By Linda Andre
LYING FOR FUN AND PROFIT
In 1975, when he was a graduate student in psychology at the University of Pennsylvania, young Harold Sackeim wrote his masters thesis on self deception. And his PhD dissertation was titled "Self Deception: Motivational Determinants of the Non-Awareness of Cognition."
So Harold became a doctor by self deception. He then seemed headed for a dead-end career in academic psychology, publishing on such decidedly unsexy topics as "Classroom seating and psychopathology." He published a book chapter called "The Adaptive Value of Lying to Oneself" and an article titled "Self Deception: A concept in search of a phenomenon."
Clearly Harold needed a product to pitch, a big-ticket tie-in; if he didn't find one he would end up just another obscure academic researcher. Sometime around 1980, his concept met its phenomenon: Harold hitched his wagon to a shock machine. It was a perfect match. Harold's star has done nothing but rise ever since.
Harold had received a grand total of about $5,000 in grant money up to 1981. That year he got half a million dollars, and the millions have been rolling in steadily ever since. By 1988, Harold was proclaiming himself a "world expert" on ECT, and not many in the world were inclined to contradict him.
The fact is that if Harold Sackeim didn't exist the American Psychiatric Association would have had to invent him, in order to get out of what it perceived as a public relations problem with electroshock. Sackeim is a born PR man. No one else has had quite the stomach for ECT promotion that Harold has; other ECT advocates, not so skilled in self deception, tend to choke on the Big Lies he tells so glibly. Harold gives the impression of actually believing his own lies, and perhaps he really does.
Whenever the media does a story on ECT, Harold is there with a sound bite on the spot. Whenever an ECT survivor sues for memory loss, Harold is likely to be the "expert witness" testifying against her. He's got his fingers in every dike where the truth about ECT might slip through.
A writer for a men's magazine once called Harold Sackeim a "designer-suited scientist." But only the first half of that description is accurate. Harold does wear the finest suits ---though like the special souped-up shock machines he uses, they must be made to order, since he stands under five feet tall. But a scientist Harold Sackeim is not. All of his money and influence have gone, not into an objective scientific investigation of ECT, but into preventing such an investigation.
--- Since 1981, Harold has been continuously funded by NIMH to study "Affective and Cognitive Consequences of ECT." He's received over five million dollars for this grant alone (he has several other million dollar grants from NIMH as well). That's five million dollars that made sure that no one but Harold would have the official say as to exactly what ECT's cognitive effects are. And it's virtually certain now that no one else ever will. This grant, now entering its third decade, no longer has to compete with other proposals for funding; it's renewed for ten years at a time, most recently in 2000.
What does Harold have to show for his twenty years of "research"? Well, he wrote last year that "we lack data" on the permanent adverse effects of ECT; in particular, he claims there is no research on the number of survivors who experience severe permanent amnesia.
--- Rather than doing this research ---- research he surely knows would be fatal to his published claims that ECT is safe, and to his position as the golden boy of the ECT industry --- Harold's chosen to simply make up some numbers. He wrote the APA's informed consent form, which is used in one version or another in most hospitals in America. The form states that only "1 in 200" ECT survivors report permanent memory loss. But that fake "statistic" is not based on anything. Harold was finally forced to admit (on national television) that this is simply a made-up number, and that there is no data to support it. Ever the PR man, he calls the figure "impressionistic."
Without blinking an eye, he's now (as of mid-2001) begun touting a new "impressionistic" figure: 1 in 500.
--- In a public hearing before the New York State Assembly in July 2001, Harold claimed he had "never" seen a case of anterograde memory loss after ECT. (Anterograde refers to loss of memory function; retrograde refers to loss of memories, or amnesia.) He invited "anyone in the country" who had experienced such loss to "come in for an evaluation." Dozens of ECT survivors with anterograde memory loss contacted Harold. How many have been to Harold's facility for an evaluation? Not one. Harold backpedaled on his invitation as fast as he could the instant it became clear that survivors would, indeed, take him up on it. Those who've phoned, emailed or faxed Harold report that he either never responded, or simply told them----without meeting them or doing any testing or evaluation----that something other than ECT was to blame for their deficits. Drugs, other psychiatric treatments---whatever he could think of---must have caused the disability or brain damage, not ECT, he said. Therefore there was no need for an evaluation to see if ECT had done it. In one memorable case of a woman whose brain damage and permanent cognitive disability had already been well documented (and attributed to ECT) by her doctors, a lesser PR man than Harold might have been at somewhat of a loss as to what to say to her. The woman had never had any drugs, treatment, or mental illness after having ECT. So what caused her deficits? Harold wasn't stumped for an answer: why, it was the short period of İmental illness she'd experienced nearly two decades earlier, for which she was given ECT, that damaged her brain! "You're saying you believe mental illness causes brain damage?" asked the astounded woman. "We know it does," came the answer, quick as a con man's switch of the cards. He explained that he believes "depression itself, period" always causes brain damage even when successfully treated.
--- But stop the presses! It's not exactly correct to say Harold isn't gathering data on the incidence of retrograde and anterograde memory loss, and brain damage, due to electroshock. A member of his research team recently admitted that he does, in fact, test his research subjects' İmemory and cognitive abilities before and after ECT. And although many of his tests are too easy or irrelevant to be useful, he does use at least one of the tests that ECT survivors have found relevant to our deficits. The catch: he's never published or disclosed any of the results of these tests, or even the fact that he administers them. Wonder why not? İAnd since he's using federal money to do the testing, how can he hide the results?
--- Much of Harold's grant money has gone, not into actual research, but into long "review" articles in which he selectively trashes everybody else's research. He did this is a 1993 article in which he dismissed the existing brain damage research, and in a 2000 article in which he trashed the memory loss research. In both articles he simply left out or distorted those published articles which say that ECT causes brain damage and memory loss.
--- For over a decade, Harold has expressed the opinion that research into whether ECT causes brain damage is "not of scientific interest", "uninteresting", and "unlikely to be funded."
A real scientist doesn't cut off entire areas of scientific investigation by fiat.
Sackeim is in a position not just to express this opinion, but also to enforce it, and that's exactly what he's done. By virtue of his role as a reviewer of every proposed ECT grant that comes into NIMH and other agencies that might fund ECT research, and by virtue of his position on the editorial boards of virtually all journals which publish ECT articles, Sackeim's arguably done more than any man in America to prevent a scientific investigation of ECT's effects on the brain from ever being funded or published.
Ironically, his lab at the New York State Psychiatric Institute is stocked with the latest brain imaging technology, technology that's available in only a handful of institutions in this country. Harold's got both the tools and the money to settle the question of whether ECT causes brain damage ---- but you see, that's what a scientist would do, and he's a PR man.
--- Harold does MRIs on his ECT patients routinely, but not to assess the effects of ECT! İHe uses the brain scans to help him learn how to design and use the giant magnet (or transcranial magnetic stimulation) machines from which is making a profit and stands to make a killing when and if they replace ECT machines! What a waste of costly MRI scans...paid for with our tax money. They could be used for science, to assess the effects of ECT on the brain, if someone would just read them for that purpose, instead of as a way to further Harold's career as a brain damage profiteer. (If you guessed that Harold's on the payroll of the magnet machine manufacturers such as Magstim, you're correct! He "consults" for them, gets grants from them, and how could he resist owning stock in them?)
--- He's also a consultant to the shock machine company Mecta, and has been since the mid 1980s. He's worked for shock machine company Somatics as well. He's even received grant money from Mecta. Federal law requires NIMH grantees to disclose actual or potential financial conflicts of interest, and requires that the conflicts be managed or eliminated. Sackeim has never disclosed his financial ties to the shock machine companies.
He does, however, disclose that he was on the board of Cambridge Neuroscience, a company that made a drug that was supposed to alleviate ECT's effects on memory. (It didn't.) Harold's position that ECT is safe and can't cause memory loss doesn't interfere with his eagerness to make a buck off that memory loss.
His biggest whopper, for which he is justly infamous, is this one:
ECT improves memory. This statement appears in the APA consent form and many other consent forms, such as the one recently adopted by the state of Vermont. When Harold first came out with this line in the early 90s, ECT survivors laughed, figuring it was some kind of sick joke.
But no one else is laughing.
As it turns out, even Harold's own published articles don't support that claim. He cites only to himself as "proof", since there isn't anyone else; he usually cites, for instance, Sackeim et al, "Subjective Memory Complaints Prior to and Following Electroconvulsive Therapy", Biological Psychiatry 39: 346-356 and Sackeim et al, "Effects of depression and ECT on anterograde memory." Biological Psychiatry 21: 921-930, 1986. What this research actually shows is that patients are poor judges of their memory functioning in the days and weeks shortly following ECT, and although when asked by their shock doctors they reported their memories to be good or better than ever, in fact their performance on objective tests of memory functioning was worse. In order words, Sackeim's own research is consistent with the conclusion that patients are suffering from acute organic brain syndrome due to ECT.
Harold is so addicted to lying, he does it just for fun. A few years ago, while teaching one of his "How to do ECT" classes, he recounted an anecdote involving a well-known New York City human rights activist and a man who was Harold's patient at the time. Harold claimed that the advocate had come to his hospital, demanded to see this patient, got into the hospital and then tried to talk the patient out of having ECT. The punch line of the story which got a resounding laugh out of the aspiring shock docs was that this patient then decided to go ahead with ECT.
It made a great story, flattering to Harold, derogatory to what he called "the anti-ECT movement." Except for one thing: it never happened. The advocate never went near Sackeim's institution, never spoke to his patient, never tried to contact him in any way. The "anti psychiatry" organization Harold claimed she represented did not exist. He just made up the name on the spot, for purposes of his story.
His audience was completely duped, to the extent that a discussion ensued on the topic of "What would you do if anti-psychiatry came to your door?"
Did Sackeim tell his students he made up the whole thing? No, he was having too much fun. Was he maybe psychotic when he told the story? Arguably. Or as a doctor of self-deception, did he actually believe it to be true?
SHAME on Harold Sackeim for worming himself into positions of public trust, then abusing the hell out of that trust, and for making a killing doing it.
SHAME for playing the "mental patients are irrational and dishonest" card, rather than honestly investigating and documenting our reports of permanent memory loss and brain damage. (See his many government-funded articles in which he argues that people who report amnesia and cognitive deficits after ECT are crazy for example, "Subjective Memory Complaints: A Review of Patient Self-Assessment of Memory After Electroconvulsive Therapy," Journal of ECT, June 2000.) SHAME for playing this card as an "expert witness" on the stand against persons with permanent memory loss and cognitive disability.
SHAME for playing the "violent mental patients" card with the media, as in his false claim that patients have made "death threats" on him.
SHAME for telling one of his research subjects who was brave enough to confront him after losing twenty years of memory that her memory loss "couldn't" be caused by ECT, and "must have" been caused by a stroke she had without realizing it.
SHAME for telling each one of the hundreds of survivors who've been his subjects or who've contacted him, "Your losses could not possibly be due to ECT", İand then saying with a straight face and fingers crossed behind his back (in court, to policymakers, to politicians, to the media) that he has "never" seen a case of permanent ECT memory loss.
Whether for fun or profit, the net effect of Harold Sackeim's lies has been to end all scientific investigation of ECT's effects on memory and the brain, and to effectively discredit survivors who report memory loss and brain damage, and to prevent future patients from being informed of ECT's permanent effects.
No one is more shameless than Harold Sackeim, and no one more richly deserves induction into the ect.org Hall of Shame.
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