In 1974, although few people realized it, the state of California was witnessing a battle with profound implications for the civil liberties of all Americans. Patients' rights advocacy groups such as NAPA-- the Network Against Psychiatric Abuse-- had persuaded State Assemblyman John Vasconcellos, a representative of my home town, San José, to introduce a bill in the state legislature-- AB 4481-- which would place severe limits upon the infliction of ECT, or electroconvulsive treatment. At first the bill wisely gave patients the absolute right to refuse such treatment, as well as psychiatric drugs and psychosurgery. This would have given anti-ECT people all that they wanted, while preserving the privacy of those who had consented to have the treatment. But perhaps precisely because they knew it left the bill open to challenge in court, lawmakers ultimately transformed this into a bill which would require a panel of three doctors to approve any administration of such treatments. Although the bill had been so altered that NAPA no longer supported it, it did represent, in a flawed sort of way, an attempt to fight back against the most dangerous medical procedure of our time, and was signed into law by then-Governor Reagan on September 24, 1974. Almost immediately, the "shock doctors" fought back-- indeed, the final form in which the bill was passed suggests that they had had a big hand in watering it down as it was being debated in the state legislature. Led by psychiatrist Gary Aden of La Jolla, founder of ACT or the Association for Convulsive Therapy, a group of them brought suit in court against it. On December 31, one day before the law was to go into effect, a superior court in Southern California issued a temporary restraining order preventing the State of California from enforcing the legislation, pending determination of its constitutionality. By April, 1976, the California Court of Appeals struck it down as constitutional, as it indeed was because it had been so altered, in the ruling Aden v. Younger. (Wade Hudson, "NAPA Battles Shock", in Leonard Frank, ed., A History of Shock Treatment, pp. 146-148; John Friedberg, M.D., Shock Treatment is Not Good for Your Brain, p. 19-20).
Aden, who was then clinical director and chief of staff at Chula Vista Hospital in Southern California as well as an outpatient psychiatrist, did not devote his time exclusively to either therapy or politics. While he was fighting the controversial law and later, unknown to his admirers, he was apparently indulging his decidedly kinky sexual predilections with patients who were in no position to give informed consent. In 1972, he established a supposedly therapeutic relationship with a former beauty queen who had consulted him because of her concerns about being a single parent. In about a dozen sessions, he managed to place her in a hypnotic trance so deep that she allowed him to sexually abuse her. Finally, he arranged to make a house call. He instructed her to wear a 1950s-style dress and saddle shoes, buy a special brand of scotch and a riding crop. When Aden arrived, he gave her a hypodermic injection then tied her to a bed with hospital restraints and then sexually abused her and beat her with the riding crop. A Chula Vista woman's abuse at the hands of Aden began in 1976. She was given a book on bondage and domination, and told to memorize and relate it as part of therapy. Like the first woman, she was hypnotized and visited at her house by Aden and other men whom he brought with him to engage in sex with her. He asked her to die for him. Ultimately six female patients brought allegations of misconduct against Aden before the state Board of Medical Quality Assurance during the nineteen-eighties. Two said that they had been branded by Aden with a hot iron bearing his initials. Aden declined to comment. His lawyer called the allegations "sensational nonsense". He responded to a tape the Chula Vista woman had made of a telephone conversation with Aden not by denying that Aden had actually said the things he had, but by saying that it was inadmissable evidence because Aden had naturally not known or given his consent to the incriminating recording. Aden gave up his medical license in 1989 and has not appeared in public since. (San Diego Union, http://tinyurl.com/6zuqx2; http:tinyurl.com/65r49v).
A number of questions arise naturally from these events. First of all, why did the women put up with this abuse, and not complain until years later? Were they lying, or was this simply consensual S/M? This is not a difficult question for me to answer, but I raise it only because it may be problem to some people. As with the patients of Ewen Cameron (see last blog), the people who went to see Aden were in a state of distress. When one is beset by severe anxieties and depression, one does not think very clearly. Also, one feels quite helpless. Such people will cling to anyone who offers them security, and will do so all the more readily if that person seems to enjoy a position of authority. In our society, medical doctors enjoy great authority and prestige. Stanley Milgram, who in the nineteen-sixties conducted famous experiments to test the "obedience to authority" of the average American, found that the tendency to obey orders increased when he wore a white jacket, suggesting that he was a medical doctor (in fact, he was a psychologist). And these were not patients-- not people in a state of distress-- but merely people who had answered his ad offering money to those who would participate in his experiments. How much more influence would a doctor have over someone suffering from emotional problems? Their first reaction would undoubtedly be to blame themselves: i.e., "Did I lead him on? Did I convey the mistaken impression that I wanted a relationship?" Only discussions with friends and family would have emboldened them to complain. Even when they finally realized that the doctor was at fault, they would have hesitated to come forward publicly. The woman who had been beaten said that she "was embarrassed" and did not think that authorities would believe her allegations against an established physician. The Chula Vista woman was too traumatized to deal with the abuse until 1982. The remaining women complained only when they read about the allegations lodged by the first three.
Secondly, why was Aden not prosecuted or sued? A law mandating a prison sentence for psychotherapists who have sex with patients was passed in 1989, but of course it could not be applied ex post facto. Actually, the Chula Vista woman did sue, and the tapes she had made were admitted as evidence. But after several weeks of trial, she gave up her suit after Aden's attorney offered her a substantial settlement. Neither she nor her attorney would discuss it. As for the other women, I have been unable to ascertain what became of their cases, but had it been me, no amount of money could have persuaded me not to press on with my suit and expose this man for what he was. Furthermore, even with the inflated income of a psychiatrist, it would be hard for Aden by himself to buy off six different women. That fact, and the precise combination of techniques he used-- ECT and narco-hypnosis, with which the CIA had done extensive experiments (see Colin Ross, The CIA Doctors, pp. 48-53) suggests that he enjoyed the protection of an governmental source with unlimited funds to pay off everyone who had complained and even issue threats to ensure that they kept their mouths shut.
The final question is, why did Aden take such a risk when he was engaged in a very public battle to overturn the anti-ECT law? His actions betray a complacent arrogance and sense of being above the law which is almost incomprehensible. The best answer to that, I think, lies in the procedure he was championing, ECT. We do not know if any of the patients who complained against him received it, but as he was the states' foremost proponent of the treatment, it is very likely that they did. Indeed, the Chula Vista woman may have been for a time an inpatient at Chula Vista Hospital, over which he presided. Most ECT treatments are of course given in a hospital. But even outpatients can be referred to a hospital for the treatment. Like the CIA, who were interested in ECT precisely because it destroys memory, Aden was most likely counting upon the procedure to erase any memory of his misconduct. The problem is, the effects of ECT are unpredictable. Sometimes the memory of recent events is lost, and that of events long passed is retained; sometimes it is the other way around. Sometimes the amnesia is reversable, sometimes it is not. Thank God at least these six patients remembered. But the question is, how many other patients did he traumatize by his sexual abuse, only to erase their memories of it?
The fact is, both the CIA and Aden, who may have had more than a passing connection with one another, were behaving unethically and unprofessionally. The mandate of the CIA, and its only legitimate task, is to gather intelligence. So when it uses a method which causes amnesia then we know that it is exceeding its mandate. And it has not only experimented with ECT but used it, along with the surgical implantation of electrodes-- ostensibly to force prisoners to work, an explanation which is entirely implausible-- resulting in at least one death (see Alfred W. McCoy, A Question of Torture, pp. 65-66). The legitimate task of a physician is to heal: sexual exploitation and the infliction of treatments designed to cover up such exploitation is contrary to his legitimate task and the Hippocratic Oath. From Aden's case it is easy to see how the use of ECT can and is indeed bound to lead to further abuses. Our system of government is based upon distrust. The Founding Fathers believed that human beings crave power and will abuse those who are dependent upon them if they are given the opportunity to. This is one excellent reason for banning ECT, beyond the fact that the treatment is bad for people. For it is impossible to trust any doctor who administers a treatment which may cause loss of memory, and the very fact that he proposes to do so should lead to the suspicion that he is up to no good.