Psychosurgery, a deeply troubling medical practice that in its violent heyday four decades ago featured such brutal procedures as lobotomies, has made a disturbing comeback in the past several years. This revival is markedly different from those old, cruel methods. Long obsolete are the ice-pick lobotomies made famous by Dr. Walter Freeman. Today’s approaches are focused on preventing mental health disorders, with more precise and strategic interventions.
In 1936, Dr. Egas Moniz made a radical leap into the field of psychosurgery. He carried out the first prefrontal leucotomy with an instrument of his own invention, which he named leucotome. This groundbreaking work won him the Nobel Prize and secured his place in the canon of medical history. It was Freeman’s vision for a faster, more direct and less expensive solution that would upend the profession in the mid-20th century.
The Dark History of Lobotomies
Dr. Walter Freeman’s hubris drove him to develop the transorbital lobotomy, which used a tool similar to an ice pick. This technique made it possible for him to perform lobotomies without requiring neurosurgeons or sophisticated operating rooms. Freeman’s testimony stated that most patients in his care made enough qualitative and quantitative progress to graduate from hospitals. Rosemary Kennedy was one such patient. She was only 23 when she had the procedure in 1941, and today she is perhaps better remembered as the sister of President John F. Kennedy. Unfortunately, the lobotomy left her mentally incapacitated.
Freeman’s method faced backlash for its unscientific basis and frequently catastrophic results. As Andrew Scull, a noted historian of psychiatry, remarked, “Even Freeman conceded not many patients retained their initiative and higher mental functions, but they could be a housewife or sit prettily at the dinner table.” This recognition brings into focus the ethical challenges that plagued the practice. They’ve left a terrible stain on the legacy of psychosurgery.
“The human brain, with all its trillions of connections, is enormously complex … The idea that we can locate any form of mental illness is wrong.” – Andrew Scull
Modern Techniques and Ethical Considerations
The field of psychosurgery has changed a great deal since the era of lobotomies. With today’s techniques emphasizing accuracy and a growing trend toward minimally invasive procedures, doctors today have new options. Dr. Nir Lipsman has pioneered the use of deep brain stimulation (DBS) to address a growing number of conditions. His creative work has led to pioneering treatments for obsessive-compulsive disorder (OCD) and alcohol addiction.
In 2018, Dr. Frank Plummer, this country’s most illustrious leader in Canadian medical research, succumbed to an all-consuming chronic addiction to heavy drinking. To solve this challenge, he turned to DBS as his solution. It was this innovative procedure that Dr. Lipsman had performed on Plummer. This was one of the first uses of DBS for such a malady in North America.
While significant progress has been made, specialists urge restraint in this rapidly developing area. Dr. Lipsman stated, “We have to be very careful not to take advantage of our patients’ desperation to get better.” As such, patients commonly see these surgical procedures as last resorts after traditional treatments have been tried and failed.
“When I see patients in clinic, they often tell me this is their last resort.” – Dr. Nir Lipsman
Patient Experiences and Outcomes
The stories of these patients who have received 21st century psychosurgery offer a picture of hope, but caution. Anya took part in an experimental treatment for OCD that spanned six years. Prior to her surgery, she said her life was a place where she constantly wanted to take her own life. Following her surgery, she described feeling a spiritual awakening.
“Before surgery, my mood was super-low, depressed, desperate, suicidal.” – Anya
“I celebrate it as my second birthday now.” – Anya
Anya’s story is a powerful testament to the life-changing outcomes now possible through today’s psychosurgery techniques. It is equally a reminder of the field’s rocky history and the importance of continued ethical oversight.
Beverly Adams, a psychologist involved in these treatments, emphasizes that “science is a field where you make corrections as you learn.” She passionately argues for more transparency when it comes to non-invasive procedures that have a huge positive impact on quality of life.
“To come to a point where there is a procedure that can really improve your quality of life and is non-invasive, I think it’s wrong not to talk about it.” – Beverly Adams
