Psychosurgery: Learning the Lessons

For two decades or so, starting in the mid-1930’s, the lobotomy, a controversial neurosurgical procedure, was prescribed for the relief of severe psychiatric conditions, particularly in the United States, but also across Europe. The procedure consisted of cutting the connections to and from the prefrontal cortex.  Initially hailed as a ‘wonder treatment’, long-term studies on patients post-lobotomy revealed a long list of negative side-effects leading to the cessation of the procedure as a mainstream treatment option. One very well-known case, that of Rosemary Kennedy, sister of President John F. Kennedy, who underwent a lobotomy in 1941 at age 23, resulted in her being permanently incapacitated.

The American neurologist and psychiatrist Walter J Freeman was one of the pioneers of this form of psychosurgery, eventually perfecting a controversial, but simple technique known as transorbital lobotomy.  Freeman’s technique could be carried out without specialized operating equipment and took only minutes to complete.

The heyday of the lobotomy came at a time where physicians were bereft of effective treatments for complex psychiatric conditions.  The lobotomy briefly offered hope to the families of those whose behaviour was seriously impaired and their functioning significantly diminished.  As such, it is perhaps understandable that some psychiatrists, exemplified by Freeman, were over-enthusiastic proponents of an invasive technique with a dubious providence.

Thankfully, psychiatry as a discipline has developed enormously since the time of Freeman, and the revolution in drug and talking therapies has brought effective treatments to those living with mental illness. Still, it is always worthwhile to look back in time to ensure that history does not repeat itself.  In this respect, the documentary below (Walter J. Freeman ~ The Lobotomist) is well worth watching:

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One thought on “Psychosurgery: Learning the Lessons

  1. Among the most dramatic, most widely publicized, and most disappointing innovations in psychiatry have been the techniques of brain surgery used in the treatment of severe emotional disorders (Moniz, 1937; Freeman and Watts, 1942). The best-known form of psychosurgery is the prefrontal lobotomy, an operation in which the nerve fibers connecting the prefrontal lobes of the brain with the hypothalamus are severed.

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