A shock seen round the world, the electricity stiffening MacMurphy's body in One Flew Over the Cuckoo's Nest, did little for psychiatry and less for electroconvulsive therapy (ECT). For many it was as close as they wanted to come to a therapy that is poorly understood and much maligned; yet, when properly used, it is dramatically effective in the treatment of psychosis. Theatergoers experienced a surge of revulsion as the procedure evoked images of judicial executions, medieval sorcery, inhumane punishment, and accidental electrocution. The lay public is not alone in its feelings, since many psychiatrists share these sentiments. A recent publication by the American Psychiatric Association,1 reviewing the published literature since the early 1940s, indicates that one third of psychiatrists are generally opposed to the modality, and a survey2 of California psychiatrists shows that less than 10% of them administer ECT.
This trend away from ECT, a therapy