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This paper elaborates on the view previously stated by Abse that the 'efficacy of convulsion therapy in mental disorder is dependent upon the fact that it exposes the patient to repeated traumatic situations' which has psychological consequences. The traumatic effect results from the excessive stimulation at the instinctual level while there is progressive disorganization of the higher centers. The induced state is labeled a 'regression' and the whole process including the 'restitution' from the convulsion is likened to an experience of rebirth. The physiological changes which are seen are compared to those of birth and its attendant 'anxiety'. These changes are reversible but the pattern leaves a lasting impression in the psyche which may be a forceful affective symbol. This 'primal anxiety' is said to be followed by an attempt at defense consisting primarily of repression and accompanied by an alteration in the distribution of the libido. A case history is given of a man admitted to a hospital in a catatonic state. Postconvulsive behavior of homosexual, anal and oral types is described. Also the fears expressed by the patient verbally and by action are stated. Despite resistance, condemnation and attempts at flight on the part of the patient after the second treatment the injections were continued.
Abse believes that the transference situation is important and that it should