ECT in action: 'It was my magic wand' ECT in action: 'It made my mania worse' Using electroconvulsive therapy for depression remains controversial. Dr Max Pemberton examines the evidence Depression kills. Suicide in the UK constitutes nearly one per cent of deaths from all causes every year.   Depression can kill. Is ECT the answer? It is the single biggest killer of young men after road traffic accidents, and the 2001 Confidential Enquiry into Maternal Deaths found that suicide was the leading cause of maternal mortality in the UK. Depression also destroys lives insidiously, dismantling them piece by piece until little remains. With around a quarter of us experiencing depression in our lifetimes, and between five and 10 per cent suffering from it at any one time, it represents a significant public health issue. But depression is treatable. The development of talking and pharmaceutical therapies such as cognitive behavioural therapy and antidepressants has meant that the lives of millions of people have been transformed. But there remains a small cohort of people for which standard treatment does not work, and it is in this group that electroconvulsive therapy (ECT) is sometimes used. In fact, empirical evidence has shown it is the most effective treatment for severe depression, meaning people can resume work and relationships. Around 80 per cent who fail to respond to standard treatments for depression respond to ECT.

It is particularly useful in older patients who present with severe forms of depression where they are so depressed they refuse food and drink, appear confused or paranoid, or experience nihilism.

For these people, ECT can mean the difference between returning home or ending their days in an institution. It was first used in the 1930s after it was noticed that patients who had both epilepsy and mental health problems often improved after going into a convulsion.

But this is not the reality. It's now given while the patient is under a general anaesthetic with nurses, anaesthetists and psychiatrists present. The electrodes are carefully placed on the temples and gel is applied to prevent any burns to the skin and to conduct the charge more easily.

There is categorically no thrashing about of the limbs, patients are not restrained in any way and the most you can hope to see is a twitch of the eye lid. It's actually rather boring to watch, and new observers frequently express their disappointment that there wasn't more to see.

The aim of ECT is to induce a seizure in the patient and the electrical current needed to achieve this varies from individual to individual, but is usually in the range of 100-500 millicoulombs. The electrical charge lasts for no more than a few seconds, patients have to give their consent before undergoing ECT treatment and can withdraw this consent at any time.

Very occasionally, someone is so ill it is felt they are not capable of consenting. In these circumstances, two doctors and a social worker must assess the patient to detain them in hospital under the Mental Health Act and then an independent psychiatrist, sent by the Mental Health Commission, must assess the patient and agree that the treatment is necessary.

There are side-effects, although ECT is among the safest medical treatments given under general anaesthetic. The most commonly reported ones are headache, dizziness and memory problems. The latter is the one that causes the most concern. Evidence shows that memories formed in the period directly before or after the treatment can be affected, but that this usually improves within a few hours to a few weeks, if it occurs at all.

Longer-standing memory problems - where patients complain of gaps in memory for past events or biographical information - are associated with very high voltages of electricity, which are no longer used. There is no evidence that ECT, as practised in Britain today, causes permanent, severe memory disturbance, although the myth persists.

There is also no evidence that ECT causes any structural damage to the brain and in many ways is safer and has fewer side-effects than the medications we readily prescribe for depression. While the exact mechanism by which ECT works is not fully understood, we know that the seizure produces changes in the brain, at a molecular as well as cellular level, which "resets" the neurochemical equilibrium by increasing serotonin levels and the sensitivity of brain cells to serotonin.

It's not a panacea. It should be used carefully and only when clinically indicated. But ECT is an invaluable weapon in the arsenal used to fight depression. Having depression is nothing to be ashamed of and neither is having ECT. Depression kills and, sometimes, ECT saves lives.

ECT case study: 'ECT was my magic wand'

ECT in action: 'It made my mania worse' Doctors don't know how it works, so why use it? Lucy Parma, 30, a PA, had her first episode of depression at the age of 20, in her second year at university When you're depressed, people often say they wish they had a magic wand to make you better. Well, ECT was my magic wand.   Lucy had tried a host of anti-depressants I had several bouts of depression in my twenties - or, to give mine its proper name, unipolar, rapid-cycling depression (I would have severe downs, but never manic ups, once a year). All metaphors to describe it sound so banal, but for me it was like wearing sunglasses and earmuffs that cut me off from the world while I suffered torment in my brain. It was actively horrific, all the time, every minute of every day. My depression always took the same form. It started with anxiety and morphed into black despair. I would wake up early and feel sick. Then I would feel a physical change coming over my body - my chest felt heavy and my limbs rinsed through with a mixture of worry and inertia. Within a couple of days, I stopped functioning properly. I couldn't wash my hair, prepare food, or think rationally. I couldn't even bear to listen to music because it seemed so flippant. Last year it was as bad as it's ever been. I became blackly depressed for months, convinced I would never get better. My psychiatrist changed my pills again. I've had around half a dozen types of antidepressants. I've never really believed they've worked.

I've also had all sorts of therapy - cognitive behavioural therapy, group therapy, counselling and all the stuff they make you do in hospital (I had one stay in 2000 after a major panic attack) when you're too ill to fight them - like art therapy and drama therapy.

Nobody had suggested ECT until this last bout of depression, but after five months it was clear I wasn't getting better. ECT was always referred to as a last resort by my doctor, and that's pretty much where I was. It was a major decision to make. My doctor told me there were side?effects - normally short-term memory loss, but I didn't really care. By that stage in the illness, I was too numb and pessimistic.

So one Tuesday morning my lovely mum got up early and drove me to a private hospital. I'd had nothing to eat or drink since midnight because of the anaesthetic. A nurse took my blood pressure. I didn't have to change into a gown, I just took my shoes off and my doctor led me into a small room with a bed.

There was a machine by it the size of a microwave. I lay down on the bed, then my doctor asked me if I'd had a pee - which I remember finding a weirdly personal question. He explained you had to empty your bladder before a treatment.

A brisk anaesthetist gave me an injection in the back of my hand. I was also given a muscle relaxant to prevent convulsions. Someone put a blanket over me. Then I had the general anaesthetic: a sudden metallic taste in the mouth, then a wonderful swimmy feeling for three seconds before drifting into unconsciousness.

Then I woke up. And I was better.

I felt a bit confused, and I had a terrible ache in my jaw, but from the second I opened my eyes I felt more present in the room than I had felt for months. My spirit and personality had returned. The sunglasses and earmuffs were off. I was taken to a side room, and told it was fine to sleep, but I sat bolt upright on the bed, drinking everything in.

I had a few more sessions after that, even though I felt 100 per cent better by the time I'd had just two. Even in the later sessions, when they were more casual and started sticking the electrodes to my forehead before putting me to sleep (the general anaesthetic only lasts a few minutes and the current only passes through you for a matter of seconds), I wasn't scared.

My doctor said that it often works for people like that, which further suggested my depression was chemical in origin. It was a physical cure for a physical illness in my brain, rather than a behavioural disorder or reaction to an event. Understanding this also helps me.

I did have side-effects, but they were worth it - and would have been even if they were ten times worse. For the first few weeks I would completely forget things - entire conversations sometimes. But this became less pronounced, and went away after about four months.

More annoying was that I felt less mentally agile. I couldn't connect things so well - for example, if I'd seen a certain actor in another film I couldn't place them. My doctor explained that if you do a brainscan on someone who's had ECT, you can actually see that their brainwaves become wonky for three months, in a similar way to someone who's had an epileptic fit.

As far as I know, nobody understands how it works. But inducing a seizure seemed to rewire my brain. And now I've found something that actually works, I shouldn't need to live in dread of the black dog. If I get ill again, I can have ECT again.

I'd urge anyone with serious depression to try it. If you truly are at absolute rock bottom, you shouldn't be put off by fear, because it isn't possible for you to feel any worse. They press a switch, and it makes you better.

Lucy Parma is a pseudonym

ECT case study: A trigger for suicide

ECT in action: 'ECT was my magic wand' Doctors don't know how it works, so why use it? Terri Cheney, who has lived with manic depression since she was 16, claims ECT triggered a manic episode I had one move left - the one I'd kept on hand in case of an emergency. One phone call. It was to Dr R, the psychiatrist who promised that he could ease my pain if I would submit to a few months of electroconvulsive therapy. The decision to allow electrodes to be placed on each side of my skull, which would then transmit enough electrical voltage to send my body flying two feet off the operating table, was calm.   Terri's severe manic episode included a 24-hours-a-day shopping spree for 18 days Dr R was considered one of the top diagnosticians in the United States. When he spoke, I listened. All he said was: "ECT". The only possibility left was to try to shock the hell out of my depression. So I signed the 15-page consent form; three additional doctors confirmed the need. We all hoped that 12 ECT sessions, and many thousands of dollars later, I would be well again. Better than well - I would be cured. I remember almost nothing of the actual ECT, except the straps that bound me to the bed. They left bruises on my arms and ankles for weeks after each session. I'm not sure that I want to remember the experience. But whether I want to remember it or not is beside the point. The main side effect of ECT is that it wipes out your short-term memory. Some of it returns, but for me there are vast grey gaps in 1994. I forgot simple things. The meaning of certain words, the associations assigned to different colours. There seemed no functional distinction to me between red and green. (Fortunately, I was forbidden to drive while undergoing treatment.) I even forgot certain smells - smells that had once been as familiar to me as my father's face. Which I also briefly forgot. But I do remember the psychotic break that took place after my eighth ECT session, triggering the most severe manic episode of my life. Previous episodes had lasted several days. This one lasted weeks.

I may never be able to pin down the events of the non-stop, 24-hours-a-day, 18-day odyssey I embarked upon. What little I know of it, I pieced together through sales receipts.

I bought anything that struck my fancy, including a dozen assorted garden gnomes, even though I have no garden. By the time I got back home, I had not only gone through my entire savings account, I had seduced the husband of one friend and made plans to seduce another.

And then, after the ninth treatment, my world convulsed. I remember only two things about the next couple of months: first, Dr R was indicted for sexually molesting one of his patients, and his licence was suspended; second, I tried to commit suicide.

It's rather strange that I hadn't tried earlier, given the depth of my distress. But suicide requires movement, and depression weighs a thousand tons. I needed a spark of mania to fire up my resolve. Mania doesn't just give you the desire for extremes, it gives you the energy to pursue them.

I woke up in hospital three days after my attempt, in a private padded room on the locked ward. Who knows what went wrong during that last ECT session? I think it was some strange kind of gift from the gods. I emerged from that chaos a different person, with a different identity. No longer depressed, but [diagnosed as being] bipolar.

The label mattered. It made sense of my erratic life. I had never before understood how, for several weeks or months at a time, I could function at such a high level of competence, only to be followed by equally long periods of hiding under my desk, under the covers, in the dark.

I'm still ashamed of having a mental illness. But now it's mostly of the consequences, not the condition itself. I believe in this diagnosis. Despite the constant shifting of the earth beneath my feet, I feel grounded at last.

SHOCK THERAPY

A History of Electroconvulsive Treatment in Mental Illness

By Edward Shorter and David Healy

Electroconvulsive treatment - known as ECT - is a procedure that induces an epileptic seizure in the brain. Since it was introduced, in the 1930s, then refined and improved over the decades, it has provided relief for such torments as psychosis, suicidality, mania or depression of bipolar swings, symptoms of schizophrenia and the severe forms of depression.

Shock Therapy: A History of Electroconvulsive Treatment in Mental Illness, by Edward Shorter and David Healy, tracks the rise, fall and current return to grace of ECT. Though the authors claim it is a "careful ... fair and comprehensive investigation of ECT," it is hardly evenhanded. Rather, it is a polemic reproaching forces that the authors claim stood in the path of ECT during its dark days of reduced use, and a vindication of its stalwart supporters.

Little else could be expected from these co-authors. Shorter, Jason A. Hannah Professor of the History of Medicine of the University of Toronto, has made a minor specialty out of maligning psychoanalysis while recounting psychiatric history. David Healy, professor of psychiatry at Cardiff University, achieved notoriety several years ago when an offer of employment from University of Toronto was rescinded after he gave a lecture that raised questions about the role of Big Pharma in academic psychiatry.

As ECT was often rejected in favour of psychoanalytic approaches (or related psychotherapies), and psychopharmacology produced powerful drugs that seriously displaced ECT, this subject gives Shorter and Healy a chance to expound their shortcomings. It is hard to say whether they delight more in vindicating a valuable treatment or vilifying their favourite bêtes noirs.

But they deserve credit for trying to get a fair hearing for ECT, a much-misunderstood, sensationalized treatment. Their title, Shock Therapy, expresses the degree to which ECT evokes images of sizzling brains sending off sparks, a legacy of exaggeration in film and literature that is still distorted today by the likes of Naomi Klein, who features grisly, out-of-date clips of obsolete ECT techniques on her website.

Early witnesses to ECT were amazed by what appeared to be miracles: Patients who once lingered for years in unreachable states of agony and delusion returning to sanity after a few treatments. In 1938, the drama and excitement were so high at a pioneering ECT clinic in Rome that physicians were summoned to watch it by two blasts of a trumpet. The authors' account of the rivalries, personalities, schemes and plots of the early innovators in the field is highly engaging. Surely, psychiatrist Henri Bersot deserves a place in posterity for being the only physician known to experimentally administer ECT to himself.

That medical procedures and their progress cannot be separated from the march of social, cultural and political history is even truer in the case of a treatment for mental illness, for the traumas and dislocations that create suffering change the conditions in which the mentally ill are treated as well as the nature and definition of mental illness itself. The authors provide an illuminating account of the titanic waves of change that washed over ECT , including the arrival of randomized controlled studies, the emergence and development of informed consent, the shift in meaning of what constitutes the patient's risk, and society's ever-changing definition of mental illness.

As psychopharmacology alleviated such severe conditions as schizophrenia enough to allow previously institutionalized persons tolive in the community, such deviance became more normalized. But by creating and marketing drugs for more commonplace mental maladies such as chronic mild depression or anxiety, psychopharmacology also made normal mental anguish seem more pathological.

Shorter and Healy grapple with these social complexities with mixed success. In particular, their discussion of the influence of culture and the academy on ECT seems overly compressed. Statements such as "a transmission line runs from the senior common rooms through the newsrooms of the quality press directly into the nation's most literate and influential living rooms" do not apply equally to the entire period of ECT's existence, and require finer specificity.

While One Flew Over the Cuckoo's Nest and the suicide of Ernest Hemingway following ECT definitely an exaggerated negative impression, the authors do not pause to consider that most other mental- health treatments were not portrayed any more accurately. ECT had Jack Nicholson; psychoanalysis had Woody Allen. Granted, the maladies of the analysand are usually nowhere near as dire as the schizophrenic or suicidally depressed, but whether amusing or terrifying, neither film character served the public's understanding.

In their zeal to vindicate ECT, Shorter and Healy undermine their own credibility. For example, though psychoanalysts opposed ECT, their resistance was not monolithic, and the authors cannot really prove its impact. Quotes taken from their own interviews, such as, "The analysts pooh-poohed it but when their patients were suicidal they sent them for ECT. ... That's bullshit," only seem petty. The shrill mischaracterizations of psychoanalysis, anti-psychopharmacology rants and the inflammatory style - ECT and psychoanalysis are "gladiators ... vying for the prize"; evidence is "brandished" rather than presented - coat the entire text with a snide veneer.

This is unfortunate, because the basic contention that ECT is an effective treatment that was displaced to the detriment of many is true, and this chapter of medical history is genuinely fascinating.

Robin Roger is an editor of Ars Medica: A Journal of Medicine, the Arts and Humanities, as well as a psychotherapist.

He was bad, so they put an ice pick in his brain...

At the age of 12, Howard Dully was given a lobotomy, one of thousands performed by the notorious Dr Walter Freeman in the 1940s and 1950s. Now Dully has written a forceful account of his survival and sheds light on the man who subjected him to one of the most brutal surgical procedures in medical history

Elizabeth Day
Sunday January 13, 2008
The Observer

Dully was a withdrawn boy who liked riding his bicycle and playing chess. He occasionally fought with his brother, disobeyed his parents and stole sweets from the kitchen cupboards. He had a weekly paper round and was saving up to buy a record player. According to Dr Freeman's meticulous records, Dully was 62 inches tall and weighed 6½ stone. He was an average child, perhaps a little unruly but nothing that would strike one as exceptional for a boy of his age.

But Howard Dully would soon become exceptional for all the wrong reasons. Barely two months after this first meeting, his father and stepmother had him admitted to a private hospital in his home town of San Jose, California. At 1.30pm on 16 December 1960, he was wheeled into an operating theatre and given a series of electric shocks to sedate him. That much he remembers. The rest is murky.

When Dully woke the next day, his eyes were swollen and bruised and he was running a high fever. He recalls a severe pain in his head and the discomfort of his hospital gown, which gaped open at the back. He had no idea what had happened. 'I was in a mental fog,' Dully says. 'I was like a zombie; I had no awareness of what Freeman had done.'

What he didn't know was that he had been subjected to one of the most brutal surgical procedures in medical history. He had undergone a lobotomy and no one, not his parents, not the medical community or the state authorities, had intervened to stop it. More disturbingly, there seemed to have been no obvious necessity for the operation.

If Dully appeared superficially vacant or mildly aggressive, there were some obvious explanations. His mother died of cancer when he was five and his father, Rodney, later remarried to a 'cold and demanding' woman called Lou, who found her new stepson's natural ebullience and physical strength almost impossible to control. Relations between the two deteriorated so that Dully grew up in an atmosphere of emotional abuse and casual neglect. He was given regular beatings and forced to eat meals on his own. Increasingly convinced that there was something emotionally wrong with her stepson, Lou started consulting psychiatrists and mental health experts before eventually being referred to Dr Freeman, a renegade physician disowned by the mainstream establishment, who ran a private practice in Los Altos, just outside San Francisco. Freeman diagnosed Dully as a schizophrenic.

'He is clever at stealing, but always leaves something behind to show what he's done,' Freeman recorded in his notes from October 1960. 'If it's a banana, he throws the peel at the window; if it's a candy bar, he leaves the wrapper around some place... he does a good deal of daydreaming and when asked about it he says, "I don't know." He is defiant at times - "You tell me to do this and I'll do that." He has a vicious expression on his face some of the time.'

Discarded sweet wrappers, daydreaming spells and the odd glimpse of youthful defiance - it would appear to be a relatively innocuous list, but it was enough for Freeman. Eight weeks after the doctor first saw him, Dully came round from his operation in a state of numbed confusion. The hospital report stated that he had been given a 'transorbital lobotomy. A sharp instrument was thrust through the orbital roof on both sides and moved so as to sever the brain pathways in the frontal lobes'. Dr Freeman's bill came to $200. Dully was his youngest-ever patient; extraordinarily, he survived.

'People freak out when they realise the person they are talking to had a lobotomy,' he says now, 47 years later, sitting under the corrugated iron awning outside his trailer home on the outskirts of San Jose. 'They expect me to be drooling.'

Over the years, the lobotomy has become almost a caricature of itself, a cultural shorthand that immediately conjures up images of zombies or dribbling madmen. Even the word itself sounds freakish and unwieldy, like an ill-judged verbal joke. For most people, it remains indelibly associated with dramatic invention: with the dazed, incoherent character of Catherine in Tennessee Williams's Suddenly Last Summer or with Jack Nicholson's Oscar-winning performance as a deranged asylum inmate in One Flew Over the Cuckoo's Nest

But for a time in the 1930s and Forties, the procedure was at the forefront of neurosurgery, viewed by the medical establishment as a cutting-edge treatment for mental illness. Before the introduction of antipsychotic drugs or the popularisation of psychotherapy, the lobotomy was touted as a miracle cure for anything from schizophrenia to postnatal depression - and not just in the United States. Neurologists in the UK are estimated to have carried out 50,000 variants of the operation, until the late 1970s.

Derek Hutchinson, a 62-year-old grandfather, underwent a lobotomy in 1974 - without his consent, he says - at the hands of surgeon Arthur E Wall while a patient at the High Royds Asylum near Leeds. Unlike Dully, Hutchinson was awake throughout his operation, which a psychiatrist had insisted would curb his aggressive tendencies.

'What did it feel like?' he says from his home in Leeds. There is a long exhalation of breath on the end of the phone, halfway between a gasp and a sigh. 'It's a situation you should only go through once in your life and that's when you're dying. It felt like a broom handle was being pushed in my brain and my head was splitting apart.'

Originally developed by Portuguese physician Antonio Egas Moniz in 1936, the lobotomy involved drilling two small holes in either side of the forehead and severing the connecting tissue around the frontal lobes. The hope was to dull the symptoms of psychiatric illness by reducing the strength of emotional signals produced by the brain. Although Moniz won the Nobel Prize for his pioneering work in 1949, he insisted that it should only be used as a last resort, in cases where every other form of treatment had been unsuccessfully tried.

Dr Walter Freeman, a neurologist and Yale graduate, brought the procedure to America in the late 1930s. Freeman's first job after medical school was as head of laboratories at St Elizabeth's Hospital in Washington DC, a sprawling mental institution that housed 5,000 inmates in near-Victorian conditions. At the time, the state legislature paid a pitiful $2 a day per patient to cover their upkeep, a sum that included staff salaries, catering, accommodation and treatment.

Spurred on by his first-hand experience of the horrors of state-run mental institutions and determined to make his name as a medical pioneer, Freeman developed a version of Moniz's procedure that reached the frontal lobe tissue through the tear ducts. His transorbital lobotomy involved taking a kitchen ice pick, later refined into a more proficient instrument called a leucotome, and hammering it through the thin layer of skull in the corner of each eye socket. The pick would then be scrambled from side to side in order to damage the frontal lobe. The process took about 10 minutes and could be performed anywhere, without the assistance of a surgeon.

Over the years, Freeman developed a reckless enthusiasm for the operation, driving several thousand miles across the country to carry out demonstrations at asylums and hospitals. An instinctive showman, he sometimes ice-picked both eye sockets simultaneously, one with each hand. He had a buccaneering disregard for the usual medical formalities - he chewed gum while he operated and displayed impatience with what he called 'all that germ crap', routinely failing to sterilise his hands or wear rubber gloves. Despite a 14 per cent fatality rate, Freeman performed 3,439 lobotomies in his lifetime.

For the survivors, the outcomes varied wildly: some were crippled for life, others lived in a persistent vegetative state. Rose, John F Kennedy's sister, was operated on by Dr Freeman in 1941 at the request of her father. Born with mild learning difficulties, she was left incapacitated by the procedure and spent the rest of her life in various institutions, dying in 2005 at the age of 86. Yet occasionally, the operation appeared to have a calming, desensitising effect on the mentally ill. The lobotomy's mixed success rate was a symptom of its imprecision: it was a hit-and-miss procedure developed at a time when little was known about the very specific nature of the brain's structure.

Dully's almost total recovery is thus an anomaly. To look at him, you would never guess that he underwent such brutal surgery. There is no slowness of speech, no telltale squinting of the eyes, none of the lack of social inhibition that characterises most lobotomy survivors. Now 58, he has a full-time job training school bus drivers and has been married to Barbara for 12 years. He has a son, Rodney, 27, and a stepson, Justin, 30, and a tabby cat called Princess who prowls on a parched flowerbed while we talk. His autobiography, My Lobotomy, co-written with journalist Charles Fleming, was published in the US last autumn and will be published in the UK in March.

'I don't feel physically different from anyone else,' he says. 'I get eye infections because I think they destroyed my tear ducts. About the most unusual thing you would notice about me is my size.'

Dully is a broad, bulky man and 6ft 7in tall. When he turns on his laptop to show me photographs of his operation, his hand completely covers the computer mouse. The pictures are disturbing in their very matter-of-factness. Freeman was a fastidious archivist and insisted on recording each stage of the operation on camera. In one black-and-white image, Dully lies unconscious, his mouth lolling open. The tip of a 12cm long leucotome has been pushed deep into his eye socket. How does he feel when he sees these photographs?

'I would describe it as a feeling of loss, like you've lost a whole part of your life.' As he speaks, he gulps intermittently on a mug of milky instant coffee. 'I like hazelnut-flavoured cream in my coffee - it makes life worth living,' he says, grinning through an enormous walrus moustache. On the surface, at least, his life is settled, but it has taken Dully the best part of four decades to be able to speak with such ease about his past.

'It was something I didn't talk about for years. I felt that I was the secret, the skeleton in the closet, the dirty laundry.' That changed in 2003 when he was tracked down by an American radio production company and asked to make a documentary about his life. It was the first time he had seen his medical files and the first time he had found the courage to confront his past and speak to his father.

'Lou [his stepmother] had died in 2001, so a lot of what happened died with her. I asked my dad about it and I don't think he meant any harm. He said he got manipulated by Lou. She threatened him with divorce if he didn't go ahead with it. My dad said he only met Freeman once.'

Dully breaks off and leans back in his chair, arms folded across his black polo shirt. 'You meet a guy once and you're going to let him drive spikes in your son's head?' he asks, incredulously.

His father, now 83, has never apologised, but Dully remains astonishingly sanguine about the operation and the chequered legacy it left him. For years after the lobotomy, he was in and out of mental institutions, jails and halfway houses. He was homeless, drug-addicted and alcoholic, a petty criminal with little concept of how to live a normal life.

'I think I was angry at society for a long time, but I went through that and now I don't think there's any point in dwelling on it. I blame everyone for what happened including myself. I was a mean little ruffian. Lou was looking for a way to get me out of the house, for a solution to the problem, and Freeman was looking for a subject. Both of them came together... and whoopa-dee-doo.

'I don't think Freeman was evil. I think he was misguided. He tried to do what he thought was right, then he just couldn't give it up. That was the problem.'

In many ways, Walter Freeman was shaped as much by human frailty as his patients. Born in Philadelphia in 1895, he was driven from a young age to be exemplary, growing up in the long shadow cast by his grandfather, William Keen, an exceptional surgeon who was the first American successfully to remove a brain tumour. 'He was motivated partly by interest in the well-being of his patients and then also by this very urgent need to feel like he was someone who was accomplishing great things,' explains Jack El-Hai, author of The Lobotomist, a biography of Freeman. 'As he grew more personally attached to the lobotomy, he became more irrational.'

The more the mainstream medical establishment derided Freeman's methods - with the advent of Freudian psychoanalysis and antipsychotic drugs such as Thorazine in the mid-1950s the lobotomy fell out of favour - the more defensive Freeman became. He took pride in what he called 'shrink-baiting' and wrote disobliging limericks about his professional enemies, once saying he would 'rather be wrong than be boring'. By the time Freeman operated on Dully in 1960, he was working exclusively from a private practice - no state hospital would touch him.

Freeman's home life unravelled alongside his professional reputation. His wife, Marjorie, was an alcoholic and Freeman had numerous affairs. In 1946, Freeman had witnessed the horrific death of his 11-year-old son Keen on a camping holiday in Yosemite national park. Keen was bending down at the top of waterfall to fill up his flask when he lost his footing and was swept over the brink. It was an experience that must have affected Freeman greatly, although he made sparse mention of it in later life. But perhaps it was telling that, 14 years after the event, when he first met 11-year-old Howard Dully, Freeman suggested that the two of them should go hiking.

'My sense with Howard is that Freeman thought he was treating a family problem rather than just a boy's psychiatric problems,' says El-Hai. 'But by the standards he used in earlier years, what he did was completely unjustifiable.'

Although Freeman ended up causing unforgivable harm, he was not, essentially, a bad man. After he died of complications arising from an operation for cancer in 1972, his four surviving children - Walter, Frank, Paul and Lorne - became staunch defenders of their father's legacy. Two of them have carried on the familial medical heritage: Paul is a psychiatrist in San Francisco and the eldest, Walter Jnr, is now professor emeritus of neurobiology at the University of California.

Walter Jnr's twin, Frank, 80, is a retired security guard, living in a modest, second-floor apartment in San Carlos, just half an hour's drive from Howard Dully's home. He is a friendly giant of a man, dressed smartly in a double-breasted, dark blue suit and burgundy tie, kept in place by a thin gold clip. 'He was a marvellous father,' Frank says, sitting in a room filled with crossword dictionaries and Dick Francis novels. 'He loved his children and always made time for us out of his busy schedule, taking us camping every summer all across the country.'

Frank recalls being invited to observe a lobotomy when he was 21 and vividly remembers hearing 'a little crack as the orbital plate fractured. It only took about six or seven minutes and Dad kept up a running commentary.' Indeed, the original ice pick used for the first transorbital lobotomy came from the Freeman family kitchen drawer. 'We had several of them,' says Frank, cheerfully. 'We used to use them to punch holes in our belts when we got bigger. I'm enormously proud of my father. I do think he's been unfairly treated. He was an interventionist surgeon, a pioneer and that took guts.'

But however well-intentioned his interventions, Freeman's life-long quest for self-glorification meant that he failed to acknowledge when his methods were doing more harm than good. I ask Frank whether he thinks Freeman was justified in operating on the young Howard Dully, a boy on the brink of adolescence, whose brain had barely begun its transformation to maturity?

'Well...' he pauses, the palms of his hands resting on his knees. 'I've had a couple of chats with Howard [when Dully interviewed him for the 2003 radio broadcast] and he said that growing up, he hated his stepmother and she was afraid of him. He was belligerent and unco-operative, frightening if you like, and I'm convinced that if he'd gone on like that he would have ended up in jail or a mental institution. Frequently, people like Howard have a lobotomy and sooner or later they straighten out. Howard's been self-supporting for a number of years and he's married, in a very pleasant relationship.'

It is impossible to say how Dully's life would have panned out if he had not walked into Walter Freeman's office one long-ago autumn day. Perhaps it would, like Frank says, have been incalculably worse or perhaps it would have carried on much the same. But it could have been better, too, and the true sadness is that Howard Dully will never be able to find out one way or the other.

Mind-boggling: a history of lobotomy

1890: German scientist Friederich Golz experiments with removing the temporal lobe from dogs and reports a calming effect.

1892: Gottlieb Burkhardt, a Swiss physician, performs a similar operation on six schizophrenic patients. Four exhibited altered behaviour. Two died.

1936: Portuguese neuropsychiatrist Antonio Egas Moniz develops the leukotomy, but advises using the operation only as a last resort.

1945: American surgeon Walter Freeman develops the 'ice pick' lobotomy. Performed under local anaesthetic, it takes only a few minutes and involves driving the pick through the thin bone of the eye socket, then manipulating it to damage the prefrontal lobes.

1946: First lobotomy performed in Britain at Maryfield Hospital, Dundee. The procedure is used for 30 years.

1954: Antipsychotic drug Thorazine licensed for the treatment of schizophrenia, causing the lobotomy gradually to fall out of favour.

1960-70: Lobotomies come under scrutiny by sociologists who consider it a tool for 'psycho-civilising' society. They were banned in Germany, Japan and the Soviet Union. Limited psychosurgery for extreme medical cases is still practised in the UK, Finland, India, Sweden, Belgium and Spain.

psychosurgery review board

a feminist imperative  

by bonnie burstow

brain-disabling treatments in psychiatry

by peter breggin

electroshock as a form of violence agianst women

by bonnie burstow

electroshock is not a healing option 

a report from canada

the electroshock quotationary

by leonard roy frank

School of Shock

News: Eight states are sending autistic, mentally retarded, and emotionally troubled kids to a facility that punishes them with painful electric shocks. How many times do you have to zap a child before it's torture?

By Jennifer Gonnerman

August 20, 2007

Every time he woke from this dream, it took him a few moments to remember that he was in his own bed, that there weren't electrodes locked to his skin, that he wasn't about to be shocked. It was no mystery where this recurring nightmare came from—not A Clockwork Orange or 1984, but the years he spent confined in America's most controversial "behavior modification" facility.

In 1999, when Rob was 13, his parents sent him to the Judge Rotenberg Educational Center, located in Canton, Massachusetts, 20 miles outside Boston. The facility, which calls itself a "special needs school," takes in all kinds of troubled kids—severely autistic, mentally retarded, schizophrenic, bipolar, emotionally disturbed—and attempts to change their behavior with a complex system of rewards and punishments, including painful electric shocks to the torso and limbs. Of the 234 current residents, about half are wired to receive shocks, including some as young as nine or ten. Nearly 60 percent come from New York, a quarter from Massachusetts, the rest from six other states and Washington, D.C. The Rotenberg Center, which has 900 employees and annual revenues exceeding $56 million, charges $220,000 a year for each student. States and school districts pick up the tab.

The Rotenberg Center is the only facility in the country that disciplines students by shocking them, a form of punishment not inflicted on serial killers or child molesters or any of the 2.2 million inmates now incarcerated in U.S. jails and prisons. Over its 36-year history, six children have died in its care, prompting numerous lawsuits and government investigations. Last year, New York state investigators filed a blistering report that made the place sound like a high school version of Abu Ghraib. Yet the program continues to thrive—in large part because no one except desperate parents, and a few state legislators, seems to care about what happens to the hundreds of kids who pass through its gates.

In Rob Santana's case, he freely admits he was an out-of-control kid with "serious behavioral problems." At birth he was abandoned at the hospital, traces of cocaine, heroin, and alcohol in his body. A middle-class couple adopted him out of foster care when he was 11 months old, but his troubles continued. He started fires; he got kicked out of preschool for opening the back door of a moving school bus; when he was six, he cut himself with a razor. His mother took him to specialists, who diagnosed him with a slew of psychiatric problems: attention-deficit/hyperactivity disorder, post-traumatic stress disorder, bipolar disorder, and obsessive-compulsive disorder.

Rob was at the Rotenberg Center for about three and a half years. From the start, he cursed, hollered, fought with employees. Eventually the staff obtained permission from his mother and a Massachusetts probate court to use electric shock. Rob was forced to wear a backpack containing five two-pound, battery-operated devices, each connected to an electrode attached to his skin. "I felt humiliated," he says. "You have a bunch of wires coming out of your shirt and pants." Rob remained hooked up to the apparatus 24 hours a day. He wore it while jogging on the treadmill and playing basketball, though it wasn't easy to sink a jump shot with a 10-pound backpack on. When he showered, a staff member would remove his electrodes, all except the one on his arm, which he had to hold outside the shower to keep it dry. At night, Rob slept with the backpack next to him, under the gaze of a surveillance camera.

Employees shocked him for aggressive behavior, he says, but also for minor misdeeds, like yelling or cursing. Each shock lasts two seconds. "It hurts like hell," Rob says. (The school's staff claim it is no more painful than a bee sting; when I tried the shock, it felt like a horde of wasps attacking me all at once. Two seconds never felt so long.) On several occasions, Rob was tied facedown to a four-point restraint board and shocked over and over again by a person he couldn't see. The constant threat of being zapped did persuade him to act less aggressively, but at a high cost. "I thought of killing myself a few times," he says.

Rob's mother Jo-Anne deLeon had sent him to the Rotenberg Center at the suggestion of the special-ed committee at his school district in upstate New York, which, she says, told her that the program had everything Rob needed. She believed he would receive regular psychiatric counseling—though the school does not provide this.

As the months passed, Rob's mother became increasingly unhappy. "My whole dispute with them was, 'When is he going to get psychiatric treatment?'" she says. "I think they had to get to the root of his problems—like why was he so angry? Why was he so destructive? I really think they needed to go in his head somehow and figure this out." She didn't think the shocks were helping, and in 2002 she sent a furious fax demanding that Rob's electrodes be removed before she came up for Parents' Day. She says she got a call the next day from the executive director, Matthew Israel, who told her, "You don't want to stick with our treatment plan? Pick him up." (Israel says he doesn't remember this conversation, but adds, "If a parent doesn't want the use of the skin shock and wants psychiatric treatment, this isn't the right program for them.")

Rob's mother is not the only parent angry at the Rotenberg Center. Last year, Evelyn Nicholson sued the facility after her 17-year-old son Antwone was shocked 79 times in 18 months. Nicholson says she decided to take action after Antwone called home and told her, "Mommy, you don't love me anymore because you let them hurt me so bad." Rob and Antwone don't know each other (Rob left the facility before Antwone arrived), but in some ways their stories are similar. Antwone's birth mother was a drug addict; he was burned on an electric hot plate as an infant. Evelyn took him in as a foster child and later adopted him. The lawsuit she filed against the Rotenberg Center set off a chain of events: investigations by multiple government agencies, emotional public hearings, scrutiny by the media. Legislation to restrict or ban the use of electric shocks in such facilities has been introduced in two state legislatures. Yet not much has changed.

Rob has paid little attention to the public debate over his alma mater, though he visits its website occasionally to see which of the kids he knew are still there. After he left the center he moved back in with his parents. At first glance, he seems like any other 21-year-old: baggy Rocawear jeans, black T-shirt, powder-blue Nikes. But when asked to recount his years at the Rotenberg Center, he speaks for nearly two hours in astonishing detail, recalling names and specific events from seven or eight years earlier. When he describes his recurring nightmares, he raises both arms and rubs his forehead with his palms.

Despite spending more than three years at this behavior-modification facility, Rob still has problems controlling his behavior. In 2005, he was arrested for attempted assault and sent to jail. (This year he was arrested again, for drugs and assault.) Being locked up has given him plenty of time to reflect on his childhood, and he has gained a new perspective on the Rotenberg Center. "It's worse than jail," he told me. "That place is the worst place on earth."

04.01.2007

Disturbing News for Patients and Shock Doctors Alike

Something most remarkable and unexpected has occurred in the field of psychiatry. Lead by a lifelong defender and promoter of shock treatment, Harold Sackeim, a team of investigators has recently published a follow up study of 347 patients given the currently available methods of electroshock, including the supposedly most benign forms--and confirmed that electroshock causes permanent brain damage and dysfunction.

Based on numerous standardized psychological tests, six months after the last ECT every form of the treatment was found to cause lasting memory and mental dysfunction. In the summary words of the investigators, "Thus, adverse cognitive effects were detected six months following the acute treatment course." They concluded, "this study provides the first evidence in a large, prospective sample that adverse cognitive effects can persist for an extended period, and that they characterize routine treatment with ECT in community settings."

After traumatic brain damage has persisted for six months, it is likely to remain stable or even to grow worse. Therefore, the study confirms that routine clinical use of ECT causes permanent damage to the brain and its mental faculties.

The term cognitive dysfunction covers the entire range of mental faculties from memory to abstract thinking and judgment. The ECT-induced persistent brain dysfunction was global. In addition to the loss of autobiographical memories, the most marked cognitive injury occurred in "retention of newly learned information," "simple reaction time," and most tragically "global cognitive status" or overall mental function. In other words, the patients continued to have trouble learning and remembering new things, they were slower in their mental reaction times, and they were mentally impaired across a broad range of faculties.

Probably to disguise the wide swath of devastation, the Sackeim study did not provide the percentages of patients afflicted with persistent cognitive deficits; but all of the multiple tests were highly significant (p<0.0001 on 10 of 11 tests and p<0.003 on the 11th). Also, the individual measures correlated with each other. This statistical data indicates that a large percentage of patients were significantly impaired.

Many patients also had persistent abnormalities on the EEGs (brain wave studies) six months after treatment, indicating even more gross underlying brain damage and dysfunction. The results confirm that the post-ECT patients, as I have described in numerous publications, were grossly brain-injured with a generalized loss of mental functions.

Some of the older forms of shock--and still the most commonly used--produced the most severe damage; but all of the treatment types caused persistent brain dysfunction. The greater the number of treatments given to patients, the greater was the loss of biographical memories. Elderly women are particularly likely to get shocked--probably because there is no one to defend them--and the study found that the elderly and females were the most susceptible to severe memory loss.

Destroying Lives
The study does not address the actual impact of these losses on the lives of individual patients. Like most such reports, it's all a matter of statistics. In human reality the loss of autobiographical memories indicates that patients could no longer recall important life experiences, such as their wedding, family celebrations, graduations, vacation trips, and births and deaths. In my experience, it also includes the wiping out of significant professional experiences. I have evaluated dozens of patients whose professional and family lives have been wrecked, including a nurse who lost her career but who recently won malpractice suit against the doctor who referred her for shock. Her story is told on my website, www.breggin.com.

Even when these injured people can continue to function on a superficial social basis, they nonetheless suffer devastation of their identities due to the obliteration of key aspects of their personal lives. The loss of the ability to retain and learn new material is not only humiliating and depressing but also disabling. The slowing of mental reaction time is frustrating and disabling. Even when relatively subtle, these disabilities can disrupt routine activities of living. Individuals can no longer safely drive a car for fear of losing their concentration or becoming hopelessly lost. Others can no longer find their way around their own kitchen or remember to turn off the burner on the stove. Still others cannot retain what they have just read in a newspaper or seen on television. They commonly meet old friends and new acquaintances without having any idea who they are. Ultimately, the experience of "global" cognitive dysfunction impairs the victim's identify and sense of self, as well as ruining the overall quality of life.

Although unmentioned in the Sackeim article, in addition to cognitive dysfunction, shock treatment causes severe affective or emotional disorders. Much like other victims of severe head injury, many post-shock patients become emotionally shallow and unable to relate on an intimate or spiritual level. They often become impulsive and irritable. Commonly they become chronically depressed. Having been injured by previously trusted doctors, they almost always become distrustful of all doctors and avoid even necessary medical care.

Decades of Opposition to Shock Treatment
This breaking scientific research has confirmed what I've been saying about shock treatment for thirty years. In 1979 I published Electroshock: Its Brain-Disabling Effects, the first medical book to evaluate the brain damaging and memory wrecking effects of this "treatment" for depression that requires inflicting a series of massive convulsions on the brain by means of passing a traumatic electric current through it. After many rejections, the courageous president of Springer Publishing Company, Ursula Springer, decided to publish this then controversial book. Dr. Springer told me about venomous attacks aimed at her at medical meetings as a result of her brave act in publishing my work. She never regretted it.

Over the years, I have continued to write, lecture, testify in court and speak to the media about brain damage and memory loss caused by electroshock (e.g., Breggin 1991, 1992, 1997, and 1998). At times my persistence has resulted in condemnation from shock advocates such as Harold Sackeim and Max Fink whom I have criticized for systematically covering up damage done to millions of patients throughout the world. It would require too much autobiographical detail to communicate the severity of the attacks on me surrounding my criticism of ECT. It was second only to the attack on me from the drug companies for claiming that antidepressants cause violence and suicide.

Given the vigor with which shock doctors have suppressed or denigrated my work, the study further surprised me by citing my 1986 scientific paper "Neuropathology and cognitive dysfunction from ECT" published in the Psychopharmacology Bulletin, noting that "critics contend that ECT invariably results in substantial and permanent memory loss." They contrast this critical view with "some authorities," specifically citing Max Fink and Robert Abrams, who have argued against the existence of any persistent shock effects on memory. The implication was clear that the critics were right and the so-called authorities were wrong. Sackeim was among those authorities.
Fink's "authoritative" testimony at a number of malpractice trials has enabled shock doctors to get off Scott free after damaging the brains of their patients. Abrams used to testify successfully on behalf of shock doctors until I disclosed his ownership of a shock machine manufacturing company.

Unfortunately, the Sackeim group did not cite the work of neurologist John Friedberg who risked his career to criticize electroshock treatment. Nor did their article give credit to the published work of psychiatric survivor Leonard Frank or the anti-shock reform activities of the survivor moment lead by David Oaks of MindFreedom. They also didn't cite Colin Ross's 2006 review and analysis showing that ECT is no more effective than sham ECT or simply sedating patients without shocking them.

Will the latest confirmation of ECT-induced brain damage cause shock doctors to cut back on their use of the treatment? Not likely. Psychiatrist and their affiliated neurosurgeons always knew that lobotomy was destroying the brains and mental life of their patients and that knowledge did not daunt them one bit. It required an organized international campaign to discredit, to slow down and to almost eliminate the surgical practice of psychiatric brain mutilation in the early 1970s (Breggin and Breggin 1994). The ECT lobby is much larger and stronger than the lobotomy lobby, and much better organized, with its own journal and shock advocates positioned in high places in medicine and psychiatry. Stopping shock treatment will require public outrage, organized resistance from survivor groups and psychiatric reformers, lawsuits, and state legislation.

This essay will appear in Dr. Breggin's column, "Politics, Practice and Breaking News," in a forthcoming issue of the journal Ethical Human Psychology and Psychiatry, sponsored by the International Center for the Study of Psychiatry and Psychology (www.ICSPP.org).

References
Breggin, P. (1979). Electroshock: Its brain-disabling effects. New York: Springer Publishing Company.
Breggin, P. (1991). Toxic psychiatry. New York: St Martin's Press.
Breggin, P. (1992). The return of ECT. Readings: A Journal of Reviews and Commentary in Mental Health, 3 (March, No. 1), 12-17
Breggin, P. (1997). Brain-Disabling treatments in psychiatry. New York: Springer Publishing Company.
Breggin, P. (1998). Electroshock: Scientific, ethical, and political issues." International Journal of Risk & Safety in Medicine 11, 5-40.
Breggin, P. and Breggin, G. (1998). The war against children of color. Monroe, Maine: Common Courage Press.
Frank, L. (1978). (Ed.). The history of electroshock. Available from L. Frank, 2300 Webster Street, San Francisco, CA 94115. Also available on www.Amazon.com.
Frank, L. (1990). Electroshock: death, brain damage, memory loss, and brain washing. Journal of Mind and Behavior, 11, 489-512.
Frank, L. (2006). The electroshock quotationery. Ethical Human Psychology and Psychiatry, 8, 157-177.
Friedberg, J. (1976). Electroshock is not good for your brain. San Francisco: Glide Publications.
Friedberg, J. (1977). Shock treatment, brain damage, and memory loss: A neurological perspective. American Journal of Psychiatry, 134, 1010-1014.
Ross, Colin (2006). The sham ECT literature: Implications for consent to ECT. Ethical Human Psychology and Psychiatry, 8, 17-28.
Sackeim, H., Prudic, J., Fuller, R., Keilp, J., Lavori, P. and Olfson, M. (2007). The cognitive effects of electroconvulsive therapy in community settings. Neuropsychopharmacology, 32, 244-254.

ELECTROSHOCKING ELDERLY PEOPLE: ANOTHER PSYCHIATRIC ABUSE

by Don Weitz

“Electroshock is violence.”

·        Ramsey Clark, former U.S. Attorney General, in an invited address at the Annual Meeting of the American Psychiatric Association in New York City, May 1983.

“If the body is the temple of the spirit, the brain may be seen as the inner sanctum of the body, the holiest of places. To invade, violate and injure the brain, as electroshock unfailingly does, is a crime against the spirit and a desecration of the soul.”

·        Leonard Roy Frank, shock survivor, editor and writer, 1991

Electroshock appears to be increasingly prescribed as a treatment for “clinical” depression and other so-called mental disorders. Women and elderly people, particularly old women, are its chief targets—more damning evidence of psychiatry’s sexism and ageism. In the United States during the last ten years, an estimated 100,000 people have been shocked each year. In Canada, perhaps as many as 10,000 people, again mostly women, have been electroshocked each year, but nobody knows for sure because Health and Welfare Canada and the provincial health ministries do not publish ECT statistics, some of which are available on request.  Besides, ECT statistics are notoriously inaccurate and unreliable, because collection methods differ from province to province and state to state; hospitals aren’t required to keep accurate ECT records and not all hospitals are required to report ECT to provincial health ministries or state mental health departments.

I have discovered some recent shock statistics in Ontario which point to alarming trends:the increasing use of ECT and the targeting of women and the elderly for electroshock. Consider these statistical highlights:

1) In 1993-94, 11,360 shock treatments were administered to approximately 1,600 people in Ontario’s general, community and psychiatric hospitals - an average of seven shocks per patients. In 1994-95, 12,865 shocks were administered to over 1,500 people, a 12 per cent increase.

2) Most electroshock (over 80 per cent) in Ontario is administered in the public general hospitals, not provincial or private psychiatric hospitals.

3) Over 40 per cent of electroshock has been administered to people 60 years and older during the last five years.

4) In 1994-95, 97 elderly people, including 72 women (60 years and older), were subjected to 1,023 shocks in Ontario’s provincial psychiatric hospitals - a high average of approximately 10 shocks per patient. In Toronto’s Queen Street Mental Health Centre, over 70 per cent of the shock patients are from its psychogeriatric unit.

5) In 1993-94, approximately 600 elderly people (60+ years) were subjected to 4,033 electroshocks in Ontario’s general and community psychiatric hospitals.

6) In the provincial psychiatric hospitals, the number and proportion of elderly people (65+ years) shocked grew from 70 (33 per cent) in 1990-91, to 82 (40 per cent) in 1993-94, to 44 per cent in 1994-95.

7) Among elderly and other ECT patients, significantly more women than men are electroshocked: two to three timnes more women than men have been electroshocked in both Canada and the United Stastes for many years.

8) During 1994-95 in the provincial psychiatric hospitals, 72 per cent of elderly shock patients (75+ years) were women, and significantly more ECT was administered to an elderly woman than an elderly man (average 10.9 ECTs vs. 8.7 ECTs).

9)  Women in their eighties and nineties have been electroshocked in general, community and provincial psychiatric hospitals in Ontario. In 1993-94, a total of 102 shocks were administered to at least 10 women of 85 years and older in general and community psychiatric hospitals. In 1994-95, at least 14 women of 80 years and older were subjected to 158 shocks in eight provincial psychiatric hospitals,an average of 11 ECTs per patient.

10)  During 1994-95 in Ontario, the estimated cost of one electroshck treatment, including physicians’ fees, drugs, use of a hospital bed and nursing care, was $400. The (under) estimated total cost for all ECT that year was well over $1,000,000.

Two very common psychiatric myths state: first, that electroshock can prevent or greatly reduce the risk of suicide in people diagnosed with “clinical depression” or “bipolar affective disorder”; and second, that electroshock is safe and effective for old and physically ill people.

The first myth was exposed at least six years ago by Dr.Donald Black and four colleagues. This study involving more than 1,000 depressed patients in Iowa found that there were no significant differences in the suicide rate among the various groups treated with electroshock, antidepressants and no treatment. However, the higher percentage of deaths among the shock patients (85 per cent higher at two-year follow-up than the non-shock patients) clearly implicates shock as a contributing factor in their deatths (Black et al.,1989).

Regarding the second myth, Drs.David Kroessler and Barry Fogel’s longitudinal study involving sixty-five depressed patients 80 years and older found that for the ECT group, 27 per cent died within one year following the “treatment”, but only 4 per cent of the “medicated” group died. In addition, one patient died after undergoing two ECTs. In other words, this study together with several previous ones, clearly show that electroshock threatens people’s survival, especially if they are old and sick (Kroessler and Fogel, 1993).

Deaths related to or caused by electroshock are usually attributed to medical conditions, not reported or simply covered up in the medical-psychiatric literature. For exmple, only six or seven ECT-related deaths in Canada have been reported in the Canadian medical-psychiatric journals during the last fifty years. No doubt a serious underestimate or cover-up. Nevertheless, respecred shock investigator and psychiatric critic, Dr. Peter Breggin, has estimated the general ECT death rate as one death for every 1,000 patients shocked, and a much higher rate of one death per 200 for elderly patients. However, in its official shock-promoting booklet the American Psychiatric Association  claims the ECt death rate from shock is !1 in 10,000” patirents and that only “1 in 200” patients suffer permanent memory loss (APA,1990). The Canadian Psychiatric Association also claims there have been virtually no deaths or medical complications from electroshock in Canada, despite the fact that approximately 500 shock-related deaths and many more serious medical complications (e.g.,cardiac arrest, other serious heart problems, permanent epileptic seizures, brain damage) have been reported in the English langugage medical-literature for over 50 years since the early 1940s when electroshock was first introduced in Canada and the United States.

Together with many shock survivors and other shock critics, Peter Breggin wants electroshock banned, because psychiatrists routinely fail to warn patients about the serious risks of permanent memory loss and brain damage (a serious violation of informed consent), and because elderly, sick and frail patients are being increasingly targeted for electroshock.

He explained his position in a recent phone interview with me last March:

“The escalating rate of shocking the elderly is one reason why I

have come out in recent years for a complete ban on the treatment.  The elderly are less able to defend themselves against shock treatment, and their brains are more susceptible to devastating damage.” (Breggin, 1996)

Leonard Roy Frank, an electroshock-insulin shock survivor living in San Francisco, shock critic, author and editor,insists that “ECB - electroconvulsive brainwashing” is a more accurate term. He agrees with Breggin and asserts, “the studies indicate that it’s the elderly who are getting the most shock, and they’re the most vulnerable, not only physically but politically” (Frank, 1996). A 1989 report from California’s Department of Mental Health supports Frank’s assessment; it reveals that 48 per cent of the 2,503 people shocked that year in the state were 65 years and older. Frank claims the figure is currently over 50 per cent and climbing.

Electroshocking women and elderly patients is also on the rise in England. For example, in a 1993 critique, patients’ rights advocate Alison Cobb reports that “...women are the majority of ECT patients (about 70 per cent), half are over 65 years of age. ...59 per cent of the 100 (in the study) ... were aged over 65, the oldest being 92 years. Given the vulnerability of older people’s memory and cognitive abilities, this has to be a grave cause of concern...”,(Cobb,1993).

Douglas Cameron, another outspoken shock survivor, critic and co-founder (with Diann’a Loper) of the World Association of Electroshock Survivors based in Texas, is extremely critical of the alleged safety of psychiatry’s modern shock machines, which can deliver as much as 300 to 400 volts of electricity to the brain:

“All modern day Sine Wave and Brief Pulse ECT devices are more powerful than early instruments. Modern day Brief Pulse suprathreshold devices have not proved safer than Sine Wave suprathreshold devices. Side effects have been >convincingly identified as products of electricity. These facts warrant the elimination of all ECT machines from the marketplace” (Cameron,1994).

Since 1995, there has been growing public protest against the only shock machine in Whitehorse in The Yukon, stored in Whitehorse General Hospital. Apparently, the shock machine hasn’t zapped anybody in Whitehorse (yet). The Second Opinion Society (SOS), the Yukon’s self-help advocacy group in Whitehorse, isn’t waiting. SOS has been organising rallies and marches against the machine.

More than fifteen years ago in Toronto’s Sunnybrook Hospital (a teaching, research and veteran’s hospital affiliated with the University of Toronto), psychiatrists Harry Karlinsky and Kenneth Shulman were electroshocking elderly people. Most were in their 70s, some in their 80s.  Karlinsky and Shulman (1984) reported having electroshocked thrity-three elderly atients (62-85 years old). At a follow-up study six months later, after having been subjected teo an average of 9 ECTs, only one-third of ther patients “were doing well”. Karlinsky and Shulman concluded that “clinically one is compelled to use ECT on an urgent or demand basis”.  Compelled? In my recent phone interview with Dr.Shulman, chief psychiatrist at Sunnybrook, he said that electroshock is still administered to old people but only “from time to time, a relatively small number.” He couldn’t say how many, but recalled the average age of his elderly shock patients is “73 or 74”. Shulman added he has “never heard” of any deths or serius medical crises from ECT at Sunnybrook or any other hospital in Canada. The ECT “mortality rate”, he added, was “similar to that for (general) anaesthesia”. He insisted that electroshock “remains an effective treatment for some debilitating and life-threatening depressions”, and claimed the only ECT risk was “short-term memory loss”.  He also asserted that electroshock is not controversial, and claimed that most patients “completely recover”. Shulman explained the use of electroshock on the elderly in these terms: “If we didn’t use ECT, these people would suffer tremendously and be at risk of dying”.

It is difficult to find any study to support the common psychiatric claim that electroshock prevents suicide or minimises the suicide risk.  Further, the relapse rate from shock is over 60 per cent, which, according to the American Psychiatric Association, still greatly minimises permanent memory loss, brain damage and death from ECT (APA,1990).

Some elderly patients have also been electroshocked at Toronto’s Clarke Institute of Psychiatry. Apparently nobody knows how many, partly because no accurate,up-to-date ECT statistics are kept at the Clarke, according to Dr. Barry Martin, head of its ECT Unit. In a recent phone interview I had with Dr. Martin, he speculated that a total of “about 100 courses” were administered at the Clarke in 1995. Each course consists of 8-10 ECTs, at least 80-90 people were electroshocked last year. According to Dr.Martin, the main reason for shocking old people is, “severe depression that has not responded to medication” (e.g.,antidepressants).  Martin estimated the ECT death rate as “3-4 per 100,000 ECTs”, similar to that for “general anaesthesia”, and said he was “not aware” of any ECT-related deaths in Canada or anywhere else.

During a 15-month period in 1993-94, eight people died in Texas,”within two weeks of receiving electroshock”; over half were elderly patients (Smith, 1995).The Texas elderly death rate from ECT at that time was probably higher than 1 in 200.

Some very courageous shock survivors and advocacy groups are fighting back and want electroshock abolished in the United States and Canada. For example, 81-year-old Lucille Austwick successfully refused to be shocked while languishing in a Chicago nursing home a couple of years ago (Fegelman, 1995). While confined in the home, Austwick was depresseed, had stopped eating and was becoming frail, so a psychiatrist wanted to shock her. She repeatedly refused the “lifesaving:” treatment which she called “bullshit”, and received strong legal support from the Illinois Guardianship Commission and other advocates across the United States. Last September, the Appellate Court “reversed the trial court’s ruling” which had ordered a series of ECTs for her two years earlier.

Psychiatrists and other medical staff at St.Mary’s Hospital in Madison, Wisconsin were found to be violating the human rights of several elderly patients subjected to electroshock against their will (Oaks, 1995). Sparked by the courageous whistleblowing of psychiatric nurse Stacie Neldaughter, who was “fired after refusing to directly assist with a shock treatment”, several women shock survivors and anti-shock activists organised a public protest outside the hospital in September 1994. In January 1995, the Wisconsin Coalition for Advocacy issued a detailed and scathing 75-page report based on its own investigations, which documented serious violations of informed consent and other rights involving at least eight elderly women patients.

In Toronto from 1983 to 1992, there have been several anti-shock protest demonstrations, particularly in front of the Clarke Institute of Psychiatry and Queen Street Mental Health Centre. Non-violent civil disobedience (“sit-ins”) were also held in the office of at least two Ontario health ministers, organised by the Ontario Coalition to Stop Electroshock (succeeded by Resistance Against Psychiatry). During a non-violent public demonstration against electroshock in front of the Clarke in May 1988, shock survivor Jack Wild and I were charged with “trespass” and arrested while trying to hand out alternative and accurate shock information to patients on one ward during visiting hours. We were arrested on the ward while engaged in a non-violent sit-in, fined over $50 each and lost our court appeals (Phoenix Rising, 1998).

Unfortunately, there have been no shock cases in Canada since “Mrs.T.” in 1983 (Weitz,1994). The “Mrs.T.” case involved a young, allegedly suicidal but cxompetent women who firmly and repeatedly refused shock while being asked to consent by both her psychiatrist and a regional review board while incarcerated in Hamilton Psychiatric Hospital. Although the case lost, “Mrs.T.” was not electroshocked. The national publicity and public outcry arising over the fact that people in Canada could still be shocked against their will led to a few important amendments in Ontario’s Mental Health Act, which now prohibits electroshock or other treatment for any person who refuses. However, electroshock can still be adminsitered against the will of an “incapable” person if he or she did not instruct a substitute decision-maker otherwise while capable. (Note: The judge’s decision in a 1997 Ontario court case involving a mother’s refusal to consent to shock for her “incapable” daughter” is pending.)

In March 1994 at a public City Hall meeting before the Toronto Mayor’s Committee on Aging (TMCA), I presented some alarming ECT statistics from the Ontario government’s Ministry of Health which showed that a disproportionately large number of people being electroshocked in Ontario’s psychiatric facilities were elderly people (over 40 per cent) and women (over 65 per cent). In one Final Report, the Committee recommend that, “the Chair of the TMCA should be asked to write to the Minister of Health to inform her of the data on ECT and the deep concern of the TMCA about the apparent misuse of this therapy.”

There is still no law banning electroshock in Ontario, Canada or the United States for elderly people or anybody else. However, some states have outlawed shock for young children. For example, Texas has banned shock for children under 16 years old, and California banned it for children under 14. There are no such age restrictions in Canada.

I believe that electroshocking old people is elder abuse.

Electroshock is a crime against humanity. It should be abolished.

[acknowledgement - My sincere thanks to Lenard Roy Frank for his valuable editorial assistance.]

References

American Psychiatric Association (1990). The practice of >electroconvulsive   therapy. Washington: APA.

Black,D.W., Winokur,G., Mohandoss,E., Woolson,R.F. and Nasrallah,A. (1989) “Does treatment influence mortality in depressives?” Annals of Clinical Psychiatry, 1(3), 165-173.

ECT

The following has been taken from   

What is electric-shock treatment

produced in association with ECT Anonymous

What is electric-shock treatment?

It's a way of bringing-on convulsions (fits) by passing a high-voltage electric current through someone's brain. It's also called electoconvulsive therapy, or ECT for short.

Who is it given to?

ECT is routinely given in response to a broad range of psychiatric conditions from depression (including post-natal depression) to schizophrenia. It is also given to children.

On average, British hospitals give 20,000 people a year a total of 140,000 shock treatments.

How is it done?

First you'll be asked to empty your bladder and bowels, and remove any dentures, hairpins or sharp-edged jewellery. Then the medical staff will:

• give you a pre-anaesthetic drug
• and another drug to relax your muscles
• so you are less likely to hurt yourself when you have the convulsion
• they put you on a machine to help you breathe
• because the drug that helps you relax virtually paralyses your whole body
• including your breathing muscles
• they put a rubber "gag" into your mouth
• and electrodes onto your forehead
• they pass an electric current of between 100 and 150 volts into your brain
• this will make you have a convulsion that will last between 30 and 60 seconds
• the convulsion is followed by a period of coma.

Will it help me?

It might

Some serverley depressed people feel less depressed after the treatment.

Will it harm me?

It might

Immediate possible complictions include:

• amnesia
• denial
• euphoria
• apathy
• mood swings
• helplessness
• submissiveness
  

The real shock is that ECT works
By Mary Wakefield
(Filed: 22/01/2006)

Tucked up in bed last week with the medical journal, The Lancet, searching idly for interesting new diseases, I came across a story that dredged up a disturbing memory.

Electric shock treatment is back, said a Professor Klaus B Ebmeier from Edinburgh university: "Despite public and professional misgivings, electroconvulsive therapy (ECT) remains the most effective treatment for depression."

The editor of The Lancet agreed. Talking therapies are overrated, severe depressives need jump starting, he said.

It took me back to the ECT room in a Louisiana hospital, eight years ago, and has kept me there for the last few days. I wasn't a patient, just an onlooker, invited in by an anaesthetist friend, Andrew, to see patients being given electric shocks. Still, I was scared.

I'd read One Flew Over the Cuckoo's Nest, The Bell Jar, seen Requiem for a Dream. I knew that ECT was wrong, and thought public outrage in the 1970s had steered the doctors away from electrodes towards gentler cures instead. But Andrew was confident, so I went, stood and watched.

In the middle of the room, beside a bed on wheels, were three doctors: one to deliver the shocks, one to administer muscle relaxant, another, Andrew, to put the patients to sleep. "They didn't use muscle relaxants in the 1950s and '60s, so patients would fracture their spines when they convulsed," said Andrew. "None of our patients break bones now." He sounded proud.

A few minutes later, the first depressive was shown in: a dark-haired woman with round shoulders who stared at the trolley-bed. She looked nervous, as the doctors snapped on their white plastic gloves, then turned and ran for the door.

Two burly orderlies bundled her onto the bed and strapped her, struggling, down. Andrew gave her gas and beckoned me closer, so I stood by her head and watched as the light died from her open eyes.

The doctor in charge of shocks smeared a circle of gel on her temples and gently taped two electrodes in place. Then a switch flicked, a light went on, 300 volts ran through the woman's brain and I came within an ace of passing out.

Even with muscle relaxants, ECT looks brutal: it's about as far from fashionable, talk-based therapies as it is possible to get. A neurologist called Cerletti dreamt it up in the 1930s while watching pigs being stunned prior to slaughter and there's an echo of the abattoir about it even now. The other alarming thing about ECT is that neither Cerletti nor any scientist since has figured out how or why it works.

Andrew's theory is that it disrupts a depressive pattern of thinking, redirects the electrochemical processes in the brain. Other say it prompts the hypothalamus to release feel-good drugs.

The anti ECT lobby (mental health charities and a large part of the NHS) talk mostly of brain damage and memory loss. They suggest that for all its drama, ECT has only a placebo effect. Depressives are often self-loathing they say, and a lightening-bolt through the brain satisfies their need for punishment.

But the fact remains, after all the scare-stories, that no one else has a better solution. Professor Ebmeier and The Lancet are right. Doctors can transplant hearts with ease, grow new skin, clone embryos but when it comes to chronic mental illness they're feeling their way in the gloom.

I spent the afternoon in the ECT room, watching the patients come and go. I helped the nurse remind them of their names after treatment and gave them tea, which they held until it went cold. But of all the disturbing things I saw - the restraints, the unconscious, twitching bodies - nothing compared to the awful hopelessness on the faces of patients as they first arrived.

"The thing to remember," said Andrew, as he walked me to my car, "is that though ECT is horrible, it helps. It's the only treatment that can shift this sort of depression. I've seen it work miracles sometimes and trust me, nothing else does."

• Mary Wakefield is assistant editor of The Spectator

Leonard Roy Frank, Editor

Publication date: April 2006

Copyright © 2006 by Leonard Roy Frank. All Rights Reserved.

Dedicated to everyone committed to ending forever the use of electroshock everywhere

The Campaign for the Abolition of Electroshock in Texas (CAEST) was founded in Austin during the summer of 2005. The Electroshock Quotationary (ECTQ) was created to support the organization’s mission by informing the public, through CAEST’s website, about the nature of electroshock, its history, why and how it’s used, and its effects on people. The editor will regularly update ECTQ with suitable materials when he finds them or when they are brought to his attention. In this regard he invites readers to submit original and/or published materials for consideration

e-mail address: lfrank@igc.org

CONTENTS

ACKNOWLEDGEMENTS

For their many kindnesses, contributions and suggestions to The Electroshock Quotationary, I am most grateful to Linda Andre, Margo Bouer, John Breeding, Doug Cameron, Ted Chabasinski, Lee Coleman, Alan Davisson, Dorothy Washburn Dundas Sherry Everett, John Friedberg, Janet Gotkin, Wade Hudson, Juli Lawrence, Peter Lehmann, Diann’a Loper, Rosalie Maggio, Jeffrey Moussaieff Masson, Carla McKague, Jim Moore, Bob Morgan, David Oaks, Una Parker, Marc Rufer, Sherri Schultz, Eileen Walkenstein, Ann Weinstock, Don Weitz, and  Rich Winkel.

I. THE CONTROVERSY

II. BACKGROUND

Since 1938, when Ugo Cerletti and Lucio Bini introduced the procedure at the University of Rome, more than six million Americans and millions of others throughout the world have undergone electroshock treatment. Today, an estimated 100,000 people in the United States undergo ECT every year. Twothirds are women, and half are elderly. Age is not a disqualifying factor: there are published reports of individuals as young as 34½ months and as old as 102 undergoing the procedure (see in the text Bender’s entry in 1950 and the American Psychiatric Association’s second entry in 1990).

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 in 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 electroshock often earn $300,000 to $500,000 a year, considerably higher than the annual mean income for all psychiatrists ($150,000).

The figures in the above two paragraphs suggest that in the United States alone electroshock is a multi-billion-dollar-a-year industry. To reduce the risk of relapse following an electroshock series, psychiatrists often urge patients to pursue continuation (or maintenance) treatment. This generally involves psychiatric drugs and often includes individual electroshocks as well, administered on an outpatient basis at various intervals for six months or longer.

III. DIAGNOSES

IV. METHOD OF ADMINISTRATION

Prior to the start of an electroshock series, the patient is given a psychiatric evaluation and a physical examination. A consent form signed by the patient, a family member, or a state-appointed guardian or conservator is almost always obtained after a psychiatrist has explained to the designated signer the nature and effects of the procedure, the manner of its administration, and why it has been deemed necessary. Some states require a confirming opinion by a second physician. Some also require a judicial hearing if the patient’s legal capacity to give or withhold consent is questionable, or if the patient withholds consent.

A routine is followed for each session. The patient is asked to avoid food and drink for 8 to 12 hours beforehand. During this period, tranquilizers or sedatives may be used to reduce the patient’s fear of and/or resistance to electroshock. Bladder and bowels are emptied just before the session, and dentures, hairpins, earrings, and the like are removed.

About 30 minutes beforehand, a conventional preanesthetic medication called atropine is administered to dry secretions in the mouth and air passages, thus reducing the risk of suffocation and other complications of swallowing one’s own saliva.

Shortly afterward, the patient is taken to the treatment room and put on a bed, padded table, or gurney. Electrolyte jelly is applied to the two areas of the head, usually the temporal areas, where the electrodes are to be placed. The jelly increases conductivity and prevents burns. An intravenous line is started, and sensors are placed on the head and chest to monitor brain and heart activity. A cuff is wrapped around the patient’s upper arm to record blood pressure.

The patient is then anesthetized for 10 to 15 minutes with a short-acting barbiturate, commonly Brevital (methohexital). Once the patient is unconscious, the muscle relaxant

Anectine (succinylcholine) is injected to reduce the risk of fractures, joint dislocations, and damage to skeletal muscle, tendons, and ligaments, which were very common before this modification became routine during the 1950s. Anectine causes an almost complete paralysis of the body, including the respiratory system, so that the patient must be supplied oxygen through a mask (oxygenation) until the Anectine wears off and the patient is able to resume breathing on his or her own.

The anesthetic is not used to spare the patient pain because the shock itself, if large enough, produces instant unconsciousness and is therefore painless. Instead, the anesthetic’s purpose is to eliminate the sensation of suffocation that the patient, without an anesthetic, would experience as the muscle relaxant gradually took effect.

ECT without anesthetics and muscle relaxants is now referred to as unmodified or classical ECT; the version with anesthetics, muscle relaxants (also called muscle paralyzers), oxygenation, and monitoring is called modified ECT. Unmodified ECT is now rare in the United States and Europe but is still common in developing countries because of its lower cost.

Just before the convulsion, a rubber gag is inserted in the patient’s mouth to prevent broken teeth and tongue-biting. Two electrodes wired to the shock machine are then positioned on the head and may be held in place by an elastic headband.

The preparations having been completed, the psychiatrist presses a button on the shock machine, releasing 70 to 500 volts (or more) of electricity for .02 second to 8 seconds.

The electric current penetrates the patient’s skull and passes through the brain, causing a grand mal convulsion that lasts for 30 seconds to a minute and sometimes longer.

The patient then is taken to the recovery room in a comatose state, from which she or he usually revives in 10 to 20 minutes. Ordinarily, the patient is able to leave the recovery room 30 to 60 minutes later.

V. EFFECTS

Once conscious, the patient experiences one or more of the following adverse effects: headache, dizziness, nausea, confusion, disorientation (not knowing who or where one is or what time or day it is), muscle ache and soreness, physical weakness, memory loss, euphoria, increased or irregular heartbeat (especially among the elderly), brief or prolonged apnea (inability to breathe), and brief or prolonged cyanosis (blue skin from loss of oxygen). Some of these effects may be so severe, even life-threatening, that emergency treatment is necessary. For this reason, ECT is typically given in a hospital, where such equipment is readily available.

After an electroshock session, patients may become “agitated,” or furious, when they realize what has happened to them. Others become delirious or actively hostile, prompting the use of mechanical and/or chemical restraints. Within a few hours, most of the immediate adverse effects dissipate. Those that don’t may continue throughout the day, for several days, or longer. During the recovery period, patients are often prevented from or asked to refrain from driving, conducting legal or business transactions, and engaging in other activities requiring alertness and memory.

It is the longer-term, and possibly severe and permanent, adverse effects of electroshock that are most troublesome and frightening to patients and their families. The worst of these, or at least the two that receive the most attention, are memory loss and learning disability (inability to learn or retain new information). The former is called retrograde amnesia; the latter, anterograde amnesia.

An ECT series causes a cumulative eradication of memory, which begins with recent events, learning, beliefs, and thoughts, and gradually extends to the distant past. In time some memories are recovered, usually within a month or two following the last ECT, although the memories lost during the treatment period are most often permanently erased. Most of the remaining gaps are filled only partially, if at all, through relearning.

Patients’ relearning involves talking with people they have known, reviewing documents from their past (letters, diaries, school and work papers, home movies, newspapers, books, and so on), and studying areas of interest with which they had once been familiar. Reacquisition of lost skills may be achieved to some degree through study and practice. The process of relearning is made more difficult because of the learning disability caused by ECT.

Some patients do not seem to mind their ECT-induced memory problems; they may even be largely, or completely, unaware of them. Others may welcome the loss of memories because some were so painful and disheartening. At the other extreme are those for whom the memory loss makes their previous way of being, lifestyle, and work no longer possible. In between are persons who adjust as best they can to varying degrees of disability.

Physicians usually regard memory impairment, particularly when pronounced, as a sign of brain damage (see in the text Sterling’s entry in 2001, and the cross-references following his citation for more information about brain damage and ECT). Memory loss may be accompanied by apathy, emotional dullness (blunted emotion, flat affect), spontaneous seizures, amenorrhea, demoralization, dependency, and hopelessness; reduced ability to think, problem-solve, concentrate, and connect with others; loss of personality; and loss of creativity, energy, enthusiasm, moral awareness, and other elements that contribute to the individual’s sense of well-being and worth. The patient’s age and physical condition, together with the intensity, duration, number, and spacing of the individual convulsive procedures, determine the severity and persistence of these effects.

Electroshock can also be fatal. Estimates of ECT-related death rates vary widely. The lower estimates include:

• 1 in 10,000 (see in the text Boodman’s first entry in 1996)

• 1 in 1,000 (Impastato’s first entry in 1957)

• 1 in 200, among the elderly, over 60 (Impastato’s in 1957)

Higher estimates include:

• 1 in 102 (see in the text Martin’s entry in 1949)

• 1 in 95 (Boodman’s first entry in 1996)

• 1 in 92 (Freeman and Kendell’s entry in 1976)

• 1 in 89 (Sagebiel’s in 1961)

• 1 in 69 (Gralnick’s in 1946)

• 1 in 63, among a group undergoing intensive ECT (Perry’s in 1963-1979)

• 1 in 38 (Ehrenberg’s in 1955)

• 1 in 30 (Kurland’s in 1959)

• 1 in 9, among a group undergoing intensive ECT (Weil’s in 1949)

• 1 in 4, among the very elderly, over 80 (Kroessler and Fogel’s in 1974-1986)

The reasons for the difficulty in estimating ECT-related deaths include the following:

• There is no central tracking of ECT-related deaths.

• Some psychiatrists and hospitals underreport the number of ECT-related deaths.

• Some psychiatrists and pathologists do not recognize deaths occurring during or soon after ECT as ECT-related.

• Families often refuse to authorize autopsies of relatives who have died during or soon after ECT.

• Professional journals are disinclined to publish reports or studies of ECT-related deaths. Not since 1957 has any journal published a large-scale study of ECTrelated deaths (see in the text Impastato’s entry in 1957).

• It is difficult to determine with certainty, or near certainty, that ECT was the cause of a patient’s death because multiple causes are often involved.

• Deciding whether or not a patient’s death is ECT-related is difficult to establish because there is no accepted time interval between a death and the last electroshock he or she received. For example, is it an ECT-related death only if the patient dies within a few minutes of undergoing ECT or may the interval be a specific number of hours, days, or weeks up to a year?

VI. DOES ELECTROSHOCK WORK?

• Patients may feel better because of the well-known placebo effect. Any treatment offered by a doctor, along with the suggestion that it will work, may have the effect of making a patient feel better, at least for a while.

• Patients may say they feel better (even when they don’t) for a variety of reasons: because it’s expected of them, because they want to please their psychiatrists or relatives, or because they fear that speaking truthfully would result in further ECT.

• Due to ECT-induced memory loss, patients may forget what had been bothering them; as a consequence, they may feel less troubled and complain less to others.

• Due to ECT-induced memory loss, patients may forget their ideas, beliefs, and forms of conduct that others had found objectionable, including resistance to being confined in a psychiatric facility and subjected to electroshock treatment.

This phenomenon may be called the brainwashing effect.

• Family, friends, psychiatrists, and hospital staff may feel sympathy for ECT patients and give them more consideration and better care.

• Patients who believe the claims of psychiatrists and agree to undergo ECT may give up so much self-respect, health, memory, intelligence, money, skills, or faith they refuse admit to themselves or others that they are worse off after ECT.

• ECT-induced brain damage may be so severe that patients are unaware of their losses.

• ECT-induced brain damage may result in a brief period of euphoria during which the depression seems to lift, so for a time patients may indeed feel better.

• ECT patients typically become dependent on others and more docile, more cooperative, and easier to get along with as they recover from the treatment.

• Because ECT deadens the emotions, patients whose everyday lives are filled with tension, anger, sadness, and misery may experience temporary relief.

VII. WELL-KNOWN ELECTROSHOCK PATIENTS

VIII. OVERVIEW

TEXT: CHRONOLOGICALLY ARRANGED QUOTATIONS

(Multiple entries for any given year are arranged alphabetically by author.) A.D. 47? — The use of nonconvulsive electrotherapy as a method for alleviating symptoms through suggestion dates back to Scribonius Largus (c. A.D. 47), who treated the headaches of the Roman emperor with an electric eel.

FRANZ G. ALEXANDER (Hungarian-born U.S. psychoanalyst) and SHELDON T. SELESNICK (U.S. psychiatrist), The History of Psychiatry, ch. 18, 1966.

1200-1500 — Far from recognizing their plight for what it was, the witch hunters and exorcists fought the witches’ delusions on the level of the deluded, and whenever the patient failed to respond to exorcism by persuasion, prayer or the sacraments, they saw no choice but to resort to their own brand of shock treatment: burning at the stake.

JAN EHRENWALD (U.S. psychiatrist), ed., From Medicine Man to Freud, ch. 7, 1956.

1400-1600 — Already towards the end of the Middle Ages and the beginning of the new period an interest developed in attempting to treat schizophrenics by some form of shock. In Switzerland, schizophrenics were put into nets and lowered into lakes until they were almost drowned and then pulled out again. Sometimes short-lasting remissions were witnessed. In other countries patients were hit with chains and whips.

Some of these patients died. But again there were some very impressive recoveries and remissions. This kind of primitive shock treatment was considered to be of a magic [sic] nature. It was believed that the devil had possession of the human body and mind, and the only logical consequence of such ideas seemed to be the attempt to make the devil’s stay in these strange places of residence as miserable as possible.

HANS HOFF (Austrian electroshock psychiatrist), “History of Organic Treatment of Schizophrenia,” published in Max Rinkel and Harold E. Himwich, eds., Insulin Treatment in Psychiatry, 1959. The term schizophrenia was coined by the Swiss psychiatrist Eugen Bleuler in the early 1900s.

1755 — Probably the first electroconvulsive treatment for mental illness was administered by the French physician J. B. LeRoy in 1755 on a patient with a psychogenic blindness.

FRANZ G. ALEXANDER (Hungarian-born U.S. psychoanalyst) and SHELDON T. SELESNICK (U.S. psychiatrist), The History of Psychiatry, ch. 18, 1966.

1756 — Having procured an apparatus on purpose, I ordered several persons to be electrified who were ill of various disorders; some of whom found an immediate, some a gradual, cure. From this time I appointed, first some hours in every week and afterward an hour in every day, wherein any that desired it might try the virtue of this surprising medicine.... To this day, while hundreds, perhaps thousands, have received unspeakable good, I have not known one man, woman, or child, who has received any hurt thereby; so when I hear any talk of the danger of being electrified (especially if they are medical men who talk so), I cannot but impute it to great want either of sense or honesty.

JOHN WESLEY (English evangelist and founder of Methodism), journal, 9 November 1756. Comment: “The desideratum[: or, electricity made plain and useful. By a lover of mankind, and of common sense] was written to popularize what he considered the cheapest, safest, and most successful treatment for ‘nervous Cases of every Kind,’ namely electricity” (Richard Hunter and Ida Macalpine, eds., “John Wesley,” Three Hundred Years of Psychiatry (1535-1860), 1963). The desideratum was published in 1760.

1787 — In the month of November, 1787, a porter of the India warehouses was sent to me by a lady of great humanity for advice, being in a state of melancholy [for almost a year], induced by the death of one of his children....

He was quiet, would suffer his wife to lead him about the house, but he never spoke to her; he sighed frequently, and was inattentive to everything that passed.... I covered his head with a flannel, and rubbed the electric sparks all over the cranium; he seemed to feel it disagreeable, but said nothing. On the second visit, finding no inconvenience had ensued, I passed six small shocks through the brain in different directions. As soon as he got into an adjoining room, and saw his wife, he spoke to her, and in the evening was cheerful, expressing himself, as if he thought he should soon go to his work again. I repeated the shock in like manner on the third and fourth day, after which he went to work: I desired to see him every Sunday, which I did for three months after, and he remained perfectly well.

JOHN BIRCH (English surgeon), “John Birch,” published in Richard Hunter and Ida

Macalpine, eds., Three Hundred Years of Psychiatry (1535-1860), 1963.

1804, 1872 — Aldini was reported to have cured two cases of melancholia by passing

galvanic current through the brain in 1804. In England, Clifford Allbutt in 1872 used the

passage of electric current through the head for treatment of mania, brain-wasting,

dementia and melancholia.

PETER SKRABANEK, “Convulsive Therapy — A Critical Appraisal of Its Origins and

Value,” Irish Medical Journal, June 1986.

1881 — [In cases of enuresis, or bedwetting] I apply usually [in the region of the boy’s

sexual organ] a tolerably strong current for one to two minutes; at the close, a wire

electrode is introduced about two centimeters into the urethra — in girls I apply “small”

sponge electrode between the labia close to the meatus urethrae — and the faradic

current passed for one to two minutes with such a strength that a distinct, somewhat

painful sensation is produced.

WILHELM ERB (German physician), Handbook of Electrotherapy, 1881, quoted in

Thomas S. Szasz, The Myth of Psychotherapy: Mental Healing as Religion, Rhetoric,

and Repression, ch. 6, sect. 1, 1978.

1893-1895 — [For a woman diagnosed with hysteria and a muscle disorder] we

recommended the continuation of systematic kneading and faradization of the sensitive

muscles, regardless of resulting pain, and I reserved to myself treatment of her legs with

high tension electric currents, in order to be able to keep in touch with her....

In this way we brought about a slight improvement. In particular, she seemed to take

quite a liking to the painful shocks produced by the high tension apparatus, and the

stronger these were the more they seemed to push her own pains into the background.

In the meantime my colleague was preparing the ground for psychical treatment, and

when, after four weeks of my pretense treatment, I proposed the other method and gave

her some account of its procedure and mode of operation, I met with quick

understanding and little resistance.

SIGMUND FREUD (Austrian neurologist and founder of psychoanalysis), Studies in

Hysteria, ch. 2, sect. 5, 1893-1895, tr. James and Alix Strachey, 1955. Thirty years later,

Freud commented on this practice, “My knowledge of electrotherapy was derived from

W. Erb’s textbook, which provided detailed instructions for the treatment of all the

symptoms of nervous diseases. Unluckily, I was soon driven to see that following these

instructions was of no help whatever and that what I had taken for an epitome of exact

observations was merely the construction of fantasy.... The successes of electric

treatment in nervous disorder (in so far as there were any) were the effect of suggestion

on the part of the physician” (An Autobiographical Study, ch. 1, 1925, tr. James

Strachey, 1927).

1914-1918 — During the First World War, among the persons responsible for torturing

soldiers with painful electric shocks and disguising the brutality as therapy was the

foremost neuropsychiatrist of Austria-Hungary and perhaps of Europe, Julius Wagner-

Jauregg.

THOMAS S. SZASZ (Hungarian-born U.S. psychiatrist), The Myth of Psychotherapy:

Mental Healing as Religion, Rhetoric, and Repression, ch. 6, sect. 1, 1978.

1930s — Psychiatrists had used a variety of aggressive measures to control mental

patients during the three centuries of the [asylum] system, but the 1930s saw a new

approach in technology. In previous years assaults on the patients had been largely

directed at the whole body rather than the brain. Patients were whipped, strapped into

spinning chairs, dunked into cold water, poisoned with toxic agents, bled, placed in

straitjackets, and thrown into solitary confinement. But with the third decade of the

twentieth century, psychiatrists discovered it was more efficient to attack the brain

directly. The major breakthrough took place in 1928, when Sakel, the inventor of insulin

coma therapy, first discovered that addicts accidentally overdosed with insulin became

more docile and manageable. The widespread acceptance of insulin coma therapy in the

1930s paved the way for a variety of brain-damaging convulsive therapies [including

electroshock], and ultimately for direct surgical destruction of the highest centers of the

brain (lobotomy).

PETER R. BREGGIN (U.S. psychiatrist), Electroshock: Its Brain-Disabling Effects,

“A diagnosis of schizophrenic syndrome was made based on his passive behavior,

incoherence, low affective reserves, hallucinations, deliriant ideas of being influenced,

neologisms. This subject was chosen for the first experiment of induced electric

convulsions in man.

“Two large electrodes were applied to the frontoparietal regions, and I decided to

start cautiously with a low-intensity current of 80 volts for 0.2 seconds. As soon as the

current was introduced, the patient reacted with a jolt and his body muscles stiffened:

then he fell back on the bed without loss of consciousness. He started to sing abruptly

at the top of his voice, then he quieted down. Naturally, we, who were conducting the

experiment, were under great emotional strain and felt that we had already taken

quite a risk.

“Nevertheless, it was quite evident to all of us that we had been using a too low

voltage. It was proposed that we should allow the patient to have some rest and repeat

the experiment the next day. All at once, the patient, who evidently had been following

the conversation, said clearly and solemnly, without his usual gibberish: ‘Not another

one! It’s deadly!’”

The next day, despite the subject’s plea, Cerletti administered a stronger shock which

caused a seizure. Thus “the first experiment of induced electric convulsions in man”

(Cerletti’s words) was carried out against the will of the subject.

Earlier in Rome, Cerletti had experimented with pigs and later wrote, “Having

obtained authorization for experimenting from the director of the slaughterhouse,

Professor Torti, I carried out tests, not only subjecting the pigs to the current for everincreasing

periods of time, but also applying the current in various ways across the

head, across the neck, and across the chest.”

Referring to the first electroshock experiment on a human being, Cerletti wrote,

“When I saw the patient’s reaction, I thought to myself: ‘This ought to be abolished.’

Ever since I have looked forward to the time when another treatment would replace

electroshock.”

LEONARD ROY FRANK (U.S. electroshock survivor and editor), summary based on

articles by Cerletti, “Electroshock Therapy,” published in Arthur M. Sackler et al., eds.,

The Great Physiodynamic Therapies in Psychiatry: An Historical Appraisal, 1956;

Cerletti, “Old and New Information about Electroshock,” American Journal of

Psychiatry, August 1950; and Frank J. Ayd Jr., “Guest Editorial: Ugo Cerletti (1877-

1963),” Psychosomatics, November-December 1963.

See Lothar Kalinowsky’s entry immediately below, Cerletti’s in 1959, Ferruccio di Cori’s in 1963, and

George Mora’s in 1963 below.

LOTHAR B. KALINOWSKY (German-born U.S. electroshock psychiatrist and for

many years the world’s leading authority on ECT, 1900-1992), quoted in Richard

Abrams, “Interview with Lothar Kalinowsky, M.D.,” Convulsive Therapy, vol. 4, 1988.

In 1933, Kalinowsky fled Germany for Italy where, between 1936 and 1939, he was

associated with Cerletti. After arriving in the United States in 1940, he wrote hundreds

of journal articles and co-authored several influential books on psychiatry’s physical

treatments.

1940 — It seems very clear that the first documented treatment of ECT in this country

[at 27 West 55th Street, New York City] was administered by Dr. David Impastato on

January 7, 1940....

The first patient was a 29-year-old woman of Italian descent suffering from severe

schizophrenia. The apparatus used by Dr. Impastato was made in Italy and brought to

the United States in 1939 by Dr. Renato Almansi, who had been associated with Dr. Ugo

Cerletti in Rome.

ZIGMOND M. LEBENSOHN (U.S. electroshock psychiatrist), “The History of

Electroconvulsive Therapy in the United States and Its Place in American Psychiatry: A

Personal Memoir,” Comprehensive Psychiatry, May-June 1999.

1940 — These sundry procedures produce “beneficial” results by reducing the patient’s

capacity for being human. The philosophy is something to the effect that it is better to be

a contented imbecile than a schizophrenic.

HARRY STACK SULLIVAN (U.S. psychiatrist), referring to lobotomy and shock

treatment (in his phrase, psychiatry’s “decortication treatments”), “Conceptions of

Modern Psychiatry,” Psychiatry, February 1940.

1941 — In a 1941 U.S. Public Health Service survey, 42 percent of [305 public and

private] institutions surveyed had electroshock machines just three years after the first

human electroshock trial.

JOEL BRASLOW (U.S. psychiatrist), slightly modified, Mental Ills and Bodily Cures:

Psychiatric Treatment in the First Half of the Twentieth Century, ch. 5, 1997.

1941 — What then of... our vitamin capsules, our electric therapies, our ultra-violet

lamps, our shortwave treatments and our shock therapy — in particular our shock

therapy, whether it be insulin or metrazol or electric! Do we use these as empirically as

our predecessors did their leeches and their bleedings?... I ask the question, are we, in

the light of others who come after us, going to be accused of being users of stupid,

bizarre or crude methods? Will they think us no better than quacks? Will they read our

shock therapy methods with horror and say, “Why, they should have used baseball bats

— it would have been just as productive of results.”

C. C. BURLINGAME (psychiatrist), 1941, quoted in David Herman and Jim Green,

“What Treatment?” Madness: A Study Guide, 1991.

1941 — All of the above-mentioned methods [i.e., various forms of shock and drug

treatments] are damaging to the brain, but for the most part, the damage is either slight

or temporary. The apparent paradox develops, however, that the greater the damage,

the more likely the remission of psychotic symptoms....

It has been said that if we don’t think correctly, it is because we haven’t “brains

enough.” Maybe it will be shown that a mentally ill patient can think more clearly and

more constructively with less brain in actual operation.

WALTER FREEMAN (U.S. neurologist and psychosurgeon who, in 1936, introduced

lobotomy in the United States and became its leading proponent, 1895-1972), “Editorial

Comment: Brain-Damaging Therapeutics,” Diseases of the Nervous System (“A

Practical Journal of Psychiatry and Neurology”), March 1941. In 1935, Portuguese

neurologist and neurosurgeon Egas Moniz introduced psychosurgery, the first method

of which was called leucotomy or leukotomy (in Europe) and lobotomy (in the U.S.). In

1949, Moniz won the Nobel Prize in Physiology or Medicine for his “discovery of the

therapeutic value of prefrontal leucotomy in certain psychoses.”

See Abraham Myerson’s entry in 1942 below.

1942 — Case 1. M.C. Philadelphia State Hospital. Reg. No. 51103. Paranoid dementia

praecox in a woman of 45. Electrical convulsion treatments, 62 [in 16 of which no

convulsion was produced], over a period of 5½ months. Numerous punctate

hemorrhages in the cerebral cortex, medulla, cerebellum and basal ganglia. Areas of

perivascular edema and necrosis....

Comment. The foregoing case is the first reported instance, so far as we know, of

hemorrhages in the brain attributable to electrical convulsion treatment....

The importance of the case lies in that it offers a clear demonstration of the fact that

electrical convulsion treatment is followed at times by structural damage of the brain.

BERNARD J. ALPERS and JOSEPH HUGHES (U.S. neurologists), “The Brain

Changes in Electrically Induced Convulsions in the Human,” Journal of

Neuropathology and Experimental Neurology, April 1942.

See Peter Sterling’s entry in 2001 below.

1942 — I do not believe shock therapy offers us any lasting benefit. It certainly is not

specific. It does not in any way help the patient to understand his own problems or to

change his attitude towards his problems. It certainly in no way assists the psychiatrist

in understanding the patient, his problems or his makeup.... To put it bluntly, I do not

believe that we can scramble brains and expect to have anything left but scrambled

brains.

ANONYMOUS (psychiatrist), quoted in Lawrence Kolb and Victor H. Vogel, “The Use

of Shock Therapy in 305 Mental Hospitals,” American Journal of Psychiatry, July 1942.

1942 — Bini in 1942 suggested the repetition of ECT many times a day for certain

patients, naming the method “annihilation.”

UGO CERLETTI (Italian electroshock psychiatrist), “Old and New Information about

Electroshock,” American Journal of Psychiatry, August 1950.

1942 — A generalized convulsion leaves a human being in a state in which all that is

called personality has been extinguished.

HANS LÖWENBACH (German-born U.S. electroshock psychiatrist) and EDWARD

J. STAINBROOK (U.S. electroshock psychiatrist), opening sentence, “Observations on

Mental Patients after Electro-shock,” American Journal of Psychiatry, May 1942.

1942 — I believe there have to be organic changes or organic disturbances in the

physiology of the brain for the cure [with electric convulsive therapy] to take place. I

think the disturbance in memory is probably an integral part of the recovery process. I

think it may be true that these people have for the time being at any rate more

intelligence than they can handle and that the reduction of intelligence is an important

factor in the curative process. I say this without cynicism. The fact is that some of the

very best cures that one gets are in those individuals whom one reduces almost to

amentia.

ABRAHAM MYERSON (U.S. electroshock psychiatrist), discussion following

Franklin G. Ebaugh et al., “Fatalities Following Electric Convulsive Therapy: A Report of

2 Cases with Autopsy Findings,” Transactions of the American Neurological

Association, June 1942.

See Walter Freeman’s entry in 1941 above.

1942 — Since October 1940 my associates and I [at Trenton State Hospital, New Jersey]

have employed electric shock therapy in 1,133 cases, in 448 of which electric shock was

combined with insulin.... Chronic Psychoses: By far the largest number of patients to

receive electric shock therapy alone were the dirty, denuded, deteriorated and disturbed

schizophrenic patients. These patients made a remarkable change in their institutional

adjustment, and the majority improved to the point of remaining clothed, going to the

cafeteria and working in occupational therapy groups in the wards. We found, however,

that if the treatments were discontinued, the patients soon returned to their previous

level; therefore we maintain these patients on a regimen of one or two treatments a

week for an indefinite period.

JOHN H. TAYLOR JR. (U.S. electroshock psychiatrist), remarks at a symposium, 13

November 1942, quoted in Philadelphia Psychiatric Society, “Symposium:

Complications of and Contraindications to Electric Shock Therapy,” Archives of

Neurology and Psychiatry, May 1943.

1943 — In the fall of 1942 I brought an electric shock apparatus overseas as part of

hospital equipment. The [military] hospital where I was stationed rapidly filled with

psychotic patients. The shipmasters refused to accept disturbed patients for return to

the States.... In late February or early March of 1943, after much deliberation, I began

the use of electric shock treatment, which was contrary to Army regulations. It was

amazing to see how rapidly the acute schizophrenic states underwent remissions.

BENJAMIN BOSHES (U.S. electroshock psychiatrist), discussion following Matthew

T. Moore, “Electrocerebral Shock Therapy: A Reconsideration of Former

Contraindications,” Archives of Neurology and Psychiatry, June 1947.

1943 — Perhaps we are doing the right thing but in a very crude way just as if one were

trying to right a watch with a hammer.

HAROLD E. HIMWICH (U.S. electroshock psychiatrist), “Electroshock: A Round

Table Discussion,” American Journal of Psychiatry, November 1943.

1943 — The mechanism of improvement and recovery [with electric shock] seems to be

to knock out the brain and reduce the higher activities, to impair the memory, and thus

the newer acquisition of the mind, namely, the pathological state, is forgotten.

ABRAHAM MYERSON (U.S. electroshock psychiatrist), “Borderline Cases Treated by

Electric Shock,” American Journal of Psychiatry, November 1943.

1943 — A subconvulsive shock, especially when the current passes through the head, is a

very disagreeable and painful experience. Such shocks cause fear and terror. Many

patients believe that they are about to be electrocuted. A shock which ends in

instantaneous unconsciousness with convulsions is not felt, for the speed of the current

far surpasses the speed of the action currents of the nervous system and does not allow

the patient time to think. After [electroconvulsive] treatment there is always a period of

retrograde amnesia.

We, therefore, treated 10 patients with 3 subconvulsive shocks daily for a period of

ten days. All of them became more and more terrified as these treatments were

continued from day to day. Some developed more intense psychoses, others remained as

psychotic as in the beginning. They had to be dragged into the treatment room. None of

them improved or recovered. These same patients were then given the regular

[electro]convulsive treatments.

In the beginning the patients were told that they were being taken into a room for the

purpose of studying their brain waves. They were then shocked into unconsciousness.

None of them remembered anything about the procedure. When they recovered from

their confusion, many demanded to be informed as to just what had been done with

them. Those who recovered and developed insight stated that all memory of the first

weeks spent in the hospital was gone. In some this retrograde amnesia extended back

for several months before they entered the institution.

CLARENCE A. NEYMAN, V. G. URSE (U.S. electroshock psychiatrists) et al.,

“Electric Shock Therapy in the Treatment of Schizophrenia, Manic Depressive Psychoses

and Chronic Alcoholism,” Journal of Nervous and Mental Disease (“the world’s oldest

independent scientific monthly in the field of human behavior”), December 1943.

1944 — [Film actress Frances Farmer arrived at Western Washington State Hospital at

Fort Steilacoom on March 14, 1944.] She was taken from the padded van and led to the

main receiving area. The straitjacket was removed and she was stripped. Standing nude

before a large crowd of patients and orderlies that had assembled to see her, she was

then numbered and fingerprinted....

Early the next morning, she was taken to another, smaller room, where she was to

begin immediately an extensive program of ECT....

Frances had a reputation for being the most angry, rebellious inmate in the asylum.

She refused to cooperate with the psychiatrists. She refused to admit she had a mental

problem. She screamed that she was being unjustly incarcerated and demanded to be

released. The stubborn independence and integrity that had made her a successful artist

were here deemed “antisocial” behavior and she was treated for it with massive weekly

doses of electroshock. When even this failed to get a response, she was given

hydrotherapy [forced baths], a primitive form of shock treatment....

Months of such treatment went by and Frances’ resistance gradually melted. She

became, she would write some time later, “like a bowl of jelly, agreeable and pliable.”

She seemed to become almost another person. (“I’m sorry,” she supposedly told the

doctors. “I was a rude and disrespectful. I was very, very sick.”) She flattered the nurses

and orderlies. She admitted the error in her thinking. She became a model patient. The

doctors immediately announced that she was completely cured. [She was then

discharged from the hospital.]

WILLIAM ARNOLD, Shadowland, ch. 30, 1978. During the year before her time at

Western Washington State Hospital, Farmer was subjected to insulin coma treatment at

a sanitarium in La Crescenta, California. After WWSH, she was, for several years, in and

out of mental hospitals, where she was drugged and electroshocked repeatedly. Finally,

in 1948, she was returned to WWSH where it is generally believed Walter Freeman

lobotomized her. She was never institutionalized again, but the spark was gone. She died

of cancer in 1970 at the age of 56.

See Gerald Clarke’s entry on Judy Garland in 1949, Lawrence Olivier’s on Vivien Leigh in 1953, and Gene

Tierney’s in 1955 below.

1944 — Even though the impairment of memory for the most part affects trivialities and

is one to which an otherwise well patient can adjust, it necessarily imposes a mental

strain. It also contra-indicates electro-therapy in those, for example teachers and

transport workers, in whom an inability to remember names of persons and places may

seriously impair working capacity. Finally, it implies permanent, or semi-permanent,

damage to the brain which... may later have untoward consequences.

M. B. BRODY (British psychiatrist), closing sentences, “Prolonged Memory Defects

Following Electro-Therapy,” Journal of Mental Science, July 1944. The article presented

the case notes of 5 patients who had undergone ECT at Runwell Hospital, Essex,

England, where Brody was the Senior Resident Physician. In the opening paragraph, he

wrote that to his knowledge his was only the second article which stated that

“impairment of memory occurring during or after electro-therapy has any serious

significance,” adding that his case notes reveal “memory defects lasting a year or more.”

1944 — I was six years old [in 1944]. My mother had been locked up in a mental hospital

just before I was born, and I was a ward of the state. A psychiatrist at Bellevue Hospital

in New York, Dr. Lauretta Bender, had just begun her infamous series of experiments

with shock treatment on children, and she needed more subjects. So I was diagnosed as

a “childhood schizophrenic,” torn away from my foster parents, and given 20 shock

treatments....

I was dragged down the hallway crying, a handkerchief stuffed in my mouth so I

wouldn’t bite off my tongue. And I woke [after the shock treatment] not knowing where

I was or who I was, but feeling as if I had undergone the experience of death.

After four months of this. I was returned to my foster home. Shock treatment had

changed me from a shy little boy who liked to sit in a corner and read to a terrified child

who would only cling to his foster mother and cry. I couldn’t remember my teachers. I

couldn’t remember the little boy I was told had been my best friend. I couldn’t even find

my way around my own neighborhood. The social worker who visited every month told

my foster parents that my memory loss was a symptom of my mental illness.

A few months later, I was shipped to a state hospital to spend the next 10 years of my

life.

Was this [referring to the electroshock] the work of some isolated sadist, some mad

scientist practicing in a closet? No, the psychiatrist who did this to me and several

hundred other children is still a leader in her field, with many articles published in

prestigious psychiatric journals; she still draws a salary from the New York State

Department of Mental Hygiene. And not one voice was ever raised within the entire

psychiatric profession to protest what she had done.

TED CHABASINSKI (U.S. electroshock survivor and attorney), “Electroshock:

Medical Cure or Physical Torture?: Ex-patient Calls It ‘Destructive,’” Daily Californian

(Berkeley), 26 October 1982.

See Lauretta Bender’s entry in 1947 and Chabasinski’s in 1982 below.

1944 — The evidence assembled from the various fields of investigation in regard to

shock therapy points definitely to damage to the brain. Perhaps the majority of authors

tend [sic] to minimize the significance of this and attempt to find some explanation

more satisfying to their consciences. There is still a tendency to consider the brain as the

“temple of the mind,” the “seat of the soul,” and the “greatest gift of God,” and to decry

any suggestion that such a holy structure is being tampered with. The shackles of

medieval thought are difficult to strike off.

WALTER FREEMAN and JAMES W. WATTS (U.S. psychosurgeons),

“Physiological Psychology,” Annual Review of Physiology, 1944.

1944? — A [concentration-camp] prisoner who worked on a Birkenau hospital block

later testified that “Dr. [Hans Wilhelm] König did electroshock experiments on women,”

and added, “These women later talked about their treatment. I believe Dr. König carried

out the electroshock experiments on sick women twice a week and that the women were

later gassed.”

In other words, the electroshock treatments could be seen as a prelude to the gas

chamber, and on the basis of such testimony and other investigations the International

Committee of the Red Cross in Geneva (in association with the International Tracing

Service in Arolsen in West Germany) placed these “electroshock experiments” on the list

of “pseudo-medical experiments” for which victims could be compensated.

ROBERT JAY LIFTON (U.S. psychiatrist), The Nazi Doctors: Medical Killing and the

Psychology of Genocide, ch. 15, 1985. In researching his book, Lifton conducted

extensive interviews with concentration-camp doctors and psychiatrists.

1944 — During the spring of 1944, the SS officer in charge of the prison hospital [at

Auschwitz] told me and one other male nurse [inmate] to report for a special

assignment. We were told to be in front of the hospital compound barracks to take

inmates from a truck to the barracks and return them later to the truck.

When the truck arrived, I found six to eight women in various states of despair....

We took the women into the barrack where a separate room had been fixed up. A

number of SS officers were in the room. Since I went back and forth into the room

several times, I saw the faces of the officers and recognized Dr. [Josef] Mengele.

After an hour, we were summoned back to remove the women. In the room where the

“medical services” were performed, one woman was still connected to an electrical

machine, presumably for electric-shock experimentation. We had been instructed to

have a stretcher ready in order to carry the women out. We found two of them dead....

Two obviously were in a coma; the others were breathing hard and irregularly. None was

conscious. I noticed that the teeth of those still alive were clenched and that wads of

paper were placed in their mouths.

ERNEST W. MICHEL (chairman of a world gathering of Jewish Holocaust survivors

in Jerusalem in 1981), “I Saw Him in Action” (op-ed column), New York Times, 6 March

1985. The column was adapted from Michel’s testimony at a Congressional hearing.

Mengele was the war’s most infamous Nazi doctor. He conducted numerous medical

experiments on Auschwitz inmates, many of them twins. He disappeared after the war.

1945 — [Shock] treatment is not without risks. A number of unexplained deaths have

occurred, large numbers of patients with organic cardiovascular hypertensive disease

have been successfully treated, yet some have died from coronary disease shortly after a

treatment.... I have had a number of patients die suddenly from cardiovascular

accidents, within a few weeks after full recovery from depressive psychoses, and am not

fully convinced that the therapy may not have hastened their deaths.

A. E. BENNETT (U.S. electroshock psychiatrist), “An Evaluation of the Shock

Therapies,” Diseases of the Nervous System, January 1945.

1945 — But what is shock? Certainly it is something that afflicts the organism physically

as well as mentally. The author of this book has no personal experience with shock

treatment. He has, however, personal experience in analyzing doctors who apply shock

treatment. The (conscious or unconscious) attitude of the doctors toward the treatment

was regularly that of “killing and bringing alive again.”... “Killing the sick person and

creating the patient anew as a healthy person” is an ancient form of magical treatment.

OTTO FENICHEL (German-born U.S. psychoanalyst), The Psychoanalytic Theory of

Neurosis, p. 508, 1945.

1945 — Smith, Hastings and Hughes reported only 10% improvement in the

schizophrenics they treated [with electroshock therapy], while Kalinowsky showed

improvement in 70% of his patients so diagnosed. The latter emphasized the importance

of adequate treatment stating, “Discontinuation of treatment after the usually early

clinical improvement leads almost invariably to relapse and is the most important

reason for failure of this method in the treatment of schizophrenia.

EDWARD F. KERMAN (U.S. electroshock psychiatrist), “Electroshock Therapy: With

Special Reference to Relapses and an Effort to prevent them,” Journal of Nervous and

Mental Disease, September 1945.

1945 — Of the 300 patients treated [with ECT], 201, or 67% are now out of the hospital,

either paroled or discharged.... Eighty-eight, or 29% are still in the hospital, either in a

state similar to that shown before treatment, or exhibiting various degrees of partial

improvement.... Five patients are dead; one committed suicide following relapse from

her former improved state; one developed tuberculosis several months after treatment

and died from the tuberculous process; one stopped breathing with the application of

the first shock and could not be resuscitated (autopsy was refused); one died suddenly

three weeks after the last shock after a slight exertion; and one died 11 days after her last

electric shock, during the course of ambulatory insulin therapy. Autopsies done on the

last 2 patients showed some equivocal findings.... One is more impressed with the

cerebral than the pulmonary factor in evaluating the cause of death.

EDWARD F. KERMAN, “Electroshock Therapy: With Special Reference to Relapses

and an Effort to Prevent Them,” Journal of Nervous and Mental Disease, September

1945.

1945 — In some hospitals, the shock machine is carried about the various wards and

more or less brought to the patient; but, in this institution [Rochester State Hospital,

New York] it has been found more convenient to bring the patient to the shock machine.

Thus a series of rooms called the shock clinic was established.... While one patient is

being treated in the shock room, another is being adjusted on the second table and can

then be wheeled in as soon as the first patient leaves the room. Thus a continuous

stream of patients is maintained and by this method 30 patients can be treated in about

one and one-half hours. Immediately after the treatment, each patient is placed in bed

and a wide canvas strap is tied across his chest and abdomen. Men and women are

treated the same day but in different groups....

The persistence of confusion varies considerably from case to case and is largely

dependent on the treatment intervals. Formerly two treatments weekly were

considerable advisable, but for some time all patients at [RSH] have been treated three

times weekly. This regime has to some extent increased and maintained the confusion,

which is evident particularly in memory loss for recent events. Patients seem to be more

amused than alarmed by this circumstance.

WELLINGTON W. REYNOLDS (U.S. electroshock psychiatrist), “Electric Shock

Treatment: Observations on 350 Cases,” Psychiatric Quarterly, vol. 19, 1945.

1939-1945 — Terror stalked the halls of the euthanasia hospitals not only because

patients feared being selected for killing at any time or because some of the staff beat

and maltreated them but also because some medical procedures imposed unusual pain.

At the Gugging and Mauer-Öhling Austrian state hospitals, physician Emil Gelny, who

was not a psychiatrist, employed a machine designed to give electroshock treatments

and thus inflict torture. Electroconvulsive therapy, common in psychiatric hospitals

during that period, was an even more painful procedure before the postwar introduction

of anesthesia and muscle relaxants. Gelny used these machines, with minor

adjustments, to kill patients. After two trial executions by Erwin Jekelius at the Am

Steinhof hospital in Vienna, Gelny installed these machines at Gugging and MauerÖhling

and used them to kill hundreds of handicapped patients.

HENRY FRIEDLANDER (German-born U.S. professor of history), The Origins of

Nazi Genocide: From Euthanasia to the Final Solution, ch. 9, 1995.

1946 — Anyone who has gone through the electric shock... never again rises out of its

darkness and his life has been lowered a notch.

ANTONIN ARTAUD (French electroshock survivor, actor, and playwright), “Insanity

and Black Magic,” 1946, Antonin Artaud: Selected Writings, ed. Susan Sontag, 1973.

Follow-up: “Gaston Ferdière, head doctor at the Rodez Asylum, told me he was there to

reform my poetry” (Artaud, “Van Gogh: The Man Suicided by Society,” 1947, Antonin

Artaud Anthology, ed. Jack Hirschman, 1965). Later, Ferdière wrote about ECT’s effects

on Artaud and their significance: “[Artaud] asked the doctors, the nurses: ‘What am I

doing here? Where am I? Who am I?’ That is absolutely normal, and this kind of subanxiety

on waking is, on the psychopathological level, even a desirable phenomenon as it

obliges the patient, who has been reduced to nothingness, who has been totally

obliterated, to build himself up again, and to follow the process of reconstruction —

which is precisely what we are aiming at” (GASTON FERDIÈRE [French electroshock

psychiatrist], quoted in Charles Marowitz, “Artaud at Rodez,” Evergreen, April 1968).

1946 — I grew up in Los Angeles in the 1940s. I was a "smart-mouth" kid who skipped

school, had “bad” surfing friends, and stayed out some nights, even hitch-hiking around.

My parents were angered and socially embarrassed by my behavior, and they consulted

the family doctor who advised electric shock treatments. He took me forcibly to his

nursing home where they were administered, without anesthetic, and where I remained

for 3-4 weeks of many treatments until I was thought "safe" enough to continue with

outpatient treatments. It was 1946; I was 11 years old; and it happened again 2 years

later. I can still recall some of what it was like:

The attendant tells me I've been here 3 weeks. I know I'm getting more and more

shock treatments. They come into my room early in the morning. They wake me up

and grab me and drag me to the treatment room. People push down on my arms and

legs. The doctor puts the metal things on both sides of my head. Now he tells me to lift

my head up and then puts a strap thing around my head over the metal things. It pulls

on my hair. He says to open my mouth. I think I'm going to die each time. It's OK. I

open my mouth and he sticks the black thing in it. Suddenly, I’m out. Nothing. Nothing

till I wake up in my bed in the same dark room. Someone must carry me back to my

room each time. I hate to wake up. Most of the time I sleep but when I wake up, I

remember where I am because I hear the old ladies moaning, the same constant hum.

I’m upset. When I look in the mirror I get more upset and want to cry. I don't even look

like me! I can't remember what I'm doing! I never wash my hair. It's sticky and itchy.

I'm so tired. I must be so bad. They just keep coming back and taking me to that room

for more shocks. My arms have red blotches on them like finger marks. Why? They

hold me down so hard on that black table. I guess that's why my back hurts. If I don't

open my mouth fast enough they grab my face and pull my mouth open. I cry and cry.

I want to die. I can't help it anymore. I can't think. I can't remember anything. The

child I was is gone forever.

After the second shock series I ran away from home, and my parents disowned me.

Now I had to make it on my own or die. I never looked back. To protect myself, I became

very vigilant, very “normal” and quiet, and very adult. I was 14 years old. I got a job as a

hospital attendant and eventually became a psychiatric nurse. I figured, "If you can't

beat 'em, join 'em." Staying focused made it possible to hide my memory retention

problems. In the mid-70s I developed symptoms of multiple sclerosis which was finally

diagnosed in 1990. Recently I have had epileptic seizures. At least so far, they are only

partial seizures. The consulting neurologists have told me that these conditions point to

brain damage, in my case, caused by the ECT. Ironically, it is possible I survived as well

as I have because I was given ECT when very young and my brain had some capacity to

repair itself or compensate more easily.

I often wonder who I would have become and what my life would have been like had

it not been for the electric shocks.

MARGO BOUER (U.S. electroshock survivor and nurse), personal communication, 16

January 2006. Bouer’s has written about her life in After Shock: A Memoir (Lost

Childhood), 1997, xlibris.com

1946 — There were 4 deaths among 276 patients who underwent electroshock at Central

Islip Hospital, New York over a three-year period ending in 1945 [editor’s summary].

ALEXANDER GRALNICK (U.S. electroshock psychiatrist), “A Three-Year Survey of

Electroshock Therapy: Report on 276 Cases,” American Journal of Psychiatry, March

1946.

1946 — Evans reported an instance of pneumonia beginning 2 days after a shock

treatment and ending fatally 36 hours later, although he did not charge this

complication to the therapy. In an unreported case, symptoms of bronchopneumonia

began 10 or 12 days after, and ended fatally 2½ weeks after a shock course, similarly

this death was not ascribed to the therapy.

LOUIS LOWINGER and JAMES H. HUDDLESON (U.S. electroshock

psychiatrist), “Complications in Electric Shock Therapy,” American Journal of

Psychiatry, March 1946.

1946 — A large group of cases, most of which were those of chronic dementia praecox

[schizophrenia], were treated [with electric convulsive therapy] mainly because of

requests from the patient’s family, regardless of the duration of the illness and the type

of onset....

Another group of chronic cases were [sic] selected for treatment because of the

difficulties presented in their care, and the object was to modify symptoms to a point at

which the patient would make a better hospital adjustment.

JACOB NORMAN and JOHN T. SHEA (U.S. electroshock psychiatrists), “Three

Years’ Experience with Electric Convulsive Therapy,” New England Journal of

Medicine, 27 June 1946. During this three-year period at Foxborough State Hospital in

Massachusetts, “approximately 4000 treatments” were administered to 266 patients. “If

no improvement was noted after the series of twenty treatments, no further treatment

was given except that in 12 cases of chronic schizophrenia fifty treatments were given,

regardless of the fact that the patients did not improve after the first twenty.” Some of

these patients “showed symptoms pointing to the possibility of organic brain damage.”

1946 — [Psychiatrist D. Ewen Cameron proposed] that after the war each surviving

German over the age of twelve should receive a short course of electroshock treatment to

burn out any remaining vestige of Nazism.

GORDON THOMAS (British writer), Journey into Madness: The True Story of Secret

CIA Mind Control and Medical Abuse, ch. 8, 1989.

See D. Ewen Cameron’s entry in 1957 below.

1946 — [Army] regulations prescribe that no more than 12 shock treatments be

administered in any one course. In many cases 12 treatments are sufficient. In others,

more treatments are required. In such instances we ordinarily terminate treatment after

the 12th reaction and begin a new course of 12 treatments after a few days’ interval when

such action is indicated.

MARK ZEIFERT (U.S. electroshock psychiatrist), “Convulsive Shock Therapy in an

Army General Hospital,” Diseases of the Nervous System, April 1946.

1947 — It is the opinion of all observers in the hospital, in the school rooms, of the

parents and other guardians that the children [a total of 100] were always somewhat

improved by the [electric shock] treatment inasmuch as they were less disturbed, less

excitable, less withdrawn, and less anxious. They were better controlled, seemed better

integrated and more mature and were better able to meet social situations in a realistic

fashion. They were more composed, happier, and were better able to accept teaching or

psychotherapy in groups or individually.

LAURETTA BENDER (U.S. electroshock psychiatrist and co-originator of the

Bender-Gestalt Scale Test, 1897-1987), “One Hundred Cases of Childhood

Schizophrenia Treated with Electric Shock,” Transactions of the American Neurological

Association (72nd Annual Meeting), July 1947. Comment: In a 1954 follow-up study,

two psychiatrists investigated 32 children who had been administered ECT by Bender.

“In a number of cases, parents have told the writers that their children were definitely

worse after EST. In fact, many of these children were regarded as so dangerous to

themselves or others that hospitalization become imperative. Also, after a course of such

treatment one nine-year-old boy made what was interpreted as an attempt at suicide.”

Soon afterwards, when being admitted to a state hospital, “he said that he had tried to

hang himself because [referring to ECT] he was ‘afraid of dying and wanted to get it over

with fast’” (E. R. CLARDY and ELIZABETH M. RUMPF [U.S. psychiatrists], “The

Effect of Electric Shock Treatment on Children Having Schizophrenic Manifestations,”

Psychiatric Quarterly, vol. 28 [supplement], 1954). Comment: “Children have been

treated without harm as shown by the extensive experience of Bender” (LOTHAR B.

KALINOWSKY [German-born U.S. electroshock psychiatrist], “Electric and Other

Convulsive Treatments,” published in Silvano Arieti, ed., American Handbook of

Psychiatry, 2nd ed., vol. 5, 1975).

See Ted Chabasinski’s entry in 1944 above; and Bender’s entries in 1950 and 1942-1969 and Chabasinski’s

entry in 1982 below.

1947 — The most persistent impression obtained is that the shock patients show a

picture resembling the post-lobotomy syndrome.

LEON SALZMAN (U.S. psychiatrist), “An Evaluation of Shock Therapy,” American

Journal of Psychiatry, March 1947.

1948 — She continued (to be) noisy, talkative, restless, into everything, throwing things

out the windows and insisting that electricity came up through the floor to bother her.

She was put on maintenance EST 7/6/48 and has had 6 treatments and none since July

20. She does not like the treatments which may account for some of her improvement in

behavior.

ANONYMOUS (U.S. electroshock psychiatrist), “continuous notes,” Stockton State

Hospital (California), case 58214, 9 August 1948, quoted in Joel Braslow (U.S.

psychiatrist), Mental Ills and Bodily Cures: Psychiatric Treatment in the First Half of

the Twentieth Century, ch. 5, 1997. In researching his book, Braslow had access to

patients’ psychiatric records in several California state hospitals for the period from the

1920s through the 1950s.

1948 — E.S.T. seems to keep her “under control” so to speak.

ANONYMOUS (U.S. electroshock psychiatrist), “continuous notes,” Stockton State

Hospital (California), case 53774, 14 December 1948, quoted in Joel Braslow, Mental

Ills and Bodily Cures: Psychiatric Treatment in the First Half of the Twentieth

Century, ch. 5, 1997.

1948 — Patients get a break at Brooklyn [State Hospital], both on the humane and

medical end. Virtually every patient who is admitted gets an early chance at shock

therapy, if suitable for such treatment....

It is a distinct pleasure to report, after the heartbreaking scenes witnessed in many

other state hospitals, that Brooklyn State Hospital, while far from being a model mental

hospital, is decidedly one that can be recommended. Would that there were many more

like it.

ALBERT DEUTSCH (U.S. writer), The Shame of the States, ch. 18, 1948. In the book’s

introduction, psychiatrist KARL A. MENNINGER wrote that Deutsch “has probably

done more than anyone else to keep before the eyes of the American people the abuses

that are perpetrated in their name in public psychiatric hospitals.... He combines the

skill of the reporter and the training of the scientist with the deep feeling of a man of

compassion and vision.”

1948 — By what mechanism do the shock therapies [i.e., insulin coma treatment,

metrazol convulsive treatment and electroconvulsive treatment] obtain their

phenomenal results? By what path does a stimulus given to the soma reach the domain

of the psyche and rehabilitate it to follow patterns that we call normal or quasi

normal?...

The following [are] 50 shock theories gleaned from American and foreign sources.

Some of them are independent, others overlap, but all challenge our attention.

I. SOMATOGENIC THEORIES....

2. Destructive. Because prefrontal lobotomy improves the mentally ill by destruction,

the improvement obtained by all the shock therapies must also involve some destructive

processes....

8. Circulation. They help by way of a circulatory shake up....

18. Capillary spasms. It produces spasms in the brain capillaries and diseased nerve

cells are eliminated....

20. Cerebral function. It decreases cerebral function....

24. Cortex cells. Irreversible changes in the cortex cells explain the change in the

mental condition....

II. PSYCHOGENIC THEORIES....

2. Dying and resurrection. There is an unconscious experience of dying and

resurrection....

4. Preparation for psychotherapy. It is only a preparation of the ground for

psychotherapy....

5. Catharsis. Emotional catharsis is facilitated....

6. Contact with physician. The treatments bring patient and physician in close

contact....

7. Physician becomes “mother.” Helpless and dependent, the patient sees in the

physician a mother....

12. Vital instincts. Threat of death mobilizes all the vital instincts and forces a

reestablishment of contacts with reality....

13. Atonement. The treatment is considered by patient as punishment for sins and

gives feelings of relief....

14. Fear. Fear of the procedure causes remission....

15. Victory and joy. Victory over death and joy of rebirth produce the results....

16. Ego. The healthy ego reobtains dominion over pathological ego....

17. Amnesia. The resulting amnesia is healing....

18. Eros. Erotization is the therapeutic factor....

22. Lower level. The personality is brought down to a lower level and adjustment is

obtained more easily in a primitive vegetative existence than in a highly developed

personality. Imbecility replaces insanity.

HIRSCH L. GORDON (U.S. electroshock psychiatrist), “Fifty Shock Therapy

Theories,” Military Surgeon, November 1948.

1948 — This brings us for a moment to a discussion of the brain damage produced by

electroshock.... Is a certain amount of brain damage not necessary in this type of

treatment? Frontal lobotomy indicates that improvement takes place by a definite

damage of certain parts of the brain.

PAUL H. HOCH (Hungarian-born U.S. electroshock psychiatrist and onetime

commissioner of the New York State Department of Mental Hygiene), “Discussion and

Concluding Remarks,” Journal of Personality, vol. 17, 1948.

1948 — 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....

Sometimes the confusion passes rapidly and patients act as if they had awakened

from dreaming; their minds seem like clean slates upon which we can write.

CYRIL J. C. KENNEDY and DAVID ANCHEL (U.S. electroshock psychiatrists),

“Regressive Electric-Shock in Schizophrenics Refractory to Other Shock Therapies.”

Psychiatric Quarterly, vol. 22, 1948.

1948 — Case 2. Mrs. J. R. represents the group of patients who have, over a period of

years, been ardent followers of a certain faith and who become depressed and confused

when thoughts of previous sex practices recur. Her conflict arose because she could not

reconcile her past conduct with her present religious beliefs. She was a woman of 65,

short and stockily built, and had raised 4 children. Her sickness followed the death of

her husband four years before and has persisted to date. She objects to any medication

or shock treatment because of her faith but does show definite temporary improvement

after shock therapy. This patient is not accessible to psychotherapy, owing to her age

and her profound religious beliefs.

N. K. RICKELS and CHARLES G. POLAN (U.S. electroshock psychiatrists), “Causes

of Failure in Treatment with Electric Shock: Analysis of Thirty-Eight Cases,” Archives of

Neurology and Psychiatry, March 1948.

1948 — The pre-treatment room, with its air of pleasant diversion, is equipped with a

radio and recording machine with a large stack of records for listening and dancing. A

librarian visits the unit daily with magazines, books, and newspapers. The Red Cross is

represented by Grey Ladies who chat and play cards with patients awaiting their turn for

[electric shock] treatment. The recreational aides and nurses also act as dancing

partners for any patients so inclined. Although the space is limited, this entertainment is

greatly enjoyed. Here the patient is induced to relax and is given an opportunity to

forget his fear and anxiety in the pleasant atmosphere of a social gathering of friendly

people.

CLINTON C. SHERMAN and LEON O. CHARBONNEAU (U.S. nurses), “Electric

Shock Therapy,” American Journal of Nursing, May 1948. Both nurses were staff

members at the U.S. Veterans Hospital in Northampton, Massachusetts while writing

this article.

1949 — The number of patients treated [with electroconvulsive treatment at California’s

Stockton State Hospital] for the year ending June 30, 1949, increased over the previous

year by nearly five times, to 2,997. Underscoring its status as the “foremost method of

therapy in the state hospitals,” doctors shocked 60 percent of the patients at Stockton

that year.

JOEL BRASLOW (U.S. psychiatrist), Mental Ills and Bodily Cures: Psychiatric

Treatment in the First Half of the Twentieth Century, ch. 5, 1997.

1949 — [While filming Annie Get Your Gun in 1949, Judy Garland] began to arrive at

the studio late or not at all, often staying home, unable to rise from her bed. Her weight

dropped to 90 pounds, and her hair began to fall out, a side effect, most likely, of her

profligate use of amphetamines. In an effort to lift her out of her depression, a new

doctor, Fred Pobirs, persuaded her to undergo a series of six electroshock treatments.

GERALD CLARKE (U.S. writer), Get Happy: The Life of Judy Garland, 2000. JUDY

GARLAND returned to the set after finishing the electroshock series, but, as she

recalled later, “I couldn’t learn anything. I couldn’t retain anything; I was just up there

making strange noises. Here I was in the middle of a million-dollar property, with a

million-dollar wardrobe, with a million eyes on me, and I was in a complete daze. I knew

it, and everyone around me knew it.” The studio soon suspended her from the film.

See William Arnold’s entry on Frances Farmer in 1944 above; and Lawrence Olivier’s on Vivien Leigh in

1953 and Gene Tierney’s in 1955 below.

1949 — Quite a number of psychiatrists object to shock treatment, or frontal lobotomy,

because they say it is only a symptomatic treatment, like giving the patient a sleeping

pill when he suffers from insomnia.... In most of our treatments what we actually are

achieving is an emotional amputation, in a sense that we prevent a conflict from

remaining dominant in the patient’s mind.

PAUL H. HOCH (Hungarian-born U.S. electroshock psychiatrist), “Theoretical

Aspects of Frontal Lobotomy and Similar Brain Operations,” American Journal of

Psychiatry, December 1949.

1949 — There were 5 deaths among 511 patients who underwent electroshock at Pontiac

State Hospital, Michigan [editor’s summary].

PETER A. MARTIN (U.S. electroshock psychiatrist), “Convulsive Therapies: Review

of 511 Cases at Pontiac State Hospital,” Journal of Nervous and Mental Disease,

February 1949.

1949 — Two soft pads, which felt slightly moist, clamped themselves against Winston’s

temples. He quailed. There was pain coming, a new kind of pain. O’Brien laid a hand

reassuringly, almost kindly, on his.

“This time it will not hurt,” he said. “Keep your eyes fixed on mine.”

At this moment there was a devastating explosion, or what seemed like an explosion,

though it was not certain whether there was any noise. There was undoubtedly a

blinding flash of light. Winston was not hurt, only prostrated.... A terrific painless, blow

had flattened him out. Also something had happened inside his head. As his eyes

regained their focus, he remembered who he was, and where he was, and recognized the

face that was gazing into his own; but somewhere or other there was a large patch of

emptiness, as though a piece had been taken out of his brain.

GEORGE ORWELL (English writer), Nineteen Eighty-Four (a novel), ch. 3, sect. 2,

1949.

1949 — It should be understood that long-continued treatment with electroshock does

no physical harm. Cases have been reported in which two hundred fifty and even one

thousand convulsions have been induced over a period of years, with no organic damage

to the patient.

PHILLIP POLATIN (U.S. electroshock psychiatrist) and ELLEN C. PHILTINE,

How Psychiatry Helps, ch. 6, 1949.

1949 — There were 2 deaths among 18 patients who underwent intensive electroshock at

Mapperley Hospital, Nottingham, England in 1949 [editor’s summary].

PAUL L. WEIL (British electroshock psychiatrist), “‘Regressive’ Electroplexy in

Schizophrenics,” Journal of Mental Science, April 1950.

Late 1940s–early 1950s — Every morning I woke in dread, waiting for the day nurse to

go on her rounds and announce from the list of names in her hand whether or not I was

for shock treatment, the new and fashionable means of quieting people and of making

them realize that orders are to be obeyed and floors are to be polished without anyone

protesting and faces are made to be fixed into smiles and weeping is a crime.

JANET FRAME (New Zealand electroshock survivor and writer), Faces in the Water,

ch. 1, sect. 1, 1961. Frame was electroshocked more than 200 times over an eight-year

period during her twenties. An acclaimed writer, Frame’s autobiography was made into

a 1990 film titled An Angel at My Table.

Late 1940s-early 1950s — Suddenly the inevitable cry or scream sounds from behind the

closed doors which after a few minutes swing open and Molly or Goldie or Mrs. Gregg,

convulsed and snorting, is wheeled out. I close my eyes tight as the bed passes me, yet I

cannot escape seeing it, or the other beds where people are lying, perhaps heavily asleep,

or whimperingly awake, their faces flushed, their eyes bloodshot. I can hear someone

moaning and weeping; it is someone who has woken up in the wrong time and place, for

I know that the treatment snatches these things from you, leaves you alone and blind in

a nothingness of being, and you try to fumble your way like a newborn animal to the

flowing of first comforts; then you wake, small and frightened, and tears keep falling in a

grief that you cannot name.

JANET FRAME, Faces in the Water, ch. 1, sect. 1, 1961.

Late 1940s–early 1950s — I tried to forget my still-growing disquiet and dread and the

haunting smell of the other ward, as I became to all appearances one of the gentle

contented patients of Ward Seven, that the E.S.T. which happened three times a week,

and the succession of screams heard as the machine advanced along the corridor, were a

nightmare that one suffered for one’s own “good.” “For your own good” is a persuasive

argument that will eventually make man agree to his own destruction.

JANET FRAME, Faces in the Water, ch. 2, sect. 1, 1961.

1950 — In April 1950, a “mute and autistic” 34½-month-old boy was administered 20

electric convulsions after being referred to the children’s ward of New York’s Bellevue

Hospital. A month later he was discharged. The discharge note indicated “moderate

improvement, since he was eating and sleeping better, was more friendly with the other

children, and he was toilet trained” [editor’s summary].

LAURETTA BENDER (U.S. electroshock psychiatrist), “The Development of a

Schizophrenic Child Treated with Electric Convulsions at Three Years of Age,” published

in Gerald Caplan, ed., Emotional Problems of Early Childhood, 1955.

See Bender’s entry in 1947 above.

1950 — Some patients come to operation [lobotomy] at the end of a long and

exasperating series of medical treatments, hospital treatments, shock treatments,

including endocrines and vitamins mixed with their physiotherapy and psychotherapy.

They are still desperate, and will go to any length to get rid of their distress. Other

patients can’t be dragged into the hospital and have to be held down on a bed in a hotel

room until sufficient shock treatment can be given to render them manageable.

WALTER FREEMAN and JAMES W. WATTS (U.S. psychosurgeons),

Psychosurgery in the Treatment of Mental Disorders and Intractable Pain, 2nd ed., ch.

8, 1950. Pictured on the page facing the above excerpt is a naked, distraught woman in a

standing position with a restraining belt around her waist struggling with 2 nurses; the

complete caption reads, “Figure 44. Case 441. ‘Other patients have to be held...’” [ellipsis

in original].

1950 — In 1950, [Yale psychologist Irving L.] Janis collected personal memories, from

childhood to the present, from 30 people, 19 of whom later received ECT. Four weeks

after ECT, all 19 suffered “profound, extensive recall failures” that “occurred so

infrequently among the 11 patients in the control group as to be almost negligible.” Most

of the gaps were for the period of 6 months before ECT, but in some cases the memory

loss was for events more than 10 years previously. Surprisingly, retrograde amnesia was

scarcely researched again until the 1970s [when] protests compelled ECT proponents to

try and prove ECT is safe.

JOHN READ (New Zealand psychologist), “Electroconvulsive Therapy,” published in

Read, Loren R. Mosher and Richard P. Bentall, eds., Models of Madness: Psychological,

Social and Biological Approaches to Schizophrenia, 2004.

1950 — Within 2 weeks from the beginning of our intensive electric shock treatment the

character of the ward [of 114 “psychotic women patients” at Stockton State Hospital in

California] changed radically from that of a chronic disturbed ward to that of a quiet

chronic ward. Combative behavior of the patients diminished dramatically. Physical

labor of the attendants was cut in half. For example, individual tray service for 40 to 50

patients per meal was abolished. Soiling and smearing were also markedly reduced.

Patients in general became better “ward citizens,” and in the words of one attendant

“began to act like human beings.” There was a general heightening of the morale of both

attendants and patients.

MERVYN SHOOR and FREEMAN H. ADAMS (U.S. electroshock psychiatrists),

“The Intensive Electric Shock Therapy of Chronic Disturbed Psychotic Patients,”

American Journal of Psychiatry, October 1950.

1951 — [On small hospital ships returning to the U.S. from the Pacific war zone during

World War II] it was discovered that the usual electric shock therapy application,

administered in the morning and afternoon of two successive days, worked nothing less

than miracles in converting wildly disturbed patients into quiet, tractable, cooperative,

and often improved individuals....

It was decided to try this intensive therapy at Willard [State Hospital in Willard, New

York] — a modality which the employees concerned came to dub the “Blitz,” ultimately

leading to the term “B.E.S.T.” (Blitz Electric Shock Therapy). The authors think time

and results have justified this descriptive classification.

The first question was the matter of selection. In most research investigations two

groups are chosen, one for control and one for experimentation. In the Willard case, one

group could well stand for both, pre-treatment histories and recorded activities serving

for control comparison. It was further decided to apply the traditional physiological

concept of “all-or-none,” and 50 of the most disturbed female patients were selected.

JAMES A. BRUSSEL and JACOB SCHNEIDER (U.S. electroshock psychiatrists),

“The B.E.S.T. in the Treatment and Control of Chronically Disturbed Mental Patients —

A Preliminary Report,” Psychiatric Quarterly, vol. 1 (supplement), 1951. Early in World

War II, the German Army developed blitzkreig tactics, literally “lightning war.”

1951 — As in Victorian and ancient times, women in mid-twentieth-century America

were liable to be seen as mentally disordered in the context of their reproductive

functions (menstruation, childbirth, menopause), as well as their gender role “duties” as

wives and mothers. Describing a married female patient who exhibited “marked

improvement” after EST, Steinfeld and his colleagues commented that “the patient, for

the first time since her marriage accepted her husband completely and did not reject his

desire for impregnating her.”

TIMOTHY W. KNEELAND (U.S. political scientist) and CAROL A. B. WARREN

(U.S. sociologist), Pushbutton Psychiatry: A History of Electroshock in America, ch. 3,

2002. The quoted material in the excerpt is from J. I. Steinfeld, Therapeutic Studies on

Psychotics, 1951.

1951 — The CIA in 1951 apparently conducted human experiments using electroshock

techniques despite warnings from an expert that they were “extremely painful and could

reduce subjects to the vegetable level.”

The CIA carried out human-behavior and mind-control projects, including the use of

unwitting subjects, from 1951 until they were ordered discontinued in 1973....

The documents included a Dec. 3, 1951, memo on the conversation a CIA officer had

with a psychologist [sic] on the use of electroshock in interrogations and for other

purposes.

Names were blacked out in copies of released material.

[The article concluded with a summary of the memo’s content.]

UNITED PRESS INTERNATIONAL, “CIA Once Tried Electroshock, Though It

Created ‘Vegetables,’” San Francisco Examiner, 8 January 1979. The following excerpts

are from a copy of an anonymous CIA agent’s memo cited in the article:

“‘Artichoke’ — [blacked out]....

2. “[Blacked out] is reported to be an authority on electric shock. He is a professor at

the [blacked out] and, in addition, is a psychiatrist of considerable note. [Blacked out] is,

in addition, a fully cleared Agency consultant.

3. “[Blacked out] explained that he felt that electric shock might be of considerable

interest to the ‘artichoke’ type of work. He stated that the standard electric-shock

machine (Reiter) could be used in two ways. One setting of this machine produced the

normal electric-shock treatment (including convulsion) with amnesia after a number of

treatments. He stated that using this machine as an electro-shock device with the

convulsive treatment, he felt that he could guarantee amnesia for certain periods of time

and particularly he could guarantee amnesia for any knowledge of use of the convulsive

shock.

4. “[Blacked out] stated that the other or lower setting of the machine produced a

different type of shock. He said he could not explain it, but knew that when this lower

current type of shock was applied without convulsion, it had the effect of making a man

talk. He said, however, that the use of this type of shock was prohibited because it

produced in the individual excruciating pain and he stated that there would be no

question in his mind that the individual would be quite willing to give information if

threatened with the use of this machine. He stated that this was a third-degree method

but, undoubtedly, would be effective. [Blacked out] stated that he had never had the

device applied to himself, but had talked with people who had been shocked in this

manner and stated that they complained that their whole head was on fire and it was

much too painful a treatment for any medical practice. He stated that the only way it

was ever used was in connection with sedatives and even then its use was extremely

painful. The writer asked [blacked out] whether or not in the ‘groggy’ condition

following the convulsion by the electric-shock machine anyone had attempted to obtain

hypnotic control over the patient, since it occurred to the writer that it would be a good

time to attempt to obtain hypnotic control. [Blacked out] stated that, to his knowledge,

it had never been done, but he could make this attempt in the near future at the [blacked

out] and he would see whether or not this could be done.

5. “[Blacked out] and [blacked out], as well as all others present, discussed the use of

electro shock at considerable length and it was [blacked out] opinion that an individual

could gradually be reduced through the use of electro-shock treatment to the vegetable

level. He stated that, whereas amnesia could be guaranteed relative [to] the actual use of

the shock and the time element surrounding it, he said it would obtain imperfect

amnesia for periods further back. He stated several instances in which people who had

been given the electro-shock treatment remembered some details of certain things and

complete blanks in other ways.

6. “.... [Blacked out] said that the standard electro-shock machine is a very common

machine in medical offices and in the major cities there must be several hundred of

them in use at all times....”

See D. Ewen Cameron’s entry in 1957 below.

1952 — Daniel Bovet (Swiss-born Italian pharmacologist) introduced succinylcholine

(Anectine) as a muscle relaxant to prevent fractures and other bone injuries during the

administration of electroshock. The new drug was a synthetic version of curare which

had been used for the same purpose on a small minority of ECT patients since 1940.

Deaths believed to have been caused by curare discouraged its broader use.

1952 — In my short experience with this patient, she has been a chronic disturbed,

unmanageable patient on Unit 5 of Cottage E. I have attempted to give her daily shock in

order to quiet her down and make her more manageable and less of a ward problem.

After about 8 shock treatments in 10 days, patient continues the same as before. She

obviously is in need of lobotomy.

ANONYMOUS (U.S. electroshock psychiatrist), “continuous notes,” Stockton State

Hospital (California), case 59533, 27 February 1952, quoted in Joel Braslow (U.S.

psychiatrist), Mental Ills and Bodily Cures: Psychiatric Treatment in the First Half of

the Twentieth Century, ch. 6, 1997.

1952 — An ancillary, nevertheless very helpful, role can be played by ECT in the

treatment of narcotic addiction. It is highly to be recommended as a tool for the

management of the withdrawal period. The so-called “annihilating” form of treatment

should be used and we have found two to three treatments administered daily for a

period of up to seven days to be of greatest help in overcoming the host of withdrawal

symptoms.

ALFRED GALLINEK (U.S. electroshock psychiatrist), “Controversial Indications for

Electric Shock Therapy,” Confinia Neurologica, vol. 12, 1952.

1952 — Price and Knouss describe three different types of music which should be played

during the three stages of preparing the patient for the treatment [ECT], for his return

to consciousness and for the rest period after the treatment. We are not opposed to such

efforts, but the most important requirement is to avoid observation of the treatment by

patients who are not only frightened themselves but through their reports contribute to

the opposition against the treatment by others.

LOTHAR B. KALINOWSKY (German-born U.S. electroshock psychiatrist) and

PAUL H. HOCH (Hungarian-born U.S. electroshock psychiatrist), Shock Treatments,

Psychosurgery and Other Somatic Treatments in Psychiatry, 2nd ed., ch. 3, sect. B.9,

1952 (1946).

1952 — After several [electroconvulsive] treatments, when the patient is much better, he

develops an increasing fear for which he is unable to account. This late and quite intense

fear is not explained by any discomfort from the treatment, nor by the psychotic fears

which have usually disappeared, at least temporarily, by this time.... “The agonizing

experience of the shattered self” (Schildge) is the most convincing explanation for the

late fear of the treatment.

LOTHAR B. KALINOWSKY and PAUL H. HOCH, Shock Treatments,

Psychosurgery and Other Somatic Treatments in Psychiatry, 2nd ed., ch. 3, sect. B.11,

1952 (1946).

1952 — An unpleasant experience in ECT is the postconvulsive excitement immediately

following the convulsion, which may last from a few minutes to one-half hour. Some

patients, particularly males, become dangerously assaultive, develop enormous

strength, try to escape, run around, and injure themselves, and may strike anyone who

attempts to control them.

LOTHAR B. KALINOWSKY and PAUL H. HOCH, Shock Treatments,

Psychosurgery and Other Somatic Treatments in Psychiatry, 2nd ed., ch. 3, sect. B.11,

1952 (1946).

1952 — All patients who remain unimproved after ECT are inclined to complain bitterly

of their memory difficulties.

LOTHAR B. KALINOWSKY and PAUL H. HOCH, Shock Treatments,

Psychosurgery and Other Somatic Treatments in Psychiatry, 2nd ed., ch. 3, sect. B.13,

1952 (1946). Compare: “Losses in intelligence, memory, and other measurable abilities

[after lobotomy] are due to the psychosis, not to lobotomy” (WALTER FREEMAN

[U.S. neurologist and psychosurgeon], “West Virginia Lobotomy Project: A Sequel.”

Journal of the American Medical Association, 29 September 1962).

1952 — Physicians who treat their patients to the point of complete disorientation are

highly satisfied with the value of ECT in schizophrenia. Such “confusional treatment”

always uses intense therapy.

LOTHAR B. KALINOWSKY and PAUL H. HOCH, Shock Treatments,

Psychosurgery and Other Somatic Treatments in Psychiatry, 2nd ed., ch. 3, sect. B.19,

1952 (1946).

1952 — At present, we can say only that we are treating empirically disorders whose

etiology is unknown, with methods such as shock treatments whose action is also

shrouded in mystery.

LOTHAR B. KALINOWSKY and PAUL H. HOCH, closing sentence, Shock

Treatments, Psychosurgery and Other Somatic Treatments in Psychiatry, 2nd ed.,

1952 (1946). Kalinowsky attributed this observation, well-known among electroshock

psychiatrists, to Hoch (interview, Psychiatric News, 5 May 1978).

1952 — What counts alone with most shock therapists is the “adjustment” their fearful

apparatus and its brain-searing explosion produces. In effect, there is little difference

between the white-coated psychiatric shock specialist and his primitive forebear, the

mud-daubed witch doctor, who also treated diseases of the mind by scaring out, shaking

out, routing out, and exorcising by dire agony and inhuman ordeal the demons or devils

— today disguised by scientific-sounding names — which they believed cause patients to

behave in such deplorable, tactless, or irritating ways. In the name of this adjustment,

and in order to bring about the desired quiet and submissiveness, the patient is put

through a crucifixion of such torment as one would wish to spare the lowliest animal.

ROBERT LINDNER (U.S. psychoanalyst), Prescription for Rebellion, ch. 2, 1952.

1952 — Something has... happened to the patient: he has been pulverized into

submission, thrashed and smashed into adjustment, granulized into cowed domesticity.

If he can now meet the criteria of the “shockiatrist” who has attended him — if he can be

polite, keep himself tidy, respond with heartiness to his physician’s cheery morning

greeting, refrain from annoying people with his complaining and, above all, make no

noise, everything will be well. If not — Quick, nurse, the little black box!

ROBERT LINDNER, Prescription for Rebellion, ch. 2, 1952.

1953 — I hope in due course to publish studies showing that the schizophrenic patient

may be as dependent on ECT for a normal existence as a diabetic is on insulin.

HAROLD BOURNE (British electroshock psychiatrist), “The Insulin Myth,” Lancet, 7

November 1953.

1953 — [The series of electroshock left her with] slight but noticeable personality

changes.... She was not the same girl that I had fallen in love with [ellipsis in original].

LAWRENCE OLIVIER (British actor), referring to his former wife actress Vivien

Leigh who had undergone ECT in 1953, quoted in “Health: Electric Shock Treatment,”

Sunday Times (London), 9 December 2001.

See William Arnold’s entry on Frances Farmer in 1944 and Gerald Clarke’s on Judy Garland in 1949

above; and Gene Tierney’s entry in 1955 and Robert J. Grimm’s in 1976 below.

1953 — Doctor Gordon [a pseudonym] was unlocking the closet. He dragged out a table

on wheels with a machine on it and rolled it behind the head of the bed. The nurse

started swabbing my temples with a smelly grease....

“Don’t worry,” the nurse grinned down at me. “Their first time everybody’s scared to

death.”

I tried to smile, but my skin had gone stiff, like parchment.

Doctor Gordon was fitting two metal plates on either side of my head. He buckled

them into place with a strap that dented my forehead, and gave me a wire to bite.

I shut my eyes.

There was a brief silence, like an indrawn breath.

Then something bent down, and took hold of me and shook me like the end of the

world. Whee-ee-ee-ee-ee, it shrilled, through an air crackling with blue light, and with

each flash a great jolt drubbed me till I thought my bones would break and the sap fly

out of me like a split plant.

I wondered what terrible thing it was that I had done.

SYLVIA PLATH (U.S. electroshock survivor, writer, and poet), describing ECT as she

experienced it in 1953, The Bell Jar, ch. 12, 1971.

See Plath’s entries in 1960 and 1963 below.

1953 — D. H. White female, age 31, was admitted to the hospital April 27, 1953.... [After

undergoing a series of 11 electroshocks, she was discharged “in good social remission.”]

As she still had a few psychotic residuals, it was arranged for her to return for outpatient

treatments. She returned four days after the last hospital treatment and the

decision was made to change the technique to the Reiter [ECT machine] and use

Atropine, Anectine, and Sodium Pentothal. Patient was given treatment at 9:40 A.M.

She apparently never took another breath nor was anyone sure that another heartbeat

was felt or heard. She was pronounced dead at 10:40.

G. WILSE ROBINSON JR., and JOHN D. DeMOTT (U.S. electroshock

psychiatrists), “How Important Is Liver Damage in the Use of Anectine Controlled

Electroshock?” Confinia Neurologica, vol. 4, 1954.

1953 — During the past eleven years, in our work with electroshock therapy (EST) at

Bellevue Psychiatric Hospital [New York City] and elsewhere, we have on numerous

occasions observed that acutely disturbed patients become quiet and cooperative after a

few shock treatments. In view of these observations, we decided to administer EST as a

“sedative” to selected patients on the disturbed wards of Bellevue Hospital. The patients

chosen for treatment were those who were grossly uncooperative, assaultive or refused

food.... The treatment schedule followed was to administer one treatment in the

morning and one in the afternoon until the patient became cooperative, and then to

control him with one or two treatments daily if he relapsed.

LEWIS I. SHARP, ANTHONY R. GABRIEL (U.S. electroshock psychiatrists), and

DAVID J. IMPASTATO (Italian-born U.S. electroshock psychiatrist), “Management

of the Acutely Disturbed Patient by Sedative Electroshock Therapy,” Diseases of the

Nervous System, January 1953.

1954 — Shock therapy never builds. It only destroys, and its work of destruction is

beyond control. It is not new. The only new thing about it is the method of delivering the

shock. A hundred and fifty years ago a well-recognized shock-treatment method was to

flog or frighten the patient, and in some instances the results were excellent. Now we

“do it electrically,” and we get about the same percentage of good results, but with some

breaking of bones, and memory losses which frightening and flogging never produced.

Memory losses in modern shock therapy may be passed off as infrequent, limited,

and temporary, but they are really frequent, they cannot be limited, and they are usually

permanent. I have heard doctors laugh about them as they laugh about other things in

mental patients, but the losses are serious to the patients themselves. And along with

such losses go changes in general intelligence and personality, but when these changes

are too obvious to be overlooked they are ascribed to the mental illness with no mention

at all of the treatment.

JOHN MAURICE GRIMES (U.S psychiatrist), When Minds Go Wrong, 2nd ed., ch.

20, 1954 (1951).

1954? — Although [the electric shock treatments] benefited schizophrenics infinitely

more than psychotherapy or other environmental treatment, they had their

disadvantages. In our unit at St. Thomas’s [a general hospital in London], for instance,

patients might become so excited and upset in the early stages of treatment that we

could not continue it under general hospital conditions, and had to send one out of

every three on to mental hospitals. Largactil [the British brand name for the neuroleptic

drug marketed as Thorazine in the United States], this French discovery, now allowed us

to keep even the worst cases under sedation while electric shock and other treatments

were being given.

WILLIAM SARGANT (British electroshock psychiatrist, 1907-1988), The Unquiet

Mind: The Autobiography of a Physician in Psychological Medicine, ch. 21, 1967.

Sargant was for many years Britain’s leading proponent of psychiatry’s physical

treatments — psychosurgery, shock, and drugs. In an essay published in The the Times

of London, he wrote, “Conscience can now be eliminated surgically without any

impairment of day-to-day working efficiency” (“The Movement in Psychiatry Away from

the Philosophical: New Chemical and Physical Methods of Freeing Tormented Minds,”

22 August 1974).

1946-1954 — When brain cells are killed, they’re dead forever, unlike skin cells that

regenerate or nail and hair cells that continue growing posthumously.

At the Woman’s Medical College of Pennsylvania (1946-1950), one of my pathology

professors told our class that ECT kills brain cells. Yet, early in my psychiatric residency

at Kingsbridge Veterans Administration Hospital in the Bronx (1951-1954), I discovered

that every resident was required to spend three months on its locked shock wards and

that this meant I would have to participate directly in shocking some of the patients.

With all my heart and whatever ingenuity I could muster, I pleaded to get out of this

mandatory service. I knew deep in my innards that I’d never push the button that would

run electricity through someone’s brain causing who knows how much brain-cell death.

One morning in desperation, I hit upon the idea of an alternative to the shock wards: I

would set up and conduct a research project! Later that day, I presented my idea to the

chief of the neuropsychiatric service and — he agreed! I would not have to shock a single

person!

The research involved interviewing insulin shock patients at the hospital, which had

an insulin ward in addition to its ECT ward. My interviews resulted in an article titled

“The Death Experience in Insulin Coma Treatment” that was published in the American

Journal of Psychiatry (June 1956).

Another assignment I created for myself to avoid the electrocutions was conducting

group therapy sessions for ECT patients. My most vivid memory from that experience

was how furious these patients were at their doctors, other staff members, their families,

or anyone they thought was responsible for their being shocked. It was only in these

sessions that they could safely vent their rage. How they raged and raged! The title of a

chapter from my book Beyond the Couch (1972) sums up the attitude I developed during

my psychiatric training: “Medical Sadism: Shock and Electricity, Ice Pick and

Lobotomy.”

If not in our era, in the future, people everywhere will look with as much horror on

our lobotomies, our insulin comas and electric shocks, and our other methods of

damaging the brain as we now look upon the cruelties — chains, purgatives, spinning

chairs, wet packs, and the like – visited upon asylum inmates in an earlier age.

EILEEN WALKENSTEIN (U.S. psychiatrist), personal communication, 20 December

2005.

1955 — [The psychiatrist] is now ridiculed because of his propensity to treat certain of

his patients with a gadget — an electroshock machine! He is now referred to as an

“electrician” and a “push button practitioner” and other opprobrious and less printable

terms.

GILBERT ADAMSON (Canadian electroshock psychiatrist), “Electroshock,”

Manitoba Medical Review, 1955, quoted in Timothy W. Kneeland and Carol A. B.

Warren, Pushbutton Psychiatry: A History of Electroshock in America, ch. 3

(epigraph), 2002.

1955 — There were 4 deaths among 112 patients who underwent electroshock at Boston

State Hospital. “J. W., aged 72, is the only patient who died as an immediate result of

EST. Eight minutes after his 51st treatment he suddenly stopped breathing” [editor’s

summary].

RUTH EHRENBERG and MILES J. O. GULLILNGSRUD (U.S. electroshock

psychiatrists), “Electroconvulsive Therapy in Elderly Patients,” American Journal of

Psychiatry, April 1955.

1955 — Over the next eight months I underwent nineteen more electric shock

treatments, a grand total, I think, of thirty-two. Pieces of my life just disappeared. A

mental patient once said it must have been [like] what Eve felt, having been created full

grown out of somebody’s rib, born without a history. That is exactly how I felt.

GENE TIERNEY (U.S. electroshock survivor and actor), Self-Portrait: Gene Tierney,

ch. 17, 1979. Tierney underwent ECT at the Institute for Living (also known as the

Hartford Retreat) in Hartford, Connecticut in 1955.

See William Arnold’s entry on Frances Farmer in 1944, Gerald Clarke’s on Judy Garland in 1949, and

Lawrence Olivier’s on Vivien Leigh in 1953 above.

1955 — The omnipotent attitude at its most blatant takes the form of a need to have the

power of life and death over one’s subjects. With electroconvulsive treatment all the

appearances of producing a death-dealing blow, followed by “rebirth,” is there.

The need to cure quickly, magically, ritualistically can be seen often in an intense

“therapeutic ambitiousness.” Slow methods, devoid of special effects and allure, may be

hard to tolerate. This zeal can cause an inability to tolerate plateaus or regressions in the

patient’s condition with a consequent generation of anxiety and anger in the physician.

He may react unconsciously with retaliatory punishment of the wayward or

disappointing child. Electroconvulsive treatment could then become the convenient

instrument to vent one’s wrath.

GEORGE J. WAYNE (U.S. electroshock psychiatrist), “Some Unconscious

Determinants in Physicians Motivating the Use of Particular Treatment Methods —

With Special Reference to Electroconvulsive Treatment,” Psychoanalytic Review (“The

oldest continuously published psychoanalytic journal in the world”), January 1955.

1956 — One of us (J. A. E.) has collected these statements over a period of eight years in

Britain and the United States. Most of them have been heard on many occasions.

Colleagues who have seen the list of comments have confirmed our findings that many

affect-laden colloquialisms are regularly used by shock therapists in referring to their

therapy....

1. “Let’s give him the works.”

2. “Hit him with all we’ve got.”

3. “Why don’t you throw the book at him?”

4. “Knock him out with EST.”

5. “Let’s see if a few shocks will knock him out of it.”

6. “Why don’t you put him on the assembly line?”

7. “If he would not get better with one course, give him a double-sized course now.”

8. “The patient was noisy and resistive so I put him on intensive EST three times a

day.”

9. One shock therapist told the husband of a woman who was about to be shocked

that it would prove beneficial to her by virtue of its effect as “a mental spanking.”

10. “I’m going to gas him.”

11. “Why don’t you give him the gas?”

12. “I spend my entire mornings looking after the insulin therapy patients.”

13. “I take my insulin therapy patients to the doors of death, and when they are

knocking on the doors, I snatch them back.”

14. “She’s too nice a patient for us to give her EST.”

DAVID WILFRED ABSE and JOHN A. EWING (British-born U.S. psychiatrists),

“Transference and Countertransference in Somatic Therapies,” Journal of Nervous and

Mental Disease, January 1956.

1956 — The [ECT] case fatality rate is apt to increase as a higher proportion of poor-risk

patients are treated. Failure to accept and make known this risk in treatment has

unfortunately given rise to the impression that the treatment is practically devoid of

such hazard; this in turn has led willy-nilly to the erroneous assumption that death

associated with the treatment must in some manner be the fault of the psychiatrist

giving the treatment or the institution involved or both. It is our plea that deaths in

electroconvulsive and related forms of treatment be reported. It is only in this way that

the actual case fatality rate can be established. This is, among other things, an important

factor in the assessment of the relative merits of the several modifications of

electroconvulsive therapy. In contrast to the American practice in which deaths

associated with electrotherapy are reported only sporadically, if at all, the rule in

England and Wales is that all unusual or unexpected deaths, including those in

electrotherapy and other somatic treatments (such as leukotomy, insulin, and

continuous narcosis) that occur in psychiatric hospitals, come within the purview of the

board of control of the Ministry of Health. This procedure, according to the Hon. S. W.

Maclay, medical commissioner of the board of control, gives “an overall picture difficult

to achieve in any other way.”

SAUNDERS P. ALEXANDER (Polish-born U.S. electroshock psychiatrist) and

LAWRENCE H. GAHAGAN (U.S. electroshock psychiatrist), “Deaths Following

Electrotherapy,” Journal of the American Medical Association, 16 June 1956.

1956 — Attention must be called to the habit formed by certain psychiatrists [during the

Algerian War] of flying to the aid of the police. There are, for instance, psychiatrists in

Algiers, known to numerous prisoners, who have given electric shock treatments to the

accused and have questioned them during the waking phase, which is characterized by a

certain confusion, a relaxation of resistance, a disappearance of the person’s defenses.

When by chance these are liberated because the doctor, despite this barbarous

treatment, was able to obtain no information, what is brought to us is a personality in

shreds.

FRANTZ FANON (French West Indian psychiatrist), A Dying Colonialism, ch. 4,

1959, tr. Haskin Chevalier, 1965. Fanon, an anti-colonialist, headed the psychiatric

department of a hospital near Algiers for several years during the Algerian War before

resigning his post and fleeing the country in 1956.

1956 — Sir: Being in contact with many psychiatrists who give electric convulsive

therapy, I am greatly alarmed by personal communications on fatalities which remain

unpublished because of understandable fear of lawsuits....

Much more serious [than the risk of death from the use of muscle relaxants in

combination with intravenous barbiturates] is the sharp rise of fatalities in patients who

are under chlorpromazine [Thorazine] and reserpine [Serpasil] medication while given

ECT. I received detailed reports on several such fatalities. One case each of death from

ECT during chrlorpromazine and reserpine medication. A man, age 55, suffering from a

depression, had a blood pressure of 145/90 and a normal EKG. He took a first tablet of

50 mg. of Thorazine the evening before the first ECT and a second tablet of 50 mg. of

Thorazine the morning of the treatment. After the convulsion he resumed normal

respiration but expired a minute later. No autopsy.

LOTHAR B. KALINOWSKY (German-born U.S. electroshock psychiatrist), letter to

American Journal of Psychiatry, March 1956.

1956 — In the amnesia caused by all electric shocks, the level of the whole intellect is

lowered....

The stronger the amnesia, the more severe the underlying brain cell damage must be.

To complete the clinical picture, it should be mentioned that the “slap-happiness” or

“punch-drunkenness” combined with [emotional] flatness, witnessed after too many

“therapeutic” electroshocks remind one of the clinical pictures in cases of frontal lobe

tumors, in the small group of paretics, or again in lobotomics [lobotomized persons]....

The aggravation set up by [ECT-caused “side effects, such as amnesia, temporary

befuddlement or euphoria”] may result in a secondary reactive depression, which in

some cases has led to suicide.

MANFRED SAKEL (Austrian-born U.S. psychiatrist who, in 1933, introduced insulin

coma treatment as a treatment for schizophrenia, 1900-1957), commenting on ECT (a

competing shock method), “Sakel Shock Treatment,” published in Arthur M. Sackler et

al., eds., The Great Physiological Therapies in Psychiatry: An Historical Perspective,

1956.

See Sidney Sament’s entry in 1983 and Peter Sterling’s in 2001 below.

1948-1956 — [After experiencing ECT, patients] “tremble,” “sweat profusely,” and make

“impassioned verbal pleas for help,” reported Harvard University’s Thelma Alper

[1948]. Electroshock, patients told their doctors, was “like having a bomb fall on you,”

“being in a fire and getting all burned up,” and “getting a crack in the puss” [1953].

Researchers reported that the mentally ill regularly viewed the treatment as a

“punishment” and the doctors who administered it as “cruel and heartless” [1956].

ROBERT WHITAKER (U.S. writer), Mad in America: Bad Science, Bad Medicine,

and the Enduring Mistreatment of the Mentally Ill, ch. 4, 2002.

1957 — We reported to the 2nd World Congress of Psychiatry in 1957 on the use of

depatterning in the treatment of paranoid schizophrenic patients. By “depatterning” is

meant the extensive breakup of the existing patterns of behavior, both normal and

pathologic, by means of intensive electroshock therapy usually carried out in association

with prolonged sleep. We have recently extended this method of treatment to other

types of schizophrenia, to intractable alcoholic addiction and to some cases of chronic

psychoneurosis impervious to psychotherapy....

[During the third stage of depatterning the patient’s] remarks are entirely

uninfluenced by previous recollections — nor are they governed in any way by his

forward anticipations. He lives in the immediate present. All schizophrenic symptoms

have disappeared. There is complete amnesia for all events of his life.

D. EWEN CAMERON (Scottish-born Canadian electroshock psychiatrist and onetime

president of the American Psychiatric Association, the Canadian Psychiatric Association,

the World Psychiatric Association, the Quebec Psychiatric Association, the American

Psychopathological Association, and the Society of Biological Psychiatry), describing

“depatterning treatment” which he developed during the 1950s at the Allan Memorial

Institute (now closed) of McGill University in Montreal, “Production of Differential

Amnesia as a Factor in the Treatment of Schizophrenia,” Comprehensive Psychiatry,

February 1960. Cameron “found [his treatment for schizophrenia] to be more successful

than any hitherto reported.” Along with the antipsychotic drug Thorazine

(chlorpromazine) and prolonged sleep lasting 30 to 60 days, Cameron used the Page-

Russell method of ECT administration in twice-daily sessions. Each session consisted of

six 150-volt, closely-spaced electroshocks of one-second each. The third stage of

depatterning occurred after 30-40 such sessions, between 180 and 240 electroshocks in

all. This stage was followed by a “period of reorganization,” during which Cameron

applied his “psychic driving” technique. According to writer JOHN MARKS (The

Search for the “Manchurian Candidate”: The CIA and Mind Control, ch. 8, 1980),

psychic driving entailed bombarding subjects with tape-recorded, emotionally loaded

messages repeated 16 hours a day through speakers installed under the subjects’ pillows

in “sleep rooms.” Several weeks of negative messages, intended to wipe out unwanted

behavior, were followed by two to five weeks of positive messages, to induce the desired

behavior. Cameron established the effect of the negative tapes by “running wires to [the

subjects’] legs and shocking them at the end of the message.” Marks concluded, “By

literally wiping the minds of his subjects clean by depatterning and then trying to

program in new behavior, Cameron carried the process known as ‘brainwashing’ to its

logical extreme.” In 1978, previously secret documents revealed that the CIA partially

funded Cameron’s brainwashing experiments as part of its MK-ULTRA (Mind Control)

Project. The Canadian government was the chief funder of these experiments. Cameron

was esteemed by colleagues and neighbors alike according to this tribute to him in 1967:

“He had a deep love of wife and family, a pervasive humor, an innate sense of fairness,

plus a deep resentment of political maneuvering. Listen to what his neighbors said of

him in an editorial after his death:... ‘His world-wide success in his profession was, of

course, due principally to his great knowledge and brilliance. But surely a great factor

also was the softness — one is tempted to say loveliness — of his personality. Those who

were privileged to know him, even briefly, will not soon forget the warmth and the

kindliness of this understanding man’” (FRANCIS J. BRACELAND [U.S. psychiatrist

and onetime president of the American Psychiatric Association], “In Memoriam: D.

Ewen Cameron, 1901-1967,” American Journal of Psychiatry, December 1967).

See Gordon Thomas’s entry in 1946 and United Press International’s in 1951 above; and Cameron’s and

Linda Macdonald’s entries in 1963 and Michael Perry’s entry in 1963-1979 below.

1957 — This report is based on the study of 214 electroshock fatalities reported in the

literature and 40 fatalities heretofore unpublished, made available through the kindness

of the members of the Eastern Psychiatric Research Association.

The death rate in electroshock therapy has been estimated to be approximately one in

one thousand patients [of all ages] treated.... The death rate is approximately one in 200

patients, or 0.5 percent, in patients over 60 years of age....

[Of the 254 electroshock fatalities under review in this study], one hundred patients

died from cardiovascular causes; 66 patients from cerebral, 43 patients from

respiratory; and 26 patients from other causes. In 19 patients the cause of death was not

stated.

DAVID J. IMPASTATO (Italian-born U.S. electroshock psychiatrist), “Prevention of

Fatalities in Electroshock Therapy,” Diseases of the Nervous System, July 1957.

Impastato’s 42-page article is the most comprehensive and detailed study of ECT deaths

published in the professional literature. Contemporary electroshock psychiatrists and

their supporters rarely, if ever, cite this article in their writings. Three-hundred and

eighty-four deaths, including the 254 deaths reported in the Impastato study, were

documented in Leonard Roy Frank’s History of Shock Treatment. The death reports

were drawn from 109 English-language sources published between 1943 and 1977. The

fully-cited sources are listed chronologically, with each entry specifying the number of

deaths reported and, in some instances, other details (“ECT Death Chronology,” 1978).

See Dennis Cauchon’s first entry (referring to the estimate of 1 death in 200 ECT patients over 60 years of

age) in 1995 below. See also (referring to the 66 ECT deaths from “cerebral” causes) American Psychiatric

Association’s first entry in 1990 and Peter Sterling’s entry in 2001 below.

1957 — The Eastern Psychiatric Research Association has recently debated the question

whether the patient should be apprised of the [electroshock] treatment he is about to

receive. Opinions were about equally divided. I feel that the patient should not be

informed. Knowledge that he is going to receive the treatment could not possibly do the

patient any good; on the contrary, it may do him irreparable harm. Most patients

associate EST with severe insanity and if it is suggested, they will refuse it claiming that

they are not insane and do not need the treatment. If these patients are left without

treatment 10 percent (depressions) will commit suicide. Other patients may be fearful of

the treatments due to information gathered in reading about it or from friends. These

also will refuse to have the treatment. Still others will refuse it because they associate

the treatment with ordinary shock or electric current and fear that they might be

electrocuted. If these patients are forced to undertake the treatment, they may develop

such fear anxiety as to lead to possible suicide. Upon consideration of the fact that it is

the knowledge rather than the ignorance that he is going to receive EST that my lead to

suicide, I recommended that patients be kept in ignorance of the planned treatment. Of

course, the closest relative should know and sign consent for the treatment.

DAVID J. IMPASTATO, “Prevention of Fatalities in Electroshock Therapy,” Diseases

of the Nervous System, July 1957.

1957 — While some therapists exceed the limits of ordinary prudence by overmedication

with potent pharmacologic agents, a few seem to have an attraction for the shock

machine itself with the result that the patient is exposed to what may be called an

iatrogenic [doctor-caused] status epilepticus. An example: “After intravenous injection

of 2.cc. of curare, the machine was set at 70 volts for .4 sec. and a stimulus

administered. Immediately after the initial convulsion, the stimulus was repeated. This

was done four times.” The patient, a 54 yr. old male, died after the fifth procedure....

Use of relaxant drugs unquestionably increases the risk of a fatal accident. In

weighing the relative merits of shock therapy with or without relaxants, the therapist

might well ask himself the question: How many vertebral compressions would he be

willing to trade for one fatality traceable to a relaxant drug? On the subject of risks

associated with cardio-vascular disease, it appears that if a patient can tolerate ECT

combined with a barbiturate-relaxant cocktail, he can take it straight as well. A certain

irreducible minimum of cardiac deaths will occur under any circumstances because the

existing clinical and laboratory methods cannot predict accurately an impending

coronary accident.

J. M. RADZINSKY (U.S. electroshock psychiatrist), “Electroshock Therapy without

Muscle Relaxants,” Diseases of the Nervous System, November 1957.

1958 — N. P. Lancaster and associates introduced unilateral ECT in the belief that it was

safer and caused fewer memory problems than bilateral ECT, the standard method of

administration. In bilateral ECT, the electrodes are placed on the patient’s temples so

that the current passes through the brain’s frontal lobe area. In unilateral ECT one

electrode is placed on a temple and the other just above the back of the neck on the same

side of the head so that the current passes through only one, usually the nondominant,

hemisphere of the brain. The advantages and disadvantages of both methods are still

being disputed. Those psychiatrists favoring bilateral ECT seem to have won out,

although some ECT psychiatrists use both methods. An estimated 70 to 80 percent of

ECT today is administered bilaterally. ARTHUR N. GABRIEL, a proponent of

bilateral ECT, wrote, “We have found that unilateral placement requires more

treatments in the long run because we find it clinically less effective. We choose to spare

the patient the additional anesthetic risk of more frequent treatments (“ECT as the

Treatment of Choice,” World Medical News Review, November 1974). Another ECT

specialist, HERVEY MILTON CLECKLEY, said, “My thought about unilateral

stimulation is that it fails to cure. I think this failure to cure is in direct proportion to the

avoidance of memory loss” (quoted in Corbett H. Thigpen, letter to Convulsive Therapy

Bulletin, October 1976).

1958 — Psychoanalysis is not alone in making use of regression in order to favor a new

development. It was recommended by Jesus to Nicodemus, who was astounded by the

recommendation that he be born again and really grow up. The same idea appears in

other (especially Oriental) religions. In a technical sense hypnosis and the insulin

therapy routine depend upon this device. (Footnote: Patients awakening from

electroshock therapy frequently describe themselves as having been reborn.) Indeed, it

occurs to some degree in all hospitalization, whether for psychiatric illnesses or for

medical and surgical illnesses, and in anesthesia, shock therapies, insulin treatment, etc.

(Footnote: The recent reports by scientific observers of various indoctrination programs

by communist governments suggest that [this] important psychological principle has

been employed in the induction of cognitive changes that vary in extent and duration.)

KARL A. MENNINGER (U.S. psychiatrist and “dean of American psychiatry,” 1893-

1990), Theory of Psychoanalytic Technique, ch. 3, 1958. Psychiatrist FRANCIS J.

RIGNEY JR. (of San Francisco) told the editor in 1975 that while he was training at the

Menninger Clinic during the early 1950s the insulin ward was closed because insulin

patients were “dying off like flies.” No explanation for the ward’s closing appeared in the

Bulletin of the Menninger Clinic, a respected and widely read psychiatric journal.

1958 — At work one day in August, [Deputy Director for Plans Frank Wisner, the

Central Intelligence Agency’s third highest ranking official] broke down completely. An

ambulance was called, and Wisner was subdued by hospital attendants and carried out

of L Building by force, while DDP officials watched in shocked silence. Even then Wisner

insisted there was nothing wrong with him — he did not need medical attention, a little

rest would do the trick — but finally Desmond FitzGerald [his friend and a top DDP

official] persuaded him that this was more than ordinary overwork, and Wisner

consented to treatment in Shepherd Pratt hospital near Baltimore. The late 1950s were

the great age of electroshock therapy, and Wisner’s six months at Shepherd Pratt were

an ordeal. He never talked about it to his old CIA colleagues except once, when he said

to FitzGerald: “Des, if knew what you’d done to me, you could never live with yourself.”

THOMAS POWERS (U.S. writer), The Man Who Kept the Secrets: Richard Helms

and the CIA, ch. 5, 1981. After being released from Shepherd Pratt in 1958, Wisner

returned to the CIA, and a less important assignment, as chief of station in London,

finally leaving the Agency in 1961. He committed suicide in 1965 at the age of 55.

1959 — This is the Psycho, the

home of the buzz and the prod,

Where the electric shock patients

speak only to the insulins

The insulins only to God.

ANONYMOUS (U.S. psychiatric patient), complete untitled poem, reprinted from a

mental hospital newspaper in Max Rinkel and Harold E. Himwich, eds., Insulin

Treatment in Psychiatry, ch. 10 (discussion), 1959.

1959 — To an attack like that in the electric convulsive treatment, the brain reacts with a

defensive mechanism by producing some substance which I call acroagonine. (Acros in

Greek means extreme; agon: struggle.) This acroagonine denotes a substance of extreme

defense in struggle.

How did I prove the existence of this substance? I obtained a suspension of pigs’

brains which had been submitted to electric convulsive treatment and I injected 1 cc. of

a suspension of this substance in mental patients in a series of 10 to 15. I observed that

these patients first regained their normal sleep patterns, lost their anxiety and their

feeling of guilt, and gradually, after 10 to 20 days, recovered. This treatment was called

electric shock by proxy. Experiments on 300 patients have given positive results while

the control patients injected with a suspension of cerebral substances of non-treated

pigs did not show any improvement.

UGO CERLETTI (Italian electroshock psychiatrist), “An Address,” Journal of

Neuropsychiatry, September-October 1959.

See Leonard Frank’s entry in 1938 above; and Ferruccio di Cori’s in 1963 below.

1959 — Once again I was on the human assembly line: electric shock clubbed my good

brain into needless unconsciousness (and I walked to my several executions like a brave

little chappie instead of questioning them) and unquestioned Old Testament authority

ruled our little club.

SEYMOUR KRIM (U.S. electroshock survivor and writer), “The Insanity Bit” (sect. 1),

1959, Views of a Nearsighted Cannoneer, 1968.

1959 — John C. Krantz Jr. introduced Indoklon, a convulsogenic drug, administered by

inhalation or injection, to treat mental illness. Two years later, researchers (including

Krantz) conducted a comparative study involving 90 patients treated with Indoklon and

another 90 treated with ECT. They found that “the complications observed in both

groups... seem to be about the same, except for the fact that there were three deaths in

the ECT group” [editor’s summary].

ALBERT A. KURLAND, T. E. HANLON (U.S. electroshock psychiatrists) et al., “A

Comparative Study of Hexafluorodiethyl Ether (Indoklon) and Electroconvulsive

Therapy,” Journal of Nervous and Mental Disease, July 1959.

1959 — I would like to add to the testimony about the harm of electric shock. I got part

of my medical records, so I know for a fact that I received about 18 shock treatments. I

believe that I [may have] received about twice that many in 1959.

I can’t really testify too much to the terrors, the horrors, of shock treatment, that

some of the people have mentioned here today, because frankly I can’t remember them.

But it’s only been 23 years, and so I am still holding out with the faith that my memory

will indeed return, as the psychiatrists assured my family it would. The psychiatrists at

that time also assured my family, who were reluctant to let me have shock treatment,

that the things they had heard about shock treatment, they could just forget, because

shock treatment was now a much more thoroughly understood procedure. It was now

much different from the things that they might have read or heard about. It was the

new, improved shock treatment....

I have almost a total memory loss about my entire childhood. I was 16 years of age

when I received shock treatment. I have very little memory of the two or three years

following the shock treatment.

GREG REISNER (U.S. electroshock survivor), testimony at a hearing on electroshock

conducted by the Berkeley Human Relations and Welfare Commission, 24 April 1982,

published in “Electroshock Hearings in Berkeley,” Madness Network News, Spring

1983.

1940s-1950s — During the 1940s and 1950s, electroshock was frequently given in the

office of the psychiatrist without the benefit of anesthesia, muscle relaxants, or

emergency equipment. In certain cases, the psychiatrist would make a “house call” with

his ECT machine, accompanied by a nurse or an assistant, and the treatment would be

administered in the patient’s own bed.

ZIGMOND M. LEBENSOHN (U.S. electroshock psychiatrist), “The History of

Electroconvulsive Therapy in the United States and Its Place in American Psychiatry: A

Personal Memoir,” Comprehensive Psychiatry, May-June 1999.

1950s — Dr. Willard Pennell, who has used ECT since the 1950s, recalled when entire

wards full of patients in state hospitals would be given shock treatment on the same

morning.

“They didn’t have the Anectine then,” he said, “and they didn’t use an anesthetic.

Patients could look up the row of beds and see other patients going into epileptic

seizures, one by one, as the psychiatrists moved down the row. They knew their turn was

coming, and it was no doubt terrifying.”

CHARLES PETIT (U.S. journalist), “Shudders over Shock Treatments,” San Francisco

Chronicle, 30 December 1974.

1960 — I can still feel the cold, sticky linoleum beneath my bare feet as I shuffled my

way to the bathroom on those freezing early mornings during the winter of 1960. The

sensations and memories are as much a part of me now as they were then, perhaps even

more vivid now, as I realize the shocking brutality of my treatment as an adolescent girl

locked into a mental institution because of my overwhelming feelings of depression.

We were lined up side by side in our beds on those mornings, four girls, huddled

beneath our cold, white sheets, petrified and silent. I can see the nurse in her starched

white uniform. I can smell the alcohol she rubbed on my bottom, and I can feel the sting

of the sharp needle as she injected the insulin into me: insulin coma therapy, five days a

week for six weeks.

After we were groggy from the insulin, but often not yet in a coma, the second

treatment would begin. I can still see him walking through the door to our bare hospitalgreen

room, his face, gray-white in color, and his black suit and black shoes. He carried

all his equipment in a small black suitcase in one hand, this man of death and

destruction. He set up his machine behind our heads, one by one. Curled up beneath our

sheets, heads covered, as though seeking womb-like protection, we were, as they peeled

the sheets off us, one by one, forcing us onto our backs, bare and open and vulnerable. I

was second in the line-up.

Before being turned, I would often peek out from a small, secret opening in my sheet

to see what they were doing to Susan, the first to receive the treatment. I would make

myself watch as if it might prepare me in some way. And when she would shake violently

all over, my eyes would close. I could no longer watch. I would shiver beneath my sheet

in fear. And then they would come to me. I can still feel the sticky, cold jelly they put on

my temples. My arms and legs were held down. Each time, I expected I would die. I did

not feel the current running through me. I did wake up with a violent headache and

nausea every time. My mind was blurred. And I permanently lost eight months of my

memory for events preceding the shock treatments. I also lost my self-esteem. I had

been beaten down.

But I was lucky. I was very, very lucky. On one of those cold, winter mornings exactly

thirty years ago, they injected my friend, Susan, in the bed next to me, with more insulin

than her frail young body could tolerate. A few hours later, as the four of us were having

our mandatory afternoon nap, still huddled beneath our sheets, my friend Susan went to

sleep and never woke up. She had just turned seventeen. When she died, she became a

part of me.

On the winter afternoons after Susan died, I can remember my “mental health care”

continued by my being taken into that same shock room, where we also slept at night, by

a mental health worker. He would lock the door, push me up against the wall, and

sexually abuse me. My head foggy from the insulin, dazed from the drugs, I was

petrified. I did not scream. I did not dare. I survived. And I did not tell anyone for a

long, long time.

DOROTHY WASHBURN DUNDAS (U.S. electroshock survivor and writer), opening

paragraphs, “The Shocking Truth” (For Susan Kelly), published in Jeanine Grobe, ed.,

Beyond Bedlam: Contemporary Women Psychiatric Survivors Speak Out, 1995.

Dundas was institutionalized for three years during which time she was subjected to 40

insulin comas and 10 electroshocks at Baldpate Hospital in Georgetown, Massachusetts.

1960 — By the roots of my hair some god got hold of me.

I sizzled in his blue volts like a desert prophet.

SYLVIA PLATH (U.S. electroshock survivor, writer, and poet), “The Hanging Man,”

1960, Sylvia Path: Collected Poems, ed. Ted Hughes, 1981.

See Plath’s entries in 1953 above and 1963 below.

1960 — In the present study, 33 women in the group reviewed were treated with

electroshock therapy during gestation. Clinical states of severe agitation and/or

catatonic withdrawal were considered indications for such treatment, as it was felt that

potential hazards of malnutrition, dehydration, and violent injury existed for both

mother and fetus. Thus, electroshock therapy was given as an emergency form of

treatment. There were 2 infant deaths in the 33 cases treated.... [There was serious fetal

damage in two other cases.]

DAVID E. SOBEL (U.S. electroshock psychiatrist), “Fetal Damage Due to ECT, Insulin

Coma, Chlorpromazine, or Reserpine,” Archives of General Psychiatry, June 1960.

Compare: “Pregnancy is definitely no contraindication [for ECT] which is again in

accordance with the known fact that pregnant epileptic women are not threatened by

abortion or premature birth. Even in patients treated at termination of pregnancy

convulsions do not produce labor pain or rupture of the membrane. Followups also did

not show any damage to the child” (LOTHAR B. KALINOWSKY [German-born U.S.

electroshock psychiatrist], “Electric and Other Convulsive Treatments,” published in

Silvano Arieti, ed., American Handbook of Psychiatry, vol. 5, ch. 27, 1975).

1961 — In some mental hospitals, it has been said, one way of dealing with female

patients who became pregnant on the hospital grounds was to perform hysterectomies.

Less common, perhaps, was the way of dealing with those patients, sometimes called

“biters,” who continued to bite persons around them: total extraction of teeth. The first

of these medical acts was sometimes called “treatment for sexual promiscuity”; the

second, “treatment for biting.” Another example is the fashion, now sharply declining in

American hospitals, of using lobotomy for a hospital’s most incorrigible and

troublesome patients. The use of electroshock, on the attendant’s recommendation, as a

means of threatening inmates into discipline and quieting those that won’t be

threatened, provides a somewhat milder but more widespread example of the same

process. In all of these cases, the medical action is presented to the patient and his

relatives as an individual service, but what is being serviced here is the institution.

ERVING GOFFMAN (U.S. sociologist), “The Medical Model and Mental

Hospitalization,” Asylums: Essays on the Social Situation of Mental Patients and Other

Inmates, 1961.

1961 — I think one should go to the extreme of always explaining to a patient if he is

going to get electroshock why he is going to get it and what it is going to be like and so

forth and so on. But as far as getting permission from the patient is concerned, this is

not necessary.

MANFRED GUTTMACHER (U.S. electroshock psychiatrist), testimony at hearings

on the “Constitutional Rights of the Mentally Ill” before the Subcommittee on

Constitutional Rights of the Committee on the Judiciary, United States Senate, 29

March 1961.

1961 — What these shock doctors don’t know is about writers and such things as

remorse and contrition and what they do to them. They should make all psychiatrists

take a course in creative writing so they’d know about writers....

Well, what is the sense of ruining my head and erasing my memory, which is my

capital, and putting me out of business? It was a brilliant cure but we lost the patient.

It’s a bum turn, Hotch, terrible.

ERNEST HEMINGWAY (U.S. electroshock patient and writer), remarks to the

author who was visiting him at the Mayo Clinic in Rochester, Minnesota where

Hemingway was being electroshocked in 1961, quoted in A. E. Hotchner, Papa

Hemingway, ch. 14, 1967. During one of his stays at the Mayo Clinic, Hemingway had

posted on the door of his room a notice, the first sentence of which read, “FORMER

WRITER ENGAGED IN PREPARATION OF SCHEDULED FULL-SCALE NEWS

CONFERENCE” (quoted in Frederick Busch, “Fear Was His Beat,” New York Times

Book Review, 25 July 1999). A few days after being released from the Mayo Clinic

following a second electroshock series, Hemingway killed himself with a shotgun blast

to the head at the age of 61. Several years later, Howard P. Rome, his Mayo Clinic

psychiatrist, was elected president of the American Psychiatric Association.

1961 — There were 3 deaths among 267 patients who underwent intensive electroshock

between 1946 and 1960 [editor’s summary].

JAMES L. SAGEBIEL (U.S. electroshock psychiatrist), “Regressive Convulsive

Therapy and Lobotomy in the Treatment of Mental Disorders,” Diseases of the Nervous

System, April 1961.

1961 — On becoming king [of Morocco] in 1961, Hassan [II] had asked the [Central

Intelligence] Agency to restructure and train his own security service. It had become one

of the harshest in the Arab world, a rival in sheer cruelty to the shah’s SAVAK. The

Moroccan security service was fully staffed with doctors who supervised a wide range of

tortures of political detainees at a purpose-built detention center near Tazmarent. It

included isolation chambers.... The center also had several Page-Russell electroshock

machines, which were routinely used on prisoners. During the post-shock periods,

Moroccan physicians questioned the detainees, seeking information about opponents to

the king.

GORDON THOMAS (British writer), Journey into Madness: The True Story of Secret

CIA Mind Control and Medical Abuse, ch. 19, 1989.

1957-1961 — Husbands might wish to have their wives forget the emotional troubles,

including marital strife, which precipitated hospitalization. Mr. Karr [a pseudonym]

commented on his wife’s long-term memory loss as proof of her successful cure by ECT,

saying that her memory was still gone, especially for the period when she felt ill, and

that “they did a good job there.” These husbands used their wives’ memory loss to

establish their own definitions of past situations in the marital relationship....

Mr. Karr... expressed pleasure to the research interviewer that electroshock therapy

had made his wife forget her hostile outbursts against him in the pre-hospital period.

CAROL A. B. WARREN (U.S. sociologist), “Electroconvulsive Therapy, the Self, and

Family Relations,” Research in the Sociology of Health Care, vol. 7, 1988. Warren’s

study was based on interviews with 10 women (and their husbands) who had been

institutionalized a total of 17 times at Napa State Hospital (California) between 1957 and

1961. In the “Discussion” section of the same article, Warren commented: “Treatments

such as ECT intervene between the prehospital and posthospital reality-negotiations of

marital partners. In the wake of hospital treatment, the couple ‘constructs not only

present reality but reconstructs past reality as well, fabricating a common memory that

integrates the recollections of the two individuals’ [Peter Berger and Hansfried Kellner].

When the recollections of one partner are to some degree erased, the dynamic

reconstruction of reality shifts a little, or a lot” [editor’s emphasis].

1957-1961 — Rita Vick [a pseudonym] had forgotten, after ECT, the five of her seven

children who had been removed from her custody. One day she found an album in the

Vick house and asked her husband “who were all those children?” For fear of upsetting

her with renewed thoughts of the custody loss, Mr. Vick told her that they were a

neighbor’s children.

CAROL A. B. WARREN, “Electroconvulsive Therapy, the Self, and Family Relations,”

Research in the Sociology of Health Care, vol. 7, 1988.

1962 — There are some of us Chronics that the staff made a couple of mistakes on years

back, some of us who were Acutes when we came in, and got changed over. Ellis is a

Chronic came in as an Acute and got fouled up bad when they overloaded him in that

filthy brain-murdering room that the black boys call the “Shock Shop.” Now he’s nailed

against the wall in the same condition they lifted him off the table for the last time in the

same shape, arms out, palms cupped, with the same horror on his face. He’s nailed like

that on the wall, like a stuffed trophy. They pull the nails when it’s time to eat or time to

drive him in to bed or when they want him to move so’s I can mop the puddle where he

stands.

KEN KESEY (U.S. writer), One Flew over the Cuckoo’s Nest (a novel), ch. 1, 1962.

See first entry in 1975 below.

1962 — “The Shock Shop, Mr. McMurphy, is jargon for the EST machine, the Electro

Shock Therapy. A device that might be said to do the work of the sleeping pill, the

electric chair, and the torture rack. It’s a clever little procedure, simple, quick, nearly

painless it happens so fast, but no one ever wants another one. Ever.”

“What’s this thing do?”

“You are strapped to a table, shaped, ironically, like a cross, with a crown of electric

sparks in place of the thorns. You are touched on each side of the head with wires. Zap!

Five cents’ worth of electricity through the brain and you are jointly administered

therapy and a punishment for your hostile go-to-hell behavior, on top of being put out of

everyone’s way for six hours to three days, depending on the individual.”

KEN KESEY, One Flew over the Cuckoo’s Nest, ch. 1, 1962.

1961-1962 — When I was young, I wanted to be a priest and I guess that was the dream

of my childhood, and I went into a seminary at the age of 16 and later went to novitiate.

And one day I woke up in a hospital. And on my medical records it said that I was a

catatonic schizophrenic and that therefore they gave me electroshock treatment. The

treatment itself was horrendous.

I remember two of them from my medical records which stated that I had 17 of them.

I remember being strapped down, totally powerless, electrodes being applied to my

head, injection of drugs, and a hum starting to appear inside my head, increasing in

volume till my whole head vibrated, and finally at the last moment it was like a crack,

like a gunshot, which blew me into nonexistence.

Coming to and not knowing who I was or where I was. An incredible fog. That was

horrendous, and I remember the last treatment that I had. I told the psychiatrist when I

was lying on the table, “I don’t want this treatment, I am afraid of it, it is horrendous, it

kills me, it’s very painful.”

And he said, “There is no pain. We give you a drug and there is no pain. Don’t be so

childish, don’t be a baby about it. Just relax and take the drug.” And that was such a

[pause] demeaning... [ellipsis in original]. I was even denied the ability to say that my

experience is that I feel pain in this treatment, that I am being a baby... [ellipsis in

original]. He is the expert. He has this credential. He went to school and studied this. He

has been certified by the state. But I am the person going through this, and I have no

credibility....

I came home a vegetable. My mother took me home. I was a little child without the

ability to do anything. I used to sit around in the front room and think about suicide.

Now that’s pretty drastic for someone who has grown up a Catholic to think about

suicide....

At some point I had to make the decision whether to kill myself or live and I made a

decision to live, even though that seemed like a great leap into some unknown, whatever

the world was, and it was a [pause] I took the leap. It is strange because, as a child, I had

all these kinds of mystical experiences or whatever, experiences with God, and that was

destroyed and that whole feeling of nature and that whole sense of being in tune with

the universe somehow or with some relationship not only to nature, but to community,

to people around me, it was destroyed.

It has taken years to regain that. And there are two years, and this is the thing that

infuriates me, there are two years of my life that are just nothing, that are just like pain,

jellied pain, that has no meaning.

STEVEN SEARS (U.S. electroshock survivor, human rights activist, and office

manager), testimony at a hearing on electroshock conducted by the Berkeley Human

Relations and Welfare Commission, 24 April 1982, published in “Electroshock Hearings

in Berkeley,” Madness Network News, Spring 1983. In addition to the ECT, Sears

underwent 19 subcoma insulin treatments at Merciville Sanitarium in Aurora, Illinois at

the age of 19 in 1961-1962.

1963 — Intelligence may be the pride — the towering distinction of man; emotion gives

color and force to his actions; but memory is the bastion of his being. Without memory,

there is no personal identity, there is no continuity to the days of his life. Memory

provides the raw material for designs both small and great. Thus, governed and

enriched by memory, all the enterprises of man go forward.

D. EWEN CAMERON (Scottish-born Canadian electroshock psychiatrist), “The

Process of Remembering,” British Journal of Psychiatry, May 1963.

See Cameron’s entry in 1957 above; and Linda Macdonald’s in 1963 below.

1963 — Thousands of papers, scientific and otherwise, poured in to support this form of

therapy [ECT] and assess its values. Countless lives, sufferings and tragedies had been

spared. However, the undaunted spirit of [Hugo] Cerletti did not rest. He “wanted to

know what was at the basis of electro-shock recovery.” He formulated a theory that the

humoral and hormonal changes provoked in the brain by the epileptic attack led to the

formation of substances which he called “acroagonines” — substances when injected

into the patient would have therapeutic effects similar to those resulting from electroshock.

Death found Cerletti still feverishly working to establish the validity of this brilliant

hypothesis....

Cerletti was essentially an individualistic and liberalistic personality. His views on

human rights led him, at the end of the Second World War, to clash with the Italian

authorities because of his antifascist leanings.

He spent most of his life in Rome and loved “his city.” Whoever had the rare

opportunity to assess his humanistic knowledge during his promenades throughout the

city had a memory to cherish and to carry in his heart. Cerletti had the supreme gift of

being a keen observer and a perceptive one. He knew the limitations of a human mind

but he had the thirst for knowledge of eternal youth. He was a friend to many, a teacher

to all, a born patrician.

To those who live in his sphere of influence, to those who have known and benefited

from his work, his end does not signify disappearance but continuation of his superb

leadership [closing paragraphs].

FERRUCCIO di CORI (Italian electroshock psychiatrist), “In Memoriam,” Journal of

Neuropsychiatry, October 1963.

See Leonard Frank’s entry in 1938 and Hugo Cerletti’s in 1959 above; and George Mora’s in 1963 below.

1963 — The name on my admission chart at the Allan Memorial reads “Linda Helen

Cowan (nee Macdonald).” It was March 28, 1963. A young wife and mother, I was to

become one of the last victims of Dr. Ewen Cameron’s experiments [“depatterning

treatment”] on the human brain. I am 49 years old today. I accept my age only because

my birth certificate validates the time, day, and the place of my birth. In reality, my

reality, I am 23. I have no memory of existing prior to October 1963, and the

recollections I do have of events of the following years until 1966 are fuzzy and few....

Dr. Cameron’s “brainwashing” experiments wiped my brain clean of every experience

I had ever known....

My parents were introduced to me that winter of 1963/64. Of course, I did not know

them. The children came back from wherever they had been living. I had no idea who

they were, and I certainly had no sense of what a “mother” was. They were all “older”

than I; the oldest could read and write — their mother could not....

A woman robbed of her life. I had decided to share my life with you. If sharing my

personal experience can help to educate the public so that such abusive experimentation

will not, for any reason, with or without consent, be performed on human beings ever

again, indeed something positive will have emerged from a living hell.

LINDA MACDONALD (Canadian electroshock survivor), “Breakthrough” (1986),

published in Bonnie Burstow and Don Weitz, eds., Shrink Resistant: The Struggle

Against Psychiatry in Canada, 1988.

See D. Ewen Cameron’s entries in 1957 and 1963 above.

1963 — In 1963 I had been discharged from Henderson General Hospital in Hamilton,

Ontario half way through a series of about 15 electroshocks. I had dutifully gone back

and had the rest of them as an outpatient. A month later I was back in the hospital again

— this time in what was then called the Ontario Hospital (Hamilton) and later renamed

Hamilton Psychiatric Hospital — because I wasn't any better. I was just as depressed as I

had been to start with. This time the experience of the hospital was the reverse.

Now I actually got to see this person who happened to be called a psychologist and I

talked. Eventually I dealt with my problem, got out of the hospital, and went home.

Up to that point, I really had not done a lot of thinking about ECT. I knew it hadn't

worked but assumed that it must be me, that I was an exception, that they would not

have this treatment unless it was a good treatment, and that I had been unlucky. I had

been one of those rare people for whom this supposedly wonderful treatment didn't

work.

Then over time I started noticing some very significant changes in myself. There were

three things that stood out. The first one was that I wasn't as smart as I had been. I

would still get to the same places, but it was a lot harder work. It took me longer. I had

to think harder to do things that I could have done before much more easily.

The second thing I noticed was that there were chunks from my life that were

missing. I kept waiting for them to come back and they didn't. There was just a sort of

random missingness. There wasn't a pattern to it. It's just that bits and pieces were

missing. These chunks were gone and they never came back.

There was also what you might call selective interference with my ability to remember

things. I discovered, for instance, that I couldn't memorize music anymore. I played the

piano. I would sit down and try to memorize a piece of music, which had never been

difficult for me. I couldn't do it. I would spend eight hours trying to memorize one page

of music. I still have exactly the same problem.

And the third thing that happened is that I was having these odd little sleeping spells

that resembled narcolepsy. I would just sort of fade out. A couple of minutes later, I

would fade back in again. That had never happened to me before. I started thinking that

all of these things might have something to do with the shock treatment but in a very

general sort of way. I didn’t really put it together. I wondered. I speculated. But I didn't

really start to put it together for fifteen years.

CARLA McKAGUE (Canadian electroshock survivor and attorney), Bonnie Burstow

interview, in 1994, presented as written testimony at public hearings on electroshock

(modified by McKague), Toronto, 9 April 2005,

http://capa.oise.utoronto.ca/personal.html

1963 — In 1959 and in 1961, at the invitation of the American Psychiatric Association,

[Ugo Cerletti, the discoverer of electroshock,] attended the annual conventions in

Philadelphia and in Chicago, respectively. Although more than eighty, those who met

him there noticed an alert expression and inquisitive mind. His interests embraced

many aspects of modern psychiatry as well as the progress achieved in this country.

Those who saw him must have also been impressed by his kind and unassuming

attitude. A true humanist, lover of art in all its expressions, and an excellent

draughtsman, Cerletti will remain prominent among those who contributed to the

greatest degree to the battle against mental illness.

GEORGE MORA (Italian-born U.S. psychiatrist), closing sentences, “In Memoriam:

Ugo Cerletti, M.D. (1877-1963),” American Journal of Psychiatry, December 1963.

See Leonard Frank’s entry in 1938 and Ferruccio di Cori’s in 1963 above.

1963 — At the head of the cot is a table on which sits a metal box covered with dials and

gauges. The box seems to be eyeing me copperhead-ugly, from its coil of electric wires,

the latest model in Johnny-Panic-Killers....

The white cot is ready. With a terrible gentleness Miss Milleravage takes the watch

from my wrist, the rings from my fingers, the hairpins from my hair. She begins to

undress me. When I am bare, I am anointed on the temples and robed in sheets virginal

as the first snow. Then, from the four corners of the room and from the door behind me

come five false priests in white surgical gowns and masks whose one life work is to

unseat Johnny Panic from his own throne. They extend me full-length on my back on

the cot. The crown of wire is placed on my head, the wafer of forgetfulness on my

tongue. The masked priests move to their posts and take hold: one of my left leg, one of

my right, one of my right arm, one of my left. One behind my head at the metal box

where I can’t see.

From their cramped niches along the wall, the votaries raise their voices in protest.

They begin the devotional chant:

The only thing to love is Fear itself.

Love of Fear is the beginning of wisdom.

The only thing to love is Fear itself.

May Fear and Fear and Fear be everywhere.

SYLVIA PLATH (U.S. electroshock survivor, writer, and poet), a thinly veiled account

of what electroshock was like for her, “Johnny Panic and the Bible of Dreams,” Atlantic,

September 1968. In her essay, Plath spoke of herself as “an unsordid collector of dreams

for themselves alone. A lover of dreams for Johnny Panic’s sake, the Maker of them all.”

She committed suicide at the age of 40 in 1963, two years before her acclaimed

collection of poems, Ariel, was published.

See Plath’s entries in 1953 and 1960 above.

1963 — How different the world might be today if only a handful of people had been sent

for psychiatric “treatments,” instead of being tried and sent to jail! Gandhi, Nehru,

Sukarno, Castro, Hitler — and of course many others, for example the “freedom riders”

in the South — have been sentenced to terms in prison. Surely, the social status quo

could have been better preserved by finding each of these men mentally ill and

subjecting them to enough electric shock treatments to quell their aspirations.

THOMAS S. SZASZ (Hungarian-born U.S. psychiatrist), Law, Liberty, and

Psychiatry: An Inquiry into the Social Uses of Mental Health Practices, ch. 13, 1963.

1964 — The average schizophrenic has no motivation for drug intake because he does

not consider himself sick. He also finds out pretty soon that the drugs slow him down or

give him other discomfort and that subjectively he feels better without medication. The

rising readmission rate in our hospitals is probably not due to diminishing effectiveness

of the drug, but to many patients’ failure to take the prescribed amount or to take them

at all. Therefore, maintenance ECT still has its indications as also, by the way,

psychosurgery has in some selected cases.

LOTHAR B. KALINOWSKY (German-born U.S. electroshock psychiatrist), “Electric

Convulsive Therapy after Ten Years of Pharmacotherapy,” American Journal of

Psychiatry, April 1964.

1964 — A person who does not have a memory is not able to perform as an actress. I’m

still able to do things — that is, I’m able to do them in a very limited way as a kind of

hobby. I have to work terribly hard to do it. Recently, I did a public theater appearance. I

had to drive around with the tape on saying the lines over and over and over and over.

Previously, I’d just do a couple of readings... and that would be enough. I don’t have this

quick ability anymore. I don’t like to appeal to emotionalism, but I’m furious about the

whole thing. I mean my life changed radically....

Since the shock treatment [in 1964] I’m missing between eight and fifteen years of

memory and skills, and this includes most of my education. I was a trained classical

pianist.... Well, the piano’s in my house, but I mean it’s mostly just a sentimental

symbol. It just sits there. I don’t have that kind of ability any longer....

I lost people by losing those eight to fifteen years. People come up to me and they

speak to me and they know me and they tell me about things that we’ve done. I don’t

know who they are. I don’t know what they’re talking about although obviously I have

been friendly with them....

[The shock treatment] diminished me.... I am certainly nothing like I was, and my life

is nothing like it would have been.

CONNIE NEIL (Canadian electroshock survivor), testimony at electroshock hearings

before the Toronto’s Board of Health, January 1984, quoted in Phoenix Rising

(Electroshock Supplement), April 1984.

1966 — Perhaps a plausible explanation for the efficacy of shock is that it produces a

slight brain damage and thus erases the most recent neurohistological changes in the

highest brain area, which stores as memories those experiences which precipitated the

psychosis. In other words, as the result of shock treatment the patient completely

forgets the events leading up to his symptoms and thus is put back into a predepression

psychological state. The best-substantiated acts of electroshock therapy are that amnesia

occurs during this period and that when the temporary memory defect based on the

patient’s reversible brain damage is restored, illness is apt to reoccur. The exceptions are

those lucky patients whose external-life situations fortuitously improve after the shock

therapy.

FRANZ G. ALEXANDER (Hungarian-born U.S. psychoanalyst) and SHELDON T.

SELESNICK (U.S. psychiatrist), The History of Psychiatry, ch. 18, 1966.

1966 — Let me describe the most horrible experience of my life. I was injected with a

muscle relaxant, while my mouth was plugged with a rubber tube to bite down on (so

that I wouldn’t bite my tongue), and an oxygen mask covered my face. Dr. Ames Fischer

fitted the pieces of metal to my temples, and then he said in a sterile voice, “Let him feel

it this time!” As the current went through my brain along with the rest of my body, I

wanted to scream, but because of the muscle relaxant, I was paralyzed — I couldn’t even

close my eyes. I remember the next time that I was to have a treatment. I begged and

begged, “Please don’t let me feel it this time!” I had fourteen of these treatments in the

period of four months that I was detained on the fourth floor Acute Treatment Ward in

Langley Porter [Neuropsychiatric Institute in San Francisco].

GARY BLACKBURN (U.S. electroshock survivor), “My Experience with Shock,”

Madness Network News, Spring 1977.

1966 — My parents, horrified [at the conditions at New York’s Bellevue Hospital], pulled

strings with money they didn’t have and had me transferred to Gracie Square Hospital, a

place where rich alcoholics dried out and rich psychotics were zapped at $50 a shock.

Terrified, having seen the price for disobedience (for I had defied the psychiatrists by

not resuming my role), I tried hard now to be “good.” The carpeted floors and pastel

walls showed me one of my choices; the vacant stares and shuffling gaits of the patients

returning each morning from the shock room showed the other. Again the lesson:

conformity or punishment!

JUDI CHAMBERLIN (U.S. psychiatric survivor, activist, and writer), published in

Dorothy E. Smith and Sara J. David, eds., Women Look at Psychiatry, 1975. Since 1971,

Chamberlin has been a leading force in the psychiatric survivors movement. Her On Our

Own: Patient-Controlled Alternatives to the Mental Health System (1978) is the most

highly regarded and influential book to have emerged from the survivors movement.

1966 — The [unmodified electroconvulsive] treatments were continued on a threetimes-

a-week schedule. Gradually there began to be evident improvement in the

behavior of the patients, the appearance of the ward, and the number of patients

volunteering for work. This latter was a result of the ECTs alleviating schizophrenic or

depressive thinking and affect with some. With others it was simply a result of their

dislike or fear of ECT. In either case our objective of motivating them to work was

achieved.

LLOYD H. COTTER (U.S. electroshock psychiatrist), describing his use of

electroshock on 120 male Vietnamese mental patients in a hospital near Bien Hoa in

1966, “Operant Conditioning in a Vietnamese Mental Hospital,” American Journal of

Psychiatry, July 1967. Later, as recounted in the same article, Cotter used a similar

approach with 130 female work-refusers at the same hospital. The electroshock was less

effective with them, he reported: after 20 ECTs only 15 women were working. He told

the remaining women, “If you don’t work, you don’t eat.” Twelve women immediately

agreed to work, and by the end of three days without food, all the rest “volunteered” for

work. Cotter concluded the report on his ECT-centered operant conditioning program

with these words: “It would appear to be most indicated for long-term patients who have

failed to respond to other treatment modalities. The use of effective reinforcements

should not be neglected due to a misguided idea of what constitutes kindness” [editor’s

summary]. Comment: “The significance of the Cotter article is not that one psychiatrist

so ingenuously reported on his use of violence — electroshock and starvation — to force

mental patients to work. That is revealing only about the individual. The significance

lies, rather, in what is revealed about professional standards by the fact that the

psychiatrist’s work resulted not in censure or sanctions, but in publication of his article

in the official journal of his professional association [the American Psychiatric

Association]” (EDWARD M. OPTON JR. [U.S. attorney and psychologist],

“Psychiatric Violence Against Prisoners: When Therapy Is Punishment,” Mississippi

Law Journal, vol. 3, 1974).

1964-1966 — A clear reference to the use of electric fish to produce shock and cure

psychiatric cases is found in a 16th century Jesuit missionary account of Ethiopia: “The

superstitious Abassines [Ethiopians] believe that it [the electric catfish] is good to expel

Devils out of the human body, and it did torment Spirits no less than men.” I find this

reference especially interesting since during my stay in Ethiopia in 1964-1966, electric

shock therapy was being widely promoted by a psychiatrist there as a new technique.

Modern psychiatry, he said in effect, was coming to Ethiopia to expel the Devil out of the

human body.

E. FULLER TORREY (U.S. psychiatrist), The Mind Game: Witchdoctors and

Psychiatrists, ch. 5, 1972. The quotation in the excerpt is from P. Kellaway, “The Part

Played by Electric Fish in the Early History of Bioelectricity and Electrotherapy,”

Bulletin of the History of Medicine, vol. 20, 1946

1967 — I was a victim of ECT when I was nineteen years old. I am now forty. The ECT

was given to me against my will.... Before the ECT I was a college student studying art

and a springboard diver in training for the Olympics. After the treatments I tried to

resume these things, but I could not remember people who knew me at school and lost

my nerve for diving. I feel the shock treatment was responsible.

My parents never would have consented to the treatment if they had been informed it

might hurt my memory and damage my brain.

SUZA GAUDINO (U.S. electroshock survivor), letter to the Food and Drug

Administration, 24 January 1988.

1967 — To explain ECT, I must first confront my shame. So I ask myself: What is the

most shaming image of yourself from the hospital? It is the image I can never see. It is

me on the shock table, writhing from the convulsion, drooling and twitching. That

paralyzed, twitching image: That’s me. There, I have just allowed you to envision my

greatest mortification.

LAUREL J. HODKIN (U.S. electroshock survivor), on her ECT experience in 1967,

Biological Psychiatry and the Invention of the Asylum in Modern America. Organic

Theories and Somatic Treatment: A History and Cast Study (unpublished dissertation,

Saybrook Graduate School and Research Center), 1999.

1968 — [Electroconvulsive] treatment is not painful or otherwise unpleasant.

LOTHAR B. KALINOWSKY (German-born U.S. electroshock psychiatrist), “Thirty

Years of Empiricism,” International Journal of Psychiatry, February 1968.

1968 — In 1968 I had 19 shock treatments. I found out later that they were probably

unnecessary and that I had severe thyroid and female hormone deficiencies. Needless to

say the electric shocks didn’t help my hormone deficiencies!

They did wreck my life however! I suffer severe memory loss which has never

returned. It covers 8 to 10 years!

I also have a very deep inability to learn and comprehend things and this has led to

problems with my own self understanding. It also has affected my relations with my own

family and other people too.

DOROTHY OIMETTE (U.S. electroshock survivor), letter to the Food and Drug

Administration, 29 January 1988.

1968 — When we are concerned with schizophrenic and paranoid psychoses,

[electroconvulsive] treatment must usually be given more intensively, in spite of which,

full freedom from symptoms is not attained. Instead, the symptoms become less marked

at the same time as a general lowering of the mental level occurs.

JAN-OTTO OTTOSSON (Swedish electroshock psychiatrist), “Psychological or

Physiological Theories of ECT,” International Journal of Psychiatry, February 1968.

1969 — A few patients may seem to feel worse after [an ECT] treatment and evidence

more agitation than before. It may simply mean that the depression was far more

intense than suspected. This is not uncommon, so do not lose heart if it happens. The

only answer here is to persist with treatment in accordance with the doctor’s

recommendation.

LEONARD CAMMER (U.S. electroshock psychiatrist), advice to relatives of ECT

patients, Up from Depression, ch. 13, 1969.

1969 — As ill luck would have it, the term “electroshock” became a disquieting

misnomer for an excellent and highly beneficial treatment method. More aptly, it should

have been called a “stimulation” procedure. However, the word “shock” attained general

usage through one of those quirks of language application....

I prefer electric-stimulation treatment, which says exactly what it is.

LEONARD CAMMER, Up from Depression, ch. 13, 1969. Comment: “Dr. Leonard

Cammer, one of electric shock treatment’s most outspoken advocates, has tried to allay

public fear concerning its use. He believes the word ‘shock’ scares a lot of people and

calls the procedure ‘electric-stimulation treatment.’ I don’t believe the word ‘shock’ in

this case scares people nearly enough, and propose that this technique be called ‘electric

shock torture’” (JOE KENNEDY ADAMS [U.S. psychologist], “You’re in for the Shock

of Your Life,” published in Sherry Hirsch et al., eds., Madness Network News Reader, p.

84, 1974).

1969 — In my department at the Vienna Polyclinic, we use drugs, and use electroconvulsive

treatment. I have signed authorization for lobotomies without having cause

to regret it. In a few cases, I have even carried out transorbital lobotomy. However, I

promise you that the human dignity of our patients is not violated in this way.... What

matters is not a technique or therapeutic approach as such, be it drug treatment or

shock treatment, but the spirit in which it is being carried out.

VIKTOR E. FRANKL (Austrian Holocaust survivor and electroshock psychiatrist who

introduced logotherapy, a method of psychotherapy), “‘Nothing But—’: On

Reductionism and Nihilism,” Encounter, November 1969.

1969 — In more modern and progressive mental hospitals the aides are not allowed to

beat up on the patients. It is necessary for the aide to report that the patient cannot

control his hostility so that the doctor can bang the patient in the head with a shock

machine.

JAY HALEY (U.S. psychotherapist), “The Art of Being Schizophrenic,” The Power

Tactics of Jesus Christ and Other Essays, 1969.

1969 — During this period I was undergoing outpatient psychotherapy with Dr. Richard

Bridburg, the Chief of Patient-Staff Services at the Institute of Living [where I had been

electroshocked in 1969]. Once, when I tried to tell him about the enormous problems I

was facing due to my lack of memory (I was going to ask his advice), he became

downright hostile and said that such a thing was impossible. He said that shock

treatments cause memory loss only right after they are administered. In no uncertain

terms, he pompously informed me that anything else I had forgotten was due to normal

forgetting. This is simply not true. In my own case, I lost years, not weeks, of time.

Besides, the difference between normal forgetting and the total erasure caused by

electroshock is like the difference between dunking your big toe in water and being

drowned. I have never met anyone else who has “forgotten” where she went to college.

But I realize that I was lucky. If I had been born ten years earlier, I might have had a

lobotomy.

I had frequent nightmares about wandering into a hospital and not being able to find

the exit door, about being burned by electrical wires, and paralyzed by injections of

mind-altering drugs. It took a long, long time for me to accustom myself to the “real”

world again. For many years I felt like there was a hole through the center of my

existence and no one knew of it but me.

JEANNE LINDSAY (U.S. electroshock survivor and school counselor), closing

paragraphs, “My Own Experience,” Madness Network News, Winter 1983-1984.

1942-1969 — Electric convulsive treatment was given to more than 500 children at

Bellevue from 1942 to 1956, and at Creedmoor State Hospital Children’s service from

1956 to 1969. In the 1940s insulin therapy was sometimes combined with electric

therapy.

LAURETTA BENDER (U.S. electroshock psychiatrist), “The Prescription of

Treatment for Children,” published in Silvano Arieti, ed., American Handbook of

Psychiatry, 2nd ed., vol. 5, 1975. Both hospitals are in New York City.

See Bender’s entry in 1947 above.

Early 1970s — In the early 1970s, when Nixon was president and Vietnam was the

visible war zone, I was going through some interesting life changes. I had many strange

and intense experiences. I was occasionally euphoric and was sometimes overwhelmed

as I tried to explore and examine the possibilities of my human potential in the fantastic

realities of our existence.

In the course of events I was captured and incarcerated for my “thought crimes.”

Thought crimes because I had broken no law, only spoken out, and acted out in

response to my environment. I was locked up in a psychiatric prison. I was immediately

forcibly injected with powerful mind-numbing and physically debilitating drugs, and

rapidly descended into the typical state of clinically induced depression. I was

repeatedly reminded that I was sick, and was forced to admit to and accept this sudden