Matthew Parris Matthew Parris

Will the shock of Covid change anything?

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Earlier this month, a curious report caught my attention. Apparently there exists no rigorously established evidence that electric shock therapy, or ECT (electroconvulsive therapy), works. At all. In Electroconvulsive Therapy for Depression: A Review of the Quality of ECT versus Sham ECT Trials and Meta-Analyses, Dr John Read, Professor Irving Kirsch and Dr Laura McGrath have shown that the therapy, commonly administered for severe depression, has not (despite claims) been shown to have any significant positive effect, ever. It can be dangerous, carrying a small risk of death and a higher risk of serious memory loss, yet (the authors say) more than a million people worldwide are undergoing this therapy today, for no proven benefit.

I doubt I ever thought otherwise, and nor perhaps did you. I’d have labelled ECT as quack medicine, but had no idea how prevalent — even popular — it is, nor how widely it is believed in. I agree with the authors that it should not be prescribed. Perhaps it should be outlawed.

The report, however, set my mind on a different track. Why are people so receptive to the claim that a big electric shock could jolt you out of mental illness? There is something inherently attractive in the idea: a way of thinking exemplified by a phrase my father used when any of us, his children, were being moody, grumpy or unhelpful. ‘Snap out of it,’ Dad used to say.

You know immediately what he meant. Actually, in a day-to-day way, if not for clinical mental illness, you’ll know too that the approach often works. We’re all prone to overthink, to let a problem ‘get on top of us’, to ‘get it out of proportion’, to get stuck in a negative groove; and we do know that dropping the preoccupation completely and switching our attention to something else can make it possible to return later and see things in perspective.

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