1.16 Psychosurgery: Definition, Types & History
Psychologists theorize that any results patients felt were due to shock and trauma, as well as drugs that may have been administered for the procedure.
It may be surprising, but the practice of trephining still has some supporters, although the tools and practices are far more refined. The ancient trephine tools were stone which later developed into metal tools. Today, the practice of opening the skull to relieve pressure is called craniotomy. This is a highly-developed procedure that is most often used to relieve large pools of blood in the brain.
The most famous type of psychosurgery is the lobotomy. Lobotomy was first introduced in 1937 by a Portugese neurosurgeon named Egas Moniz. A lobotomy involves severing the neural connections of the brain’s frontal lobes. Moniz used lobotomy as a treatment for schizophrenia and won a Nobel prize for his work in 1949.
Although there is no good scientific evidence as to why lobotomies would work for schizophrenia, the practice grew in the US in the 1940’s and 50’s. In 1945, Dr. Walter Freedman developed a technique to gain access to the frontal lobes of the brain through the eye socket using an instrument much like an ice pick. Freedman traveled around in a vehicle known as the ‘lobotomobile,’ performing multiple lobotomies daily inside his van. Luckily, development of antipsychotic drugs in the 1950’s replaced the practice of lobotomies that had left thousands of people in a zombie-like state.
Psychosurgery is still practiced today, although it is very rare and used only in severe cases where patients have not responded to other types of treatments. For example, severely and chronically depressed patients whose symptoms have not been helped by drugs, talk therapy or even ECT (electroconvulsive therapy) sometimes opt for psychosurgery. Today’s psychosurgeries bear little resemblance to psychosurgery practiced during the early part of the 20th century. Patients are seen in operating rooms where the procedures are done using state of the art tools such as MRI machines and computer driven electrodes. Small lesions are created by burning bits of very specific brain tissue. Patients understand that the procedure involves irreversible brain damage, but still seek the relief that may be brought by creating lesions in the areas of the brain related to emotions.
When you are finished, you should be able to:
- Recall what psychosurgery is
- Outline the history of using psychosurgeries to treat mental disorders
- Describe the two psychosurgery techniques that were popular in the past
- Explain why psychosurgery might still be used in certain cases today