Shock Therapy: A short history

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There has been a growing sophistication in the methodology and technology used over the years but the basic concept has remained unchanged.

In some nations traditional mental illness treatment methods are still used. For example in Nigeria where a person cannot pay for the more sophisticated Western variations of treatment the unmodified traditional method is used. The insane person is shackled and to drive out the demons beatings are applied. By such means over the months and years the person's problems are 'controlled' at very low cost.

An English variation of such therapy, in use in the 1800's, was the Darwin Chair (invented by the grandfather of Charles Darwin). Patients were strapped in and the chair rotated very fast until blood oozed from their mouths, ears and noses. For many years successful cures were reported from using this therapy.

Today there is a dislike for therapies, which are seen by the lay public, as violent or that visibly draw blood in such ways. Thus medical professionals have had to press new electrical and chemical technologies into use.

In 1938 Dr. Ugo Cerletti became interested that pigs were prepared for slaughter by being electrically shocked through the temples. This rendered them unconscious but did not kill them, indeed they could survive the shock if allowed to recover. Deciding to try it on his patients Dr Cerletti found such electric shocks caused his obsessive and difficult mental patients to become meek and manageable. Large quantities of insulin will also chemically shock patients into a coma that lasted about an hour and was also starting to be used. Other doctors quickly adopted these new therapies.

Some resistance was encountered, for example:
Dr. Roy Grinker of Chicago said, at a 1941 meeting of psychiatrists about electric and insulin shock treatments, "I think it can be stated unequivocally that it is fraught with extreme danger. There is not only an emotional but an intellectual change in the patients ... careful studies reveal a definite 'organic' change in memory which does not entirely clear up.... Often the so-called normal alpha rhythm increases greatly in voltage, making one suspicious that irreparable damage to the brain has been produced."

But the quick-fix nature of the new treatment won out and led to wide use for all kinds of 'mental illness'. By 1942 85% of all psychiatric institutions in the United States used some form of shock treatment for psychosis, depression, mania, and homosexuality. That same year Dr. Abraham Myerson wrote "The reduction of intelligence is an important factor in the curative process.... The fact is that some of the very best cures that one gets are in those individuals whom one reduces almost to amentia." [feeblemindedness] And in 1948, Drs Kennedy and Anchel reported in Psychiatric Quarterly (22(2):317-320,1948) research on regressive electric-shock: "We started by inducing two to four grand mal convulsions daily until the desired degree of regression was reached....We considered a patient had regressed sufficiently when he wet and soiled, or acted and talked like a child of four."

One remaining problem was that the patient's convulsions, on being electro-shocked, were violent. One researcher X-rayed every patient after their first course of shock treatment and discovered that 20% had compression fractures of the spine. Thus in the 1950s psychiatrists began using muscle relaxants and anaesthesia.

This methodology became widespread by the 1960s and is today often called the "modern form of ECT" by its proponents. With the body immobilised more electrical current could actually be applied to the brain. Of course some inherent risks were added due to the side effects of anaesthesia and powerful muscle relaxants.

Again adverse comment was made:
1966-Dr. Robert Morgan: "In summary, even one or two ECT treatments risk limbic damage in the brain leading to retarded speed, coordination, handwriting, concentration, attention span, memory, response flexibility, retention, and re-education. On the psychological side, fear of ECT has produced stress ulcers, renal disease, confusion, amnesic withdrawal, and resistance to re-educative or psychological therapy. The research thus indicated that ECT was a slower-acting lobotomy with the added complications of shock-induced terror."

1974-Dr. Karl Pribram: "I'd much rather have a small lobotomy than a series of electroconvulsive shocks.... I just know what the brain looks like after a series of shocks-and it's not very pleasant to look at."

Starting in the mid 1970's following community lobbying action and public outcry against ECT in the mass media 35 US States passed laws restricting the use of shock treatments, and by 1980 ECT use had fallen 46% in the US.

But the Psychiatric Empire was planning to strike back and had formed the International Psychiatric Association for the Advancement of Electrotherapy to defend and promote the use of ECT and publicly assert its "harmless" nature. Thus in 1983 when due to a citizen vote Berkeley, California became first city in the US to ban ECT within the city limits, ECT proponents fought back getting the courts to rescind the law in less than two months as a local infringement on a matter of statewide concern. Efforts to ban ECT continue to day around the world, but medical professional ECT advocates push a message that shock treatment is a good thing and currently shock treatment is making something of a comeback.

ECT is cheap to employ and makes an 'unmanageable' person manageable, and in some cases leads to the very rapid death of the subject under conditions that do not raise human rights issues too clearly.

Such advantages have equal appeal to NSW government planners today be they responsible for management of a strapped for cash health care system or suppressing dissidents. So in today's NSW it is high of the list of preferred treatments and a 1997 Mental Health Act allows ECT to be applied against the will of any person who has been identified by authority as being at risk of damaging their reputation or financial position. And an important thing in today's NSW is that a rather full politically correct vocabulary now exists. Such words as Therapy, unilateral ECT and bilateral ECT, hide from a lay public, so easily blinded by pseudo science, that the concept is still just one of trying to drive out 'demons' by destroying a patient's brain bit by bit simply because no medical professional has yet come up with a better idea about what to do.