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DEFINITION OF PSYCHOTHERAPYFor the purposes of this essay, I will use the term “psychotherapy” to refer to a particular type of interpersonal process intended to facilitate conscious awareness of that which had previously been unconscious.  It is not meant to include the direct attempt to modify behavior, whether overt as action or covert as thoughts and feelings, through medication or manipulation of the external consequences of behavior.  Similarly, it does not include counseling, coaching, advising, or teaching as its primary goal.THE RECENT HISTORY OF PSYCHOTHERAPYIn its current form psychotherapy has been popular for only about a century, although its roots are ancient.  Freud called attention to the importance of the personal unconscious, repository of those thoughts and feelings which are unique to a particular individual and presumed to be a result of his or her personal life experiences and genetically transmitted instincts.  Jung invited us to notice the collective unconscious, where we find ourselves connected to all of humanity through shared patterns of thoughts and feelings.  Each of them found the contents of a person’s dreams to be of particular value in accessing the unconscious, whether personal or collective.   Many followers of these two pioneers have refined the methodology for accessing these two types of unconscious material and integrating it into one’s conscious awareness, particularly with regard to the manifestation of unconscious material in the transference and countertransference.  However, Freud and Jung deserve most of the credit for making popular in modern culture the idea that the exploration and integration of unconscious material is a very important task, perhaps even the most important task any person can undertake.  THE GOAL OF PSYCHOTHERAPYInterestingly, both Freud and Jung became interested in the unconscious through their role as physicians, whose goals are healing and the alleviation of suffering.  Each of them realized that these goals could be served through greater conscious awareness of the unconscious, although Freud’s model implied somewhat more modest goals than Jung’s.  Freud held that greater awareness of the contents of the personal unconscious might help one to adjust more comfortably to the demands of civilization, but that a certain degree of discontent was unavoidable.  Jung believed that the exploration of the collective unconscious could reveal the purpose of one’s life and bring one closer to a state of union with God.  It is important to note that, in spite of a difference in the ultimate goal of psychotherapy, the exploration of unconscious process, particularly as manifested in the contents of dreams and fantasies, were considered to be central in its achievement.THE LARGER IMPORTANCE OF PSYCHOTHERAPYAs noted above, psychotherapy is a new name for an ancient practice.  Introspection in the broadest sense has ancient roots in practices such as contemplation, meditation, dream incubation and interpretation, fasting and other ascetic practices, prayer, religious ritual, music, ingestion of psychedelic plants, vision questing, sleep deprivation and the like, to facilitate it.  The intentional use of any technique which facilitates introspection implies that introspection is in some way of value.  Whether one limits that value to the alleviation of some psychological suffering, as Freud would, or sees the value as ultimate spiritual realization, as Jung would, there is no disagreement that there is value in the facilitation or enhancement of introspection. One way to examine the value of introspection is to think about one’s source of authority.  In particular, the external versus internal locus of the source of authority is important to consider.  If an external authority, such as parents, culture, or church, leads me to believe that I should feel guilty or fearful, then the alleviation of such guilt or fear may come about as a result of discovering a more powerful  internal source of authority which contradicts this belief.  Of course there can be no guarantee that one can contact a more powerful internal source of authority.  Similarly, there is not guarantee that, once contacted, it will indeed counteract a belief previously instilled from an external source of authority.  However, many examples of such a counteraction are part of the experience most psychotherapists.Here is a personal example of the shift from an external to an internal source of authority.  I was born in Utah and raised a Mormon.   I left Utah in the first year of my life, and left the Mormon church in the second decade.  The final chapter took place in my fourth decade, after having cultivated my sense of inner authority in therapy for 8 or 10 years, when I managed to get myself officially excommunicated.  During the course of the trial which resulted in my excommunication, I was sternly admonished by some of the members of the jury that the price I was going to pay in the hereafter for having been cast out of the Mormon brotherhood would be high indeed.  This invocation of the external authority of the belief system of the church produced a brief surge of terror in me–what if they were right?  Realizing after a few moments that my great fear was the result of my having been abusively conditioned as a child by such frightening stories, my terror quickly converted to rage.   Now paying more attention to my inner authority, I managed to suppress expression of both of these strong emotions and to continue with a fairly interesting dialogue with my jurors, and even got invited to offer a closing prayer when the trial came to an end.  The most powerful experience of my inner authority came after I walked out of the church.  When I got to the parking lot, and was quite separate from those who represented external authority of the church, I spontaneous and exuberantly began to leap into the air and shout for joy. A more interesting question about internal versus external authority comes up when there are major philosophical or moral questions in need of answers.  Questions about the purpose of one’s life, the ultimate nature of reality, or what is intrinsically moral in response to a given situation, are examples of such questions.  These are the types of questions that come up repeatedly during the course of one’s life, and one is therefore well advised to have some ongoing way of introspecting deeply enough to be able to find answers as they are needed. As example of the need for such answers was presented a few years ago by the publication of the book, Hitler’s Willing Executioners (Goldhagen, 1996).  It told of the thousands of German citizens, seemingly normal and decent human beings, who willingly went along with one of the most ghastly examples of genocide the world has seen.  It is interesting to speculate about the response of a German bureaucrat to the news that he will no longer be managing the logistics of railroad cars filled with merchandise bound for market.  Starting tomorrow his job will be the same with the minor exception of the cargo, which will now be human beings bound for torture and death.  He goes home, has dinner with his family, helps his children with their homework, makes love with his wife, and goes back to work the next day to carry out his slightly revised duties.  What is missing from this picture?  I would suggest that introspection is missing.  If this man had a habit of introspection, whether through prayer, meditation, contemplation, or psychotherapy, it is hard to imagine that he would go to work the next morning believing that his participation in genocide would not be in violation of some intrinsic moral principle.  (For research supporting this rather broad generalization, see May, [1987].)  Without such introspection, he is at the mercy of external authority, in this case the German state, which clearly reports to him no moral conflict in his compliance.  In fact, quite the opposite is the case.I am not suggested that a brief course of psychotherapy or meditation instruction would have stopped a German bureaucrat in his or her tracks in the weeks before genocide became the assignment of the day.  The development of moral awareness that I am suggesting such introspective practices might have fostered would have to begin much earlier.  The popular TV show, “The Sopranos,” makes an attempt to examine what might happen when a person whose moral development has arrested at an early age is exposed to psychotherapy as a adult.  The result is certainly not a rapid compensation for earlier deficiencies in such development.  What I am suggesting is that a habit of introspection over the course of one entire life, or at least one’s entire adult life, can make a difference. At the most generic level it would seem that the capacity for introspection may be something like a muscle.  With regular use it becomes flexible and strong and can be very helpful to its owner.  Without regular use it atrophies and becomes useless.  In the most extreme case of neglect of the inner life, one not only loses the capacity to introspect deeply; one also can lose the awareness that there even exists any significant internal territory to explore through introspection.  Such a loss makes one extremely vulnerable to the Hitlers of the world, which in turn makes all of us vulnerable.  Just as there is increasing evidence that regular mental activity can counteract the loss of cognitive capacity that often accompanies aging, so regular introspective activity could be expected to sustain the capacity to introspect.Although the Hitlers of the world give a dramatic lesson about our vulnerability as a species if we lose sight of our internal resources, more mundane examples abound.  The young retail clerk who cannot make the simplest of change without using the calculator built into the cash register has lost sight of an internal ability to calculate.  The weatherman who tells us that tomorrow will be a miserable day because rain is predicted invites us to forget that we can decide for ourselves whether we enjoy rainy weather.  The increasingly bizarre warning labels that come with electronic appliances, telling us to refrain from all sorts of things that would only be done by a person too handicapped to live outside an institution or a person committed to a painful suicide, invite us to ignore our common sense.However, it is the ignoring of our internal resources regarding how to live a meaningful and a moral life that presents the greatest possibilities for individual and mass misery.  A life without a conscious sense of meaning or purpose will generate a certain desperation of its own, which is in some way the manifestation of the unconscious as it tries to get one’s attention regarding the failure to heed one’s calling.  However, if one’s habits and culture do not generally support introspection under such circumstances, one is likely to express one’s desperation in harmful ways.  The situation is made worse by the absence of internal awareness of morality, leaving even greater room for destructive acting out of such desperation. The use of introspection to discern an inner moral awareness is particularly under assault in much of the world today.  Laws, regulations, ethics codes, religious creeds, mandatory sentencing, and other external constraints on behavior, are displacing our internal awareness of what is moral and what is not.  As such external rules proliferate, they invite us to forget that we ever had any internal way of knowing such things in the first place–like the  young clerk who scarcely is aware of having the capacity to make change without a cash register.  Psychotherapy is one way to facilitate a reconnection with our inner moral compass.This is not to say that external constraints on behavior are always negative.  I am quite pleased to have external constraints when needed in the short to prevent injury and death to humans as well as other species.  They may also raise awareness by calling to the public’s attention certain problems that need to be addressed.  However, in the long run such external constraints run the risk of displacing and weakening our internal constraints.  These internal constraints seem to me to be our only long term hope.  If we rely on some of us to wield the power to constrain others of us, who will constrain the some of us who are constraining the others?  If power corrupts, where will those in power turn for the moral awareness that could prevent them from being corrupted?  If I take a maintenance antibiotic to combat any infection that I might get, having the antibiotic doing the work my immune system should and could, how can I expect my immune system to remain robust or even reasonable competent?  ON THE TRIVIALIZATION OF PSYCHOTHERAPYGiven the significance noted above of reclaiming deep introspection through psychotherapy,  it is noteworthy that psychotherapy itself is in some ways under attack at the present time.  At the most superficial level this attack has to do with funding–i.e. payment for psychotherapy by private health insurance and public agencies.  Although a statistical case can be made for the proposition that good psychotherapy pays for itself in increased productivity and reduced utilization of other general medical resources, there seems to be a trend toward the restriction of third party funding for psychotherapy.  One theory frequently put forward to explain this strange trend is that it is simply a result of the greed and shortsightedness of the CEOs of managed care organizations.  No doubt these factors play a role.At a deeper level a more pernicious trend is emerging–the trivialization of psychotherapy.  Those who find deep introspection to be personally threatening have always expressed their anxiety through deprecating references to psychotherapy as involving self-absorption, navel gazing, and mental masturbation.  More recently the ways in which psychotherapy is trivialized have become more subtle and perhaps even auto-immune in nature.   That is, even among those who describe themselves as psychotherapists there seem to be increasing numbers who see their work as little more than providing a mental tune-up so that the client can function more efficiently in his or her already prescribed role in society.   At the core those who dismiss all introspection as nonsense, and those who see psychotherapy as merely intended to relieve symptoms,  both seem to share a disregard for the importance of deep introspection and the human relationship in the conduct of psychotherapy.If one assumes that the human relationship is important in psychotherapy, then the selection of a good psychotherapist for a particular person involves much more than finding one with certain academic or professional credentials.  It involves some exploration of the inherent compatibility, or fit, between the two persons involved before a prediction can be made of the probable outcome of the psychotherapy.  Such exploration is all but prohibited by most managed care arrangements.  First the psychotherapist is usually referred to as a “provider of services,” a term which seems to connote that the function is more important than the person.  That might be true for a person who delivers a pizza to one’s home, but it is most certainly not true for a person with whom one contemplates entering into a most intimate relationship.  After getting past the insult of thinking of one’s psychotherapist is a provider of services, one is told that it is necessary to select a psychotherapist from a preselected panel of candidates, a very small fraction of those who might otherwise be available.  The members of this panel have usually been chosen on the basis of some minimal academic requirements and the willingness to work under adverse conditions.  These adverse conditions include low pay and frequent violation of the privacy necessary for effective psychotherapy.The trivialization of psychotherapy as a result of the conditions imposed by managed care is increasingly being matched by conditions imposed by the professional disciplines which provide formal training and credentials for most psychotherapists.  Psychology is probably the discipline with the most noteworthy case of identification with the aggressor.  It has actively promoted the “manualization” of psychotherapy.  This term does not refer to conducting psychotherapy without the use of machinery; it refers to the notion that for any given condition, like depression, there is a single correct therapeutic approach to be taken.  This approach can be described in a manual, and then any person who can read the manual and follow its instructions can perform the psychotherapy.  While it may be true that anyone who can read a map and drive a car can deliver a pizza, it is certainly not that simple with psychotherapy.  For psychology as a profession to pretend otherwise trivializes and demeans psychotherapy.   I was recently involved in an informal supervision session, in which a very mature and sophisticated psychotherapist presented a complicated clinical dilemma which had arisen in one of her psychotherapy groups.  Several respected colleagues, all working within essentially the same theoretical framework, offered feedback.  Although the underlying premises about the importance of such things as authenticity, integrity, and respect were the shared by all, the actual recommended actions to be taken diverged greatly. The woman presenting the case thoughtfully took in all these recommendations, asked for clarification or elaboration regarding some of them, and then formulated her next intervention for her group.  She also commented that the diversity of opinion from highly respected colleagues was both disturbing and relieving, since it made clear that there is no single correct approach to any given clinical situation.  Clearly this woman is not a candidate for getting involved in anything the looks like “manualization.”  On the other hand, she is someone to whom I would refer, without hesitation, a person I love.  The most recent example of the trivialization of psychotherapy in our culture has come in the form of legislatively mandated keeping of “Medical Records.”  In some instances legislation has been written in such a way as to include psychotherapists in general, and psychologists in particular, within its requirements.  For psychotherapists to keep such records has at least two trivializing implications for psychotherapy.  First is the implication that there would be some genuine utility in the keeping of such records.  This assumes that a person could move from one psychotherapist to another, have his or her “Medical Records” transferred to the new psychotherapist, and pick up where he or she left off with the previous psychotherapist.  This is a preposterous assumption when applied to as personal a relationship as is involved in psychotherapy.  The second, and perhaps more chilling, implication of such record keeping is contained in the actual act of writing down for possible future disclosure to others, as yet unnamed, any meaningful part of what transpires in psychotherapy.   It would be hard to imagine a mechanism more antithetical to the creation of the kind of trust and safety required for meaningful psychotherapy to take place.WHAT IS TO BE DONE?The problems arising from the trivialization of psychotherapy are the tip of the iceberg.  The trivialization of introspection lies below it, with grave consequences for the Titanic of humanity if ignored.  No amount of enforcement of current or future environmental laws have a chance of saving the earth in the long run unless a significant percentage of humans have a more immediate and personal experience of a deep connection to other humans in particular and to All Things in general.  A similar statement could be made about the possibility that international treaties, tribunals, and organizations will save us from future wars or nuclear holocaust through their ability to impose external constraints on our behavior.  As mentioned above, they may heighten our awareness of the problems we face, and they may helpful by starting meaningful dialogue between people who would otherwise be killing each other.  However, if such dialogue does not ultimately lead to a greater appreciation of The Other, genocide will merely be postponed.  Dialogue combined with introspection can provide the opportunity to genuinely experience “walking a mile in your enemy’s moccasins,” and this experience can in turn open us up to non-violent options for dealing with old hatreds and fears.  Anything that facilitates the kind of introspection which can lead to such deeply meaningful experiences increases our chances of survival, not to mention peace of mind.  Anything one can do to support the profound significance, as opposed to trivialization, of such a process should help.  The first step probably has to be a reaffirmation of the importance of deep introspection in one’s own life.  Clearly psychotherapy is not the only way to do this, but it is a very good place to start.   ReferencesGoldhagen, Daniel Jonah, Hitler’s Willing Executioners: Ordinary Germans and The Holocaust, 1996, Alfred A. Knopf, New York, 640 pages.May, Gerald G. Will and Spirit, 1987, Harper, San Francisco, 368 pages.—————————ADDENDUMSince this paper was originally drafted, two things have occurred which call for additional comments.  The first of these is the series of tragic events which took place on 9-11-01.  The second is the response of the editor to the first draft.  Among other things she notes that deep introspection might lead to the desire for violence, rather than the opposite, and that many good and moral people do not introspect and have never experienced psychotherapy.In the weeks after September 11, like many others, I found myself very curious about the motivational dynamics of those who had been willing to kill so many others.   What began to emerge for me was a picture of young men who had been completely cut off from meaningful interpersonal support for introspection since they were very young.   This means not only the deprivation of anything as structured and formal as psychotherapy, but also the absence of any opportunity for more informal interpersonal exchanges having to do with introspection or subjective experiences other than those prescribed by family, friends, religion, and one’s entire social milieu.  In the extreme I imagined what it would have been like for one of those young men, in the months before September 11, to have raised doubts or misgivings about the plans they were making.  A dream, a fantasy, or an emotion that had such implications would have to have been suppressed or repressed almost immediately.  Certainly to allow oneself such experiences, and to open discussion about them with one’s fellows, would have been to risk complete rejection as a minimum, and immediate death as a high probability.At the opposite extreme would be the ancient mystical and meditative traditions of the world.  What little I know of Buddhist and other such practices is that an enormous variety of powerful subjective experiences are expected when the seeker enters into the particular form of deep introspection associated with a given tradition.  Vivid fantasies of unbridled sexuality and violence are common, but in the end give way to–or perhaps are part of– experiences which ultimately develop deep compassion and equanimity in the seeker.  Psychologically this process may be seen at least in part as a withdrawal of the projection of evil which, when projected, leads to the perception of “evil-doers” in external reality and the conviction that one’s holy task is to slay them.  The Vietnamese Buddhist monk Thich Nhat Hanh reports having been able to view the corpses of six young men he regarded as his sons, brutally murdered because of their opposition to the war in Vietnam, and still feel compassion for their killers.Perhaps most people navigate a middle course, being somewhat introspective in a random or unconscious sort of way.  Thanks to sleep researchers we know that everyone dreams, whether or not the dreams are available for conscious recall upon awakening.  Similarly, everyone daydreams, although there appear to be enormous differences in the degree to which this experience is invited or suppressed.  In any case, a certain degree of introspection seems to be inherent in the human condition.   It is up to us to decide how much to nurture this tendency, as individuals and as a culture or society.

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With construction accidents on the rise over the last few decades, the U.S. Department of Labor (DOL) specifically focused on those in the welding sub-profession of construction to find an alarming increase in accidents and death among welders. According to the DOL, from 1992 to 2001, the death rate of a welder increased by 68 percent of all construction workers represented.

If an employee currently works, previously worked, or is in an area where industrial welding is being performed, chances are the employee was exposed to welding rod fumes. Recent medical research suggests that exposure to welding fumes may lead many health problems, including two serious illnesses, Parkinson’s disease and Manganism. There are many court cases pending regarding this exposure, the hazards involved and the health impact on employees.

For example, in early September 2005 a Mississippi shipyard worker who claimed his neurological problems were caused by inhaling fumes from welding rods concluded his lawsuit by settling with the final two welding company defendants in his case. The worker’s lawsuit against the two welding manufacturers was scheduled for trial the following week. The lawsuit was settled for more than one million dollars.

As stated, the two diseases most commonly reported in medical research from the exposure to welding fumes are Manganism and Parkinson’s disease. A description of each of these diseases follows:

* Manganism, also known as secondary Parkinsonism, is a condition that develops when excessive levels of manganese injure that portion of the brain that controls body movements. Symptoms of this condition include fatigue, headache, slow or slurred speech, poor memory, impaired balance and tremors, delusions and hallucinations, disorientation and/or difficulty walking.

* In addition to Manganism, recent studies have found that exposure to manganese fumes is associated with the early onset of Parkinson’s disease. In fact, research conducted at the Washington University School of Medicine found that welders developed symptoms of Parkinson’s disease an average of 15 years earlier than the general population.

Many motor system disorders are caused by the decrease and eventual loss of brain cells that produce dopamine, which is imperative to the body. Of these diseases, Parkinson’s is classified with these disorders. Of the four main symptoms of the illness is a seizure or tremble like movement that often occurs in the face and appendages including legs, hands and arms; rigidity, or stiffness of the limbs and trunk; slowness of movement; and balance as well as poor or wavering posture and coordination are among the other symptoms. As these symptoms become more pronounced, patients may have difficulty walking, talking, or completing other simple tasks. Early symptoms of the disease are subtle and occur gradually. Other symptoms may include depression and other emotional changes; difficulty in swallowing, chewing, and speaking; urinary problems or constipation; skin problems; and sleep disruptions.

It is advisable that legal consultation is sought out by those who have been or currently are working as a welder or for those who may have been in the area where welding has occurred. It is necessary to study work history records and evaluate medical records to determine whether there may be a valid claim against the manufacturers. It is advisable to contact a welding injury law firm as soon as possible because there is a statute of limitations on some claims.

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Four state and local agencies of North Carolina government have documented hazards of faulty gas chambers and supply cylinders at public animal shelters since 2004. Leaks and malfunctions were recorded by the North Carolina Department of Labor, North Carolina Department of Health and Human Services, North Carolina Department of Agriculture, and local fire marshals in Reidsville and Stokes County. The findings of these agencies were obtained through public record requests.

Most gas chambers in our state had reportedly never been formally inspected prior to 2004. Since that time, complaints from thousands of residents to government officials and the media have brought the controversial euthanasia method to the forefront.

One of the most compelling documents is a North Carolina Department of Labor inspection for Sampson County Animal Control in 2004 (1). The inspector’s worksheet reads,

“The animal begins to struggle because it cannot breathe…They wait approximately 10 minutes until the animal stops making sounds and then turn on a fan that is supposed to evacuate the CO from the chamber.”

Gas monitor readings showed employee overexposure to carbon monoxide, which the officer believed “is occurring when the chamber door is opened to remove the animal.” No respiratory protection was provided for employees.

Reidsville Fire Marshal John Harris inspected a gas chamber at Rockingham County Animal Control in 2004, on the property of Reidsville Veterinary Hospital, after repeated attempts to repair gas leaks (2). An inspection from August 2004 recounts:

“Harris checked the chamber finding that the door seals to the chamber were in disrepair and damaged in several locations. Harris also observed where attempts to repair the seals were made with what appeared to be caulking. Also noted that the integral safety systems for monitoring carbon monoxide levels has been DISABLED. Vent pipe from the top portion of the chamber is poorly fitted and sealed with what appears to be adhesive tape. During operation of the euthanasia chamber carbon monoxide monitors were used to test levels present adjacent to the chamber….carbon monoxide levels exceeded 984 ppm in the area of the chamber….After the purge cycle during removal of animals a reading of 460 ppm still remaining in the chamber as officers removed dead animals.”

Not only can gas chambers leak and malfunction, but gas cylinders provided by carbon monoxide suppliers have also been documented as a potential hazard. North Carolina Department of Labor inspections revealed faulty gas cylinders at Columbus County Animal Control (3) and Davidson County Animal Control in 2006 (4). The Davidson County inspection notes that National Welders Supply does not formally test the cylinders for leaks. The Columbus County inspection says, “It was determined the overexposure occurred whenever the valve on the CO cylinder was initially opened, so the feasible engineering control would be to have the cylinder and valves checked for leaks.” Animal control supervisor Rossie Hayes replied to the NCDOL, asking “for any suggestion on how to check the unit for leaks.” He asked if employees should wear some type of respirator.

Stokes County Fire Marshal inspected a rusty dump-truck gas chamber at Stokes County Animal Control in January 2007 (5). A letter from the Marshal to shelter supervisor Sarah Shumate documented high levels of gas at the supply tank as well as the gas chamber door. Marshal Bradley Cheek warned:

“During the euthanasia process, levels of carbon monoxide in excess of 1000 ppm were detected on the exterior of the chamber loading door. It is not known what the exact readings were; this is due to the monitor having a maximum reading of 1000 ppm….Carbon monoxide is immediately dangerous to life and health at 1200 ppm.”

Yet another jaw-dropping inspection was performed for Montgomery County Animal Control by North Carolina Department of Agriculture inspector Shelly Swaim in 2007 (6). Swaim writes,

“It was reported to me by Mr. Beane that the chamber is leaking and that there were visible cracks as well as an insufficient gasket around door. There is also no mechanism to facilitate venting of this unit. Inmates were on property and addressing chamber issues at 12:17. It appears that this CO chamber even with corrections employed at this time will pose a significant risk to the safety and life of the operator.”

Industrial hygienist Marilyn Parker of the North Carolina Department of Health and Human Services has performed gas monitor readings for two animal shelters, Granville County Animal Control in 2006 (7) and Randolph County Animal Control in 2007 (8). Both inspections revealed high level leaks of carbon monoxide around the edges of the gas chamber doors. Chambers at both facilities are modern, commercially manufactured units. Concerning the Randolph County inspection, Parker wrote, “While the chambers were in operation the monitor was placed in various locations around the door seals. Levels of CO were detected in excess of 500 ppm around the door seal….It was determined that the seals did not prevent carbon monoxide (CO) from escaping while the chambers were in operation.” Ms. Parker requested in both letters that she be called for follow up inspections after corrections were made. As of October 2008, Parker said that she was not aware of any correspondence with county officials since the inspections.

CO levels above 10% are explosive, as affirmed by the gas chamber explosion at Iredell County Animal Control of Statesville in 2008. No inspection record for the machine was available, but an invoice shows that the unit had been purchased only months prior from Cutting Edge Fabrication, after originally being sold to Union County Animal Control in Monroe. In a Statesville News and Record article (9), Cutting Edge owner Stephen Whitesell is quoted: “Whitesell believes the fan somehow sparked the carbon monoxide before the gas could be purged from the chamber….Whitesell said the fan is not explosion proof.” To the contrary, the AVMA 2007 Guidelines on Euthanasia include this warning about carbon monoxide chambers, “Any electrical equipment exposed to CO (eg., lights and fans) must be explosion proof.”(10) Union County Sheriff Eddie Cathey told the Enquirer Journal in August 2008, (11) “the chamber that was eventually sold to Iredell was returned to Cutting Edge three years ago because it had a warped door.” These are among the most expensive and hi-tech gas chambers on the market. Gas chambers from this manufacturer are reportedly still in use at Gaston, Cabarrus, and Union county animal control facilities.

Dangers to Humans

Carbon monoxide oozing from gas chambers can put shelter workers at risk of health problems, some of which can be delayed for weeks after exposure.

*The AVMA 2007 Guidelines on Euthanasia warns humans operating CO chambers: “In humans, exposure to 0.32% CO and 0.45% CO for one hour will induce loss of consciousness and death, respectively. Carbon monoxide is extremely hazardous for personnel because it is highly toxic and difficult to detect. Chronic exposure to low concentrations of carbon monoxide may be a health hazard, especially with regard to cardiovascular disease and teratogenic effects.” (10)

* The National Institute for Environmental Safety and Health published an International Chemical Safety Card for Carbon Monoxide, which states,

“The gas mixes well with air, explosive mixtures are easily formed. The gas penetrates easily through walls and ceilings…Fatal if inhaled. May damage fertility or the unborn child if inhaled. Causes damage to blood if inhaled. Causes damage to blood and central nervous system through prolonged or repeated exposure if inhaled…Inhalation Risk: A harmful concentration of this gas in the air will be reached very quickly on loss of containment. Effects of Short-term Exposure: The substance may cause effects on the blood, resulting in carboxyhaemoglobinemia and cardiac disorders. Exposure at high levels may result in death. Effects of Long-term or Repeated Exposure: The substance may have effects on the cardiovascular system and central nervous system. May cause toxicity to human reproduction or development. ” (12)

* The U.S. Environmental Protection Agency says, “Perhaps the most insidious effect of CP poisoning is the development of delayed neuropsychiatric impairment within 2 – 28 days after poisoning and the slow resolution of neurobehavioral consequences.”(15)

* According to an article from the Journal of the American Medical Association in 2006, “Researchers discover a link between severe carbon monoxide poisoning and death years later from heart disease.”(14)

* A materials safety data sheet from National Welders Supply, a leading supplier of bottled carbon monoxide to animal shelters, says that carbon monoxide is “Harmful if inhaled. Causes damage to the following organs: Blood, Lungs, Cardiovascular System, Central Nervous System. Vapor may cause flash fire…Extremely flammable. Gas may accumulate in confined areas, travel considerable distance to source of ignition and flash back causing fire or explosion.” (18)

* A study by Ramona Hopkins and Fu Lye M. Woon states, “It is estimated that as high as 50% of individuals with carbon monoxide poisoning will develop neurologic, neurobehavioral, or cognitive sequelae.” (17)

* A study of patients poisoned by carbon monoxide, from LDS Hospital in Salt Lake City, Utah in 1999 concluded, “Ninety-three per cent of the patients exhibited a variety of cognitive impairments, including impaired attention, memory, executive function, and mental processing speed. Ninety-five per cent of the patients experienced affective changes including depression and anxiety.” (18)

* Yona Amatai studied the effects of low-level CO exposure on higher cognitive function. The study concluded, “The lower scores on neuropsychological tests indicate dysfunctions in memory, new learning ability, attention and concentration, tracking skills, visuomotor skills, abstract thinking, and visuospatial planing and processing. These dysfunctions correspond with previous reports of carbon monoxide neurotoxic effects in patients with moderate carbon monoxide poisoning. Low-level exposure to carbon monoxide results in impairment of higher cognitive functions.” (19)

* A 1925 study by William C. Stadie and Kirby Martin of Yale University School of Medicine says, “Occasionally the blood becomes free of carbon monoxide and the coma terminates, but the patient subsequently sinks into a coma again and dies, probably as a result of central nervous system damage.” (20)

* A 2006 study by Christopher Henry and Daniel Satran, M.D. states, “Myocardial injury is a frequent consequence of moderate to severe CO poisoning.” (21)

* The Department of Health and Human Services, Center for Disease Control and Prevention says, “Red blood cells pick up CO quicker than they pick up oxygen. If there is a lot of CO in the air, the body may replace oxygen in blood with CO. This blocks oxygen from getting into the body, which can damage tissues and result in death.” (22)

* Science Daily reported in 2004, “Brain damage occurs – days to weeks later – in half of the patients with a serious case of CO poisoning.” (23)

* A 1983 article from Archives of Neurology detailed delayed neurologic effects of CO: “The most frequent symptoms were mental deterioration, urinary or fecal incontinence, gait disturbance, and mutism.” (24)

* Dr. David G. Penney, author of several books on the subject of carbon monoxide, lists nervous system damage caused by CO exposure: causes seizure disorders, multiple-sclerosis-type disorders, speech impairments, forms of aphasia; effects on learning, decrements in intellectual capacity, judgment, ability to concentrate, memory, executive functioning, multi-tasking, emotion; effects on short- to long-term memory and limbic system, ataxia, and slurring of speech. (25)

Ineffectiveness of Gas Chambers

Several mishaps have been reported by North Carolina media, showing that gas chambers are not always effective. Leaking carbon monoxide can keep the machines from reaching or maintaining a lethal level of 6%-10% for animals inside the chamber. The result can be a slower death, or mere unconsciousness and assumed death before the animal is placed in a freezer, dumpster, landfill, or incinerator. Some animals do not die the first time, whether due to inadequate gas levels, age of animal, or health issues.

Kerry Prichard of the Charlotte Observer reported a leaking gas chamber at Cabarrus County Animal Control in March 1998. “The gas chamber used to euthanize the animals was in clear view of visitors and, some critics say, it didn’t always work well. Critics say it killed the animals too slowly or not at all, because of leaks or overcrowding….The gas chamber has been reconditioned and moved to the new shelter.” The same chamber is still in use, complete with patching compound. (26)

A September 2003 article from Charlotte Observer reporter Hannah Mitchell uncovered problems with a gas chamber used at Alexander County Animal Control. “League volunteers heard a dog barking in a freezer after it went through the shelter’s gas chamber and was assumed to be dead. The county’s gas chamber used for euthanizing animals is sealed with duct tape. Campbell worried that the makeshift sealer lengthened the time it takes for animals to die.” (27)

The Charlotte Observer’s “Death at the Pound” series in June 2003 reported the same problem in other county shelters : “In Union, as many as 10 dogs are gassed together in a 4-by-4-foot steel container. It replaced a cinder-block chamber that leaked, causing some animals to survive the gassing.” In the same article, Stanly County Animal Control Officer Randy Palmer described a situation with a newer commercially manufactured gas chamber: “After you bring them out, some of them aren’t all down. Sometimes we have to put them back in.” (28)

Heather Howard of the Charlotte Observer interviewed Catawba County officials in 2004. County Manager Tom Lundy said that the existing gas chamber at the animal shelter “is inefficient and outdated.” Emergency Services Director David Weldon felt that a new model “would ensure that animals in the device are euthanized.” (29) Instead, the county made the change to euthanasia by injection in 2008.

Doug Clark of the Sampson Independent wrote a gripping story about a litter of puppies that survived the gas chamber at the local shelter in 2004 and were later adopted, only to die the next day. Attempting to dispel rumors of parvo in the facility, former employee Dianna Williford admitted, “We had tried to euthanize those puppies a half hour earlier and it just didn’t work.”(30) The only method of euthanasia used by the shelter at that time was a carbon monoxide chamber.

The most well known canine gas chamber survivor in North Carolina is Davie, a dog who was found alive in a dumpster after being dumped and assumed dead by Davie County Animal Control of Mocksville in 2005. Local residents Jeff and Susan Armsworthy were discarding trash at the dump when they heard a whining noise, which turned out to be a crying puppy in a plastic bag in the dumpster. The fearless couple jumped in and rescued the pup among piles of animal carcasses. Author Mike Gunning wrote, “Apparently, one of the puppies, while knocked unconscious by the gas, didn’t inhale enough to be fatal. It appears to have become conscious while in the dumpster.” (31)

Though many shelters have made the transition toward humane euthanasia in recent years, at least 22 county animal control facilities in North Carolina still kill unclaimed animals in gas chambers as of December 2009.

Sources

1. North Carolina Department of Labor Inspection, Sampson County Animal Control, March 2004. 2. Reidsville Fire Marshal inspections of Reidsville Veterinary Hospital/ Rockingham County Animal Control 2004-2006. 3. North Carolina Department of Labor Inspection, Columbus County Animal Control, 2006. 4. North Carolina Department of Labor Inspection, Davidson County Animal Control, May 2006. 5. Letter from Stokes County Fire Marshal to animal control supervisor Sarah Shumate, January 4, 2007. 6. North Carolina Department of Agriculture, Montgomery County Animal Control, inspection by Shelley Swaim, September 19, 2007. 7. Letter from North Carolina Department of Health and Human Services, Epidemiology Section, Granville County Animal Control inspection, August 21, 2006. 8. Letter from North Carolina Department of Health and Human Services, Epidemiology Section, Randolph County Animal Control inspection, April 24, 2007. 9. Statesville News and Record, July 24, 2008, author Bethany Fuller. 10. 2007 American Veterinary Medical Association Guidelines on Euthanasia 11. Enquirer Journal article, August 3, 2008, Author Billy Ball. 12. National Institute for Environmental Safety and Health, International Chemical Safety Card, Carbon Monoxide. 13. “Heart Injury Due to Carbon Monoxide Poisoning Increases Long Term Risk of Death,” Journal of the American Medical Association, January 24, 2006, Timothy D. Henry, M.D. 14. “The Brain Lesion Responsible for Parkinsonism After Carbon Monoxide Poisoning,” Young H. Sohn, MD; Yong Jeong, MD; Hyun S. Kim, MD; Joo H. Im, MD; Jin-Soo Kim, MD, Archives of Neurology 2000;57:1214-1218.  15. “Carbon Monoxide Poisoning- A Public Health Perspective,” US Environmental Protection Agency. 16. Carbon Monoxide Materials Safety Data Sheet, National Welders Supply.  17. Neuroimaging, Cognitive, and Neurobehavioral Outcomes Following Carbon Monoxide Poisoning Ramona O. Hopkins, Fu Lye M. Woon, Brigham Young University 18. “MRI, quantitative MRI, SPECT, and neuropsychological findings following carbon monoxide poisoning,” Gale, S.D., Hopkins, R.O., Weaver, L.K., Bigler, E.D., Booth, E.J., Blatter, D.D., 1999, Brain Injury, 13 (4), pgs. 229-243. 19. “Neuropsychological Impairment From Acute Low-Level Exposure to Carbon Monoxide,” Yona Amitai, MD; Zoli Zlotogorski, PhD; Vered Golan-Katzav, MA; Anya Wexler, MD; Ditza Gross, PhD Archives of Neurology. 1998;55:845-848. 20. “The Elimination of Carbon Monoxide from the Blood,” William Stadie and Kirby Martin, Yale University School of Medicine, 1925.21. “Myocardial Injury and Long-term Mortality Following Moderate to Severe Carbon Monoxide Poisoning,” Journal of American Medical Association, 2006, Christopher R. Henry, BS; Daniel Satran, MD; Bruce Lindgren, MS; Cheryl Adkinson, MD; Caren I. Nicholson, RN; Timothy D. Henry, MD;295:398-402. 22. Department of Health and Human Services, Centers for Disease Control and Prevention, 23. “Long-term Effects Of Carbon Monoxide Poisoning Are An Autoimmune Reaction,” Science Daily; Veena M. Bhopale, Donald Fisher, Jie Zhang, and Phyllis Gimotty. 24. “Delayed neurologic sequelae in carbon monoxide intoxication,” Archives of Neurology, July 1983, I. S. Choi. 25. “Major Sites of Nervous System Damage,” Dr. David G. Penney. 26. “Happy Endings Now Possible for Strays,” Charlotte Observer, March 5, 1998, Author Kerry Prichard. 27. “Animal League Told to Leave- Alexander County Resumes Control of Shelter,” Charlotte Observer, September 7, 2003, Author Hannah Mitchell. 28. “Death at the Pound: Animals in the Charlotte Region…” Charlotte Observer, June 29, 2003, Authors Michelle Crouch and Scott Dodd. 29. “Needs of Animal Shelter Outlined- Catawba Official Pitches Plan,” Charlotte Observer, April 28, 2004, Author Heather Howard. 30. “Inhumane Treatment Or a Doing Their Best?” The Sampson Independent, February 07, 2004, Author Doug Clark. 31.”Puppy Survives Euthanasia Attempt, Trip to Dump,” Davie County Enterprise Record, April 2005, Author Mike Gunning.

Electronic copies of public records referenced above are available from the author at no charge.

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