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