On some gut level, the whole idea of electroshock therapy is absurd. At a time when people with mental illnesses can choose from a pharmacological cornucopia, why would they have electricity run through their brain instead? Didn't electroshock disappear around the same time as three-martini lunches?
Actually, electroconvulsive therapy, as psychiatrists call it, has remained a common treatment for those who are severely depressed and who don't respond to (or can't tolerate) drugs. Its use has been quietly on the rise in the past two decades. Because most states don't require reporting on electroshock, there are no hard figures, but many people in the electroshock world agree that at least 100,000 Americans receive the treatment annually, up from a 1980 federal estimate of 33,000. Research on electroshock has also surged. Just last month the American Psychiatric Association released a second edition of its report on electroconvulsive therapy; it lists more than 1,000 citations.
Why all the interest? One reason is that electroshock remains a nagging scientific puzzle: it works a little bit like banging the side of a fuzzy TV--it just works, except when it doesn't. Second, a small but persistent group of advocates wants to ban it--they say it causes brain damage--and a larger, more mainstream group of activists wants more research before the treatment spreads any further. Many of these folks are former patients (or survivors, to use a term of choice), and they have helped persuade a handful of state legislatures to consider a ban. No states have agreed, though at least four have enacted restrictions.
Psychiatrists and some former patients who found the treatment beneficial are rushing to try to prove the dissenters wrong. An ugly war of words has erupted. Dr. Peter Breggin, a psychiatrist who has written four books critical of electroshock and who favors therapy and human services instead, told TIME that shock is used by "cold, aloof guys who seem to feel more comfortable with machines than patients." Dr. Harold Sackeim, who runs the department of biological psychiatry at the New York State Psychiatric Institute, responds that caregivers who forgo the use of electroshock and other biological methods to treat the suicidally depressed "are going to end up with a lot of dead patients."
If you are a filmgoer of a certain age, your image of electroshock was shaped by such movies as The Snake Pit or One Flew Over the Cuckoo's Nest. In the latter, a small army of orderlies and nurses restrain Randle Patrick McMurphy (Jack Nicholson) as he is connected to the electrodes. The treatment is agonizing because McMurphy isn't given anesthesia, which has been routine for years.