Electroconvulsive therapy (ECT), popularly known as "shock treatment," dates from 1938, when two Italian psychiatrists, searching for a cure for schizophrenia, adapted a pair of tongs used to stun hogs before slaughter and applied them to the temples of a disturbed patient.
The tongs induced a grand mal seizure, similar to those experienced by epileptics. For unknown reasons, the patient's condition improved.
For the next two decades, shock treatments often were performed, without anesthesia, for a variety of psychiatric problems. The side effects -- which ranged from confusion and memory loss to convulsions and broken bones -- led doctors to seek other methods of treatment.
With the development of psychoactive drugs like Thorazine in the 1950s and '60s, it was believed -- incorrectly -- that doctors needed only to discover the proper drug and dose to cure a patient.
Civil rights concerns of the 1960s and '70s helped fuel the backlash against ECT. The practice was banned by referendum briefly in Berkeley in 1982.
But the shortcomings and side effects of anti-psychotic drugs, combined with the success of ECT in treating some severely depressed patients, have led to its resurgence in recent years.
Currently about 100,000 people undergo ECT annually, a procedure that has been refined since its primitive early days. Patients now receive the equivalent of 80 to 150 volts of electricity, delivered in a fraction of a second, which causes a brain seizure to register on an electroencelograph. ECT is given in a series of treatments -- between five and 15 is typical -- that costs about $5,000 and can be performed on an outpatient basis.
The controversy surrounding ECT has not diminished. A Washington-based group of former "shock survivors" maintains that the treatment causes profound memory loss, and some psychiatrists remain reluctant to use it.
ECT, according to Lee Coleman, a Berkeley psychiatrist, is an attempt to "bludgeon . . . depression away" by making a patient forget painful memories. "You could do the same thing with two-by-four," Coleman has said, "but that doesn't look very doctorly."