Read Part 1 – Psychosurgery’s chilling history
Walter Freeman believed the lobotomy would revolutionize psychiatry and empty overflowing asylums. He traveled the country, visiting institutions and lobotomizing patients, once operating on 25 women in a single day, and performing 228 transorbital lobotomies in two weeks.
The frontal lobe of the brain controls many elements of cognition, including planning, coordinating and executing behavior. The prefrontal area is associated with judgment, impulse control, language, memory, problem solving, socialization, and spontaneity.
Destroying part of this area of the brain could be expected to have harmful effects. Freeman claimed success in many cases, but this usually meant that the patient was more docile, compliant, and easier to manage. And “success” had a price: many patients were left without personality, transformed into living zombies.
Sometimes even Freeman had to admit that a case was a failure, as when the patient became more aggressive, or when a patient was killed by the surgery.
Psychosurgery Today: Depression, Addiction, and More
Cloaked as “neurosurgical treatment of psychiatric disease,” psychosurgery has been making a quiet comeback.
Some of the techniques now in use, especially for severe OCD, include stereotactic cingulotomy, capsulotomy, subcaudate tractotomy, and limbic leukotomy. All of these involve various methods of lesioning. Mashour and colleagues, who support the use of psychosurgery, point out that sterile techniques and adequate anesthesia are used, and the procedures are always performed by neurosurgeons. High-tech instruments like the radiosurgical “gamma knife,” they say, have further improved psychosurgical technique.
In addition, techniques such as deep brain stimulation are becoming popular. Mashour’s group points out that this technique does not “stimulate” brain activity. The process actually results in inhibition of neural activity, “and thus is the functional equivalent of lesioning.”
Psychosurgery is being explored for depression, bipolar disorder, addiction, and other problems.
In Oregon, psychosurgery is restricted, but not entirely prohibited. ORS 677.190 bans doctors from performing psychosurgery, but defines it narrowly, so that procedures like deep brain stimulation would probably be allowed.
Shannon Hextrum, of Dartmouth, raises concerns about the new era of psychosurgery. Aside from possible dangers from the techniques now in use, what are the ethical implications of manipulating the emotions of others?
Further, writes Hextrum, in our fast-paced society, we often look for a quick fix, including drugs that radically tamper with brain chemistry and surgery that could have unforeseen consequences. While some safeguards are in place, Hextrum warns that in this realm, it is not enough to be critical–we must be scrupulous.
“Neurosurgeons perform world’s first operation on ‘habenula’ to treat depression,” Jan. 8, 2010
Bilateral Cingulotomy: Psychosurgery for Mental Illnesses
“The Neurosurgical Treatment of Addiction,” Bianca Stelton et al, 2008
Massachusetts General Hospital Guidelines for Neurosurgical Treatment of Psychiatric Disorders
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