In reply to this from Paul Brandon on ECT >And then there's the hypothesis that people change the way that >they talk about themselves in order to avoid going through t again.
I responded briefly: >Only someone who has no conception of the indescribable >nightmare of living through prolonged clinical depression >could believe something like that. To which Paul replied: >Allen – the severity of a problem is not proof of the >effectiveness of a given treatment That is a non sequitur. I said nothing about the effectiveness of ECT. The point I was making was that whatever the (understandable) fears about undergoing ECT, and the immediate reaction, it would not compare with the minute-by-minute pain of severe clinical depression. William Styron, for instance, described his experience as "suffering beyond expression". Of course patients' experiences of ECT vary widely, but how would, e.g., Dick Cavett's report of his ECT treatment – "My wife was dubious, but when she came into my room afterward, I sat up and said, 'Look who's back among the living'," -- fit with the "they only say it to avoid more treatment" notion. http://bipolar.about.com/cs/celebs/a/dickcavett.htm Or consider this balanced comment in a letter to the Irish Times in 2010 on a subject not always treated in a nuanced way: "I do have great sympathy with anyone who has been adversely affected by ECT. In my case, it lifted me out of the depths of suicidal despair twice, and enabled me to resume a normal and fulfilling life again." http://www.irishtimes.com/newspaper/letters/2010/0112/1224262121159.html Allen Esterson Former lecturer, Science Department Southwark College, London allenester...@compuserve.com http://www.esterson.org --------------------------------------------------- From: Paul Brandon <pkbra...@hickorytech.net> Subject: Re: How ECT Works? Date: Tue, 20 Mar 2012 09:26:12 -0500 Allen-- The severity of a problem is not proof of the effectiveness of a given treatment. The question here is what the most parsimonious explanation is of why people report that ECT is effective. We must at least consider alternative explanations before systematically eliminating them (see Mike Williams' post). On Mar 20, 2012, at 3:10 AM, Allen Esterson wrote: > Paul Brandon wrote on ECT: >> And then there's the hypothesis that people change the way that >> they talk about themselves in order to avoid going through it again. > > Paul: Only someone who has no conception of the indescribable nightmare > of living through prolonged clinical depression could believe something > like that. > > Allen Esterson > Former lecturer, Science Department > Southwark College, London > allenester...@compuserve.com > http://www.esterson.org > > ------------------------------------------------------------- > From: Paul Brandon <pkbra...@hickorytech.net> > Subject: Re: How ECT Works? > Date: Mon, 19 Mar 2012 19:34:59 -0500 > > And then there's the hypothesis that people change the way that they > talk about themselves in order to avoid going through it again. > > On Mar 19, 2012, at 6:19 PM, Michael Palij wrote: > >> A new research study in the Proceedings of the National Academy of >> Sciences (PNAS) claims that electroconvulsive therapy (ECT) reduces > the >> "crosstalk" among three neural networks in the brain, bringing their >> level back to that of nondepressed "normal" people. One population >> media is available here: Paul Brandon Emeritus Professor of Psychology Minnesota State University, Mankato pkbra...@hickorytech.net From: Paul Brandon <pkbra...@hickorytech.net> Subject: Re: How ECT Works? Date: Tue, 20 Mar 2012 09:27:36 -0500 Again possible, but needs to be -systematically- demonstrated, not just anecdotally. On Mar 20, 2012, at 5:47 AM, Lilienfeld, Scott O wrote: > It also does not square with the findings of several studies indicating that many or most patients who have undergone ECT describe the treatment as less disturbing or frightening than a trip to the dentist: > > See e.g., http://bjp.rcpsych.org/content/137/1/8 > > ....Scott > > Scott O. Lilienfeld, Ph.D. > Department of Psychology, Room 473 > Emory University > Atlanta, Georgia 30322 > From: Paul Brandon <pkbra...@hickorytech.net> Subject: Re: How ECT Works? Date: Tue, 20 Mar 2012 09:32:17 -0500 Ed-- These observations are consistent with your point, but do not prove it. I'd still like to see something more rigorous. I'm not denying that ECT -may- work, but given the fact that it's a bit of a blunt instrument with serious potential side effects, I'd like to see stronger support. On Mar 20, 2012, at 7:09 AM, Pollak, Edward (Retired) wrote: Paul Brandon wrote, "And then there's the hypothesis that people change the way that they talk about themselves in order to avoid going through it again." That bit of nonsense has been around for many years despite extensive evidence against it and virtually no supporting evidence. I wish that instructors would stop promoting this absurd hypothesis. I've been listening to this humanistic clap trap for 40 years and it really needs to end. The most obvious disconfirming observations include a) ECT is equally effective whether the treatment is given "eyes open" or under general anesthesia. If the "avoidance hypothesis" is correct, one would predict that ECT given "eyes open" would be far superior to ECT given under general anesthesia. b) The fact that ECT is decidedly ineffective in most other disorders. If depressives change there behavior to avoid "going through it again" then why wouldn't that be true of patients with schizophrenia, mania, OCD, etc., etc.? Ed Paul Brandon Emeritus Professor of Psychology Minnesota State University, Mankato pkbra...@hickorytech.net ----------------------------------- From: Lilienfeld, Scott O <slil...@emory.edu> Subject: RE: How ECT Works? Date: Tue, 20 Mar 2012 16:31:29 +0000 Paul - To believe that patients' self-reported improvement following ECT stems from a desire to avoid the treatment, one would also need to believe that: (1) Even though most patients describe the procedure as no more threatening than a trip to the dentist, their report is not especially plausible or at least not plausible enough to be taken on its own merits (see Paul's message below); (2) Even though scores of published studies on ECT assure patients' that their self-report reports of depression are confidential, they somehow don't believe this assurance of confidentiality, and instead think believe the treatment team will gain access to this information and use it to decide on the course of future treatment; (3) Even though most (today, probably all) patients in published controlled outcome studies of ECT give full informed consent regarding to whether to receive the treatment (and therefore the treatment is voluntary), they somehow don't believe that their participation is voluntary and instead believe that the treatment will be forced upon them against their will. (4) Even though patients in contemporary controlled studies of ECT are told they will be randomly assigned to either a treatment arm or an alternative treatment arm, they don't actually believe that the assignment is random, and instead believe that the investigative team can decide at will whether to alter the treatment plan on the basis of their self-reports. Paul, I don't find this hypothesis for the effects of ECT on self-reported depression in published studies at all plausible. This isn't to say that lots of reasonable questions can't be raised concerning the reported efficacy of ECT (e.g., integrity of the blinding in sham ECT studies), only that I don't think that this hypothesis holds water. ....Scott Scott O. Lilienfeld, Ph.D. Professor Department of Psychology, Room 473 Emory University 36 Eagle Row Atlanta, Georgia 30322 sli...@emory.edu; 404-727-1125 ----------------------------------------------- From: Joan Warmbold <jwarm...@oakton.edu> Subject: Re: How ECT Works? Date: Tue, 20 Mar 2012 15:02:08 -0500 (CDT) Since I don't think any one else has mentioned this, I would recommend reading Carrie Fisher's book, Wishful Drinking, as she talks about her experiences with ECT. She admits to it causing memory loss but believes these ongoing treatments are the only reason she is alive today. This woman is so open and frank about her life it's quite amazing--and she is funny. Joan jwarm...@oakton.edu --- You are currently subscribed to tips as: arch...@jab.org. To unsubscribe click here: http://fsulist.frostburg.edu/u?id=13090.68da6e6e5325aa33287ff385b70df5d5&n=T&l=tips&o=16857 or send a blank email to leave-16857-13090.68da6e6e5325aa33287ff385b70df...@fsulist.frostburg.edu
