In the early days of electroconvulsive therapy (ECT), while some psychiatrists were trying to find ways to reduce the memory loss associated with the treatment, others were going off in the opposite direction and experimenting with “intensified ECT”.
One of these was Robert Russell, a young psychiatrist at the Three Counties Asylum, in Arlesey, Bedfordshire. The asylum had been built to take paupers from the counties of Bedfordshire, Hertfordshire and Huntingdonshire, hence its name. By the 1960s it was known as Fairfield Hospital. It closed in 1999, and became a housing development.
In the 1946 Dr Russell, together with the deputy superintendent, Dr Page, began to experiment with “intensified ECT”. Instead of being given one electric shock three times a week, which was the usual practice, Russell and Page gave their patients up to 15 (occasionally more) one-second shocks at half-second intervals on a daily basis (twice-daily for the “severest cases”).
Page and Russell also increased the voltage and the duration of the electric shocks: from the usual 100 volts for 0.3 seconds to 150 volts for 1 sec or more (by modern standards these values are not excessive). The extra shocks were given during the convulsion, and required a machine where the time-switch could be operated rapidly. Writing in The Lancet in 1948, Page and Russell described how they had given this treatment to over 300 patients, aged from 16 to 74. In 1953, again in The Lancet, the psychiatrists were able to review five year’s experience of intensified ECT, having treated by now more than 3,500 patients. The treatment, as the numbers suggest, was not reserved for the most severely ill patients, but also used on people with mild and moderate depression. Neither was it reserved for people whose condition had not responded to other forms of treatment or a change in environment: Page and Russell preferred to give people intensified ECT within 24 hours of admission to hospital. It was also used on disturbed long-stay patients (“chronic psychotics”) in an attempt to control their destructive behaviour.
But by 1953 there had evidently been some criticism of intensified ECT and Page and Russell found it necessary to defend the treatment against accusations that it caused brain damage.
“In our experience it is less dangerous than ordinary electroconvulsant therapy… We have seen no clinical evidence of ‘cerebral damage’ following the normal use of intensive electroconvulsant therapy. The degree of amnesia and confusion following treatment varies from case to case, but it is no greater than that following a comparable number of ordinary electroconvulsant treatments”.
The most famous practitioner of Page and Russell’s technique was the Scottish-American psychiatrist Ewen Cameron, the first president of the World Psychiatric Association. While professor of psychiatry at McGill University in Canada, he developed his own version of the Page-Russell electroshock technique, as he called it, and used it to “de-pattern” his patients, deliberating wiping out their memories by the use of intensive ECT. It later emerged that the CIA, who were interested in the mind-control implications of de-patterning treatment, had put funds into Professor Cameron’s institute (whether or not he was aware of where these funds were coming from is still debated) and in 1988 nine of his patients received compensation of approximately $80,000 each from the US Government. The Canadian Government offered a similar sum to a further 80 patients whose treatment had not been funded by the CIA, and legal battles over who is entitled to compensation continue to this day in Canada.
Meanwhile, in 1950, Robert Russell had set up a company to manufacture ECT machines. In 1999 he was still running the company in Letchworth, Hertfordshire, with the help of some family members and a couple of employees. At one time Ectron had a virtual monopoly on ECT equipment in Great Britain, as well as exporting machines to other countries. In 1980, for example, 80 per cent of ECT units were using Ectron machines and almost all the rest were using machines made by Theratronics, a Channel Islands company which was bought by Dr Russell the following year. Since the 1990s, however, British hospitals have increasingly been using American ECT machines.