On this occasion, it is likely that Esther Greenwood experienced the less traumatic 'modified ECT', given with muscle relaxant and a short-lasting anaesthetic.
When Esther Greenwood goes to obtain a contraceptive device (what is described in the text as 'a fitting'), it is likely that she is being supplied with a diaphragm, a barrier method of contraception.
In 1873, the Comstock Law had made contraception illegal at a federal level in the U.S.A. However Margaret Sanger, the birth-control activist, decided to challenge this law and introduced the diaphragm to America in 1916.
Legislation regarding contraception varied from state to state, with Connecticut and Massachusetts having some of the severest restrictions. In fact, it was not until 1972 that a Massachusetts law prohibiting the provision of contraceptives to unmarried men and women was overturned.
The Florence Crittenton Homes (not Crittenden) were set up under the auspices of the National Florence Crittenton Mission which was founded by Charles N. Crittenton in 1883.
The object of the venture was to help young women who were experiencing difficulties (particularly unmarried mothers and those involved in prostitution), and at its height, the organisation was responsible for 76 homes throughout the United States.
Although the structure of the organisation has changed considerably over the years, a body called The National Crittenton Foundation continues to oversee programs designed to help young women develop their potential and live fuller lives.
The ego is the name given to the organised, logical part of the mind, which is in touch with 'reality'; the id to the primitive, instinctual part of the mind, which is operative, for example, when we are dreaming.
Here Esther Greenwood is making the very valid point that although the ego and the id may be important theoretical concepts in psychoanalysis and some forms of psychotherapy, they would not normally form part of the discussion between client/patient and therapist/analyst.
As has been noted previously, the character Joan Gilling is loosely based on a real person, Jane Anderson, who was a contemporary of Sylvia Plath's at Smith College.
As has also been noted on several occasions, The Bell Jar is full of fictionalisations of easily recognisable individuals and events, and it was this aspect of the novel which led to specific difficulties in relation to the fictionalisation of Jane Anderson:
In 1987, Anderson (a doctor specialising in psychiatry) brought a defamation case against the makers of a 1979 film based on The Bell Jar, claiming that the portrayal in the film of lesbian tendencies in the character Joan Gilling, and the fact that she hangs herself, had damaged her reputation.
The case inevitably highlighted the enormous complexity that arises when real-life events and real individuals are fictionalised. This complexity is neatly captured by Jacqueline Rose in her book, The Haunting of Sylvia Plath (p.108), when she states: Anderson's case rested, necessarily, on a double claim - that she both was, and wasn't, the character portrayed in the novel and the film.
To learn more about the ramifications of this case, click here.