Hi--

I am glad to see so many postings, even though many seem very angry. I can no longer reply individually so let me respond more broadly.

How do we make sense of a treatment that half of the respondents praise as amazing and half condemn as misguided and barbaric? Is it possible that ECT truly benefits some people and damages others?

One way to try to solve this quandary is more scientifically based studies that test ECT against other treatments. But we would be kidding ourselves if such studies are likely to definitively prove ECT's value one way or the other. Medicine is moving away from broad illness categories like depression or schizophrenia and appreciating that these conditions can be different in different people, likely based on their genetic make-up. As such, certain treatments might work in some cases of disease but not others. This may be the case for ECT.

What is so striking to me about these posts is the power of the illness narrative, in which individual people try to make sense of their sicknesses. I wrote about this in the book cited at the end of my article, "When Illness Goes Public," which describes the illnesses of 12 famous patients (like Lou Gehrig, Rita Hayworth, Steve McQueen and Arthur Ashe) and how their stories were told and retold over time. If someone gets better after ECT, it is not surprising that their story becomes one of ECT as triumphant and effective. And if one does not improve or worsens, the story becomes one of ECT as evil and ineffective. The point is that these individual stories become PROOF for the person telling them, regardless of what "the data" show. I think this is an important phenomenon to appreciate, especially in the era of evidence-based medicine. People may make treatment decisions based not on the "best" data but on the stories that affect them the most.

Anyway, thanks again for all of the feedback. One thing we should all agree on is that ECT should be only one of multiple possible therapeutic options for people with certain mental illnesses. Discussing all of these options with one's doctors and, if you are so inclined, doing some independent research on the Internet, is essential.

Barron Lerner

Thank you Mr. Lerner,

As a nurse I have seen ECT from both sides of the bed rail and applaud it. What most people don't realize is that psychiatrists still go to it as a last resort--can we say stigma? I get the idea from some of the responses here that people believe that doctors are trying to shove ECT down patients throats. It is a last resort when the patient has become treatment resistant (unfortunate terminology that is not anti patient) to meds and other therapies. Hopefully, now with your book the stigma attached to ECT and mental health will start a healthier recede.

I only wish that a doctor had suggested ECT for me years ago--I would still be bipolar but I would have had more options and perhaps some better years to look back on--YES, I do remember them.

This is kind of unrelated to the main topic, but I noticed that the "stories" factor with ETC is similar to other issues influenced by stories. Spanking is a good example. Every time people cite studies that indicates spanking doesn't work, tons of people rise up and try to prove it does work by way of personal testimonial. These people in turn are countered by those who try to prove spanking doesn't work with their own testimonials. It just goes to show that some issues are more complex than individual stories or studies would have you believe.

Let me start by saying what the word Psychiatry means in its full sense:

Psychiatry: initially meant the study of the soul - psyche (soul) and ology (study of). Originally thought that the mind and body were separate entities.

In 1829, Webster's International Dictionary of English Language defined "psychology" as a " discourse or treatise on the human soul; the doctrine on the nature and properties of the soul".

So by that definition psychiatry and psychology are doing quite a wrongful act by treating human beings as if they were just a piece of meat.

Let me also add that if you do your research very well you will see that Psychiatrists & Psychologists have no absolute data nor any idea as to how the human mind works. All they have is assumptions to how it works here is a statement from this exact article "Doctors did not know how ECT worked, although it was assumed that the seizure relieved symptoms by somehow "resetting" the nerve cells in the brain." Now it is only logical that if you don't know how something works you then don't promote it as a cure, I think it is quite absurd.

You will not go to a doctor to treat you broken leg who will tell you "I don't know how this works but I think if we hit your leg with a hammer a few times it will maybe get back together", now that sounds quite absurd, doesn't it?! But, this what all Psychiatrists/Psychologists are saying to everybody, and strangely enough people believe them.

I suggest to everyone, before you consider any ECT, psychiatric drugs or even going to see a psychiatrist you do your research on that field and find out for your self what is the truth.

Here is a very good website to visit for your research: www.CCHR.org

Contact your local CCHR office and ask for the DVD named: Psychiatry An Industry Of Death. It is a very informative DVD on psychiatry.

I hope that what I have said was very informative to you, thank you for reading my article.

- Alex

Alex, the above poster cites a website that is part of the Church of Scientology, nuf said, too bad Alex could or would not tell us.

It is disturbing when some seem unwilling to acknowledge the difference between having ECT available as an option for themselves and having it forced on someone else, or the difference between choosing it as a treatment for symptoms that bother them and having it be choosen for someone else because some third party thinks they exhibit disturbing symptoms. I once read someone compare the difference between forced and voluntarily chosen ECT to the difference between consensual sex and rape, and I think that in some ways that analogy makes sense.

Forced ECT isn't something from the distant past - just last summer the state of New York went to court to force ECT on patients in some of its state institutions who had explicitly said that they didn't want it. I suspect that state, and others, probably do this on a more or less regular basis. Just as with those who freely choose it, some who are forced to have ECT have negative and damaging results. Some have cognitive damage that forces them to live a life of poverty, because they are unable to do any kind of work that pays very well. I think those who profit the ECT industry should have to use some of their profits to set up a fund to ease the hardship of the victims of forced ECT who had damaging results.

Fewer people would object to this procedure if it's use was limited only to those people whose misery was so bad that they freely choose to try it for themselves, even after being fully informed of all the possible consequences. But I think it is sometimes used on people just because someone else is troubled by their "symptoms" - it seems more like an issue of social control than a medical procedure in instances such as this. The people who promote the use of ECT without addressing the issue of forced treatment kind of remind me of people who talk about what a lifesaver it was for them to get an organ transplant, even if that organ may have come from an executed prisoner in someplace like China.

If you promote the use of ECT, I think you have a responsibility to at least acknowledge that it is sometimes forced on people. Actually, I don't think there has ever been a time in the history of ECT use when at least some of its receipents weren't people who had objected to it but had it forced on them anyway. The medical & psychiatric professions seem unable to restrain themselves from sometimes using it forcibly as long as it is considered a medically valid procedure. So if you profit from its use, I think you should at least try to mitigate the damages to those who had to have it only because their symptoms bothered someone else.

Once again, "myfranz" resorts to ad hominens.

barronlerner wrote the following post at 01/08/2008 9:17 AM:

"Hi--

* * *

" ... One thing we should all agree on is that ECT should be only one of multiple possible therapeutic options for people with certain mental illnesses. ....

"Barron Lerner"

******************************­****************

Dear Mr. Lerner

Why, exactly, "should all agree" on this wholly specious point? Neither you, nor the authors you discuss, have provided the slightest scientific or rational evidence that ECT is a "treatment" for anything. Before that could be done, you'd have to define what a "treatment" is supposed to do, and whether the effect of the so-called "treatment" is worse than the so-called "disease". Heck, neither you, nor anyone you mention have bothered to define, in objective, unequivocal, terms the "certain mental illnesses" you seek to treat.

There is no reason to think that ECT does anything 'theraputic'. Mr. Lerner's apology for ECT is just as circular in its logic, as the authors he discusses: Without any independent standard for "sanity" or "normalcy" or "therapy" they define the debilitated state a person suffers due to ECT to be a "cure" and then claim that ECT "cures" people.

Lets see... Nope, I dont think any reasonable case can be made for "ECT forced" and "ECT elective" when desperate people go to credentialed "experts" (well intentioned or not), looking for answers, and ECT is legitimized, and offered as a viable option.

Thats at least misleading... and at worst an abuse of power. It doesn't really matter how fervently it's practitioners believe, or how much evidence they can construct thru the statistical interpretation of selective data.

While A starving person might eat whatever gruel is set before them before starvation, but wouldn't it be nice to have more options than that? It remind's me of a Mark Twain quote: "If the only tool you have is a hammer, every problem looks like a nail"

Unfortunately life cannot be reduced to miracle cures and Hundai's cannot be represented as BMW's.

David

David:

"A starving person might eat whatever gruel is set before them before starvation, but wouldn't it be nice to have more options than that?"

I agree. I'm "starving" (suffering from major depression and have tried other treatments)... ECT is being presented as an option for me. What is your other option?

Seriously, I'm interested. I don't know what to do, and as you've said what seems to be my best hope at this point is not a viable option and shouldn't be 'legitimized', I'm wondering what you suggest instead, as you obviously feel qualified to speak out on this matter.