STEPHEN FRY

Long long ago, in a land far away; when you and I were young Toby; I worked for a year as a nursing assistant in a huge psychiatric hospital somewhere in "the Shire"

Every Thursday morning we would administer ECT to the chronic admission ward patients deemed in need of it.
These consisted of quite a few screwed-up late adolescents who would have done better with sensitive counselling around disfunctional attachments and self esteem.

Other (fewer) were middle aged depressed men going through mid life changes, frequently associated with separation and loss (empty nest syndrome, divorce, redundancy,latent and now emerging sexual identity issues etc) all of whom might have been better given some help to understand, manage and work through the issues.

Those who had more chronic and embedded conditions were treated no differently.

The concept seemed to be the same as was applied to the valve television sets of the day.
If you can't put it right by twiddling the knobs give it a good had thump on the to or side to shake it up, and maybe all the bits will fall back into the right place again.

The effect that psychiatrists seemed to be looking for was a reduced objection to lifes problems and a more fatalistic acceptance of what befalls the patient, and abandonment of ambition.

This seemed to co-relate to being cured.

I saw people gradually lose their "vital spark" character, and that which I found engaging about them (yes they were difficult to rub along with a lot of the time but there was always those monents when their true creative/repciprocal/responsive/interactive/creative intelligence shone thruogh and really engaged with you.

There was one you man who was repeatedly admitted and thus treated, who I particularly identified with, who eventually became dull and passive enough to survive in our society.

In one of my medium manic phases I googled him a couple of years ago ( he had an unusual name) and found he was some kind of tame under-vicar in a C of E parish somewhere in middle England, living out his life accourding to a set of moral instructions and calendared routines. Success of a sort!!

My observations would concur with those who claim that ECT can reduce IQ,

The actual process itself is barbaric to observe, and as it affects/temporarily eradicates the short term memory, the patient can't remember the actual administration of the treatment.

Even though they were given a muscle relaxant and a seditive, it appeared at the time that they could feel and experience the high direct curent being passed across their frontal lobes, until they went into an induced epileptic fit ( if they didn't we did it again until they did)

When they awoke they had no clue who or where they were, and ot took the best part of a day for most of their personal resource information to return....but they never seemed to remember the moment of the shock or how it felt....if they did I wonder if they would ever consent again?

I would never concede to it.

This was in the late seventies. I am surprised they still do it.

For me it is in the same bag as Insulin shock therapy, lobotomy and leucotomy.

Short and long term (some permanent) memory problems are always acknowledged by the profession. Complaints of "losing their personality" are fairly common.

NICE say;

"The National Institute of Health and Clinical Excellence (NICE) have looked in detail at the use of ECT and have said that it should be used only in depression, resistant mania or catatonia.

They say ECT should be considered for acute treatment of severe depression that is life-threatening and when a rapid response is required, or when other treatments have failed.

It should not be used routinely in moderate depression, but should be considered for people with moderate depression if their depression has not responded to multiple drug treatments and psychological treatment.

ECT is unlikely to help those with mild to moderate depression or most other psychiatric conditions. It has no role in the general treatment of schizophrenia."