THE TROUBLE WITH SPIKOL

Shocked and Appalled
If The Atlantic Monthly can’t get its facts straight about shock treatments, I suppose it’s up to me.

BY LIZ SPIKOL
LSPIKOL@PHILADELPHIAWEEKLY.COM
2-7-01

In the fall of 1996, I had electroconvulsive therapy, or ECT. While I have written in the past about the good it has done for me–saving me from suicide and enabling me to follow a medication regimen for a couple months after–I have also pointed out the negatives, which include long-term memory loss, changes in personality and a general drop in intellectual acuity. Given that I was back in a psychiatric hospital in the fall of 1997 and endured several suicidal crises after that, I don’t believe ECT had any long-term benefit for me or, as studies have shown, for any psychiatric patient.

Most ECT benefits last little more than a month, though it has been shown that ECT makes patients more docile. You could do as much with a lobotomy–or by smacking them in the head with a ball-peen hammer.

ECT is a series of “treatments” that are generally given over the course of three weeks. It can be done inpatient or outpatient, though the latter can be especially difficult for people without sufficient support systems. The treatments consist of electrically induced grand mal seizures. While sedatives and muscle relaxants prevent the body from convulsing � la One Flew Over the Cuckoo’s Nest, it is still necessary to wear a bite-plate and a diaper–just in case.

Aside from wearing a diaper as an adult, which never bodes well, I was distressed by the fact that each of the 12 times I came out of the ECT room, I had no idea where I was, why I was in a wheelchair, where I was going or how to speak. My head ached horribly, my muscles felt sore and tired and I could not understand the simplest, most basic proof of one’s sanity: who I was. I was told I would not remember the ECT itself, nor the month before and the month after the treatments. According to the shrink-math I consented to, I would only lose, at most, three months of memory.

If only. Ask anyone close to me–my parents, my friends, my ex-husband–and they will all tell you how much I changed after the treatments and how much I forgot. Even today, I have a severely compromised memory for the years–years –between 1986 and 1998. I have intermittent flashbacks, usually triggered by smell, and I can often piece things together so that, at least logically, I know what happened. But knowing and remembering are two different things.

I wrote a cover story on all of this a couple years ago and, despite my harsh words, received a letter from the American Psychiatric Society thanking me for doing a responsible job on the piece. Part of what was responsible, I thought, was pointing out that the leading figures in the psychiatric community who were constantly endorsing ECT, writing so-called scientific studies of ECT and who edit the only journal on ECT–and who are thus oft-quoted on the subject–are all, in one way or another, ethically compromised.

Dr. Max Fink makes money from the videos sold by the makers of the Thymatron, a seizure inducement machine, yet a recent article in The Atlantic Monthly leans heavily on Fink’s testimony. A local psychiatrist said of Fink: “He makes me ashamed to be in this profession.” Many of Fink’s colleagues have a financial stake in ECT’s success, which would normally disqualify them from commenting so publicly and with such a discursive monopoly on this controversial procedure.

But it doesn’t, because no one is minding the store, and of those who are, most are disgruntled patients who lack credibility because they’re not objective. I would think clinicians who stand to gain financially would not be objective either, but their presence in a respectable publication like The Atlantic implies (incorrectly) otherwise.

The Atlantic Monthly, a magazine in the style of the “old, good” New Yorker –that is, long, rambling stories by the likes of boring naturalist John McPhee–just published another long, rambling story about author Daniel Smith’s experience at McLean Hospital in Massachusetts, where he observed ECT being administered. Mainly, it’s pro-ECT, though it does present the movement against ECT–in the most unflattering light.

While it’s true that the loudest group of activist ex-patients are Scientologists, theirs aren’t the only voices crying out in this scientific wilderness. In fact, there are many credible voices, including my own, calling for a wholesale reinvestigation of the practice and the industry. Yet Smith picks quotes that make them sound daft. If they are still crazy, maybe it’s because the ECT didn’t work for them after all.

There are many problems with ECT that must be acknowledged: the overwhelming application of it to the elderly; the increasing use on children and adolescents; ECT done against a patient’s wishes; and the lack of real informed consent.

But Smith doesn’t address these issues. Instead, he goes for the extremist jugular. For example: The Atlantic published an article in 1980 called “Electroshock: The Unkindest Therapy of All.” According to Smith, Max Fink compared that article to Mein Kampf. Which I guess is rational when you consider that Fink’s reputation owes everything to the continuation of ECT.

Unfortunately, I do not have the space here to do a point-for-point refutation of Smith’s take on ECT. But shouldn’t respectable journalists do more research before taking on subjects as truly puzzling as this one? People are being misinformed and taken advantage of because of the lack of ethics in the administration of ECT. I’m thinking maybe it’s time for Daniel Smith, the author of “Shock and Disbelief,” to have his head examined. PW

Added: Jul 17, 2006 12:04 pm | Trackback URI |  Email This Post  | Print