Electroconvulsive therapy is often used as a last line of treatment against mood disorders. It works by sending short electrical shocks to the brain to induce a seizure. The approach was innovated in Italy, where they coined an efficient transitive verb to describe what the machine does to you: zapare, meaning “to zap.”
As a grateful zappee, I sometimes get the question: Why do so many writers get ECT? I’m not sure we do, really. I just think we’re more likely to write about it. The less-glib response would be that writers are often down to try the risqué, or to make experiments in our lives.
For a long time, I resisted writing anything about my experiences of getting voluntarily electrocuted, or about the touches of memory loss that followed. It didn’t seem the sort of thing one should crow about. But I kept getting maddening questions about the whole process. “Were they punishing you?” Or, “Isn’t that just a high-tech lobotomy?” Not at all. Along with music and true love, electroshock is one of the few real miracles I’ve experienced firsthand.
So I wrote a book about it, Jolt: My Electric Journey Out of Darkness. The title, I grant, is somewhat dramatic. But then the treatment itself offers an undeniable sense of drama: you lie down on a table, are given a euphoric cocktail of anesthetics and muscle relaxants, and—after the indicated number of treatments—you arise sufficiently changed that you no longer wish to disappear from life.
One early reader of Jolt, who receives semiregular maintenance ECT treatments, wrote to me the other week: “I remember an actual medical doctor saying to me just last year that he couldn’t believe ECT was ‘still a thing.’ It horrified me. I want to stuff Jolt into his hands. Maybe smack him around with it first. But then stuff it into his hands.” That’s a bit violent for my taste, but I certainly honor the sentiment.
Point being: books can offer a lifeline for patients. Here are some that offered one to me.
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Sylvia Plath, The Bell Jar
I’ve long been confused to see Plath held up as a cautionary tale about ECT. In fact, Plath—like her novelistic stand-in, Esther—was saved by the treatment. It’s true that Esther’s first experience with unmodified shock therapy is traumatic:
…something bent down and took hold of me and shook me like the end of the world. Whee-ee-ee-ee-ee, it shrilled, through an air crackling with blue light, and with each flash a great jolt drubbed me till I thought my bones would break and the sap fly out of me like a split plant.
I wondered what terrible thing it was that I had done.
But once Esther enters the care of a far more sensible and kind doctor (a loosely fictionalized version of Plath’s own Dr. Ruth Barnhouse), she receives modified ECT, administered with an anesthetic and muscle relaxant. (“If It’s done properly,” Doctor Nolan said, “it’s like going to sleep.”) After her first modified treatment, Esther reports on the experience of anesthesia and awakening:
…darkness wiped me out like chalk on a blackboard….I woke out of a deep, drenched sleep…. All the heat and fear had purged itself. I felt surprisingly at peace. The bell jar hung, suspended, a few feet above my head. I was open to the circulating air.
Given that Esther was suicidal until this breakthrough, it’s a little odd to see Plath’s continued conscription into a chorus of ECT voices. In biographies, Plath was judged to have experienced long-term remission after her ECT course under Dr. Barnhouse. Just as salient, for me: if you read The Bell Jar, or anything else by Plath for that matter, you’ll see that ECT doesn’t doom creativity. (It’s the illness that does that.)
Edward Shorter and David Healy, Shock Therapy: A History of Electroconvulsive Treatment in Mental Illness
A crucial and thrilling history, merciless and evenhanded in its descriptions of the precursors of ECT (these include insulin coma therapy and metrazol shock treatment), and the authors cover the full range of its colorful history. In these pages, you’ll drop your jaw at the historical abuses of ECT—and you’ll wonder equally at the stunning success stories. The authors evoke the historical ironies with beautiful precision. Take the disputes between psychoanalysts and proponents of somatic treatments such as ECT:
For the analysts, ECT was a brutal, primitive treatment, sadistically inflicted, and masochistically accepted as an expiation of guilt. Yet behind the scenes many analysts were warmer toward ECT because they needed it to make their patients better….ECT, it could be said, was the secret love of psychoanalysis.
Shorter and Healy are also capable of something like poetry:
A major difference between Prozac and Zoloft compared with ECT is that these drugs come with the stamp of familiarity, whereas ECT for most people is quite alien. ECT is treated as a stranger; Prozac is treated as a neighbor.
A keenly balanced and richly informative account. Best to read once you’re on the mend.
Robert Pirsig, Zen and the Art of Motorcycle Maintenance
In the 1970s and ‘80s, Pirsig attained a priestly status among readers, and this big book became a counterculture scripture. The novel’s turning-point is when the narrator recalls being involuntarily subjected to ECT. As the narrator says of his former self:
[He was] destroyed by order of the court, enforced by the transmission of high-voltage alternating current through the lobes of his brain. Approximately 800 mills of amperage at durations of 0.5-1.5s had been applied on twenty-eight consecutive occasions, in a process known technologically as “Annihilation ECS.” A whole personality had been liquidated without a trace in a technologically faultless act….
Like The Bell Jar, Pirsig’s blockbuster philosophical novel (the narrator calls it a “chautauqua”) contains elements of autobiography. But its fictionalization of life is much looser than Plath’s. Still, many readers developed a parasocial love for the narrator—and grew furious on his behalf, to the extent that even today the novel is still sometimes invoked as a devastating indictment of electroshock. Yet the main character’s electroshock has very little to do with Pirsig’s own experience. As David Healy and Bruce G. Charlton observed in 2009, in the journal Medical Hypotheses:
…newly published biographical information on Pirsig from Mark Richardson (Zen and Now: On the Trail of Robert Pirsig and the Art of Motorcycle Maintenance, New York: Knopf; 2008) has documented that the role of ECT in ZAMM is a “literary device,” added at a late stage in drafting the book. In reality the ECT had erased some short-term memory, but Pirsig’s long-term memory had quickly returned….It seems that one of the most famous depictions of ECT, one that had appeared factual, was actually fictional.
As literary devices go, it’s a brilliant one: the long-delayed smoking gun in the narrator’s quest to unravel the mystery of what happened to him. The book’s narrator is so engaging, and Pirsig’s own style so appealing, that one can almost forgive his acolytes for their overdetermined loyalty to his fictional counterpart.
Donald Antrim, One Friday in April
As Donald Antrim writes in this remarkable account of depression and deliverance, it was David Foster Wallace who persuaded him to seek out ECT. Antrim recounts the near-miraculous results:
We talk about the weight of the world. After ECT, the feeling in my body of immense weight went away; I felt a kind of physical lightness….These days I think of ECT as clean power, good electricity added to a wet, saline medium in which electrical signaling has become chaotic and mistimed.
ECT, of course, remains stigmatized, and Antrim memorably refers to stigma as “society’s unacknowledged violence toward the sick.” In One Friday, the author does noble work to counter that violence.
Martha Manning, Undercurrents: A Therapist’s Reckoning with Depression
Manning is a delight on the page (and reportedly in person), whether she’s discussing childcare or mental illness. And her lucid remarks about the ECT that delivered her from unbearable depression felt, to me, like light belatedly allowed into a horrible container where I’d been confined:
Nobody bats an eye when electricity is delivered to a stalled heart. There is no outcry. In fact, it’s considered a miracle….I will never be the ECT poster-girl. I am the first to admit the downside—confusion and memory loss. But damn it, it worked. I didn’t want to have it. Who would? I didn’t want to have a caesarian section either. I ended up with a terrible infection, a long scar, and a difficult recovery. But I got Keara. A beautiful healthy new life….I’d do it again in a heartbeat….In choosing the hospital and ECT I chose to fight for my life.
Camilla Nord, The Balanced Brain: The Science of Mental Health
Nord is a neuroscientist and an excellent translator of complicated science for a broad popular audience. Among her many fascinations is neurogenesis: the brain’s capacity for growth and self-renewal. Antipsychiatry voices, particularly anti-ECT partisans, like to describe ECT as causing “brain damage.” From the neuroscientists with whom I’ve spoken, that’s utterly wrong. Taken most generously, that critique confuses disruption with damage. Among its innumerable insights, The Balanced Brain, offers a fascinating reading of the hippocampal growth often spurred by a successful course of electroshock: “On balance, rather than brain death, ECT may be more likely to engender brain cell life.”
Carrie Fisher, Wishful Drinking and Shockaholic
I read Fisher’s memoirs before my electro-treatments. Her writing prepared me for localized memory loss—and implicitly reassured me about many other things, including one’s ability to retain a sense of humor, even after a deep disturbance and the shock that restores equanimity. Fisher is quite breezy about her memory loss, writing that she’s learned “to live in the present, now that the past seems to be otherwise engaged.” I’m blessed to have lost far less memory than Fisher did. (While I got a lot of treatments—23 in all, over the course of a few months—Fisher received many more over the course of years.) Tellingly, not once does she suggest that these memory deficits were debilitating; nor that they weren’t absolutely worth it.
Charles Fernyhough, Pieces of Light: The New Science of Memory
Completely reframed my way of thinking about autonoetic consciousness—i.e. the proprietary sense of your memories as belonging to a single self. “Memory is an artist as much as it is a scientist,” Fernyhough writes. As I went about rediscovering certain lost memories, and making peace with the unrecoverable ones, this sharp and compassionate book was an enormous help and comfort.
A. Alvarez, The Savage God: A Study of Suicide
Kay Redfield Jamison has called this singular 1971 study “rather romantic.” I suppose it is. But along with Jamison’s Night Falls Fast: Understanding Suicide, it’s one of the best books on the topic. Richly psychoanalytic, deeply literary, unflinchingly personal. It helped me understand the chillingly rational part of me that had craved a release from life. And I needed to understand that part fully before I was able to free myself of it. There were many people and things that called me back, including friends and family, as well as ECT—and this book.
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Jolt: My Electric Journey Out of Darkness by Ted Scheinman is available from Scribner, an imprint of Simon & Schuster.
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