Shock therapy, a method to overcome crises and phobias

Some mental health problems resist the usual therapies and we must go one step further. In this article we talk about shock therapy and its variants in both psychiatry and psychology, a therapy that has been highly questioned and that causes divisions among the professionals themselves. Perhaps because throughout history many errors have been made in the application of this shock therapy and it still raises certain suspicions today. But what is shock therapy? Is it really an effective method to overcome crises and phobias?

What is shock therapy

• Shock therapy produces a strong impact on the patient to bring about the change they need. It is about inducing, in a controlled way and minimizing the risks, a state of physiological shock. It is generally used in cases of severe depression when the rest of the therapies have already failed and, precisely, that this shock therapy is not taken into account as an initial treatment, already alerts us to its possible risks.
• It is not only used for the most severe cases of depression, it is also very effective in the treatment of phobias, in cases of bipolar disorder or in people with schizophrenia. In any case, shock therapy induces an artificial mental state in order for the patient to improve his disorder. Psychology and psychiatry use different methods in this type of therapy and at this point we have to talk about the dreaded electroconvulsive therapy, the only shock therapy carried out more commonly in the 21st century.

Shock therapy in psychiatry

1. Electroconvulsive therapy is what psychiatry uses to treat the most serious mental disorders. In addition to controversy, this therapy is accompanied by urban legends that are each more terrible. The history of psychiatry does not help at all to consider this therapy without fear due to the mistakes made in its beginnings, in which some patients were left in a vegetative state and with irreparable cognitive losses.
2. But, currently, electroconvulsive therapy is practiced with fewer risks and more safety. It is performed in specialized clinics and consists of the application of small electric shocks that induce a seizure. This practice is done under anesthesia and the patient is monitored at all times. The objective of this therapy is to produce changes in brain neurochemistry in such a way that the symptoms of some mental illnesses are reversed.
3. If you are in doubt about the safety of this type of treatment, we will tell you the steps that are taken when applying this shock therapy.
4. The first thing that is needed to perform this therapy is a complete evaluation of the state of physical health. The clinical history is reviewed, an analysis is done and an electrocardiogram is also done.
5. Electroconvulsive therapy requires general anesthesia, with all the measures that this implies. An anesthetic and muscle relaxant are given intravenously to reduce the risk of injury in seizures.
6. The medical team places electrode pads on your head. Depending on the problem that is going to be treated, the pads can be placed on only one side or on both sides, depending on the areas of the brain that the treatment focuses on.
7. The monitors are responsible for recording brain activity, heart and lung activity. And a mouth guard is also used to prevent injury.
8. With everything set up, it’s time to induce seizures. The electrical current reaches the brain through the electrodes and a small convulsion lasts about 60 seconds.
9. In this process the patient does not notice anything because he is anesthetized, but the activity of the brain increases.
10. The procedure takes about 10 minutes, although preparation and recovery time must be added.
11. The usual thing is to do the treatment two or three times a week, but it all depends on the problem to be treated and its severity. And in most cases, activities of daily living can be resumed within hours of receiving therapy.
12. When do you start to notice the improvement? Generally, positive results are observed after about six sessions, which does not mean that the end of the treatment has come.
13. Electroconvulsive therapy is also supported by antidepressants and psychotherapy.
14. As you can imagine, electroconvulsive therapy has some risks, and some side effects such as confusion, nausea, or headache may occur. In the thesis of Marta Cano Català (Neurobiological correlates of Electroconvulsive Therapy in patients with Major Depressive Disorder) for the University of Barcelona, ​​alterations in orientation and amnesia or memory loss are also mentioned. Usually, all these effects disappear a few hours after the treatment.

Shock therapy in psychology

• Faced with the possible risks of this electroconvulsive therapy, psychology proposes another shock therapy without physical side effects but almost as impressive. This is exposure therapy, which we have already discussed on other occasions and which, in its mildest version, is used to overcome anxiety disorders and phobias.
• If in this article we generally talk about progressive exposure therapy, sometimes this exposure is not done gradually and the patient is confronted face to face with their fears. The goal is the same, like shock therapy, which is to make a big impact on the mind of the patient.
• In this way, a stimulus is provoked to expose the patient to his discomfort, his fears, his most unpleasant and painful sensations. As we say, this exposure therapy can be done gradually or it can be done in a single session and has different techniques.
• Exposure in vivo consists of facing the patient with the object, animal, situation or activity that he fears or that blocks him.
• The exposure in the imagination is the softest technique, but it is about doing the same as in the live exposure, only that the feeling of danger in this case is reduced because it is a confrontation that occurs in the imagination.
• Virtual exposure uses new technologies to create a virtual reality in which the patient is exposed to the stimulus they fear.
• Interoceptive exposure induces or provokes in the patient the physical sensations that he generally tries to avoid in his daily life.

The efficacy of shock therapies to treat anxiety, phobias, depression…

1. Obviously, these two shock therapies do not have the same risks and are not used for the same disorders. If we ask about the effectiveness of each one and its results, exposure therapy shows good results in the case of phobias, anxiety and panic disorder, but not so much for depression and other mental disorders.
2. There is a point at which the severity of mental disorders requires more invasive techniques and, without abandoning psychotherapy, one must count on psychiatry in the process. And this is where electroconvulsive therapy comes into play, which does prove effective in transforming brain chemistry due to seizures and, therefore, can help improve the quality of life of people with severe depression.
3. We also have to assess the risks in each of the therapies. So let us insist that while it is true that shock therapy has very advanced means in terms of safety, it is also clear that the impact of electroconvulsive therapy sessions cannot be predicted one hundred percent.