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Psychiatric Times. Vol. 21 No. 4
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A New Appreciation of ECT

Max Fink
By
| April 1, 2004
Dr. Fink is professor of psychiatry and neurology emeritus at the State University of New York at Stony Brook. He is the author of Electroshock: Restoring the Mind (Oxford University Press) and founder of the quarterly journal Convulsive Therapy (J ECT).

I went back to work in July. The rest at home and some sessions with a sympathetic psychotherapist had done me good, and I felt almost like my old self again.

I came home from the office the first day feeling panicky. I didn't know where to turn. I didn't know what to do. I've never been a crying person, but all my beloved knowledge, everything I had learned in my field during twenty years or more, was gone. I'd lost the body of knowledge that constituted my professional skill. I'd lost everything that professionals take for granted. I'd lost my experience, my knowing. But it was worse than that. I'd felt I'd lost my self. I fell on the bed and cried and cried and cried.

She continued in psychotherapy:

I was still seeing my psychotherapist. ... I asked him about recovering my memory through hypnosis. ...

He was a Freudian psychoanalyst at heart. He got me talking--to blubbering out a sort of intellectual life history. ... All I wanted was a kind of parlor trick. I wanted him to pull my memory back. All he wanted was to analyze me. ... He said he could help recover an emotional memory loss--but not a loss from brain damage.

At the end of the article, Rice admitted:

I believe the electric-shock literature is right in one regard. My brain may be damaged insofar as part of my memory has been erased, but my mentality is certainly not impaired. I can still use my mind.

But I don't want to sound like a pill. ... I mustn't give the impression that my experience with electric shock was a total disaster. There have been some beneficial results. For one thing, my physical health has improved. I'm beginning to eat again, my digestion is much improved, and I have no trouble with sleep. I also feel emotionally relaxed. And I've lost a lot of bothersome inhibitions.

In the PBS/BBC supported series Madness (1991), neurologist, playwright, author and operatic impresario Jonathan Miller presented an extensive history of mental disorders. In "Brainwaves," he discussed somatic treatments of the mentally ill, from the pre-19th century restraint chairs, chains, douches and isolation chambers to insulin, electroshock and leucotomy of the first half of the 20th century, and their replacement by psychotropic drugs in the last half of the century. Miller is particularly harsh in his castigation of psychiatrists and the use of somatic treatments. In the voice-over, the following statements set the viewer's tone:

[E]lectroshock, a controversial procedure ...

The administration of an electric shock through the skull is a comparatively crude assault on the brain. ...

[A]s machines were invented to whirl, swirl, shock, rock, and douche the patient back to sanity, the sick brain was treated to a series of traumatic assaults presumably in the hope that its distorted parts would be jolted into place. ...

[T]he treatments resulted in violent convulsions with serious bruising å fractures of limbs and spine å and other atrocious consequences. ...

[D]espite [ECT's] understandably sinister reputation, ECT, Metrazole and insulin have much more in common with the whirling chairs and rotating cradles which they superseded, in that they were addressed to the brain as if it were a single undifferentiated organ.

Miller excoriates all aspects of modern psychiatry with equal disappointment.

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