Tuesday, 25 December 2007

Criticism Anxiety, part II

"If you want to know something, ask an experienced, not a scholar." -Chinese

So, here we've got it, the latest issue of Outsideren. Including the summary of the ECT-debate, and thus the article "Nej, nej og aldrig!" (No, no, and never!), based on an interview with me. As promised at "Criticism Anxiety, part I", I'll comment. Both on the article, and also on psychiatrist Martin Balslev Jørgensen's reply on some of my arguments against ECT: "Kun når det virkelig gælder" (Only when really necessary).

The editor's introduction to the issue states that ECT-(psychiatry-)critics don't show enough readiness for dialogue. This simply is wrong, as the example Dresden has shown. We're more than ready for dialogue. Which we're, nevertheless, are not willing to do, is exactly which psychiatry most often and quite consequently asks us to do, that is, to deny our experiences, and the positions we hold as a result from these experiences. Dialogue presupposes our experiences and positions to be respected. Just as we are supposed to respect others' experiences and positions. Interestingly, mental health staff mostly is in complete lack of the first. Psychiatrists' positions usually are based on theoretical knowledge alone, knowledge they acquired by studying clever books, written by people with a purely theoretical knowledge, acquired by studying clever books, written by people etc. Thus, their positions' foundation is of a more or less completely theoretical kind, not based on experience. Empirical research is a city in China to psychiatry.

Dialogue presupposes listening to each other. With very few exceptions, psychiatry has always been and still is characterized by denying to listen to its clientele. Martin Balslev Jørgensen (M.B.J.) the same - and I shudder to think, that the man also acts as a therapist. "People who are against ECT, from a philosophical position for example, do not have any understanding for how miserable these people feel", he says. Dear Martin Balslev Jørgensen, I feel like commenting, most of the most inveterate critics of ECT have been exposed to this kind of torture themselves. Are you implying that these people don't know what they're talking about??

"That psychiatrists can't think of anything but administering ECT as soon as possible, isn't true", M.B.J. replies to my statement, that "psychiatrists do (...) the only they can and the only they are trained to do: WRITING PRESCRIPTIONS and zapping people's brains", as it is put in the Outsideren (my emphasis). M.B.J. here, elegantly (?), navigates round half of my argumentation. The decisive half. A look at the patients' complaints board's rulings concerning complaints about involuntary ECT, shows clearly that the only less intrusive measures tried before ECT was administered, was medication. None of the rulings mentions any kind of dialogue to have been tried. Dialogue, which, by the way, isn't only less intrusive than ECT but also much less intrusive than medication. BUT: Psychiatrist indeed aren't trained to talk with their clientele. They are trained to administer "medicine" and ECT. As mentioned in a previous post: That's that. It's not without reason that they also refer to themselves as "psychopharmacologists".

In reply to my remark that psychiatry's view of human nature is a purely naturalistic one, that it doesn't take the metaphorical dimension of the mind, the psyche, into account, M.B.J. states, he "would rather compare mental distress to diabetes than to a broken leg", as the article "Kun når det virkelig gælder" tells us. I must admit, I'd be tempted to laugh if it wasn't that sad. Once again the simplistic comparison, Outsideren chooses to print instead of the more complicated explanation, I also went into at the interview, is misunderstood (on purpose?). The question is not at all, if crises are comparable to broken legs or diabetes. The question is, if crises altogether are comparable to physical harm, illness, "regulating mechanisms which do not work" (interesting rewording of the by now slightly hackneyed phrase "imbalances in brain chemistry"!), or not.

And, dear Martin Balslev Jørgensen, if you are capable of listening at all - once again I shudder...: My own EXPERIENCE (and I'm not alone in this) is, that they definitely are not. No matter how much you would like to make people believe it, in order to be able to sell them your "treatment", your pills and your ECT. And disregarded that you try to save your honour as a therapist by the bell by saying that crises aren't "a PURE physiologic problem" (my emphasis).

That M.B.J. himself is an individual who "doesn't want to face reality", as he accuses ECT- (and psychiatry-)critics to be, statements like "...only a very few individuals complain about persistent memory loss", "It has not yet been possible to make out for sure, if memory loss is a side effect of ECT, or if it is due to the preceding depression" and: "As a psychiatrist you use which is provenly effective" prove. Again, I can only point to the Sackeim-study - which Outsideren, unfortunately, and incomprehensibly to me, chose not to refer to - as the newest of numerous studies showing persistent memory loss and persistently reduced cognitive abilities with up to 50% of the individuals who were exposed to ECT, unmistakably being caused by the "treatment". How "effective" psychiatry's "treatment" options really are, no less numerous studies show, which compare ECT to sham-ECT and "medicine" to placebo. The "effectiveness" is the same, whether it is the real McCoy or sham-ECT/placebo. Should M.B.J., the "expert" in the field he so desperately seeks to appear as - in contrast to the, according to him, oh so stupid critics - not have any knowledge of these studies?? To me, this wouldn't exactly be a sign of especially great expertise.

How "strict" the rules for involuntary ECT are, a comparison of the numbers from 2005 and 2006 shows: In 2005 90 individuals were exposed to involuntary ECT in Denmark. In 2006 this number is five times as high (!): 450 individuals were exposed to involuntary ECT. Further increase is to be expected. Inhibitions clearly dwindle, the rules become decreasingly strict. That it allegedly is impossible to do without coercion, the fact, that there are countries, like Germany and Norway, where it is against the law to administer ECT involuntarily, disproves.

It is incomprehensible to me that Outsideren chooses to link to Dansk Psykiatrisk Selskab's (The Danish Psychiatric Association) 2002-study, which is characterized by the same bias and misinformation the whole psychiatric system strongly is characterized by, but chooses to do completely without any of the links to critical and independent information, I provided several of. Admittedly: Really critical and from the pharmacological as well as the ECT-lobby independent information is only available in foreign languages, primarily in English. Information in Danish is, as far as I know, not available.

Looked at in isolation, Outsideren's article about the arguments of ECT-critics is nowhere near satisfactory, and borders to the annoying in its simplicity that invites misunderstandings, like M.B.J.'s, of my argumentation. Additionally annoying is, that M.B.J. is widely allowed to avoid the issue in his defence of ECT, that, obviously, the misunderstandings aren't corrected. Nevertheless, all in all, the whole issue of Outsideren taken into consideration, a slightly greater differentiation can be observed, which, partly, saves the honour by the bell. Partly. Still it is avoided to take a stand, and, which is worse, to let a third party, such as I am in this case, FULLY take a stand that isn't in line with mainstream psychiatry's. As far as I am concerned, I feel a strong urge to apologize to people like Leonard Roy Frank, and, in future, I will consider more carefully whom I'll give an interview.


Anonymous said...

this is another awesome post. Aside from natural talent, how many years of Uni does it take to write this good?

I am surprised there was no comments before me.

you are a real warrior to engage directly with psychiatry this way

cheers for you Marian

Marian said...

Hahah, Jane, did you never hear of that an obsession with words, language, is regarded almost a "symptom" of "schizophrenia", psychosis in general? One of the forms this obsession often assumes is creating neologisms.

Indeed, I think, there's some truth to it. Although it's not a "schizophrenic" one. It's simply that a "psychotic" (spiritual) experience often includes the (unconscious) realization, that words are not the thing itself, but only pointers. This realization opens up for undreamt-of possibilities to play with words. It can increase one's linguistic awareness (if made conscious), or it can render one's discourse unintelligible to others (if it stays unconscious: "psychotic speech"), as the otherwise rather firm and secure connection between pointer and the pointed-at, dissolves, becomes increasingly insecure.

So, it doesn't take any academic training at all. It only takes this realization. And: your writing is just as good (as you, too, have come to the realization, I bet).