The current thinking
A new film aims to reverse the negative image people have of using electrotherapy for neurological disorders. This treatment isn't easy to watch, but it seems to get results
"The most painful thing about depression is the thought process. The imagination stops working," confesses Amir Weinberg in the documentary film "Hamoah Hahashmali" ("The Electric Mind" ).
"There is no feeling, no understanding, no grasping. There is no sense of humor. I was a highly successful press photographer with a distinguished career. At the age of 35 the disease erupted, taking a severe toll on my journalistic career. My life stopped, has stopped, basically isn't taking place," he says.
After years of suffering from bipolar disorder, Weinberg decided to participate in an experimental study of an innovative psychiatric therapy that uses electrical stimulation.
In the lab, he dons what looks like a blue swimming cap. Two people then attach an egg-shaped machine to his head, reminiscent of the type of old hair dryers that used to stand in every beauty parlor. Weinberg sits frozen in place, his eyes shut. "Another five seconds," says the intern operating the equipment. A moment goes by, and then a strange rattling sound fills the room. As soon as it starts, Weinberg's face becomes slightly distorted. The corner of his mouth is yanked to the right, and goes back in place only when the rattling stops.
"Bipolar disorder, better known to the general public as manic depression, is a disorder that afflicts 2 percent of the population," says Dr. Eran Harel, a psychiatrist at Shalvata Mental Health Center in Hod Hasharon, who is leading the experiment in which Weinberg is participating, and which is documented in the movie. "It is a disruption in mood control. In view of the limited efficacy of antidepressants, we are examining other avenues, one of which is using electromagnetic stimulation to effect electrical activity in the brain."
"The Electric Mind" was entered in the Israeli competition at this year's DocAviv documentary film festival (its second and final screening is scheduled for noon tomorrow at the ZOA House, in Tel Aviv ). Its director, Nadav Harel, 40, set out to examine cutting-edge neurological therapies that attempt to treat various diseases or disorders by means of electrical stimulation. He takes the camera into the treatment rooms, documents patients' reactions to the electrical current being sent to their brain, follows them during the ensuing days, and tries to understand from the psychiatrists involved the principles behind such therapies, which still suffer from a questionable public image.
The moments when the camera documents the patients' convulsive responses to the electrical current being transmitted to their brain prompt repeated discomfort among viewers, and the sequences in which Harel films patients lying on the operating table, while the scalpel makes its way through their brain, are devastating. On the other hand, some of the explanations provided by doctors interviewed concerning the function of the human brain are fascinating, and reawaken a childlike sense of wonder at the mysterious organ, about which we know so very little, despite the fact that it runs our lives.
Nadav Harel's first documentary, "Area K: A Political Fishing Documentary" (2001 ), was about the state of fishing in the Gaza Strip under the territorial restrictions that Israel imposes there. His "Attack of the Happy People" (2003 ) examined the connection between the recreational drug ecstasy and consumer culture and religion in Israel.'Horrific images'
"The very notion that an electrical current is transmitted into the brain through electrodes on both sides of the head is a scary idea," says Dr. Shmuel Kron, the director of Shalvata, and one of the experts featured in the film, "and this treatment has been saddled with a very harsh image, partly based on popular works of fiction. 'One Flew Over the Cuckoo's Nest,' for example, has horrific images of the use of electroshock."
Kron proposes a historical explanation for the spread of this negative image: "The anti-psychiatry movement had subversive elements that were not necessarily aimed at psychiatry, which discovered a terrific social metaphor for the wave of 1960s counterculture: Psychiatry was a perfect representative of the repressive establishment, which sought to control the free spirit and turn everyone into robots and soldiers. And electricity was an excellent tool in the hands of the profession's detractors, because according to the naive view, only the severely mentally ill - extreme lunatics - should be treated with therapies like electroshock. And this, of course, is a perception that has no basis in reality."
Dr. Eran Harel, the Shalvata psychiatrist involved in the experiment seen in the film, is the director's brother; conversations with him prompted Nadav to make the movie.
Says Nadav Harel: "When I began working on the film, I decided that one of the things I would like to focus on is stigmas about people who suffer from various mental illnesses, and about treating these with electricity. The film tries to shed light on these stigmas from a new perspective, and brings together people who are afflicted with mental disorders and also motor disorders."
Besides Amir Weinberg, "The Electric Mind" follows three other patients as secondary protagonists: Opal, a 14-year-old girl who suffers from epilepsy; Sami, who suffers from dystonia, a movement disorder that causes him to limp; and Mila, an elderly woman who has suffered from depression since her husband died. "This film seeks to dispel the belief that madness and mental illnesses are different from things like a limp or epilepsy. It does away with that separation," Harel says.
Work on the film lasted four years. "It took me so long to make the film because, among other reasons, it was hard to find people who would agree to be filmed; to find people who suffer from depression and are willing to present their imperfection publicly, and to talk about their painful and problematic situation," he goes on. "We offered lots of people the opportunity to take part in the film, but they declined. They were afraid to be seen in their weak moments. And it's a pity, because there are a lot of stigmas about mental illnesses, but when you talk about depression and about these things, the stigmas suddenly fade away and it reduces fear of them."
Harel sought out people with different sorts of disorders, all of whom receive medical treatment by means of electromagnetic therapy.
"That is the term," he explains, "and this therapy is different from electroconvulsive therapy, which is what used to be called electroshock - terms that are no longer acceptable today because they carry a negative association. In contrast to electroconvulsive therapy, in which an electric stimulus is sent to the entire brain, and plunges all 10 billion of its cells into total chaos, electromagnetic stimulation is focused on a specific area in the brain."
Despite this focus, the sight of a person receiving an electrical current to the brain is still stressful for an outside observer. Says Harel: "It got a bad name because first of all it looks bad. There's the convulsion, which looks very intimidating, because the person is not in control and his brain is going wild.
"In both an epileptic seizure and in electroshock," Harel continues, "it is the same convulsion, a sort of anarchic storm of electrical activity in the brain. And this seizure is very difficult to watch. It looks threatening and unpleasant, even though the person doesn't feel it. It was no easy decision, whether or not to show the seizure in the film, and in the end we decided in favor."
Another thing "The Electric Mind" manages to do is present the patients as characters with whom viewers can identify. Amir Weinberg is heart wrenching in his tougher moments, and inspires relief and joy when he finally smiles and laughs. Opal is heartwarming thanks to her verbal ability, courage and clear-sightedness, and arouses a fierce desire in the audience to see this girl freed of the shackles of her disorder.
Harel's film makes no mention of conventional psychotherapy. "People who are accepted into this study have tried every possible method of psychotherapy and every possible pill, and neither was of any help to them," he explains. "The data show that at least 30 percent of all depression sufferers are not helped by any treatment: not antidepressants, not psychotherapy, and not alternative treatments. And the data also show that, of those who were helped by nothing else, half experienced improvement following electromagnetic therapy. And that says a lot."
The film is dedicated to the Harels' late father, who was a neurologist. Eran is the fifth generation of doctors in the family. "There is respect for medicine in particular, and for science in general, in the film's approach," Nadav Harel concedes. "The Electric Mind" mentions the negative reputation that electrotherapy has taken on, but it does not address pointed criticism against it. "There is a gigantic phenomenon called anti-psychiatry, and in the criticism of every psychiatric therapy there are a thousand opinions that are based on a great deal of ignorance," says Nadav Harel. "I didn't want to get into that because it is an enormous pit that can suck you into lots of accusations, and to tackle every accusation of this kind separately - that would be a film in itself. The film aimed to take a look at the therapies, see whether or not they work, and present the treatments that are available."
From Harel's perspective, one of the statements the film makes regards attempts "to shatter the existence of a soul beyond our corporeal existence. In my opinion, the concept that the soul is something that exists beyond our body, and continues to exist after the body dies, is nothing but man's arrogant perception that he is eternal, a narcissistic concept that says, 'My self exists forever and is above everything.'"
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