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The feelings of six patients about being shocked electrically are sketched. In schizophrenia, 'ECT destroys … [the] fantasy world and restores feelings at a higher level than the instincts'. What Sandison means by instincts is not clear, though he states 'consciousness and civilization have brought emotion and instinct close together'. Fear is a necessary aspect of the treatment but it is not the treatment itself. The sudden loss of consciousness and nearness to death with temporary cessation of respiration are the psychologically important factors.