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Five part series on the history of madness and psychiatry. Part 3: Brainwaves. Dr. Jonathan Miller Surveys 200 years of physical treatments in the "management" of the mentally ill, focusing especially on ECT, insulin shock therapy and psychosurgery.

Shot list: ECT - preparation - Stoneybrook, Long Island; Confused patient; ECT preparation, in detail; treatment shown; Fools' Tower, Vienna; Physiognomy of madness - various examples of 19th C. psychiatric illustration; Josefinum Collection, 1775, Vienna; wax models - whole body, head, and female figure, wearing pearl necklace, intestines displayed; Hudson River Psychiatric Center; Restraint chair invented by Benjamin Rush, U.S.; How it works; Print of person bound and blindfolded in chair; Prints of other treatments - whirling, douching, etc.; Fairground - visual parallels with these treatments; Film (1928? feature film?) of insulin shock treatment. Male patients.; Dr. Joseph Wortis; Photo, Ladislaw Meduna; Insulin shock treatment - film; Ugo Cerletti - electric shock experiments on rabbit, cat and larger animal; Lothar Kalinowsky - he saw first electric shock treatment; Film - interview with U.S. team giving shock treatment. Shows patient's violent spasms; ECT with muscle relaxant; Picture of Franz Joseph Gall, phrenologist; Phrenological skull; Phrenological hat demonstrated; Picture of the explosion that injured Phineas Gage; Tamping iron; skull shown (He lived 13 years after accident);19th. C. picture of path of tamping iron through skull; António Egas Moniz who won 1949 Nobel Prize for lobotomy technique; John Fulton (picture) whose experimental work laid groundwork for lobotomy. He induced experimental neuroses in chimps (photo of JF with chimps) and found they could be abolished by surgical intervention. But he did not share Nobel Prize; Dr. James Watt who worked with psychiatrist Walter Freeman, commenting on film of his (Watt's) lobotomy operation; Film of lobotomy operation with text description (Operation takes place under local anaesthesia; Watts describes how Freeman chatted to patients during operation); Film of Freeman and Watts in operation theatre; Still of operation scene; Film of present day lobotomy preparation, with post-operative scan; Film of woman - catatonic schizophrenic - before and after lobotomy; Film - man- catatonic immobility - before and after lobotomy; Women patients damaged by lobotomy, walking with difficulty; Brain cells - photos of network; Film of brain nerve fibres; Pill production, mid '50s, b/w; Man being forced into straitjacket (feature film?); Dr. William Sargant with patients; Dr. William Sargant 1968 interview with Dr. Tom Maine; asylum scenes, men and women, 1960s; Prof. Andrew Scull; Grand Central Station, New York; homeless and mentally ill man ejected from station by police officer; Street scenes; Psychotropic drugs - array of bottles; Dr. Ruth Seifert; Patients lining up for medication; Patient using bubble pack; Kate Millett describes side-effects of chlorazine; Hand tremors, result of over-use of drugs; Patients describe benefits of ECT.

Jonathan Miller looks at 200 years of the use (and abuse) of physical treatment in the "management" of the mentally ill, focusing especially on the controversial procedures of ECT and lobotomy. Psychosis and affective illnesses may be caused by chemical imbalance in the brain; ECT aims to correct this balance by stimulating the brain to produce an unknown but beneficial substance. The long term aim is to induce the brain to produce this substance without the need for such drastic stimuli. Dr. Max Fink of Stoneybrook Hospital, Long Island, U.S.A., speaks of the time before the discovery of muscle relaxants - which are now routinely administereed during ECT treatment - when ECT resulted in bruises, lacerations and even fractures. Insulin shock treatment for schizophrenic patients is also discussed; in this method, the timing of glucose administration is crucial or brain damage can occur. It was risky but often successful and the practice of producing artificial convulsions gained in popularity. In 1936 electricity , passed across the head in order to avoid dangerous contact with the heart, was tried, but a public relations problem occurred, electricity being associated with executions. In contemporary interviews, patients speak positively of ECT results but Jonathan Miller is of the opinion that it underestimates the complexity of the brain. Intercut with film and discussion of ECT are pictures and reconstructions of obsolete treatments for madness. The simplest of these was confinement, perhaps in isolation, as practised in Vienna in 1784 in the "Fools' Tower". Compared to this, Bedlam was a sociable and stimulating environment. Progressing from simple confinement, new treatments were aimed - or thought to be aimed - at the brain itself; implements of restraint are shown, the idea being that a patient could be strapped down to prevent struggle and injury, and then whirled, shaken or douched back to sanity, the violent movement being supposed to shake the brain back to equanimity (compare "Battle for the Mind") and Sargent's examination of regular, violent movements on the disordered brain). (Might also explain various puzzling references in Victorian novels to characters being tossed in a blanket, either for exercise or punishment.) A new form of violence became popular with the rise of the lobotomy and in 1949 the Portuguese neurologist who had originated this operation became a Nobel prizewinner. By interrupting traffic between two parts of the brain - the emotions and the intellect - certain neurotic responses could be eliminated. Dramatic improvements were claimed and the expense was small, but the casualties of this operation were many and serious. It is rarely carried out now. The days of asylum proliferation are over. Governments in Britain and the U.S.A. are intent on saving money by changing to what they describe as care of the mentally ill in the community. Jonathan Miller looks at the situation in the U.S.A. and sees credible evidence that patients are discharged and effectively abandoned with prescriptions and instructions they are unable to manage or understand. Homeless people are shown being expelled from Grand Central Station, New York.


UK : BBC-TV, 1991.

Physical description

1 videocassette (VHS) (60 min.) : sound, color, PAL.
1 DVD (60 min.) : sound, color, PAL.


Copyright note

BBC Television.

Creator/production credits

Brook Production for BBC Television in Association with KCET Los Angeles.


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