Fink, Maximilian (Max)

   (1923–)

   The leader of the movement to bring electroconvulsive therapy (ECT) back into American psychiatry, Fink was born in Vienna, the son of a physician. His parents moved shortly after his birth to the United States, and in 1945 Fink graduated with an M.D. from New York University. Between 1948 and 1953, he trained in psychoanalysis at the William Alanson White Institute, while simultaneously doing a psychiatry residency at Montefiore, Bellevue, and Hillside hospitals; he certified in neurology in 1952 and in psychiatry in 1954. In 1954, Fink was appointed director of research (and after 1956 director of the department of experimental psychiatry) at Hillside Hospital in Glen Oaks, New York. Between 1962 and 1966, he was director of the Missouri Institute of Psychiatry in St. Louis, then returned to New York where he was professor of psychiatry at New York College of Medicine. From 1972 until his retirement in 1997, he taught at the State University of New York campus at Stony Brook.

   When Fink came to the largely psychoanalytically oriented Hillside Hospital as a resident in 1952, he was assigned to electroconvulsive therapy, and upon qualifying in psychiatry 2 years later, he became chief of the ECT and the insulin coma treatment service. In 1954, he received from the National Institute of Mental Health a grant for the study of electroencephalography (EEG) in electroconvulsive therapy, thus beginning his research career. In 1959, he and Donald Klein began at Hillside a randomassignment study of imipramine, chlorpromazine, and placebo, determining in several articles beginning in 1961 the antidepressant action of chlorpromazine and the effects of both drugs in various diagnoses. Fink studied the EEG effects of chlorpromazine (1955) and imipramine (1957) in patients and in normal volunteers. This marked the beginning of research in pharmaco-EEG. At a scientific congress in Rome in 1958, Fink met Turan Itil (1924–), a psychiatrist at the University of Nuremberg. (At that meeting, the two of them, together with Dieter Bente [1921–1983], also at Nuremberg, formed the International Pharmaco-EEG Group [IPEG].) At Fink’s invitation, in 1963 Itil came to the Missouri Institute of Psychiatry, and the two of them began collaborating on a computer system for analyzing EEGs.

   Fink’s efforts to re-legitimize ECT, then under a cloud as a result of the antipsychiatry movement, began in 1967 as he and collaborators Richard Abrams (1937–) and Jan Volavka (1934–) of Prague began a systematic study of ECT supported by the National Institute of Mental Health. In 1972, together with Seymour Kety (1915-2000), then at Massachusetts General Hospital, and James McGaugh (1931–) of the University of California’s Irvine campus, Fink organized the NIMH Conference on the Psychobiology of Convulsive Therapy (proceedings published in 1974). Fink’s involvement with the American Psychiatric Association’s task force on convulsive therapy, which met for the first time in 1975, represented a step forward in his efforts to rehabilitate ECT. (The task force’s report on ECT appeared in 1978.) From 1980 to 1982, Fink served on the collaborative ECT project of the National Institute of Mental Health, and in 1985 he became founding editor of the journal Convulsive Therapy. Fink was the author of the then standard guide to ECT: Convulsive Therapy: Theory and Practice (1979) as well as of several later books on the subject.