Electro-convuslive therapy (better known as ECT) was introduced in 1938, and quickly became widely used in psychiatric hospitals as a new therapeutic treatment. It was found to be particularly useful in treating major depression, and ECT rapidly replaced the use of less safe drugs that had previously been used to induce seizures, such as Metrozol. However, the therapy was not without controversy, and ECT is still sometimes met with negative connotations to this day.
Early Use
Dr Ugo Cerletti first discovered the potential of electroconvulsive therapy whilst conducting research on epilepsy during the 1930s. In 1935, he was appointed as chief of the Clinic for Nervous and Mental Disease at the University of Rome. He took on three assistants to continue his research into inducing convulsions, and in 1936 they discovered that delivering an electric current through electrodes placed on the temples of dogs would safely induce such convulsions. After conducting numerous experiments on animals, it was then successfully used to treat a patient suffering from psychotic symptoms. After eleven rounds of ECT (consisting of 100 volts for a fraction of a second), the man was able to return to a more or less normal life.
News of the successful treatment quickly spread, and by 1959 ECT had become the treatment of choice for depression throughout the US and Europe. Psychiatrists found that it was more effective than other physical therapies, and had relatively few side effects.
The Anti-Psychiatry Movement
However, as science and medicine made more and more progress, many people began to feel that doctors were lacking in empathy. With so many new drugs available to treat patients, some felt that psychiatry had become cold and clinical rather than caring. Chief among the critics was the idea that there was no such thing as mental illness; intellectuals such as Michel Foucault argued that madness was a social and cultural invention, and that psychiatry was simply a way of controlling people who didn’t behave the way society wanted. This mindset was exacerbated by the abuse of ECT in disreputable state asylums on non-compliant patients, and the use of ECT on patients who were unable to give informed consent.
Following growing public mistrust of ECT, American lawmakers began to strictly regulate the use of ECT in psychiatric hospitals, even going so far as to ban it in some states. The Scientology movement also used its considerable funds to spearhead a number of campaigns to have ECT completely outlawed. In the 1950s, Scientology had introduced ‘dianetics’ as an alternative to psychotherapy, and saw ECT as a dangerous threat. As court case after court case garnered mass media attention, the public was naturally alarmed – if ECT was as safe as doctors claimed, why were so many jurisdictions considering banning it?
Though many psychiatrists still argued that ECT was one of the most effective treatments for depression, the public was swayed by constant negative portrayals, not just from Scientology-funded court cases, but also in popular media. Films such as the 1975 adaptation of One Flew Over the Cuckoo’s Nest seemed to cement the idea that ECT was nothing but a cruel punishment. Most universities stopped including ECT in their training programmes, and by 1980 the use of ECT in psychiatric hospitals had dropped by about 39%.
Science Fights Back
Even against public opinion, advocates of ECT continued to push the empirical evidence , arguing that all the data showed that ECT was much more effective than any other treatment available. In 1985, a conference held by the National Institutes of Health concluded that universities should resume training in ECT. Many other countries had continued to employ the use of ECT, and American attitudes were beginning to look quite outdated. In 1990, a new report from the American Psychiatric Association recommended ECT not just for severe depression, but also for bipolar disorder and psychotic schizophrenia. The public, however, remained squeamish about what seemed like such a severe intervention, and the use of ECT reduced by roughly half as doctors began to favour less invasive treatments.
E.C.T Today
Modern doctors and psychiatrists still use ECT to treat severe depression when a patient has not responded to other treatments or medications. Unlike its past use, it is now generally seen as a last resort therapy, as advancements in cognitive based therapies and new drug innovations have improved the options and prospects for those experiencing mental health problems.
Sources and Further Reading
https://en.wikipedia.org/wiki/Electroconvulsive_therapy
https://en.wikipedia.org/wiki/History_of_electroconvulsive_therapy_in_the_United_Kingdom
Shorter, E., A History of Psychiatry, (1997)