Last December the journal Nature Neuroscience published an article with the title “An electroconvulsive therapy procedure impairs reconsolidation of episodic memories in humans”. There was immediate media interest (for example, here at the BBC) with speculation that ECT could become a treatment for post traumatic stress disorder. It remains to be seen however whether the results of the study are replicable and whether they have any practical implications.
Rather late in the day, The Atlantic has joined the debate with an article called “The ethics of erasing bad memories”. Much of the article is taken up with a discussion on memory, with quotes from appropriate experts. But when it comes to ECT the article makes an astonishing claim:
“Electricity has been used in medical treatments all the way back to 46 C.E. when Scribonius Largus treated the Roman Emperor Claudius for headaches with an electric eel, a process that he recorded in his Compositiones Medicae. But it wasn’t until Sigmund Freud came along that electroshock therapy took on its more modern form….
Although Freud quickly threw it out of his repertoire, over a century later, electroconvulsive therapy (ECT) is back in use. While Freud used ECT as a localized treatment for physical maladies, it’s now predominately used on the brain as a treatment for mental illnesses.”
The author is getting confused here. What Freud and many others in the nineteenth century used was not electroconvulsive therapy. It involved electricity but not convulsions. The electrical current used was much smaller. For example, one Victorian psychiatrist, Dr Wiglesworth, used a current of on average 15 milliamps. ECT uses a current of about 800 milliamps. ECT was invented by Italian doctors Ugo Cerletti and Lucio Bini in 1938.
The author is not alone in this confusion; I have seen other articles that refer inappropriately to, for example, electric shocks used as aversion therapy, as ECT. The confusion may arise because, especially in the United States, ECT is sometimes referred to as electroshock. Authors may be advised to use the term ECT instead, but then go on to replace any instance of the use of electric shocks with ECT. The article also refers rather bizarrely to ECT sessions as “ECT bursts”.
The illustration at the beginning of “The Atlantic’s” article shows part of the control panel on a vintage ECT machine from St Audry’s Hospital, Suffolk, England. It doesn’t say how old it is but it says AEI on the machine and Associated Electrical Industries was taken over by the General Electric Company in 1967 so presumably it is 1960s or earlier. Interestingly, the timer on the machine is calibrated up to one second. In those days people were given much shorter shocks than nowadays, when the shock typically lasts for 2 or 3 seconds and modern machines can deliver shocks lasting up to 8 seconds.