No way out: the hospital that became a childhood hell

• The Age
• By BILL BIRNBAUER Sunday 14 October 2001 
• Leslie Kiriona, who was given shock treatment as a patient there in 
• 1973. Picture: JOHN DONEGAN 
• The New Zealand Government has apologised to 95 people who were 
• repeatedly treated with electric shock "aversion therapy" in the 
• 1970s while under the care of a psychiatrist now practising in 
• Melbourne. 
• The formal apology, by New Zealand Prime Minister Helen Clark and 
• Health Minister Annette King, comes with a $5.3 million pay-out to 
• settle a class action launched by the group, all former "patients" 
• of Lake Alice Hospital, near Palmerston North, north of Wellington. 
• While at the hospital in the 1970s, the "patients", aged between 
• eight and 16, were given electric shocks and painful injections for 
• minor breaches of discipline, and lived in a state of "extreme fear 
• and hopelessness", according to former New Zealand High Court judge 
• Sir Rodney Gallen. 
• He said: "Statement after statement indicates that the children 
• concerned lived in a state of terror during the period they spent at 
• Lake Alice. All were in need of understanding, love and 
• compassionate care. That is not what they received at Lake Alice." 
• Most were taken to Lake Alice Hospital because their parents or 
• state carers could not cope with their unruly behavior. 
• Once at the hospital, a sprawling mental institution with 
• dormitories, a school and a maximum-security facility for the 
• criminally insane, they came under the care of Dr Selwyn Leeks, a 
• tall, quietly spoken man who once described electro-convulsive 
• therapy (ECT) as "fairly definitive treatment". 
• Dr Leeks has a practice in the bayside suburb of Cheltenham. He 
• established the 46-bed child and adolescent unit at Lake Alice 
• Hospital in 1972, but left in the late 1970s after two inquiries 
• into his use of ECT. 
• A Medical Practitioners Board of Victoria spokeswoman said the board 
• was concerned, and would investigate to see if further action was 
• required. 
• Electro-convulsive therapy, during which an electric shock is 
• administered to the brain, normally is used with anaesthetics and 
• muscle relaxants on patients suffering severe depression or 
• psychiatric conditions. But at Lake Alice it was used without 
• anaesthetics or relaxants and was given to the head and other parts 
• of the body. 
• Sir Rodney said that ECT was "in constant use" at Lake Alice 
• hospital - administered on children as a punishment for unacceptable 
• behavior, low school grades or running away. 
• "The ECT was plainly delivered as a means of inflicting pain in 
• order to coerce behavior," he says. "ECT delivered in circumstances 
• such as those I have described could not possibly be referred to as 
• therapy, and when administered to defenceless children can only be 
• described as outrageous in the extreme." 
• Statements by the former patients, which Sir Rodney accepted as 
• true, showed they had received ECT on their heads, legs and even 
• their genitals in cases where they had been accused of unacceptable 
• sexual behavior. The statements referred to two incidents in which 
• children had administered ECT to other children under the 
• supervision of staff. 
• Dr Leeks came to Melbourne in 1978 and was the director of child 
• psychiatry at a child guidance clinic. In 1986, he worked briefly as 
• a part-time psychiatrist at the Children's Court outpatients' 
• clinic. 
• Dr Leeks refused to comment on the New Zealand apology and pay-out. 
• He still faces separate court action by two former Lake Alice 
• residents. 
• Last week, the 20/20 television news program in New Zealand showed 
• Dr Leeks telling a former Lake Alice resident with a hidden camera 
• that the electric shocks were "a form of aversion therapy". When the 
• children administered shocks to another child it was "a behavioral 
• therapy thing". 
• One of the victims involved in the class action, Melbourne resident 
• Kevin Banks, told The Sunday Age he was relieved the case was over, 
• and welcomed the apology. However, he said he still had migraines 
• and nightmares, and relived his experiences daily. He could not work 
• and still suffered throbbing pain on his temples, arms and legs 
• where the electrodes were clasped more than 20 years ago. 
• He estimated he received more than 100 ECT treatments, as well as 
• pain-inducing injections of the sedative paraldehyde. 
• Sir Rodney described paraldehyde as a particularly unpleasant and 
• extremely painful injection that was used to punish children. 
• "There can be no doubt that paraldehyde was used by staff members on 
• their own initiative, without any instruction from medical 
• personnel, whenever the staff member concerned wished to impose a 
• punishment and, on the basis of some of the statements, it seems to 
• have been administered on quite a capricious basis." 
• Other punishments were being kept naked in solitary confinement, and 
• threats of being placed with criminally insane adults. Several 
• former patients complained about sexual abuse from other inmates. 
• Sir Rodney said that perhaps the most appalling story involved a 15-
• year-old boy who claimed he was locked in a wooden cage with a 
• seriously deranged adult. 
• "He describes a situation where, for a considerable period, he 
• crouched in the corner being pawed by the particular inmate, 
• screaming to be released and unable to get out or to get away from 
• the contact to which he had been exposed." 
• Sir Rodney said that even those not subjected to behavior 
• modification lived in terror because of the random nature in which 
• ECT was given. 
• He had read all 95 statements and had interviewed 41 of the 
• claimants in order to determine the amount paid to each claimant. 
• "Claimant after claimant indicated that on one day in the week 
• children were gathered together in the day room where they sat 
• waiting for those to be selected to whom ECT would be applied. Both 
• boys and girls spoke of young children lying in a foetal position on 
• the floor in attempts to avoid being taken up for ECT, and of 
• children who, in tears and through sheer fear, had lost control of 
• their bodily functions before any application had taken place. 
• Whether they received ECT or not, they all lived in fear of 
• receiving it. 
• "There were allegations, which I accept, that it (the ECT machine) 
• was brought into the dining room and placed in a prominent position 
• in order to encourage children to eat their meals if they were 
• reluctant to do so." 
• Complaints were made to police, welfare officers and probation 
• officers, but they were not believed. "There was literally no way 
• out for them," Sir Rodney said. 
• An investigation by The Age in 1999 found that, in December 1975, Dr 
• Leeks wrote to New Zealand welfare authorities about his use of 
• shock treatment on a 13-year-old boy from the Polynesian island of 
• Niue. 
• He said the boy appeared "to be a living memorial to the 
• inadequacies of the immigration system in New Zealand. He behaved 
• very much like an uncontrollable animal, and immediately stole a 
• considerable amount of money and stuffed it into his rectum. 
• Incidentally, the amount of money which he had pushed into his 
• rectum was retrieved along with a considerable amount of interest, 
• which will be forwarded when he returns to you". 
• An investigation by an ombudsman in the late 1970s found that a 15-
• year-old boy was given ECT against his will and without the 
• knowledge of his parents or welfare officers. This might have been 
• contrary to the law and was a grave injustice, the investigation 
• found. 
• In July 1977, Dr Leeks told Wellington's Dominion newspaper that his 
• unit was full of murderers, rapists and liars. He had not used ECT 
• in a punitive way, and defended it as a useful treatment when a 
• patient was dangerous. 
• In a statement, Prime Minister Helen Clark said that, whatever the 
• medical practice was at the time, "what occurred to these young 
• people was unacceptable by any standard, in particular the 
• inappropriate use of electric shocks and injections". 
• "The people involved were young - some of them children - and many 
• from troubled backgrounds, including wards of the state," she 
• said. "Some were sent to the child's adolescent unit primarily 
• because there was nowhere else for them to go."
  
  
  

How might ECT really "work," if only for a limited time?

* Early researchers variously believed that ECT worked by "abolishing pathological experiences,""total dissolution of brain function," i.e. damaging the brain and/or erasing memories of painful experiences.

*Some doctors, using a psychodynamic model, hypothesised that the "near death" of ECT induced a "rebirth"experience. Repeated use of general anaesthesia within a few week period would serve to heighten the effect of dying.

* Some doctors suggest that ECT, like head injury, artificially induces euphoria. Noted by early researchers as "post convulsive euphoria," this giddiness or high due to brain damage is interpreted by psychiatrists as improvement.

* The limited "efficacy" of ECT may be due to the highly ritualised use of electricity generating a "profound placebo effect" the fear of renewal of treatment, and/or special attention from staff now believed to be responsible for any efficacy of insulin coma.

Does ECT cause death due to medical complications?

* The official psychiatric literature admits only 1 death in 10,000 persons after ECT, without any supporting documentation.

* Anaesthesia alone, used with each ECT treatment, causes three deaths per 10,000 persons.

* A national newspaper, citing 5 studies and statistics from new reporting requirements in Texas, reported a death rate of one in 200 among the elderly.

*A 1993 study reported a death rate of over 25% among elderly patients within one year of the ECT treatments, compared to less than 4% with non-ECT treatments.

* ECT does not prevent suicide. One study found a suicide rate almost double for people undergoing ECT--a 14% death rate compared to about 7.5 % for non-ECT. Risks of Electroconvulsive Therapy (ECT)

By JOHN HAUSER, M.D.

Modern electroconvulsive therapy (ECT) is generally considered a safe and effective treatment for severe, chronic depression and treatment-resistant depression, although it may occasionally be used to treat other conditions as well. Despite its general safety and efficacy, like psychiatric medications, it carries with it a number of side effects.

Your doctor or psychiatrist should go through each of these risks with you prior to the ECT procedure taking place, and answer any questions you may have about these risks. If your doctor fails to do so, that may be a sign they minimise the risks associated with ECT.

1. Memory Loss

Memory loss is the primary side effect associated with ECT treatment. Most people experience what’s called retrograde amnesia, which is a loss of memory of events leading up to and including the treatment itself. Some people’s memory loss is longer and greater with ECT. Some have trouble recalling events that occurred during the weeks leading up to treatment, or the weeks after treatment. Others lose memories of events and experiences in their past.

Memory loss generally improves within a few weeks after ECT treatment. As with psychiatric medications, no professional or doctor can tell you for certain what kind of memory loss you will experience, but virtually all patients experience some memory loss. Sometimes the memory loss in some patients is permanent.

2. Concentration and Attention Problems

Some people with have ECT treatments complain of ongoing problems with concentration and attention, much like a person with attention deficit disorder. While in most people this clears up within a few weeks of treatment, you may find it harder to concentrate on tasks or reading that you could previously do before ECT treatment began.

3. General Confusion

Many people who undergo the electroconvulsive therapy find that they experience a period of confusion after the procedure has been completed. You may forget why you’re in the hospital, or even what hospital you’re in. For most people, this confusion fades after a few hours, but can last as long as a few days after the ECT treatment. Older adults tend to have a greater problem with confusion than middle-aged or younger adults.

4. Other Side Effects

Similar to some psychiatric medications, some people undergoing ECT may experience physical side effects such as nausea, headaches, muscle aches or spasms, and vomiting. These are temporary side effects that nearly always go away within a few hours or days after treatment.

5. Other Risks

ECT is a medical procedure that can only be performed by a qualified physician or psychiatrist. Because general anaesthesia is administered, electroconvulsive therapy carries with it similar risks that any medical procedure using anaesthesia does. Hospital staff and an anaesthesiologist monitor your vital signs during the procedure — including heart rate and blood pressure — to watch for any signs that you may be having difficulty with the treatment.

Patients with a history of heart problems generally should not undergo ECT treatment, because the risk associated with receiving the electrical stimulation is greater.

 What are the psychic effects of ECT?

*Acute disorientation is common after ECT, and delirium which occurs in 10% of patients. Delirium is comparable to an acute psychotic state with hallucinations. This set of symptoms induced by ECT has been termed an Organic Brain Syndrome.

* ECT induces "chronic stress. as a series of shock treatments are typically given, The biological signs and symptoms after ECT can be compared to Post Traumatic Stress Syndrome.

Does ECT cause brain damage?

* Patients typically report symptoms of euphoria, denial, memory loss---a syndrome consistent with brain damage.

* ECT's "efficacy" is correlated with the development of slow Delta waves in the brain, that is typically an indicator of brain damage, as in acute head injury.

* In animal studies, ECT impairs synaptic connections in the brain's hippocampus, which is believed to be central to long term memory.

* Recent animal studies have shown that even a few brief seizures induced by electric shock cause damage to neurons in the brain.

*Electrical injury opens large holes in the body's cell membranes, known as electroporation---where the cell's sensitive ion volt channels are damaged.

* Persons who suffer from conditions that have clear physiological pathology such as lesion induced seizures, electric injury,  or head trauma  have memory loss and patterns of intellectual / cognitive deficits similar to ECT.

Does ECT cause memory loss and other long term effects?

* Memory loss is a problem with all patients who receive ECT, especially around the time of treatment.

* The literature admits permanent memory loss for up to several weeks or months around the time of treatment. "significant" memory problems in more than half of the patients, and "persistent memory loss" for autobiographical memories at 6 month follow up to periods of up to ten years.

* Physicians have failed to devise a specific memory test for ECT, leaving the full impact of memory loss unknown.

The highest governmental authority on medical matters in the United States, the Food and Drug Administration (FDA), agrees that ECT is not good for your health. It names brain damage and memory loss as two of the risks of ECT. The FDA is responsible for regulating medical devices such as the machines used to administer ECT. Each device is assigned a risk classification: Class I for devices that are basically safe; Class II for devices whose safety can be assured by standardisation, labelling, etc.; and Class III for devices which pose "a potential unreasonable risk of injury or illness under all circumstances. As a result of a public hearing in 1979, at which survivors and professionals testified, the ECT machine was assigned to Class III. There it remains today, despite a well-organised lobbying campaign by the American Psychiatric Association. In the files of the FDA in Rockville, Maryland, are at least 1000 letters from survivors testifying to the damage that was done to them by ECT. In 1984 some of these survivors organised as the Committee for Truth in Psychiatry to lobby for informed consent as a way of protecting future patients from permanent brain damage. Their statements challenge the assumption that survivors "recover" from ECT:

Patient 2

A 78-year-old female patient, temporarily admitted to the recovery department after ECT, developed atrial fibrillation and chest pain. Her medical history showed hypertension, severe depression and paroxysmal atrial fibrillation. Her ECG 3 months before ECT was completely normal. Immediately after ECT her blood pressure was 230/140 mmHg, but later decreased to 110/45 mmHg. Examination of heart and lungs revealed no abnormalities. The ECG showed atrial fibrillation with a ventricular rate of 140 beats/min and new negative T waves in leads I, II, aVL and V2-6. The second ECG showed sinus rhythm and persisting negative T-waves (Fig. 2). Troponin T level was 0.02 μg/l (normal) and no other laboratory abnormalities were found. A differential diagnosis was made and the following possible causes were taken into account: post ECT, post tachycardia due to atrial fibrillation, severe hypertension or myocardial ischemia. Since the patient reported to have had previous anginal complaints, coronary angiography was performed. In the left anterior descending artery two significant stenoses were identified in the proximal and the mid section, respectively. Furthermore, a stenosis was found in the right coronary artery. Due to her psychiatric condition, PCI was not performed and she was treated with anti-anginal medication and warfarin.

Fig. 2

Second ECG of patient 2, 8 h after ECT, showing persistent negative T wavesRisks

Although it wasn’t like this before when the experts were starting with this method- today- recent advances in medical technology have significantly reduced the complications associated with ECT. Some of the most common complications include:

·         Memory loss – it is important to point out that one of the most common side effects of electroconvulsive therapy is memory loss and patients may be unable to recall events that occurred before and after treatment.  

·         Confusion

·         disturbances in heart rhythm

·         slow heartbeat (bradycardia)

·         rapid heartbeat (tachycardia)

It isn’t the same with all the patients! It is proven that the patients at high risk of having complications following ECT include those with:

·         a recent heart attack

·          uncontrolled high blood pressure

·         brain tumors

·         some previous spinal injuries

In extremely rare cases, ECT can cause heart attack, stroke, or death. People with certain heart problems usually are not good candidates for ECT.  

Other possible side effects include:

·         Nausea

·         Headache

·         Jaw pain

Normal results

What are the normal results of the electroconvulsive therapy? Well, it is important to not expect a miracle although ECT often produces dramatic improvement in the signs and symptoms of major depression, especially in elderly patients. Where are the best results? Well, most of the experts are claiming that remarkable 90% of patients who receive ECT for depression respond positively while, on the other hand- only 70% respond as well when treated with antidepressant medications alone. Not only that- mania also often responds well to treatment with ECT, while with schizophrenia isn’t so good! It is also important to explain the term “maintenance ECT”! This term means that they must return to the hospital every one to two months as needed for an additional treatment.

What could be considered to be an abnormal ECT result? Well, if an ECT-induced seizure lasts too long during the procedure, doctor that’s performing an ECT will control it with an intravenous infusion of an anticonvulsant drug, usually diazepam (Valium). However, this could be considered to be an extremely safe procedure. Some are interested are there any long-term complications but- experts are saying that there is no convincing evidence of long-term harmful effects from ECT.  

Sources & Links 

External control of the heart by cerebral and neurohormonal factors is well established [8, 9]. Although ECT is a generally accepted, widely performed and safe therapy, cardiac complications may occur. The most frequently observed are arrhythmias and T-wave inversion on the surface ECG, but also transient wall motion abnormalities have been reported . Transient cardiac abnormalities have been explained by the concept of adrenergic excess [10]. In this concept, however, coronary artery disease was not considered to play an important role, because intense sympathetic activity was thought to be the exclusive explanation. One case report supported this concept by showing development of acute myocardial infarction during a course of ECT without underlying coronary artery disease .What are the immediate physiological effects of ECT?

* A Grand Mal Seizure where the brain's neurons are forced to fire at their maximal  rate, four to 6 times normal. In a neural short circuit, such paroxysmal firing of cells causes the brain's EEG recording to look like a black smear.

* ECT results in a drastic fall and increase of blood pressure, causing acute circulatory stress on the heart. Evidence is strong that ECT causes heart tissues to be starved of nutrients (myocardial ischemia) resulting in improper heart function.

* The immune system is activated, indicating that the body is attempting to repair damage. After ECT Nerve Growth Factor is released to repair injured cells, as well as specialised cells (phagocytes) to digest damaged tissue.

*The body's built-in "pain killer,"endorphins, are released to reduce the severity of seizures and their recurrence.

* The body's stress response system is aroused. The body's glandular / endocrine system responds to electric shock by flooding the body with many of its major hormones including adrenalin, growth hormone, thyroxine, prolactin, and oxytocin.

 Risks Associated with Electroconvulsive Therapy

There are several risks that are associated with the electroconvulsive therapy that you will have to weigh out carefully before agreeing for the procedure for your loved one or yourself. The risks are similar to the effects of brief general anaesthesia. Here is a list of some of the risks:

Memory Loss: A ECT can cause various types of memory loss. It can cause retrograde amnesia that is the patient will have trouble remembering events leading up to the electroshock session. Usually the patient will have trouble remembering events a couple of weeks old, but in some cases, the memory loss can extend for a period of more than 2 years. Further, in some cases, this condition is only temporary while in a few cases, the memory loss can be permanent.

Cognitive Impairments: Immediately after the ECT, the patient may experience a brief period of confusion and will have no idea as to where and why they are at a particular place. This condition is known as cognition, meaning impairment of the thought process and can last for a few minutes or several hours. The more the number of ECT the patient undergoes, the longer will be the duration of these periods.

Medical Complications: During the process of ECT, the heart rate and the blood pressure increases and this can lead to serious heart problems. It is therefore very important that the doctor undertakes the pre-ECT evaluation very seriously to avoid any complications that may arise due to ECT.

Physical Problems: Immediately after the ECT, the patient may experience headache, jaw pain or muscle pain along with nausea and vomiting. This is very common and can be treated very effectively with the help of medicines. 

DOES ECT HAVE ANY RISKS?

Yes, like any medical procedure, ECT has some risks. In rare cases, ECT can cause heart rhythm problems, or other potentially serious complications. In patients with pre-existing heart disease, there is an increased risk of these complications. If you have a heart condition, your doctor will take special care to monitor your heart and take other precautions with you, so that the treatment is as safe as possible. For instance, he or she might give you medicines to offset the effects of the ECT, if necessary.

This is so expected and routine on ECT wards that hospital staff become inured to making chart notations like "Marked organicity" or "Pt. extremely organic" without thinking anything of it. A nurse who has worked for years on an ECT ward says:

Some people seem to undergo drastic personality changes. They come in the hospital as organised, thoughtful people who have a good sense of what their problems are. Weeks later I see them wandering around the halls, disorganised and dependent. They become so scrambled they can't even have a conversation. Then they leave the hospital in worse shape than they came in. (Anonymous psychiatric nurse, quoted in Bielski, 1990)

Electroconvulsive therapy in patients with heart failure or valvular heart disease.

Rayburn BK.

Source

Department of Medicine, University of Alabama at Birmingham, 35294, U.S.A.

Abstract

As the use of electroconvulsive therapy (ECT) increases, the chance of a practitioner's encountering a patient with significant heart failure, ventricular dysfunction, or valvular heart disease also increases. This article reviews the epidemiology, pathophysiology, and available data on the risk of ECT in these patients. Recommendations are made regarding evaluation and treatment of such patients. Some special situations are identified that may require a modification of routine procedures. Overall, ECT can be performed safely in most patients with underlying cardiac conditions, as long as appropriate precautions are taken to identify these patients ahead of time.

PMID: 9342130 [PubMed - indexed for MEDLINE]Patient 1

A 67-year-old male was admitted to our cardiology department after ECT because of low oxygen saturation and persistent ECG abnormalities (Fig. 1). His medical history comprised hypertension, dilated abdominal aorta, diabetes and severe mental depression. MRI of his brain showed an old cerebral infarction. His ECG 6 months before ECT showed sinus rhythm with small biphasic T waves in leads V5-6.

Fig. 1

ECG of patient 1 showing new negative T waves after ECT

After ECT he did not express any symptoms. Physical examination revealed no abnormalities. Blood pressure was 140/80 mmHg. His ECG showed a normal sinus rhythm of 67 beats/min with a left axis deviation. Negative T waves were seen in leads V1-5, which were new compared with previous ECGs. Laboratory investments showed maximal troponin-T level of 0.06 μg/l (normal value <0.05 μg/l). All other parameters were normal except an increased d-dimer. Echocardiography showed a normal left ventricular function with mild concentric hypertrophy. Because of the combination of ECG changes, increased troponin level and low oxygen saturation at admission, coronary angiography was performed. In the proximal left anterior descending artery a significant stenosis was demonstrated at the division of the first diagonal branch. The other coronary arteries did not show stenoses. A few days later, the patient underwent elective PCI with stenting of the stenotic artery. The negative T waves on the ECG resolved. Afterwards he remained clinically stable.Electroshock As Head Injury

Written by Linda Andre

Report prepared for the National Head Injury Foundation

September 1991

by Linda Andre

Introduction

Electroshock, variously known as electroconvulsive therapy, ECT, shock treatment, or simply shock, is the practice of applying 70 to 150 volts of household electric current to the human brain in order to produce a grand mal, or generalised, seizure. A course of ECT usually consists of 8 to 15 shocks, administered every other day, although the number is determined by the individual psychiatrist and many patients receive 20, 30, 40 or more.

Psychiatrists use ECT on persons with a wide range of psychiatric labels, from depression to mania, and have recently begun to use it on persons without psychiatric labels who have medical diseases such as Parkinson's disease.

A conservative estimate is that at least 100,000 persons receive ECT each year, and by all accounts this number is growing. Two-thirds of those being shocked are women, and more than half of ECT patients are over the age of 65, although it has been given to children as young as three. ECT is not given at all in most state hospitals. It is concentrated in private, for-profit hospitals.

ECT drastically changes behavior and mood, which is construed as improvement of psychiatric symptoms. However, since psychiatric symptoms usually recur, often after as little as one month, psychiatrists are now promoting "maintenance" ECT---one electrical grand mal seizure every few weeks, given indefinitely or until the patient or family refuses to continue.

The Evidence For ECT Brain Damage

There are now five decades of evidence for ECT brain damage and memory loss from ECT. The evidence is of four types: animal studies, human autopsy studies, human in vivo studies which use either modern brain-imaging techniques or neuropsychological testing to assess damage, and survivor self-reports or narrative interviews.

Most of the studies of the effects of ECT on animals were done in the 1940s and '50s. There are at least seven studies documenting brain damage in shocked animals (cited by Friedberg in Morgan, 1991

. The best known study is that of Hans Hartelius (1952), in which brain damage was consistently found in cats given a relatively short course of ECT. He concluded: "The question of whether or not irreversible damage to the nerve cells may occur in association with ECT must therefore be answered in the affirmative."

Human autopsy studies were done on persons who died during or shortly after ECT (some died as a result of massive brain damage). There are more than twenty reports of neuropathology in human autopsies, dating from to 1940s to 1978 (Morgan, 1991, p. 30; Breggin, 1985, p.4). Many of these patients had what is called modern or "modified" ECT.

It is necessary to clarify briefly here what is meant by "modified" ECT. News and magazine articles about ECT commonly claim that ECT as it has been given for the past thirty years (that is, using general anaesthesia and muscle-paralyzing drugs to prevent bone fractures) is "new and improved", "safer" (i.e. less brain-damaging) than it was in the 1940s and '50s.

Although this claim is made for public relations purposes, it is flatly denied by doctors when the media is not listening. For example, Dr. Edward Coffey, head of the ECT department at Duke University Medical Centre and a well-known advocate of ECT, tells his students in the training seminar "Practical Advances in ECT: 1991":

The indication for anesthetic is simply that it reduces the anxiety and the fear and the panic that are associated or that could be associated with the treatment. OK? It doesn't do anything else beyond that...There are, however, significant disadvantages in using an anaesthetic during ECT...The anaesthetic elevates seizure threshold... Very, very critical...

So it is necessary to use more electricity to the brain, not less, with "modified" ECT, hardly making for a safer procedure. In addition, the muscle-paralyzing drugs used in modified ECT amplify the risks. They make the patient unable to breathe independently, and as Coffey points out this means risks of paralysis and prolonged apnea.

Another common claim of shock doctors and publicists, that ECT "saves lives" or somehow prevents suicide, can be quickly disposed of. There is simply no evidence in the literature to support this claim. The one study on ECT and suicide (Avery and Winokur, 1976) shows that ECT has no effect on the suicide rate.

Case studies, neuroanatomical testing, neuropsychological testing, and self-reports that remain strikingly similar over 50 years testify to the devastating effects of ECT on memory, identity, and cognition.

Recent CAT scan studies showing a relationship between ECT and brain atrophy or abnormality include Calloway (1981); Weinberger et al (1979a and 1979b); and Dolan, Calloway et al (1986).

The vast majority of ECT research has focused and continues to focus on the effects of ECT on memory, for good reason. Memory loss is a symptom of brain damage and, as neurologist John Friedberg (quoted in Bielski, 1990) points out, ECT causes more permanent memory loss than any severe closed-head injury with coma or almost any other insult to or disease of the brain.

ECT and Brain Damage

Written by Juli Lawrence

Does ECT cause brain damage?

Dr. John Breeding gives testimony to the New York State Assembly hearings on electroshock, May 2001. Dr. Breeding says ECT *always* causes brain damage.

Writing in Nature, Dr. Peter Sterling says: ECT damage is easy to find if you look for it, and says that ECT practitioners don't find any memory loss because they don't test for it.

What do they really think?

In public, psychiatrists say that ECT is safe. But what do they say to each other?

What does ECT do to the brain? 

An in-depth look at what the brain goes through during ECT.

Do neurologists know something the rest of us haven't yet figured out?

Does ECT cause brain damage?

This MD says yes, in an article on ECT and EEGs.

Can ECT permanently harm the brain? This article says it has, and can, cause permanent brain pathology.

Dr. John Friedberg, writing in the American Journal of Psychiatry, takes an in-depth look at the effects of ECT on the brain and questions, "Do we really want to offer brain damage to our patients?"

A lengthy chronology on epilepsy and ECT, something denied by the ECT industry. Yet there are many documented cases of ECT-induced epilepsy.

Psychopathology of Frontal Lobe Syndrome

This article from Seminars in Neurology details frontal lobe syndrome, which many neurologists believe is one of the side effects of ECT. The researcher explains how this injury is often difficult to measure clinically, but how damaging the results are to the person who has it.

Neuroscientist testimony on ECT brain effects

From Dr. Peter Sterling, a neuroscientist at the University of Pennsylvania School of Medicine, this remarkable testimony and review of the available studies on the effects of electroconvulsive therapy on the human brain. Analysing years of data, including private communications with one of the leading researchers of our time on memory loss from ECT (Janis), Sterling strongly concludes that ECT does, in fact, cause organic brain damage, similar to that seen from the results of trauma or toxicity in the brain.

Neuropsychological assesment

This journal article from Dr. Alan E. Brooker, clinical neuropsychologist with the USAF, details the complexities of evaluating the function of the brain. What this shows is how extensive the measurements are when truly understanding how one's brain is working on a day-to-day basis.

ECT as head injury?

In a report for the National Head Injury Foundation, the case is made that ECT works by inducing the effects of head injury. This well-researched report highlights the work of many neurologists and psychiatrists who believe this is the mechanism of action of ECT, as well as case reports of patients. Included are some great tips on recovery.

Electroshock: Scientific, ethical and political issues

From Dr. Peter Breggin, this comprehensive article explains how ECT works as head trauma, and goes into the scientific, ethical and political ramifications of the controversial treatment. A Must Read!

Dr. Charles Kellner (Hall of Shame winner) says "There are now important carefully controlled studies with MRI brain scans before and after ECT showing conclusively that there is absolutely no structural brain damage." Here are those "carefully controlled studies." Judge for yourself. Are these proof of "absolutely" no brain damage?View the video

Quite a bit more on the issue of brain damage in the news section.

A new article about how ECT induces PTSD and what can be done to aid recovery, from David Armstrong. I strongly believe this is an effect of ECT that is almost always overlooked, so this is an important article to read! 

Brain–Damaging Effects of Electroshock

Anyone who has seen electroshock (ECT) performed knows this procedure has all the marks of physical torture that belongs in the armoury of a Gestapo interrogator. Electroshock is up to a brutal 400 volts of electricity sent searing through the brain to induce a grand mal seizure. Dr John Breeding, psychologist says, "It is prima-facie common sense obvious that ECT causes brain damage. After all the rest of medicine, as well as the building trades, do their best to prevent people from being hurt or killed by electrical shock. People with epilepsy are given anticonvulsant drugs to prevent seizures because they are known to cause brain damage."

The same ECT machine that is used for "therapy" is used to torture political prisoners. Consider also that after exposure of the electrical shock methods used on prisoners at Abu Ghraib prison in Iraq, the US Congress included provisions in the Department of Defense Appropriations prohibiting "cruel, inhuman and degrading treatment or punishment" with regard to persons kept in detention by the Department of Defense and in the custody or control of the United States Government worldwide. We do not condone the use of electrical shock of prisoners of war, and we shouldn't condone its use as "therapy" on the mentally disturbed. It never addresses the cause of the person's problems and offers no cure.

Psychiatry deceptively cloaks electroshock with false medical legitimacy: the hospital setting, white-coated assistants, anaesthetics, muscle paralysing drugs and sophisticated-looking equipment. But the scientific principle behind ECT is no more advanced than the principles behind neighbourhood bullying. ECT is dangerous, cruel and inhumane.

History of Electroshock

• Electroshock was developed in 1938 out of a Rome slaughterhouse, where pigs were electroshocked to make it easier to slit their throats in order to kill them. A psychiatrist, Ugo Cerletti, had been experimenting with electric shock on dogs, placing an electrode in the dog's mouth and another in its anus. Half of the animals died from cardiac arrest. After seeing the pigs being shocked, he decided to use this on humans.
• In Australia in the early 1940's one of Australia's first ECT machines was constructed by Birch, the Superintendent of Mental Institutions for South Australia. He first tested the ECT machine on rabbits and then used it on patients in August 1941 at Parkside Mental Hospital in Adelaide.

Side Effects

• ECT can cause severe and permanent memory loss, brain damage, suicide, cardiovascular complications, suicide, intellectual impairment and even death. The 2006 Western Australian E.C.T. Consent Form, states: "In some people, memory loss may be severe and can even be permanent."
• A 2010 study by John Reed from the University of Auckland and Richard Bentall from Bangor University in Wales on the efficacy of ECT concluded there is no evidence at all that it prevents suicide and that there have been significant new findings confirming that brain damage, in the form of memory dysfunction, is common, persistent and significant and that it is related to ECT rather than depression. Further they stated, "The continued use of ECT therefore represents a failure to introduce the ideals of evidence based medicine into psychiatry."
• Psychiatrist Lee Coleman says, "the brain, for a while is so injured (even children know that electricity is dangerous for them and other living things) that the patient is too confused to know or remember what was troubling him. Unfortunately when the brain begins to recover somewhat, the problems usually return since electricity has done nothing to solve them."
• In 2000, psychiatrist Harold A Sackeim a major proponent of ECT, when addressing the frequency with which patients complain of memory loss stated, "As a field, we have more readily acknowledged the possibility of death due to ECT than the possibility of profound memory loss, despite the fact that adverse effects on cognition [consciousness] are by far ECT's most common side-effects."
• A 2001 Columbia University study found ECT so ineffective at ridding patients of their depression that nearly all who receive it relapse within 6 months.

The Electroshock Machine

• In January 2011, the U.S. Food and Drug Administration recommended that devices used to deliver ECT remain in the high risk category (Class III), reserved for the most dangerous medical devices and not be downgraded to a lower risk category. In doing so, it recommended that companies which manufacture ECT devices be required to prove that ECT is both effective and safe in order to remain in use.
• The early 2000's Graylands W.A psychiatric hospital's Medical Policy and Procedures Manual gave instructions on how to administer ECT. It explained how to turn the ECT machine on and then stated, "At this stage the electrode set is as lethal as a loaded gun, and should be treated as such!"

Number of Electroshock Treatments Given in Australia

• Today, psychiatry shocks and tortures the brains of more than 1 million individuals every year worldwide. Most people think it is banned in Australia. In fact as of June 2011, there are no restrictions in Australia to ban it from being given to children, the elderly or pregnant women.
• During 2010 in Australia, nearly 25,000 'treatments' of ECT were given funded by Medicare. Of these 25,000, Queensland psychiatrists gave the highest number of electroshock in 2010 with 7,433, followed by Victoria at 6,400, N.S.W. at 5,733 and W.A, at 2,184. This is not the total numbers of ECT given in Australia. For example in 2007/08, Medicare funded 5,327 treatments in Victoria. A Freedom of Information Request by CCHR revealed that for 2007/08 there had been 17,720 treatments in total given in Victoria alone.
• The elderly can be a target for ECT; In Australia, in 2010, over 4,700 electric shocks were given to people between the ages of 65 and 85 funded by Medicare.
• In June 2011 it was reported that patients in N.S.W. had been anaesthetised for more than 2 days to undergo court ordered ECT. Psychiatrist Jonathan Philips said he was concerned that such treatment could be the start of the "slippery slope" for even more radical treatment.
• Anaesthetising someone for 2 days to administer electroshock has parallels to Chelmsford Hospital in NSW where deep sleep treatment (patients were put into a drug induced coma and given electroshock) was administered and 48 people died. A Royal Commission was held in the late 1980's into Chelmsford Hospital and subsequently saw deep sleep therapy was banned.

Does Psychiatry Know How Electroshock Works?

• Psychiatry admits it still doesn't know how ECT "works." Psychiatry has over 50 theories but when one psychiatrist was questioned under deposition in a California ECT suit about what the 460 volts of electricity does to the brain, he said he wasn't an expert, go ask an electrician!
• Imagine a heart surgeon claiming he doesn't know how the heart works but has dozens of theories—and no scientific fact—about why a coronary bypass operation should be performed. You'd sue him for malpractice, which is what should be done to any psychiatrist damaging a patient with ECT today—and the colleges that taught him, as well as the psychiatric associations still endorsing it.

No one should stop taking any psychiatric drug without the advice and assistance of a competent medical doctor.