Academic journal article Ethical Human Psychology and Psychiatry

The Electroshock Quotationary

Academic journal article Ethical Human Psychology and Psychiatry

The Electroshock Quotationary

Article excerpt

Since its introduction in 1938, electroshock has been the subject of intense controversy; there appears to be little if any middle ground between the positions taken by its proponents and opponents. The author/editor, himself an insulin coma-electroshock survivor, has for more than 30 years actively opposed any use of electroshock on the grounds that the procedure is inherently destructive and dehumanizing. The Introduction briefly describes the nature of the controversy, provides background information, lists the diagnoses for which ECT is (or has been) used and its effects, describes the method of administration, offers some answers to the question of why it seems to "work" in certain instances, lists some of the well-known individuals who have undergone the procedure, and closes with a short overview of the current situation. The text presents a historical perspective on ECT in the form of 78 chronologically arranged excerpts from professional and lay writings. Included are descriptions by survivors of their experience with ECT and how it affected their lives, as well as reports and claims regarding clinical and nonclinical uses of ECT, its effectiveness and ineffectiveness, and its safety and danger (especially brain damage, memory loss, learning disability, and death).

Keywords: electroshock; history; brain damage; memory loss; death

INTRODUCTION

The Controversy

Electroshock (also known as shock therapy, electroconvulsive treatment, ECT, EST, ECS, and convulsive therapy) involves the induction of a grand mal seizure, or convulsion, by passing electricity through the brain. It is the most controversial "treatment" in psychiatry, and perhaps in all of medicine. Proponents call it a safe and highly effective way to address various kinds of "mental illness" and certain medical conditions. Opponents charge that it causes brain damage and is an instrument of social control, sometimes administered by means of coercion or outright force and seldom with genuine informed consent.

Background

Since 1938, when Ugo Cerletti and Lucio Bini introduced the procedure at the University of Rome, more than 6 million Americans and millions of others throughout the world have undergone ECT. Even today, an estimated 100,000 people a year in the United States undergo ECT. Two-thirds are women, and half are elderly. Age is not a disqualifying factor: There are published reports of individuals as young as 34 1/2 months and as old as 102 undergoing the procedure.

A typical electroshock series for a hospitalized "patient" in the United States costs between $50,000 and $75,000. An ECT series may also be administered on an outpatient basis, in a hospital or a psychiatrist's office, at considerably less expense: $1,500 to $2,000 per session. Government or private insurance usually covers most, if not all, of the cost. Psychiatrists who specialize in administering electroshock often earn $300,000 to $500,000 a year, an annual income considerably higher than the mean for all psychiatrists, which is $150,000. The figures cited in this article suggest that in the United States alone electroshock is a multibillion-dollar-a-year industry.

To reduce the risk of relapse after an electroshock series, psychiatrists often urge patients to pursue continuation treatment (sometimes called maintenance treatment). This generally involves psychiatric drugs and often includes individual electroshocks as well, administered on an outpatient basis at various intervals for 6 months or longer.

Diagnoses

The most common indication for electroshock is a diagnosis of clinical or severe depression. An ECT series for depression typically consists of 6 to 12 sessions. People diagnosed with schizophrenia or bipolar disorder (manic depression) may also be subjected to electroshock, but this is less common; for such patients, a series of 15 to 25 sessions is standard. ECT is usually administered in the early morning, three times a week (Mondays, Wednesdays, and Fridays). …

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