Home

Tete du Mannequin d'Andre Masson (1937) Raoul Ubac. *4

Tete du Mannequin d’Andre Masson (1937) Raoul Ubac. *4

REFERENCE NOTES FOR ELECTROSHOCKED

[1] Wilson, Sarah. “Artaud, homo sacer”, Antonin Artaud. La Casa Encendida (Madrid): 2009.

[2] Scheer,Edward Eds. “ Sylvére Lotringer from an interview with Jacques Latrémolière”, Antonin Artaud : A critical reader. Routledge (London): 2004.

[3] Find the 1st Person database (maintained from 1995-2010) and related projects hosted at http://www.ect.org.[Accessed April 19 2014] The following patient submissions have been quoted in this post:

  • [3.1] a. Submitted by “Zetron“, reporting 140 bilateral sessions between ages of 20-27, while treated in the U.S. This participant notes it was the most horrible thing he has ever experienced. He adds that he might undergo the therapy again but only if to save his life.
  • [3.2] Submitted by “trent lynn‘, reporting 15 sessions at age 30, in Italy. Recalls submitting to treatment voluntarily, doesn’t recall the decision-making process, but is certain she was not forewarned of resultant long-term implications. Participant notes loss of ability to speak languages she previously was adept with. 
  • [3.3] Submitted by ‘survivor‘, reporting four sessions at the age of 25, in the U.S. Notes he was coerced into a decision that has ‘destroyed’ his ‘life and soul’.
  • [3.4] Submitted by ‘Sue Clark‘, reporting five bilateral sessions at age 17, in Canada. Notes that doctor responded to complaint of ongoing symptoms by ‘mocking’ her but that she was, subsequently, diagnosed with a short-term-memory disorder.
  • [3.5] Submitted by ‘Helene‘, reporting six sessions at age of 17, in the U.K. Notes that she chose the treatment, and was further coerced, but that it immediately ‘lifted’ depression. She would recommend it to others upon condition of being adequately informed in advance.
  • [3.6] Submitted by ‘Juliet‘, reporting 26 mixed sessions at age of 31, in Australia. Notes that her doctor was sympathetic to complaints of ongoing symptoms but also asserted that the treatment was life-saving.
  • [3.7]  Submitted by ‘Chris‘, reporting 25 bilateral sessions at age of 24, in the U.S. Noting that the decision was chosen, voluntarily executed, and that this ‘snapped’ him out of depression. Enabling, shortly afterward, a return to functional / productive life.
  • [3.8] Submitted by ‘Emma Pierce‘, reporting four-to-six sessions at the age of 24, in Australia. Notes that the choice was hers but that she felt pressured to undergo this treatment. Also provides the common reference to a ‘lack of concern’ as a result of ECT. Participant would “never!” do it again nor recommend it to others.
  • [3.9] Submitted by ‘Wendy Funk‘, reporting fourty-three bilateral sessions at age 32, in Canada. Notes that “original diagnosis was sore throat with fever’, and yet was coerced into ECT, and that complaints afterward weren’t taken seriously by her doctor.
  • [3.9a] Submitted by ‘Steven J. Strnad‘, reporting six sessions at age 26, in the U.S. Notes that he felt pressured to undergo the treatment and wouldn’t recommend it to others. Participant notes that his doctor ignored complaints and adds that it was ‘the most traumatic and devastating experience’ of his life.

[4] After writing this review of the 1st Person entries, I came across a research paper focussed on consent issues specifically, and that finds the very same trend among past-patients. Though negative feedback isn’t as  disproportionately represented, the study concludes that: “Neither current nor proposed safeguards for patients are sufficient to ensure informed consent with respect to ECT, at least in England and Wales.”  Rose, Diana  & Pete Fleischmann, Til Wykes, Morven Leese, Jonathan Bindman. Information, consent and perceived coercion and patients’ perspectives on electroconvulsive therapy. The British Journal of Psychiatry (2005)186: 54-59 doi: 10.1192/bjp.186.1.54

[5] Rose, Diana  & Pete Fleischmann, Til Wykes, Morven Leese, Jonathan Bindman. Patients’ perspectives on electroconvulsive therapy: systematic review. BMJ 2003;326:1363 (Published 19 June 2003) doi: http://dx.doi.org/10.1136/bmj.326.7403.1363 [Accessed April 20 2014]

[6] Refer to: Poublon, Nathan A. & Marieke Haag. The Efficacy of ECT in the Treatment of Schizophrenia. A Systemic Review. Erasmus Journal of Medicine Vol 2 / No 1 : June 2011.

1934 study outcomes of Hungarian neuropathologist Ladislas von Meduna, M.D, found that inducing seizure is not an effective treatment for long-time sufferers of schizophrenia. Though he experimented with chemical (drug) applications many contemporary experts of ECT report the same. I have come across a great deal of opposing expert opinions on the matter. It is interesting to note however that, in both present-day and historical treatment case studies, patients with acute schizophrenia have the highest rate of immediate relief from a course of this treatment. See ECT: Serendipity or Logical Outcome? Editorial, at Psychiatric Times, on 70th anniversary of use of induced seizures to treat mental disorder. January 01, 2004. [Accessed April 23 2014]  :

Meduna described his experience with 110 patients in his 1937 monograph: Die Konvulsionstherapie der Schizophrenie. The remission rate varied with the type and duration of the illness. For those ill for less than a year, more than 80% remitted. The remission rate fell to 50% for those ill from one to two years; 25% for illnesses of three to five years; and there were no remissions in those with illnesses longer than a decade. Of patients with the acute form of schizophrenia, 95% remitted. Of those with “process schizophrenia,” 57% remitted, but if the illness was allowed to go untreated into “post-process” schizophrenia, only 6% remitted. While our diagnostic language and criteria no longer recognize these criteria, the experience with ECT today confirms Meduna’s conclusions that patients with schizophrenia treated during the first two years of their illness–when the psychosis is dominated by positive symptoms–have an excellent prognosis for sustained remission. For those patients in whom the illness has been allowed to fester for years–and especially for those who develop the negative symptoms of apathy, withdrawal and emotional blunting–relief is no better than with other treatments.

That said, reviews that compare early study conditions to contemporary ones, note sub-standard or contradictory testing and data collection measures. For example see: Sackeim, Harold A. & D.P. Devan & Mitchell S. Nobler. Electroconvulsive Therapy. Psychopharmacology: the Fourth Generation of Progress. Raven Press, New York: New York (1995).

There is considerable controversy about the role of ECT in the treatment of schizophrenia. Surveys of utilization indicate marked disparity in rates of use between and within countries. Likewise, recommendations of expert groups and professional organizations have been contradictory. For example, an National Institutes of Health consensus panel stated that evidence regarding the efficacy of ECT in schizophrenia was not compelling (37). The American Psychiatric Association Task Force on ECT recommended that ECT be considered particularly for schizophrenic patients who manifest prominent affective features or catatonia during exacerbations (2). In contrast, the Royal College of Psychiatrists expressed skepticism that any symptomatological features were predictive of response to ECT in schizophrenia (48).

…. Using real–sham designs, four studies were conducted in the 1950s and 1960s, and three recent studies in the 1980s (29). With the possible exception of Ulett et al. (67), the early studies failed to demonstrate a therapeutic advantage for real ECT compared to repeated administration of anesthesia alone… There is evidence that the combination of ECT and neuroleptics is a more effective treatment than either form of monotherapy (29).

Also see: Dawkins, Karon MD. Refinements in ECT TechniquesPosted at the Psychiatric Times: April 19, 2013. [Accessed April 23 2014]  The latter contains information of future import regarding cases of comorbid diagnosis and personality disorders:

Personality disorders comorbid with major depression are common‚ with poorer outcomes with psychotherapy or pharmacotherapy. Patients with these comorbid conditions are likely to be referred for ECT. One study examined 139 patients with a primary diagnosis of unipolar major depression and scores of at least 20 on the 24-item Hamilton Depression Rating Scale; personality disorders were assessed with a structured interview. Outcomes were compared in patients with no personality disorder‚ patients with borderline personality disorder‚ and patients with personality disorders other than borderline personality disorder. Only 22% of patients with borderline personality disorder met criteria for remission‚ compared with 56% of patients with personality disorders other than borderline personality disorder and 70% of patients with no personality disorder. ECT can be rapidly effective in mania and catatonia‚ and it can be an early consideration for depressions with psychotic features. Although antipsychotics continue to be the first-line intervention‚ ECT can be considered in patients with medication-resistant schizophrenia. However‚ the probability of significant improvement may be low.

[7] ECT: Serendipity or Logical Outcome? Editorial, at Psychiatric Times, on 70th anniversary of use of induced seizures to treat mental disorder: January 01, 2004, pg 2.

[8] Kellner, Charles H. & Rebbeca G. Knapp, Georgios Petrides, Teresa A. Rummans, Mustafa M. Husain et al. Continuation Electroconvulsive Therapy vs Pharmacotherapy for Relapse Prevention in Major Depression. A Multisite Study From the Consortium for Research in Electroconvulsive Therapy (CORE). Arch Gen Psychiatry. Dec 2006: 63(12): 1337-1344.Published in PMC Jul 11 2013 doi: 10.1001/archpsyc.63.12.1337

[9] Wilson, Sarah. ‘Artaud, homo sacer’, Antonin Artaud. La Casa Encendida (Madrid): 2009.

[10] Eshleman, Clayton & Bernard Bador.A note on Antonin Artaud The Free Library: January 1, 2005.[Accessed April 23 2014]

[11] Wilson, Sarah. ‘Artaud, homo sacer’, Antonin Artaud. La Casa Encendida (Madrid): 2009.

[12] Bougeois, Louis E. & Stephen Barber. “Blows and Bombs: Stephen Barber on Antonin Artaud”. Complete with Missing Parts: Interviews with the Avant-garde. Vox Press:  2008.

[13] Foucault, Michel. Madness and Civilization. London: Routledge, 2001.

[14] Scheer, Edward Eds. “Sylvére Lotringer from an interview with Jacques Latrémolière”. Antonin Artaud : A critical reader. Routledge (London): 2004, pg 25.

[15] ibid, pg 26.

[16] Note that the acute phase represents the first or earliest onset of depression or mania with some positive symptoms (hallucinations, delusion, dissociation, etc). As compared to a chronic condition, which Artaud had surely developed, which gives way to psychotic episodes. Patients with the former diagnosis, or whom are catatonic, or are instead schizoaffective, more often experience relief with electroconvulsive therapy. I will be looking at these distinctions more closely in the near future. Also see: ECT: Serendipity or Logical Outcome? Editorial, at Psychiatric Times, on 70th anniversary of use of induced seizures to treat mental disorder: January 01, 2004.

[17] Scheer, Edward Eds. “Sylvére Lotringer from an interview with Jacques Latrémolière”. Antonin Artaud : A critical reader. Routledge (London): 2004, pg 22.

[18] Wilson, Sarah. ‘Artaud, homo sacer’, Antonin Artaud. La Casa Encendida (Madrid): 2009.

[19] Edward Eds. Antonin Artaud : A critical reader. Routledge (London): 2004.pg 185

[20] This and related practitioner concerns are discussed in an article by Brian K. Clinton, MD, PhD. Ethical Issues in Disclosing to Patients: Should Patients Be Allowed to Read Their Charts? Special Report at Psychiatric Times (March 11, 2014) :

How do we predict the risks and benefits of granting or denying access to the chart? Several related studies offer guidance.1,2 Examination of the content of psychiatric case notes revealed that up to 80% contained elements that were potentially puzzling, offensive, alarming, or upsetting to patients.3-5 Studies of the impact of patients’ review of their charts have been conducted primarily in acute inpatient settings, usually during active treatment and with direct supervision. A substantial percentage (35% to 50%) of inpatients felt more pessimistic or upset after reading their records, but there was also a consensus that little or no substantial harm was involved.6-8 Most inpatients who read their records reported that they felt better-informed and more involved in treatment.6 Some patients with psychotic diagnoses thought it demystified the medical record.9 Staff members reported that the studies changed their charting practice (eg, by minimizing upsetting notations and psychotic diagnoses), and they observed that important communications sometimes failed to be charted.6,10

ADDITIONAL READINGS

Artaud, Antonin. Artaud Anthology, ed. Jack Hirshman. San Francisco: City Lights Books, 1965.

Brown University. “Debate Over Repressed Memories.Science Daily: 8 July 2009.

Enns, Murray W. M.D. and Jeffrey P. Reiss, M.D. Electroconvulsive Therapy. Canadian Psychiatric Association (CPA) Position Paper: April 2013.

Guide to the Sylvère Lotringer Papers and Semiotext(e) Archive 1960-2000 (Bulk 1973-2000). Also see: Evil Influences by Sylvère Lotringer.

Kellner, Charles M.D. ECT Today: The Good It Can Do. Psychiatric Times: September 14, 2010. 

Kroes, Marijn C W and Indira Tendolkar, Guido A van Wingen, Jeroen A van Waarde, Bryan A Strange & Guillén Fernández. “An electroconvulsive therapy procedure impairs reconsolidation of episodic memories in humans“. Nature Neuroscience 17, 204–206 (2014) doi:10.1038/nn.3609 Dec 22 2013 [Accessed April 23 2014]

Mangaoang, Maeve A.  & Jim V. Lucey. “Cognitive rehabilitation: assessment and treatment of persistent memory impairments following ECT”. Advances in Psychiatric Treatment (2007), vol. 13, 90-100 doi: 10.1192/apt.bp.106.002899 Published at ECT [dot] Org [Accessed April 24 2014] 

Stone, Alan A. Electroconvulsive Rx: A Memoir and Essay (Part 1). Psychiatric TimesSeptember 14, 2010. [Accessed April 19 2014]

Tharyan, P. Adams, C.E. (2005). “Electroconvulsive therapy for schizophrenia”. In Tharyan, Prathap. The Cochrane Database of Systematic Reviews (2): CD000076.doi:10.1002/14651858.CD000076.pub2.

Torrey, E. Fuller and Yolken, Robert H. Psychiatric Genocide: Nazi Attempts to Eradicate Schizophrenia. Schizophrenia Bulletin; Oxford University Press: September 16 2009. doi:10.1093/schbul/sbp097

Walter, Garry M.D. and Karen Fisher M.D. and Angela Harte M.D. ECT in Poetry. Journal of ECT, Vol 18 / No 1 (March 2002): 47-53.

WHO Resource Book on Mental Health, Human Rights and Legislation. The World Health Organisation (2005): Geneva, 64.

ARTWORKS

1. Wonderer (1921) by Paul Goesch. A summary biography in EnglishPainter and architect, Paul Goesch was a student at the academy in Munich, Karlsruhe and Berlin. With his brother, he became friends with Otto Gross, who introduced him to Freudian psychoanalysis. An attempt at auto-analysis seems to have been the cause of a profound psychological upheaval that would cause his committal to a hospital in Hedemünden and Rasemühle in 1909. Despite these troubles, he managed to finish his studies in architecture. He was passionate about theosophy and anthroposophy of Rudolf Steiner. But in 1917 he was hospitalized for schizophrenia. It was then that he began creating, the result being nearly one thousand drawings, partly preserved in the Prinzhorn collection. In the autumn of 1919, he left the hospital and joined his father in Berlin, where he enjoyed the artistic life of the capital, seeing Kokoschka, Gropius, participating in the current avant-garde. However, beset by hallucinations and delusion, he was again hospitalized at the clinic of Göttingen. In 1934 he was transferred to the psychiatric hospital in Teupitz. He was forbidden to paint and forced to work until exhaustion. In 1940 he became one the many victims of the euthanasia program orchestrated by the Nazis.

2. Psychiatric Hospitals (1954) by Philippe Charbonnier. Curated by Gery Cichowlas with photographs supplied by Galerie Agathe Gaillard (Paris, France): Some of the photographs were first published in Réalités in January 1955. Here a selection of the original reportage is shown followed by the magazine layouts – published in the magazine with two fluffy cats on the cover. It is interesting to see that a number of most powerful images were not published due to the sensitivities of the 1950s and that the eyes of the patients are at times masked to protect their identities. In 2006 a 24 page booklet Jean-Philippe Charbonnier: HP hôpitaux psychiatriques was published by Le traitement contemporain n°4 in conjunction with gallery Agathe Gaillard.

3. Psychiatric Hospitals (1954) by Philippe Charbonnier. Curated by Gery Cichowlas with photographs supplied by Galerie Agathe Gaillard (Paris, France).

4. Tête du Mannequin d’André Masson (1937) by Raoul Ubac. Gelatin silver photograph, 29.7 × 23.8 cm, at the Stephen Daiter GalleryMannequin, that was an made by André Masson, and other found objects.

OTHER MEDIA

Antonin Artaud at Memoires de Guerre blog.

Antonin Artaud (chronology) at Le printemps des poetes blog.

Antonin Artaud : histoire vécue d’Artaud-Mômo at L’amour délivre by Joel Becam.

Electroconvulsive Therapy Can Erase Unwanted Memories by George Dvorsky.

La Seconde Guerre Mondiale 1939-1945 at Canalblog.

On This Day: France Surrenders to Nazi Germany by Denis Cummings at finding Dulcinea library.

Nineteenth & Twentieth Century Psychiatry: 22 Rare Photos at the CBS News Website.

The History of Shock Therapy in Psychiatry by Renato M.E. Sabbatini, PhD.

The Strange Case of Dr. Ferdiere at Psyche & Muse Library of Yale (blog post with notes).

The video address below, by Dr. John Breeding, touches upon the history of ECT. He is seen by some as reactionary in his activism but offers an informed arguement.

 

One thought on “ECT Ref-Notes

  1. Pingback: Electroshocked | scrapaduq

What say you?

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s