Autism Contingent Shock Therapy: Therapy or Torture?
I was disgusted to read in Forbes of a treatment center that uses electroshock therapy, known as "contingent shock" in the United States today as a form of therapy. The founder of this treatment center, a follower of B. F. Skinner (a famous behaviorist) has been using negative reinforcement techniques for years to try and resolve behavior problems with children who have developmental disabilities or mental illness.
While electroconvulsive therapy has been used for years in the treatment of people with mental disorders or depression, it's a therapy done when the patient is anesthesia and usually only as a last resort as it remains controversial. Contingent shock therapy, on the other hand, is given to someone while they are conscious, aware, and performing undesirable behaviors.
The therapy is based on the work of B. F. Skinner's "Skinner Box" he developed during his research time at Harvard in the 1930's which placed lab rats in a box with an floor that could be charged with electricity anytime the rodent did a behavior that was undesirable. Slowly, the rodent would learn not to do the behavior, and therefore not get shocked.
Since the early 1900's, when autism was first used to describe a range of psychological conditions, it had a stigma associated with mental illness. In 1911, Eugen Bleuler first used the term to refer to a group of symptoms of schizophrenia. In the 1940's, researchers in the US used the term to describe children with emotional or social problems, often called pediatric schizophrenia. And because of this, as of the 1960's, doctors had a direct link between autism and schizophrenia in their minds.
So during the 1960's and 1970's, research into autism treatments focused on medications like LSD and negative (punishment) behavior change techniques like electric shocks, pinching, spanking, and even breaking vials of ammonia under the nose. Contingent shock, which is a shock administered after an undesirable behavior has begun or happened, is a direct decedent of this practice.
What's interesting is research exists out there to suggest that any gains using these methods are temporary, and not permanent. In 1968 Todd Risley found in his research that there is no permanent gain in behavior when people receive these electric shocks. This was back in 1968 with the research was fresh, the technique in vogue, and the results were quickly ascertained. Lichstein and Schreibman found in 1976 that while the techniques seemed to work, it was often very traumatic for the clinician (often more so) than the patient.
The technique remains controversial, particularly since the U.N. has now declared the therapy as practiced by the Judge Rotenberg Center is torture as outlined in the U.N. Convention against Torture. Why? Because the voltage used in the personal devices administering the electric shock can and does leave a mark that can last for days.
So, the question remains, should this method of treatment be allowed, given the current application and research? Has any other research been done? And even if the research suggests electrocuting someone to modify behavior works, should it be used in this day and age when spanking is strongly discouraged?
I've seen a couple more recent articles, one by the founder of the Judge Rotenberg Center, and one other, that extolled the virtues of contingent shock therapy. But I can't get past the image presented in the book, The Alliance where whole masses were controlled using electric shocks embedded in the brain. It's an extreme jump I admit, but it's still the image that comes to my mind.