‘Electroshock Therapy’ in the Third Reich

Abstract

The history of ‘electroshock therapy’ (now known as electroconvulsive therapy (ECT)) in Europe in the Third Reich is still a neglected chapter in medical history. Since Thomas Szasz’s ‘From the Slaughterhouse to the Madhouse’, prejudices have hindered a thorough historical analysis of the introduction and early application of electroshock therapy during the period of National Socialism and the Second World War. Contrary to the assumption of a ‘dialectics of healing and killing’, the introduction of electroshock therapy in the German Reich and occupied territories was neither especially swift nor radical. Electroshock therapy, much like the preceding ‘shock therapies’, insulin coma therapy and cardiazol convulsive therapy, contradicted the genetic dogma of schizophrenia, in which only one ‘treatment’ was permissible: primary prevention by sterilisation. However, industrial companies such as Siemens–Reiniger–Werke AG (SRW) embraced the new development in medical technology. Moreover, they knew how to use existing patents on the electrical anaesthesia used for slaughtering to maintain a leading position in the new electroshock therapy market. Only after the end of the official ‘euthanasia’ murder operation in August 1941, entitled T4, did the psychiatric elite begin to promote electroshock therapy as a modern ‘unspecific’ treatment in order to reframe psychiatry as an ‘honorable’ medical discipline. War-related shortages hindered even the then politically supported production of electroshock devices. Research into electroshock therapy remained minimal and was mainly concerned with internationally shared safety concerns regarding its clinical application. However, within the Third Reich, electroshock therapy was not only introduced in psychiatric hospitals, asylums, and in the Auschwitz concentration camp in order to get patients back to work, it was also modified for ‘euthanasia’ murder.

Hans Asperger, National Socialism, and “race hygiene” in Nazi-era Vienna

“… 68 This view has recently been challenged on the grounds that the adoption of electroconvulsive therapy in Nazi Germany was in fact slower than previously assumed [ 124 , 125 ]. My argument in this context, however, is based on the interest the “T4” organization took in the issue, which is not in dispute.…”

The introduction of leucotomy in Germany: National Socialism, émigrés, a divided Germany and the development of neurosurgery

“…The widely held assumption of a quick and comprehensive introduction of the 'hard' cures in Nazi psychiatry is just a 'cliché', as Heinz Faulstich (1998) persuasively argued in Hungersterben in der Psychiatrie 1914Psychiatrie -1949. The widely held idea that psychiatrists during the period of National Socialism were enthusiastic about 'euthanasia' and shock therapies proves to have been historically mistaken (Faulstich, 1998;Rzesnitzek and Lang, 2017). Intriguingly, leucotomy is not mentioned in the historiography of Nazi psychiatry and of psychiatry in Germany in general.…”

“…As mentioned above, Japan and France had introduced leucotomy by 1939, Britain by 1940, Denmark by 1943 and Sweden by 1944. The Copenhagen Congress would prove central for the introduction of electroconvulsive therapy in Nazi Germany; Cerletti and Bini presented their new shock technique, and German psychiatrists present at the Congress immediately started trying to get the technique adopted on their return to Germany (Rzesnitzek and Lang, 2017). Counterintuitively, this does not also seem to be the case for leucotomy.…”

Risk Assessment of Electroconvulsive Therapy in Clinical Routine: A 3-Year Analysis of Life-Threatening Events in More Than 3,000 Treatment Sessions

“…Indeed, ECT is mainly used as one of the last treatment options for patients with depression and schizophrenia. This is attributed to persistent stigma ( Gazdag et al, 2017b ; Rzesnitzek and Lang, 2017 ; Alexander et al, 2020a , b ) and the lack of knowledge about modern ECT techniques and their risk-benefit ratio ( Grover et al, 2019 ; Kellner et al, 2020 ). Physicians, as well as patients, are often hesitant to administer or accept ECT ( Birkenhager and van Diermen, 2020 ), which, at first glance, appears to be dangerous because of its invasive approach.…”