Shock Therapy: A History of Electroconvulsive Treatment in Mental Illness

Shock Therapy: A History of Electroconvulsive Treatment in Mental Illness

Shock Therapy: A History of Electroconvulsive Treatment in Mental Illness

Shock Therapy: A History of Electroconvulsive Treatment in Mental Illness

Synopsis

Shock therapy is making a comeback today in the treatment of serious mental illness. Despite its reemergence as a safe and effective psychiatric tool, however, it continues to be shrouded by a longstanding negative public image, not least due to films such as the classic One Flew over the Cuckoo's Nest, where the inmate of a psychiatric clinic (played by Jack Nicholson) is subjected to electro-shock to curb his rebellious behavior. Beyond its vilification in popular culture, the stereotype of convulsive therapy as a dangerous and inhumane practice is fuelled by professional posturing and public misinformation. Electroconvulsive therapy, or ECT, has in the last thirty years been considered a method of last resort in the treatment of debilitating depression, suicidal ideation, and other forms of mental illness. Yet, ironically, its effectiveness in treating these patients would suggest it as a frontline therapy, bringing relief from acute symptoms and saving lives.

In this book, Edward Shorter and David Healy trace the controversial history of ECT and other "shock" therapies. Drawing on case studies, public debates, extensive interviews, and archival research, the authors expose the myths about ECT that have proliferated over the years. By showing ECT's often life-saving results, Shorter and Healy endorse a point of view that is hotly contested in professional circles and in public debates, but for the nearly half of all clinically depressed patients who do not respond to drugs, this book brings much needed hope.

Excerpt

It is 1947. X, a thirty-eight-year-old New York physician and veteran of World War II, has just dropped out of training in internal medicine. He has been diagnosed with lung tuberculosis and has become depressed. He develops feelings of guilt, particularly about his income tax, “complaining that he did not file properly after he sold his house.” He confesses to his wife that he has had extramarital affairs “and that he has committed so many crimes that he will never be able to do penance for it.” He is fearful of starting up practice on his own, that patients will never come, and is “convinced that he is incompetent and that he does not have any chances of getting out of the mess in which he finds himself.”

In the second week of May, X attempts suicide, swallowing a handful of the barbiturate drug, sodium Seconal. Taken to Queen’s County General Hospital in New York, he awakens twenty-four hours later, deeply depressed and yet bewildered that he could have attempted to end his life. He is transferred to Hillside Hospital, a private psychiatric facility at the eastern end of Queens, where his attendants describe his state as “gloomy, his whole attitude expresses deep despair, his voice [is] soft, his posture … stooped, his movements … slow, his eyes … [look] down at the floor as if he [is] one of the most terrible criminals not being able to carry his burden.” He is also concerned about his physical body: his bowel movements, overall weakness, “his inability to move his legs and arms, and … pain in his back and in his heart.” the staff cannot get him to stay in bed as he keeps “jumping up to go to the mirror and look at his face in order to find the confirmation that he [is] deadly ill.” Most alarmingly, he threatens another attempt at suicide . . .

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