Beyond Stigma: The Compassionate Application of Electro-Convulsive Therapy
by Linda Andre

The only reason shock treatment has gotten such an undeserved bad rap is because doctors who give it don't treat patients nice enough.

What's wrong with this statement? If you said nothing, I can think of some prime real estate in Brooklyn that's for sale real cheap.

Most people would probably say, "While I have no personal knowledge about shock treatment and haven't researched it myself, I am willing to take the word of a psychiatrist and member of the American Psychiatric Association, who must know what he's talking about. Besides he wouldn't have produced and marketed a tape with such nice music, and couldn't sell it for so much money, and wouldn't have a web site devoted to selling it, and wouldn't be so apparently sincere about it, if it were all a bunch of hooey."

Brooklyn Bridge for sale: $10.

Christian Hageseth might have gotten the idea for his new video, "Beyond Stigma: The Compassionate Application of Electro-Convulsive Therapy," from watching late-night TV. This is a nation of people who believe in credit-card psychics, he probably said to himself. If the suckers will pay for that, have I got a gimmick for them! In fact, the more unbelievable and outrageous it is, the more they'll love it! I know! I'll call it Compassionate ECT!

You might consider giving Chris points for originality, at least. Surely no one else has ever had the gall to try to market such a bizarre idea. But sadly, there are one or two precedents. In the 1970s, shock doctor HC Tien tried to change shock's name and reputation: he called his version ELT, or Electro-Love-Therapy. The "Love" was a form of shock so intense that patients, who were always women, frequently those not happy in their housewife and mother roles, forgot their entire identities and regressed to the point of having to be bottle-fed. They were then resocialized by Tien into their housewife and mother roles, and Tien and the husbands were pleased with the results. The women even took new names to distance their new docile personalities from their old troublesome ones.

At one time in the 80s, I believe there was also a shock machine company that advertised "A Machine with a Memory---and Compassion." Perhaps the machines sucked up and acquired the stolen memories of the patients they were attached to. No one explained how the machines came by compassion. Anyway, the compassion thing never caught on as a marketing slogan, until now.

It turns out that Chris has a different idea of what compassion is. But before we ask what he means, let's just look at the logical absurdities of his fundamental premise. You don't need a Ph.D. to do this. ECT is the application of electricity to the human brain to produce grand mal seizures. The brain is the brain (humans haven't changed much in the past 50 years), electricity is electricity, and what happens when they meet is governed by the laws of physics, not by what patients do in the waiting room, how reassuring the doctor is, what the patient is wearing, how many people are present when shock is done, or anything else Hageseth thinks can magically affect what shock is and does.

Since shock always causes permanent memory loss of weeks, months or years, and since that memory loss almost always includes the actual administration of the shocks, the patients will never remember any of those things anyway. Had they been misled by his recommended tricks to feel slightly less anxious before the shock, they won't know or care about this afterwards. We can't help asking: Who is Hageseth seeking to reassure, and, who is he seeking to benefit by making this video? It can't be his patients.

"The stigma of ECT didn't just happen," Hageseth claims. "It came about because of the way it was administered in the past."

Maybe, he suggests, getting ECT should be more of a happy occasion, like having a baby. He even says that psychiatry should take cues from obstetrics: set up special "suites" just for ECT, for instance. Most hospitals already do this. The logical problem for Hageseth's theory is that obstetrics, unlike psychiatry, did not get stigmatized for not having special suites, or for having 'small and crowded' rooms, or for not allowing family members to be present during procedures for which patients are unconscious. Nor did any other medical or surgical procedures, which, cosmetically at least, resemble shock---requiring surgical gowns, anesthesia, special rooms, and life-support equipment. Why aren't these procedures, and the professionals who give them, stigmatized because of "the way they are administered?" Might there just be something else that is different about psychiatry in general, and shock in particular?

There can't be, he insists. He protests too much. ECT suites are not enough, he says. We must do ECT with compassion.

What does he mean by compassion?

Turns out, something different from what the rest of us think it is. He's confused compassion with infantilism, a switch that speaks volumes about his opinion of his patients. The video not only tells us about, but demonstrates, Hageseth's brand of compassion.

First, it involves mural wallpaper. Hageseth papered his free-standing Colorado psychiatric clinic in photographic murals of forests and mountains. In fact, there's a little trompe l'oeil sequence in the video where you just see the forest scene until the view expands, and you see it's only wallpaper. The clue is that the scene is interrupted, fittingly, by electrical outlets that couldn't be papered over. Humans have an affinity for nature, Hageseth tells us very seriously, the difference between a real forest and a wallpaper forest in a psych clinic being minimal.

He's even put a picture of a bird on the ceiling of the room where the patients are anesthetized so they can have a more pleasant experience of losing consciousness just before shock. Watch out: if this catches on for tonsillectomies, they too might shed their stigma.

The next way Hageseth thought of to show his consideration for the patients whose brains he is about to burn is to offer them a choice in paper gowns: they can have their unconscious bodies covered in a pattern of brightly colored balloons, Bugs Bunny, or Tweety and Sylvester.

The video pointlessly has one of Hageseth's employees, a burly gray-bearded social worker named Al, "act" as a shock patient in order to demonstrate the gowns, the IV, the heart monitors, and so on. Al's acting style is strictly tongue in cheek, and he doesn't look too good in balloons. Perhaps he should have chosen Tweety.