The therapy works by passing electrical currents to parts of the brain, which triggers a brief seizure.
Credit: Getty Images
Into the Asylum
Diseases of the mind have always held a special place in the dark regions of our imagination. In this slideshow, we explore the history of how the lunatic asylum of ancient times became the psychiatric hospital of today, including how patients were treated before the advent of modern medicine. And though the treatment of patients who suffer from mental disorders has evolved considerably over the centuries, some of the stigma these people endure is very much the same.
The First Facilities
The first mental asylum can be traced back as early as the 5th century in the Middle East. Prior to that, families who had members suffering from mental health disorders just kept their ill relatives at home. Even after the advent of the mental asylum, it really wasn't until the 18th and 19th centuries that urbanization allowed for greater access to these facilities. A psychiatric hospital in Aleppo, Syria, that operated from the 14th century into the 20th century appears in this photo.
A Prison, Not a Hospital
Most sufferers of mental disorders throughout history have not been treated as patients, but rather as prisoners. This illustration depicts female mental patients chained up at Pitié-Salpêtrière Hospital in Paris, France. Although the facility has since evolved into one of the largest hospital's in Europe, during the 18th century, the period this painting depicts, patient care wasn't high on the list of priorities for officials working at this facility.
Made in America
Psychiatric institutions first appeared in the United States during the Colonial era as a result of urbanization, according to the website of the U.S. Surgeon General. In this photo, Blackwell's Island Lunatic Asylum, built in New York at the beginning of the 19th century, was the first municipal mental hospital in the United States, according to the American Journal of Psychiatry.
A Jolt to the System
As mental health asylums gradually transformed into institutions that went from confining those with mental health disorders to treating them, psychiatrists began experimenting with different therapies for treating a range of diseases. Although drugs treating depression, anxiety, psychosis, or any number of different symptoms of a larger disorder are readily available today, early patients of the new psychological revolution did not have quite the range of options available to them. In this photo, a medical team preps a patient for electroconvulsive treatment, better known as shock therapy. Although the practice continues to this day in hospitals around the globe, its efficacy as a treatment for psychological disorders has long been questioned by the medical community.
A Surgical Solution?
The lobotomy is among one of the most brutal and infamous treatments for mental health conditions. The process involves a surgeon intentionally causing trauma to the prefrontal cortex, the part of the brain that deals with behavior and personality among other functions. Ever since its invention in 1935, the treatment has sparked controversy over its effectiveness and sheer brutality. Many patients who underwent this procedure were left permanently incapacitated; some even died. In this photo taken in 1961, a prison official preps a convict to undergo a lobotomy.
Credit: Getty Images
Hypnotism was another popular early form of psychiatric diagnosis and treatment. Hypnotism predated psychological study, but was first described in clinical terms in the 19th century. It was employed as a diagnostic and treatment tool by some of the earliest pioneers of the field of psychology, including Sigmund Freud, who eventually fell out of favor with the practice. Even today, hypnotism is promoted with the promise of helping patients with sleep disorders, nicotine addiction, depression, and a whole range of diseases and conditions.
Not all treatments are as aggressive as electroconvulsive therapy. In this photo, a painting, the product of a patient's therapy, provides medical professionals with an insight into the patient's condition. Art therapy could also be a window through which patients along with their therapists can examine past traumas or challenges that they wouldn't have been able to approach otherwise.
An Abandoned Institution
As patient care became a higher priority for mental health professionals as opposed to simply corralling patients into a facility to segregate them from society, what were once called lunatic asylums gave way to psychiatric hospitals. An abandoned asylum, such as the one photographed here known as Northern State Hospital for the Insane, still conveys an eerie quality as though still haunted by the patients who used to be kept there.
A Modern Asylum
Not all more modern facilities treat their patients with quality care and a little empathy. In 1989 and 1990, photographer Claudio Edinger traveled to Juqueri Mental Hospital in Sao Paolo State, Brazil, where his visited his grandmother, a once lively woman who had been transformed by Alzheimer's Disease. What Edinger witnessed at the facility was a "chaotic environment" with appalling conditions -- a place where many patients walked around naked in their own filth. Worse, Juqueri is the largest psychiatric facility in Latin America.
We're still a far ways off from the kind of memory erasure portrayed in the film Eternal Sunshine of the Spotless Mind, but a recent experiment has just taken us one step closer. By using electroconvulsive therapy on depressed patients, scientists were able to disrupt their ability to recall emotionally jarring events.
Every time we recall a memory we have to take it out of our mental storage banks. According to theory, these memories have to be re-written back onto the brain's circuits each them they're accessed. It's an imperfect process called memory reconsolidation, and it's the crucial idea behind a recent experiment conducted by Marijn Kroes and his colleagues from Radboud University Nijmegen.
By using electroconvulsive therapy (ECT), which was once called electroshock therapy, the neuroscientists were hoping to disrupt this reconsolidation process. They wanted to disturb the re-formation of disturbing or unwanted memories in patients suffering from depression. In future, a more refined technique could be used to treat mental trauma, psychiatric disorders, and drug addiction.
For the experiment, Kroes took 39 patients who were undergoing ECT for severe depression (ECT works by passing electrical currents to parts of the brain, which triggers a brief seizure; patients are given muscle relaxants and an anesthetic). Each patient was asked to watch two rather upsetting videos, one about a child who is hit by a car and has to have his feet severed by surgeons, the other involving a pair of sisters, one of whom is kidnapped and sexually assaulted.
A week later, the patients were asked to recall details about one of the two stories (not both), after which time they were randomly sorted into three groups, A, B, and C (a control group).
Members of Group A and B were treated with ECT immediately following the retelling of the story. The following day, Group A participants had to complete a multiple-choice quiz about both stories. Fascinatingly, they did a better job recalling the story for which their memories hadn't been reactivated (or reconsolidated).
Their recall ability for the recounted story was no better than chance. Group B, on the other hand, had their memories tested about 90 minutes after the ECT, and their recall abilities were intact -- suggesting that it takes time to impair a memory. Group C did not receive ECT at all, and their recall abilities were solid, indicating that both ECT and reconsolidation is required to impair memory recall.
So this study furthers the memory reconsolidation theory. The technique could also prove useful for therapists -- albeit a very blunt one.
Read the entire study at Nature Communications: "An electroconvulsive therapy procedure impairs reconsolidation of episodic memories in humans."
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