Psychosurgery or lobotomies, as we are more familiar with in the United States, were introduced during the 1930s. It was a neurologist by the name of Walter Freeman who brought it to the United States. It enjoyed enormous popularity in the 1940s. At one point, up to 5000 operations were being carried out a year. In this article we will be looking at the history, the use, the effectiveness and the criticisms of psychosurgery.
There is evidence that people were drilling holes in each other’s heads as far back as 5000BC. However, there is no explanation as to why this was done or what the outcome was.
Psychosurgery, as we would recognize it today, was first introduced in 1888 by a man named Gottlieb Burckhardt. He was a Swiss psychiatrist. He operated on 6 individuals, cutting pieces of their cerebral cortexes out. One of them died. He received such backlash about the operations that he never performed another.
Psychosurgery was introduced to the world by Egas Moniz in 1935. He was a Portuguese neurologist. Again, the response to Moniz’s operations was not positive, except for in the United States where a neurosurgeon named James Watts and a neurologist named Walter Freeman began their own experiments and operations using psychosurgery. Freeman is the one who came up with the “lobotomy”. This is the method that involves using an ice pick-looking instrument and shoving it under the eye of the patient, making a sweeping motion to destroy the frontal lobes. The simplicity of the procedure made it possible to perform anywhere. Freeman performed the operation out of his van, which he called, “the lobotomobile”. Psychosurgery enjoyed popularity in the 1940s, but saw a decline in the 50s with the introduction of new drugs.
Psychosurgery was originally used on people suffering from depression and obsessive compulsive disorder, or what, at the time, they would call melancholic and obsessive cases. Why which few cases did seem to work was never understood. Egas Moniz believed that he was interrupting unhealthy thoughts that were being looped in the synapses. By cutting up the path it made newer, healthier thought loops. Throughout the 20th century psychosurgery was continued to be used on chronic depression and obsessive compulsive disorder.
The effectiveness of the treatment was quite low and there was quite a high chance that the patient would die. In one study only 5 out of the 18 patients who had been operated on were found to have made any improvements. The treatment was also responsible for causing long term damage in many of its patients. As a result of its efficacy being called into question and in light of its high death rate and long term damages, the question of its continuation was brought to court in the United States in the 1970s. There are only a small number of clinics that continue to perform this operation.
The 3 main criticisms of psychosurgery are: its effectiveness, its high death rate, and the long term effects of the treatment. The effectiveness of the procedure never enjoyed high numbers and what could be considered a successful operation was subjective to whomever was performing the operation. A client becoming more compliant and apathetic could be seen to the physician that was working with them as an improvement while it could be seen to another as a form of brain damage. Although there are not any numbers for how many people died as a result of this surgery it is generally concluded that they were quite high. As for long term effects, many patients were left in vegetative-like states afterwards.