The controversial use of electroshock treatment on children is at the centre of the Royal Commission of Inquiry into Lake Alice's child and adolescent unit.
If used properly, the treatment can be a life-saving option in a small number of cases, according to psychiatrist Richard Porter.
"People with depression who are getting ECT are really very, very unwell and sometimes if not treated, they will die," he said.
The Royal Commission of Inquiry into Lake Alice has been hearing how it was used on children without anaesthetic.
However, things have changed in the decades since.
“For the last 30 years, at least — probably 40, in fact — anaesthetics have been used in New Zealand," Porter said.
ECT involves sedating a patient and placing two electrodes on their temples. A series of brief, high-voltage pulses send electric currents through the brain, causing a surge, also known as a seizure.
Porter said "giving enough electricity to cause that seizure is what causes the improvement".
But it is not without side effects, as he goes on to explain: "Approximately 25 per cent of people say that their memory has been affected and of course, that's why we reserve it for very, very severe cases."
In New Zealand, about 200 to 300 patients are treated with ECT every year, with many of them with severe depression. But, unlike at Lake Alice, it’s virtually never used on children.
Even back in the 1970s, it was not standard practice, with then Chief Ombudsman Sir Guy Powles saying in 1977 that ECT "plays little or no part in the treatment of children".
However, a clinical psychologist who is testifying before the Royal Commission, Dr Barry Parsonson, went further. He compared the use of ECT, as a form of aversion therapy that involved electrodes being placed on a person's groin or genitalia, to techniques used by the Nazi secret police.
When questioned about whether that was a regular practice in the field of aversion therapy Dr Parsonson replied: "There is nothing, I have ever read in the literature [like that]...the only people who did that were state organs of terror, mainly the Gestapo," he said.
He said at Lake Alice ECT appeared to be frequently used as punishment for things such as fighting, smoking or expressing homosexuality.
"Using pain as a means of trying to stop people doing things that were probably perfectly normal," Parsonson said.
The electrodes were placed not just on their temples but their arms, legs and genitalia.
"The treatment was not therapeutic, it didn't meet any of the criteria of therapy, it bordered upon maltreatment if not torture," he said.
"The consequences, I think, have been trauma, a distrust in authority."
Dr Selwyn Leeks, who was in charge of the rural psychiatric hospital, never swayed in his conviction he was right, however.
"What was treatment then may not be seen as treatment now," he told Sunday in old archival footage.
More witnesses are due to describe their ordeals as wards of the state as the hearings continue this week.
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