In a PBS documentary, ECT is Bad for “Curing” Homosexuality, but Great for Depression! – Mad In America – James Moore
When I heard that a documentary was in the works which was fiercely critical of the diseasing of homosexuality by the American Psychiatric Association (APA), I was curious how the filmmakers were able to get it shown on PBS’s Independent Lens (this October 11, National Coming Out Day). As I explained in my CounterPunch review of Cured, my belief is that what allowed this documentary to get aired on PBS is that it painted a picture of the current APA as a very different institution than the APA that had barbarically attempted to “cure” homosexuality.
There is one disclaimer at film’s end which will likely enrage many Mad in America readers. In my CounterPunch review, I stated that I could not imagine that the filmmakers would have inserted this disclaimer on their own without pressure from the APA and establishment psychiatry, and owing to that speculation, the filmmakers reached out to me, requesting a chat. Five days after my CounterPunch review had been published, the filmmakers and I spoke on a conference call for approximately an hour. I’ll get to that, but I’m getting ahead of myself.
Cured
Filmmakers Bennett Singer and Patrick Sammon’s Cured is the story of how gay activists forced the APA in 1973 to rescind its declaration that homosexuality is a psychiatric illness and, ultimately, to remove it from their DSM manual of disorders.
Cured includes a graphic portrayal of the use of electroconvulsive therapy (ECT), commonly known as electroshock, to “cure” homosexuality,” showing just how traumatizing and brain-injuring ECT was for its victim patients. Cured also points out that another commonly used barbaric “treatment” was “aversion therapy,” in which electric shock to the genitals and/or nausea-inducing drugs were administered simultaneously with the presentation of homoerotic stimuli; and Cured notes that psychiatry also attempted to “cure” homosexuality with castration and lobotomy.
Cured is being promoted as a documentary about a pivotal event in the movement for LGBTQ equality, rights, and de-stigmatization. However, as I make clear in my review, Cured will also help viewers—at least critically-thinking ones—understand why this gay activist victory over the APA remains such a pivotal event for individuals today who may not be LGBTQ but who feel dehumanized by psychiatric diagnosis and treatment.
While the APA is pleased with itself for finally abolishing its diseasing and stigmatizing of homosexuality, Cured provided me an opportunity to discuss the issue of stigma in a manner that will not please the psychiatry establishment. The film provides an opportunity to assert that history tells us that not only does mental illness labeling maintain and even increase societal stigma, but that for those who accept their sickness branding, what ensues is a crippling belief that their fundamental humanity is defective.
This is a truth, as Cured shows, that gay activists brought to public attention in their battle against psychiatry, as journalist and gay activist Ron Gold famously scolded the APA, “Stop it, you are making me sick!” Gold then offered some common sense to a psychiatry profession lacking any: “The worst thing about your diagnosis is that gay people believed it. Nothing makes you sick like believing you are sick.” Sadly, this is a truth that has been re-buried.
Many Mad in America viewers will appreciate what astronomer Frank Kameny, one of the most influential gay activists in U.S. history, had to say about psychiatry, calling it a “shabby, shoddy, sleazy pseudoscience masquerading as science.” As a scientist, it was obvious to Kameny that the APA’s illness declaration of homosexuality was the result not of any kind of science but of politics, and as such, could only be abolished by political activism. I point out that Kameny’s quote not only indicts psychiatry’s pathologizing of homosexuality but all of psychiatry’s illness declarations.
Psychiatry Continues to Pathologize Normality
While psychiatry and the current APA would like Cured viewers to believe that psychiatry has been “fixed” and no longer medicalizes normality, I make clear in my review that this is not the case, and I had a question for filmmakers about this issue (I will return later to their response). While homosexuality is no longer listed in the DSM because brave and well-organized gay activists—assisted by a changed cultural climate—had enough political clout to intimidate psychiatry into abolishing this insult to their humanity, psychiatry quickly turned to an even larger population, one with little potential for organizing and no such political clout—children and teens.
In the 1960s and 1970s, not all that radical was the idea that it is quite normal for many young people—especially critical thinkers and artistic souls—to feel alienated and oppressed by standard schools; but beginning in the 1980s, this commonsense wisdom had begun to be replaced by the psychiatric wisdom that a failure to adapt to one’s schooling is a symptom of mental illness. Today, young people who refuse to pay attention in the classroom are diagnosed with “attention deficit hyperactivity disorder” and put on Adderall or some other such speed; shy school-resistant youngsters are diagnosed with “social anxiety disorder” and put on Paxil or some other such antidepressant; stubborn noncompliant young people are diagnosed with “oppositional defiant disorder” or some other such “disruptive behavioral disorder” and placed on a variety of drugs. And what would have been completely bizarre fifty years ago is the now increasingly popular psychiatric illness of “pediatric bipolar disorder,” in which even five-year-olds are placed on antipsychotic drugs based on their failure to “regulate their moods” in a manner that doesn’t put adults out of control.
Having hopefully laid the foundation for readers to rethink current psychiatry, I invite readers to reconsider another group of people that society has allowed psychiatry to control: “voice hearers,” who are as angry with psychiatry as those earlier gay activists who defeated the APA, but who, unlike children and teenagers, have increasingly politically organized and are utilizing gay activists’ successful model of resistance against psychiatry. I explain that while voice hearing is deemed by psychiatry as a major symptom of schizophrenia, it is deemed by many voice hearers themselves as a meaningful human experience; and I recommend to readers who want to get a sense of the damage created by psychiatry’s standard treatment for voice hearers and the meaningfulness of such voices to check out the Eleanor Longden TED talk “The Voice in My Head.”
I then draw parallels between gay activists battling psychiatry with voice hearer activists. I report that Dutch psychiatrist Marius Romme, in contrast to the overwhelming majority of his colleagues, has championed the idea that hearing voices is a normal, albeit unusual, human variation, and he has challenged the notion that it is a characteristic of serious mental illness. Romme, along with journalist Sandra Escher and ex-psychiatric patients, created the Hearing Voices Network. Similar to how gay activists depathologized, normalized, and destigmatized homosexuality with the help of Alfred Kinsey’s studies that showed gay fantasies and experiences are more widespread than previously acknowledged, the Hearing Voices Network reports there are several studies showing the widespread nature of voice hearing, which is termed by psychiatrists as “auditory verbal hallucinations” (AVH).
A 2013 review of these studies concluded: “Epidemiological studies have estimated the prevalence of AVH to be between 5 and 28% in the general population”; and most importantly, among those who hear voices, the difference between those who are diagnosed as ill and “treated” versus those who never encounter psychiatry is highly related to how positively (e.g., a meaningful experience) or negatively (e.g., a symptom of schizophrenia) voices are experienced.
Next, I come to what I believe is the most important point in my review, which is the following: There are two opposite models of how to destigmatize people whose human variations have caused fear, rage, and extreme tension in the majority of society. There is the model promulgated by the APA and the major institutions of psychiatry—one of viewing these variations as an “illness like any other” with the belief that societal acceptance of “illness” diminishes stigma. In contrast, there is the model asserted by the gay and voice hearer activists—a model that depathologizes and normalizes human variations. History tells us which model works. Specifically, diagnosing homosexual thoughts and behaviors as illnesses to be treated did not reduce stigmatization but instead routinely worsened it; what has majorly reduced stigmatization of homosexuality is society viewing it as a normal human variation.
Pressured by Psychiatry? Filmmakers Respond
Cured is the story of the victory by courageous radical gay activists over the APA, but a more radical documentary would have had one of the film’s talking head psychiatrists responding to these questions: What did psychiatry learn from diseasing homosexuality? Did it compel psychiatry to let go of its arrogance in pathologizing what simply makes them uncomfortable, and attempting to “cure” what is essentially normal? Has psychiatry gotten any humility over what they disease?
When gay activists defeated a homophobic APA in the early 1970s, they were not battling an APA partnering with Big Pharma, as is the case today. Psychiatry’s barbaric “cures” for homosexuality were, for the most part, not making drug companies rich—so can you see how much more difficult today it is for a group who is being unscientifically pathologized by psychiatry whose “cures” are now drugs that are making enormous profits for drug companies which have enormous influence?
When I spoke to the filmmakers Bennett Singer and Patrick Sammon, I asked them why the above issue wasn’t dealt with in Cured. Their response was that their film was about a piece of gay activism history and not about present psychiatry. I responded that this would be a reasonable explanation except for the fact that in Cured, at the end of the film, a disclaimer (which they call an “epilogue text”) is included about present psychiatry, a disclaimer that the current APA and contemporary mainstream psychiatry is most certainly happy to see included.
So what is this disclaimer that, as I mentioned, many Mad in America readers will find egregious? At film’s end, there is a statement: “Electroconvulsive therapy is no longer used to ‘cure’ LGBTQ people in the United States, but it continues to be used as an effective treatment for severe forms of depression.”
When I saw that disclaimer, I was jolted (as I’m guessing many Mad in America readers will be). I told Singer and Sammon that I believe many film viewers in the general public will ask: “Why was that disclaimer inserted?” After all, the film makes it obvious that the APA abolished homosexuality as a mental illness, and thus obvious that electroconvulsive therapy (ECT) is no longer used by psychiatry as a “treatment” for homosexuality. This insertion of ECT “effectiveness” appears to be an appeasement to the APA and mainstream psychiatry institutions who continue to promote ECT. I added that even for film viewers who are not well-informed about psychiatry, this claim will be a controversial distraction to the message of their film, as many Americans believe that ECT is no longer used. And for more knowledgeable viewers, such as Mad in America readers, this insertion will be an egregious claim that is disputed by the research.
In my CounterPunch review I provide that research, summarizing John Read, Irving Kirsch, and Laura McGrath’s comprehensive 2019 review of the research on ECT effectiveness for depression, which reported that there have been no randomized placebo-controlled studies (ECT versus simulated/sham ECT) since 1985 and that those studies that were done prior to 1985 (five meta-analyses based on 11 studies) are of such poor quality that conclusions about efficacy are not possible. I reported that the review authors concluded that, given ECT’s uncontroversial adverse effect of permanent memory loss (and its smaller risk of mortality), the “longstanding failure to determine whether or not ECT works means that its use should be immediately suspended until a series of well designed, randomized, placebo-controlled studies have investigated whether there really are any significant benefits against which the proven significant risks can be weighed.”
Before my scheduled teleconference with the filmmakers, through my Cured team contact, I emailed them the following: “Patrick or Bennett might be interested in the following 2020 article in the Conversation ‘No Evidence that ECT Works for Depression – New Research.’ One of the co-authors of that research is Irving Kirsch, associate director of placebo studies at Harvard Medical School and perhaps the world’s leading researcher on the placebo effects of psychiatric treatments. While you may have been assured by many bigshot psychiatrists that ECT is effective, this claim, at best, is highly controversial. Not to be obnoxious, but you would have been assured by many psychiatrists in 1970 that homosexuality is a mental illness. Psychiatry has a long history of being wrong in their proclamations, and your film is about only one of their many blunders that was damaging for many people.”
In our conversation, I told Singer and Sammon that for many psychiatric survivor activists and dissident mental health professionals, given what they know about the media, it will be difficult for them to believe that the filmmakers on their own felt obliged to proclaim that ECT is an “effective treatment for severe forms of depression.” Singer and Sammon insisted that neither the APA nor anybody but themselves had control over any of Cured’s content.
After Singer and Sammon told me that they did include the ECT effectiveness assertion because of the APA or because they were pressured by NAMI or any bigshot psychiatrists, I asked them about their basis for concluding that ECT is an effective treatment. They mentioned a Mayo Clinic web site, a 2021 Lancet article with 10,000 subjects, and anecdotal reports. I briefly discussed with them the lack of science behind their grounds for claiming ECT effectiveness, and after the interview I emailed them the following:
“Thanks, Bennett and Patrick, for spending so much time with me and answering my question. A couple things you might be interest in . . . . In our discussion about the evidence you used to conclude that ECT was effective, you mentioned a 2021 Lancet study with 10,000 subjects. The 2021 Lancet study in the news with 10,000 subjects offers findings about safety (dubious ones from my point of view), not about effectiveness. If you don’t want to read the entire study, you can check out this MedicineNet report of it. The lead author of the Lancet study is Tyler S Kaster, and despite MedicineNet’s headline, in the MedicineNet article, they state the following: ‘This study did not gauge the effectiveness of ECT, Kaster said. But it’s estimated that up to 80% of patients with severe depression see their symptoms substantially improve after ECT, according to the American Psychiatric Association.’ You guys should know as well as anyone from Cured that ‘according to the American Psychiatric Association’ means nothing to critical thinkers who want to see the scientific evidence. . . . Second, as your evidence of ECT effectiveness, in addition to citing the Mayo Clinic website, you also mentioned anecdotal reports of ECT effectiveness such as with Kitty Dukakis. I told you that anecdotal evidence is not considered scientific evidence, and that I can give you many anecdotal reports from famous and nonfamous people of ECT horrific outcomes (this true even with the so-called modern “new-and-improved” ECT); and that I had written at length about Lou Reed’s ECT experience, which provided him only with the material for a hell of an angry song—here’s the link to my 2019 piece Lou Reed: That Which Does Not Kill Us Can Radicalize Us.”
What bothered Singer and Sammon about my CounterPunch review was that I had concluded that from the looks of Cured, its filmmakers must have received the message that the only way they could show just how unscientific, arrogant, and barbaric psychiatry was in its treatment of homosexuals fifty years ago was to paint a picture of current psychiatry being a completely different institution, one that includes openly gay psychiatrists in leadership positions in the APA. I stated in the review that at the bottom of the Cured website homepage, the following is stated: “Outreach and Engagement Sponsorship Provided by the American Psychiatric Association Foundation.”
Singer and Sammon were adamant that the APA Foundation supplied no production funding and had no editorial control of the film, and that they had complete control. They indicated that their major reason for reaching out to me was to ask me to clarify to my readers that the grant that they received from the APA Foundation was purely for “outreach and education,” allowing them to have 100 screenings of the film and get feedback from it, and that the grant was not for financing film production. They stated that they had complete control of the film product.
I asked Singer and Sammon if the APA Foundation had given them this grant without seeing the film, and they told me that the APA Foundation had seen the film before giving the grant. I then told them it’s difficult for me to imagine that while they were creating and editing their film, they weren’t thinking about what type of content would or would not be viewed as “irresponsible” by the APA and mainstream psychiatry such as NAMI. They responded that they were not thinking about that, and I told them I don’t know how that’s possible, as I would think any filmmaker dealing with the subject of psychiatry would know—or quickly discover—that certain material may be considered “irresponsible” resulting in being marginalized. I pushed this issue, perhaps obnoxiously so, but Singer and Sammon remained adamant that they had not been controlled or influenced by mainstream psychiatry institutions.
This exchange led to a discussion about psychiatry movies. Interesting for me, one of the Cured filmmakers was aware of how in the 2001 film A Beautiful Mind, its filmmaker Ron Howard had falsified a key fact to make the film more acceptable for establishment psychiatry. Many Mad in America readers are aware of the line in the movie in which 1994 Nobel Prize-winning mathematician John Nash (Russell Crowe) states, “I take the newer medications,” despite the fact that Sylvia Nasar’s 1998 book (with the same title) states that Nash stopped taking medication in 1970, and Nash himself, in a 2009 interview, confirmed that he had long ago stopped taking medication. I mentioned to Singer and Sammon the 2015 report in the The Guardian that stated: “The change was apparently made because the screenwriter, Akiva Goldsman, whose mother was a prominent psychologist, was worried that the film might persuade people to stop taking their medication,” and that The Guardian also reported that there were rumors that NAMI had “put pressure on the filmmakers to include the line about medication.” It wasn’t clear to me whether or not the Cured filmmakers had heard about The Guardian report.
I then asked Singer and Sammon if they had ever heard of the 2017 film 55 Steps. They had not, and I told them that I’m not surprised.
I would not have heard of 55 Steps either except that fellow Mad in America writer Sera Davidow alerted me to it in 2018, and we tried to get to the bottom of why damn near nobody knew about this film despite its all-star cast and director. You would think a film starring Helena Bonham Carter and two-time Academy Award-winning actress Hilary Swank and directed by Academy Award-winning director Bille August (Pelle the Conqueror) would get some attention—especially since it was based on a true story about a human rights issue that no major film had examined. But 55 Steps has been almost completely ignored since it premiered in 2017.
55 Steps is true story of a friendship between two women formed during a fight for patient rights. When Eleanor Riese (Helena Bonham Carter) discovers that the psychiatric drugs that she is being forced to take at St. Mary’s Psychiatric Hospital in San Francisco are damaging her physically, she hires patient’s rights lawyer Collette Hughes (Hilary Swank). Then, as the film’s official description states: “With the help of expert attorney Mort Cohen (Jeffrey Tambor) the two defeat St. Mary’s in court while the indefatigable Eleanor and Collette become best of friends; a friendship where the colorful psychiatric patient Eleanor teaches the work-obsessed Collette a thing or two about life itself!”
The speculations that Sera and I discovered from those involved in 55 Steps as to why it is unknown and forgotten didn’t seem to make sense. For example, Helena Bonham Carter guessed that “It might have been something to do with Jeffrey [Tambor], who has had a whole sexual scandal drama to do with the Amazon TV series Transparent. Unfortunately that came out just at the time, and people might have thought: ‘Oh, we can’t touch it.’” However, the problem with this theory is not simply that 55 Steps is a Helena Bonham Carter-Hilary Swank film with Tambor only having a relatively minor role, but in 2017, another Tambor film, The Death of Stalin, got a huge amount of attention and continues to get attention.
What made sense to me is that 55 Steps is not a feel good story for establishment psychiatry but rather a feel good story for psychiatric survivors, and because 55 Steps is not a film that the psychiatry establishment is enamored by, this has resulted in it being marginalized and receiving almost no media attention.
Cured has already been shown multiple times, and the filmmakers made no indication to me that for its upcoming PBS broadcast, they would consider pulling that ECT effectiveness text at film’s end, and so I’m assuming it will still be there. Given how powerful and valuable most of Cured is, that will be a shame—like being nearly home after a fun road trip, but in the middle of the night with nobody on the road, getting nailed in a speed trap by the police and slapped with an expensive ticket. But I suppose the disclaimer could have been even worse, as instead of calling ECT an “effective treatment” the filmmakers could have called ECT a “safe and effective treatment”—which would have been like ending what had been a fun road trip with not only getting pulled over by a cop and getting ticketed but also tased.
Editor’s Note: This piece was first published under the title of: “Cured” Filmmakers React to My Review of their Upcoming PBS Documentary.”