ECT without consent - comments from a thoughtful psychologist - Irish Times

[Guest guest]

http://www.irishtimes.com/newspaper/letters/2010/0125/1224263034952.html

The Irish Times - Monday, January 25, 2010

ECT without consent

A chara, I am strongly opposed to electroconvulsive therapy (ECT),

whether voluntary or involuntary, as I believe the scientific basis for

its effectiveness is weak, and the amount of evidence for its failure

and, beyond this, its damage to people, is very strong.

I agree with Ingrid Masterson (Letters, January 12th): we should be

wary of any form of treatment that damages, particularly one whose

side-effects include loss of memory and, thus, loss of identity.

The continued presence of ECT is a symptom of a wider malady in our

mental health system. It indicates that there is still a belief that if

a person is shaken up, and forgets the pain experienced in their lives,

they can be just like anyone else.

The choice of ECT also indicates a lack of imagination, and a

failure, in many instances, to recognise that a person remains

depressed and may become more severely so when the underlying issues

(often including forms of abuse) have not been addressed.

We should question how distress comes to be seen as illness, and

how, in turn, a new logic is used; a medical logic of diagnosis,

prescription, additional intervention and review.

If we are to bring about the kinds of changes needed, we must tackle

the medical model of human distress itself, and question its validity

and value for all involved.

The issue of ECT is important, but all that we have recently read

about it reflects the system as a whole, including the assumption that

the professional is in a better position than the patient to know his

or her needs. We should also recognise, from recent scandals

implicating other kinds of institutions, that systems that regulate

themselves require some external scrutiny to ensure the welfare of

vulnerable people.

So long as we view distress as illness, we are going to turn to

medical personnel, who are generally not trained specifically to

understand human distress, and who are in a position to provide only

medical solutions. Our mental health system is still strongly skewed

towards the medical treatment of distress. All recent trends suggest

this will intensify.

It may take a full-scale public outcry and a more sustained

revelation of what is wrong with these methods to bring about what

people in distress need: an environment open to the person's situation,

and patient, sufficiently qualified staff who will listen and help the

person to make sense of and come through their difficulties. 'Is mise,

Dr JOHN O'CONNOR,

Lecturer in Clinical Psychology,

School of Psychology,

Trinity College Dublin.