Controversial Psychiatric Practices: Background information when reading The Frozen Dead

Controversial Psychiatric Practices

This article relates to The Frozen Dead

The fictional Wargnier Institute in Bernard Minier's The Frozen Dead is, put simply, "a place where they lock up murderers who've been judged insane." When psychologist Diane Berg learns about the "treatment" programs offered, her fears and concerns escalate. The experience of observing a patient being "evaluated" makes Commander Servaz physically unwell.

Unfamiliar with the world of psychiatric hospitals, I was shocked by the descriptions of electro-convulsive therapy and penile plethysmography (among others), but on investigation found that they are not as uncommon as I had imagined.

Electro-convulsive Therapy (ECT) – using electric shocks to treat psychiatric disorders in patients — was first introduced by Hungarian neuropsychiatrist Ladislas Meduna in January 1934. As a therapy procedure, it has fallen in out and out of favor over the decades, largely due to the development of antidepressants. But as The New York Times reported in 1990, towards the end of the last century it experienced a resurgence. Despite public distaste and suspicion, generated at least in part by movies such as One Flew Over the Cuckoo's Nest, the practice was found to be effective in severe cases where antidepressants and other therapies failed to help. Currently the American Psychological Association defines ECT as "an effective treatment of severe depression." Carried out with consent and with the careful use of anesthetics and muscle relaxants to limit physical damage to the body during spasms and seizures, electro-convulsive therapy is now an established treatment. What shocks Diane Berg in the Wargnier Institute in The Frozen Dead, is that ETC is used as a punishment and without an anesthetic. This seems barbaric, unimaginable even, but in August 2014, CBS News reported that the Judge Rotenberg Center in Massachusetts routinely applied painful electric shocks to young people on the autistic spectrum as part of a behavior modification plan.

Another controversial practice in use at the Wargnier Institute is penile plethymography, a method of assessing sexual interest by measuring erectile response (changes in blood flow to the penis) to visual images of men, women and children. In 2007, The New York Times described the use of this procedure as "routine" in civil commitment facilities, with plethymography accepted as a standard tool to assess risk or repeat offenses by sexual offenders. In The Frozen Dead, plethymography is described as a "new method of evaluating sexual deviancy" although in fact it was first developed by Kurt Freund in Czechoslovakia in the 1950s as a way of determining sexuality, with the intention of identifying and perhaps "curing" homosexuals.

It should be noted that plethymography is a commonly used technique to determine organ function. For example, pulmonary plethymography is used to evaluate lung capacity by measuring the air displaced by the patient.

Picture of Ladislas Meduna from Edumed

Filed under Medicine, Science and Tech

This "beyond the book article" relates to The Frozen Dead. It originally ran in September 2014 and has been updated for the September 2015 paperback edition. Go to magazine.