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November 3, 1956


JAMA. 1956;162(10):966-969. doi:10.1001/jama.1956.02970270026009

• Some light is thrown on the modus operandi of electroshock therapy by two sets of observations. One relates to the reciprocal relation between depression and anxiety; the other, to the differences found among the effects of the new tranquilizing drugs. Depression, defined asa state of sadness with self-reproach and psychomotor inhibition, has been converted into anxiety by the use of shock. Anxiety, defined as a state of tension with fear and psychomotor excitation, has been converted back into depression by the use of nonconvulsive electrostimulation in a controlled, predictable, and repeatable manner. Among the tranquilizing drugs, chlorpromazine and reserpine have in common the ability to relieve states of agitation and overactivity, especially manic psychoses and organic-toxic states, in which secondary inhibitory or disorganizing effects upon the ego are slight or readily reversible. Certain other drugs can be classified into relaxant, ataraxic (deconfusing), and antiphobic groups distinct from the tranquilizing drugs. The varied mechanisms thus revealed enable one to assert that electroshock therapy relieves the secondary traumatic state of the ego (panic and/or depression) by reducing the excitability of the nervous system, especially the cortex cerebri. The ego and its defenses appear strenghtened after electroshock therapy because its excitation threshold has been raised. Unconscious warning anxiety can then no longer overstimulate the cortical ego and thus frighten it into panic or paralyze it into depression as it did before.