24. ELECTROSHOCK: THE "NEW, IMPROVED" PSYCHIATRIC THERAPY

Electroshock treatment is a form of psychiatric therapy born in the age of lobotomies and made famous in "One Flew Over the Cuckoo's Nest." Electrodes are placed on a patient's temples and electricity is shot through the brain, inducing an epileptic-like seizure that is supposed to cure mental illness. After years of abuse, highlighted by the "dark days" of the 1950s when hospitals turned into "shock mills" and patients were forced to undergo shock treatments that often turned them into zombies, electroshock treatment seemed destined to disappear along with lobotomies.

Today, however, hospitals are secretly bringing back electroshock therapy. To introduce the new shock therapy, now called electro-convulsive therapy (ECT), the American Psychiatric Association (APA) held a December 1989 press conference where psychiatrists announced ECT has become "safe and effective." The most significant change is that ECT is now applied to only one side of the brain - the more creative, emotional side - rather than both sides, as in the past.

Proponents say ECT is now on the rise because of its effectiveness. "It's a life-saver," says Dr. Glen Peterson, of Providence Hospital, in Oakland, California. "In the face of all the negative criticism, we haven't been able to get away from the fact that ECT is a very effective treatment." The hospital's informational brochure says "ECT is an exceptionally effective medical treatment, helping 90 percent of the patients who take it. Most patients remain well for many months afterwards."

As ECT returns, the question of brain damage has disappeared from most discussion of the treatment. The APA's new 217-page report on ECT doesn't even mention the issue, except to say that doctors needn't include brain damage as a risk they mention to patients. Meanwhile, former shock patients, patients' rights advocates and doctors say the treatment doesn't really cure problems - but may cause some serious ones. "It's a quick-fix treatment that causes brain damage, but it doesn't work," says neurologist John Friedberg of Berkeley, author of the book "Shock Treatment is Not Good for Your Brain."

Critics charge that one reason that ECT is becoming more popular is because it is immensely lucrative. The average ECT patient will stay in the hospital for about a month, at a cost of about $500 a day; when the cost of treatment is added, the bill comes to about $20,000. Insurance companies and Medicare support ECT by paying for longer hospital stays for psychiatric patients who receive the treatment compared to those on medications or undergoing psychotherapy.

To support increased use of ECT, the APA has requested that the Food and Drug Administration reclassify the machine used to shock patients from Class III to Class II. The shock machine was put in Class III in 1979, after the FDA's Neurological Device Classification Panel identified eight risks to health in ECT, including brain damage and memory loss. Class II is for low or moderate-risk devices.

Since the APA has been able to maintain a low media profile on its efforts to bring back electroshock therapy, the number of patients receiving such therapy has been on the rise, and it is now estimated that 100,000 people, mostly middle-aged, white females, receive it annually.

SSU CENSORED RESEARCHER: TONY WEEKS

SOURCE: THE SAN FRANCISCO BAY GUARDIAN, 520 Hampshire St., San Francisco, CA 94110-1417, DATE: 4/18/90
TITLE: "Electroshock's Quiet Comeback"
AUTHOR: VINCE BIELSKI

COMMENTS: Investigative journalist Vince Bielski feels it is important for the general public to know about the resurgence of electroshock therapy because as it becomes "a more common practice, tens of thousands of patients will be receiving shock therapy each year in the U.S., and many won't have full knowledge of its effects. The psychiatric associations consistently play up its potential benefits (short-term recovery from severe depression) and play down and perhaps cover up its risks (brain damage, learning disabilities and memory loss). The responsibility to inform patients falls on the shoulders of the media and the health advocacy groups. I wrote my story to inform a very vulnerable consumer, the psychiatric patient, and it carried the simple warning, `beware'." Bielski believes his article in the Bay Guardian was the first to announce the resurgence of shock therapy, although, he added, the New York Times did the story a few months later using several of his sources and even the same headline but it was not as critical of the therapy as Bielski's. He said that the limited coverage given the issue tended to benefit conservatives in the psychiatric establishment who tend to be the practitioners of shock therapy. "They are on a crusade to convince other psychiatrists and the public that mental illness is a biochemical disorder treated best with electroshock. To this end they have produced popular videos and several articles in magazines touting electroshock. The only real check on this campaign to bring electroshock back is the media, because those who consider themselves victims of electroshock tend to either go into hiding, or if they do speak out, they often lack credibility due to their illness." As a result of Bielski's efforts, electroshock therapy is not expected to become a common practice again without at least some public debate. His investigative report sparked a debate among politicians, psychiatrists, and activists whether to ban or restrict the use of electroshock in the city. As Bielski noted "The controversy (resulting in part from his article) ... illustrates the important role of the media in exposing potentially harmful activities and forcing politicians to find solutions."