Lake Alice and the Ectron machine

While I was looking for information about the use of ECT (electroconvulsive therapy) in New Zealand I was reminded of Lake Alice and the legal case of former child patients.

Lake Alice was a psychiatric hospital (closed in 1999) in Rangitikei, north of Wellington. The hospital included a unit for children and adolescents, and it is the events at this unit in the 1970s, in particular the use of ECT and aversive electric shock treatment, that have made the hospital notorious. Ten years ago a number of former patients were awarded compensation, much of it eaten up by lawyers, but the case continues. You can read about the case here.

The psychiatrist responsible was Selwyn Leeks. He was first investigated in 1977 when allegations of abuse and mistreatment at the unit emerged, but was cleared. In the meantime he had moved to Melbourne, Australia, and continued practising as a psychiatrist. He retired in 2006 in order to avoid a hearing into his professional conduct. In 2008 it was reported in The Age that he had lost an appeal to pay 55,000 damages to a patient he sexually assaulted in the 1990s.

Selwyn Leeks, a former pupil of Auckland Grammar School and graduate of Victoria University, was for a time in the 1960s attached to the department of psychological medicine at the University of Otago. He arrived at Lake Alice in 1971 after having studied abroad. So where had he been? Where had he got the ideas for the techniques which would make him infamous at Lake Alice? The British Medical Journal of 16 August 1969 (page 423) lists him as having received the diploma in psychological medicine from the Royal College of Physicians of London so possibly it was in England that he had first thought of using painful electric shocks as a form of therapy.

It was certainly in England that he found the machine that suited his purposes. The Ectron machine which he used, manufactured by Ectron Ltd in Letchworth, Hertfordshire, could deliver both the large electric shocks needed for ECT (which Dr Leeks also used) and much smaller, painful shocks used in aversive shock treatment. A former patient from Lake Alice has set up a website and published a letter written by Selwyn Leeks in 1977, in which he defended his techniques to the Medical Council of New Zealand:

“In this treatment [a 14 year old boy] was asked to discuss feelings and past events, and to the ‘symptoms’ of his psycho-sexual disorder was paired an aversive electrical stimulus of between 5 and 10 milliamperes. This order of current is below the threshold of pain but is nevertheless experienced as a noxious stimulus. Some writers have suggested greater current magnitude but most clinicians prefer to keep below 10 milliamperes. The faradic circuit itself was housed in a machine which could also, on a separate circuit, administer electro-convulsive treatment (E.C.T.). This circuit however was only used for ECT. Conversely the ‘Electonic’ [sic] circuit could not produce a convulsion nor unconsciousness. The ‘Electonus’ [sic] circuit is sometimes used for inducing sleep in the sleep therapies or for stimulating respiration after E.C.T.”.

The website shows an ECT machine from Lake Alice: “Duopulse E.C.T. apparatus Made in England Ectron Ltd” complete with the Ectonus switch (which was what was meant by “Electonus” and “Electonic” in the letter).

Ectron Ltd is still manufacturing ECT machines which incorporate these circuits that can deliver a “noxious stimulus” as Selwyn Leeks put it. In fact, it is a selling point of their latest machine, the Ectonustim Constant Current Series 6+ (“Well established machine, sold throughout the world”). According to the product specification:

“Ectonustim also incorporates the non-convulsive ‘CEREBRAL STIMULATOR’ used as a counter stimulus to ECT reducing the effects of amnesia and confusion. Additionally it is commonly used as a treatment for hysteria”.

In Britain the Royal College of Psychiatrists has long been sceptical of the claims made by Ectron Ltd for the Ectonustim. Their guidelines on ECT published in the 1980s had this to say:

“The manufacturers claim that using the non-convulsive cerebral stimulation mode the ‘counter stimulus of ECT to reduce amnesia or confusion’ can be given. There is no evidence to support this claim”.

And in the updated guidelines in the 1990s:

“The ‘cerebral stimulator’ function is redundant. There is no scientific evidence to support the claim that a ‘counter stimulus’ reduces amnesia or confusion, and the therapeutic use of a non-convulsive painful stimulus amounts to aversive shock therapy – an outdated behaviourist technique sharing nothing in common with ECT”.