Psychosurgery

Date: The 1930’s forward
Type of psychology: Psychological methodologies
Fields of study: Anxiety disorders; biological treatments; depression;
endocrine system; schizophrenias
Psychosurgery is brain surgery in which brain parts are disconnected or removed to do
away with psychiatric problems such as aggression, anxiety, and psychoses. It was
used most from 1935 to 1965, until psychoactive drugs began to replace it. Psychosurgery
is not used to relieve psychiatric symptoms resulting from structural brain disease
such as brain tumors.
Key concepts
• electroconvulsive therapy
• psychopharmaceuticals
• psychosurgery techniques
• somatic theory of insanity
In the early twentieth century, the treatment of mental disease was limited
to psychotherapy for neurotics and long-term care of psychotics in asylums.
In the 1930’s, these methods were supplemented by physical approaches using
electroconvulsive therapy (ECT) and brain operations. Psychosurgical
operations were in vogue from the mid-1930’s to the middle to late 1960’s.
They became, and still are, hugely controversial, although their use had
drastically declined by the last quarter of the twentieth century. Controversy
arose because, for its first twenty-five years of existence, crude psychosurgery
was too often carried out on inappropriate patients.
ECT developed after the 1935 discovery that schizophrenia could be
treated by convulsions induced through camphor injection. Soon, convulsion
production was accomplished by passage of electric current through
the brain, as described in 1938 by Italian physicians Ugo Cerletti and Lucio
Bini. ECT was most successful in alleviating depression and is still used for
that purpose. In contrast, classic psychosurgery by bilateral prefrontal leucotomy
(lobotomy) is no longer performed because of its deleterious effects
on the physical and mental health of many subjects. These effects included
epilepsy and unwanted personality changes such as apathy, passivity, and low
emotional responses. It should be remembered, however, that psychosurgery
was first planned to quiet chronically tense, delusional, agitated, or
violent psychotic patients.