The Big Sleep

A startling new treatment for schizophrenia marked by delusions of persecution (one of the most difficult forms of the disease) was reported to Zurich by Dr. D. Ewen Cameron, director of Montreal's Allan Memorial Institute. Key to the treatment: "complete depatterning" of the patient's mind through shock therapy and deep sleep. Unlike brainwashing, Psychiatrist Cameron's method does not seek to implant alien ideas in the mind, but rather to break the chain of schizophrenic reactions and leave the mind free to reorganize itself. Granting that the method is "a sharp tool," Cameron considers it justified for the most stubborn cases, declares this controversial technique has proved "more successful than any previously reported."

The Experiment. In Cameron's experiment, each of 26 patients aged 17 to 54 (five men, 21 women) was dosed with chlorpromazine, which increased the sedative effect of barbiturates. By the end of the first week they were sleeping 20 to 22 hours a day. After getting solid food during this week, they were switched to semisolid. They got five units of insulin half an hour before each meal. With the onset of deep sleep, patients were wakened three times a day for meals and toileting. By the tenth day they were put on intensive electroshock treatment--usually one treatment daily, and often receiving four or five shocks in two to three minutes--far more intensive than previously tried shock treatments. Said Dr. Cameron: "The rate is set so that complete depatterning is achieved between the 13th and 16th days, after about 30 shock treatments. Complete depatterning is maintained five to seven days."

At first the patient knows why he is in the hospital, recognizes individuals. In the second stage he loses his sense of space and time, but is conscious of the loss and worries about it. In the third stage, depatterning, he no longer bothers about the lack of space-time sense and is contented just as he is. He recognizes nobody and does not care.

The Results. When they are satisfied that depatterning has gone on long enough, the psychiatrists withdraw the barbiturates gradually and cut the shock treatments to three a week. During a month of rehabilitation, a nurse or attendant helps the patient to reorient himself. After discharge there is intensive follow-up through doctors and social workers. By way of "maintenance treatment," the patient goes back to the hospital every week for shock therapy during the first month, and once a month for the next two years.

Results of Cameron's experiment: of ten patients previously ill less than two years, all have been discharged, and none has had to be readmitted, though a few have had additional shock treatments as outpatients. Of 16 ill longer than two years, all but three have gone home (though two others had to be readmitted). Most have gone back to work or keeping house: some have even married and had children--getting shock treatments regularly during pregnancy.

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