The term ‘electroconvulsive therapy’ conjures the infamous scene with Jack Nicholson from the movie “One flew over the Cuckoo’s nest,” or similar such brutal scenes from popular culture. But this reputation is seriously outdated. More importantly, it belies a procedure that is in fact mostly benign and enormously helpful to people who are severely depressed or suicidal. This article is about a new use for ECT: treating children with autism who harm themselves repeatedly, sometimes to the point of blindness or death. Right now, there are fewer than 50 children with autism who are being treated with ECT, but for these children, ECT is a desperately needed life-saving treatment, say the children’s parents and the psychiatrists who administer the therapy.
The piece opens with an ECT session for 17-year-old Kyle, a boy who, before the therapy, could not stop hitting, biting and pinching himself. It also later traces the story of Doug DePrisco, who showed a different set of symptoms that were equally debilitating. Their stories reveal a little known medical phenomenon in autism: catatonia.
In people with autism, ECT appears to alleviate not the autism itself, but rather catatonia, a condition that is known to accompany other psychiatric conditions such as depression and schizophrenia. Psychiatrists say that the repetitive and uncontrolled self-injury seen in children with autism is a representation of the “psychomotor agitation” aspect of catatonia.
Underlying the entire article and its scientific aspects is the theme of stigma. Kyle and Doug’s parents talk about the judgment they feel from people who think they are torturing their children. And even among psychiatrists, there is misinformation and ignorance about the nature of ECT or its potential to help people. The story ends on an optimistic note, returning the ECT session at the opener, with Kyle calm and read to face his life for the next week.