I can't see how giving someone an electrically-induced head injury that causes a grand mal seizure is thrillingly good for brain health. As having once been the recipient of this enlightened scientific intervention, the memory devastations weren't an abstract speculation, but a brutal lived reality.
It's true: there is a small minority returned to mental health with minimal side-effects. But then there's also freaks who've drunken a bottle of vodka a day for fifty years, run a thriving business and are as sharp as a tack. Are they representative of the typical alcoholic? Hardly.
I saw a video recently of someone who has started getting severe epilepsy, out of nowhere it seemed. Never had it before, doesn't run in the family.
Except one small detail: at one point she'd had a few rounds of ECT. No history of epilepsy? At one stage she'd been getting epilepsy three times a week.
Post-ECT epilepsy is a lot more common than shrinks are prepared to admit. The accounts of this "clinically impossible" outcome aren't rare, and the psychiatric denial of this reality amply point to the true-believer, venal infantilism that rules the roost at Electroconvulsion Incorporated.
Somehow I think there's some Thymatron-fetishising, beady-eyed geeks that need to grow up, wake up, and possibly study ethics extramurally.
The point is that the research hasn't been done. A century after convulsive techniques began, there is no proper account of the efficacy or risks of ECT. It would be the easiest thing in world to organise a proper prospective study across half a dozen countries but they won't do it just because they know the figures don't support them. My ECT review from a few years ago (reference above) refutes every claim made for ECT but that has no effect, the RANZCP simply ignores the paper.
It's more than just "grow up," it's "get honest." It's mainly money but also ignorance and desperation but this all flows from the so-called biological approach to mental trouble. Too many psychiatrists have invested too much of their careers and themselves in biological reductionism and they're incapable of admitting error.
Well for grown ups that make the decision to actually engage in genuine, evidence-based research rather than industry-corrupted, ideological posturing, clinical reality looks a lot different to the spin-doctored garbage most starry-eyed supplicants are presented with.
Agreed but it is a failure of education. Critical thinking and logic should be a core element of every university course and probably every high school course. Medical students are told what to remember, there is no training in criticism, questioning the professor is a sure way to be thrown out. We would like to think a mature person can look at things objectively but too many of them are, as you say, infantilised in respect of their status, incapable of admitting error.
I completely agree with that but I also think emotional literacy and empathy is vital too -- though I'm not sure how that would be taught without inappropriate invasiveness and subjective agendas.
If critical thinking and logic was married with emotional sensitivity that would make moral injury much more of a likelihood. Which would be good, actually: the profession would be considerably more self-aware and accountable, but then genuine awareness would probably incinerate the credibility of the bulk of the profession as a whole.
"Any System that can be gamed, will be gamed" - I'm sure some clever wordsmith has already created that aphorism at some point.
The 'gaming' in this instance is allowing private profit from ECT therapy in Oz.
If people can make profit from a legal act, then morality will not apply for the majority. Many will still do it even if it was made illegal - so keeping such tortures legal is just asking for trouble.
Thanks, Niall, I completely agree with you, and with the team of Read et al. I have commented here before that I have never used ECT in my practice. I have also visited facilities in Italy, where ECT is mostly banned, and they seem to manage very well without it, and that includes a forensic unit and a long-term residential unit for people with chronic mental illness.
Truly amazing that the RANZCP claims ECT is "essential," "life-saving," "irreplaceable," etc. entirely without evidence. So much for "evidence-based practice." Peter Medawar said of Teilhard de Chardin: “(The) author can be excused of dishonesty only on the grounds that, before deceiving others, he has taken great pains to deceive himself.”
I can't see how giving someone an electrically-induced head injury that causes a grand mal seizure is thrillingly good for brain health. As having once been the recipient of this enlightened scientific intervention, the memory devastations weren't an abstract speculation, but a brutal lived reality.
It's true: there is a small minority returned to mental health with minimal side-effects. But then there's also freaks who've drunken a bottle of vodka a day for fifty years, run a thriving business and are as sharp as a tack. Are they representative of the typical alcoholic? Hardly.
I saw a video recently of someone who has started getting severe epilepsy, out of nowhere it seemed. Never had it before, doesn't run in the family.
Except one small detail: at one point she'd had a few rounds of ECT. No history of epilepsy? At one stage she'd been getting epilepsy three times a week.
Post-ECT epilepsy is a lot more common than shrinks are prepared to admit. The accounts of this "clinically impossible" outcome aren't rare, and the psychiatric denial of this reality amply point to the true-believer, venal infantilism that rules the roost at Electroconvulsion Incorporated.
Somehow I think there's some Thymatron-fetishising, beady-eyed geeks that need to grow up, wake up, and possibly study ethics extramurally.
The point is that the research hasn't been done. A century after convulsive techniques began, there is no proper account of the efficacy or risks of ECT. It would be the easiest thing in world to organise a proper prospective study across half a dozen countries but they won't do it just because they know the figures don't support them. My ECT review from a few years ago (reference above) refutes every claim made for ECT but that has no effect, the RANZCP simply ignores the paper.
It's more than just "grow up," it's "get honest." It's mainly money but also ignorance and desperation but this all flows from the so-called biological approach to mental trouble. Too many psychiatrists have invested too much of their careers and themselves in biological reductionism and they're incapable of admitting error.
Well for grown ups that make the decision to actually engage in genuine, evidence-based research rather than industry-corrupted, ideological posturing, clinical reality looks a lot different to the spin-doctored garbage most starry-eyed supplicants are presented with.
Agreed but it is a failure of education. Critical thinking and logic should be a core element of every university course and probably every high school course. Medical students are told what to remember, there is no training in criticism, questioning the professor is a sure way to be thrown out. We would like to think a mature person can look at things objectively but too many of them are, as you say, infantilised in respect of their status, incapable of admitting error.
I completely agree with that but I also think emotional literacy and empathy is vital too -- though I'm not sure how that would be taught without inappropriate invasiveness and subjective agendas.
If critical thinking and logic was married with emotional sensitivity that would make moral injury much more of a likelihood. Which would be good, actually: the profession would be considerably more self-aware and accountable, but then genuine awareness would probably incinerate the credibility of the bulk of the profession as a whole.
"Any System that can be gamed, will be gamed" - I'm sure some clever wordsmith has already created that aphorism at some point.
The 'gaming' in this instance is allowing private profit from ECT therapy in Oz.
If people can make profit from a legal act, then morality will not apply for the majority. Many will still do it even if it was made illegal - so keeping such tortures legal is just asking for trouble.
Thanks, Niall, I completely agree with you, and with the team of Read et al. I have commented here before that I have never used ECT in my practice. I have also visited facilities in Italy, where ECT is mostly banned, and they seem to manage very well without it, and that includes a forensic unit and a long-term residential unit for people with chronic mental illness.
Truly amazing that the RANZCP claims ECT is "essential," "life-saving," "irreplaceable," etc. entirely without evidence. So much for "evidence-based practice." Peter Medawar said of Teilhard de Chardin: “(The) author can be excused of dishonesty only on the grounds that, before deceiving others, he has taken great pains to deceive himself.”
Thanks again, Niall, what a wonderful quote from Medwar.
Carolyn
Psickiatry.
major issue with selection bias with this study of ECT - though I am definitely NOT if favour of it .