Shock therapy

There’s a review in today’s Times Literary Supplement of a new book about ECT (or electroconvulsive therapy) as a treatment for mental illnesses such as psychosis or depression.

It traces the history of the therapy from the experiments of Ugo Cerletti in Rome in the 1930s, through the widespread use of it in the 40s and 50s, to its discrediting in the 60s (think One Flew Over the Cuckoo’s Nest) and its cautious reintroduction in the 90s as an alternative to drug-based therapies.

All very interesting, but what I wonder about is that starting date. Electric treatment was used for shell-shock cases in several countries during the Great War – remember Dr. L.R. Yealland, the man Pat Barker loves to hate.

I hold no brief for Yealland’s methods – often they seem to amount to torturing men into submission – but his electic shock treatment seems sometimes at least to have been successful in removing symptoms such as tremors.  Is there really no link between wartime shock therapy and the later applications? The TLS reviewer, who writes as though he’s very authoritative, implies not…

When I look at magazines of the twenties, I often flick through the adverts, and have noticed a lot for electical health ppliances of one sort or another – often promising to get rid of neurasthenia or nervous complaints. I don’t know whether these gave a shock (and if so, was it a jolt or a tingle?) or whether they just sent a current round a belt in the hope of doing something magnetic. I think there were other medical or pseudo-medical use of electricity too, before Signor Cerletti got going in the thirties.  I wonder if anyone has researched them.

4 Comments

  1. Andy Frayn
    Posted September 18, 2008 at 11:26 am | Permalink

    If you read Yealland’s book on the subject it’s actually pretty shocking stuff… In describing the ‘cure’ of a Private who had been rendered mute by his reaction to his involvement in the notoriously horrific battles at Mons, Ypres, and Loos, Yealland tells us that:

    He had been strapped down in a chair for twenty minutes at a time, when strong electricity was applied to his neck and throat; lighted cigarette ends had been applied to the tip of his tongue and “hot plates” had been placed at the back of his mouth. Hypnotism had been tried. But all these methods proved to be unsuccessful in restoring his voice.
    […]
    In the evening he was taken to the electrical room.[…] The mouth was kept open by means of a tongue depressor; a strong faradic current was applied to the posterior wall of the pharynx, and with this stimulus he jumped backwards, detaching the wires from the battery. “Remember, you must behave as becomes the hero I expect you to be,” I said. “A man who has gone through so many battles should have better control of himself.”

    Lewis R. Yealland, Hysterical Disorders of Warfare (London: Macmillan, 1918), pp.7-9.

  2. Jessica
    Posted September 19, 2008 at 7:03 am | Permalink

    Ah, yes, the famous case of Private ‘E’. It is that mention of lighted cigarettes that really turns the description into one of torture, isn’t it?

    Actually, it would be quite interesting to know how Yealland defines a ‘strong’ current in this context. The main purpose of his use of electricity, as he himself states in ‘The Treatment of Some Common War Neuroses’ (The Lancet, June 1917), was to impose his authority over the patient. By demonstrating his mastery over the new and mysterious power of electricity, he emphasised his status as the expert doctor and that of his patient as the ignorant layman so that when he ordered his patient back to health, he did so with the authority of the lay professional as well as the military officer (almost all his patients were Other Ranks). Some just had to be shown the electrical equipment to become appropriately compliant. ‘E’ was more recalcitrant and so has become notorious.

    Interestingly, there was a reasonable amount of controversy over Yealland’s methods at the time – they were viewed as being too ‘German’ in their use of authority and physical bullying.

  3. Andy Frayn
    Posted September 20, 2008 at 10:48 am | Permalink

    Thanks Jessica, that’s interesting – that quotation had been sat on my hard drive for a long time, but has stuck with me for obvious reasons.

    I wonder how far the controversy extended? Was it among liberal / pacifist circles or was the distaste for Yealland’s methods wider than that? Thinking in terms of the well-documented civilian distaste for, or at least suspicion of, returning combatants, and of those suffering ‘mental illnesses’ as cowardly or malingering.

  4. Posted September 21, 2008 at 8:32 pm | Permalink

    The evidence to the Southborough Commission into “Shell Shock” in 1922 includes statements from many points of view, but the consensus is that it is a matter of control – men losing control and regimental officers not exerting enough control.
    There are witnesses like Lieut-Col E.C.S. Jervis of the Lancers and Machine-Gun Corps, who insists that is just a matter of “loss of nerve.” According to the summary, “he would have said that most of it was nothing at all. Then when he was in the line he had seen men go quite off their heads for the time being, and that sort of thing, but they very often came back quite all right after a little rest.”
    He thought that any regiment with many cases must be badly led.”Asked whether he held that emotional “shell-shock was a disgrace to a regiment, he said that he was inclined to think it was.”
    Yealland’s methods were a way of exerting control over the soldier, and so were the strict diet and exercise techniques.
    I’ve found quite a bit of fiction in 1919 or so that takes this line. “What Every Soldier Knows” – a story by Warwick Deeping (an Army doctor) is a case study of malingering. Other stories show ex-soldiers feeling sorry for themselves, and being cured when they are forced to pull themselves together.
    Fiction sympathetic to “shell-shocked” soldiers in the early twenties tends to be about officers suffering melancholia. Often they are cured by natural surroundings or the love of a good woman.
    Fiction critical of the medical treatment of shell-shockers seems to come later – Mrs Dalloway (1925) or Deeping’s “Kitty” (1927). In eight years Deeping has done a complete U-turn, from scorn for NYD(N) cases to sentimental sympathy.


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