Psychosurgery

This page contains recent news articles, when available, and an overview of Psychosurgery but does not offer medical advice. You should contact your physician with regard to any health issues or concerns.

Background information on Psychosurgery

Psychosurgery is a term for surgeries of the brain or autonomic nervous system involving the severance of neural pathways to effect a change in behaviour, usually to treat or alleviate severe mental illness. The procedures typically considered psychosurgery are now almost universally shunned as inappropriate, due in part to the emergence of less invasive methods of treatment such as psychiatric medication. Although the term psychosurgery might imply a broad class of treatments, in reality, it is confined to variations on two themes:

leucotomy/prefrontal lobotomy/cingulotomy - the intentional severing of the pre-frontal cortex from the thalamic region of the brain
sympathectomy - the intentional severing of the sympathetic nerve trunk

Psychosurgery should not be confused with neurosurgery, though they may seem similar; neurosurgery is surgery intended to treat or alleviate neurological disorders, which may or may not manifest mental illnesses as symptoms. Psychosurgery should also not be confused with the practice of psychic surgery -- surgery purportedly performed by paranormal means. History

There is evidence that trephining (or trepanning)—the practice of drilling holes in the skull for pseudo-medical reasons—has been in widespread, if infrequent, use since 5000 BCE. This may have been done in an attempt to allow the brain to expand in the case of increased brain fluid pressure, for example after head injuries; several documented cases of healed wounds indicate that such crude surgery could be survived back then. However, psychosurgery as understood today was not commonly practised until the early 20th century.

The first systematic attempts at psychosurgery in humans occurred from 1935, when the neurologist Egas Moniz teamed up with the surgeon Almeida Lima at the University of Lisbon to perform a series of prefrontal leucotomies - a procedure severing the connection between the prefrontal cortex and the rest of the brain. This procedure is commonly (and incorrectly) called a "lobotomy", although this name should refer to a whole class of unrelated surgeries (that is, a lobotomy should refer to the removal of a lobe of the brain, not merely the severing of interconnections).

Moniz and Lima claimed fair results, especially in the treatment of depression, although about 6% of patients did not survive the operation and there were often marked and adverse changes in the patients' personality and social functioning. Despite the risks the process was taken up with some enthusiasm, notably in the US, as a treatment for previously incurable mental conditions. Moniz received a Nobel Prize in 1949.

The initial criteria for treatment were quite steep, only a few conditions of "tortured self-concern" were put forward for treatment. Severe chronic anxiety, depression with risk of suicide and incapacitating obsessive-compulsive disorder were the main symptoms treated. The original leucotomy was a crude operation and the practice was soon developed into a more exact, stereotactic procedure where only very small lesions were placed in the brain.

The procedure was popularized in the United States when Walter Freeman invented the "icepick lobotomy" procedure, which literally used an icepick and rubber mallet instead of the standard surgical leucotome. Leaving no visible scars, the icepick lobotomy was heralded as a great advance in "minimally invasive" surgery, and was eventually done under only local anaesthesia.

In a minimally invasive procedure, Freeman would hammer the icepick into the skull just above the tear duct and wiggle it around. Between 1936 through the 1950s, he advocated lobotomies throughout the United States. Such was Freeman's zeal that he began to travel around the nation in his own personal van, which he called his "lobotomobile", demonstrating the procedure in many medical centres. He reputedly even performed a few lobotomies in hotel rooms.

Freeman's advocacy led to great popularity for lobotomy as a general cure for all perceived ills, including misbehaviour in children. Ultimately between 40,000 and 50,000 patients were lobotomised. A follow-up study of almost 10,000 patients claimed 41% were "recovered" or "greatly improved", 28% were "minimally improved", 25% showed "no change", 4% had died, while only 2% were made worse off (Tooth, et al 1961). Lobotomies gradually became unfashionable with the development of antipsychotics and are no longer performed. The era of lobotomy is now generally regarded as a barbaric episode in psychiatric history.

It is possible that some patients did benefit from the more precise psychosurgery, but there was a strong division amongst the medical profession as to the viability of the treatment and concern over the irreversible nature of the operation and the extension of the surgery into the treatment of unsuitable cases (drug or alcohol dependence, sexual disorders etc). Whatever the truth, psychosurgery was offered in only a few centres and by the 1960s the number of operations was in decline. The signal improvements in psychopharmacology and behaviour therapy gave the opportunity for more effective and less invasive treatment.

Neurological impact

The frontal lobe of the brain controls a number of advanced cognitive functions, as well as motor control. Motor control is located at the rear of the frontal lobe, and is usually unaffected by psychosurgery. The anterior or prefrontal area is involved in impulse control, judgement, language, memory, motor function, problem solving, sexual behaviour, socialization and spontaneity. Frontal lobes assist in planning, coordinating, controlling and executing behaviour.

Thus, the efficacy of psychosurgery was often related to changes in personality and reduced spontaneity (this included making the person quieter, and lowering their sex-drive). Certain processes related to schizophrenia are also believed to occur in the frontal lobe, and may explain some success. However, certain types of inappropriate behaviours increased, as a function of reduced impulse control (in some respects they became more child-like). Further, it decreased their ability to function as a member of the community by reducing their problem solving and planning abilities and making them less flexible and adaptive. It usually had no impact on IQ except with respect to problem-solving.

Present day

Psychosurgery today is almost entirely limited to endoscopic thoracic sympathectomy (ETS surgery). While this is normally used for somatic conditions, many patients with anxiety disorder report significant reduction in fear and alertness after this intervention (Teleranta, Pohjavaara, et al 2003,2004).

Today, lobotomy is very infrequently practised. It may be a treatment of last resort of OCD sufferers, and may also be used for people suffering chronic pain. In the latter case, the surgery does not act on the perception of pain, but leads to a lack of concern about the pain. The procedure usually involves a 2-3cm lesion in the cingulum, near the corpus callosum. The efficacy is not high, with improvement in 5 of 18 patients (Baer et al., 1995). Lobotomy is no longer used as a treatment for schizophrenia.

From Wikipedia

News Articles on Psychosurgery

A No-Brainer  -  Apr 1, 2008
Insurance Networking News,...â€œMRI, CT scan and results of the performance of psychosurgery patients have been used to determine whether the tests activate the prefrontal cortex (the

Biological Influences on Criminal Behavior  -  Feb 1, 2008
Psychiatric Services (subscription)The author poignantly reviews the checkered history of psychosurgery and describes current psychosurgery applications to criminal behavior.

The Abolition of Man? How Politics and Culture Have Been ...  -  Feb 7, 2008
Heritage.org,They accepted at face value the purported benefits of such procedures as lobotomies, psychosurgery, and forced sterilization. They made grand promises about

Lobotomy: Proceeding Without Caution  -  Jan 20, 2008
Tampa Tribune,A now-discredited form of psychosurgery, the lobotomy at one time was heralded as a medical breakthrough in the treatment of mental disorders.

Is he crazy?  -  Dec 9, 2007
Los Angeles Times,This premise is flawed and has been used to justify the horrors of psychosurgery or a dictator's attempts to eradicate human imperfection.

WOULD GOD BLESS AMERICA  -  Dec 17, 2007
NewsWithViews.com,...â€œWe need a program of psychosurgery for political control of our society. The purpose is physical control of the mind. Everyone who deviates from the given

Specialists were stumped by man's unrelenting pains  -  Dec 2, 2007
Evansville Courier & Press (subscription),The day an ophthalmologist at Johns Hopkins suggested cingulotomy, controversial psychosurgery reserved for intractable psychiatric problems, was arguably

the noonday demon by andrew solomon  -  Nov 5, 2007
Bookslut,...desperation involved. and it does take desperation to convince yourself to try something like electro-convulsive therapy (ect) or psychosurgery. imagine

â€˜help give them proper memorialâ€™  -  Oct 28, 2007
Bradford Telegraph Argus,...benches and a sculpture. mr hutchinson, founder of survivors' campaign against lobotomy and psychosurgery (scalps), said: "to put 2800 people on that

a pain in the head  -  Nov 12, 2007
Washington Post,...controversial psychosurgery reserved for intractable psychiatric problems, was arguably "the worst moment," recalled neta nelson, who accompanied her

human rights group commends piedmont regional council for landmark ...  -  Nov 19, 2007
American Chronicle,...and victims of psychiatric brutalities ranging from electroshock and involuntary commitment to political torture, psychosurgery and the devastating

Schizophrenics gain by practice, not meds  -  Oct 15, 2007
Science Daily (press release)...full article Psychosurgery -- Psychosurgery is a term for surgeries of the brain involving procedures that modulate the performance of the brain,

"One Flew over the Cuckoos Nest" comes to Cal Rep  -  Oct 3, 2007
Milpitas Post,...is a dramatic and disturbing view into the world of psychosurgery and social management by electric shock therapy. Adapted from the 1962 novel by Ken Kesey,

10 things you might not know about the nobel prize  -  Oct 14, 2007
Sun-Sentinel.com,Today, some forms of "psychosurgery" are performed, but they are quite rare. 7 The most controversial honor in Nobel history? Perhaps the Peace Prize of

Some patients' bad memories haunt Oregon State Hospital's history  -  Oct 15, 2007
Salem Statesman Journal,In 1973, Oregon lawmakers created a Psychosurgery Review Board to provide guidelines and stringent controls for the by-then rarely used operation.

Howard Dully's searing story of his lobotomy at age 12  -  Sep 1, 2007
The Plain Dealer - cleveland.com,His surgeon was Dr. Walter Freeman, "sort of like the Henry Ford of psychosurgery," Dully writes. "He didn't invent the procedure, but he turned it into an

Review: Howard Dully's memoir about having a lobotomy at age 12  -  Sep 10, 2007
San Francisco Chronicle,..."Freeman," writes Dully, "was sort of like the Henry Ford of psychosurgery." At the time, psychiatrists used various methods to treat mentally ill patients,

Man survives lobotomy surgery, shares horrendous experience Man ...  -  Aug 20, 2007
San Mateo County Times,..."Freeman was sort of like the Henry Ford of psychosurgery," Dully writes. "He didn't invent the procedure, but he turned it into an assembly line process,

Man survives lobotomy  -  Aug 6, 2007
New Hope Courier,..."Freeman was sort of like the Henry Ford of psychosurgery," Dully writes. "He didnâ€˜t invent the procedure, but he turned it into an assembly line process,

Uncivil Liberties And The Empire's War On Its Citizens  -  Jun 19, 2007
Atlantic Free Press,...in a now-infamous program called MK ULTRA which also used hypnosis, electroshock therapy, and psychosurgery and which continued into the 1970s.

Gondry fest celebrates fantasy  -  May 10, 2007
Minneapolis Star Tribune (subscription),Gondry shared an Academy Award for Best Original Screenplay with Charlie Kaufman for the story of a bitter breakup between a couple who use psychosurgery to

Citizens Commission on Human Rights UK Celebrates its 38th Year  -  27 Apr 2007
PR.com (press release),Christine Mainstone described Chapman as a remarkable and courageous lady, whose experience serves to highlight the brutality of psychosurgery.

Sie sind hier: Home > Pressemitteilung: Swedish Big Brother behind ...  -  Apr 25, 2007
Informationsdienst Wissenschaft (Pressemitteilung),Psychosurgery, with its roots in Switzerland, Portugal, and the US, came to be widely used in the modern mental hospitals in Sweden of the late 1940s.

Rise of psychosurgery  -  Apr 9, 2007
The Phoenix,Dr. Peter Breggin says lobotomy and other forms of psychosurgery which involved the destruction of portions of the human brain by surgery, irradiation,

One Flew Over the Cuckooâ€™s Nest  -  Apr 10, 2007
Stage,...where the insane are systematically subdued and any disruptive surge of individuality can be permanently counterpointed with the dreaded psychosurgery.

Three human rights awards presented by CCHR UK at Saint Hill Castle  -  Apr 25, 2007
PR-Inside.com (Pressemitteilung),Christine Mainstone described Chapman as a remarkable and courageous lady, whose experience serves to highlight the brutality of psychosurgery.

The Right Brain Hypothesis for Obesity  -  Apr 24, 2007
Journal of American Medical Association (subscription),Psychosurgery in the Treatment of Mental Disorders and Intractable Pain. 2nd ed. Springfield, Ill: Charles C. Thomas; 1950. 3. Regard M, Landis T. "Gourmand

Should we allow the sun to shine on sex offenders?  -  Apr 7, 2007
Times of Malta,Many modes were applied which included psychosurgery, castration, drug therapy, counselling therapies and psychotherapy.

Five by Tenn - Five Landmark Plays by Tennessee Williams, New York  -  Mar 23, 2007
Blogcritics.org,...lies, or even psychosurgery if necessary), presents Goldie as both heartlessly brazen â€œtruthâ€? teller and instrument of Berthaâ€™s imminent confinement.

Bill censors offenders' letters to the media  -  Feb 23, 2007
Kansas.com,The amended bill allows sexual predators to retain some of the rights they now have, including the right to refuse medication, psychosurgery or shock

Antidepressants Associated With Increased Risk For Suicide ...  -  Dec 7, 2006
Science Daily (press release)Psychosurgery -- Psychosurgery is a term for surgeries of the brain involving procedures that modulate the performance of the brain, and thus effect changes

Prisoner of his thoughts  -  Dec 16, 2006
Providence Journal,Hanging over them was the grim history of psychosurgery, performed during the 20th century without ethical guidelines, informed consent or even evidence

Antidepressants Associated With Increased Risk For Suicide ...  -  Dec 7, 2006
Science Daily (press release)Psychosurgery -- Psychosurgery is a term for surgeries of the brain involving procedures that modulate the performance of the brain, and thus effect changes in ...

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