ELECTROSHOCK: Restoring the Mind

Rating:
Summary: A lot of little lies in the service of one Big Lie (0 stars)
Review: Dr. Fink seems to have either erred or did not do his homework when he discusses Mrs. Rice in his chapter, "Controversy in Electroshock." The very small organization that she had established during her lifetime, Committee for Truth in Psychiatry (CTIP), was never at any time known as the Committee Against Assault in Psychiatry. Dr. Fink knew Mrs. Rice very well, enough to have told her to sit down when he was hosting the 50th Anniversary of ECT at Friend's Hospital in Philadelphia, Pennsylvania. In fact, during the deposition of a minor of an ECT recipient, the child was asked if his mother knew Mrs. Rice. Dr. Fink was well aware of Mrs. Rice's position, whose agenda consisted for only two objectives: required reporting of ECT and truly informed consent. Why Dr. Fink chose to state in his book that "She spoke at psychiatric conferences, appeared before state legislatures, and wrote harshly critical letters about psychiatry and psychiatrists" is unknown to this reviewer. Mrs. Rice only wanted other electroshock recipients who suffered permanent and extensive memory loss, such I have, to know that they were not alone. She did this by typing a monthly newsletter on an old portable typewriter, and sending them to ECT recipients who mourn the loss of precious memory caused by the treatments they thought would help them with their depression. CTIP continues to exist today, with newsletters produced by Linda Andre in Manhattan, New York, and mailed out by a former casino employee in Nevada, who likewise lost a tremendous amount of memory due to electroshock. I would be delighted to provide the few newsletters I have, which were given to me by a friend, as well as the address and telephone number of CTIP. I believe Dr. Fink should amend his book to accurately provide this information to the public, as well as make federal reporting mandatory, along with establishing a truly informed consent form for use in all facilities administering ECT.

Rating:
Summary: The Patient's Experience?
Review: Dr. Fink's book contains a chapter titled, "The Patient's Experience" which I read with particular interest. I was curious to see whether or not Dr. Fink's description of the patient's experience would match ECT patient descriptions as provided to an objective person who has no financial motive to promote the continuing practice of ECT. I regret to note that Dr. Fink has failed to include critical details about the ECT patient experience. To be more precise, Dr. Fink's description of the ECT patient experience bears little resemblance to direct reports which I have received from ECT patients and former patients. If you truly believe that ECT is safe and harmless, Dr. Fink, why not prove that to the world by undergoing a few rounds of it yourself? In fact, if ECT actually "Restores the Mind," as the title of your book suggests, what could you possibly have to lose by volunteering to directly encounter the ECT experience in the name of scientific inquiry? After all, Dr. Fink, the primary ethical obligation within the field of medicine is "Do No Harm." Surely you would not aggressively market and promote any 'therapy' which has the potential to cause harm without clearly spelling out all of the the details and potential ramifications? Perhaps your next book will provide us with a first hand account of the ECT patient's experience. Alison D. Spalding, Ph.D., MSW

Rating:
Summary: An excellent professional guide for the layman.
Review: Finally, a comprehensive book that is informative, easy to read and understand for the non-medical person on ECT. Not only does Dr. Fink supply the reader with a wealth of information on ECT, but also explains many forms of mental illness and disorders. He gives thorough explanations of illnesses and disorders, what the symptoms are, how to treat the illnesses, how patients respond and length of treatments. This book is now a vital part of my personal library on the subject of severe depression and its treatment. Having been hospitalized for severe depression, not able to respond to meds, I underwent a series of nine shock treatments in 1988. I am sure I would not have survived if my psychiatrist had not prescribed ECT. I now have a book that clearly explains the reasoning behind ECT and how it works. Everyone needs to understand that having had ECT does not make me a "freak", but a living, productive example of the benefits of this treatment of severe depression. We as a society do not judge extreme treatments of cancer or other illnesses, it's about time we accepted and understood this very beneficial treatment of some mental illnesses. I thank you, Dr. Fink for sharing this information in a way that we can all understand and grow with the knowledge you provide.

Rating:
Summary: A must-read for anyone dealing with depression
Review: Finally, a comprehensive book that is informative, easy to read and understand for the non-medical person on ECT. Not only does Dr. Fink supply the reader with a wealth of information on ECT, but also explains many forms of mental illness and disorders. He gives thorough explanations of illnesses and disorders, what the symptoms are, how to treat the illnesses, how patients respond and length of treatments. This book is now a vital part of my personal library on the subject of severe depression and its treatment. Having been hospitalized for severe depression, not able to respond to meds, I underwent a series of nine shock treatments in 1988. I am sure I would not have survived if my psychiatrist had not prescribed ECT. I now have a book that clearly explains the reasoning behind ECT and how it works. Everyone needs to understand that having had ECT does not make me a "freak", but a living, productive example of the benefits of this treatment of severe depression. We as a society do not judge extreme treatments of cancer or other illnesses, it's about time we accepted and understood this very beneficial treatment of some mental illnesses. I thank you, Dr. Fink for sharing this information in a way that we can all understand and grow with the knowledge you provide.

Rating:
Summary: Cautious, Not Unconvinced
Review: I have some hesitation recommending a book on Electro-shock which is so clearly pro-ECT and does not review this very controversial subject with an objective eye, however, having said that, I believe it is a worthwhile book as long as it is read in conjunction with a book that seriously questions the value of ECT and studies the mechanism by which it is assumed to work. Dr. Fink gives some very clear and logical sounding reasons for choosing ECT, but he does not counterbalance these
with serious looks at the downsides of ECT. I am not an anti-ECT protester, nor an I a pro-ECT advocate. ECT does offer some valuable help to some patients, but, having had ECT myself, I also know that in the case of ECT, the cure can sometimes be worse than the illness. Memory problems are not the only side effect of ECT and Max Fink is remiss in not presenting patient accounts that tell the whole story. Would I choose ECT again? I don't know, (my recovery from ECT has been slow - 2+ years now), but I do know that I wish I had read both a book like Max Fink's ALONG WITH one that talked about the flip side of the coin. One more word of caution - Max Fink makes his living by pushing the ECT button many times a day. It pays better than "talk therapy" and takes less time to provide, so be cautious in viewing Fink's book as an objective or "outside" endorsement of ECT. And remember, that what works for one, may not work for another.

Rating:
Summary: Disclosure
Review: Max Fink reports from the perspective of an ect enthusiast. He earns from administration of ect and from those who manufacture ect equipment. So he is naturally a champion of his technology.

Standard informed consents for ect procedures do not reveal the risks of long-term memory loss reported to the FDA by many many ect recipients.

Fink also omits reporting on the growing use of involuntary ect. A Wisconsin study reported that women over 65 are the largest group receiving ect without consent.

This book presents one portion of the picture of using electricty and convulsions to change the brain.

Rating:
Summary: A very useful publication for patients and families
Review: Max Fink's "Electroshock: Restoring the Mind", despite its provocative title, is a very useful, easily absorbed, informative,and lucidly written book presenting a master clinician's perspective on this controversial -yet indispensable- treatment for severe mental illness. Professor Fink explains the changes that have made this once feared treatment safe and painless with only minor and reversible side effects and guides the reader with admirable clarity through technical explanations, indications and side effects, easily understood descriptions of the mental conditions this treatment is particularly helpful in,intriguing insights about the way ECT works, and interesting speculations about the future. These are all very helpful to demystify the treatment, particularly for patients who are offered the treatment and their relatives,present an introductory text for psychology and psychiatry students, and alleviate fears associated with rumors and prejudice for the general public. This is an important and timely contribution in an era when the use of ECT is actually on the rise and its application is finally based on solid scientific research. The book is also significant for two additional reasons. One is the history of ECT it provides which gives a perspective in time and helps understand the social and scientific contexts in which this treatment was born, used, abused, and denigrated. The second is the wealth of invaluable stories of the many patients that Dr Fink has cared for over the decades, who have had their illness restored by ECT when nothing else was working, and who in turn, through the exposition of their experience, are the the ones who truly restore its reputation

Rating:
Summary: Scientifically Out of Date, Disappointing
Review: This book does serious harm to the effort to overcome the historic stigma against ECT, by perpetuating misinformation, and by misleading both practitioners and the public. Discussion of vital treatment issues, such as electrode placement and seizure thresholds, uses long out-of-date research and directly contradicts the recommendations of the American Psychiatric Association Task Force on ECT. Instead of a balanced view on both the lifesaving value and the serious issue of risk of cognitive side effects, Fink takes a highly defensive tone that denies accepted current knowledge. While understandable, given his longstanding role in the difficult battle to legitimize this crucial medical treatment, it does not justify ignoring known risks, promoting his own 1986 video which denies APA statements on memory loss, and failing to provide the most current treatment information impacting on both efficacy and side effects. ECT is too important a treatment: it should not be allowed to be damaged by a book which fights a political battle under the false guise of presenting accurate medical information.

Rating:
Summary: A must-read book for families of new patients
Review: This book fulfills a very important function: written by a foremost medical expert on ECT, it provides the lay reader with a brief, clear, up-to-date summary of this much maligned yet highly effective treatment. To this reader, the most valuable (and original) contribution of this book is its emphasis on continuation ECT. Fink gives repeated examples of individuals given ECT who responded, as the families put it "miraculously." But then, when the symptoms returned months or even years later, ECT was not used again. It was assumed to have "failed" because its effects were not permanent. But no one assumes that drugs have failed if they are taken and symptoms return when the patient stops taking them. Patients who have responded well to ECT have an excellent chance of responding again: many patients will do best if they are given ECT on a continuation basis but spaced far more broadly than at the initial crisis. There are two other particularly important contributions of this book. One is the discussion of the large variety of mental illnesses (not just depression) that respond well to ECT. The other is the encouragement it gives families to use ECT early in schizophrenia (where it is not rarely used at all, early or late). ECT used early in acute onset schizophrenia can not infrequently cut off the disease at the start, saving patients and their families a lifetime of torment.

Rating:
Summary: A book for individuals with severe depression
Review: This book is targeted towards those with severe forms of mental illness, particularly severe mood disorders. Most people, including many Medical Doctors and many talk therapist "mental health" professionals do not adequately understand severe depression and its related conditions. However Max Fink clearly does understand severe depression and not in a psychobabble fashion either. Fink understands the underlying Neurological processes that occur in severe depression and he explains how an artificially induced ECT grand mal seizure is the best way to destroy severe depression. And this is one of the many reasons why you should read this book if you have a severe mood disorder of ANY type. Whether you have unipolar major depression, bipolar manic depression or "psychotic" depression...you should read this book.

Why should you read this book? One of the main reasons is that its very difficult to find credible sources of information about modern ECT. Most of the websites on the internet concerned with ECT are emotionally ANTI-ECT and run by biased individuals who do not understand severe mental illness and do not understand ECT. Max Fink's book sets the record straight and gives you the hard cold facts about modern ECT. He explains it in adequate detail, but without getting so technical you fall asleep.

Also, some of the books written about ECT in the past were written by individuals who had ECT in the forties, fifties and sixties, before oxygenation was instituted during ECT and when it was routinely forced upon patients and used for "behavioral control" rather than using it to treat severe mental illness. Therefore, Fink's book does justice to explaining how the MODERN form of ECT is used in the MODERN era, not in 1952 in some dark, dank state run mental institution.

Fink explains many of the fundamental technical differences between "old style" ECT used forty or more years ago and the modern ECT used today. One of these fundamental differences is the use of oxygenation during ECT. In the original forms of ECT, patients were not oxygenated and during the seizure, patients tended to hold their breath for several minutes at a time and their faces would turn blue. This accounted for many of the "ECT induced brain damage" cases which so tainted the original form of ECT. Fink explains in detail, that in the modern form of ECT, you are fully oxygenated, breathing 100% pure oxygen just like pilots breathe at high altitude when flying high tech figher jets. This artificial oxygenation prevents the excessive memory loss and prevents brain damage from occurring.

Fink also does a good job at explaining what happened to psychiatry in the late forties and fifties, when it was pretty much taken over by the Freudian psychoanalysts. Who believed severe mental illness was not a brain based Neurological condition, but a problem which occurred due to deep seated, mysterious "psychological" issues which could only be resolved by endless talk therapy. Many many patients were ruined as a result of this adherence to the belief severe mental illness was not a physical, brain based illness.

Fink also does a good job of explaining how the "anti-psychiatry" movement got started. The "anti-psychiatry" movement is behind most of whatever lobbying that goes on to ban ECT.

Another thing I liked about Fink's book is that he points out that many psychotic patients could benefit from ECT but arent getting it. And many of them could possibly avoid the movement disorder side effect risks from anti-psychotic drugs. I think this is a particularly important point to make when psychiatrists are increasingly prescribing atypical anti-psychotics for persons with depression and anxiety and do not have psychosis. Maybe many of these individuals would benefit more from ECT and not risk the "Extra Pyramidal Syndrome" (pseudu-parkinsons disease) side effects of even low dose atypical anti-psychotic drugs?

ECT has many many benefits over anti-psychotic drugs and Fink points this out. ECT does not induce the debilitating movement disorders that ALL anti-psychotic drugs can induce, such as Extra Pyramidal Syndrome (mild parkinsons), the dreaded Tardive Dyskinisia, Neuromuscular Malignant Syndrome, dystonia and other nasty movement disorder problems you dont want to ever get. ECT causes none of this, in fact ECT is the ONLY treatment in psychiatry which has both anti-psychotic and anti-parkinsons effects rolled into one. Fink points this out in his book.

Also, ECT does not raise blood sugar levels and induce diabetes as many of the newer atypical anti-psychotics tend to do. Many of the newer atypical anti-psychotics are being implicated in cases of inducement of diabetes, Zyprexa is one of these. ECT carries none of these elevation of blood sugar risks.

In fact, the only real side effect of modern ECT is memory loss.

I for one believe ECT deserves a resurgence in the treatment of severe mood disorders and if you read Max Fink's book, you will no longer be afraid of ECT. Finally, it should be noted that ECT is the single best treatment for severe mood disorders that exists and many times it is the ONLY thing which will work.

Thank God we have ECT, for living with an untreated severe clinical depression is the worst hell you can possibly imagine. If you or a loved one has a severe mood disorder and are considering ECT, I would highly recommend this book