It is our position that depression is an emotion and is secondary to our interaction with life. Part of the expression of any emotion is a change in our physiological and chemical state. We have stated that this change is not a disease created by a sick brain, and should not be treated as one. Our fundamental position on the current use of medication is that it should not be presented to patients as it now is — as a cure for an underlying fault or deficit in the hardware of their brain. In truth, their distress is the result of a shift in their software programme, their thoughts and feelings.
Our simple plea is for honesty.
1. If a doctor wishes to prescribe an antidepressant, rather than saying to the patient "you are suffering from a chemical imbalance, a deficiency in serotonin", thus giving the impression that there is something seriously wrong with their brain's functioning, it would be more appropriate to say "you are going through a difficult time because of your circumstances, and I will prescribe something to give you a lift". No-one is arguing that in some cases antidepressants can create that sought-after ‘lift' in mood and enhance a person's feeling of well-being. So can other uppers such as amphetamine, cocaine, ecstasy and the like, all of which do so by acting on the same serotonin pathway, amongst others. None of these, however, claim to be curing any underlying imbalance, but simply to make one feel good. As every regular cocaine user would agree " there's only one thing better than a line of coke, and that's another line of coke". Helen described what it did for her: "It filled me with energy, I felt I could get things done, my thinking was clear, I was confident and relaxed interacting with people, and it made me enjoy life."
When considering how antidepressants are prescribed now, and the exaggerated claims for them, it's worth recalling that amphetamines were widely used for the treatment of depression in the 1950s and 60s, but in a straightforward and honest fashion. If you were down, you took an ‘upper' (amphetamine), and if as a result you became too speedy and couldn't sleep, you took a ‘downer', usually a barbiturate. In those days nobody spoke of diseases of the brain. Amphetamine and barbiturates, both of which worked effectively to influence emotions, were withdrawn from general prescription because of their addictive qualities. Amphetamine is now an illegal, Class A drug.
2. Doctors should inform patients from the beginning of potential well-known side-effects, such as loss of libido, inability to orgasm, and other sexual dysfunctions, insomnia, dizziness, nausea, constipation, dry mouth, and many others. Among the more serious are self-mutilation and suicidal thoughts.
3. The third untruth, by way of omission, is that doctors neglect to inform patients that the antidepressant can be addictive, and that severe withdrawal effects may be experienced when they attempt to come off them. This is so much the case that some people, after many unsuccessful attempts to do so, have to remain on them for years, beginning a life-long relationship with them. Another thing that patients might like to know is that, in the process of artificially elevating their mood, the medication suppresses the body's own natural ability to manufacture neurochemicals such as serotonin. While the artificial substance is being taken, that natural process is suspended and in time the body ‘forgets' how to produce them. Should the substance be withdrawn, there is an inevitable gap in production, and the catch-up to normal levels may never kick in, hence the inevitable dependency or addiction.
If anyone has any doubts as to the side-effects of antidepressant medication, look to the Seroxat saga, which stands out as the most problematic of the SSRI group (selective serotonin re-uptake inhibitors). Its link to suicide, self-mutilation, and addiction is now well established, to the degree that it has recently been withdrawn for prescription in the under-18 age group. Notwithstanding this information, because of mass marketing and the withholding and suppression of negative trial results, it continues to be the most widely subscribed worldwide. The head of Seroxat's manufacturing company is quoted as saying, as he commented on the wide range of illnesses that they could get licensing for, "there's a lot of runway space out there, let's get the planes down".
From a doctor's perspective, reading the ‘Prescribing Information Leaflet' associated with the use of psychiatric medication is a cautionary exercise. Headings like ‘Special Warnings and Precautions', ‘Contra-indications', ‘Adverse reactions', ‘Undesirable effects' ‘Drug Interactions', ‘Renal Impairment', ‘Hepatic Impairment', ‘Over-dosage', leap out at you like tigers from the small print, informing you that just about anything is possible after swallowing these pills. Potentially, no cell, no normal bodily function, no organ is safe from harm — from passing urine to the regularity of your heart beat. And the dangers dramatically go up when cocktails of medication are ingested together — polypharmacy. It's not uncommon to see patients who are taking up to seven or eight different types of psychiatric medication every day, some of which are to offset each other's side-effects, others to compensate for thyroid function which has been destroyed by the use of lithium. And yet, often many decades later, they are still depressed. Naïve patients are sometimes stunned to hear that they are taking uppers and downers at the same time. One has to wonder about the logic: don't they cancel each other out?
Threats to life are boldly stated on the prescribing information leaflet, and we are not just talking about suicide. One drug company declared that its product can actually cause mortality, and that ‘This information is derived from clinical trials'. In a Dear Doctor letter dated 8 March 2004, we were thus informed of the deadly dangers of olanzapine, better known as Zyprexa. ‘While taking Olanzapine, elderly patients with dementia may suffer from stroke, pneumonia, urinary incontinence, falls and have trouble walking. Some fatal cases have been reported in this group of patients.'
The letter came from the medical director of Eli Lilly & Co (Ireland) Ltd (this drug company is also the manufacturer of Prozac). Zyprexa is widely used in the treatment of schizophrenia and in certain depressive disorders. What is most disturbing in these alerts to doctors about these fatal side-effects, is the implication that they have then discharged their duty in merely issuing such a warning. Surely the appropriate response would be to withdraw the medication instantly from the market, and the Irish Medicines Board to immediately suspend its use in all age groups, not just the elderly? If Zyprexa were a car, it would be recalled without question, lest even one fatality occur.
There is a common misperception that antidepressant medication is specifically designed for the human brain. The truth of the matter is that they are widely used in veterinary medicine. Polar bears in zoos are prescribed them to help them cope with their inappropriate surroundings, and horses and greyhounds are given them illegally because they enhance performance.
Humpty Dumpty science
The pharmaceutical industry has hijacked science, and piggybacked its efforts onto the neurochemical model of illness for profit motives, marketing the sick-brain model of depression, and coming up with emotional painkillers as the antidote. It cooks the books, tells lies, and selectively withholds the negative results of trials, putting people's lives at risk. With vast sums of money at their disposal, they have managed to turn lies into the truth. As Humpty Dumpty said to Alice in Wonderland: "When I use a word it means just what I choose it to mean — neither more nor less".
If we choose to stand back, we can see that while antidepressant medication may have helped some in the short term, it has failed many in terms of offering relief and freedom from their symptoms. The thousands of revolving-door patients attending outpatient clinics year-in, year-out bear testimony to this — their life a balancing act where the juggling of doses of ‘corrective' medication has become a life-long process. In Ireland, 7,545 patients were admitted for depressive disorders in 2003, and 68% of these were readmissions. This warehousing of suffering human beings would be a thing of the past if antidepressants delivered what they claim to deliver. But they don't.
Toxic pregnancies, intoxicated babies
It is a common misperception that there is a vast difference between the nutritional needs of a day-old baby on the mother's breast, and one on the threshold of birth, its nutrition arriving through the mother's placenta via the umbilical cord. Everyone is agreed that toxic substances are bad for babies. Would any mother in her right mind give a day-old baby alcohol, a cigarette, or Prozac?
Pregnant women have a right to be informed that studies are now finding that newborn infants are manifesting symptoms similar to the infants of crack cocaine-addicted mothers: seizures, muscular rigidity, jitteriness, abnormal crying, respiratory difficulties such as going blue on feeding, with some requiring hospitalisation. What mother, if she knew of such dangers, would persist with a drug simply to make her feel better while her baby was at risk? Especially given that she has already taken precautionary measures such as stopping smoking and avoiding alcohol, junk food, sleeping pills, and even painkillers.
The nine month journey from a fertilised egg through the process of cellular specification (when cells go on to specialise, differentiating into bone, muscle, nervous tissue, heart, eyes, ears, etc), and into the trillions of cells of a fully mature baby, is a phenomenon beyond comprehension. The entire journey is backed up by hundreds of millions of years of the DNA story. This delicate finely-tuned developmental ecosystem, the foetus, the goal of which is to become a unique human being, can be diverted off-course by the slightest alteration from normal in any of the variables affecting this act of creation. We must understand that every cell in the foetus is bathed in a fluid which delivers the oxygen that is inhaled into its mother's lungs, the amino acids that come to it through the mother's gut, and the hormones produced by her endocrine glands, etc. Similarly, less natural substances reach the foetus, such as nicotine, alcohol, pesticides and other environmental toxins, and drugs, street drugs or otherwise.
The Thalidomide scandal of the 1960s shocked the world. Innocent mothers were prescribed medication for nausea during pregnancy. Tragically, thousands of babies were born with gross limb deformities, and the drug was immediately withdrawn. In the aftermath, no pregnant mother could be persuaded to even take a Panadol for a headache lest it harm her baby. All trust had been lost in the pharmaceutical industry's reassurances that certain drugs were safe in pregnancy. The discovery of foetal alcohol syndrome, which was accompanied by retarded growth and intellectual impairment, alerted us to the detrimental effect of even small quantities of alcohol reaching the baby in utero. Likewise, the link between low weight and delays in intellectual developmental in the babies of smokers is well established.
Current research shows that there is a strong link between Attention Deficit Disorder (ADD) and Attention Deficit Hyperactive Disorder (ADHD) following exposure in the womb to the SSRI group of antidepressants. Buzzed-up, intra-uterine babies are primed to need a similar substance after birth in order to function optimally. Enter the amphetamine Ritalin. Once started on the amphetamine route, research now shows that 80% will be on some version, prescribed or otherwise (street drugs such as crystal meth), for life.
We live in an age where women are giving serious consideration whether to even have a child at all, and if they do so will go to any lengths to ensure its safe delivery. Many prepare their bodies for the pregnancy to make sure that the foetus is not developing in a toxic ecosystem; they give up smoking, take up yoga, eat only organic foods and cultivate optimal nutrition. In order to achieve a pregnancy, some go down the tortuous road of pursuing an assisted conception through IVF, possibly for years. When they do get pregnant, they continue the healthy approach: watching their sleep, maintaining their health, cutting down on stress, and getting the best anti-natal advice. The primary focus is the baby; whether they will breast feed, have a home delivery, underwater if it helps, or a maternity hospital with the neonatal backup if it makes for greater safety.
Some are even seeking advice as to how to go about every step in the most conscious way possible, from the conception onwards, learning ways of communicating with their unborn child, with a view to its transition into the world being optimal for all concerned. Books such as Spirit Babies, by Walter Makichen, reflect this growth in consciousness in this growing group of highly-motivated and aware mothers. It seems unbelievable that after all this effort, during a visit to their doctor, where they complain of moodiness or irritability, they will allow themselves to be prescribed an antidepressant. Why? Because they are assured it is safe.
Take Lexapro, the most prescribed antidepressant for newly diagnosed patients in Ireland. In its abbreviated prescribing information, under the heading ‘pregnancy and lactation', its manufacturer states: "As safety during human pregnancy and lactation has not been established, careful consideration should be given prior to use in pregnant women. It is expected that escitalopram [the active ingredient] will be excreted into breast milk. Breast-feeding women should not be treated with escitalopram." This information implies that the drug reaching the baby through the mother's breast milk is different than when it is delivered to the baby from the placenta via the umbilical cord. The fact of the matter is that if it is not safe during breast-feeding, then it is not safe during pregnancy, since the developing foetus is even more prone to damage than a new-born. Surely this is Humpty Dumpty science at its worst.
Another group of women, already on antidepressant medication when they became pregnant, continue to take them, innocently assuming it is safe. Some, who are taking a cocktail of medication which may include lithium, may not realise that even in adults, male or female, it destroys the thyroid gland and compromises kidney function. What effect must it have on the developing foetus? Are pregnant women informed that lithium causes congenital defects, mainly affecting the heart?
At the scene of an accident, after someone has crashed into you, do you ever think to ask the other driver, apart from the usual insurance details, "are you taking antidepressant medication?" Does the Garda who arrives at the scene, apart from breathalysing the offending driver, ever ask the question either? Are blood levels ever taken for prescribed drug analysis?
Pilots are instantly grounded when prescribed antidepressants, due to awareness of the responsibility of their job relative to other's safety. Should mothers (or fathers) displaying ‘baby on board' stickers not also be? Or bus drivers, taxi drivers, truck drivers, or any citizen driving a moving vehicle while ‘under the influence' Clearly, the warnings on the prescription bottle "Avoid alcoholic drink. May cause drowsiness. If affected do not drive or use machinery" or the proprietary PIL (patient information leaflet) approved by the Irish Medicines Board are not taken seriously by consumers of these drugs. This is not their fault. The ‘warnings' hardly qualify as such. They have a purely advisory tone. Compared to the fearsome warnings of death and serious illness on tobacco products, they constitute no warning at all.
Then there is the question of whether people read the PIL that came with their medicine with any great degree of attention. As with a cigarette package, the box is the place for a serious warning against potentially fatal consequences, and the warning should not mince words.
It should state, bluntly and clearly:
DO NOT DRIVE AT ALL WHILE TAKING THIS MEDICATION. THIS PRODUCT COULD BE RESPONSIBLE FOR A FATAL ACCIDENT OR SERIOUS INJURY IF YOU DRIVE WHILE TAKING IT.
Doctors have access to the information as to the dangers of medications through the ‘prescribing information'. The abbreviated prescribing information relating to Lexapro under the heading ‘precautions' reads: "Driving and operating machinery: no direct impairment of psychomotor function. However, as with other psychotropic drugs, patients should be cautioned about the risk to their ability to drive or operate machinery." What exactly are they saying? They seem to be saying there is no impairment, yet there is a risk to driving ability. More Humpty Dumpty science.
Relative to Zyprexa, (a major tranquilliser frequently used in combination with SSRIs in the treatment of manic depression) under the heading ‘Driving, etc', it elaborates: "May cause somnolence or dizziness. Patients should be cautioned about operating hazardous machinery, including motor vehicles". What does cautioned mean? That you should drive more carefully? That your insurance may not cover you if you have an accident? Surely most people already drive with caution. The manufacturers of Seroquel, a drug also used in the treatment of depression, under the heading ‘Effects on ability to drive', inform us of their concerns: "Patients should be advised not to drive or operate machinery until individual susceptibility is known". Does this mean you have to crash before you know you are ‘susceptible'?
If psychoactive medication can cause dizziness, sleepiness, poor concentration, slow reaction time and other deficits in higher intellectual functioning, just as alcohol does, then surely the person on medication should be suspended from driving as the alcoholically intoxicated are, lest even one road traffic accident results? We can argue about where responsibility lies, but ultimately we feel that since doctors are the gatekeepers to accessing prescribed medication, it is our ethical responsibility to embrace the Hippocratic oath which enshrines the notion ‘First Do No Harm' by exercising the power of the pen and ceasing to prescribe medication of such toxicity and potential for death on the road. The time has come where doctors need to make it clear to their patients that if they prescribe psychoactive medications that they should inform both their car insurance company and the licensing authorities. One can be absolutely certain that in this litigious age the pharmaceutical companies have covered themselves with respect to liability.
Most psychiatric drugs can cause withdrawal reactions, sometimes including life-threatening emotional and physical withdrawal problems. In short, it is not only dangerous to start taking psychiatric drugs, it can also be dangerous to stop them.
Withdrawal from psychiatric drugs should only be done carefully under experienced clinical supervision. We list a number of sources of advice on this on our Resources page.
Click here to see all, or download the Icarus Project guide to slow withdrawal from anti-psychotics and other drugs here
Electroconvulsive therapy (ECT)
If a psychiatrist believes that depression results from a sick brain, and medication has failed to cure a patient, what is their next step? The same one that a gastroenterologist would take when conservative medical treatment of a bowel disorder such as Crohn's disease or ulcerative colitis fails: the last resort is considered, surgery. For a biological-model psychiatrist, the end-point of the sick brain conveyor belt is ECT. In many respects it resembles a surgical procedure.
An electrical current of between 70 and 400 volts is passed through the brain of the patient with the intention of producing a grand mal or major epileptic seizure. The voltage is typically as great as that found in the wall sockets in your home. If the current were not limited to the head, it could kill patients through inducing cardiac arrest, the cause of death in electrocution.
Electrodes are placed over both temples. The electric shock is administered for as little as a fraction of a second to as long as several seconds. The electricity in ECT is so powerful it can burn the skin on the head where the electrodes are placed. Because of this, psychiatrists and technicians use electrode jelly, also called conductive gel, to prevent skin burns from the electricity. Because a shock-induced seizure is typically far more severe than those suffered during spontaneous epilepsy, in earlier times, when the patient's body was not paralyzed by pharmacological agents, it would undergo muscle spasm sufficiently violent at times to crack vertebrae, break limb bones, and damage teeth. To avoid this, current practice involves sedation with a short-acting intravenous barbiturate, followed by muscle paralysis with a curare derivative, and artificial respiration with oxygen to compensate for the paralysis of the patient's breathing musculature.
The shocks create an electrical storm that obliterates the normal electrical patterns in the brain. They are administered in a series over a few weeks, up to an average of from six to ten sessions, to ensure the procedure 'takes', that is, to alter the electrical activity of the brain sufficiently so that the individual will not remember, at least for several months, the depression that they were experiencing before the shocks. In our practice, we have met a number of patients who over the years have been administered upwards of 100 ECT sessions, and are no better.
In essence ECT is a closed-head electrical injury, typically producing a delirium with global mental dysfunction (an acute organic brain syndrome). Following it the individual is dazed, confused, and disoriented, and therefore cannot remember or appreciate current problems. The changes one sees when electroshock is administered are completely consistent with any acute brain injury, such as a blow to the head from a hammer, a concussion.
The greater the brain damage, the more likely that certain memories and intellectual abilities will never return. Memory deficits, retrograde and anterograde (before and after the event), are among the most common early signs of traumatic brain damage, and are seen in virtually all cases of ECT. Events which follow an ECT session are forgotten completely, such as visitors calling, phone calls received, speaking with their psychiatrist, etc. Overall, the studies of autobiographic memory confirm widespread and devastating losses, extending to even the major events of their previous lives. Memories are foggy about details of personal history such as family weddings, graduations, jobs, etc. Since the mind is the place the memory calls home, such deficits are extremely anxiety-provoking and disorienting. In essence, one's very identity is being altered. Autopsy studies of animals and some of humans show that ECT causes severe cellular damage, including cell death.
Brigid, a 69-year-old former nun, recalls how, at the age of 35, she became unsure of her vocation and considered leaving the order. Depression was diagnosed, and ECT eventually prescribed in an effort to ‘bring back some perspective'. Her family, on a Sunday visit to the convent in the country, discovered that she had been hospitalised three weeks earlier. On arriving at the hospital, they were shocked to find her disoriented and dispirited, and took her home immediately. She had received over 20 sessions of ECT. Over the following months, with her family's encouragement she decided to leave the order. While she regained physical health, certain intellectual deficits became apparent. She had been a secondary teacher in a convent school, and her presumption was that she would resume this career, seeking a post locally. To her horror, she found that many of her teaching skills had vanished, and she had to accept that it would not be an option. Exploring alternative vocational avenues, she decided to develop healing skills and trained as a nurse, finding that she was still able to learn new material. To this day she still suffers from memory blanks extending as far back as her early childhood.
If a woman like Brigid came to an emergency room in a confusional state from an accidental electrical shock to the head, perhaps from a short circuit in her kitchen, she would be treated as an acute medical emergency. If the electrical trauma had caused a convulsion, she might be placed on anticonvulsants to prevent a recurrence of seizures. If she developed a headache, stiff neck, and nausea, a triad of symptoms typical of post-ECT patients, she would probably be admitted for observation to the intensive care unit. Yet ECT delivers the same electrical closed-head injury, as a means of improving mental function.
Elderly women, an especially vulnerable group, are becoming the most common target of ECT. Veronica, a 92-year-old woman, became extremely distressed following a burglary to her home and was admitted to hospital. She had a long psychiatric history which began following the death of her husband 25 years previously, and had been on various cocktails of medication over the years. She failed to respond to an increase in her medication and ECT was suggested by her psychiatrist. The family sought a second opinion and a decision was made to bring her home and provide home nursing instead. With the combined support of her family and her general practitioner she rallied and regained her previous levels of functioning. One has to wonder what the outcome would have been for an elderly woman who lacked family backup or interest.
Arguments put forward as to the benefits of ECT have to be examined with extreme caution for several reasons: because it is fundamentally traumatic in nature, because so many of the patients are vulnerable and unable to protect themselves, because it is administered to many involuntarily, due to their having being committed to mental hospital against their will, and because most controlled studies of efficacy in depression indicate that the treatment is no better than placebo.
As they attempt to recover from ECT, patients frequently find that their previous emotional problems have now been complicated by ECT-induced brain damage and dysfunction that will not go away. If their doctors tell them that ECT never causes any permanent difficulties, they become further confused and isolated, creating conditions for further depression and in some cases suicide.
The question has to be asked: given that ECT is a desperate measure, and is tied up with the sick brain model, and causes brain damage, why has it not been banned? Parallels exist in other areas of medicine and in industry where practices have been discontinued which were once thought viable. In the gynaecology area, an operation called symphysiotomy was widely practiced as a means to widen the pelvic aperture and facilitate a baby's birth in a complicated labour. While the baby may have been born safely, with time the adverse effects to the mothers were judged to be prohibitive, lasting often for decades and compromising further pregnancies. It is now regarded as inappropriate practice. The Fenton procedure, which was used to widen the vaginal opening in cases of vaginismus (spasm of the vagina preventing intercourse), has likewise been discontinued. These are merely two examples where medicine has evolved and made the appropriate changes.
In industry, asbestos is now used only with extreme safety precautions since evidence of its link with lung cancer was established. Likewise atomic waste. Why has the same questioning of ECT as a procedure not occurred? There can only be one of two answers. Either the psychiatrists using it are misguided enough to believe still that the dubious benefits outweigh the well-established risks to their patients, or a cover-up is occurring in case, if brain damage to patients is acknowledged, law suits will follow.
‘Let Wisdom Guide'
This is the motto of The Royal College of Psychiatry, which unequivocally supports the use of ECT. The following is from their patient information on-line service:
Repeated treatments alter chemical messages in the brain and bring them back to normal. This helps you begin to recover from your illness.
How well does ECT work?
Over 8 out of 10 depressed patients who receive ECT respond well making ECT the most effective treatment for severe depression. People who have responded to ECT report it makes them feel "like themselves again" and "as if life was worth living again". Severely depressed patients will become more optimistic and less suicidal. Most patients recover their ability to work and lead a productive life after their depression has been treated with a course of ECT.
What ECT cannot do
The effects of ECT will relieve the symptoms of your depression but will not help all your problems. An episode of depression may produce problems with relationships, or problems at home or at work. These problems may still be present after your treatment and you may need further help with these. Hopefully, because the symptoms of your depression are better, you will be able to deal with these other problems more effectively.
What are the side effects of ECT?
Some patients may be confused just after they awaken from the treatment and this generally clears up within an hour or so. Your memory of recent events may be upset and dates, names of friends, public events, addressees and telephone numbers may be temporarily forgotten. In most cases this memory loss goes away within a few days or weeks, although sometimes patients continue to experience memory problems for several months. ECT does not have any long term effects on your memory or your intelligence.
There are literally hundreds of scientific papers on the dangers and inappropriateness of ECT, not to mention the thousands of personal testimonies published as to its barbaric effects. The enormous conceit shown by The Royal College in the face of such feedback, while patients continue suffering, should not be tolerated any longer. Even the information above, which it issues to patients, is full of contradictions, fudging the issue of damage to mental function, seeking still to justify it. While it accepts that brain damage occurs, why does it continue to trumpet its value? Is it saying that brain damage is a reasonable price to pay? Surely this is Humpty Dumpty science at its worst. Its position is a farce and is reminiscent of the movie The Eternal Sunshine of the Spotless Mind which tells the story of a company called Lacuna (meaning gap, space or cavity) whose services are available to individuals wishing to erase unpleasant memories through a brain-washing procedure.
The Royal College, in its online information to patients, makes ECT look like a routine dental procedure:
What will actually happen when I have ECT?
For the treatment, you should wear loose clothes, or nightclothes. You will be asked to remove any jewellery, hair slides or false teeth if you have them.
The treatment takes place in a separate room and only takes a few minutes. Other patients will not be able to see you having it. The anaesthetist will ask you to hold out your hand so you can be given an anaesthetic injection. It will make you go to sleep and cause your muscles to relax completely.
You will be given some oxygen to breath as you go off to sleep. Once you are fast asleep, a small electric current is passed across your head and this causes a mild fit in the brain. There is little movement of your body because of the relaxant injection that the anaesthetist gives. When you wake up, you will be back in the waiting area. Once you are wide awake, you will be offered a cup of tea.
Note ‘small current' and ‘mild fit'.
The Procrustean bed
In Greek mythology Procrustes, otherwise known as ‘The Stretcher', would capture innocent travellers and compel them to stay the night. To satisfy his sadistic humour he would insist they sleep on his iron bed, and would stretch the ones who were too short until they died, or if they were too tall, would cut off their limbs to make them short enough. Either way, the bed remained the same size in spite of those sacrificed. His name has survived him, a byword for cruelty and obstinacy.
The Royal College is taking a Procrustean position regarding ECT, tailoring statistics and the term ‘wisdom' to fit the outcome they desire. Like Procrustes, the cries of whose victims fell on deaf ears, the college declines to hear information which begs to differ. In doing so the college is guilty of creating a false consciousness: a hideous lie, using ‘wisdom' and bad science to create their version of the ‘truth'. In effect they have led us to believe that a mathematical formula exists: wisdom + science = truth.
The eminent American psychiatrist Thomas Szasz wrote: "Electricity as a form of treatment is based on force and fraud and justified by 'medical necessity'. The cost of this fictionalisation runs high. It requires the sacrifice of the patient as a person, of the psychiatrist as a clinical thinker and moral agent."
In their paper ‘Time to Abandon Electroconvulsion as a Treatment in Modern Psychiatry' the authors Youssef and Youssef (1999) state: "Is ECT necessary as a treatment modality in psychiatry? The answer is, absolutely not. In the United States, 92% of psychiatrists do not use it, despite the existence of an established journal entirely devoted to the subject to give it scientific respectability. ECT is and always will be a controversial treatment and an example of shameful science. Even though some 60 years have been spent defending the treatment, ECT remains a revered symbol of authority in psychiatry. By promoting ECT, the new psychiatry reveals its ties to the old psychiatry and sanctions this assault on the patient's brain. Modern psychiatry has no need of an instrument that allows the operator to zap a patient by pressing a button. Before inducing a fit in a fellow human being, the psychiatrist as clinician and moral thinker needs to recall the writings of a fellow psychiatrist, Frantz Fanon: ‘Have I not, because of what I have done or failed to do, contributed to an impoverishment of human reality?'."
Let us not forget the Health Research Board statistics: "The 2003 data show that 859 patients received ECT in Ireland." We, the authors, take the position that this is 859 individuals too many, and that ECT should be banned on the grounds that it is no longer medically sustainable and is dehumanising for all concerned.
We invite the psychiatric profession to consider the words of Alfred Adler: "The truth is often a terrible weapon of aggression. It is possible to lie, and even to murder, for the truth."