Another Look at Electroshock Therapy

Years ago my team and I watched something we had never seen before. Someone reliving something that looked like a birth primal and yet quite different. We let him go through it for about a half hour and then asked him what it was. He wasn’t sure. We then found that he’d had ten shock therapies in England for depression. He was reliving the shock, in the same way that another patient, also from England, was reliving her shock therapy (which we filmed). It looked to me like shock therapy and when I put a pencil between her teeth, her back arched and she went into what looked like an epileptic seizure. She knew when she came out of it what it was. It seems clear to me that what goes in has to come out; it is a shock just like any other shock we go through in our lives. It overwhelms the system and shuts down large parts of it. Patients need to relive electroshock therapy without a specific event in the same way as reliving the shock of seeing their parents die in a car crash. The system is overwhelmed in both cases. Part of memory is shutdown in both situations. The doctors find shock therapy helpful since it hides away past memory, keeps the person unconscious; but, as I have said before, “You cannot get well unconsciously.” It’s no different than hypnosis.

The authors of a recent study on shock therapy noted that over 10-20% of depressed persons unaffected by psychotherapy go on to shock therapy. This also seems to be true for tranquilizers, which often cannot touch depression. The doctors conclude that the only option left is to blast the patient’s brain with electrical energy. And again, there is no asking “why?” Why is depression there in the first place? Or even, what is depression anyhow? There is no thought that perhaps we need a therapy that goes deep enough to effect deep, suicidal depression.

The template here seems to be that a first-line imprint from gestation or birth leaves the prototype of hopelessness (or terror or rage, etc.), impressed into the system. Until that original imprint is addressed and relived there will always be a tendency to deep depression. Yes, it will help to discuss one’s feelings with another person, a therapist, but that still leaves the template intact. Still, talking it out eases the load a bit, even temporarily, and is a good thing.

It is not that depression is refractory to psychotherapy. It is that psychotherapy is refractory to depression. It is that current psychotherapy is too superficial to change anything profoundly. It is the fault of the therapy, not the patient. Once we know what it is and have the proper tools it is no longer untreatable. Cognitive therapy only worsens matters by remaining in the realm of cognition instead of feelings. Thinking “positive thoughts” will never change the feelings that are at the heart of depression. It isn’t that depression cannot be touched by therapy because it is such a serious affliction; it is that conventional therapy is not designed to probe the depths of the unconscious where generating sources lie. And today it seems that the only way conventional shrinks can get to those deep-lying imprints is through jolts of electricity.

Doesn’t it seem bizarre that when we are at a loss we start to blast the brain with electricity? But the shock doctors, they don’t see it as a loss. Of course there is memory loss in shock therapy; it is meant to happen. We are programmed to forget. In a way, our therapy is shock therapy in reverse. In reliving we are feeling shocked again but we can integrate that shock and so be done with it. We become superconscious, hyperaware of what went on. We don’t blast away the imprint; we approach it and finally welcome it. We don’t make it an alien force; we make it become part of us. Until that happens we must take measures to put down the force—pills, shots, shocks, endless discussion, cheerleading, jogging and exhortations to get going. And in cognitive therapy, the advice by doctors, “You see there is no reason for you to be depressed; your kids are healthy, your wife loves you…blah blah blah.”

The force is that ancient engraved imprint. The doctor is sitting behind his desk and cannot see an event that is forty years in the past. He therefore can draw no other conclusion: he (the patient) needs to get over it. For the cognition/technician it is all in the present, and seems to be irrational. They try to make it all rational without noting that the symptom has antecedents far back in history. And for such antecedents there are consequences—depression. It is all a logical extension, reacting to something specific in the past; once we get to the past it becomes eminently rational. To be bereft of the past makes it all seem irrational. We cannot make sense of any of this without referring to history. It is not just some bad thing we must blast away but specific feelings that need to be felt.

What is being blasted away? Often it is hopelessness and helplessness, the bedrock of most suicidal depressions. Those feelings are trying to make it up to the top for release, but alas, pills and then shock therapy keep it down. So the one thing that can cure is seen as the enemy, something to be avoided. What a strange paradox!

In shock, as in both that form of therapy and life, there is a fundamental disconnection from feeling centers to the top level comprehension areas of the brain (see Perrina, et al., 2012). A sort of functional lobotomy. The brain is saying, “I can’t take any more input so I will just shut down.” And with that shutdown come hidden forces that constantly render the person uncomfortable, like he is carrying a heavy load that he cannot get rid of (which he is—of feelings). His movements therefore are slow and labored; he has trouble breathing; it all seems like such an effort. There is no energy left to do anything in life, even eat. Repression is at an extreme,  and it weighs the whole system down. All energy is being used in the service of gating/repression.

The current rationale for depression seems to be that it comes out of nowhere (some textbooks state it thusly—“endogenous depression”), like some phantom to haunt us. And if we do not understand the imprint we are forced to call in the phantoms. We need to know that suicidal depression is something knowable and genuinely treatable. We don’t need to insert something like a shock machine into someone. All we are doing there is ensuring that would-be liberating memories are more hidden and inaccessible. There are treatments that are much easier, safer, and quicker; and a way to truly get rid of depression.

Perrina, J.S., Merzb, S., Bennetta, D.M., Curriea, J., Steelec, D.J., Reida, I.C., and Schwarzbauerb, C. (2012) Electroconvulsive therapy reduces frontal cortical connectivity in severe depressive disorder. Proc Natl Acad Sci USA, 109(14):5464–5468

On the Mystery of the Unconscious Part 2/2

We have seen in my past blog how we go in and out of consciousness in ordered fashion. In therapy we start at the end and move to the start, evolution in reverse. We start in the present and move to the past, to the origin of the nervous system. The thrust of the therapy is to begin with the end product in our evolution, the neocortex and move slowly downward. And this order is unshakeable in every way. An approach that defies this order is doomed to failure. The brain is an orderly entity that brooks no insurrection. So we begin on the third line (present) move to the second line (childhood) and finally the first line (after conception to months after birth). When we are anchored in the present it then allows us to dip into feelings, and those feelings become the vehicle for a deeper descent in the brain. Words are not the primary vehicle, feelings are because their origin is lower down. It is like a mine elevator that takes us ever so slowly into the lower depths. Words cannot be the primary vehicle because they exist on the top level. We descend in therapy to where feelings lie, where they begin their organization; those feelings begin their and our liberation. Evolution dictates how our therapy works; for if we want to provide connection to feelings we need to be cognizant of where feelings lie. And obviously, we cannot produce connection only on the cortical top level of the brain; we are connecting lower level imprints to higher level understanding. We need to learn how to descend to lower levels of consciousness where our pain lies. Our job is the opposite of most other approaches who cover over the pain. We let it rise in ordered fashion. Perhaps more accurately, we descend to meet them.

When deep levels rise faster and higher than higher levels, as in rebirthing, we’re in trouble. This defies the natural order of the brain. That is why hallucinogens are so dangerous; unleashing deep levels prematurely. They are too powerful to allow connection so they produce only abreaction, or they rise to produce strange ideas, sometimes psychotic ideas. These are never connected but simply the effluvia of too many and too strong feelings. All because the doctor has decided to skip evolutionary steps and produce what looks like super dramatic results; too dramatic to be of any therapeutic use. What I am describing is a neurologic dictatorship; it allows no disobedience and demands absolute loyalty. It is merciless, permitting no second chances, no opportunities to take a different route. Follow the prescribed evolutionary route or suffer. Evolution, as I have said, is pitiless. If we want to get along with it we must learn its rules. So of we want to take a fast route to the depths of the unconscious and use drugs we will pay a heavy price. We can’t trick mother nature.

We know more about how drugs work now based on the neurologic hierarchy; how we react to them, how we come out of them, how we suppress different brain levels with different kinds of drugs. And because of this evolution we never want insights, ideas, to precede feelings; that is not how it happened in our history. We didn’t speak before we had feelings. Why should we speak our insights now in therapy before we get to feelings? Evolution! We were first all brainstem, then limbic, finally neocortex. Each brain has its secrets, and it is our job to find them out.

Each new level absorbs part of the previous level, which is why as we descend down the hierarchy of consciousness and feel on one level we are also feeling part of the previous deeper level; we feel about our childhood but it may incorporate without our knowing it, aspects of the birth trauma, as well. When the previous level is too strong it may well interrupt the feeling. So we feel on the level of childhood and suddenly there is gagging and choking as the deeper level of the birth trauma is surging forth. It does this because our gating system between levels is impaired. It is impaired due to the heavy load of pain which has weakened it.

Only when we follow evolution do we have a chance to get well. We need to know how to read the instructions; they are there and are obvious to the attentive. When we try to outsmart those instructions we get in trouble. And those who want to outsmart it are those usually in their heads: the intellectuals who believe they know better. They think that way because they are bereft of access to their feelings; they do know more and would inform them of evolution. There is nothing like access to feeling to keep us straight. We can think straight when those ideas come fluidly out of our feelings. When we don’t feel, our ideas are not anchored, become detached, and can be anything. That is why when doctors concoct a theory from their heads it may have nothing to do with us humans, and their therapy goes off track and cannot be curative. The reason is that it is all intellectual and ignores the human body and physiologic system. Theory must evolve out of the human experience, and not out of the head of the doctor. So intellectuals become therapists and superimpose their beliefs on to how we do therapy. (I am not against intellect, only intellectuals). They superimpose their beliefs onto feelings, and what that does is suppress feelings and make it look like the therapy is a success because the patient can no longer feel her pain. But it won’t last and she will keep on having to do it. Because feelings will surge their head again and again upwards, searching for neocortical connection. Connection means final relief. No connection, no relief, no matter what anyone believes. Well yes, a bit of relief for a short time but nothing definitive. When I discuss connection it means taking a lower level feeling towards the neocortex. We need to access feelings to do that.

Scientific American just published a piece called, Decoding the Body Watcher. (4-5-12) They ask the question, what is the difference being attentive to the outside world as opposed the inner one? They explain that while the top level cortex can attend to the outside, the older more buried parts (Insula and posterior cingulate cortex) specialize in our inner world. If we want to appeal to the inner world we need to go there, and we cannot do it by an act of will or conscious deliberation. “Will” is a top level event that has no roots. We need to go to the unconscious. If we remain on the level of ideas we cannot get there from here. We go there via the lower structures but need the higher levels to start us on the track. Descent can never be an act of will (top level); it is an act of total submission as we leave the neo-cortex behind. When we usually say “Pay attention” we mean using the top level cortex to focus. Abandoning the top level and sinking into feelings is the proper way to get feeling’s attention.

When we stay on unanchored cortical level the lower levels can dominate perception so that we mistake someone’s intention or their interest in us? Those lower levels can make us suspicious and untrusting. What the university of Toronto researchers found was is that we become victims of our feelings and have little control over them. Segal and Anderson found that feeling perceptions rely on deeper level brain processes, lower level consciousness—older brain systems.
So here is the key: we cannot rely on newer brain systems to access the older ones, especially the very old ones that lie deep in the brainstem. We mistakenly think that we can resolve our emotional problems from the top down; using the new brain to figure out the old one, the one that is millions of years away from the present. They suggest that we need to bypass the cortical area to get lower to feelings tapping directly into body areas. That describes what we do completely. When you do that you eliminate what Freud used to call the superego; you bypass critical judgment and let the feeling rise. You are not endlessly ruminating about what you are thinking or believing.

Imagine now going to a shrink who makes a mystery of the unconscious and presumes to tell us what is in our unconscious; something millions of years away in neurologic time. He will need something more powerful than the Hubble telescope to do that. It is impossible yet many therapies are based on that; thinking our way to health. Too often, we seek out doctors who will tell us what is wrong with us. They tell us what to do to improve when, as I repeat ad nauseam, only we can do that in a proper environment where we can access deeper levels. In our case, a quiet padded room with softened light. And unlimited time for the session.

Too often shrinks tell us what and how to think; to think positive and deny what our body is importuning all of the time. When doctors have little access to feeling, they can manufacture a therapy that offers us little access, as well. When we ignore access, all the other ways of therapy become alleviating, palliatives, quick-fixes, and don’t last. That doesn’t stop millions from trying it. They seem to want to learn how to stuff back those naughty feelings. Yet it is so much easier and freer to let it all out. But all of these old conventional theories come out of ancient times when feelings were an anathema. Feelings became equated with nuttiness; true to this day. You know, “John is so emotional. We need to be careful around him. “ Or, “so and so can’t think straight because he is so emotional. “ What this usually meant was that his feelings overwhelmed his rational mind. So long as his feelings meld with understanding he is rational.

It seems to be true that the only way we are willing to go deep into ourself in therapy is if we are already suffering; which means that the pain has risen into conscious/awareness. Otherwise, we seem to look for a little touch-up, a bit of suppression so that we can go on with our neurosis. We don’t seem to want change; we want to make our neurosis work.. I believe that in doing that we are surely shortening our life. The pain doesn’t leave; it stays and agitates and eventually will get at our heart or brain. There is no escape, just evasion.