Living the Life of No One: Electroconvulsive Treatment as Mnemonic Metaphor

Abstract

The article investigates how electroconvulsive therapy (ECT) is represented in the following four literary works of the 21st century: October’s Child, Store Kongensgade 23, The Parakeet, and I Am What I Remember. The article argues that electroconvulsive therapy is treated as a mnemonic metaphor that highlights not just its significance for individual experiences of memory loss following treatment and how such treatment elicits traumas that span generations, but also how ECT can be said to have a gendered bias. The article attempts to show how the practice of ECT is emblematic of a certain patriarchal tendency within psychiatry that obfuscates women’s chance of being heard. It makes the argument that ECT as a metaphor paradoxically works as a narrative catalyst that forces a practice of remembrance, and that this practice is in many ways a feminist project. As such, it offers a critical insight into psychiatric practices and shows the importance of giving voice to those who suffer from after-effects of psychiatric treatment. Finally, the article argues that ECT is a feminized metaphor that continues a figurative line of thought in Western social imagination, which entangles women, technology, and mental illness.

1. Introduction

About a third into Linda Boström Knausgård’s semi-biographical novel October’s Child (Knausgård 2019), the narrator provides this simple yet poignant statement: “Sweden is the country that performs most electroconvulsive treatments in the whole wide world” (Knausgård 2019, p. 47). The dry statistical fact comes with a twist—for as the reader has well understood up until this point in the novel, electroconvulsive therapy is not just a treatment like so many others, but a violent attack on the very core of subjectivity: memory.

In this article, I approach the issue of electroconvulsive treatment (ECT) and memory via the following four different literary works: October’s Child (2019) by Knausgård; Danish author Søren Ulrik Thomsen’s memoir Store Kongensgade 23 (2021); The Parakeet (2017), a graphic novel by French writer Espé, detailing his mother’s mental illness; and I Am What I Remember by Danish investigate reporter and writer Peter Øvig Knudsen, an account of his personal experience with ECT mixed with historical, diagnostic, and cultural discussions. In each, ECT is imaginatively interwoven with the question of memory, specifically memory as formative of selfhood, and, in counterpoint hereto, the loss of that same memory as a moment of trauma. These four books fascinate insofar as they are each a kind of testimony, but in three different incarnations; particularly, Knausgård’s dances on the fine line between fiction and memoir by calling the narrator “Linda” as well as recounting details from her marriage to famous Norwegian author, Karl Ove Knausgård. As autobiographical works dealing with mental illness, the narratives inherently raise the question of who gets to tell their own story. As a French graphic novel, The Parakeet is somewhat the odd one out in what could be a framework of Scandinavian works, but Espé’s excellent and deeply unsettling depiction shows that the entanglement of remembrance, mental illness, and gender is precisely not regional. I hope by its inclusion to show a configuration that cuts across national and regional boundaries.

Significantly, none of the books is really about ECT; rather, they are about the relation between self and memory. Thus, my argument is that the problem with which these works struggle is not so much memory loss itself as it is the memory of the memory loss. ECT is deployed as a mnemonic metaphor, a madeleine cake for the 21st century’s psychiatric institution. ECT is, ironically, what makes the texts speak of the past. However, it is ambiguously staged in the texts, and it is only in Knausgård’s novel that we can speak of it as a truly feminist metaphor, where ECT becomes a way of giving voice to the mentally ill woman. However, in each text, the figure of the “electrified woman” works as a narrative catalyst.

ECT becomes a vehicle for the practice of remembrance because one of the most recurring side-effects of the treatment affects memory, to be precise, autobiographical memory (van Daalen-Smith et al. 2015). Thus, the issue of remembrance is embedded in most discussions and depictions. Also, because ECT not only has a clinical history but a cultural history in what Charles Taylor calls our “modern social imaginaries” (Taylor 2004), it always doubles as a metaphor. This figurative aspect is important, for while metaphorizations can in some cases easily obscure and/or twist actual suffering, the deployment of metaphor can also make something visible: here, it illustrates a silencing of women within the discourse of psychiatry, and it makes us remember a certain feminine figure of modernity, namely the woman/machine couple. The relation of ECT and woman becomes in many ways symptomatic of Western culture’s pathologization of the feminine because that relation has been upheld by an association between the mechanical and the feminine—the machinic is already a metaphor for female mental illness.

Thus, I argue in the last part of the article that the remembrance with which these literary works juggle always has both an individual and a cultural dimension. The coupling of woman and machinery—in this case the ECT machine—is always a recalling of one of the 20th century’s most persistent and troubling figures of psychiatry’s patriarchal dominance: the gynoid. To highlight this aspect, I turn to two influential works that reinterpret the relation between humans and machinery, namely Gilles Deleuze and Félix Guattari’s Anti-Oedipus (1972) and Donna Haraway’s A Cyborg Manifesto (1985).

What Is ECT?

Before getting into the literary works, it is important to sketch both the therapeutic and the cultural history of electroconvulsive therapy. ECT was first conceptualized and performed by Italian psychiatrists Luciano Bini and Ugo Cerletti in 1938, even though the use of current on mental patients had a longer prehistory, particularly on French soldiers during WWI. The two Italians took inspiration from an abattoir where pigs were stunned with current as a method of anesthetic, and inferred that with lower current, the technique would be applicable to humans. It had furthermore been observed that schizophrenics with epilepsy displayed fewer schizoid symptoms after a seizure, and from there the leap seemed obvious. What the treatment does is provoke a seizure in which the brain is put into overdrive, so to speak. ECT was relatively quickly hailed as a success throughout the Western psychiatric community, and especially the American psychiatrists were enthusiastic about the new treatment, not least because it was cheaper than the methods used at the time. Current practice uses complete narcosis in order to relax the muscles before applying current (a practice that, as Knausgård remarks, necessitates the use of higher voltage).

It is, and was, an almost mysterious treatment, as there is still no one who really knows why it helps to alleviate symptoms of depression, schizophrenia, psychosis, and bipolarity. There is more or less consensus on the fact that the hippocampus shrinks in depression and that ECT makes it grow again, and that ECT strengthens the brain’s neuroplasticity; however, apart from these two facts, not much else is known. Certainly, there is no agreement between researchers and many “psychiatric survivors”, to use a consciously loaded term from Bonnie Burstow, as to the possible side effects of the treatment. Indeed, some question whether there is anything but side effects “mislabelled as signs of improvement, rather than as actual symptoms of brain injury” (van Daalen-Smith et al. 2015, p. 145). It is presently more or less acknowledged that the treatment affects the memory centre of the brain, particularly autobiographical memories; however, whether or not this is temporary or permanent is still a major point of contention.

As Edward Shorter and David Healy argue in Shock Therapy (Shorter and Healy 2007), their book on its history, ECT has culturally suffered from extraordinary bad press. Initially brought into Hollywood fame in the film The Snake Pit from 1948, it since rose to Oscar-glory with Milos Foreman’s adaptation of One Flew Over the Cuckoo’s Nest (1975) starring Jack Nicholson before ending up as a punishment (for a troublesome woman, of course) in the Netflix series Stranger Things (2016–2025). For 78 years, the treatment has lived a double life to the great frustration of psychiatrists convinced of its benefits and its safety. The gap between their perception and the public’s is simply enormous. Most people might automatically flinch by the thought of ECT still being used in psychiatry, likely throwing it in the same bag as lobotomy and hydrotherapy. Official health system pamphlets are symptomatic of this state of affairs, often going to lengths to underline the safety of the procedure and that it is emphatically not like it once was. In fact, most information on ECT specifically addresses this problem up front with a marked defensive stance which also characterizes Shorter and Healy’s book that pointedly starts with a homage to the “unacknowledged heroes in the twentieth-century history of psychiatry” (Shorter and Healy 2007). Furthermore, ECT became something of a focal point for the anti-psychiatric movement of the 1950s–1970s, signified by the ways in which writers like Claude Steiner, Ronald D. Laing, and David Cooper treat it. They saw in the forced use of ECT the epitome of psychiatry’s violence to the individual in the service of a state that wished to stamp out psychic difference.

ECT has been, and looks as if it will continue to be, a controversial therapeutic practice; in equal parts, perhaps, due to both institutionally unacknowledged after-effects and the cultural imagination which seems hard to dislodge.1 As Anita Helle points out, “the cultural ground of electroshock’s social and historical meanings has long been dynamic and shifting. This has to do not only with changing social attitudes but also with the labile metaphorical possibilities of electricity and shock that have provided ample ground for literary figuration” (Helle 2019, p. 266). Helle rightly sees that the question of ECT cannot be analyzed in isolation from a wider set of cultural metaphors. However, as we will see in the following, it is not first and foremost the electricity metaphor that the writers in this article focus on; it is rather ECT’s role as mnemonic narrative catalyst.

2. The Experience of Loss

October’s Child tells the story of the writer Linda’s several stays at a mental institution where she nicknames the ECT ward “the factory.” Divorced from her husband (an author) with four children, the narrator tells of suffering a mental breakdown where she attempts to kill herself while pregnant with her fourth child, an event which we only learn about relatively late in the novel. She is admitted to the institution, subjected to electroconvulsive therapy, and the days in the institution are mixed with memories of her previous life, particularly the shared life with her ex-husband.

The novel’s narrative is hard to follow, as almost everything seems to happen at the same time: her stay at the mental institution, the break-up with her husband, her childhood, and her youth. The jumble of memories, with transitions between different points in time that happen without warning, seems to illustrate both the confusion of waking after the treatments, but also the challenging labour of piecing one’s memories back together:

“That there were later large expanses of time that I could not remember, no one cared about. The memory-loss was set against the effect of the treatment. And what do memories weigh? How do you measure them? How do you assess memories? Memories had low status in the factory”

(Knausgård 2019, p. 10)

Narratively speaking, it is the treatment that becomes the incentive to remember, i.e., to narrate, and the narrative breakup mirrors a loss of the sense of continuous selfhood constituted by memories. If we tend to see memories in linear terms—the different experiences leading chronologically up to the person that we are now—then loss of those autobiographical memories has profound effects on who we think we are. In that moment, we become other to ourselves and to our loved ones. The ending of October’s Child seems to indicate that this self-estrangement will linger on even after she is released from the institution: “I walked in the corridor. When I passed myself I looked at me as you would look at something you pass, without fastening your gaze. I saw myself leaving the ward” (ibid., p. 187).

In their analysis of the after-effects of ECT on a selection of Canadian women, Cheryl van Daalen-Smith, Brad Hagen, and Peter Breggin call precisely the experience of electroconvulsive treatment a “diminishment”, a reduction in the person that the patient was prior to institutionalization—an experience which Linda calls “living the life of no one” (Knausgård 2019, p. 13). The women recount being isolated from friends and family as people “grew increasingly uncomfortable” and “they all discussed a profound change in their affect, motivation, and selfhood. They described being flat with no drive and little emotion” (van Daalen-Smith et al. 2015, p. 149). This is one aspect of ECT which psychiatry has tended not to include in considerations of the treatment, one reason being that there have been no “observable” physical data to back it up, apart from the testimonies of a group of former patients. It raises the question—as I will explore further later on—as to what counts as fact in a psychiatric context.

Two other works let us see how this experience of otherness looks when seen from the perspective of a loved one. Danish author Søren Ulrik Thomsen writes in Store Kongensgade 23 of his experiences of moving to Copenhagen with his family as a boy. While Thomsen’s memoir initially focuses on the apartment in Copenhagen that constitutes the essay’s title, it is readily apparent that the centre of the work—what Freud called the dream’s “navel”—is the experience of his mother’s illness:

“Now, I find myself hesitant in front of the keys, for as I approach the time and the place where the points of the compass is placed, I remember not only the intoxication of having moved to Store Kongensgade 23, but also the sense of being lost […] That the bewilderment should have something to do with the fact that my mother would not be there at Store Kongensgade 23 when I got there because she had once again been admitted to a mental institution, did not occur to me”

(Thomsen 2021, pp. 26–27)

In Thomsen’s text, the perspective is shifted so that what we witness is the loss of the mother through the eyes of the young boy in what is essentially the book’s centre. The image of maternal estrangement shows how the memory loss attributed to ECT is never just an individual problem, but something that makes communal waves. The trauma of lost memory applies not just to the patient but to everyone affected by a shared life that appears lost. Thomsen’s narrative recounts the encounter with how intimacy turns to otherness:

“But suddenly one day in 1973, she insisted that I should visit her at the closed section of Copenhagen University Hospital, and the sight of her, terribly skinny and wearing a washed-out, pale red hospital gown, irrepressibly laughing and with unnaturally shining eyes, will always dwell in me as something uncanny, for rather than being healed she was now, after a series of electroshocks, acutely manic”

(Thomsen 2021, pp. 35–36)

It is on this issue of loss that psychiatry’s defensive insistence on the safety of ECT misses something: the experience of a void, a gap in oneself or the loved one, constituting a moment of trauma that does not easily dissipate. The point of trauma is witnessing the self, or the loved one, as completely Other. Maternal estrangement is perhaps one of the strongest kinds there is, and many horror films, for instance, play upon precisely this trope of a boy witnessing his mother turn into something horrifying. The fear of becoming a stranger to her children also haunts the narrator of October’s Child.

The combination of estrangement through the eyes of the child is also chillingly imagined by French graphic novelist Espé in The Parakeet from 2017, in which he recounts a young boy’s attempt to navigate his mother’s mental illness and the conflicts it causes in the family. The boy Bastien experiences firsthand a series of breakdowns and institutionalizations of his mother and lists the many treatments she unsuccessfully receives: “I hear daddy talk about ‘sophrology’…‘phytotherapy’…‘psychotherapy’…‘sleep therapy’…‘electroshocks.’ […] I hear him talk about ‘anxiolytics,’ ‘antidepressants’, ‘mood stabilizers’, ‘sedatives’, ‘lithium salts’, ‘anticonvulsants.’ The weird names echo in my head” (Espé 2017, pp. 28–29). The narrator’s description of his mother when she returns from treatments is almost unbearable, when he sees what seems to him a stranger: “The doctors think that is good enough. To me, it feels like it’s all over. I don’t recognize her. She’s not the mom she was. The one who goes on hikes. And feeds me strawberries. She’s like a stone statue. With blank staring eyes. Maybe mama’s already dead” (ibid., pp. 60–61). It is not clear what role the mental institution plays in the transformation of Bastien’s mother, but then that is not the point. What matters is the way in which the boy can make sense of it; the novel focuses on the boy’s emotional experience.

His mother’s schizoid episodes are interpreted by him as akin to the powers of superheroes, but her institutionalized self is somehow beyond interpretation. She becomes a void, something absolutely other, a state that Espé visualizes by drawing her eyes as dark holes (whereas the schizoid are episodes always in red). The point is not that the schizoid episodes should somehow be better for the boy—such a claim would be callous. The point is that there is no vocabulary of imagination available to him that can account for the institutionalized doppelgänger he now sees. As in Knausgård, the therapy indeed renders her as “no one,” while Bastien’s reimagining of her as a superhero does not break the communal bond between them; in fact, it helps him to strengthen his place in his community of school children.

Seeing through the eyes of the child is a perfect way of capturing the experience of loss because the child is incapable of grasping the many rational reasons and arguments for his mother’s transformation; the reassurances of the doctors do not register emotionally. He sees, and transmits to us, only the emotional fact of her disappearance. This fact remains in both boys despite the very different outcomes of the two novels: whereas Thomsen’s mother ends up living a long and relatively healthy life, Bastien’s mother hangs herself in the asylum, leaving him only with the toy-parakeet of the novel’s title. For these writers, both mental illness and ECT is something that echoes through the generations: Linda fears that her “bad genes” will be given to her children, while The Parakeet ends with a grown Bastien passing on the parakeet to his newborn child.

Peter Øvig Knudsen’s I Am What I Remember is half memoir, half journalism, and is very different in tone from the other works. He retraces his own history of psychotic depression and his subsequent cure via ECT. The narrative deals with his attempt to align his own former anti-psychiatric attitude to what appears to him to be a “miraculous” cure, while also giving equal voice to psychiatrists and former patients suffering from long-term side-effects. Knudsen’s text, then, is a mix of personal experience, historical research, and interviews. However, while the text presents itself as a balanced investigation, albeit with a personal investment, there are several problems along the way. One of them is that Knudsen subtly puts himself, and thus his authority as a prolific public writer, squarely on the side of the institution. He comes back several times to the argument, often underwritten by his authority as a prolific writer, that memories are untrustworthy and that we do, to an extent, construct our own memories. What this argument effectively does is undermine some of those voices his own text takes pains to present. For if we do indeed construct our own memories, what can these people be said to have actually lost? His implicit argument suggests that the loss of memory is in effect an illusion.

3. Temporally Diminished

It is specifically what is termed autobiographical memories that are in danger of being lost with ECT. While people might lose muscle memory and have to relearn practical day-to-day tasks, the loss of autobiographical memories is much more traumatic. Imagine not being able to remember the time you spent with your children; imagine no longer remembering their births. The diminishment of the self is an experience of the past shrinking.

The loss discussed above, then, is the loss of a kind of temporal self—what French philosopher Paul Ricoeur defines as idem. In Oneself as Another (1994), Ricoeur juxtaposes the following two aspects of identity: ipse (selfhood) and idem (sameness), and only the latter implies “assertion concerning some unchanging core of the personality” (Ricoeur 1994, p. 2). Idem, then, signifies consistency through time—the feeling that I am, at least to an extent, the same today as I was yesterday. It is this temporal sense of self that is necessary for any kind of ethical duty and juridical judgement. Unless there is some kind of continuity of identity, I could hardly assume responsibility for my past actions, nor could I be punished for them accordingly. Idem is essentially a narrative kind of self where “permanence in time constitutes the highest order” (ibid.).

Importantly, this narrative self works both in an individual and communal sense: friendships and family are contingent on a shared history, shared memories, shared traumas (Caruth 1996), and a narrative self is by necessity an involvement with others. The temporal sense of self is both a projection forward as well as backwards. However, this latter is precisely what the ECT short-circuits. It is important, then, that all three narrators are writers, because idem is precisely a narrative kind of self:

“I told him that I was a writer and that I needed my memories. Only then did he look at me and said that the memories would return. They always do. Sooner or later. Maybe not all of them, really not all of them, but it is hard, if not impossible to find a treatment completely without side-effects. You understand, surely? You can always make stuff up. Isn’t that what writers do?”

(Knausgård 2019, pp. 36–37)

That Linda is a writer has a double meaning here which the doctor eminently fails to grasp. Because the self is a question of narration, the inability to write becomes a metaphor for an inability to be, a discrepancy within the self. In response to what is essentially an erasure of her person, Linda tries to strangle the doctor. There is thus an intricate relationship between the act of writing, the act of remembrance, and the act of “selfing.”

However, through the novel, we saw how a loss of idem in fact leads to an encounter with ipseity; the loss of the temporal self equals an encounter with Otherness that constitutes selfhood. Put differently, losing memories engenders a mnemonic activity. In opposition to idem, ipse signifies the play of self and other. In a weird twist, then, the loss of the continuous selfhood marks a break that ends up reinstating the self. The experience of being no one, of emerging from the narcosis and the ECT as fundamentally other, effects a reconstitution of Linda, a chance to stitch together her fragmented selves back into a new entity as Sister Maria, who works at the institution, encourages Linda to remember her life. However, the end of the novel is ambiguous on this point. Despite her efforts to remember, her stay in the institution has still affected a lingering splitting. As “Fran”, from van Daalen-Smith et al.’s study puts it: “I don’t know who I am anymore. I’ve had to re-create myself” (van Daalen-Smith et al. 2015, p. 150). Even if this temporal self is basically an illusion, as Knudsen argues, a construction that we make in order to make sense of the past, its loss is nevertheless traumatic, not least because it equals a severing of emotional communal bonds.

It is this play between idem and ipse that makes narrative identity and autobiography as such, inherently unstable, because, as Roland Barthes has pointed out, the “I” of the narrative is not the same as the one who writes, who in her turn is not the same as the “I” in the real world (Barthes and Duisit 1975). Knausgård is quite the most interesting case here, because her text short circuits an inherited notion of autobiography, namely that of a (male) author making sense of his life from a privileged vantagepoint of earned wisdom—“this is how I came to be thus.” October’s Child is somehow constantly present, even in spite of its use of the past tense; the fact that the novel ends with a split self underlines the impossibility of such a position that traditional autobiography might imply. It is hard not to argue that this is inherently a feminist point, if we compare it to both Knudsen’s and Thomsen’s texts that do indeed trace a coherent identity.

In a paradoxical way, then, electroconvulsion is a mnemonic metaphor with a completely reverse valorisation than what we encounter in the testimonies of the “psychiatric survivors,” but also in the historical and cultural material of the treatment. We know, for example, from released documents that work was done in the 1950s, paid for by the CIA, which actively (and successfully) used ECT as a way of erasing memory completely (Knudsen 2021). We also encounter ECT as a memory-wipe in works like Stranger Things where a troublesome mother gets her memory all but erased, and it is reimagined as a memory-erasing apparatus in the movie Eternal Sunshine of the Spotless Mind (2004), in which the protagonist willingly asks to have all memory of his ex-girlfriend removed from his mind.

Watching oneself or the (m)other disappear from view forces the narrators to ask painful questions about self and time. The end of The Parakeet shows Bastien as an adult sitting with his wife and newborn child—the last words of the novel being “I’ll tell you about it one day, my dears…I’ll tell you all about it” (Espé 2017, p. 147). The experience of the mother’s illness and institutionalization engenders a need to tell; it is a narrative catalyst.

4. Metaphors and Concepts

It is as a metaphor that ECT turns out to activate a practice of remembering, and Knausgård turns the problem upside down, in effect giving voice to the mad, silenced woman. If ECT is indeed a mnemonic metaphor, we should look at some of the metaphors that surround it: the factory, the miracle, and the superhero. It is a point of little contention that metaphors are not an ornamental element, but on the contrary essential as an epistemological tool (Ricoeur [1975] 2003; Derrida 1974; de Man 1979; Lakoff and Johnson [1980] 2003). Metaphor brings things together that had no previous relation, and by doing so, it rearranges our conceptual horizon. Through metaphor, we can perceive new connections between phenomena. Using ECT as a mnemonic metaphor that activates memory rather than erasing, it is precisely such an ontological reconstitution.

How does the transition from actual occurring phenomenon to metaphor happen? According to Susan Sontag, it is due to “diagnostic lacunae.” In the essay Illness as Metaphor from 1978, Sontag analyses the ways in which cancer and tuberculosis have been described through, and deployed as, metaphors (in other words, that illnesses can function as both tenor and vehicle); it is those illnesses without clear causality that lend themselves most easily to metaphoric use (Sontag 1978). With ECT, the case is double-sided for here the treatment is also without obvious causality. As mentioned above, psychiatrists seem to know that it works—they just do not know why. Mental illnesses like schizophrenia and depression are conditions without either clearly understood cause or cure, but what confounds the narratives in the present case is that this same lacuna also haunts the cure.

The two central metaphors which Knausgård and Knudsen utilize, respectively, are instructive in their opposition. Knausgård calls the ECT department of the mental institution “the factory” (fabrikken). Likewise, ECT is explained to her as “like restarting a computer. They really did use such despicable images” (Knausgård 2019, p. 5). “Factory” makes visible how psychiatry is also a matter of production—production of health and of healthy individuals. It signifies the business side of what is aptly called “the health industry”: “It went on at a speedy pace in there. They knew what they were doing. They managed, as I said earlier, to squeeze in twenty unfortunates each morning” (Knausgård 2019, p. 8). This metaphor underlines the intimate role that psychiatry plays vis-à-vis the welfare state. “The factory” signifies not only something fully man-made but also the capitalist logic that always underwrites it. The factory as a vast machine might be a metaphor with potential for emancipation, but in Knausgård’s novel it underlines first and foremost the business side of psychiatry, where the alleviation of symptoms is fundamentally in service to capitalist society: getting better means getting back to work. The factory produces functioning humans.

Knudsen, on the other hand, keeps referring to his own cure as “miraculous”, often coinciding with descriptions of his depression as “demonic”, labels which are echoed by the psychiatrists he interviews. This kind of religious-figurative language in the context of an institution that is famous for only accepting measurable things as evidence is striking because the imagery precisely circumvents causality. The problem with the metaphor of miracles is not only that it is in a way at odds with the epistemological nature of metaphor itself, but more importantly that it requires a certain subjective stance: the miracle must be taken on faith alone.

When recalling Sontag’s point about diagnostic lacunae, Knudsen’s recurring metaphor makes perfect sense. A miracle is by definition something that intervenes in the state of things without rational explanation. The miracle cannot be put into the causal logic of things. This means that the metaphor is also ethically perilous in the context of treatment: just as there can be no logical explanation for the miracle and thus it can only be surrendered to, the analogy seems to be that we must surrender to ECT in a similar manner. The religious metaphoric framework basically asks us to surrender to the miracle of electroconvulsion—and, by implication, to the god-father-psychiatrist—without unnecessary and troublesome questions. However, when the loss of memory actually becomes an injunction to remember, suddenly the metaphor of “factory” gains an additional meaning: it is also the production of memories, particularly those memories that Linda perhaps has not wanted to remember in the first place (“shit memories”, as she calls them). Almost in spite of herself, she chooses a metaphor that mirrors the labour that the text performs.

Finally, the metaphor in The Parakeet: the superhero. Bastien recalls the first time he hears the word “electroshock”, immediately after he has told the reader of his enthusiasm for superheroes. He reads how the hero Wolverine is given a metal skeleton to make him strong, and when he looks up the word “electroshock” in the dictionary, his imagination immediately fuses the two: “Wowww!!! Maybe mama’s a superhero!!!,” he exclaims, followed by a vision of his superhero mother zapping monsters (Espé 2017, p. 43). When his friends happen to witness one of his mother’s episodes, they interpret the situation along the same lines. Attempting to deal with the unexplainable—Sontag’s diagnostic lacuna—of his mother’s condition, metaphor provides a way out: it provides him with an explanation that rearranges the coordinates of his situation. Indeed, to the child, the cure is now more unfathomable than the illness, as we saw earlier how the father’s overheard medical explanations collapse into a heap of meaningless signifiers.

5. The Gender of ECT

One thing conspicuously absent from Knudsen’s book is the issue of gender—which is essential for understanding both Knausgård’s and Espé’s works. In the latter, it becomes clear to the reader that the problem of psychiatric authority can in no way be confined to a clinical context but must take into account the larger context of patriarchal authority. The elegance of these two works is the subtlety in which they do so. An important moment in Knausgård is Linda’s dream of her father: “with a gesture he showed that he was in charge on this island. He swept his arm over the crowds of people who suddenly showed up behind him and I knew my life was over. […] He was the leader of this island” (Knausgård 2019, p. 50).

There is a marked gender bias when it comes to the question of who is given electroconvulsive treatment. One study puts the figure at 62–73 percent, and van Daalen-Smith et al. write that “regardless of setting, 75 percent of the total electroshock procedures were administered to women” (van Daalen-Smith et al. 2015, p. 144). The authors likewise quote a study from 2007 that found “persistent and significant detrimental effects on mental function, in such areas as memory retention, attention, and autobiographical memory. The authors also found that […] the female ECT patients experienced the most impairment” (ibid., p. 145), and women are in general more likely to be moved quickly from pharmaceutical drugs onto ECT while male patients stay longer on drug treatment. In an additional twist, this change in treatment is sometimes used to assign guilt to the patients themselves, that they “respond poorly” to the drugs:

“It became evident that the main rationale for ECT being prescribed was the conclusion that they had each ‘failed’ to adequately respond to other treatments, thus individualizing its necessity. Once they were labelled ‘treatment-resistant,’ the women were told that they had ‘failed’ to respond to (any number of) psychiatric drugs and hence, they had reached an assumed point of no return; in other words, electroshock was their only recourse and their only opportunity to regain some semblance of a normal life”

(ibid., p. 148)

Knausgård mentions the same logic of undefinable somatic guilt: “They were so scared to come under scrutiny that they blamed everything on the patient. She was unmanageable. She was already too far gone. She was desperate” (Knausgård 2019, p. 6). Van Daalen-Smith et al.’s article on gender and ECT in Canada relies among other things on the testimony of seven women who had been in, or were in the midst of, electroconvulsive treatment. In each of the cases presented, the progress was the same: being prescribed drugs to counter various symptoms of emotional distress, the women all recount how they are relatively quickly moved on to ECT “as a last resort”. As “Celeste” states, “they told me it would cure my depression… no one cared why I was depressed” (van Daalen-Smith et al. 2015, p. 148). According to the women, it was in many cases a question of ECT being prescribed to counter the effects of the drugs, not the original complaint. A closed loop. Perhaps this is what Knausgård alludes to when she calls the electric current “that which saves the doctors” (Knausgård 2019, pp. 9–10). But why is ECT brought in earlier in the case of women? Perhaps it is because the illnesses that drugs are administered to counteract, in the case of women simply is not illness but a range of gendered, political, and historical responses to personal and social trauma that from an institutional viewpoint just looks like pathology:

“Rather than addressing the underlying causes of the women’s distress and listening empathically, medical professionals prescribed medications that made their mental conditions worse. To a health care practitioner who views women’s distress ‘symptoms’ through a bio-psychiatric lens, the women’s modes of ‘coping’ become pathologized and medicalized”

(van Daalen-Smith et al. 2015, p. 151)

Even if the issue of gender is studiously avoided in Knudsen’s account, one poignant scene from the beginning of the book strands out, not just for its visual violence but also for the effect that it will work on the narrator and, essentially, the book as such. It is a moment where the gender politics of psychiatry cries out. Having recently been admitted to the mental institution, the narrator refuses to receive ECT. Having had his formative years in the generation of anti-psychiatry, he is understandably sceptical. However, while walking in the corridor, he encounters a woman being forcibly wheeled into ECT:

“One day I see one of the other patients—a beautiful woman that I have talked to on several occasions—being wheeled down the corridor and past me while I am standing in the doorway to my room. The woman is strapped to a bed while one of the male orderlies pushes her towards a door at the other end of the hallway. I do not know where the door leads, but the woman does.

‘Nooo, no, I don’t want any more electroshocks’, she screams while writhing in the restraints. ‘I don’t want any more electroshocks!’

The door at the end of the corridor opens and the bed with the screaming woman disappears down yet another hospital corridor towards a destination of endless horror”

(Knudsen 2021, p. 27)

While this scene is haunting in itself, the lesson that the narrator draws from it is puzzling, not least for its metaphors: “I want to walk to the gallows myself, becomes the thought I hold on to from that moment. […] Rather than being forced, tied up with restraints and wheeled to the electroshock execution, I will walk myself” (ibid., pp. 27–28). Rather than really empathizing with the unknown woman, the narrator uses her as a yardstick for what he does not want to be, reinforcing the distance between them instead of the intimacy. In a book dedicated to an exploration of ECT, this woman appears as merely a phantom, a prop upon which the male protagonist can lean on for his own sense of actional self. The traumatized woman merely pops up only to disappear again immediately as soon as the narrator has gotten his epiphany.

This meditation is by no means gender neutral; in fact, it enforces in many ways the culturally entrenched opposition between the violent and hysterical (mad)woman and the rational and brave man (one might also wonder about the relevance of her “beauty”—would it somehow be less shocking if she was ugly?). It is a classic display of the trope of the unruly female body that must be restrained in order to be cured; as Elaine Showalter has argued in her analysis of the Victorian “madwomen,” the statistical prevalence of female patients proved to psychiatrists “that women were more vulnerable to insanity than men because the instability of their reproductive systems interfered with their sexual, emotional, and rational control” (Showalter 1985, p. 55). Knudsen is generally throughout the text a thoughtful and empathic narrator, so what goes wrong here? Why is this moment of extreme gendered violence so quickly left behind? Perhaps because it offers a very different look on psychiatry than the one the text constructs via interviews with nuanced and friendly psychiatrists.

It is remarkable that Knudsen as an investigative journalist does not seek to know the identity of this woman, but perhaps there is textual logic to this as well. Perhaps this nameless, terrified woman and her screams comprise the disavowed centre around which the text’s insistence on salvation-metaphors tries to cover up. Knudsen both interviews women who suffer effects from ECT and he refers in depth to CIA-sponsored ECT experiments on female patients in the 1950s. However, he does not pause to consider these women’s situation qua women. What is also discreetly passed over is the issue of gendered violence.

The Parakeet plays with this interweaving of different kinds of patriarchal authority through the figure of the boy’s maternal grandfather. Tracing the history of his parents, we learn that the grandfather tried to force Bastien’s mother to have an abortion because she was not married to the father. Thus, the novel creates uncanny echoes across the text and images, where the initial forced hospitalization of his mother—screaming in the garden in images drenched in aggressive red colours—mirrors the grandfather dragging the pregnant woman to the car, the grandfather violently shaking the depressed mother because he “doesn’t believe” in her illness. The images of different men manhandling (pun intended) the ill mother makes visible a dimension of gendered violence which is so notably absent from Knudsen’s encounter with the restrained woman.

However, if women’s voices are less discernible within psychiatry—if the mad discourse is constitutively offside and women’s doubly so—how is informed consent or disagreement even possible?

6. Manufacturing Consent by Threat of Death

Bonnie Burstow writes on the institution of psychiatry that “we are convinced, indeed are continually primed to be convinced, that such measures are for their own good” (Burstow 2015, p. 2). Many psychiatric articles underline that ECT is safe and that it is mostly applied in cases where there is consent. However, as Noam Chomsky and Edward S. Herman pointed out, consent can also be manufactured; it is not simply a question of individual willing or refusing (Chomsky and Herman 1988). In order to consent, a horizon of desirable and undesirable choices must first be made visible, and ideas about the good life made clear. To Burstow, this consent rests in large part upon the enormous prestige that the institution of psychiatry has in our society. In its marriage to the state apparatus, psychiatry has been given immense authority, in some cases holding a power that undercuts normal legal and juridical parameters. As she argues, psychiatry “is the only profession that can as a matter of course utterly take away the freedom of people who have committed no crime” (Burstow 2015, p. 4). Such power “to act and to enforce” could hardly function as blatant exercise of power; it must, to work properly, ride on a general societal consensus.

How does an institution sit so powerfully outside of the general practice of legality? What is the institutional or discursive logic that leads to those moments where ECT can be applied against the subject’s will? It has to do with the creation of a moment of krinein, of crisis. The Greek word denotes a moment of split, a decisive point that separates one state of affairs from another. In our case, the phrase that denotes this shift in legality is “danger to herself and others.” ECT is specifically mentioned in Danish law on psychiatry’s forced admissions and treatments, where it is stated that ECT can only be forcibly applied “if the patient (…) is in a state of actual or potential life-threatening circumstances” (Psykiatriloven paragraph 12, § 3).

When a person is deemed a danger to herself—for example in psychotic depression—any and all means can be applied; the reason, of course, being that compared to death—everything else is a blessing in comparison. The logic of crisis sets the parameters for judging some effects to be “side” (meaning “minor” or “irrelevant”). In order to make this kind of hierarchy, you need something at the top—something that is the ultimate problem to which all others are subordinate. In the cases where ECT is used, it is the threat of suicide that constitutes the krinein, the point of crisis that necessitates fast measures—psychiatry’s version of politics’ “emergency powers.” This is not to question the ethical value of preventing suicides; it is merely to understand the logic empowering those uses of the treatment that entails violence. If memory loss is an acceptable consequence of the treatment, this is because the alternative seems to be death.

This logic of crisis unlocks an impasse regarding consent. For if the patient is judged to be unable to understand her own good, how should the doctor react to a refusal of for example ECT or drugs? “Celeste” tells of her treatment taking place “despite flatly refusing consent countless times including in the OR, while strapped down on a gurney and wheeled to the treatment room” (van Daalen-Smith et al. 2015, p. 148). Michel Foucault (for example) is one of those who have analyzed the procedures by way of which society responds to “mad discourse”, and the relations between discourse and the power of institutions. One of these is precisely to value the mad discourse at naught and at the same time establishing procedures for who can then hold the power to speak the truth about what is really going on (Foucault 1972). By this logic, the mad discourse is simultaneously dismissed and symptomatic: it can, at different times and even at the same time, be both irrelevant because it is uttered by a “mad” person and significant for the same reason. It both means nothing (as rational, sincere expression of free will) and everything (as a symptom, as simply the illness speaking):

“It wouldn’t do to say that I didn’t need the treatment. It has never helped. Quite the opposite. No one listened. I could decide nothing for myself as long as I was forcefully admitted and was a danger to myself and others”

(Knausgård 2019, p. 117)

Pathologizing the patient’s discourse eschews the dialogic relation between patient and doctor, but it is also a strategy that might come in handy when faced with outside criticism. When Knudsen interviews retired psychiatrist Tom Bolwig, he has a few choice words for some of those who criticized his practice in the heyday of anti-psychiatry: discussing his experiences with people opposed to ECT, he says that “their perception of reality was akin to psychosis because it was a misconception which had enormous persuasive power, and like the psychotic, they could not be moved” (Knudsen 2021, p. 207). On the next page, Bolwig argues that a few of his opponents “were on the edge of the paranoid and were in actuality perhaps in need of help” (ibid., p. 208). Reading the interview with Bolwig, it is hard not to agree with Burstow’s assessment that psychiatry is “a regime of ruling in which the psychiatrist’s voice displaces all other voices and creates the facts to which the system, indeed, the world as a whole gives credence” (Burstow 2015, p. 15). One way of instituting and maintaining such a regime is precisely by pathologizing those who might disagree with your standpoint. The interview demonstrates a problem at the very heart of psychiatry, namely the power to strip from someone the weight of their words. To assign pathology is also, whatever else it might be, to mark the subject’s discourse as irrelevant at best, symptomatic at worst.

Bolwig then, probably unintentionally, underlines another of Burstow’s recurring points: that the patient’s words and wishes count for nothing against those of the psychiatrist’s verdict. He recounts instances where he and the staff would forcibly give someone ECT, in spite of their protests, which in Bolwig’s account seems to be primarily traumatic for…the staff: “it is most unpleasant to have to resort to force […] ECT by force is really in a class for itself when it comes to difficulties” (Knudsen 2021, p. 211). When Knudsen reasonably asks whether there were not cases where they would accept that some people did not want ECT, the psychiatrist answers “Yes, if a patient put his heels down hard and mobilized the family lawyer who came to the department and demanded an interview with the chief doctor where he threatened a lawsuit…” (ibid.). So, the only way to be heard is to have the resources to call in “the family lawyer”, implying a necessity for both a financial and cultural capital that far from every patient can be assumed to possess; to have a representative from another institution speak on your behalf. But what of those for whom this is not an option—perhaps the restrained women we encountered in the beginning of Knudsen’s narrative? Bolwig’s admission underlines how entry into the psychiatric institution, no matter how well-intentioned and necessary, equals a silencing—the words of the mad do not hold the same legal weight as that of their family, lawyer, and therapist. Indeed, it is very telling in van Daalen-Smith et al.’s article that in most cases, the consent that the doctors could not get from the patient would be obtained from the husband.

Burstow hits the nail on the head: “the decrees of the psychiatrist can indeed be challenged, for instance in court, but the challenge must be part of the same discourse, must obey the same rules. (…) while a psychiatric pronouncement such as ‘Jill is schizophrenic’ may be called into question, only on the basis of the words of other psychiatrists—people, significantly, who have undergone comparable training, overwhelmingly believe in the same concepts, apply the same texts, are granted the same credibility. As such, this powerful system is additionally a closed system” (Burstow 2015, p. 4).

We might wonder whether the unnamed woman from Knudsen’s memoir was without such legal and institutional support. The image of her is in many ways symbolic: screaming the word “No!” and yet completely unheard. Not even her (male) chronicler really hears her—he is too busy coopting her experience to his own Bildungsroman.

Thus, the question of gendered force is not posed in this account, even if the person he encounters in the clinic—restrained, forced, protesting to no avail—is a woman. It is easy to imagine how the experience of ECT would differ dramatically in cases of force. However, as we have seen, this is a major element in Espé’s The Parakeet, in which there are numerous instances of Bastien’s mother being forcefully restrained, particularly (and most graphically) in one of the opening scenes:

“It sounded like a hurt animal…but it was mama…She was on the ground screaming…Her body was twisting all around. She was crawling through the bushes, yelling…She was dancing in the night. Two men were with her. They were strong…They wanted her to stop moving…but mama made them dance with her. Through the branches, I saw them put her in a big white shirt with belt on it…Mama screamed louder and louder…Then they dragged her across the yard, down the gravel path, and shut her in an ambulance. The shirt kept her from moving but not from yelling…The screaming stopped. It was night. Mama wasn’t dancing now”

(Espé 2017, pp. 6–10)

As the very next chapter is titled “Grandpa” and opens with him screaming at the mother, forcefully shaking her to get her to “get it together”, the novel quite elegantly makes it clear to the reader that there is more at stake here than mere illness; it is hopelessly entangled with “regimes of ruling” that are inherently patriarchal. It seems to suggest that the challenge is that the krinein justifying physical violence is pronounced by the same patriarchal institution that will then perform said violence. It is a circular logic in which the patient’s voice becomes muted.

7. The Mother Machine

Apart from the value of the individual stories we have encountered so far, there is a cultural–historical dimension that illuminates this relation between woman and machine that ECT makes visible. Arguably, if ECT can work as a mnemonic metaphor that is specifically feminized, it is because of a certain historical configuration: modernity poses a specific metonymic link between woman and machine, one whose signification is very different from how the “man–machine” has been imagined by writers such as Ernst Jünger. Rita Felski proposes a list of four central “woman figures” that have characterized modernity. She argues that these figures have been instrumental for how the configuration of the modern and the feminine has functioned in the social imaginary of Western modernity. Of these, it is the mechanical woman that is of interest to us here.2

One early modern incarnation of this gynoid is French author Auguste de Villiers de L’Isle-Adam’s L’Eve Future from 1880, but it is easy to locate predecessors like E.T.A. Hoffmann’s Der Sandmann (1816), and the archetypical image of the (male) creation of an artificial woman in the 20th century is arguably Fritz Lang and Thea von Harbou’s Metropolis (1927). Historian Minsoo Kang characterizes this phenomenon as “fantasies of industrial machinery taking on female characteristics and the creation of female automata endowed with irrational and sometimes even supernatural powers” (Kang 2018, p. 28). The reason why we might speak of ECT as a feminized machine is because of the constellation of woman, modernity, and the machinic; even that ECT is the female prosthesis of the last 78 years insofar as the prosthetic element marks the point at which a disability has gone “too far” vis-à-vis a normative community and is in need of correction. ECT is an actual piece of machinery coupled to a living, female body, but it is also something that engenders narrative or imaginative action in virtue of seeking to correct a “disabled” situation. In this case, electroconvulsive therapy is a prosthesis that seeks to fix an incorrect affective state and in doing so, it sets a narrative movement going. This is the reason why David T. Mitchell and Sharon L. Snyder have famously coined the term “narrative prosthesis” in their book Narrative Prosthesis. Disability and the Dependencies of Discourse (Mitchell and Snyder 2000). Thus, ECT is a feminine prosthesis because it is the narrative element by way of which the stories of female mental illness are often imagined. By historically having woman and machine in close proximity—a proximity mediated by the motif of something running amok—metonymy is by degrees turned into metaphor. We saw how the restrained woman of Knudsen’s narrative becomes a prosthesis that allows the narrator to imagine himself as “not that,” a moment which then forms the structure of the rest of the narrative.

If we look at two metaphorizations of the machine—Gilles Deleuze and Félix Guattari’s Anti-Oedipus [1972] (2024) and Donna Haraway’s A Cyborg Manifesto [1985] (2016)—we can, I think, get a better grasp on this entanglement of femininity and machinery. Anti-Oedipus famously speak of machines désirantes—desiring machines—where one of the most cited examples is the breast as “a machine that produces milk, and the mouth a machine coupled to it” (Deleuze and Guattari [1972] 2024, p. 1). The point is that this machine does not first and foremost produce milk; it produces a relation between two subjects (mother and child). The book seeks to articulate a version of desire that is free of a Freudian-familial framework, and the machine becomes precisely the metaphor that can do this. The machine, like desire, produces relations that cannot be reduced to the Freudian confines. One problem, however, with Deleuze and Guattari’s use of the machine as a way of stepping outside both the Freudian framework and the institution of psychology and psychiatry is that the machine does not stand outside of those institutions—it is rather part and parcel in that same repression that the philosophers seek to combat. Their analysis fails to take account of the particularly gendered nature of the machine in Western imagination, as well as the very real ways in which the machine is employed within the institution of psychiatry.

Haraway’s influential essay owes a debt to Anti-Oedipus, I think. She writes explicitly that “the cyborg is a creature in a postgender world” (Haraway [1985] 2016, p. 8), and that “a cyborg might be about lived social and bodily realities in which people are not afraid of their joint kinship with animals and machines, not afraid of permanently partial identities and contradictory standpoints.” (ibid., p. 15). While Haraway does to some extent fall into the same trap of seeing the cyborg as a somehow historically “neutral” metaphor, the cyborgian fractured identity that she advocates illustrates an important aspect of Knausgård’s work. Here, the machine does indeed create “partial identities”, i.e., from the estrangement of the self and other that memory loss entails, and while it may have to travel the hard road through the estrangement of the electric machine, we can nevertheless see Knausgård’s literary strategy as precisely an example of one of “the different ways in which women drew upon, contested, or reformulated dominant representations of gender and modernity in making sense of their own positioning within society and history” (Felski 1995, p. 21). When Knausgård turns ECT upside down in turning it into a mnemonic metaphor, she also turns around the machine as an apparatus of repression and silencing. It becomes a way of reformulating a self outside of patriarchy. Additionally, what strikes me as particularly poignant is that she does not lapse into any kind of happy, salutary ending but chooses to stay with the trouble. To end on a note of joyous triumph would somehow be a betrayal of the traumas suffered along the way.

We come across another piece of memory technology in October’s Child, the camera. Coming upon a dead animal at their doorstep, her husband is eager to photograph it. However, as the narrator points out, the camera is her memory prosthesis:

“You went to get your camera and photographed the prey. You were enlivened by the sight. I do not know why you had to photograph all of the sudden. You never usually did. It was me who photographed. Who developed the film and enlarged the pictures of the children and put them in albums”

(Knausgård 2019, p. 27)

It is telling that the narrator takes pictures of the couple’s children, while the husband is more interested in documenting “prey”, and significant that we are presented with another constellation of “woman–machine–memory.”

If the ECT machine becomes a narrative prosthesis in Knausgård’s narrative, it is discreetly countered by another apparatus, the camera. As the camera as a mnemonic device is coopted by her husband, the only possible route for the narrator is the one that leads through the institution and Sister Maria’s injunction to collect her memories. Things are turned upside down as the camera becomes associated with a male character, and the very machinery which robs her of her memories becomes productive of memory.

The remembrance that ECT as a textual element makes visible is thus always double: the individual as well as the cultural–historical. Apart, then, from the importance of making those women heard, who in spite of the reassurances of psychiatrists, continue to suffer from ECT, the ways in which we imagine the relation between the woman and the machine speaks volumes about the gendered constitution of our social imaginaries. Perhaps one of the reasons why women are transitioned quicker from pharmaceuticals to ECT is because the figure makes sense; the “electrified woman” is part and parcel of our cultural history. It is, as Felski would say, one of the essential figures of modernity.

As a way of summing up the problems of “gynoidism” and psychiatry, we can turn to a painting by German writer and visual artist Unica Zürn: the image Zirkus (Zürn 1956). There are several elements in the painting that give associations to machinery. In fact, the entire image looks like a giant machinery that via wires creates the haunting figure in the middle of the foreground. Features of houses are clearly discernible, but these are transformed into machines—an anticipatory echo of Knausgård’s factory.

As Deleuze and Guattari never tyre of repeating, machines produce. Their vision of the machine as liberatory ideal arises from its severing of the Freudian triad of “mommy–daddy–me”: the machine makes all kinds of new couplings, connections, and desires possible that are not oedipal in nature. However, in Zürn’s image, the situation is something else entirely. Even if it would be hard to identify any Freudian phantoms here, the horizontal connectivity is devastating. The wire-like strings connected to the central figure in the front with its maniacal grin and staring eyes is reminiscent of Thomsen’s experience of seeing his manic mother post-ECT. Is Zürn’s image not emblematic of how ECT helps to create that “mad woman” that it is meant to help; however, at the same time, might it also create the means by which the patient may set herself free? The grin of Zürn’s figure is both sad and triumphant.

8. Conclusions

In this article I have shown how electroconvulsive therapy and memory have become so entangled with each other that they constitute a kind of configuration, and how a selection of contemporary writers deploy ECT as a textual and ideological phenomenon. In effect, ECT can work narratively as a metaphor for remembrance. We can see that contemporary literary works that deal with electroconvulsive treatment are concerned with practices of remembering, underlining how ECT echoes through generations. Especially for Knausgård and Espé, the literary presentation of ECT makes visible the gender-political aspect of how mental illnesses are conceived within the psychiatric institution. The concern is not so much whether side-effects are temporary or permanent; what matters is the emotional experience of the otherness within oneself or in the loved one. That is a side-effect which is not easily remedied. Even if it is true, as Shorter and Healey argue, that ECT historically has suffered from extraordinarily bad press, the continued literary preoccupation with issues of memory and selfhood seems to suggest that the therapy is not self-evidently free of problems. The problem is in part psychiatry’s focus on alleviation of symptoms and apparent lack of any long-term side effects. However, the experience of memory loss, both in self and in the beloved other, is a haunting encounter with an Otherness. However, this encounter can be made to work as a textual or narrative catalyst via metaphorization.

Furthermore, I have tried to show how the individual remembrance via metaphor also brings up the shadow of our culture’s previous metaphorical relations between woman, machine, and mental illness. Even attempts at reinvigorating the machine metaphor, such as Deleuze and Guattari, risk perpetuating a certain figurative-patriarchal dimension if attention is not sufficiently paid to “the gynoid” as a figure of modernity.

ECT is, regardless of its virtues or dangers as a therapeutic tool, a cultural phenomenon that exists in a double reality: always institutional and figurative, always individual and communal. However, it is also a phenomenon that is inherently feminized—a metaphor not just for remembrance, but for the patriarchal dimensions of psychiatry.