Electric Shock Therapy "To Do or Not to Do" That is the Question

This Hub briefly explores the history of Electroshock Therapy and how the treatment’s beginning continues to be the highlight of what’s portrayed in present day. Many professional, both in the psychiatric and medical field, find the treatment to be beneficial. Lakshmi Yatham, a professor of psychiatry at the University of British Columbia in Vancouver, says “there is no doubt this treatment is effective, it saves lives” (Picard, 2009). Although Yatham and a broad range of other mental health professionals advocate the treatment, those who are against ECT are more willing to lecture on the topic, portraying the treatment to be as barbaric and unnecessary. Peter Breggin, M.D., known for the “emphasis on effective empathic approaches in mental health and education, [o]nce canvassed Congress to outlaw the physical treatments of the mentally ill” (Finx, 2010). Although the general public is more susceptible to hear and read the opinions of the more vocal anti-ECT professionals, there is a contrast by greater support for the therapy, which is suggested by the patients who have received and benefited from the treatment. Much of this hub will examine the pros and cons of Electroconvulsive Therapy, as well as provide valid research and statistics that suggest the treatment is better continued than abolished, considering the circumstances in which the treatment is given.

Keywords: Electric shock Therapy, Electroconvulsive Therapy

History Hesitates and Conflicts the Present Idea of Electroshock Therapy

Creating a Controversial Opinion Involving the Pros and Cons

Electroconvulsive Therapy, also referred to as Electric Shock Therapy, has had a long confabulating history, which has brought about an extended debate in reference towards the methods of safety and effectiveness. The therapy can first be acknowledged as far back as the ancient Romans, who used a method of shock through electricity on those suffering from “madness”. The shock was produces by applying electric eels to the cranium of those diagnosed. Although the Romans subsequently practiced a form of the therapy, ECT’s “true origins have been traced to the late 1700s, where it was discovered, that a machine was being used, to treat a wide range of illness, through administering weak electric currents” (Health Facts, 2010). The machine was first put to work at “Middlesex Hospital in England where a London brain surgeon, John Birch, used the machine to shock the brains of depressed patients” (Health Facts, 2010).

The modern practice of Electroconvulsive Therapy, initiated almost forty years after Birch, was brought to knowledge by an Italian psychiatrist Ugo Cerletti. Cerletti supported metrazol-induced convulsions; a method used at the time to cause seizures by insulin overdose, “in the treatment of schizophrenia, [but in contradiction] Ceritti also thought it to be too dangerous and uncontrollable” (Sabbatini Ph. D, 1998). Cereletti’s idea for using the method of electrical currents first came while watching pigs being anesthetized with electroshock before being butchered. The butchers used the shock as a method or replacement of anesthesia, "As soon as the hogs were clamped by the [electric] tongs, they fell unconscious, stiffened, then after a few seconds they were shaken by convulsions.... During this period of unconsciousness, the butcher stabbed and bled the animals without difficulty” (Cereletti, 1877). Impressed by the method, in which the pigs were induced unconscious, he convinced two colleagues, Lucio Bini and L.B. Kalinowski to assist in developing a method to deliver brief electric shocks to humans. Cereletti went on to test this method on animals and finally humans. His discovery for the time was viewed as nothing less than spectacular.

A few short years after Cereletti discovery, “Kalinowski (Cereletti’s colleague) began a tour that introduced ECT around the globe, visiting the Netherlands, France, Switzerland, England, and the United States” (Sabbatini Ph. D, 1998). ECT quickly became the therapy of choice in most hospitals and asylums. The ECT ‘trend’ continued until the 50’s, but slowed due to the introduction of alternative drugs such as Thorazine. However, by the 70’s, these new drugs were not showing to be as effective as professionals had hoped and ECT was again favored. The period of this practice up until the 1970’s was where ECT achieved its harsh reputation. During this time, patients did not receive the help of anesthetics or muscle relaxants, such as; “succinylcholine, necessary in regards to preventing broken bones, fractures, and cracked vertebra as a result of body thrusting during the procedure”, which lead to the flood of horror stories from those who endured the experiences (Berham, 2000).

Hollywood saw the potential from pain in ECT and used the circulating stories by incorporated them into featured films. The first and most popular film related to the treatment is the 1975 film “One Flew Over the Cuckoo's Nest”, which creates empathy for “the protagonist (who) suffers both electroshock and lobotomy at the hands of unbridled caretakers” (Fink, 2010). More exaggerated depictions on the subject of ECT have also been found, as the highlighted torture, in numerous and popular horror film such as, “House on Haunted Hill” and “Mirrors”. Film productions, although popular, have not been the only form of entertainment to feature the negative effects of ECT. They have also been incorporated or the subject of literature and poems; including the still widely read Sylvia Plath, who writes on personal experience,

By the roots of my hair some god got hold of me.
I sizzled in his blue volts like a desert prophet.

The nights snapped out of sight like a lizard's eyelid:
A world of bald white days in a shadeless socket.

A vulturous boredom pinned me in this tree.
If he were I, he would do what I did.

-Sylvia Plath
"The Hanging Man"
(A poem about her experience with electroshock therapy)

and in popular books; “ the psychiatrist Thomas Szasz castigated psychiatrists as agents of the state who coerced the mentally ill into forced and unwelcome hospital care. He especially criticized the use of electroshock” (Fink, 2010).

One of Szasz’s former students, Peter Breggin, is known for practicing traditional therapy and his strong standing against ECT and psychiatric drugs. Breggin’s has even gone as far as comparing ECT to Lobotomy stating “I began to realize that lobotomy differs little in principle from the most potent psychiatric drugs and from electroshock. All of the major psychiatric treatments work by producing brain dysfunction, and too often they result in lobotomy like effects and permanent damage” (Breggin). Breggin is not completely wrong in his standing; Electroconvulsive Therapy does have weaknesses when considering the side effects, but so do the prior failed methods of treatment such as, antidepressant medication, which modern patients are usually prescribed first before being introduced to ECT.

Due to modern improvements, by way of treatment in Electroconvulsive Therapy, the negative side effects have improved greatly. The two forms of treatment used are nondominant unilateral ECT, “electrodes are only applied to one side of the head, the right, in order to protect the left side of the brain, the area that manages language and auditory memory” and brief-pulse stimulus, which “introduces a quick jolt of electricity instead of a steady stream, minimizing the possibility that a patient will suffer serious memory problems later on” (Berham, 2000). When using these methods of ETC the worst and most frequent side effect to be expected is memory impairment. Specialists believe “the memory loss is primarily acquired immediately after electroshock treatment, but other reports have suggested that memory loss is extended” (Berham, 2000). Over the course of ECT patients have had difficulty remembering new information. Memory loss has also been reported to extend throughout the day, week and even months after a treatment. In worst cases “years after the treatments, patients are unable to recall many events that took place shortly before, during, and after the two- to three-week course of treatment” suggesting permanent memory loss in the treatments brief time period (Bioethics for Students, 1999). Other side effects can include headaches, confusion, nausea, and soreness.

Although the thought of permanent or even temporary memory loss is disturbing, the mental state in which individuals are in before receiving the treatment is severely depressed to suicidal, finding no mean of improvement through other methods of therapy or psychiatric medication. ECT is a method of treatment that’s shown to improve and relieve depression, when all other methods have failed. It is not a treatment that is forced or conducted on those with illnesses not compliant with the treatment. Permission is asked followed by an agreement of informed consent. Once all has been agreed upon, in regards to the treatment, the “person consenting to the procedure is kept informed of progress and may withdraw consent at anytime” (Behram, 2000). Studies show an outcome or success for “recovery from depression in 75 to 85 percent of patients who receive ECT” a greater percentage than antidepressant drugs (Bioethics for Students, 1999). ECT also has the advantage of “working more quickly than drugs”, nor does treatment by ECT “have the dangerous side effects of many anti-depressants” (Bioethics for Students, 1999).

Although the voices of professional, who oppose Electroconvulsive Therapy, seem to be louder and heard more often due to our nature as human beings to focus on the negative with regards to protecting ourselves, the method in which ECT is performed has drastically changed for the better in the past twenty years and has regaining the respect of many psychiatrists. In fact psychiatrists “now consider it an efficient way to relieve severe depression or to break the manic cycle for the manic depressive” due to the success rate (Behram, 2000). ECT seems to be proving more successful than even the newest forms of antidepressant medications. According to the American Psychiatric Association, ECT success rate, “is 80%, considerably higher than the 50% to 60% success rate of most antidepressant medications” (Berham, 2000). Many organizations are also recognizing the valued effects of ECT, including “The National Depressive and Manic Depressive Association” (NDMDA, “the National Alliance for the Mentally Ill” (NAMI, and the National “Mental Health Association” (NMHA).

While many organizations and advocacies are considering and now praising the results ECT can bring, there are still the other powerful and influential opponents, such as Peter Breggin, who refers to the therapy as “taking a chance at electroshock is like playing Russian roulette with your brain” (Breggin,). Breggin and other anti-ECT advocates will continue fighting in regards to making the treatments protocol strict and closely watched.

The issue of ECT can almost be compared to the issue of abortion in that both the professional and patient opinions are set at opposite ends of the board. There are psychiatrists that offer, refer, or condone the treatment, as well as, patients who recommend, refer, or disapprove of the treatment. The remaining views and opinions on the issue are left up to the general public, which is considered to be more misinformed than informed and uneducated than have proper facts on the subject. The rough start and imperfections in regards to ECT will always allow room for debate, even for the most educated professionals involved in the treatment of abnormal psychology.

Behrman, Andy, “Fighting Depression and Bipolar Disorder” Electroboy Viewpoint In Contect. Web. 2000

Breggin, Peter, M.D “Toxic Psychiatry”,Why therapy, empathy, and love must replace the drugs, electroshock, and biochemical theories of the “new psychiatry. 1^st ed. Chapter 1: Psychiatry Out Of Control. St. Martin's Press, 1991.

Breggin, Peter, M.D “Brain-Disabling Treatments in Psychiatry” Drugs, Electroshock, and the Psychopharmaceutical Complex. 2^nd ed. Springer Publishing Company, New York, 2008.

"Electroconvulsive Therapy." Bioethics for Students: How Do We Know What¿s Right?. Ed. Steven G. Post. Vol. 2. New York: Macmillan Reference USA, 1999. Gale Opposing Viewpoints In Context. Web. 1 Nov. 2010.

Fink, Max. "Electroshock Revisited." American Scientist 88.2 (2000): 162. Gale Opposing Viewpoints In Context. Web. 1 Nov. 2010.

“Heath Facts” Electroconvulsive Therapy: An Overview of Then and Now. Copyright © 2010Advameg, Inc.Viewpoint in Context. Web. Sept. 2010

Picard, Andre. "In praise of 'electroshock'." Globe & Mail [Toronto, Canada] 17 Oct. 2009: F7.Gale Opposing Viewpoints In Context. Web. 30 Oct. 2010.

Plath Sylvia, “The Hanging Man” from Collected Poems. Copyright © 1960, 1965, 1971, 1981 by the Estate of Sylvia Plath. Eds. Ted Hughes. Harper Collins Publishers Inc, 1992

Sabbatini, Renato M.E., Ph.D. “The History of Shock Therapy” Brain and Mind Electronic Magazine of Neuroscience. Ed. Dr. Silvia Helena Cardoso. The Edumed Institute, Brazil,1997 – 2003. Web. Feb. 1998.

Ugo Cerletti, M.D., Quoted in Frank J. Ayd, Jr., Guest editorial: 1877-1963, Psychosomatics, 4: A/6-A/7 (Nov.-Dec.), 1963