It is not uncommonly believed that convulsion treatment produces its successes mainly or entirely through the fear which it engenders. This opinion, more often implied than definitely stated, has been crystallized by McCowan (1), who boldly wrote:

“No reasonable explanation of the action of hypoglycæmic shock or of epileptic fits in the cure of schizophrenia is forthcoming, and I would suggest as a possibility that as with the surprise bath and the swinging bed, the ‘modus operandi’ may be the bringing of the patient into touch with reality through the strong stimulation of the emotion of fear,” and “that the intense apprehension felt by the patient after an injection of cardiazol, and so feared by the patient, may be akin to the apprehension of the patient threatened with the swinging bed. The exponents of the latter pointed out that fear of repetition was an important element in success.”