The Lobotomy: An Old-school Mental Health Treatment

By Becca Tarvin • April 16, 2010 at 9:50 am


Since CAS requires that its non-Core Curriculum students take a number of Divisional classes, I chose to take two semesters of Psychology to broaden my academic horizons. This is not an article about my experience in those classes (although I can say that I disliked the first and enjoyed the second), but rather about something that one of the professors only mentioned briefly- lobotomies.

The following is not for the light of stomach.

Walter Freeman and James Watts performing a lobotomy.

A lobotomy (aka leucotomy) is a “psychosurgical” procedure that aims to solve some of the affects of a serious mental disorder such as schizophrenia. The first theory behind this practice was that the particular physical organization of the brain was one of the major causes of disordered affects, so lesioning certain parts of the brain could relieve some of the symptoms of mental diseases. The first few attempts of a lobotomy were performed by a man named Gottlieb Burckhardt in the 1880s on six patients, but his 50% “success” rate and hard to-believe theory received general negative feedback from the psychiatric crowd.

In the 1930s, another man, Egas Moniz, embarked upon a similar approach to relieving symptoms of psychological disturbances by drilling holes and injecting alcohol into the frontal lobes of the brain. Later he employed a leucotome, which had a wire loop to cut brain tissue. Moniz theorized that affects due to mental illnesses were caused by pathological, fixed neural pathways rather than disorganized modules of the brain as Burckhardt believed, so he aimed at disturbing connections of the brain rather than destroying tissue. His work received the Nobel Prize for medicine in 1949.

An orbitoclast, one of the instruments used to sever nerve connections in the brain.

Perhaps the most influential proponent of lobotomies was Walter Freeman, an American psychiatrist and neurologist. His first few procedures in the 1930s were similar to those of Moniz, but Freeman wanted to make the procedure available to patients in mental hospitals who did not have operating rooms, or even appropriate anesthetic. This led to two unfortunate changes in the procedure starting in 1945: (1) patients were rendered unconscious by electroconvulsive therapy rather than anesthesia and (2) instead of drilling holes into the patient’s head, an ice pick from Freeman’s kitchen drawer was inserted into the eye orbital of the patient, drove into the brain cavity using a mallet, and then swished around to cut brain tissue. Freeman severed the connection between the frontal lobes (known to be a basis of our emotional responses and personality) and the thalamus (a big player in our sensory systems and alertness), in the hopes that the agitations, depression, or anxiety that the patient was feeling would be relieved once certain parts of the brain were not permitted to communicate. Although later Freeman used an orbitoclast instead of his ice pick, his partner James Watts left him shortly after these changes were made.

Lobotomies frequently had nasty side-effects, such as: death, epilepsy, loss of motor function, loss of cognitive abilities, blunting of personality and emotion, and incontinence. It is worth noting, however, that some patients did improve in relation to their pre-operational state.

Tens of thousands of people in the US were lobotomized, including one of JFK’s siblings, Rosemary Kennedy. As far as the rest of the world knew, she was mentally handicapped, but in reality, at an age of 23, she had received a simple procedure called a lobotomy.

With the advent of antipsychotic drugs in the 1950s, the frequency of a lobotomy gradually phased out.

If you’re still curious, check out these videos:

A PBS feature on Walter Freeman: http://www.youtube.com/watch?v=_0aNILW6ILk
A four-part BBC series on mental health treatments in the 1950s: http://www.youtube.com/watch?v=2KxU3dPeink&feature=related

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See http://en.wikipedia.org/wiki/Lobotomy for more information




Responses

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