Review An exploration of the patient's experience of electro-convulsive therapy in mid-twentieth century creative literature: A historical study with implications for practice today Claire Hilton ⁎ Consultant Psychiatrist Central and North West London Mental Health NHS Trust, United Kingdom MA student Wellcome Trust Centre for the History of Medicine at University College London, United Kingdom Received 14 April 2006; received in revised form 29 May 2006; accepted 30 May 2006 Available online 2 August 2006 Abstract Background: Understanding a patient's subjective experience of electro-convulsive therapy (ECT) is important. Creative literature may both express such experiences and influence how ECT is perceived since scenarios and characters in literature become incorporated into cultural stereotypes and mythologies. Clinical discussions with patients and their families suggest that One Flew over the Cuckoo's Nest still has an impact on their perceptions of ECT, and therefore still has clinical relevance today. This study aims to explore experiences of ECT through creative literature focussing on novels from the 1960s. Method: Study of three novels depicting ECT in their historical context. Results: Various factors identified in the books studied may be associated with reluctance to accept ECT as a treatment, in particular images related to electricity. Limitations: Since this is a historical survey rather than a clinical research project, and is based on creative literature, it may not reflect 21st century reality. Conclusions: Fear of electricity and other factors in the practice of ECT in the past may still be important in the acceptance of ECT as a clinical treatment. This warrants further qualitative exploration. © 2006 Elsevier B.V. All rights reserved. Keywords: Electroconvulsive therapy; Creative literature; Electricity Contents 1. Introduction ....................................................... 6 1.1. The early history of ECT ............................................. 6 2. Creative literature depicting ECT ............................................ 7 3. The authors ........................................................ 7 4. ECT in the novels .................................................... 8 Journal of Affective Disorders 97 (2007) 5 – 12 www.elsevier.com/locate/jad ⁎ Mental Health Services for Older Adults, Northwick Park Hospital, Watford Road, Harrow HA1 3UJ, United Kingdom. Tel.: +44 208 869 2396; fax: +44 208 869 5087. E-mail address: claire.hilton@nhs.net. 0165-0327/$ - see front matter © 2006 Elsevier B.V. All rights reserved. doi:10.1016/j.jad.2006.05.032