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52 Ancestors in 52 Weeks: Week 43. Shock. Electroconvulsive Therapy.

 


ECT: ELECTROCONVULSIVE THERAPY

Bethlem Hospital London c1830 now part of the Maudsley Hospital
www.psychology.wikia.org

I couldn't immediately think of what to write for this weeks theme of shock. There have been a few 'shocks' whilst researching my family tree. I have already written posts about many of them and some still have personal memories for living relatives.

So for this weeks theme I thought I would write a post about the psychiatric treatment of ECT.  My Great Aunt suffered from anxiety and depression for much of her life. In the 1950's she received treatment with both surgery and courses of ECT, leaving her with long term 'fugue' type episodes.

From my point of view I trained as a Mental Health Nurse (then Psychiatric) back in the 1980's in an 'asylum' in the process of being closed. There were still a number of 'long term patients,' one, I recall had been an inpatient for over 40 years. These people generally initially had a diagnosis of Schizophrenia, but having been hospitalised for so many years had become institutionalised. Please don't think life for these people, was similar to 'One Flew over the Cuckoo's Nest at the time I met them, their lives weren't perfect, however  most of them had a little structure in the day, with various supported work within the hospital, often menial, but enough to earn money to visit the local pub in town. For these people the prospect of leaving the hospital to what were in fact smaller institutions elsewhere was daunting. But this post is to talk about ECT, not the political, social and health implications these people were facing.

Alongside institutionalisation, the side effects of long term use of the Phenathiazine group of drugs, most commonly, Chlorpromazine were negative factors to these people's health. Whilst over the years, the administration of ECT, had become a medical procedure under general anaesthetic. Patients who received this treatment in the mid 20th century, would receive the treatment whilst sitting in line with no anaesthetic or muscle relaxant.

MIND, the UK mental health charity describe, Electroconvulsive therapy as a treatment that involves sending an electrical current through the brain, causing a brief surge of electrical activity within the brain (siezure).

Whilst in recent decades this type of treatment is administered twice a week and a course prescribed is generally from 5- 12 treatments. However, in it's early usage, treatment could be administered daily, and there are records showing it being given 4 times a day. There did not appear to be any limits on the number of treatments, and some of those patient's I cared for had records, recording ECT x 140. Yes 40 years later, this is still imprinted on my memory and I still wonder how that particular gentleman was able to function, years after this.

So my Great Aunt, experienced this treatment, but also had surgery, a lobotomy or leucotomy involved severing connections in the pre frontal cortex. In the period between the 1940's and 1970's around 20,000 of these operations were undertaken in the UK. Even in the early years of my nursing career a handful of these operations a year were undertaken at the Maudsley Hospital in London.

As for Electroconvulsive therapy, it was a treatment that was a last resort, one which I would attempt to avoid, in all aspects, whether in accompanying a patient to the treatment in latter years or being involved in recovery in earlier years, a position I never felt competent to undertake.

I have seen it work, perhaps most remarkably in a Gentleman, who had completely stopped eating and drinking. After his first treatment, the first thing he did was drink a cup of water and that was the start of his recovery. For others, the treatment was often less successful.

So this is my post for this weeks theme, after all many laymen call it electric-shock treatment.



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