ECT and suicide

[From Mike Acree (971218.1148)]

Bruce Gregory (971217.1320 EST)

Depression is hardly unknown among psychiatrists; they have one of


highest rates, if not the highest rate, of suicide among the
professions. Many of them also insist that electroshock therapy


is the treatment of choice for severe depression. Yet Robert Morgan,
author of the _Iatrogenics Handbook_, has pointed out in court


that _no_ psychiatrists have ever prescribed ECT for themselves--or


anyone they liked. (There was one case of a psychiatrist prescribing


for his mother-in-law.)

What lesson are we to draw from this example? That electroshock
therapy is bad? Or that psychiatrists can't recognize when they
might benefit from it? I've always heard that someone who treats
his own disorder has a fool for a doctor and a fool for a

It struck me as a particularly telling example of the lack of respect I
had referred to (in my previous post) among some helping professionals
for those they are supposedly helping. But it may be telling you
something else.

Bruce Abbott (9712.1420 EST)

Electroshock therapy evokes images of the electric chair or the


chamber. It was depicted as a kind of punishment in the movie _One


Over the Cuckoo's nest. Do you have any idea what electroshock

therapy is

like, from the patient's perspective? From the therapist's


What its side-effects are? Why do you suppose psychiatrists would not
prescribe it for themselves?

The most notorious "side" effect is memory loss. For this reason it is
overwhelmingly favored for elderly people, who already have enough
memory problems that any additional deficit due to treatment would be
hard to prove in court.

The standard acronym, by the way, is, as Dan Miller (971217.1450) notes,
ECT, for electroconvulsive therapy, which conveys a little more of what
it's like from the patient's point of view. In my one experience
working on a psychiatric ward, I had the impression that ECT was indeed
used punitively, judging from the behaviors it was prescribed for and
the patients who were threatened with it; I didn't see "Cuckoo's Nest"
as very fictionalized.

Mark Lazare (971217(f?))

I always ask their permission to help or at least "try" to help them.


always start and progress in terms of cooperation -- force is only

used as a

last resort, because the CT is unable or unwilling to cooperate --

also I

never tell the ct that is part of my powers of control, IF I did I

could not

be sure they were cooperating because they did not want to be forced



I'm not much impressed with the defense of force that it is used only as
a last resort. The same would be said by muggers or the IRS, who are
quite right in believing they couldn't get our money any other way. A
few months ago I quoted Al Capone's remark that "you can get a lot
farther with a kind word and a gun than you can with the kind word

Rick Marken (971217.1400)

Thanks for your moving story of S. As you anticipated, I liked your way
of being with her. Your observation to her that suicide is always
available is one I took first from Nietzsche--"The thought of suicide is
a comforting one; by means of it one gets successfully through many a
difficult night"--and found helpfully apt in my teens. I know,
incidentally, one courageous therapist who met a very seriously suicidal
woman in her despair, let her see (over the phone, at midnight) that he
really "got" it; and the experience of finally being understood (and
accepted) was transformative for her.