Excuse the poor video quality here though the sound is fine. Not sure whether using the “selfie mode” on my iPhone made the video poor or what?? Anyone have suggestions? Anyhow I would love reactions to my reading below….(Just nothing obvious on how bad the vid quality is. I ALREADY know this! By the way, I made this for David H. and his project in the U.K. so that is why I referred to the Brits in it…
Mentally strong people have healthy habits. They manage their emotions, thoughts, and behaviors in ways that set them up for success in life. Check out these things that mentally strong people don’t do so that you too can become more mentally strong.
They Don’t Waste Time Feeling Sorry for Themselves. Mentally strong people don’t sit around feeling sorry about their circumstances or how others have treated them. Instead, they take responsibility for their role in life and understand that life isn’t always easy or fair.
They Don’t Give Away Their Power. They don’t allow others to control them, and they don’t give someone else power over them. They don’t say things like, “My boss makes me feel bad,” because they understand that they are in control over their own emotions and they have a choice in how they respond.
They Don’t Shy Away from Change. Mentally strong people don’t try to avoid change. Instead, they welcome positive change and are willing to be flexible. They understand that change is inevitable and believe in their abilities to adapt.
They Don’t Waste Energy on Things They Can’t Control . You won’t hear a mentally strong person complaining over lost luggage or traffic jams. Instead, they focus on what they can control in their lives. They recognize that sometimes, the only thing they can control is their attitude.
They Don’t Worry About Pleasing Everyone. Mentally strong people recognize that they don’t need to please everyone all the time. They’re not afraid to say no or speak up when necessary. They strive to be kind and fair, but can handle other people being upset if they didn’t make them happy.
They Don’t Fear Taking Calculated Risks. They don’t take reckless or foolish risks, but don’t mind taking calculated risks. Mentally strong people spend time weighing the risks and benefits before making a big decision, and they’re fully informed of the potential downsides before they take action. You may be interested in this too:
14 Things Positive People Don’t Do
They Don’t Dwell on the Past. Mentally strong people don’t waste time dwelling on the past and wishing things could be different. They acknowledge their past and can say what they’ve learned from it. However, they don’t constantly relive bad experiences or fantasize about the glory days. Instead, they live for the present and plan for the future.
They Don’t Make the Same Mistakes Over and Over. Mentally strong people accept responsibility for their behavior and learn from their past mistakes. As a result, they don’t keep repeating those mistakes over and over. Instead, they move on and make better decisions in the future.
They Don’t Resent Other People’s Success. Mentally strong people can appreciate and celebrate other people’s success in life. They don’t grow jealous or feel cheated when others surpass them. Instead, they recognize that success comes with hard work, and they are willing to work hard for their own chance at success.
They Don’t Give Up After the First Failure. Mentally strong people don’t view failure as a reason to give up. Instead, they use failure as an opportunity to grow and improve. They are willing to keep trying until they get it right.
They Don’t Fear Alone Time. Mentally strong people can tolerate being alone and they don’t fear silence. They aren’t afraid to be alone with their thoughts and they can use downtime to be productive. They enjoy their own company and aren’t dependent on others for companionship and entertainment all the time but instead can be happy alone.
They Don’t Feel the World Owes Them Anything. Mentally strong people don’t feel entitled to things in life. They weren’t born with a mentality that others would take care of them or that the world must give them something. Instead, they look for opportunities based on their own merits.
They Don’t Expect Immediate Results. Whether they are working on improving their health or getting a new business off the ground, mentally strong people don’t expect immediate results. Instead, they apply their skills and time to the best of their ability and understand that real change takes time
Now I want to share a website where you can find out more about YOU, and why you are the way you are. This website provides a test and a resulting personality profile, which will give you a clue about your ways of being and how and why your interact with others the way you do, as well as your preferences in life for being and doing. http://16personalities.com The test here is free and may be saved as long as you remember to register by putting in your email. The basic profile is free and you can pay for an indepth one but once you get your test results, which is four letter code, much info is available for free on the internet.
Another site, with the official Myers-Briggs test or MBTI, of which the 16 Personalities is a version, and gives much the same results, and this can be found here: https://my-personality-test.com then go to the Personality TYPE test. Now, some of you may be fearful of being labelled but the thing about the MBTI is that it has nothing to do with labels being IMPOSED but any individual’s personal preferences leading to their type being discovered. I found it quite extraordinary, after taking the test a few times, and getting the same results each time, upon reading my profile with an open mind, just how predictive as well as descriptive of my behavior it was. The one thing it never is was prescriptive. It does not tell you what you HAVE to do only what you are likely to want to do or how you are likely to react in any given situation, given your personal preferences in life, and your personality style. Try it, if you don’t like it or don’t respond to it on a visceral level, disregard it!
I remember names…some of them. For instance, the short, chubby, blond nurse, who was worried about her weight and who was so instrumental in torturing me? Her name was Debra. And the head nurse who seemed so oblivious to the fact that her policies were indeed torture, even though she admitted that she expected the guards to inflict pain on patients when “escorting” them to seclusion in order to “subdue them faster” as she put it to me, openly. Her name was Barbara, and even though I was horrified by things she told me, I believe that she was innocently deluded and believed in her job, did not mean to be mean, not the way Debra seemed to, and honestly wanted the best for her patients. But let me start at some beginning which is to say, anywhere at all, and give you an idea of what I am talking about.
I have written in multiple places and on many occasions about what happened to me at New Britain Hospital (aka Hospital of Central Connecticut on Grand Street in New Britain) and I do not want to go into the whole thing here. All you need to do is search on the subject of Michael E Balkunas at this blog and you will get most of the gory details. That said, much that happened has never been told not even here. For instance, that Debra was the nurse who in a sadistic impulse and in an apparent fit of frustration, decided to have the security guards strip me naked when she was secluding me for some unknown (and always unnecessary) reason yet again…as they did nearly daily at W-1 in New Britain Hospital in May 2014….that it was Debra who was directly responsible for this I have never stated. But I remember her name clearly, and her face….And the fact that after she did this the second or third time she went on leave for several days, and when she came back told me she had almost quit her job.
I was momentarily cheered because I thought perhaps she had had some serious regrets about what she’d done to me. I asked her, Was it because of me? I thought she would tell me yes. She looked at me, and nodded, then said, “Because you are such a challenging patient.” Huh? I looked at her, and saw no remorse, no regrets only residual anger and scorn…and a certain unrepentant rancor that I had “made her do what she did.” Clearly she felt that I was to blame for her behavior, that I was to blame in general and that it was all justified.
But to get back to what happened. After she had me stripped naked by four male guards, after I loudly and vociferously protested being left alone in that freezing seclusion cell for I never knew how long, I began mildly hitting my head on the wall in protest. They threatened to four-point me and then they came barreling back in and threw me onto a restraint bed. The thing is, I knew, completely naked, I could not take the cold in that seclusion cell. But if they restrained me they would HAVE to cover me with something, and at the very least I would not freeze to death in that frigid cell for an indefinite number of hours…But when they came for me, they grabbed me and angrily threw me onto a gurney, even though I put up no resistance, spread-eagled my legs, deliberately exposing my private parts, and shackled them to the corners of the gurney with my arms pinioned above my head until I shrieked in pain even as they laughed. Then they held me down, gratuitously I might add, since I was already restrained, compressing my neck and chest, in order to give me the usual three-injection cocktail of punishment drugs — Haldol, Ativan and Benadryl — forcibly slammed into my buttocks. All of this done to me while I was naked and immobilized in four point restraints. Then fearing that they would leave me alone there, freezing cold, I screamed for them to cover me. With a look of disgust, someone threw a draw sheet over me, but no more.
The charge nurse came in for my “face to face” interview to see that all was “proper” and she visibly and audibly shivered, but refused me a warm blanket, or any at all, due to “safety concerns.” Then she left with the rest of them and turned off the intercom, so “we won’t have to listen to her scream.” They closed the door behind them, leaving me all alone behind a metal cell door that did not even have an observation window in it.
I screamed from the base of my lungs as deeply and as loudly as I could for as long as I could last. No one took mercy on me or brought me water or a blanket or spoke to me the entire time. Only when, exhausted, I finally lapsed did they relent and ask, from outside the door, “can we turn the intercom back on? She is quiet now…” And apparently got assent for that… Because eventually I heard someone flip a switch but nothing more.
After I was released, the next day, I told the unit director, Dr Michael E Balkunas what they had done to me, and he must have recognized the egregious nature of it because his response is telling. Instead of dismissing it as not so terrible, he said: “They would NEVER do such a thing as that in my hospital. You are a liar!” So he saw how awful it had been, what they had done to me, he just refused to acknowledge it had happened, and that he did not in fact what his staff were up to. But I was never in fact the liar he believed me to be. His stock answer to everything he did not want to see or believe was routinely that I was lying, but this was not true, and he was so sickeningly dismissive of the truth that I did not wait to listen to more this time. I was so wiped off the map by his response that I got up and walked out of the interview room and did not bother with him from then on…I KNEW I was never a liar, and that in actuality it was the STAFF who lied all the time, but telling Balkunas that would have done no good. He wanted to believe what he wanted to believe and nothing i said got through to him from day one…So I thought, so why bother ? WHY BOTHER. Balkunas wanted to murder my body and my spirit, and I could not let him succeed. He could imprison my body in his hospital, but i was damned if i would let him get my spirit. FUCK HIM!
But Dr Balkunas, Michael, you did not in point of fact know what went on at W-1 ever, nor at the ER, when you were there. Abuse was rampant because you encouraged it to be…and you never cared much what they did to achieve “order” so long as it was “quiet” when you were around. So you gave tacit assent to the tortures that they inflicted, and you likewise tacitly approved the very behaviors that you told me would “never happen on your watch”…Yeah? Well, I feel certain that if they behaved as they did towards me, they had done it before me, and did so to others after I left as well…and they continue to inflict these things on patients to this day.
I will leave it there. Your unit staff and you too, Balkie, are Out of control, and deserve, as my Obama post notes, to be CLOSED down for good.
The other day I made this little polymer clay figure to illustrate what Debra did to me.
It blew me away and I could not sleep all night the night I made her….Until Wendy and I decided to heal her, and perhaps heal me, from the experience, First, talking to the figure in the little bed calmly and with compassion, we covered her with a thick cotton blanket. That brought me some relief as I no longer felt chilled. Then we took off the restraints, which despite being made of polymer clay actually slipped right off, and we brought her arms down to her sides so she could sleep in comfort. By the time we were through I felt immensely better.
Neither of us could even imagine treating another human being as Balkunas had had me treated on numerous occasions by routine.
My drawing of my mother, Marian Wagner Spiro, suffering from the effects of dementia, wearing the iPod and headphones I gave her. (from a photo taken by my sister, Martha, in the last weeks of mom’s life…)
There is so much to say, and so little that I find myself capable of saying at this time. The loss of one’s mother, no matter how fraught the relationship, is always incalculable, quite literally unable to be calculated. Because of the divorce from much of my family, included the extended network of cousins and so forth, imposed by my father for nearly forty years, I lost many years and many memories I might have made with my mother, and needless to say with the rest of my native family. However, because of this, along the way I learned the value of friendship, not just the emotional support and love from some one significant other, since I had none, but the kind of friendship about which it has been written: Greater love hath no man than this, that a man lay down his life for his friends. I learned what true friends are, and that they can love a person and care about a person perhaps with deeper love and kinder regard even than one’s family of origin.
This is not to say that I do not love and care about my family, of course, but it is my friends to whom I dedicated my newest book of poems and art, my friends both old and new. And they know who they are, I am sure they do. Because I feel it and I know it.
But that much said, I loved my mother, and what is more, I know she loved me and would have wanted me to have these loving friends in my life, especially once she understood that having a nuclear family of my own was not in the picture for me. I do not believe that she cared about whether I ever became a doctor or even a successful poet or artist, but only that I found contentment and love in my life, somewhere, somehow, and that she would be proud of me now, not for my achievements but for all these wonderful friends whom I love and who I know love me in return ( and in return for nothing except being me).
I love you, Mom, and I wish you well on your journey, wherever that takes you…Be at peace and know that all is well.
I wrote this poem, or started it the night of my last visit to my mother, after weeks of not being able to put pen or pencil to paper. My younger sister, Martha and I had been splitting up the time and watch at the Hospice, though Martha had done the lion’s share of everything, living as it were just around the corner, while I needed a driver to get me first to Agawam and then to from Vermont to Amherst each day. In any event, just as I was finishing it, Martha called me with tears in her voice telling me that mom had passed away more suddenly than expected, no time to call me to come down to the hospice to be with her at the end.
HIATUS – June 18, 2017
“Just letting you know I am taking a hiatus because my mother is in the process of passing away and I need to give that my full focus.”
In the snapshot I take, you are almost not there,
barely stitched to your body by broken breathing,
those strands of beads upon which none of us pray
to keep you here, still here, still here…
the seeming years of days and nights
of your going having frayed the long wick of your life
till it seems impossible your heart pulses and breath
still clings to the flesh that clings to your bones.
In the stillness like stopped breath,
as the clock duties our days, from your morphine remove,
you can’t know how we mark a terrible time
while we wait for what is to come,
the inexorable exit-gong sounding: It is done.
All the same, they say life starts over, Mother,
if there is ever any life on earth without you,
as if we believed this day would come, or any other,
I wrote the bulk of this piece back in Connecticut in 2013, when i still believed in the concept of mental illness yadda yadda. i am adding this preface in Vermont, from a place of somewhat greater stability and even more firmness.
Asexuality is not a common orientation but it is not unknown or in any fashion abnormal. As i note below, a good 1% of the human population may be asexual all their lives and many, many more may find themselves “asexual” at some time in their lives. I put the quotations around the word because i believe that those who find themselves suddenly asexual while taking certain psycho-tropic drugs may not quite understand that it is the medications that have induced this change in them, but sometimes the state is an unnatural change from their native orientation and not a natural state of affairs.
if you happen to be asexual, as i am, you surely know that it is not a state of being without discrimination. For one thing, people make assumptions about us that are almost always to our detriment, and they never bother to inquire first who or what we are about. For instance, i am 64, childless, unmarried, and unpartnered…and yet i like to contribute to the well-being of young people, either by teaching them or by assisting them in other ways. If i were married with children, i believe my intentions would not be regarded with suspicion, but as it is, i feel frequently suspected as some sort of sexual predator. An asexual friend of mine evinced similar feelings, saying that he could not invite a friend from work out for a drink without that person clearly fearing that he was being “hit on” when all my friend ever wants is friendship from anyone, male or female!
I dont understand why the A in LGBTQIA stands for “allies” not for “asexual” and why there is still no place for us within it.
Let me state this plainly so there is no misunderstanding: I am tired of people thinking there is something wrong with me just because I do not have a husband or boyfriend/lover or even a girlfriend/lover or a love-interest of any kind. I am not interested in sex and have never been interested in sex for whatever reason. This does not distress me and it never would have in the past, had others not insisted that it ought to. I have finally come to the conclusion that being asexual — definition: having no interest in a sexual relationship with another person — is okay.
I am not unhappy. I get a lot done and I am likely more satisfied by my life as an asexual than someone who is sexual and without a partner. I am never lonely. And I have tons of friends. (At least 16 friends — all of whom I adore — came to my 60th birthday party!)
It has taken me, via a tortuous up and down path, a long time to come to this position. And there may well be those who shake this foundation yet, as other people’s opinions, alas, still manage to have a strong effect on me. I have never told openly the story I am now going to relate, but I think it is time. It should be an eye-opener and a warning to those who believe they have the right, even the duty to “help” a young person discover “her true identity…”
As some of you know, a very long time ago, I was a student in a medical school in Connecticut. The two years I attended med school were extraordinarily difficult ones for me and I admit now that even as I matriculated, I “knew” at an almost conscious level that I would never get through. I didn’t honestly want to be a physician. Not really. Oh, yeah, I thought I could be a good psychiatrist. I knew that I understood people and mental illness enough to empathize and help others. But the notion that I could successfully get through four years of med school and four years of residency in order to achieve that goal was something I also knew would be impossible, even as I nominally attempted to undertake it. I had no choice. It was what you did in my family. And there was no question in my mind that I could work at a “regular 8-hour a day job.” I simply didn’t have the stamina either interpersonally or physically. I didn’t know why, I just didn’t. (I also didn’t understand that I had narcolepsy, so I construed my constant drowsiness as “boredom” for everything.)
So there I was in med school, without the ability to make friends or any interest in relationships, especially having just broken up with Bruce, the one boyfriend I had had and with whom I had sex (because he pushed it). I hated it…which was why I broke it off. I know I was noticed. I felt noticed. Possibly because I made little effort to be friendly, possibly because my narcolepsy made me noticeable. I don’t know. It is not that I was or am a striking person at 5′ 3″ and 105 lbs…hardly! Perhaps it was my mere aloneness that struck people. I dunno.
Things were hard to start with, but then the voices started up telling me to hurt myself and I acted on their commands, frequently. I had horrific nightmares nightly. And I could not stay awake in class or to study no matter what I did. People had all sorts of advice and jokes for me but no understanding. They gave me No-Doz and Vivarin for my birthday, which precipitated a caffeine-toxic all-night-up of horror. They took photos of “Rip van Winkle” sleeping on the med school lobby couch and published it in our newsletter. No one knew what was really going on, at home, at night, in my bedroom when the voices took over.
I had a run-in with the student health doctor, Dr E, to whom I had gone about possible Reynaux (sp?) Syndrome. When she saw certain scars on my body she became concerned and spoke with the psychiatrist I was seeing at the time. Dr S, who was a cold man who seemed to dislike me from the start, was angry at our next appointment for “parading” my wounds and warned me against ever doing so again.
I went back to Dr E and told her what Dr S had said. She seemed perturbed and gave me the name of a therapist that she said she often referred “troubled students” to. I might consider seeing Tamara instead of Dr S. The other students liked her a lot, Dr E said. What were their problems? I asked. Dr E shook her head and responded, Not so very different from yours.
I sit nervously in the waiting room, hoping that Tamara will be so late she won’t have time to see me today after all. I feel sick to my stomach and wonder why I’ve come. Five minutes late, ten minutes late. I am just about to leave when a very pregnant woman opens the door to the office and welcomes me in. I do not look at her face but whisk myself inside, trying not to guess how many more weeks she has.
Before she asks me anything, Tamara says, “Now, I see girls who like girls and boys who like boys. You’re okay with that?”
What is she talking about? I don’t understand. Girls who like girls? I like girls, I like boys. Why shouldn’t I be okay with it? So I say, yes. And assume that even so, she sees people whose issues are very different…
I didn’t ask her. I simply assumed that she had other interests. And went on from there. But it was critical, because I did not get that she was conducting therapy as if I had agreed that I was a lesbian, and yet I had made no such admission. I did not even understand what she was getting at. Why was she so coy? Why didn’t she just come out and ask me whether or not I was gay and then tell me that she only treated lesbians and gays with issues around their sexuality?
As it turned out, she had no idea that I was not in fact assenting to her coy proposition that I “liked girls.” On the contrary, if she had asked me point blank, I would likely have said, “Me? No way. I am not even interested in boys. I couldn’t care less about sex. I like, but don’t love, boys and girls…so to speak.” But the operant word, clearly, was not “like” at all, but love, as in “making love.”
Actually, in point of fact, I would not have been able to respond at all, if I remember my former self accurately. I was nearly mute much of the time, esp in therapy, and when I did speak it was often very cryptically and with difficulty making myself clear. This may account for the misunderstanding that so horrified me in what follows.
It was a crazy-making psychotherapy for about 6 months. I had no idea what notion she was operating under, because I didn’t know what kind of therapy she “did.” Likewise, if she knew the least thing about me, it was completely mis-colored by her mis-understanding of me as a lesbian. So when one afternoon she “told” me that she empathized with me, because I had had a sexual relationship with my previous psychiatrist…I hit the roof.
“WHAT? What the F— are you talking about?!” I nearly leapt out of my chair.
“It’s okay Pam, I understand,” she soothed me.
“It is NOT okay! I never said anything of the sort! This is YOUR filthy mind! I’m out of here. Go to hell!” And with that I got up and walked out. I realized then that she was nuts. Somehow she had gotten the entirely wrong idea, but I didn’t understand how. It made no sense to me. Where on earth had she fashioned that notion? I certainly had never said any such thing…
Then her statement “I treat girls who like girls…” came back to me. And I understood more. Dr E surely knew Tamara’ orientation, her clinical expertise, so Dr E must have believed that I needed to talk about conflicts about my “homosexuality,” about coming to terms with being a lesbian, unbeknownst to me. So she had set it up that I see Tamara, believing that she knew me better than I knew myself. But what right had she to do that? And how would she know whether or not I was a lesbian? Just because I was a conspicuous loner? How dare she? She knew nothing about me! What she had done was a violation of me as bad as any man who wanted to have sex just to prove he was Mr Right!
I spent a lot of time after that utterly paranoid that I might be gay, feeling that I must be gay, certain that I was gay…I even came to the point that I accepted it eagerly. But it was never true. It was just another identity forced on me by others who would not let me be. Who would not accept that I simply have never had interest in sex or sexuality beyond a pervasive non-sexuality. My libido, my psychic energy, is invested in other things, in art, in science and in life, but not in erotic interests. And you know what? Being non-sexual or asexual doesn’t make me an amoeba or less than human.
At least 1% of humanity is asexual, has always been asexual, permanently. That’s a LOT of people. We may not be the norm, but there are enough of us out there to rate your acknowledgement and the respect you would pay to any other human being. That’s all we ask, that’s all I ask. And for you not to try to change me just because you do not like it or understand my way of being. Thank you.
“You don’t know what you got till its gone ” This adage could be old or recent ,all Flor knows is that its true except for the fact that she knows exactly what she has ,and it isn’t lost yet! Humanity ,pursuit for justice still runs deep within me..and my hatred for barbarity in whatever version ,hasn’t moved an inch . It still stands but for reasons; my fear of it finding its way into our traditions. I give credit where its due but also dish out criticism where its due ..so I’ll spit it out however contradictory. Are you for erosion of the rule of law? Well Wachira’s daughter isn’t. Just so you know.
Earlier last April ,Kenyans on social media woke up to what I’d refer to as the most unfortunate scenario all told by a video which went viral depicting a broad-daylight extra judicial execution of a…
Just want to keep people aware that these things are absolutely continuing to this day. They have not stopped persecuting psychiatic patients just because YOU dont hear about it. Every single thing in this post has happened to me within the last five years, and is still happening to others. Remember, and dont forget it! Your relatives may not talk about it, but it is happening to someone.
All i can say is everything in this picture was as deliberate as i know how to make it, without planning it at all, and it contains symbolism both public and private. With reference to my signature quotation, (see below) it makes use of what the negative spaces offered me without leaving any in the end. “There is no negative space, only the shapely void. Hold your hands out, cup the air. To see the emptiness you hold is to know that space loves the world.” P. Wagner (for those who are not familiar with WWII, over the gates over Auschwitz, the notorious concentration camp where Jews and many other despised groups were taken to be tortured and killed, were emblazoned the words: ARBEIT MACHT FREI, or “work will set you free,” which was of course a lie and a horrible joke, because it was only meant to kill you at what was not a labor camp but just a death camp. ) PSYCHIATRIE MACHT FREI?
All i can say is everything in this picture was as deliberate as i know how to make it, without planning it at all, and it contains symbolism both public and private. With reference to my signature quotation, (see below) it makes use of what the negative spaces offered me without leaving any in the end.
“There is no negative space, only the shapely void. Hold your hands out, cup the air. To see the emptiness you hold is to know that space loves the world.” P. Wagner
(for those who are not familiar with WWII, over the gates over Auschwitz, the notorious concentration camp where Jews and many other despised groups were taken to be tortured and killed, were emblazoned the words: ARBEIT MACHT FREI, or “work will set you free,” which was of course a lie and a horrible joke, because it was only meant to kill you at what was not a labor camp but just a death camp. )
PSYCHIATRIE MACHT FREI?
Psychiatrie Macht Frei? Mixed media anti-psychiatry picture, 24″by 19″
I know the basic science, but the problem (so they tell us) is that the products are NOT safe and are not given at safe ages. Hepatitis B at birth?! Why? (That might be a good question) But not all vaccines are even efficacious. (How would we know that?) Plus we are making trivial diseases more dangerous. (We are?) You wonder why there are so many allergies and so much asthma in children? (Yes I do) And okay, why is autism astronomically increasing? WHY is it??? Watch this movie and then, yes, take a look further at the new film VAXXED.
(I did and I was taken, and taken in..and still am perplexed as to what the F is going on…Who is right and who is in the gd dark??? All i know is I have always believed in the science of vaccines, ever since I read about Jenner and cow pox as a child; way before Big Pharma had anything to do with anything. So I do not blame Jenner for anything…
Watch this movie but DO NOT CHECK YOUR REASON AT THE DOOR…Okay? Think, think think and question everything, then do your own research. Remember you are biassed even when you believe you are not. Do not take anything at face value or for granted…And question everything told to you as dogma. Especially when presented as DOGMATIC TRUTH but not backed by any proof. Remember: correlations are not causes.
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 generalized, 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. 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, p. 29). 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 anesthesia 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 Center 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 anesthetic during ECT…The anesthetic 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.
Reports of catastrophic memory loss date to the very beginning of ECT. The definitive study of ECT’s memory effects remains that of Irving Janis (1950). Janis conducted detailed and exhaustive autobiographical interviews with 19 patients before ECT and then attempted to elicit the same information four weeks afterwards. Controls who did not have ECT were given the same interviews. He found that “Every one of the 19 patients in the study showed at least several life instances of amnesia and in many cases there were from ten to twenty life experiences which the patient could not recall.” Controls’ memories were normal. And when he followed up half of the 19 patients one year after ECT, there had been no return of memory (Janis, 1975).
Studies in the 70s and 80s confirm Janis’ findings. Squire (1974) found that the amnesic effects of ECT can extend to remote memory. In 1973 he documented a 30-year retrograde amnesia following ECT. Freeman and Kendell (1980) report that 74% of patients questioned years after ECT had memory impairment. Taylor et al (1982) found methodological flaws in studies that purport to show no memory loss and documented deficits in autobiographical memory several months after ECT. Fronin-Auch (1982) found impairment of both verbal and nonverbal memory. Squire and Slater (1983) found that three years after shock the majority of survivors report poor memory.
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 standardization, labeling, 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-organized 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 organized 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:
Most of my life from 1975-1987 is a fog. I remember some things when reminded by friends, but other reminders remain a mystery. My best friend since high school in the 1960s died recently and with her went a big part of my life because she knew all about me and used to help me out with the parts I couldn’t remember. (Frend, 1990)
I haven’t had a shock for over ten years now but I still feel
sad that I can’t remember most of my late childhood or any of my high school days. I can’t even remember my first intimate experience. What I know of my life is second hand. My family has told me bits and pieces and I have my high school yearbooks. But my family generally remembers the “bad” times, usually how I screwed up the family life and the faces in the yearbook are all total strangers. (Calvert, 1990)
As a result of these “treatments” the years 1966-1969 are almost a total blank in my mind. In addition, the five years preceding 1966 are severely fragmented and blurred. My entire college education
has been wiped out. I have no recollection of ever being at the University of Hartford. I know that I graduated from the institution because of a diploma I have which bears my name, but I do
not remember receiving it. It has been ten years since I received electroshock and my memory is still as blank as it was the day I left the hospital. There is nothing temporary about the nature of memory loss due to electroshock. It is permanent, devastating, and irreparable. (Patel, 1978)
ECT AS TRAUMATIC BRAIN INJURY
Both psychiatrist Peter Breggin (Breggin,, 1991, p. 196) and
ECT survivor Marilyn Rice, founder of the Committee for Truth in Psychiatry, have pointed out that minor head injury as a result of trauma often occurs without loss of consciousness, seizures, disorientation, or confusion, and is thus much less traumatic than a series of electroshocks. A better analogy would be that each individual shock is the equivalent of one moderate to severe head injury. The typical ECT patient, then, receives at least ten head injuries in rapid succession.
Proponents as well as opponents of ECT have long recognized it as a form of head injury.
As a neurologist and electroencephalographer, I have seen many patients after ECT, and I have no doubt that ECT produces effects identical to those of a head injury. After multiple sessions of ECT, a patient has symptoms identical 😮 those of a retired, punch-drunk boxer.. .After a few sessions of ECT, the symptoms are those of moderate cerebral contusion, and further enthusiastic use of ECT may result in the patient functioning at a subhuman level. Electroconvulsive therapy in effect may be defined as a controlled type of brain damage produced by electrical means. (Sament, 1983)
What shock does is throw a blanket over people’s problems. It would be no different than if you were troubled about something in your life and you got into a car accident and had a concussion. For a while you wouldn’t worry about what was bothering you because you would be so disoriented. That’s exactly what shock therapy does. But in a few weeks when the shock wears off, your problems come back. (Coleman, quoted in Bielski, 1990)
We don’t have a treatment. What we do is inflict a closed-head injury on people in spiritual crisis.. .closed-head injury! And we have a vast literature on closed-head injury. My colleagues are not eager to have literature on electroshock closed-head injury; but we have it in every other field. And we have considerably more than people are allowing for here today. It is electrical closed-head injury. (Breggin, 1990)
There has never been any debate about the immediate effects of a shock: it produces an acute organic brain syndrome which becomes more pronounced as shocks continue. Harold Sackeim, the ECT establishment’s premier publicist (anyone who has occasion to write about or refer to ECT, from Ann Landers to a medical columnist, is referred by the APA to Dr. Sackeim) states succinctly:
The ECT-induced seizure, like spontaneous generalized seizures in epileptics and most acute brain injury and head trauma, results in
a variable period of disorientation. Patients may not know their names, their ages, etc. When the disorientation is prolonged, it is generally referred to as an organic brain syndrome. (Sackeim, 1986)
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 organized, thoughtful people who
have a good sense of what their problems are. Weeks later I see
them wandering around the halls, disorganized 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)
A standard information sheet for ECT patients calls the period
of most acute organic brain syndrome a “convalescence period” and warns patients not to drive, work, or drink for three weeks (New York Hospital-Cornell Medical Center, undated). Coincidentally, four weeks is the maximum time period for which proponents of ECT can claim alleviation of psychiatric symptoms (Opton, 1985), substantiating the statement made by Breggin (1991, pp. 198-99) and throughout the ECT literature that the organic brain syndrome and the “therapeutic” effect are the same phenomenon.
The information sheet states as well that after each shock the patient “may experience transitory confusion similar to that seen in patients emerging from any type of brief anesthesia.” This misleading characterization is belied by two doctors’ published observations of patients after ECT.(Lowenbach and Stainbrook, 1942). The article begins by stating “A generalized convulsion leaves a human being in a state where all that is called the personality has been extinguished.”
A compliance with simple commands like opening and closing the eyes and the appearance of speech usually coincide. The first utterances are usually incomprehensible, but soon it is possible to recognize first the words and then sentences, although they may have to be guessed at rather than directly understood…
If at this time patients were given a written order to write their name, they would not ordinarily follow the command…if then the request was repeated orally, the patient would take the pencil and write his name. At first the patient produces only scribbling and has to be constantly urged to continue. He may even drop back into sleep. But soon the initial of the first name may be clearly discernible…Usually 20 to 30 minutes after a full-fledged convulsion the writing of the name was again normal…
The return of the talking function goes hand in hand with the writing ability and follows similar lines. The muttered and seemingly senseless words and maybe the silent tongue movements are the equivalent of scribbling.. .But as time goes on it “is possible to establish question and answer sessions.. .From now on, the perplexity of the patient arising from his inability to grasp the situation pervades his statements.
He may ask if this is a jail. ..and if he has committed a crime.. The efforts of the patient to re-establish their orientation almost always follow the same line: “Where am I.”… know you” (pointing to the nurse)… to the question “What is my name?” “I do not know”…
The patient’s behavior when asked to perform a task such as to get up from the bed where he lies demonstrates another aspect of the process of recovery.. .he does not act according to voiced intentions. Sometimes urgent repetition of the command would set off the proper movements; in other cases beckoning had to be initiated by pulling the patient from the sitting position or removing one leg from the bed.. .But the patient then frequently stopped doing things and the next series of actions, putting on his shoes, tying the laces, leaving the room, had each time to be expressly commanded, pointed out, or the situation had to be actively forced. This behavior indicates lack of initiative…
It is possible, indeed likely, that a patient and her family could read the entire information sheet mentioned earlier and have
no idea that ECT involves convulsions. The words “convulsion” or “seizure” appear not at all. The sheet states that the patient will have “generalized muscular contractions of a convulsive nature”.
Recently Dr. Max Fink, the country’s best-known shock doctor, offered to let the media interview a patient right after a course of electroshock… for a fee of $40,000 (Breggin, 1991, p. 188).
It is common for persons who have received ECT to report being “in a fog”, without any of the judgment, affect, or initiative of their former selves, for a period of up to one year post-ECT. Afterwards they may have little or no memory of what happened during this period.
I experienced the explosion in my brain. When I woke up from the blessed unconsciousness I did not know who I was, where I was, nor why. I could not process language. I pretended everything because I was afraid. I did not know what a husband was. I did not know anything. My mind was a vacuum. (Faeder, 1986)
I just completed a series of 11 treatments and am in worse shape than when I started. After about 8 treatments I thought I had improved from my depression.. . I continued and my effects worsened. I began experiencing dizziness and my memory loss increased. Now that I had the 11th my memory and thinking abilities are so bad I wake up in the morning empty-headed. I don’t remember many past events in
my life or doing things with the various people in my family. It is hard to think and I don’t enjoy things. I can’t think about anything else. I can’t understand why everyone told me this procedure was so safe. I want my brain back. (Johnson, 1990)
LONG-TERM EFFECTS OF ECT ON COGNITIVE AND SOCIAL FUNCTIONING
The loss of one’s life history–that is, loss of part of the self–is in itself a devastating handicap; but added to this unique quality of ECT head injury are the cognitive deficits associated with other types of traumatic brain injury.
There is not now nearly enough research on the nature of ECT cognitive deficits, or of the impact of these deficits on social roles, employment, self-esteem, identity, and long-term quality of life for survivors. There is only one study which examines how ECT (negatively) affects family dynamics (Warren, 1988). Warren found that ECT survivors “commonly” forgot the very existence of their husbands and children! For example, one woman who had forgotten she had five children was furious when she found out her husband had lied to her, telling her the children belonged to a neighbor. Husbands frequently used their wives’ amnesia as an opportunity to reconstruct marital and family history, to the husbands’ advantage. Clearly, Warren’s study suggests there is much to explore in this area.
There is currently no research which addresses the question of how best to meet the rehabilitative and vocational needs of ECT survivors. One such study, proposed but not implemented in the 1960s, is described in Morgan (1991, pp. 14-19). Its hopeful conclusion that “with enough data, it may some day be possible to deal therapeutically with ECT-damaged patients, perhaps with some radically new approach to psychotherapy, or direct re-education or modification of behavior” has, a generation later, not come to pass. Funding sources such as the National Institute on Disability and Rehabilitation Research must be encouraged to sponsor such research.
The research which exists shows that sensitive psychometric testing always reveals cognitive deficits in ECT survivors. Even given the differences in available testing methods, the nature of these deficits has remained stable over 50 years. Scherer (1951) gave tests of memory function, abstraction, and concept formation to a group of survivors who had received an average of 20 shocks (using brief-pulse or square wave current, the type that is standard today) and to a control group of patients who did not receive ECT. He found that “lack of improvement as between pre- and post-shock results may indicate that shock has injured the patient to the extent that he is unable to achieve his premorbid intellectual potentialities, even though he can shake off the intellectually debilitating effects of the psychosis.” He concluded that “harmful organic results in areas of intellectual function.. .may nullify the partial benefits of the treatment.”
Templer, Ruff and Armstrong (1973) found that performance on
the Bender Gestalt test was significantly worse for persons who had received ECT than for carefully matched controls who had not.
Freeman, Weeks and Kendell (1980) matched a group of 26 ECT survivors with controls on a battery of 19 cognitive tests; all of the survivors were found to be significantly cognitively impaired. The researchers attempted to attribute the impairment to drugs or mental illness, but could not do so. They concluded that “our results are compatible” with the statement that ECT causes permanent mental impairment. The interviews with survivors revealed almost identical deficits:
Forgetful of names, gets easily sidetracked and forgets what he was going to do.
Forgets where she puts things, can’t remember names.
Memory poor and gets confused, to such an extent that he loses jobs.
Difficult to remember messages. Gets mixed up when people tell her things.
Said she was known in her bridge club as the “computer because of her good memory. Now has to write things down, and misplaces keys and jewelry.
Can’t retain things, has to make lists.
Templer and Veleber (1982) found permanent irreversible cognitive deficits in ECT survivors given neuropsychological testing. Taylor, Kuhlengel and Dean (1985) found significant cognitive impairment after only five shocks. “Since cognitive impairment is such an important side effect of bilateral ECT, it seems important to define as carefully as possible which aspects of the treatment are responsible for the deficit,” they concluded. Although they did not prove their hypothesis about the role of an elevation in blood pressure, “It is important to continue to search for the cause or causes of this impairment. If this important side effect could be eliminated or even modified, it could only be a service to patients…” But there is no separating the so-called therapeutic effects from the disabling cognitive effects.
A study-in-progress designed and implemented by members of the National Head Injury Foundation (SUNY Stony Brook, unpublished thesis project) with the same size sample as the Freeman et al study uses a simple self-scoring questionnaire to evaluate cognitive deficits in both the acute and chronic organic brain syndrome stages. The study also elicits information about coping strategies (self-rehabilitation) and about the amount of time it takes to accommodate to deficits.
All respondents in the study indicated they suffered from common symptoms of head injury both during the year after ECT and many,
many years afterwards. The average number of years since ECT for
the respondents was twenty-three. 80% had never heard of cognitive rehabilitation.
Only one-fourth felt they had been able to adjust to or compensate for their deficits by their own efforts. Most indicated they were still struggling with this process. Of those few who felt they had adjusted or compensated, the average number of years to reach this stage was fifteen. When those who had adjusted or compensated were asked how they did it, the most frequently cited answer was “hard work on my own.”
Respondents were asked if they would have liked acknowledgment of or help with their cognitive problems during the year after ECT, and whether they would still like help regardless of how long ago they had been shocked. All but one of the respondents said they would have wanted help in the post-ECT year, and 90% said they still wanted help.
In the last several years with the increased availability of neuropsychological testing, increasing numbers of ECT survivors have taken the initiative where researchers have failed, and have had testing done. In every known case, testing has shown unmistakable brain dysfunction.
Patients’ accounts of cognitive deficits from diverse sources
and across continents remain constant from the 1940s to the 1990s. If these people are imagining their deficits, as some shock doctors like to claim, it is unthinkable that patients over five decades should all imagine exactly the same deficits. One cannot read these accounts without calling to mind the description of minor head injury in the National Head Injury Foundation brochure “The Unseen Injury: Minor Head Trauma”:
Memory problems are common.. .You may be more forgetful of names, where you put things, appointments, etc. It may be harder to learn new information or routines. Your attention may be shorter, you may be easily distracted, or forget things or lose your place when you have to shift back and forth between two things. You may find it harder to concentrate for long periods of time, and become mentally confused, e.g. when reading. You may find it harder to find the right word or express exactly what you are thinking. You may think and respond more slowly, and it may take more effort to do the things you used to do automatically. You may not have the same insights or spontaneous ideas as you did before.. .You may find it more difficult to make plans, get organized, and set and carry out realistic goals…
I have trouble remembering what I did earlier this week. When I talk, my mind wanders. Sometimes I can’t remember the right word to say, or a co-worker’s name, or I forget what I wanted to say. I have been to movies that I can’t remember going to. (Frend, 1990)
I was an organized, methodical person. I knew where everything was. I’m different now. I often can’t find things. I’ve become very scattered and forgetful. (Bennett, quoted in Bielski, 1990)
These words eerily echo those of the ECT survivors described by Dr. M.B. Brody in 1944:
(18 months after 4 shocks) One day three things were missing, the poker, the paper, and something else I cannot remember. I found the poker in the dustbin; I must have put it there without remembering. We never found the paper and I am always very careful of the paper. I want to go and do things and find I have already done it. I have to think about what I am doing so that I know I have done it.. .it is uncanny when you do things and find you cannot remember them.
(One year after 7 shocks) The following are some of the things I forget: the names of people and places. When the title of a book is mentioned I may have a vague idea that I have read it, but cannot remember what it is about. The same applies to films. My family tells me the outlines and I am able to remember other things at the same time.
I forget to post letters and to buy small things, such as mending and toothpaste. I put things away in such safe places that when they are needed it takes hours to find them. It did seem that after the electric treatment there was only the present, and the past had to be recalled a little at a time.
All of Brody’s survivors had incidents of not recognizing familiar people:
(One year after 14 shocks) There are many faces I see that I
know I should know quite a lot about, but only in a few cases can I recall incidents connected with them. I find I can adjust myself to these circumstances by being very careful in making strong denials, as fresh personal incidents constantly crop up.
38 years later, a woman who had 7 shocks wrote:
I was shopping in a department store when a woman came over to me, said hello and asked me how I was. I had no idea who she was or how she knew me.. .1 couldn’t help feeling embarrassed and helpless, as if I were no longer in control of my faculties. This experience was to be the first of many encounters in which I would be unable to recall people’s names and the context in which I knew them. (Heim, 1986)
The deficits in storing and retrieving new information associated with ECT may severely and permanently impair learning ability. And, just as the NHIF brochure states, “Often these problems are not encountered until a person returns to the demands or work, school, or home.” Attempting to go or return to school especially overwhelms and commonly defeats ECT survivors:
When I returned to classes I found I couldn’t remember material I had learned earlier, and that I was totally unable to concentrate… My only choice was to withdraw from university. If there was one area in which I had always excelled, it was in school. I now felt like a complete failure and that I’d never be able to return to university. (Heim, 1986)
Some of the things I tried to study was like trying to read a book written in Russian—no matter how hard I tried I could not get the sense of what the words and diagrams meant. I forced myself to concentrate but it continued to appear gibberish. (Calvert, 1990)
In addition to destruction of entire blocks of pre-ECT memories I have continued to have considerable difficulty in memory with regard to academic pursuits. To date, of embarrassing necessity I have been forced to tape-record all education materials that require memorization. This has included basic classes in accounting and word-processing materials. I was forced to retake accounting in 1983. Now, I am again forced to retake a basic one-semester course in computerized word processing. Currently, I am finding it extremely embarrassing and hurtful when fellow classmates (however innocently) refer to my struggles in grasping my study materials, thusly: “You are an AIR-BRAIN!” How can I explain that my struggles are due to ECT? (Winter, 1988)
I started school full time and found I did much better than
I could imagine remembering information on field placement and classes—but I couldn’t understand what I read or put ideas together—analyze, draw conclusions, make comparisons. It was a shock. I was at last taking courses on theory.. .and ideas just didn’t remain with me. I finally accepted the fact that it was just going to be too much torture for me to continue so I quit my field placement, two courses, and attended only one discussion course until the end of the semester when I withdrew. (Maccabee, 1989)
It is often the case that the ECT survivor is disabled from
her or his previous work. Whether or not a survivor returns to work depends on the type of work previously done and the demands it makes on intellectual functioning. The statistics on employment of ECT survivors would seem to be just as dismal as statistics on employment of head-injured persons in general. In the SUNY survey, two-thirds of the respondents were unemployed. Most indicated that they had been employed prior to ECT and unemployed since. One elaborated:
At the age of 23 my life was changed because after ECT I experienced disabling difficulty understanding, recalling, organizing and applying new information and also problems with distractibility and concentration. I had ECT while I was teaching and because my level of functioning had changed so dramatically I quit my job. My abilities have never returned to pre-ECT quality. Pre-ECT I’d been able to function in a totally individualized sixth-grade classroom where I designed and wrote much of the curriculum myself. Due to the problems I had after ECT I never returned to teaching. (Maccabee, 1990)
A nurse writes of a friend at one year post-ECT:
A friend of mine had 12 ECT treatments in September-October 1989. As a result, he has retrograde and anterograde amnesia and is unable to perform his work as a master plumber, cannot remember his childhood and cannot remember how to get around the city where he has lived all his life. You can imagine his anger and frustration.
The psychiatrists have been insisting that his problem is not ECT-related but is a side effect of his depression. I have yet
to see a severely depressed person fight so hard to regain their ability to think clearly and be able to go back to work again. (Gordon, 1990)
She has stated clearly the impossible situation of ECT survivors. There can be no help for them until there is recognition of the traumatic brain injury they have sustained and its disabling effects.
ECT survivors have the same needs for understanding, support,
and rehabilitation as other head injury survivors. If anything, it could be said that their needs may be greater, since the massive retrograde amnesia unique to ECT can precipitate an even greater crisis of identity than occurs with other head injuries.
Neuropsychologist Thomas Kay, in his paper Minor Head Injury: An Introduction for Professionals, identifies four necessary elements in successful treatment of head injury: identification of the problem, family/social support, neuropsychological rehabilitation, and accommodation; Identification of the problem, he says, is the most crucial element since it must precede the others. Tragically at this time it is the rule rather than the exception that for ECT survivors none of these elements come into play.
This is not to say that ECT survivors never successfully build a new self and a new life. Many courageous and hardworking survivors have—but they have until now always had to do it alone, without any help, and it has taken a sizable chunk of their lifetimes to do it.
As time goes on, I have made a great effort to regain the maximum use of my brain by forcing it to concentrate and to try to remember what I hear and read. It has been a struggle… I feel like I have been able to maximize the undamaged parts of my brain.. .I still mourn the loss of a life that I didn’t have. (Calvert, 1990)
Survivors are beginning to share their hard-won strategies with other survivors, professionals who would help them would do well to listen to those whose daily business, even decades after ECT, is surviving.
I tried a course in general psychology, which I’d had As on in college. I quickly discovered that I couldn’t remember anything if I just read the text.. .even if I read it several times (like four or five). So I programmed my materials by writing out questions for each sentence and writing the answers on the back of the cards. I then quizzed myself until the material was memorized. I have all the cards from two courses. What a stack… I memorized the book, practically… and worked five to six hours a day on weekends and three or four during the work week… It was quite different from when I was in college. Then, I read things and remembered them. (Maccabee, 1989)
She also describes her own cognitive retraining exercise:
The main exercise consists primarily of counting from 1-10 while visualizing, as steadily as possible, some image (object, person, etc.) I thought of this exercise because I wanted to see if I could practice using the right and left sides of my brain. Since I began this I think I read that that isn’t what I was doing. But, it seemed to work. When I first started the exercise I could hardly hold an image in mind, much less count at the same time. But I have become quite good at it and I relate it to an improved ability to deal with distractions and interruptions.
Similar exercises, in fact, are practiced in formal cognitive rehabilitation programs.
Often self-rehabilitation is a desperate, trial-and-error process that takes many lonely, frustrating years. A woman describes how she taught herself to read again after ECT, at age 50:
I could process language only with difficulty. I knew the words, how they sounded, but I had no comprehension.
I did not literally start at “scratch”, as a preschooler, because I had some memory, some understanding of letters and sounds—words—but I had no comprehension.
I used TV for newscasts, the same item in the newspaper, and tried to match these together to make sense. Only one item, one line. Try to write it in a sentence. Over and over, again and again.
After about six months (this was daily for hours), I tried Reader’s Digest. It took me a very long time to conquer this–no pictures, new concepts, no voice telling me the news item. Extremely frustrating, hard, hard, hard. Then magazine articles. I did it! I went on to “For Whom the Bell Tolls” because I vaguely remembered I had read it in college and had seen the movie. But it had many difficult words and my vocabulary was not yet at the college level, so I probably spent two years on it. It was 1975 when I felt I had reached the college level in reading.(I started in 1970.) (Faeder, 1986)
One survivor for whom the slow process of rehabilitation has taken two decades expresses the hope of many others that the process might be made easier for those being shocked in the ’90s:
I might never have thought that rehabilitation was something that ECT patients could benefit from until I was examined in 1987, at my request, at a local psychogeriatric center because I worried that perhaps I had Alzheimer’s disease because my intellectual functioning still caused me problems. During the psychological testing, which extended over a period of two months due to scheduling problems, I observed that my concentration improved and I functioned better at work. I reasoned that the “time-encapsulated” efforts to concentrate and focus my attention carried over. The tests were not meant to be rehabilitative, but they somewhat served this purpose—and convinced me that sequential retraining or practicing of cognitive skills could be beneficial to ECT patients. Of course, this was almost 20 years after ECT…
I hold a responsible, though poorly paying, job as an administrative assistant for a professional organization—performing at tasks that I never thought I would be able to do again. I might have been able to do them earlier if I’d had rehabilitation training. At this time I am concerned about the plight of ECT patients who are still struggling. While these ECT “complainers” are at risk of becoming increasingly depressed—and perhaps suicidal—because
of their disabilities, professionals continue to argue about whether or not ECT causes brain damage using insufficient and in some cases outdated data.
I wish that some brain trauma research and rehabilitation
center would accept a few ECT patients and at least see if practicing or “reprogramming” of cognitive skills could result
in improved performance. (Maccabee, 1990)
In 1990, three ECT survivors were treated in the cognitive rehabilitation program of a New York City hospital. Slowly, attitudes and preconceived ideas are changing.
ECT IN THE ’90s
ECT has gone in and out of fashion during its 53-year history; now on the wane, now making a comeback. Whatever happens in this decade (ironically designated by President Bush the Decade of the Brain), ECT survivors cannot afford to wait until a favorable political climate allows them the help they need. They need it now.
There are some hopeful signs. The 1980s saw an unprecedented boom in ECT (medical malpractice) lawsuits citing brain damage and memory loss, to the point where settlements are steadily increasing for those with the stamina and resources to pursue legal redress. The ECT machine remains in Class III at the FDA. ECT survivors are joining head injury support groups and organizations in record numbers.
State legislatures are toughening ECT laws, and city councils
are taking courageous stands against ECT. On February 21, 1991, after well-publicized hearings at which survivors and professionals testified, the Board of supervisors of the City of San Francisco adopted a resolution opposing the use of ECT. A bill pending in the New York State Assembly (AB6455) would require the state to keep statistics on how much ECT is done, but its accompanying strongly worded memorandum opens the door for stricter measures in the future. In July 1991 the Madison, Wisconsin city council proposed a resolution to recommend a ban on the use of ECT. (Shock was banned in Berkeley, California in 1982 until the local psychiatrists’ organization overturned the ban on a technicality.) The council’s Public Health Committee unanimously agreed that accurate information about the effects of ECT on memory must be presented to patients, and they are writing a resolution to contain full and accurate information. And in August 1991 ECT survivors testified, and a manuscript containing accounts of memory loss by 100 survivors was presented, at hearings in Austin, Texas, before the Texas Department of Mental Health. Subsequently the Department’s regulations were revised to contain a stronger warning about permanent mental dysfunction.
It is difficult, even in so many pages, to paint a full picture of the suffering of ECT survivors and the devastation experienced not only by the survivors but by their families and friends. And so the last words, chosen because they echo the words of so many others over the years, belong to a former nurse estranged from her husband and living on Social Security Disability, fighting in the legal system for redress and working with an advocacy group.
What they took from me was my “self”. When they can put a dollar value on theft of self and theft of a mother I would like
to know what the figure is. Had they just killed me instantly the kids would at least have had the memory of their mother as she
had been most of their lives. I feel it has been more cruel, to
my children as well as myself, to allow what they have left to breathe, walk, and talk.. .now the memory my kids will have is of this “someone else” who looks (but not really) like their mother. I haven’t been able to live with this “someone else” and the life I’ve lived for the past two years has not been a life by any stretch of the imagination. It has been a hell in the truest sense of the word.
I want my words said, even if they fall on deaf ears. It’s not likely, but perhaps when they are said, someone may hear them and at least try to prevent this from happening again. (Cody, 1985)
Avery, D. and Winokur, G. (1976). Mortality in depressed patients treated with electroconvulsive therapy and antidepressants. Archives of General Psychiatry, 33, 1029-1037.
Bennett, Fancher. Quoted in Bielski (1990).
Bielski, Vince (1990). Electroshock’s Quiet Comeback. The San Francisco Bay Guardian, April 18, 1990.
Breggin, Peter (1985). Neuropathology and Cognitive Dysfunction from ECT. Paper with accompanying bibliography presented at the National Institutes of Health Consensus Development Conference on ECT, Bethesda, MD., June 10.
Breggin, Peter (1990). Testimony before the Board of Supervisors of the City of San Francisco, November 27.
Breggin, Peter (1991). Toxic Psychiatry. New York: St. Martins Press.
Brody, M.B. (1944). Prolonged memory deficits following electrotherapy. Journal of Mental Science, 90 (July), 777-779.