Shock Therapy...IT'S BACK - Anecdotal Miracles about Shock Therapy

Written by SANDRA G. BOODMAN The Washington Post

Anecdotal Miracles

Because of the stigma of psychiatric illness in general and of shock treatment in particular, most patients do not openly discuss their experiences. Among the few who have is talk show host Dick Cavett, who underwent ECT in 1980. In a 1992 account of his treatment Cavett told People magazine that he had suffered from periodic, debilitating depressions since 1959 when he graduated from Yale. In 1975 a psychiatrist prescribed an antidepressant that worked so well that once Cavett felt better, he simply stopped taking it.

His worst depression occurred in May 1980 when he became so agitated that he was taken off a London-bound Concorde jet and driven to Columbia-Presbyterian Hospital. There he was treated with ECT. "I was so disoriented I couldn't figure out what they were asking me to sign, but I signed [the release for treatment] anyway," he wrote.

"In my case ECT was miraculous," he continued. "My wife was dubious, but when she came into my room afterward, I sat up and said, `Look who's back among the living.' It was like a magic wand." Cavett, who was in the hospital for six weeks, said that he has taken antidepressants ever since.

Twice in the past six years writer Martha Manning, who for years practiced as a clinical psychologist in Northern Virginia, has undergone a series of ECT treatments. In her 1994 book entitled "Undercurrents," Manning wrote that months of psychotherapy and numerous antidepressants failed to arrest her precipitous slide into suicidal depression. When her psychologist Kay Redfield Jamison suggested shock treatments, Manning was horrified. She had been trained to regard shock as a risky and barbaric procedure reserved for those who had exhausted every other option. Ultimately Manning decided that she had too.

In 1990 she underwent six ECT treatments while a patient at Arlington Hospital. She said she suffered permanent memory loss for events surrounding the treatment and was so confused for several weeks that she got lost driving around her neighborhood and didn't remember her sister's visit 24 hours after it occurred.

"It is scary, despite anybody's promises to the contrary," Manning said in an interview. Although some of her memories before and during ECT have been forever obliterated, Manning said she suffered no other lasting problems. "I felt I got 30 IQ points back" once the depression lifted.

"I was lucky," said Manning, who says her depression is now controlled by medication. "ECT was safe for me and very, very helpful. It was a break in the action, not a cure."

"I'm coming from a position of seeing ECT at its best," added Manning, who said she would have ECT again if she needed it. "I'm sure there are other people who've seen it at its worst."

Vanished Memories

Ted Chabasinski is one of those people.

A lawyer in Berkeley, Calif., Chabasinski, 59, says he has spent years trying to recover from the dozens of ECT treatments he underwent more than a half-century ago. At age 6, he was taken from a foster family in the Bronx and sent to New York's Bellevue Hospital to be treated by the late child psychiatrist Lauretta Bender.

As a child Chabasinski was precocious but very withdrawn, behaviors that a social worker who regularly visited the foster family believed were the beginnings of schizophrenia, the same illness from which his mother, who was poor and unmarried, suffered. " At the time hereditary causes of mental illness were fashionable," he said.

Chabasinski was one of the first children to receive shock treatments, which were administered without anesthesia or muscle relaxants. "It made me want to die," he recalled. "I remember that they would stick a rag in my mouth so I wouldn't bite through my tongue and that it took three attendants to hold me down. I knew that in the mornings that I didn't get any breakfast I was going to get shock treatment." He spent the next 10 years in a state mental hospital.

Bender, who shocked 100 children, the youngest of whom was 3, abandoned the use of ECT in the 1950s. She is best known as the co-developer of a widely used neuropsychological test that bears her name, not as a pioneer in the use of ECT on children. That work was discredited by researchers who found that the children she treated either showed no improvement or got worse.

The experience left Chabasinski with the conviction that ECT was barbaric and should be outlawed. He convinced residents of his adopted hometown; in 1982 Berkeley voters overwhelmingly passed a referendum banning the treatment. That law was overturned by a court after the APA challenged its constitutionality.

The Old and the New

There is little dispute that ECT administered before the late 1960s, commonly referred to as "unmodified," was different from later treatment. When Chabasinski underwent ECT, patients did not routinely receive general anesthesia and muscle paralyzing drug s to prevent muscle spasms and fractures, as well as continuous oxygen to protect the brain. Nor was there monitoring by an electroencephalogram. All of these are standard today. In the old days shock machines used sine-wave electricity, a different -- and ECT supporters say riskier -- form of electrical impulse than the brief pulse current dispensed by contemporary machines.