by Susan Griffith

The general public equates electric shock treatment on par with public executions; but according to the American psychiatric profession, it remains the single most effective treatment for severe depression, according to Jonathan Sadowsky, the Theodore Castele Associate Professor of Medical History at CWRU.

To further understand the evolution of shock treatment-now referred to by the medical community as electroconvulsive therapy (ECT)-as a medical treatment, Sadowsky will spend time in 2003-2004 researching its history.

He received a $20,000 fellowship from the George A. and Eliza Gardner Howard Foundation, administered by Brown University. He was among 13 scholars chosen from 164 individuals nominated from the fields of history, history of science and political science.

"Many historians of medicine have grown adept at taking technologies commonly understood to be advances and showing them to be a means of social control," Sadowsky said. "ECT is a treatment commonly understood to be a form of social control that is, in important respects, an advance."

He said this reversal of themes is the "crux" of his research.

In his research, Sadowsky also plans to pay careful attention to coercive abuses of the therapy. In addition, he intends to study the coercive uses of ECT.
Early forms of shock treatment date to the 1930s and originate in Italy.

"When ECT was introduced into the United States, psychiatric thinking was dominated by psychoanalysis," Sadowsky said.

While some psychoanalysts welcomed its curative effects, Sadowsky said others saw those effects as coming from the gratification of the masochistic need of the patient.

He is particularly interested in exploring the time frame of the 1960s.

"ECT became a symbol for the anti-psychiatry movement," Sadowsky said, adding that the social, cultural and intellectual movement gave rise to a "powerful public expression" in books, films and the media.

"Historically, the majority of ECT patients have been women, but the extent to which this is-because women received certain diagnosis more frequently, as opposed to getting different treatment for the same diagnoses-is not yet clear," he said.

"In those early years of ECT, a time when psychiatrists considered homosexuality an illness, ECT was used in attempts to alter the sexuality of gay men, a practice which continued even after published clinical data showed it to have no effect on sexual preferences," Sadowsky continued.

The associate professor also will look at what medical progress means framed in the development and use of ECT.

"As medical technology has become more powerful, its role in providing hope for the suffering has grown, often outstripping its capabilities," Sadowsky said, adding that it leads to disappointments and "cynical bemusement about changing fads in therapeutic programs.

"This project offers readers a view of medical progress not as a mythic and inexorable force or as a cruel lie foisted on us by a self-satisfied profession, but as an ambiguous reality," Sadowsky continued.

He added that if he can succeed in promoting such a view, "that would be progress."

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