stop treatment

Like most shock patients, Jeanne Bengston of Hilton Head, S.C., was shown an “educational” video before getting her series of shock treatments.

The video, sold by shock machine manufacturer MECTA Corp. of Lake Oswego, Ore., does not mention death rates or the views of critics who believe that shock causes brain damage.

Instead, the video ends with a patient declaring: “It was a good experience. If I do feel myself slipping, I’d like to come back for a tune-up. It works!”

For Bengston, the reality was more complicated.

She became severely depressed last fall after having knee surgery; for some reason, every hospital visit in her life – whether to give birth or have an operation – has triggered depression.

“Something about being in the hospital – either the environment or a reaction to anesthesia – triggers her depression,” says her husband, Dean, a retired Air Force pilot.

She received nine shocks in November 1994. Her depression lifted temporarily but quickly returned. She had 12 more shocks in March and April.

The doctors wanted to give more shocks, but the Bengstons stopped because she was experiencing serious memory loss.

Jeanne Bengston isn’t depressed anymore, and much of her memory has come back, but not all of it.

She can’t remember family trips taken two years earlier. She doesn’t play bridge as well. And she has to use recipes to make food she once knew how to make by heart.

Dean Bengston isn’t sure whether the shock therapy or the passage of time was responsible for ending his wife’s depression.

“The doctors wanted us to go on, but I’m convinced now it was right to stop when we did. It’s a hard decision to make. There are so many factors, and we probably don’t know them all.”

By Dennis Cauchon, USA TODAY

Video and audio clips about electroconvulsive therapy

Audio

Tune in every Tuesday at 1 ET (12 Central, 10 am Pacific) for the Mind Freedom Weekly News Hour, hosted by David Oaks.
http://www.progressiveradionetwork.org/

Electroshock as violence against women:
Dr. Bonnie Burstow explores electroshock as a form of violence against women. She is a feminist therapist, an anti-psychiatry and anti-fascist activist. She is also the former co-chiar of the Ontario Coalition Against Electroshock and is the author of Radical Feminist Therapy: Working in the Context of Violence. Listen

Weekly Paul Henri Thomas updates:
WGBB radio has vowed that it will carry weekly updates until Paul Henri is no longer at risk of forced electroshock treatments. You may listen to the show live on the net on Monday nights at 7 pm Eastern time. I will try and record the shows for those who miss them:

  • Feb. 26, 2001: WGBB on Long Island, New York carried a GREAT program that featured Sherry Taub, a New York activist, and PAUL HENRI THOMAS! (He’s the man at Pilgrim being forcibly electroshocked currently) He’s difficult to understand at times due to his French accent and the effects of the THIRTEEN psychiatric drugs he’s on, but it’s a great interview. A MUST LISTEN! (30 minutes)
  • March 5, 2001: The second show featuring advocate Anne Kraus talking about the hearing and the latest news on Paul Henri. (29 minutes)
  • March 12, 2001: The third show featuring Sherry Taub and Laura Ziegler talking about the latest legal news concerning Paul Henri. (38 minutes)
  • April 2, 2001: Another show, featuring Linda Andre of CTIP and Anne Kraus. (11 minutes)

My interview on CKLN Radio in Toronto, where I discussed ECT, the Kathleen Garrett case, forced ECT and other issues in September, 2000. (25 minutes)

Feb. 26, 2001: KUCI in Irvine, California has a weekly show on Mondays called Mind…Your Own Business, where they discuss mental health issues. I was the guest for this show and talked about ECT, Paul Henri, forced ECT and more. (50 minutes)

Three excerpts from the recent series by Gary Null (www.garynull.com) on ECT and the use of force.

  • Gary interviews a number of ECT survivors, who speak about their experiences and talk about the issues surrounding ECT. Listen (45 minutes)
  • Gary speaks to psychiatrist Dan Fisher of the National Empowerment Center, who discusses issues, plus talks about why ECT isn’t an effective treatment. Dr. Fisher says 50 percent of psychiatrists are opposed to ECT. (The audio on this is a little fuzzy). Gary also discusses the current state of research and does an exhaustive lit review. Listen (22 minutes)
  • Gary interviews more ECT survivors and continues his series. Listen (57 minutes)

Dr. Max Fink on informed consent issues and protecting yourself against lawsuits (if you’re an ECT doc). (3 minutes)

Dr. Max Fink sums up how psychiatrists are given the power to play god: “The judgment is yours. Society says….YOU’RE the psychiatrist…” (1 minute)

Video

The issues

Channel 11 in St. Louis reports on HB134 which would require ECT reporting. (48 seconds)

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An interesting clip from 60 Minutes II. (24 seconds) Oh boo hoo, CBS had the video removed.
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Extra
The Extra news show explores the issues surrounding ECT. This segment interviews Liz McGillicuddy, who lost much of her memory from electroshock in 1994. (3:47 minutes)

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It also includes interviews with Dr. John Friedberg, neurologist in California, who talks about the fact that the FDA has NEVER required safety testing of the machines, and they interview Harold Sackeim, PhD, shock proponent extraordinaire. In his interview, he *admits* that the famous 1 in 200 statistic is not based in science!
Here, Harold Sackeim admits the truth – the statistic is not based in science! (30 seconds)

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Gordon Elliot Show

Diann’a Loper discusses how a bill she helped create has helped other ECT patients. This kind of reporting MUST be made mandatory across the USA. Lobby your legislators! (30 seconds)

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Diann’a Loper fell into a post-partum depression. Her psychiatrist pushed her into ECT, and she lost everything – her marriage, her new baby, and most of her life. Says Diann’a, “I wish they would have killed me.” (2:30 minutes)

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Hope Morgan received ECT when she began suffering from insomnia. Her doctor diagnosed depression. “My life was in a shambles,” says Hope, referring to the devastation following the ECT. (3:10 minutes)

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Marcia Fink says ECT turned her life around. “I do things anyone else can do.” She says the only memory loss she suffered was three months’ worth. (1:47 minutes)

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Hal Haralson says ECT in the state hospital 40 years ago turned his depression around. (43 seconds)

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A doctor from the audience speaks against ECT, and the role of insurance companies. (1:02 minutes)

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Dr. Charles Kellner blatantly lies about the current stimulus dosing used in today’s ECT! BUSTED! (1 minute)

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More from Charles Kellner
When questioned about his financial ties to Mecta, one of the shock machine manufacturers, Dr. Charles Kellner attempts to change the subject. (32 seconds)

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Here, Dr. Kellner says the tragic experiences of patients like Hope and Diann’a are “unfortunate” and goes on to say that most people will be cured by ECT. He fails to mention the now-admitted high relapse rate, or the need for continuation/maintenance ECT. (30 seconds)

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Dr. Charles Kellner misleads the public about the effectiveness of ECT. (1 minute)

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Dr. Charles Kellner makes up a story about how ect works. The truth is, nobody knows, and he’s CAUGHT ON TAPE fabricating a nice tale. (50 seconds)

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Dr. Peter Breggin discusses the role of the FDA in the ECT controversy, and how they dropped the ball. (1 minute)

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Dr. Breggin talks about the literature, and why some people become *more* depressed after ECT. (35 seconds)

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Dr. Breggin explains how the perception of ECT has changed, and how the longstanding theory that “brain damage was helpful” has been given a new spin. (50 seconds)

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Dr. Peter Breggin sums it all up: View the clip (10 seconds)

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Scottish Documentary on Ewen Cameron, who worked with the CIA to brainwash and erase memory using electroshock. In three parts.
Part 1

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Part 2
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Part 3
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News stories on Christian Hageseth and his legal woes

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Video clips from the Mecta lawsuit, Harold Sackeim testimony