Electroconvulsive therapy is misused in Frances (1982), a movie based on the life of free-spirited actress Frances Farmer (Jessica Lange). Her defiant and unconventional behavior lands her in a county hospital, where she is given ECT. We witness Farmer struggling in a straitjacket, being dragged down a corridor to the ECT suite. Soon after, Farmer is at the review tribunal declaring her recovery and decision to return to Hollywood. The chief psychiatrist proclaims, "I think this case demonstrates just how successfully antisocial behavior can be modified ... a significant victory for the mental hygiene program here in the state of Washington." Alas, Farmer's hygiene lapses, she ends up having the new "icepick lobotomy" and, by the film's end, she has been drained of all vivacity. She is an emotionless, socially compliant being. We are left to conclude that there was nothing ever wrong with her, and whatever problems existed were those of her mother and a society that insisted on conformity. Psychiatry had conspired with the establishment to crush this carefree spirit, and ECT had been used as weapon of social control.
Ordinary People (1980), portraying a compassionate, personable and ever-available psychiatrist, is sometimes championed as one of the motion picture industry's more sympathetic representations of psychiatry. Yet even in this movie, ECT is devalued. On being reminded that young Conrad (Timothy Hutton) had ECT, Conrad's swim coach berates him, "You know, Conrad, I'm no doctor, but I would never've let them put electricity through my head." It is only when Conrad's case is taken on by an understanding therapist who absolves him of his guilt that he can be cured.
Death Wish II (1982) takes the stand that psychiatry is ineffectual and insufficiently punitive. The film follows the revenge odyssey of an average American tough guy, Paul Kersey (Charles Bronson), whose daughter is kidnapped and raped by idle bad guys. Kersey tracks down one of the killers, who has evaded prison and has been remanded to a state hospital after convincing authorities that the crime occurred while he was under the influence of the hallucinogen PCP (phencyclidine). Kersey smuggles himself into the hospital disguised in a white coat, sporting a fake name badge and carrying a clipboard. He is led to a room containing what looks like a mainframe computer. He asks the aide what it is and is told it is the shock therapy equipment. The aide adds, "Since you guys turned up, we don't use it. It's all done with kindness now, isn't that right, Doctor?" His prey is led into the room and immediately recognizes Kersey. A bout of fisticuffs ensues, and with a misdirected right hook, the villain finds himself stuck in the shock therapy equipment. Quick-thinking Kersey sees his chance and throws a large switch on the machine. Sparks fly, and the villain mortally convulses as the machine makes a grinding, whirring sound. The villain drops dead--the first ECT fatality in cinema--as the machine is switched to standby. Kersey's use of the machinery is clearly unorthodox, but apparently condoned by the filmmaker.
Recent slapstick comedies also depict or refer to ECT. The treatment that had been portrayed with horror and social outrage now has become a cheap source of laughs. In The Beverly Hillbillies (1993), feisty and feral Granny is wrongly institutionalized for strange behaviors including eating raccoon. She is examined by an unconventional psychiatrist who declares her to be a perfect candidate for electroshock therapy. She is eventually rescued, but not before receiving electroshock treatment. After the treatment, we see her standing dazed in a straitjacket, muttering unintelligibly, her hair standing on end, sparks flying from her head. A quick sip of her home-brewed elixir restores her strength and sanity, allowing her to escape.
The horror potential of ECT is rejuvenated in House on Haunted Hill (1999). Set in a refurbished psychiatric hospital supposedly abandoned seven years before the Italians actually performed the first ECT in 1938, it is equipped with no less than 18 ECT suites! It is possessed by the spirits of its many victims, who manage to lure the descendants of five former staff members to a party. By the end of a night of horror, three are dead. Early in the film, a ruthless couple fabricate a murder using high-voltage electricity in one of the ECT suites. The scene opens with a woman convulsing wildly, apparently conscious, strapped to a table with ECT leads attached. All attempts to kill the power are futile and she convulses for 30 seconds. Eventually, the master switch is pulled, and she comes to rest, blood gushing from her mouth. She is pronounced dead by her accomplice lover, an unscrupulous doctor.
The portrayal of insulin coma treatment in A Beautiful Mind (2001), culminating in a violent seizure of the Nobel Prize-winning mathematician John Nash (Russell Crowe), confuses insulin coma therapy and ECT. So distressing was the seizure for Nash's wife, who is shown observing the treatment, that she tearfully turns away and asks the treating psychiatrist, "How often?" He replies, "Five times a week for 10 weeks." Clearly, even one treatment was one too many.
The portrayals of ECT in non-American films are also glum. In An Angel at My Table (1990), a New Zealand film about the novelist Janet Frame, Frame screams during the treatment. In the next scene, sitting alone in the laundry, she sounds defeated as she tells us, "Over the next eight years, I received 200 applications of electric shock treatment, each one equivalent in fear to an execution." More subtle in its criticism of ECT is the Academy Award-winning movie Shine (1996), a film about the pianist David Helfgott. While he is in the ECT suite, a phone is heard ringing. In the next scene, the phone is still ringing. David's father answers it but puts the receiver down after David identifies himself. The meaning is clear--David's plea to be rescued from the fate of having ECT has fallen on deaf ears.
How true-to-life is the practice of ECT in film? In every domain that we examine--diagnostic indications, consent, administration, outcome and side effects--ECT is not portrayed with authenticity. It is most commonly prescribed to overcome antisocial behavior rather than as a treatment for depression or psychosis. Despite the routine use of anesthesia since the 1950s, the films show patients fully awake and in terror. The most frequent outcomes are the change to a mute and confused zombie state or the treatment has no effect (clearly at odds with clinical experience). The electrotherapist is depicted as cruel, the embodiment of evil, in contrast to more avuncular presentations of the psychotherapist, for example in Ordinary People.