John Read: What the Science and Evidence Tell Us About Electroshock

James Moore
19
2247

This week we interview Professor John Read. Professor Read worked for nearly 20 years as a Clinical Psychologist and manager of mental health services in the UK and the USA, before joining the University of Auckland, New Zealand, where he worked until 2013.

He has served as Director of the Clinical Psychology professional graduate programmes at both Auckland and, more recently, the University of Liverpool.

He has published over 120 papers in research journals, primarily on the relationship between adverse life events (eg child abuse/neglect, poverty etc.) and psychosis. He also researches the negative effects of bio-genetic causal explanations on prejudice, the opinions and experiences of recipients of anti-psychotic and anti-depressant medication, and the role of the pharmaceutical industry in mental health research and practice.

John is on the Executive Committee of the International Society for Psychological and Social Approaches to Psychosis (www.isps.org) and is the Editor of the ISPS’s scientific journal ‘Psychosis’.

He is also a member of the BPS’s Alternatives to Diagnosis working group.

In this episode we discuss Professor Read’s research interests and in particular, the science and evidence base for Electroconvulsive Therapy or Electroshock as its known in the United States.

In this episode we discuss:

  • How Professor Read became interested in psychology, partly because of difficulties in his younger years and he wanted to understand those experiences
  • That his first experiences with patients in a psychiatric ward would be that people often wanted to share traumatic experiences, but that the psychiatrists didn’t seem that interested
  • That, by and large, mental health services around the world prefer to count symptoms and to medicate rather than to understand what has happened in a person’s life
  • How John came to have an interest in and research the efficacy and safety of Electroconvulsive Therapy (Electroshock)
  • That ECT is designed to induce a grand mal seizure and it started as a treatment for people diagnosed as schizophrenic
  • That the justification in the 1940s was that schizophrenics did not suffer with epilepsy and epileptics did not suffer with schizophrenia, so psychiatry made the leap to inducing epileptic seizures as a ‘cure’ for schizophrenia
  • That nowadays it is not used for people labelled as schizophrenic but it is most often used for treating depression
  • How actually it is not the diagnosis that is the best predictor of who gets ECT, it’s age and gender
  • Women aged over 60 are twice as often given ECT as men, and people over 60 are given it 2-3 times more often as those under 60
  • That the other rationale given for ECT treatment is the tendency for ECT to obscure traumatic memories because of memory loss
  • That the science and evidence tells us that after 70 years there has never been a single study showing that ECT is better than placebo beyond the end of the treatment period
  • That placebo in this sense is like sham surgery, the anaesthetic is given but not the electricity
  • That during the treatment (usually 3-4 weeks and an average of 8-10 sessions) roughly a third of those treated gain some lift of mood but that even for this minority of responders, the effect wears off after a few weeks
  • That this explains why some people will give anecdotal evidence that ECT saved their life and that they tend to have repeated treatments because they want the same life of mood
  • That the method used to assess success of the procedure is most often a rating scale or a ‘clinical judgement scale’ and these methods are open to bias
  • That there is not a single study that has ever shown that ECT can ‘prevent suicide’ when compared to placebo, the claims that it can are based on anecdotal evidence
  • That Earnest Hemingway killed himself shortly after receiving ECT saying “it was a brilliant cure, but unfortunately we lost the patient”
  • That there are temporary effects such as headaches after the procedure, but the enduring difficulties are often with memory loss which can be short term or longer term memories
  • Roughly a third of people will have serious, debilitating and ongoing memory loss which is caused by the brain damage caused by ECT
  • That the Guardian newspaper reported in April 2017 that ECT use was increasing in the UK but that their figures were wrong
  • That a third of psychiatrists will use ECT, a third will only use it after other options have been explored and a third will not use it under any circumstances
  • That ECT can get catatonic people moving and speaking but it is not difficult to artificially stimulate mood and it should not be seen as a cure
  • That there haven’t been any placebo controlled trials of ECT since 1985 and that was the last of only four that have ever been done that compared ECT with placebo after the end of treatment
  • How the fact that we do not have any successful trials showing that ECT is effective should mean that psychiatry either puts effort into proper research or that the procedure should be stopped
  • That John feels that eventually we will look back at ECT in the same way that we now view lobotomy, blood letting, rotating chairs and the like
  • How the principle should be informed consent and that people should be able to get treatment that they feel will help them but only if they know fully the risks and benefits and if they have been offered alternatives
  • There is a low but signifiant death rate from ECT, partly down to the general anaesthetic and partly due to cardiovascular failure because of the induced seizure but this death rate is never mentioned to potential patients
  • That it is probably down to the placebo effect of having attention and a procedure that expectations are created and hope is raised
  • That there is effort being put now into transcranial magnetic stimulation (TMS) and people can actually shock themselves using this method
  • That if we have large numbers of people walking round depressed, we really need to start asking questions about our society rather than trying to artificially eradicate those feelings
  • That John’s view is that depression is largely cause by depressing things happening to people rather than because of depressive illness and assuming that we can identify the parts of the brain that are ‘diseased’

Relevant Links:

The effectiveness of electroconvulsive therapy: A literature review, John Read and Richard Bentall

Is electroconvulsive therapy for depression more effective than placebo? A systematic review of studies since 2009

The Guardian, April 2017, ECT on the rise

Ernest Hemingway

To get in touch with us via email: [email protected]

© Mad in America 2017

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19 COMMENTS

      • What a pathetic survey this was. Couldn’t locate some patients. Acknowledgements that those who did not take part in the study probably had “a very bad experience”?
        You think. An absolutely ridiculous and worthless study. Suggesting patients “forgetting they signed a consent Ead due to them being ill or depressed?? No, brain damage!! The effect of the seizure and electrocution. The lying and misrepresenting is crazy. Concerns about parking and wait time for “electrocution”. Comments from “carers” that their (zombified and numbed)?loved ones “seemed” better??
        People who administer and promote ECT are the most ignorant, deluded, and blind people to walk the planet. They truly need to be gifted with the “treatment” they are giving their hapless victims.

  1. I continue to be appalled at the “ECT miracle” stories that are popping up like mushrooms being printed in Huff Post, Healthy Place, and newspapers rehashing Kitty Dukakis’s ECT story. Why is equal space not given to the stories about brain damage, loss of careers, and suicide caused by ECT??
    Why, in absence of science or evidence to suggest ECT is useful or safe, do high profile psychiatrists like David Healy and Sarah Lisanby and Charles Kellner Kellner keep promoting and advocating for ECT?
    Why have neurologists as a collective specialty not condemned this practice and lobbied to have it banned?

    How are the “doctors” who just “know” it works bc they “see”
    able to not see the “relapse” of their patients and the evident cognitive and memory dysfunctions??

    • Doctors, hospitals, and healthcare companies make most of their money on procedures, which motivates them to find ways to convince clients/families that they are needed and helpful, and to promote such procedures to the general public as “safe and effective”. There are great financial incentives for mental healthcare to push ECT, since it is the only medical procedure that it does, sometimes earning thousands per “treatment”. And clients usually receive it in the hospital – inpatient care is of course much more lucrative than outpatient. So maybe the people who promote ECT are somehow benefiting financially from the whole thing.
      One other thought I wanted to add – When ECT recipients do report feeling better after getting several ECT “treatments”, could the ECT merely be serving as a punishment for being depressed, which motivates them to desperately find a way to somehow make themselves feel better (or report that they are feeling better), in order to get the horrible punishment to stop? This would be similar to how torture is used to motivate captives to reveal secrets in order to get their torture to stop. Since ECT recipients lose memory for most of what happened during the period they were shocked, they may go through all of this but then permanently forget it.

      • There is nothing “medical” about this “procedure” inflicting traumatic brain injury on the sick and vulnerable. To call TBI via ECT a “treatment” is wrong. Smashing someone in the head with a bat has a similar effect, but no one calls it treatment.
        ECT is tied up in ignorance, greed, arrogance, lack of education, and desperation to do “something”, usually after driving a patient
        iatrogenically insane.
        Doctors should be given ECT before they can use the torture machine, like cops enduring tasering before being allowed to use them.
        ECT schock docs are ignorant and deluded and unwilling to review the science.
        ECT is a lasting chemical lobotomy, with,?unfortunately, as small number of deluded patients claiming benefit- those with low dose, minimal numbers of ECT. They are lucky and not the norm.

      • I would recommend Buddhist Practice and Meditation as a safe and effective alternative to the use of ECT for “Depression” and “Schizophrenia”.

        I am qualified to my opinion as I have a Diagnosis of “Schitzo Affective Disorder” and made recovery many years ago as a result of stopping psychiatric treatment.

        I was also diagnosed as a fairly hopeless case while I remained within Psychiatry.

  2. Excellent, thank you. I’ve posted a lot about the potential dangers of ECT but have taken some time to deal with my husband’s health issues – heart failure related – a direct result of the guilt and despondency he feels at signing the form authorizing ECT for me – I had refused to sign – he was told it was the last and only hope for me. The last and only hope was, in fact removal of all the pharmaceuticals – all of them – not one was necessary or even indicated. His bright, slender, trendy, articulate wife returned home as a bloated zombie collapsing to the floor, frothing at the mouth with spontaneous seizures, and missing about 25 years of memory. He used to wipe the blood from the corners of my mouth after ECT and explain where I was and why I was being tortured. We had both been told that I was demented, had severe psychotic depression, needed maintenance ECT for the rest of my life, needed pharmaceuticals for the rest of my life, and to top it all off – I would not be coming home but would be going to an institution. I went to the psych facility carrying Peter Breggin’s book – Your Drug May be Your Problem – I went for help in withdrawing from the drugs – they seized me and declared that I was an excellent candidate for ECT. IDIOTS!. I am now dealing with cracked teeth and cracked dental restorations – and I am terrified of anyone going near or into my mouth.

  3. I was eventually able to lodge a complaint with the Irish Medical Council against my former Consultant Psychiatrist and Psychiatric Researcher (who at the time was on one of their committees, and who had been promoting the drugs that had caused my Akathisia).

    During procedures my Former Consultant Psychiatrist tried to point the finger at his former colleague the “Professor” who had been previously “done” for Patient Homicide Suicide.

    The Irish Medical Council did let my Former Psychiatrist off the hook (at the time) – but he left the Medical Council and Medicine shortly after.

    In my estimation both of these “doctors” were “Dr Shipmans”.

  4. it is good to hear that a class action lawsuit against MECTA and Somatics, two companies producing ECT machines, has been filed in California by the DK law firm on Sept. 11, 2017.
    We can only hope that this action succeeds in bringing some justice to the people disabled and injured by ECT. The best case scenario sees multi million dollar payouts that bankrupt these vile companies while educating the public and the medical profession about the brain damage wreaked upon thousands and thousands of people by the idiots and sadistic practioners of ECT. The pro- ECT propaganda machine has done its evil work well. Time for it to be exposed for its lies and greed.

  5. Yes, it is good to hear that Dr. Read is clear there is no science or evidence to support the use of electroshock. But what are he and his colleagues actively doing to work towards a ban on this procedure. I know there are informative videos, but why haven’t psychologists and neurologists and anti-ECT psychiatrists joined together to lobby for an end to this lunacy?
    Videos and articles are fine, but what is actually being done, other than a yearly March??
    Why are there so few voices speaking out and encouraging action? Each day there are new victims. It must stop.