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Electroconvulsive Therapy

A patient undergoing ECT. Screenshot from ECT in Modern Psychiatry on YouTube.

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10th March 2021

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Declan Henry

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Articles : Social Issues

The brain is a most complex and mysterious organ that analyses information from all our senses. It controls the body with more than five trillion signals every second, such as telling our limbs to move and our eyes to blink. The brain determines how we behave and what we say and contains all our thought processes. This intricately delicate organ weighs a mere 1.36 kilograms. It’s hard to believe a psychiatric treatment exists that is capable of causing more damage to it than a severe head injury. Welcome to the world of Electroconvulsive Therapy – commonly referred to as ECT.

ECT was previously known as Electroshock Therapy when first introduced in 1938 by Italian neuropsychiatrists Ugo Cerletti and Lucio Bini who initially tested it on pigs. Between the 1940s and ‘60s, it was widely used as a form of treatment for conditions like depression, mania and schizophrenia. Psychiatrists alleged that electric shocks to the brain cured obsessive and difficult mental patients and made them meek and manageable.

ECT received exceptionally bad press in the 1970s after it was used in the film One Flew Over the Cuckoo’s Nest, based on the novel by Ken Kesey. Jack Nicholson played a character in a psychiatric hospital who was given ECT as punishment. Its practice has often been described as barbaric and has been compared to a form of torture not unlike that used by various tyrant regimes, including electric torture used by the Nazis during the Second World War.

Each year over one million people worldwide have ECT – two-thirds are women and over three-quarters of all patients are over the age of sixty. There has been a steep increase in ECT statistics in the UK in the last five years with a current estimate indicating that around 30,000 have ECT each year. This is in contrast to previous decades that saw figures decrease to around 2,000 each year from its peak in the 1980s when figures were as high as 50,000 and above. In the past, it was claimed to be used only as a last resort for those who were seriously depressed. Nowadays, it is widely used and even given to women suffering from post-natal depression and older people in their seventies and eighties. Now, after years of relatively low usage because of the global preference for antidepressants, ECT has started to make a comeback. New marketing of ECT claims it to be a safe and effective treatment that can be used on those who are resistant to antidepressants and whose depression remains enduring despite the use of psychotropic drugs. Psychiatrists also claim ECT is beneficial in subduing unwanted emotions and proving more effective than antidepressants because it solves the underlying symptoms of depression. Could a reason for this be that ECT kills brain cells resulting in less brain function and is, therefore, less operational?

The science behind ECT is non-existent with psychiatrists acknowledging they have no idea how it works which has resulted in accusations of them being woefully ignorant about electricity and its effects on the brain and body. Nevertheless, they administer patients with up to 460 volts of raw electricity through a special ECT machine called a thymatron. Since every person is different, the amount of electricity needed to induce a seizure on each patient is also different. Before ECT takes place, the patient is given a paralysing drug called succinylcholine which is the same drug used on prisoners on death row before they are given a lethal injection.

Electrodes are placed on the patient’s temples and then the thymatron is switched on resulting in the electric current running throughout the brain and body before the person has an induced convulsion. During ECT, the brain copes with up to 2,300 times more electricity than it needs to function, which in turn leads to severe trauma. Each treatment takes just a few minutes and is initially administered two or three times a week with some patients having up to 35 treatments per year – especially those who are recommended to have follow-up treatments referred to as ‘maintenance sessions.’

Opponents of ECT claim it is a form of torture and not a bona fide medical treatment. The words used to describe it are ‘brutal – cruel – and inhumane.’ Despite acknowledging that years of memories are wiped out of the mind after a course of ECT, psychiatrists still claim its usage exceeds its disadvantages despite a long list of side-effects that includes: destructions of brain cells, cognitive decline, permanent memory loss, lowering of intellectual ability including a lower I.Q., recurring spontaneous seizures, personality changes, blood clots, brain haemorrhage, cardiac problems, stroke and a reduced lifespan. MRI scans on people who have had ECT have revealed brain shrinkage along with severe damage because the immense heat of the electricity tears holes in the brain cells.

As well as the risk of lasting brain damage, ECT can be fatal in some cases and in others, it leads to suicidal thoughts and suicide itself. Did you know that the writer Ernest Hemingway committed suicide after a course of ECT? Before his death, he wrote: ‘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.’ His words are as true today as they were at the time of his death in 1961. Indeed, this great writer’s legacy would have been all the richer had people listened to his poignant and wise words and sought to have ECT banned. Hemingway wasn’t the only famous person to have had ECT – others include Clementine Churchill (wife of Sir Winston Churchill), Judy Garland, Vivien Leigh, Sylvia Plath and Yves Saint-Laurent.

The psychiatric profession itself is split about ECT. Those who advocate its practice state that clinical and research determines it to be a safe, effective, painless and sometimes life-saving treatment for emotional and mental disorders. Some psychiatrists have said they have seen ECT relieve very severe depressive illnesses when other treatments have failed, before adding that a significant percentage of people with severe depression commit suicide and that ECT has saved patients’ lives. They claim the overall benefits are higher than the risks. Indeed, some patients agree that ECT has worked for them and state they wouldn’t hesitate in having it again if their depression returns. The counter-argument to this comes from psychiatrists who say ECT belongs to the past and want to see it banned. They fully acknowledge the severe side-effects and state that psychiatrists have either intentionally or recklessly ignored how ECT causes permanent damage to the brain and the mind.

They are also sceptical of patients who claim their condition improved after ECT because of its track record of causing harm to the brain. Electricity not only travels through the frontal lobes – the seat of intelligence, thoughtfulness, creativity and judgment – it also goes through the temporal lobes – the seat of memory.

Perhaps what you have read so far has shocked and upset you, but I’m afraid there is still worse to come. Despite the World Health Organisation advising against the use of ECT on children, it is now being used on children and young people who are deemed severely depressed or those with ADHD (Attention Deficit Hyperactivity Disorder) and children with autism who self-harm. It is often used on children in America in preference to first prescribing psychotropic medication. Although there is no evidence that it has been used on children in the U.K. and Ireland, it is known to have been used on children in Australia and in Turkey. This is incredibly wrong given the damage it is likely to cause to the nerve cells still developing in children, knowing that it causes seizures as well as the possibility of it leading to cognitive and learning difficulties.

The monopoly and profiteering between the psychiatric profession and the pharmaceutical industry have been well reported over the years. What isn’t initially clear though is how psychiatrists benefit financially from ECT. They receive a substantial extra income for recommending and carrying out ECT on patients because they must be present when the procedure is administered. It is estimated, for instance, if a psychiatrist carries out 20 sessions a week, they will earn an extra few hundred thousand pounds each year. This is fast becoming a lucrative business within a much unregulated and unethical system. It is shameful to think that large amounts of money is earned through these means when the bulk of the work merely entails flipping a switch on a machine and results in unremitting misery and personal suffering caused by the damage this brutal procedure evokes.

ECT is banned in Luxembourg, Slovenia, Northern Italy, and certain cantons of Switzerland and in some American states – which leads to question if Britain is any closer to banning it too. The truth is, probably not, although there are several survivors of ECT who have become well-known activists and are making their voices heard around the world by writing books and doing public speeches about their experiences. These include Dr John Read (University of Liverpool), Mary Maddock (Mind Freedom International/Ireland), Ted Chabasinski (U.S. Human Rights Lawyer) and Linda Andre (American author).

Lobbying in Britain is no easy feat because successive governments haven’t been receptive to changing the medical model of treatment, so therefore, it is essential for survivors of ECT to make their voices heard. Organisations like Mind Freedom International and the Citizens Commission on Human Rights are doing their best to educate the public. Through public protests, they highlight how deceptive psychiatry is when they say ECT these days is different and less harmful than in the past.

In Ireland, the late Dr Michael Corry, another outspoken opponent of the use of electro-convulsive therapy in the treatment of mental illness, led a campaign to end ECT. This resulted in a private members’ bill being introduced into the senate in 2008 which would have barred the forced use of ECT – use without informed consent. While the government did not accept the bill as proposed, the Minister for Mental Health started a consultation process which may have led to the first steps towards ending this practice. Sadly, Dr Corry died in 2010, ending the campaign.

Being able to make an informed choice is key to all of this because as Shakespeare once wrote, ‘there is no darkness but ignorance.’ Survivors of ECT need their voices to be heard by professionals, including those in the mental health field, to ensure that others might be spared the suffering they’ve endured. It is therefore important that ECT is never thrust upon someone without them being able to make an informed decision. They need the chance to weigh up the arguments for and against. The literature and information in the public domain on ECT is primarily negative, although a handful of psychiatric books support it. But it is essential for any person who encounters ECT to read books and search for YouTube clips to reach a conclusion that hopefully prevents them making the most regrettable decision of their lives. Education and being fully informed is paramount in all of this.