Decoding Lobotomy: Past, Present and Legacy
BY: Neighbors’ Consejo|
The history of psychiatrics is marked by significant milestones, among them the development and widespread use of lobotomy. This article provides an overview of lobotomy as a treatment for various psychiatric disorders, tracing its emergence, adoption, and eventual decline. Through an exploration of its techniques, outcomes and ethical implications, we aim to illuminate the complex legacy of lobotomy in the context of mental health care.
“Doctors developed the lobotomy in the late 19th and early 20th centuries, at a time when there were no drug therapies for mental health disorders, and psychotherapy was still in its early stages. As there were no standardized or effective treatments, people with severe symptoms often lived in psychiatric hospitals and asylums. In Europe, many of these facilities were overcrowded, which led doctors to look for a solution.”
According to Britannica, “lobotomy, was a surgical procedure in which the nerve pathways in a lobe or lobes of the brain are severed from those in other areas. The procedure was formerly used as a radical therapeutic measure to help to help grossly disturbed patients with schizophrenia, manic depression, and mania (bipolar disorder), and other mental illnesses.”
In the document “Violence, mental illness, and the brain -A brief history of psychosurgery: Part 1- From trephination to lobotomy.”, published in the National Library of Medicine, we can read how “psychosurgery was developed early in human prehistory (trephination) as a need perhaps to alter aberrant behavior and treat mental illness. The “American Crowbar Case” provided an impetus to study the brain and human behavior: The frontal lobe syndrome was avidly studied.” To read the full document, see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3640229/
What does a lobotomy do? WebMD affirms:
- Obsessive-compulsive disorder (OCD)
- Severe depressive illness
- Psychosis
- Schizophrenia
- Manic depressive psychosis
- Chronic neurosis
- Psychopathic personality
Additionally, “a lobotomy disrupts the connections between the frontal cortex and the rest of the brain, particularly the thalamus. Doctors believed that doing so would reduce abnormal stimuli reaching the frontal area. Such stimuli were thought to cause impulsive and violent behavior. A lobotomy would make the patient calm and docile so that they could be sent home to live with their family.”
“The intended effect of a lobotomy is reduced tension or agitation, and many early patients did exhibit those changes. However, many also showed other effects, such as apathy, passivity, lack of initiative, poor ability to concentrate, and a generally decreased depth and intensity of their emotional response to life. Some died as a result of the procedure.”
Now, the “question of the century”: Do doctors still perform lobotomies? “According to 2017 research, lobotomies are rare today. Although the techniques have advanced and improved, most doctors consider the surgery obsolete. However, lobotomies are still legal in some places. A 2019 study, reports that after lobotomies became unpopular, most states enacted laws to regulate the use of surgery for mental illness. However, despite this effort, the laws across the United States are inconsistent.”
Dr. Miriam Posner of UCLA consider, “we now think of lobotomy as an atrocity and rightfully so, but it’s also important to understand how a lot of very smart, educated people could have believed otherwise during the procedure’s prime.” Plus, she affirms, “when we talk about the history of psychiatry, we have to be careful about which mode of evidence we use to bolster our claim. The story the journals tell is different from the psychiatry physicians performed for each other on the lecture stage…”
In conclusion, the rise and fall of lobotomy offers profound insights into the complexities of medical innovation and ethical decision making. As we reckon with its troubled legacy, let us commit ourselves to learning from the mistakes of the past and working towards a future where mental health care is characterized by compassion, efficacy and respect for human dignity.
References
“Lobotomy Definition & Meaning.” Merriam-Webster, Merriam-Webster, www.merriam-webster.com/dictionary/lobotomy. Accessed 12 Apr. 2024.
“What Is a Lobotomy? Uses, Procedure, and History.” Medical News Today, MediLexicon International, www.medicalnewstoday.com/articles/what-is-a-lobotomy#do-they-still-happen. Accessed 12 Apr. 2024.
“Lobotomy.” Encyclopædia Britannica, Encyclopædia Britannica, inc., www.britannica.com/science/lobotomy. Accessed 12 Apr. 2024.
Faria, Miguel A. “Violence, Mental Illness, and the Brain – A Brief History of Psychosurgery: Part 1 – from Trephination to Lobotomy.” Surgical Neurology International, U.S. National Library of Medicine, 5 Apr. 2013, www.ncbi.nlm.nih.gov/pmc/articles/PMC3640229/.
“What Is Lobotomy and Why Is It Done?” WebMD, WebMD, www.webmd.com/brain/what-is-lobotomy. Accessed 12 Apr. 2024.
Caruso, James P., and Jason P. Sheehan. “Psychosurgery, Ethics, and Media: A History of Walter Freeman and the Lobotomy.” Jns, American Association of Neurological Surgeons, 1 Sept. 2017, thejns.org/configurable/content/journals$002fneurosurg-focus$002f43$002f3$002farticle-pE6.xml?t%3Aac=journals%24002fneurosurg-focus%24002f43%24002f3%24002farticle-pE6.xml&tab_body=fulltext.
JA;, Nadler R;Chandler. “Legal Regulation of Psychosurgery: A Fifty-State Survey.” The Journal of Legal Medicine, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/31940252/. Accessed 12 Apr. 2024.