In the movies, general practitioners perform brain surgery as frequently as obstetricians call for towels and hot water. With the exceptions of intramuscular injections and mismanaged restraint, real-life psychiatric interventions are not physically painful, but cinema gave psychiatry a chamber of horrors beyond that of the dentist or surgeon.

Most early representations of sadistic psychiatrists were about emotional/psychological manipulation: by hypnosis (see the February 2009 issue, p. 116) or deception. Psychopathic psychiatrists inflict emotional wounds: A Fine Madness (1966), Bad Timing (1980) and Asylum (2005). The psychologist of Peeping Tom (1960), played in flashbacks by the film's director Michael Powell, deliberately manipulates his young son and creates a homicidal sadistic voyeur. Aligning psychiatry with state torture, Manchurian Candidate (1962) sees moral soldiers turned into cold killers to the apparent pleasure of their psychiatrist jailors, who boast ‘not brainwashing, but dry-cleaning’. The brutal, aversive behavioural techniques of A Clockwork Orange (1971) attempt to condition a sadistic murderer against violence: self-referential scenes where Alex is forced to watch violent films in restraints with eyes forced open, evoke his earlier brutal behaviour. The Ludovico Technique is perfect for the quick-fix Home Office minster, but lacks understanding of morality or real choice. A remake would give Alex ‘dangerous severe personality disorder’ (DSPD). In The Jacket (2005), Dr Becker (Kris Kristofferson) uses drugs and brutal confinement in a coffin with sensory deprivation to punish his patient-inmates.

In One Flew over the Cuckoo's Nest (1975), McMurphy (Jack Nicholson) receives two brutal procedures. First, unmodified electro-convulsive therapy (ECT) fails to control his mutinous behaviour: in this film, ECT is used to punish three patients in one sitting. Later McMurphy is lobotomised. Many who have seen the film recall this surgery as killing him, rather than his euthanasia – leaving the impression of institutional murder.

The most harrowing scene of Regeneration (1997) is when electrode-happy Dr Yealland applies increasing voltage shocks to the vocal chords of an aphonic soldier. Our horror is amplified by electricity's dubious status as ‘treatment’. Electricity always hurts – as torture (Underground, 1995), punishment (Face/Off, 1997), or execution (Green Mile, 1999). It is a colourful means of dispatching villains: Goldfinger (1964) begins and ends with Bond's assassinations by electrocution. Drawing on discredited psychiatric claims of ‘curing’ homosexuality, the glamrock musician (Ewan McGregor) of Velvet Goldmine (1998) has received ECT as a child ‘to knock the fairy out of him’, such that he ‘goes bonkers every time he hears an electric guitar’. The archetypal video nasty Child's Play (1988) murders its psychiatrist by applying continuous ECT to his brain, thereby frying it. The hunter has become the hunted.