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Intro music

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Feedback part 2

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Feedback part 1

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Pictures of Mrs Garbett notes - 15th June

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Pictures of Mrs Garbett notes - 15th June

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Pictures of Mrs Garbett notes - 15th June

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Pictures of Mrs Garbett notes - 15th June

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Pictures of Mrs Garbett notes - 15th June

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Pictures of Mrs Garbett notes - 15th June

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- how are we all starting
- how can we add more to Annabel's monologue because it is very short
- like the walking dead has a lot of dramatic potential
- What is Nick's doctor character like?
- How can we make Annabel's character feel real
- Lauren's monologue build up. Whispering first
-Add music to make up scene
- drink spiking is very effective
- ensemble work for Lauren's but is great
- who? What? Where? Etc. Make it more effective
- The motif works really well
- Olivia's scene (names called) needs to be more stylised
- How can we work as an ensemble for this section
- Use mirroring to show Annabel is playing Olivia at the start of the scene
- Too much Naturalism
- How can we use soundscape to make therapy more impactful
- Did you feel better?
- Is the therapy good or bad
- If bad how do we imply this?
- We need to consider what  Nick will do/say
- Structure is great
- Too much naturalism for betrayal scene. Make it abstract how you felt (sick, betrayed, rejected, let down etc.)
- Carmelina/Lauren either keep it the same or always Carmelina
-What's the point of the weird one (Nick in Carmelina's scene)

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-Lauren

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Annabelle

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Some of the asis for my Character's background -Olivia 

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Some of the asis for my Character's background -Olivia 

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https://books.google.co.uk/books?id=MDwWDAAAQBAJ&pg=PA52&lpg=PA52&dq=girl+bullied+because+she+lives+on+estate&source=bl&ots=boh0tY63X4&sig=L-A5u169OsMp_5QRAfvg8Lm5rDU&hl=en&sa=X&ved=0ahUKEwjNh5Hbsb3UAhXhJsAKHUgeBbwQ6AEIVDAI#v=onepage&q=girl%20bullied%20because%20she%20lives%20on%20estate&f=false

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For my monologue it starts with me talking about how my character got bullied in school because of the estate that I lived on, and that the teachers knew and didn't help. This is portrayed by the rest of the ensemble (Nick, Lauren, Carmelina, Joe and Annabel) acting out what I am saying behind me and then we have some dialogue between the teacher and Annabel who plays my character as I am speaking. After that scene I talk about how after school I had no social life and felt like there was a wall being built between me and the rest of the world, that although my character does want to make friends she feels pre-judged already before they have even spoken to her.
Then we have a short scene between my character and her parents where she refuses their affection and tells the to "F**** off" ( which will be mimed as our audience is younger than us) a friend of my characters mum reference her to the Dr and when I go there to see him that's when the more abstract ensemble pieces start to happen. When the Dr says that my character needs ECT we have the other three ensemble actors say "electro !" "Convulsive!" "Therapy !" "Electro convulsive therapy" which is our motif that is repeated in the other characters monologues. Then I say how all I had to do was sign a form and we went into a dark room and then all ensemble members form the machine that carries out the therapy whilst the Dr flips the switch. That's what we have got up to ( since 14/06/2017) and all I have left to add to my scene is talking about how I feel like I cant live with out it and that I get ECT every month or so otherwise I can feel my depression creeping back in.
_Olivia

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Heya Joe, today we did more of Lauren's scenes, carrying on from where we left off last lesson. From the party scene after Carmelina stats coughing we all form a line ( apart from Lauren who continues with her monologue) we then all cough (a bit Artuad style) and drop to the floor when she says "dead". After that Lauren talks about the Doctor and Nick steps forward we will then all shout NO and turn around. We then patronise Lauren's character and repeat the motif "electro !" "Convulsive!" "Therapy !" "Electro convulsive therapy" after Lauren says she hadn't understood what ECT stood for.
Don't worry about this too much, as on Tuesday we will put you into this I thought that writing it out however might save a bit of time:) -Olivia

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Fear, anxiety and confusion
•    feeling strange afterwards, e.g. light headed, dissociated, numbing, “mixing up the emotions”
•    headaches (which could be severe and “indescribable”)
•    jaw ache
•    memory loss surrounding their treatment time
•    disorientation
•    problems thinking e.g. “they fried my brain”
•    fatigue
•    “wooziness”, “groggy”, dizziness
•    nausea
•    drooling
•    looking like you’d “had a stroke”
•    muscle stiffness
•    feeling shaky
•    inability to eat

•    intense sleepiness

•    hallucinations

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http://www.rolereboot.org/life/details/2016-02-shock-therapy-made-depression-worse/

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A creepy advert for ECT that promotes the use of electro convulsive therapy in 2017, we go through our personal monologues whilst other characters act as ensemble depicting what is being said using dramatic techniques, the doctor (nick) drives the practice of ECT and throughout the piece the audience should be aware of him having a secret motive ??. This lesson we went through Annabels monologue and added to our plot synopsis for a better idea of our over all piece. Next lesson we should try and do another character instead of going over the same one again which will help us progress . -Olivia

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-Nick

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Electroconvulsive Therapy (ECT): update and evidence based information about EC produced by the Royal College of Psychiatrists.

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-Nick

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When most people think of electroconvulsive therapy (ECT), or shock therapy, they imagine a strapped-down patient writhing in pain, or an outdated, barbaric treatment no longer in use. Here are some common myths and facts about the procedure.

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Last lesson we went over Annabelle's monologue and the actions that went with it

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https://www.barnet.gov.uk/citizen-home/libraries/local-studies-and-archives/pocket-histories/finchley-friern-barnet-and-totteridge/finchley-colney-hatch-asylum.htmlhttps://www.barnet.gov.uk/citizen-home/libraries/local-studies-and-archives/pocket-histories/finchley-friern-barnet-and-totteridge/finchley-colney-hatch-asylum.html

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I thought I could use this girl for my character. The article also has things that Nick the doctor could use. - Lauren

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Captivated by academic study, she quickly became one of the highest-achieving students on her Classics degree course at Bristol University, finding time to play percussion with several bands and orchestras, too.

Tania, then 19, also met and fell in love with Matthew, a maths student, now her husband.

Then tragedy struck: the couple just returned from their first holiday together when Tania was told that her best friend, Ali, had been killed in a car accident.

'It was a terrible shock - as though a screen suddenly came down between me and the rest of the world,' recalls Tania, now 38, from North London.

'After the funeral, when I went back to university, I felt detached from everyone. My mind had started racing and I couldn't sleep.'

Within a month, Tania had stopped studying altogether.

'I remember sitting in a common room waiting for a lecture. It felt like everything was swimming around me and I had to get out of the building.'

Tania was experiencing depression, specifically an episode of bipolar disorder, previously known as manic depression.

According to the NHS, around 500,000 Britons have been diagnosed as bipolar, although recent studies suggest the true incidence may be more than five million.

Sufferers typically swing between two phases - manic and depressive.

During the manic phase they may experience feelings of euphoria, talk at extreme speed and go for days without food or sleep. The depressive phase is characterised by severe low mood, a loss of sense of purpose and, at its most extreme, thoughts of suicide.

Several weeks after her friend's death, Tania sought help from her GP who prescribed tricyclic anti-depressants - the standard treatment at that time.

'It was a shock to be diagnosed with depression,' she recalls. 'When the doctor prescribed medication, I realised something was very wrong with me.

'I've since learned that my grandmother had been hospitalised twice for psychiatric depression: she had heard voices.' (There is strong evidence for a genetic vulnerability to developing the illness.)

However, after five months of taking anti-depressants, Tania was forced to acknowledge they were having no effect.

'The depression got worse. I was getting two hours' sleep at night, if that, invariably with sleeping pills involved.

'I gave my pills to Matthew to look after as I felt I couldn't trust myself any more not to take them all as an overdose.'

Eventually, Tania went as a voluntary inpatient to a private psychiatric hospital in London, where she stayed for two months. But despite being given every type of major antidepressant, nothing seemed to help and Tania and her family became desperate.

Then, by chance, Tania met a friend of a friend who was a psychiatrist at London's Charter Nightingale Hospital (now Capio Nightingale).

'He said it was clear the drugs weren't working and suggested I come off all the pills and have electroconvulsive treatment.'

Many will recoil at the thought of electroconvulsive treatment (ECT), which was famously depicted in the 1975 Jack Nicholson film One Flew Over The Cuckoo's Nest.

But it is considered an effective treatment for severe depression which is resistant to medication and talking therapies such as Cognitive Behavioural Therapy.

About 20 per cent of all depression sufferers fall into this category, of which more than half would benefit from ECT, says Dr Cosmo Hallstrom, consultant psychiatrist at the Royal College Of Psychiatrists in London.

The treatment involves sending an electric current through the brain, under general anaesthetic, to cause a fit.

Although it is not exactly known how it works, one theory is that the fit triggers certain brain chemicals, including the 'feel-good' chemical, serotonin, which is thought to be depleted in patients with severe depression.

The treatment was first introduced around 70 years ago but it fell out of favour following the introduction of antidepressant medication in the Fifties and Sixties.

In the past, ECT has been used indiscriminately, at times under duress and without general anaesthetic.

As a result, it remains the most controversial treatment in modern psychiatry.

Indeed earlier this year the British Psychological Society called for it to be banned, describing the treatment as 'inhumane and degrading', and having only a short-term effect on people with manic depression.

However, many clinical studies show ECT is significantly more effective than antidepressants in inducing a speedy remission for severe treatment-resistant depression, says Dr Hallstrom.

'It can cure a particular bout of depression - although it does not prevent relapses,' he says.

Indeed, it is even recommended by the National Institute For Health And Clinical Excellence (Nice).

In 2008 Nice published guidelines on the management of bipolar disorder, which recommended ECT 'to achieve rapid and short-term improvement of severe symptoms after an adequate trial of other treatment options has proven ineffective and/or when the condition is considered to be potentially life-threatening'.

Tania's brother, then a practising psychiatrist, had himself carried out ECT many times and told her he had seen it have remarkable results.

'He was very much in favour,' she says. 'You know your own brother has your best interests at heart.'

'It wasn't what people may think - being restrained in some sort of straitjacket. It was all very civilised. You go under a general anaesthetic for a few minutes and that's really all you know.'

Dr Hallstrom says patients see an improvement after six twice-weekly treatments. Tania started to feel things changing after five.

'It was a very sudden thing. I just woke up one day and thought: "I feel like something's lifted." Suddenly you're released from internal torment.'

Six months after completing her course of ECT, Tania returned to her studies and got a First.

The treatment is not risk-free - half of those who undergo it experience side-effects, such as confusion and disorientation, after each treatment.

'But this tends to fade after a few days,' says Dr Hallstrom.

A trial is under way in Australia on a new form of ECT, which involves running an electric current through the brain for less time, and has been shown to have less of an effect on memory.

Tania had some memory loss in the period during which she received ECT, 'but nothing really substantial' she says.

Indeed, after university she went on to gain a Masters and eventually a PhD in Classics, and fulfilled her dream of teaching.

For 11 years, she remained off medication and had no contact with any psychiatrist. Tania and Matthew married and had a daughter who is now seven.

ECT does not cure the problem for good, though, as Tania discovered. When her daughter was two, she became pregnant again. But then she miscarried, plunging her into a severe depression.

'Within three weeks I was in hospital. My consultant psychiatrist suggested I try ECT again. It worked and after six treatments, all of a sudden I didn't feel suicidal any more.'

Dr Hallstrom believes more people suffering with severe, medication-resistant depression should be given the option of ECT.

'It can be a lifesaver,' he says. Tania can only agree.

'ECT won't cure you, but it will get you out of the crisis state,' she says.

'Hands down I owe my life to ECT.'

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Electric-shock therapy lifted me from the hell of depression

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Captivated by academic study, she quickly became one of the highest-achieving students on her Classics degree course at Bristol University, finding time to play percussion with several bands and orchestras, too. Tania, then 19, also met and fell in love with Matthew, a maths student, now her husband.

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Within a couple of days, I stopped functioning properly. I couldn't wash my hair, prepare food, or think rationally. I couldn't even bear to listen to music because it seemed so flippant.

Last year it was as bad as it's ever been. I became blackly depressed for months, convinced I would never get better. My psychiatrist changed my pills again. I've had around half a dozen types of antidepressants. I've never really believed they've worked.

I've also had all sorts of therapy - cognitive behavioural therapy, group therapy, counselling and all the stuff they make you do in hospital (I had one stay in 2000 after a major panic attack) when you're too ill to fight them - like art therapy and drama therapy.

Nobody had suggested ECT until this last bout of depression, but after five months it was clear I wasn't getting better. ECT was always referred to as a last resort by my doctor, and that's pretty much where I was. It was a major decision to make. My doctor told me there were side?effects - normally short-term memory loss, but I didn't really care. By that stage in the illness, I was too numb and pessimistic.

So one Tuesday morning my lovely mum got up early and drove me to a private hospital. I'd had nothing to eat or drink since midnight because of the anaesthetic. A nurse took my blood pressure. I didn't have to change into a gown, I just took my shoes off and my doctor led me into a small room with a bed.

There was a machine by it the size of a microwave. I lay down on the bed, then my doctor asked me if I'd had a pee - which I remember finding a weirdly personal question. He explained you had to empty your bladder before a treatment.

A brisk anaesthetist gave me an injection in the back of my hand. I was also given a muscle relaxant to prevent convulsions. Someone put a blanket over me. Then I had the general anaesthetic: a sudden metallic taste in the mouth, then a wonderful swimmy feeling for three seconds before drifting into unconsciousness.

Then I woke up. And I was better.

I felt a bit confused, and I had a terrible ache in my jaw, but from the second I opened my eyes I felt more present in the room than I had felt for months. My spirit and personality had returned. The sunglasses and earmuffs were off. I was taken to a side room, and told it was fine to sleep, but I sat bolt upright on the bed, drinking everything in.

I had a few more sessions after that, even though I felt 100 per cent better by the time I'd had just two. Even in the later sessions, when they were more casual and started sticking the electrodes to my forehead before putting me to sleep (the general anaesthetic only lasts a few minutes and the current only passes through you for a matter of seconds), I wasn't scared.

My doctor said that it often works for people like that, which further suggested my depression was chemical in origin. It was a physical cure for a physical illness in my brain, rather than a behavioural disorder or reaction to an event. Understanding this also helps me.

I did have side-effects, but they were worth it - and would have been even if they were ten times worse. For the first few weeks I would completely forget things - entire conversations sometimes. But this became less pronounced, and went away after about four months.

More annoying was that I felt less mentally agile. I couldn't connect things so well - for example, if I'd seen a certain actor in another film I couldn't place them. My doctor explained that if you do a brainscan on someone who's had ECT, you can actually see that their brainwaves become wonky for three months, in a similar way to someone who's had an epileptic fit.

As far as I know, nobody understands how it works. But inducing a seizure seemed to rewire my brain. And now I've found something that actually works, I shouldn't need to live in dread of the black dog. If I get ill again, I can have ECT again.

I'd urge anyone with serious depression to try it. If you truly are at absolute rock bottom, you shouldn't be put off by fear, because it isn't possible for you to feel any worse. They press a switch, and it makes you better.

Lucy Parma is a pseudonym

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Within a couple of days, I stopped functioning properly. I couldn't wash my hair, prepare food, or think rationally. I couldn't even bear to listen to music because it seemed so flippant. Last year it was as bad as it's ever been. I became blackly depressed for months, convinced I would never get better.

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What happened to Carrie Mathison in the final episode of Homeland wasn't real. I'm not referring to yet another plot twist. Or even to the broadly admirable portrayal of an intelligent woman with bipolar disorder. I'm talking about the traumatic electroconvulsive therapy (ECT) scene. It's actually not a big deal. And I should know - I've had it several times.

I'm 34, and I've had severe bouts of depression almost every year since university. I'm unipolar - I get no highs, only lows. I've never attempted suicide (that's what everyone really wants to know) but I've had periods of several months where I've barely functioned as a human being.

Depression is the most horrific, degrading, painful experience there is. I've been on umpteen drugs and tried numerous therapies. But nothing stopped me getting ill, and nothing helped me get better. That was until five years ago, when I tried ECT. And it was miraculous.

So what was wrong with the portrayal of it Homeland? Carrie grimaced, apparently in pain, once treatment started. Her sister was allowed in the room. Her impending memory loss was over-egged. Carrie said: "This isn't Cuckoo's Nest" but it wasn't a great improvement. That 1975 film has a lot to answer for, as it is everybody's point of reference for ECT.

In fact you are hard pressed to find a positive example of it. In the recent BBC drama White Heat, Tamsin Greig's character had the treatment. Again, it was a traumatic depiction - and she didn't appear to be given a general anaesthetic, which was factually inaccurate, even for the 1970s.

Dr Peter Byrne, director of public education for the Royal College of Psychiatrists (RCP) believes that attitudes towards ECT are informed by such cultural representations: "Only one mainstream film, Fear Strikes Out, (1959) portrays it positively," he says. "ECT frightens people because they assume it's barbaric, untested and has unknown effects on the brain. None of that is true; it's the most tested and evidence-based psychiatric treatment of all."

By contrast, Carrie Fisher's 2011 memoir Shockaholic was a revelation, with her candid descriptions of having the therapy. "Over time, this fucking thing [ECT] punched the dark lights out of my depression," she wrote. "It was like a mute button muffling the noise of my shrieking feelings."

So what is it actually like? You go in, have your blood pressure taken, sign a form, lie down, go to sleep, wake up with a slight headache and go home. And often, you feel instantly better.

I've always been an outpatient, both on the NHS and privately. One involves more admin, and a less comfortable waiting room. The other costs rather a lot of money, upwards of £700 a go.

The memory lapses that follow treatment are a bore, but that passes. The first few times, I didn't remember arriving at hospital that morning. But for up to three months after a course of treatment, I can still forget names, routes and what I was just thinking. Some people experience it more severely but in the vast majority of cases, the memory eventually returns to normal.

Research continues into its effectiveness. A study published earlier this year that was led by Dr Ian Reid at Aberdeen University suggested that ECT "turns down" overactive connections between parts of the brain that govern mood and those responsible for thought and concentration. Reid is hopeful that his work will help to change attitudes: "If our study does anything to reduce the stigma of ECT and mental health generally, that might be its most important contribution."

According to the NHS there were 7,000 treatments in England and Scotland in 2011, compared with 12,800 between January-March 2002 and 16,500 for the same quarter in 1999. However, Dr Islam at the Priory Hospital in Roehampton says the numbers have remained the same: 500-600 treatments a year. A 2009 RCP report concluded: "ECT is becoming an increasingly specialised field within psychiatry, psychiatrists are prescribing less of it and therefore gaining less experience of its use."

It is a fine balance for mental-health organisations to be able to support anyone who has had a negative experience of ECT, while trying not to put off those who might benefit. Alison Kerry of Mind says: "The most important thing is that anyone opting for ECT is fully informed, so that they can give a truly informed consent."

There is certainly still a stigma around it within the medical profession. When I had to be assessed while pregnant two years ago, I was giving my medical history to a psychiatric nurse in a very factual manner. When I mentioned ECT she interrupted and said: "I'm so sorry." "No, don't be," I replied. "It is the best thing that's ever happened to me."

For those who do decide to try it, ECT remains a treatment, not a cure. But I can now manage my condition, which takes me out of circulation for two weeks rather than several months. The choice for me is a no-brainer.
For more information on ECT, visit Mind's website
This article will be opened for comments on Monday morning.

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What happened to Carrie Mathison in the final episode of Homeland wasn't real. I'm not referring to yet another plot twist. Or even to the broadly admirable portrayal of an intelligent woman with bipolar disorder. I'm talking about the traumatic electroconvulsive therapy (ECT) scene. It's actually not a big deal.

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The aim - though psychiatrists admit they have no idea how it works - is to induce severe convulsions to make the mentally ill better, the depressed happier.

The result, say critics, is memory loss, brain damage, physical disability, paralysis and, too often, death. 'There's many patients whose brains are frankly fried,' said one campaigner.

This week the psychiatric profession - which is set to be hit by a wave of compensation claims by Electroconvulsive Therapy (ECT) 'survivors' - will robustly defend what is often seen as the indefensible, in a move that has been dismissed as a public relations stunt.

The Institute of Psychiatry, based at London's prestigious Maudsley Hospital, will stage a high-profile debate on ECT.

Pat Butterfield, founder of the pressure group ECT Anonymous, was invited to put the case against, but boycotted the event. 'I think it's a bit of a PR job. They're trying to gain a bit of credibility' said Butterfield, whose group has 600 members who say they've been harmed by ECT. 'We think it's beyond debate. There is so much evidence that it harms people. What we need is action.'

Dr Mark Salter, a consultant psychiatrist at St Bartholemew's Hospital - who has administered ECT himself - will be putting the case for the treatment. 'The emotional debate obscures the arguments in favour of ECT,' he insists. 'I am certainly in favour of ECT as a treatment of last resort. It's the one reliable treatment for severe psychotic depression, which can kill people.'

Some severe depression drives people to 'kill themselves for no particular reason,' says Salter. 'There is no doubt it is a physical disorder, and ECT cures that. ECT definitely saves lives. You should see someone when they are starving and dehydrating themselves to death. The change after a couple of ECTs is incredible. You are saving them and their families'.

Which is little comfort for Alex Doherty, a Glaswegian whose brother Joseph was one of the thousand people a year in Britain given ECT against their will. 'His nursing notes record 17 times when he resisted treatment or said he didn't want it,' said Doherty, whose younger brother had schizophrenia. 'The doctor didn't even get a second opinion. Joe was given eight or nine treatments against his will over eight weeks. He just wasn't Joe, he became hyper and permanently confused.'

Nursing notes show Joe told his 'carers' twice that if it carried on he would run away and jump off a bridge and kill himself. 'And that's exactly what he did. He was 30,' said Doherty. 'It was horrendous'.

ECT patients are given general anaesthetic and strong muscle relaxant to virtually paralyse them, and stop dangerous physical convulsions. Their skin is smeared with gel for electrical conduction, and electrodes are taped to the forehead.

The patient is then strapped on their back to a flat table, which pivots so patients can be turned upside-down if they vomit. One patient was recently given ECT on a fixed table, and when he started vomiting they couldn't remove him quick enough to prevent him choking. He ended up brain damaged and permanently paralysed.

Psychiatrists increase voltage until they get a twitching toe - a sign that, despite paralysing drugs, the body's nervous system is in major convulsion. The electrical storm raging through every synapse of the brain is meant to cure patients, although psychiatrists admit they have no idea how.

Rebecca Jason (not her real name), a literature graduate, went through ECT about 40 times. 'It was very easy for them to get me to agree to it, because I did not know what I was doing,' she recalled. 'It had a very profound effect on my ability to make decisions. I had panic attacks for ages. It affected my memory greatly - I could no longer remember books, or quote from them, which I used to be able to. There are certain things I've never been able to do since, like sew. I'm shaking all over just thinking about it.'

Butterfield claims half those given ECT are harmed by it. Solicitors are preparing two class actions for ECT survivors who want compensation, and hope to force a ruling on its legality. Butterfield wants ECT banned for those over 65 or under 18 and pregnant women - but most urgently on forcing people to have it.

Salter admits that, if people are given it against their will, psychiatrists should have to go to court to get permission. 'But for God's sake, carry on using it when it can save lives. Are we going to just let these depressed people die?'
Topics

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The aim - though psychiatrists admit they have no idea how it works - is to induce severe convulsions to make the mentally ill better, the depressed happier. The result, say critics, is memory loss, brain damage, physical disability, paralysis and, too often, death. 'There's many patients whose brains are frankly fried,' said one campaigner.

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The public perception of electroconvulsive therapy (ECT) is rooted in cultural depictions, not least the dramatic scene in the film One Flew Over the Cuckoo's Nest in which Jack Nicholson is held down as the treatment is carried out.

Sylvia Plath's account in The Bell Jar is hardly less brutal. Describing ECT, administered without general anesthetic, the protagonist says: "With each flash a great jolt drubbed me till I thought my bones would break and the sap fly out of me like a split plant."

The reality today, however, is very different.

First, patients get a general anaesthetic. Once unconscious they are given a muscle relaxant and a mouth guard is put between their teeth. Their blood pressure, blood oxygen, heart rate and brain activity are monitored continuously. A clinician then applies one electrode to each temple, and an electrical current is applied for up to eight seconds to trigger a seizure - which generally lasts between 20 and 40 seconds.

The amount of charge delivered by ECT, experts add, is tiny, with the electricity given in very short pulses. "If you applied it across your hands you would get a range of sensation, but you wouldn't get a huge electrical shock," says Tim Oakley, chair of the ECT accreditation service (ECTAS) accreditation committee and a clinical director at the Northumberland, Tyne and Wear NHS foundation trust.

The seizure, he adds, is very different from the thrashing about typically shown in films, and is often seen only by looking at the change in brain activity as recorded by electroencephalogram (EEG). "Because people are given muscle relaxants when given ECT the muscles are nearly paralysed," he says. While the limbs can move briskly, the more common reaction is subtle. "When we have taken their shoes and socks off, we would look at their feet and normally what you would see is their toes might twitch or curl up rhythmically," says Oakley. The patient is then transferred to a recovery room to come around.

The whole procedure is finished within half an hour and is repeated twice a week, typically for six to eight treatments.

Just how ECT works is unclear, with both the electricity applied and the seizure itself thought to be involved in producing effects.

A review published in 2011 highlighted a number of possibilities, suggesting ECT could increase the release of certain hormones in the brain or affect the growth of neurons, or biological mechanisms which kick in to end a seizure might trigger changes that produce therapeutic effects. ECT could also affect levels of neurotransmitters, or the sensitivity of their receptors. Research published in 2012 showed that ECT decreases connectivity between areas of the brain involved in emotional processing and mood change, a possible mechanism for alleviating depression.

"They are not mutually exclusive. [The brain] works on different levels," says Ian Anderson, professor of psychiatry at the University of Manchester. "It seems that ECT causes effects at each of these levels and it is hard to say which is the primary one, because it is all interlinked."

Regardless of the mechanism, advocates for the therapy point to its rapid success in alleviating severe depression and other mental health issues. Critics meanwhile point to the foggy understanding of the procedure, the short duration of benefits, which generally last weeks or months, and side-effects which can include headaches, nausea and confusion in the short term, and memory impairment that can last for several months.

But perceptions rooted in dramatic depictions, and a question mark over ECT's mechanism, says Oakley, have done little to help patients feel comfortable about the procedure. "It is about it being an unusual treatment, it is about having bad press and that combined with not being able to say with absolute certainty 'this is how it works', is a problem," he says.

Andrew Molodynski, consultant psychiatrist at Oxford Health NHS foundation trust and national mental health lead of the British Medical Association's consultant committee, agrees. "The stigma around it is enormous," he says.

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The public perception of electroconvulsive therapy (ECT) is rooted in cultural depictions, not least the dramatic scene in the film One Flew Over the Cuckoo's Nest in which Jack Nicholson is held down as the treatment is carried out. Sylvia Plath's account in The Bell Jar is hardly less brutal.

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The use of electroconvulsive therapy to treat serious mental health problems, a procedure long thought to be in steep decline, is on the rise again in England, a Guardian analysis indicates.

Exclusive data covering four-fifths of NHS mental health trusts in England shows that more than 22,600 individual ECT treatments were carried out in 2015-16, a rise of 11% from four years ago, when about 20,400 were carried out.

The number of patients treated also rose, albeit more modestly, to more than 2,200, suggesting that on average individuals undergo more ECT procedures than before.

The figures, obtained through freedom of information requests, show that despite being a crude, controversial treatment, which fell sharply out of favour around the turn of the millennium, ECT is enjoying a revival.

The procedure involves anaesthetising the patient and passing electricity through the brain to induce seizure. Despite ghoulish depictions in popular culture and a marked lack of science explaining how and why it works, treatments can prove effective. Patient stories range from life-changing benefits to tales of lives being ruined.

The data collected by the Guardian covers 44 NHS trusts that provided comparable data. Figures for private clinics are not included.

After considerable fluctuation over the last four years, a comparison of figures from 2012-13 and 2015-16 reveals an 11% rise when it comes to the number of ECT treatments. Almost two-thirds of NHS trusts reported a rise in the number of ECT treatments carried out over the four-year period. The average number of ECT treatments per patient also rose, from 9.6 in 2012-13 to 10.1 four years later.

The changes in ECT were more striking in some parts of the country than others. While the number of treatments carried out by Mersey Care NHS trust, for example, has remained fairly constant over the last four years, the figures for Lincolnshire Partnership NHS foundation trust show a 75% increase in treatments.

Experts and practitioners say a slew of factors could be responsible for the revival. Some say it is down to improved patient access, lack of credible alternatives for serious cases of mental illness and the fact that in many cases ECT does seem to make a difference.

"I think [ECT] should be on the increase because it has been underused for a number of years," said Tim Oakley, chair of the ECT Accreditation Service (ECTAS) accreditation committee and a clinical director at the Northumberland, Tyne and Wear NHS foundation trust.

"There are some patients who would respond very well to ECT who perhaps don't get it as quickly as they should or don't get it at all for various reasons," he said. "In terms of getting people better, particularly for depression where everything else fails, it is still the best treatment."

Others point to the patchwork nature of provision - popular in some parts of the country, not in others - as a sign that it is down to local medical preferences.

"The decision about whether ECT is to be used or not is based on the quirks of the local psychiatrist," said Richard Bentall, professor of clinical psychology at Liverpool University. "There are some places where psychiatrists think it works, and they just do it lots of times, and there are some places where people think: 'Bloody hell, I don't think the evidence for this is very good,' so will only do it in absolutely desperate circumstances."

He added: "My view is that ECT is a classic failure of evidence-based medicine. I don't believe that there are adequate clinical trials of ECT to establish its effectiveness."

While some, including Oakley, have argued that historical ECT trials do show a benefit from the treatment, Bentall believes their design was not up to scratch, and said the data obtained by the Guardian highlighted the need for large randomised placebo-controlled clinical trials - a proposal some proponents of ECT have argued would be unethical.

But Bentall said: "It is clearly unethical to pass electric shocks across people's brains unless it is effective [and] helpful to do so and therefore there is an ethical requirement to show that treatment is effective."

Others have suggested the increase in number of ECT treatments could be down to a change from bilateral to unilateral therapy, where the electrodes are applied to one side of the head, rather than at both temples.

"That has slightly fewer side-effects and is less likely to cause memory impairment," said Andrew Molodynski, consultant psychiatrist at Oxford Health NHS foundation trust and national mental health lead of the British Medical Association's consultant committee. "It is also slightly less powerful, so it might be that if more people are having that then they are needing slightly more treatments."

"It is by far the most powerful treatment for depression," he added. "As a treatment it is certainly not bad as long as it is done properly and for the right people, which is people with genuinely treatment-resistant depression." While Molodynski added that he did not believe it would be ethical to carry out new clinical trials of the effectiveness of ECT, he thought studies into outcomes over prolonged periods would be valuable.

But Molodynski pointed out that the Guardian figures suggested either that the procedure was being used more freely, or that more people appeared to be falling into the category of those with treatment-resistant depression.

He said the increase should be viewed negatively if it was a result of people with less severe forms of depression not getting the care they needed. "Equally, if people are resorting to ECT for inpatients more quickly, because it works more quickly than antidepressants, in order to get them out of hospital because of our perpetual bed crisis, that would be a major concern."

One ECT service manager from a London-based mental health trust, who asked not to be named, said the Guardian findings tallied with his own experience of a recent rise in ECT use, adding that the trend was likely to be linked to changes in practice and better regulations, with people becoming more accepting of the procedure. "Our trust treated more patients last year than they have ever treated before," he said.

A 2014-15 survey which included clinical outcomes for 2,148 people, published by ECTAS and covering England, Wales, Northern Ireland and the Republic of Ireland, reported that 91.5% of patients had improved after the treatment, compared with 1.7% who had become worse.

The mental health charity Mind, however, warned of side-effects, pointing to a 2003 survey it carried out with patients who had undergone ECT who reported memory loss, difficulty concentrating and dizziness.

While the idea of inducing a seizure for therapeutic reasons was first recorded in 1785, ECT was not developed until the 1930s. It was subsequently introduced to England and was commonly used well into the 1960s and 1970s.

But its use waned towards the end of the 20th century. According to the Royal College of Psychiatrists: "Between 1985 and 2002, its use in England more than halved, possibly because of better psychological and drug treatments for depression."

Dr Rob Chaplin, from the Royal College of Psychiatrists, said: "Previous data collection has shown a decline in ECT, but this appears to have plateaued, perhaps suggesting a change in attitude towards a therapy that has historically been poorly administered and badly misunderstood.

"Since the launch of our accreditation service for ECT in 2003, safety standards have doubled, making ECT in the UK one of the best in the world.

"There is unmistakable evidence that electroconvulsive therapy is an effective treatment for many depressive illnesses, and can act much faster than drugs."

At present, the National Institute for Health and Care Excellence (Nice) advises that ECT be used only as a last resort for those with prolonged or severe manic episodes, who are in a catatonic state, or who have severe depression or moderate depression when other treatments have not worked.

The data

There is a dearth of information on how widely ECT is used, so the Guardian requested data from every English NHS mental health trust, as listed by the Care Quality Commission, under the Freedom of Information Act for a 10-year period between 2005-06 and 2015-16.

It quickly became clear that many trusts either did not hold or could not access relevant data for the decade covered by the request.

The vast majority could not provide data for the full 10-year period requested. The data presented here begins in 2012 for that reason: a number of trusts were unable to provide figures prior to that year.

Three trusts refused the request outright, saying the staff time required to comply with the request was too great, while seven trusts could not even provide consistent data from 2012-13 onwards. Some trusts admitted they were missing data over periods of months in certain years.

Two trusts provided data that turned out to be completely incorrect, only providing accurate figures after multiple contacts.

The majority of the trusts provided financial year data. However, in those cases where calendar year data was provided, the data was grouped with the closest financial year.

This project may have revealed an increase in ECT use in England but it has also uncovered a lack of properly collected data relating to the procedure.

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Electroconvulsive therapy on the rise again in England

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The use of electroconvulsive therapy to treat serious mental health problems, a procedure long thought to be in steep decline, is on the rise again in England, a Guardian analysis indicates. Exclusive data covering four-fifths of NHS mental health trusts in England shows that more than 22,600 individual ECT treatments were carried out in 2015-16, a rise of 11% from four years ago, when about 20,400 were carried out.

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The idea of treating a psychiatric illness by passing a jolt of electricity through the brain was one of the most controversial in 20th Century medicine. So why are we still using a procedure described by its critics as barbaric and ineffective?

Sixty-four-year-old John Wattie says his breakdown in the late 1990s was triggered by the collapse of his marriage and stress at work.

"We had a nice house and a nice lifestyle, but it was all just crumbling away. My depression was starting to overwhelm me. I lost control, I became violent," he explains.

John likens the feeling to being in a hole, a hole he could not get out of despite courses of pills and talking therapies.

But now, he says, all of that has changed thanks to what is one of the least understood treatments in psychiatry - electroconvulsive therapy (ECT).

"Before ECT I was the walking dead. I had no interest in life, I just wanted to disappear. After ECT I felt like there was a way out of it. I felt dramatically better."

The use of electricity to treat mental illness started out as an experiment. In the 1930s psychiatrists noticed some heavily distressed patients would suddenly improve after an epileptic fit.

Passing a strong electric current through the brain could trigger a similar seizure and - they hoped - a similar response.

By the 1960s it was being widely used to treat a variety of conditions, notably severe depression.

But as the old mental asylums closed down and aggressive physical interventions like lobotomies fell out of favour, so too did electroshock treatment, as ECT was previously known.

The infamous ECT scene in One Flew Over the Cuckoo's Nest cemented the idea in the public's mind of a brutal treatment, although by the time the film was released in 1975 it was very rarely given without a general anaesthetic.

Perhaps more significantly, new anti-depressant drugs introduced in the 1970-80s gave doctors new ways to treat long-term mental illness.

But for a group of the most severely depressed patients, ECT has remained one of the last options on the table when other therapies have failed.

Annually in the UK around 4,000 patients, of which John is one, still undergo ECT.

"It's not intuitive that causing seizures can be good for depression but it's long been determined that ECT is effective," says Professor Ian Reid at the University of Aberdeen, who heads up the team treating John.

ECT procedure (Warning: Some may find images upsetting)

In the 75 years since ECT was first used scientists have argued about why and how it might work.

The latest theories build on the idea of hyperconnectivity. This new concept in psychiatry suggests parts of the brain can start to transmit signals in a dysfunctional way, overloading the system and leading to conditions from depression to autism.

Prof Reid and his colleagues used MRI scanners to map the brains of nine patients before and after treatment.

In an academic paper in 2012 they claimed ECT can "turn down" overactive connections as they start to build, effectively resetting the brain's wiring.

"For the first time we can point to something that ECT does in the brain that makes sense in the context of what we think is wrong in people who are depressed," Prof Reid says. "The change that we see in the brain connections after ECT reflects the change that we see in the symptom profile of patients who generally see a big improvement."

But passing electricity through the most complex organ in the body is not without risk. Many doctors think the side-effects of ECT can be so serious they outweigh any possible benefits.

Helen Crane was given two rounds of ECT in the late 1990s. She now blames the second course for wiping years of her memory, from trips abroad to dramatic family events.

"After ECT, I had this instinct that something was wrong with my mother. I said to my husband 'What's happened to my mother?' And then he had to tell me that she'd died nearly two years earlier," she says.

"It was devastating going through bereavement again. How on Earth could I have forgotten something so important and fundamental? Getting words wrong is frustrating, but to have lost really basic stuff in your life is awful."

"Start Quote

I'm convinced that in 10 or 15 years we will have put ECT in same rubbish bin of historical treatments as lobotomies and surprise baths that have been discarded over time"

End Quote Dr John Read University of Liverpool

Critics of ECT claim around a third of patients will notice some sort of permanent change from memory loss to problems with speech and basic skills like addition.

"What happens is a little like recharging a car battery," says the psychologist Dr John Read from the University of Liverpool, one of the most vocal critics of ECT.

"It's not difficult to get artificial changes in the brain, you could do it with cocaine, but it doesn't last and three or four weeks later the person is either back at the same level of depression or many studies show worse levels of depression."

Opponents say that ECT patients can enter into an addictive cycle of repeated treatment and that any improvement beyond the very short term is likely to be little more than an extreme form of the placebo effect, with patients benefitting psychologically from the extra care and medical attention associated with ECT.

"It's not in any way addressing the cause of their depression. It's systematically and gradually wiping out their memory and cognitive function," says Dr John Read.

"I'm convinced that in 10 or 15 years we will have put ECT in same rubbish bin of historical treatments as lobotomies and surprise baths that have been discarded over time."

ECT in the UK

Women are twice as likely to be given ECT as men, reflecting the general pattern of serious depression in society

Around a third of patients are too ill to give their consent

Across the UK as a whole it is thought around 4,000 people a year are given ECT

Scottish hospitals alone still treat 370 people a year, according to the latest figures.

But Prof Reid says when weighing up the risks and benefits of the treatment "it is important to realise that the people who are treated with ECT are suffering from an illness that could kill them".

"Depression is associated with a measurable mortality. It can be lethal. Untreated patients can die."

The team in Aberdeen now hope their research will allow drug companies to develop new treatments that mimic some of the effects of electroconvulsive therapy.

"One of the exciting things about being able to identify a change in the brain related to a psychiatric disorder is that it might make it easier to diagnose that condition over time," Prof Reid says.

"No one would be happier than me if we could reproduce the changes that ECT has on the brain in a less invasive and safer way for patients."

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The idea of treating a psychiatric illness by passing a jolt of electricity through the brain was one of the most controversial in 20th Century medicine. So why are we still using ECT, a procedure described by its critics as barbaric and ineffective?

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This reminds me of the 6 or 9 image
Mrs G

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WHAT: "World's Apart," a new Heineken ad that involves some frank conversations between people with differing views.

WHO: Agency Publicis London

WHY WE CARE: Earlier this month, Pepsi tried to walk in step with the #Resistance, and ended up falling on its face. Hard. The company's tone-deaf ad-which used Black Lives Matter iconography and Kendall Jenner to suggest that carbonated beverages can heal America's wounds-inspired such a seething backlash it was pulled almost instantly, and savagely parodied. It would've been a fine time for Coca-Cola to step up and deliver a perfectly calibrated topical ad, thereby eating Pepsi's lunch. In truth, though, Coke had to do absolutely nothing to achieve the same result. Instead, Heineken has come along a couple weeks later with an ad that gets to the heart of political engagement in a straightforward way that makes Pepsi's self-congratulatory ad seem even more embarrassing.

The main political problem in post-Brexit UK, as well as post-Trump America, is the depth of our division. People with opposite views believe in their own opinions so vehemently, they're convinced everyone on the other side is practically from a different species. Making matters worse, these people from opposing sides rarely get to meet each other outside of Twitter @-replies, which are among the most contentious places to be on the planet. In Heineken's "Worlds Apart" experiment, complete strangers who have been selected for their political opinions, but not told what the experiment entails, are matched up and made to converse. The climate change denier meets face-to-face with the environmental doomsayer, and both are made to hear out their respective views. Other issues explored throughout the ad include feminism and transgender rights. This kind of heady material is impossible to fully explore in a meaningful way within the space of a beer commercial. However, encouraging actual dialogue is a thousand times more of a mature and responsible way to address our current international predicament than glamorizing, fetishizing, and whitewashing the protest movement.

[via Upworthy]

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Heineken Just Put Out The Antidote to That Pepsi Kendall Jenner Ad

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WHAT: "World's Apart," a new Heineken ad that involves some frank conversations between people with differing views. WHO: Agency Publicis London WHY WE CARE: Earlier this month, Pepsi tried to walk in step with the #Resistance, and ended up falling on its face. Hard.

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- set in an asylum
- a child comes to visit their mother or father in the asylum
- The person has a split personality, we would use split characters to show this
- They might experience shock therapy
- We will use flashbacks to show how it all started

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Hey, I found this pre made prezi on Artaud so if your curious then take a look, it has some cool pictures and a very creep video clip from a drama production. -Olivia
https://prezi.com/2uuss0ytgjfr/theater-of-cruelty/

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Came across this game by accident and spent hours watch different game plays of it. It is all based around the butterfly effect, you don't have to watch it all as it takes forever and is not for the faint of heart ;)  However if your interested in the idea here is the link to the synopsis I found - Olivia
https://en.wikipedia.org/wiki/Until_Dawn

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Heya, I have been looking at some examples of paradoxes and I think that we could maybe try and put a concept like this into our piece however it might be a little too complicated. Linking with the whole idea of "what's behind closed doors" we could consider doing a sci-fi ish devising piece where we demonstrate different realities where the same scenario is presented but the characters act differently, displaying a theory called the butterfly effect ( every action has a direct and indirect consequence). -Olivia

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This could link to the second stimulus

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Some of the lyrics in this song could work well because of the idea that you never know what is going on in someone else's life like in the 1st stimulus.

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This could link to stimulus 2 because of the idea of how the media manipulates the truth

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I thought this song may be quite useful because it links to the idea of politics, equality and who influences us and our opinions.

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MACKLEMORE & RYAN LEWIS - SAME LOVE feat. MARY LAMBERT (OFFICIAL VIDEO)

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Well done for the ideas so far - keep them coming!

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Maybe this is the message behind the 6 or 9 image

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Thought that this displayed an interesting concept that we could look at whilst we discuss ideas for our devising piece such as underlying motives and corruption in society. - Olivia

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Heya, this was the film I told you guys about in class, thought the concept was very innovative; maybe we could use something from this in our devising piece :]
here is the synopsis of the film - Olivia http://www.imdb.com/title/tt1637688/synopsis

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A wild Blue sky abreast of Winds - by  Emily Dickinson

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A wild Blue sky abreast of Winds - by  Emily Dickinson

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A wild Blue sky abreast of Winds
That threatened it -- did run
And crouched behind his Yellow Door
Was the defiant sun --
Some conflict with those upper friends
So genial in the main
That we deplore peculiarly
Their arrogant campaign --

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“Until you realize how easily it is for your mind to be manipulated, you remain the puppet of someone else's game.”
― Evita Ochel

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Escaping from North Korea in search of freedom | Yeonmi Park | One Young World

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Black Eyed Peas: Where is The Love Lyrics

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No copyright intended.Not my song Made by Black Eyed Peas

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This could link to stimuli 2 and 3 because of the idea not everything is as it seems especially people.