So, society has strangled in its asylums
all those it wanted to get rid of or protect itself from,
because they refused to become its accomplices
in certain great nastiness.

[Quoting Artaud, in 1947, in Seminar: In Homage to Antonin Artaud
Delhi University & National School of Drama, New Delhi, January 1997.]

As it is with us each, Antonin Artaud had his own situated relationship to the (early twentieth century) world and a cultivated understanding of his active place in it. In keeping with the artist’s call for an art mirrored by a life lived, I hope to invest an appropriate degree of care surrounding his experiential circumstances, while interpreting the record of his correspondences and artworks. As opposed to romanticizing the affects of madness, for example, or idealizing the artist’s expressed worldview.

A small part of this effort has led me to qualitative studies and subjective accounts of electroconvulsive therapy (ECT). Adding, at least vicariously, to my understanding of what Artaud had endured as a psychiatric patient. The artist was subject to six courses of ECT, ranging from 4 to 13 sessions each, between June 20th, 1943 and January 24th, 1945.[1] This amounted to approximately 51 – 58 sessions, among other approaches to treatment at the Praraire asylum in Rodez (France), under guardianship of Director Dr. Gaston Ferdière and administered by psychiatrist Dr. Jacques Latrémolière [2]. News of this treatment elicited uproar from Left Bank community members, associated artists and intellectuals, and their attending publics.

I was interested in how others describe their electroshock experience and the conditions surrounding its administration. A quick search located a database online, created by a former ECT patient, whom had originally intended to collect reports as a part of her Phd researches.[3] 1st Person is open to anyone who would like to contribute or view participant’s feedbacks.

When the time came my name was called. I was required to defecate and urinate, I removed my belt, everything in my pockets and my shoes. In those last horrifying minutes before the doctor came I would say an act of contrition to God over and over again (once they caught me kneeling and doing this). During the treatment I was held down by the doctor, who worked alone behind a LOCKED door. From what I would hear and smell of the others treated before me I was able to figure out what was going on. I could hear the patient convulsing and then the deep gasps for air, then the smell of flatus. After the treatment I was able to walk out of the office on my own with some difficulty. It usually took a whole day in bed to recover. The headache was intense and many times I had a bitten tongue. A psychologist told me in 1995 that I had been tortured. I feel there is no one who I can relate with except maybe a Holocost survivor!!!!    [3.1]

Reading through the database entries, the most common complaints surrounding ECT relate to memory loss and cognitive impairment. These outcomes are documented in numerous clinical studies and discussed as either temporary or otherwise inconsequential reactions. Among these former patients’ descriptions, however, there is common inference to trauma as well. A significant number of participants use the word ‘torture’ to describe their experiences, for example, and indicate they would not recommend ECT to others. In fact the entries seem predominately negative and, contrary to expert reports, describe lasting complications as the reason. Although inclusive of moderate, or widely mixed responses, there are notably fewer participant entries offering encouraging feedbacks.

I lost my soul [3.2]

It burned away much of my intelligence, memory and cognitive skills. It turned a bright, emotionally deep young man into a guy walking around in a permanent daze, unable to concentrate or connect with people. It simply deleted much of my soul. The trauma was worse than a violent rape. With enough work, you can heal from physical or sexual trauma. You can’t heal from brain damage that burns away your personality and cripples your mind. It didn’t even improve the depression – it made it far worse.  [3.3]

I feel I was tortured against my will. The permanent damage by the short term memory loss has had a negative effect on my life. I find it difficult to learn anything new. Prior to having ECT, I had an good memory and no learning difficulties. Many in the medical community are aware of the potential dangers of ECT and refuse to abolish ECT. I want ECT abolished now. I don’t want anyone to go through what I did. It is a crime against humanity. I was tortured in my own country, paid by the Ontario Ministry of Health. It is horrendous.  [3.4]

An arrest and commitment by Jean-Philippe Charbonnier (1954)

Photo-documentation of apprehension (1954). *2

Those encountering life-long disability, as a result of consecutive ECT sessions, would be understandably motivated to share their experiences and publicize warnings. It is nonetheless notable how many, among those reporting improvements to their wellbeing, also indicated that they had willingly consented to this treatment option. Whereas a surprising number report an involuntary, pressured or coerced, context for undergoing the procedure. A sense of powerlessness or alternatively, a process of deliberation leading to informed consent, clearly contributes to the character of patients’ reflections and recommendations.[4]

Among those with mixed or positive feedbacks there is frequent reference to ECT saving the patient’s life, explicitly noting suicidal ideations, or inferring that this risk is the premise upon which they recommend the treatment. Associatively, most database participants point to severe depression as the reason for seeking medical care. There is however rarer mention of schizophrenia and bipolar disorder alongside a smattering of references to misdiagnosis.

Sickness, bad head, confusion, after last treatment euphoria!! If I hadn’t had it I would be dead.  [3.5]

I am a GP and became severely depressed in 2001. Without the ECT I am sure that my 4 year old would not have a mother. I am working again, with daily difficulties, but it has made me a better doctor that’s for sure  [3.6]

I was given 25 rounds of bilateral ECT and it helped me tremendously. I did encounter some short term memory loss but most of this was regained over a short time and my family and close friends were very supportive of me during this time and helped me with anything I may have forgotten. I won’t lie, this was a last resort for me, but it helped me to regain my strenth and will to live again. It essentially saved my life.  [3.7]

While reviewing these brief attestations I wondered about the full implications of trauma before / during / after electroconvulsive sessions. There is, of course, the physical trauma from which patients would require recovery. If compounded by other factors, such as injury from convulsions and psychological or emotional duress, an added dimension of dis-ease might be a reasonable expectation. Neglected manifestations or suppression of traumatic stress is thought to increase risk of debilitating illness; such as chronic fatigue syndrome and clinical depression for example. Loss of memory may therein also represent a theoretical quagmire for ECT proponents. These, and obvious ethical considerations, are of especial import where involuntary treatments are administered with only the consent of the courts or family members instead.

One human being taking a shot in the dark at the most sacred organ of another human being, violating human dignity in the process.  [3.8]

memory loss for Everything prior. Kneecap was removed (and not replaced) due to dislocations resulting from ect. Heart valves are not good causing severely low blood pressure since ect. ECT ect is a barbaric, humiliating, and dangerous procedure. It is not a medical treatment – but torture!  [3.9]

ECT in 1954 by Jean-Philippe Charbonnier

Photo-documentation of session (1954). *3

Senior researcher, Diana Rose, presents an overview of fifty-one studies pertaining to the benefits of ECT, and seven that measure memory loss outcomes specifically. In the 2003 summary of findings her research team notes significant disparities where a study was clinician-led, patient-led, or led by a collaborating team composed of both. Citing problems of too-soon or too-short investigation durations, and over-simplified professional questionnaires, they state that the “patient led studies reported lower rates of perceived benefit than clinical studies“.[5] This paper highlights the unreliability of traditional research questions even though distributed with intention of informing the medical community of qualitative outcomes, risks and benefits.

It must be affirmed without question that ECT causes brain damage. The effects on cognition can be severe and permanently devastating. It is wrong that patients are not being told about the possible lifelong negative repercussions of shock treatment. It is a dirty trick to “cure” mental illness through impairing a persons ability to think and reflect. I doubt I will ever be the same.  [3.9a]

How are patients to assess their options if the informations they are provided are incomplete, practitioner biased, or methodologically skewed? How can medical professionals expect fair assessment of this treatment, when feedback upon side-effects are regularly dismissed, and rehabilitation processes are not so much as anticipated? Ponder the ethical problematic inherent to the inducing of seizures, as an early twentieth century experiment, that was administered at the discretion of scientists working in neglected and over-crowded asylums. Such was the case when Antonin Artaud was first considered for the treatment (in 1939).

It is possible that the artist suffered a schizotypal disorder, until elicit drug and medicalized abuses accumulated injury beyond his own plastic limits, eventually bearing out all the ‘positive’ traits of schizophrenia. I have come across several inconclusive, and many contradictory, studies surrounding efficacy of treatment for this ailment [6]. Which begs the question of how worthwhile the punishing sessions were for Artaud. Only more recent protocols require that anaesthesia, muscle relaxants, and oxygen are administered before ECT to prevent pain and injury [7] So, our mômo would have met with every traumatic neuropathic and muscular contortion unless (or until) passing out. A multisite study from the Consortium for Research in Electroconvulsive Therapy (CORE) likewise offers the following concluding summary after reviewing clinical depression studies:

Both C-ECT and C-Pharm were shown to be superior to a historical placebo control, but both had limited efficacy, with more than half of patients either experiencing disease relapse or dropping out of the study. Even more effective strategies for relapse prevention in mood disorders are urgently needed. [8]

In a society that binds survival to an efficient ability to produce, and is prone to demoralizing those deemed unproductive, there are limited opportunities for reprieve. How does one weigh out ‘management’ options that carry so great potential of long-term disability, compounding event distress, and yet still the plausibility of recurrences? Putting aside the problems inherent to diagnosis processes, medical systemics, and the for-profit over-lording of Health as an industry: There are reasons public outcry against electroshock ‘therapy’, in Artaud’s lifetime and still today, have been so vehement.

Artaud was no stranger to institutional methods and measures. He struggled with health issues for the most of his earthly years. Commencing with meningitis in childhood, burdening him with chronic pain at an early age, and lending to drug experimentation as a youth. He is said to have suffered from an inherited strain of syphilis and several ‘nervous breakdowns’. Though born to a bourgeois family, a vagabond period of “poverty and self-neglect” [9] was followed by diagnosis of acute schizophrenia, somewhere around his fourtieth year. Artaud was by then long addicted to opiates and, though had taken to sanatorium ‘rest stays’ in the past, this time was committed to hospital after a psychotic episode and while in withdrawal. Clayton Eshleman and Bernard Bador confer [10] that Antonin Artaud had, upon arrest in Ireland, identified himself to authorities as Antoneo Arlanopoulas from Smyrna :
Antonin Artaud

Artaud spent the next eight years and eight months in five insane asylums. He was diagnosed by Dr. Jacques Lacan as chronically and incurably insane. By 1942, when asylum rations consisted mainly of cabbage soup, he was described as having become so emaciated that he looked like a walking skeleton–an eerie evocation of Nazi concentration camp inmates. He now believed that the doctors as well as his old friends in Paris were infested with Doubles who were Initiates, for example that Andre Breton was not Andre Breton but a member of some secret society empowered with black magic. Because these Initiates participated in orgies and sexual spells against him, he was forced to fight them ceaselessly. Antoneo Artaud himself had been invaded by Doubles, among whom were Astral, Flat-Nosed Pliers, The One Born of Sweat, and the Incarceration of Evil, known as Cigul. These Doubles often dictated letters in his head, and attempted to steal his thoughts before he could make them conscious.

Transported to France in a straight-jacket, Antoneo was admitted with formal notice that he was a danger to himself and others. First to the psychiatric ward at Sotteville-lès-Rouen in 1937, to Saint-Anne in 1938, and then to the Ville-Evrard asylum from 1939-1943. Art Historian Sarah Wilson describes the intense cultural conditions surrounding Artaud’s institutionalisation, elaborating upon the impact of two world wars, and the relevance a Nazi invasion. She notes that:

While deported populations faced extermination outside France’s national boundaries, within, the population in mental asylums faced a slow death by attrition – starvation – of which Artaud too was a victim. In 1952, the review Esprit mentioned a figure of 40,000 deaths; in 1990, long after the publication of Max Lafont’s L’Extermination douce, with its intolerable nazi parallels and the ensuing polemics, and in the context of French anxieties around the trial of Klaus Barbie, -the figures of asylum deaths mounted to over 76,000.  [11]

Nazi march on Paris (Ave Foch) June 1940

Nazi troupes parade into Paris June 1940.

Upon realizing that her son was among the forgotten, deprived and / or persecuted in an occupied suburb of Paris, Artaud’s mother arranged for a transfer. His doctor and friends spirited him away to the Praraire asylum of Rodez. Stephen Barber mentions the treatment referral, that preceded this relocation, in part of an interview [12] that can be read online:

At that time, electroshock therapy was new and had an aura of innovation, and Ferdière was a young doctor who wanted to experiment. Artaud experienced the treatment (over fifty sessions in all) as agonizingly painful, and as triggering severe memory losses. Many of his final writings (in the years 1946-48, after his release from Rodez and return from Paris) are outcries against his treatment at Rodez.

Artaud, already the survivor of novel healing approaches and experimentations, could not have provided informed consent to ECT. It is evident, in 1983 interviews with Sylvére Lotringer, that psychiatrist Dr. Latrémolière long remained defensive in response to criticism surrounding the administering of this treatment. While his insights upon Artaud’s narcissistic megalomania are valuable, Foucault’s analysis of a morality-policiing dictum for confining society’s outcasts [13], too well resonates while reading transcripts of this interview.

You judge people in order to be able to return them to normal. It’s the role of a doctor to return them to normal. To allow them to live in a millieu outside the clinic without embarrassing anyone. [14]

Artaud was “no longer viable you see. He was not fit. He really should have stayed with us. I protected society from him.” When asked what they were afraid of, Latrémolière added, “That he’d do stupid things” but had stated that he and Ferdière weren’t concerned Artaud would commit suicide.[15] Apparently he was referring to the artist’s performance, at an event staged in a church, which was widely considered blasphemous. Artaud was described as a sometimes charming, but often difficult patient, long before putting his doctors to shame. According to Eshleman and Bador:

Ferdiere was increasingly irritated by such behavior and decided to give Artaud a series of electroshocks to return him, as he put it, to a more creative and useful social life. Between July 1943 and December 1944, Artaud underwent fifty-one electroshock sessions. During one, his ninth dorsal vertebra was fractured; during another he went into a coma so long that, convinced that he had died, Ferdiere ordered his body dispatched to the asylum mortuary–where Artaud came to! In 1944, he began to suffer intestinal hemorrhages and by the end of that year, all of his teeth had fallen out.

*5 Antonin Artaud & Gaston Ferdiere 1946

Antonin Artaud & Gaston Ferdiere 1946 at Rodez.

Artaud would soon articulate his indignation and rage, but there is indication also of more dichotomous sentiments, and even signals of appreciation. Perhaps contradictions stemmed as much from perceptual confoundment as from a kind of relief? Notice (as previously quoted) that a former patient refers to sensation of elation after a ECT course, for example, and how this resonates with some of Artaud’s creative aims. In any case, it can be argued that he did benefit – at least to some notable degree – from the time spent at Rodez.

His doctors forever maintained their treatment choices were to thank for his ‘reconstitution’ of wits. Granted, there is ample documentation of an immediate ECT efficacy among patients with early onset, acute schizophrenia symptoms. On the other hand, Artaud was episodically afflicted for at least a dozen years by now, and electrotherapies aren’t considered effective for treatment of chronic symptoms of psychosis [16]. Admittedly, after reviewing the above materials, I’ve less confidence in the unmitigated torture sessions and more enthusiasm for description of his living conditions.

Artaud resided in a room of his own, had freedom of mobility on the arboured grounds, and for the first time in years was assured a healthy diet. Dr. Latrémolière claimed to have invited Artaud to his home for dinner, to attend readings in his salon, and to have once considered himself ‘a friend’[17]. It is known also that Dr. Ferdière furnished the artist with contemporary literature, magazines, and cultural discourses. Once an aspiring poet himself, and a supporter of the surrealist movement, Ferdière invested in and encouraged Artaud’s therapeutic art-making during convalescence.

While staying at Ivry-sur-Seine.

These ‘liberties’ supported a free-flow of communications between friends, admirers, and adversaries too. Rodez ushered in a phase of abundant creativity and, although often volatile, a more lucid high-expressiveness. He had resumed a presence, and a place of prominence, among the artistic and intellectual communities with which he had previously affiliated. Given the persecutory attitudes cultivated toward the mentally ill, and atrocious institutional conditions reported from Europe at this time [18], these circumstances would appear to represent improvements for Artaud. Who then, at around fifty years of age, moved back to Paris and into two rooms at the Ivry-sur-Seine rest home [19] but was now also dying of cancer.

As might be interpreted from – and is loosely correlated within – the database entries discussed in the middle section of these notes: Any measure of compassionate respect, dignifying empowerment, and an actively collaborative care is an assuredly sounder method of promoting the wellbeing of another. Combined with the egality of knowledge transparency [20], that which informs consent and agreements, the best interests of a given society may hope yet to be protected. According to many past patient feedbacks however, it is clearly still the vulnerable whom are the unprotected, and from the very ‘pillars of society’ they are expected to seek for help.

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