What is psychosurgery? Elliot S. Valenstein, Ph.D., Professor Emeritus of Psychology and Neuroscience at the University of Michigan, defines psychosurgery as a "brain operation for the purpose of alleviating a severe psychiatric disorder in the absence of any direct evidence of neuropathology" (Behavior Today, June 28, 1976, p. 5). The following definition appears in a psychiatric textbook: "Psychosurgery is the surgical intervention to sever fibers connecting one part of the brain with another or to remove, destroy, or stimulate brain tissue with the intent of modifying or altering disturbances of behavior, thought content, or mood for which no organic pathological cause can be demonstrated" (John Donnelly, M.D., Sc.D., in: Kaplan & Sadock, Comprehensive Textbook of Psychiatry/IV, 1985, p. 1563).
The term psychosurgery is as illogical as many of the other words used in psychiatry. What is illogical about the term psychosurgery is that the psyche is not a part of the body, and therefore it is completely impossible to do surgery on it. Saying a psychiatrist or a surgeon is going to do surgery on someone's psyche is as illogical as saying he is going to do surgery on the person's soul. Although psychosurgery is obviously done on the brain, there is good reason for not calling it brain surgery, since unlike psychosurgery, brain surgery deals with known abnormalities in the brain, such as benign or malignant brain tumor, infection, or intracranial hemorrhage. What is magical about the word "psychosurgery" is somehow it seems to justify psychiatrists or surgeons doing surgery on brains that as far as is known are biologically speaking perfectly healthy! (Thomas Szasz, M.D., The Myth of Psychotherapy, Anchor Press 1978, pp. 6‑7)
Psychosurgery goes by various names for variations on what most people call lobotomy. Because the term lobotomy has such stigma attached to it, and because late 20th Century and early 21st Century psychosurgery is at least allegedly less damaging than the psychosurgeries performed 50 years ago, those who perform or defend psychosurgery today usually use terms other than lobotomy to describe it. Among these terms are subcaudate tractotomy, anterior cingulotomy, limbic leucotomy, anterior capsulotomy, and behavioral surgery. According to Dr. Benjamin Greenberg, professor of psychiatry at Brown University and chief of outpatient services at Butler Hospital in Providence, R.I., "We don't like to call it psychosurgery anymore ... It's neurosurgery for severe psychiatric illness" (quoted in Benedict Carey, "New surgery to control behavior", Los Angeles Times, August 4, 2003, & mindfully.org). In an editorial in 1990 in the Journal of Neuropsychiatry, Stuart Yudofsky, M.D. and Fred Ovsiew, M.D., wrote: "We propose unburdening so-called psychosurgery from the multifarious limitations of this appellation by advancing a new term: neurosurgical and related interventions (NRI) for psychiatric disorders" (Vol. 2, No. 3, Summer 1990, pp. 253-255, bold print in original). When lobotomy became a pejorative term, it became "psychosurgery". When the harm caused by psychosurgery became widely known, some sought to change the name to behavioral surgery, neurosurgery for psychiatric disorder, NRI, or other terms.
Some critics are unimpressed by the new names. For example, in a letter to the editors of The New York Times, "Lobotomy as Ancestor of Psychosurgery", published December 8, 1991, Graceann V. Inyard, a social worker, expressed her "outrage" about a November 3 article titled "Lingering Effects of Lobotomies of 40's and 50's". She says "The article gives the impression that lobotomies were not performed in this country after the advent of neuroleptic drugs. This is not true. They were just given different names under the umbrella term 'psychosurgery,' stereotaxis and cingulotomies among them."
NOW IN THE EARLY 21st CENTURY
PSYCHOSURGERY IS MAKING A COMEBACK
The first I recall learning about psychosurgery was in an abnormal psychology class I took in college when our professor, a psychologist, described it in a class lecture. One type he described is drilling two holes in the "patient's" skull on each side of the forehead at about the hairline to allow access to the frontal lobes of the brain where intellectual mental functioning, thinking, and emotion are believed to take place. In one version, he said, a cylindrical shaped device that resembles an apple corer is inserted into each side of the brain, and a cylindrical shaped piece of each frontal lobe is removed. He said in other versions of the operation a scalpel is inserted to sever connections in the frontal lobes or between the frontal lobes and other parts of the brain. In one type of psychosurgery (transorbital lobotomy), instead of drilling holes in the skull, a scalpel or instrument similar to an ice-pick is poked or hammered through a thin part of the skull in each eye socket known as the orbit into the frontal lobes of the brain, and, our professor said, "the scalpel is moved like this", as he wiggled his finger from side-to-side. In his book Molecules of the Mind: The Brave New Science of Molecular Psychology, University of Maryland journalism professor Jon Franklin describes the same operation as "forcing a thin, ice pick-like instrument through the patient's eye socket and then waving the point around in the brain" (Dell Pub. Co. 1987, p. 64). In their textbook Synopsis of Psychiatry, published in 1988, psychiatry professors Harold I. Kaplan and Benjamin J. Sadock say the "surgical" instrument used in transorbital lobotomy or leukotomy not only is "like" an ice pick; they say it is an ice pick (p. 531). According to two supporters of psychosurgery, the inventor of this method of psychosurgery was Dr. Walter Freeman, and "His [Dr. Freeman's] initial operating instrument was in fact an icepick taken from his kitchen drawer" (Rael Jean Isaac & Virginia C. Armat, Madness in the Streets: How Psychiatry and the Law Abandoned the Mentally Ill, Free Press/Macmillan, Inc. 1990, p. 179). Although my psychology professor didn't use this specific analogy, he made it unmistakably clear that he thought such psychosurgeries are as unscientific and senseless as trying to repair a malfunctioning television set by drilling a hole in its cabinet, inserting a machete, and rattling it around inside the TV cabinet. In other words, these types of psychosurgery, generally known as prefrontal lobotomy, were indiscriminate infliction of damage in the frontal lobes of the brain. The Bantam Medical Dictionary says what it calls the "Modern" version of psychosurgery that is done today is more refined and involves making "selective lesions in smaller areas of the brain" ("leukotomy", Bantam Dell 1981, p. 405). University of Iowa psychiatry professor Nancy Andreasen, M.D., Ph.D., describes modern psychosurgery as follows in her book The Broken Brain: The Biological Revolution in Psychiatry (Harper & Row 1984, p. 214, italics added):
Whereas the older technique of "prefrontal lobotomy" involved cutting large amounts of white‑matter tracts, the modern technique of psychosurgery emphasizes the selective cutting of very tiny and quite specific portions of the tracts connecting the cingulate gyrus to the remainder of the limbic system. This technique is assumed to break up the reverberating circuits of the limbic system and thereby stop the self‑perpetuating cycle of emotional stimulation...
The use of the word assumed is an admission that psychosurgeons don't know for sure what they are doing from a biological perspective. In The Broken Brain, Dr. Andreasen also says that "While we know a great deal about the motor, sensory, and language systems, and quite a lot about the memory system, the frontal system is still a poorly understood frontier area" (Id., p. 118). She refers to this part of the brain as "the mysterious frontal lobe" (Id., p. 95). Yet, despite our ignorance of what the frontal lobes do and how they work, it is in this very area of the brain that "psychosurgery" is done! In a book published in 2007, psychologist Bruce E. Levine, Ph.D., says G. Rees Cosgrove, M.D., formerly Associate Professor of Surgery at Harvard Medical School, and currently Professor of Neurosurgery and Chair of the Department of Neurosurgery at The Warren Alpert Medical School of Brown University, is "perhaps the most well-known psychosurgeon in the United States" (Surviving America's Depression Epidemic, Chelsea Green Publishing Co. 2007, p. 74). In his book The Noonday Demon—An Atlas of Depression, Andrew Solomon quotes Dr. Cosgrove making the following admission about psychosurgery: "We don't understand the pathophysiology; we have no understanding of the mechanisms of why this works" (Scribner 2001, p. 164). Dr. Cosgrove and Scott L. Rauch, M.D., Professor of Psychiatry at Harvard Medical School and Psychiatrist-in-Chief at McLean Hospital, in an article on a Massachusetts General Hospital and Harvard Medical School web page with a last modified date of March 2, 2005 (still on-line when I checked on September 22, 2014) say "The surgical treatment of psychiatric disease can be helpful in certain patients with severe, disabling and treatment refractory major affective disorders, obsessive compulsive disorder and chronic anxiety states." In that article they make the following admissions (italics added):
Although the neuroanatomical and neurochemical basis of emotion in health and disease remains undefined, there is evidence that this system and its interconnections with the cortico‑striato‑thalamic circuits play a central role in the pathophysiology of major affective illness, obsessive-compulsive disorder and other anxiety disorders. ... Therefore, it is intuitively appealing, to believe that psychiatric disorders that are characterized by affective and cognitive manifestations (eg. depression, OCD, and other anxiety disorders) might reflect a final common pathway of limbic dysregulation. ... Neurochemical models suggest that the affective and anxiety disorders may be mediated via monoaminergic systems. ... Although the exact neuroanatomical and neurochemical mechanisms underlying depression, OCD and other anxiety states remain unclear, it is believed that the basal ganglia, limbic system and frontal cortex play a principal role in the pathophysiology of these diseases. [http://neurosurgery.mgh.harvard.edu/functional/psysurg.htm]
It is on the basis of such merely suggestive evidence and conjecture that psychosurgeons cut, remove, or destroy fibers or tissue in human brains that as far as anybody can determine are perfectly normal.
What might be the effect of, to use Dr. Andreasen's words, "cutting of very tiny and quite specific portions of the tracts connecting the cingulate gyrus to the remainder of the limbic system"? According to neuroscientist and PET scan pioneer Marcus Raichle of Washington University in St. Louis, the cingulate gyrus is shown by positron emission tomography or PET scan studies of the brain to be a center for solving word problems. It also activates whenever "subjects are told to pay attention...It also shines with activity when researchers ask volunteers [whose brains are being studied by PET scans] to read words for colors—red, orange, yellow—written in the 'wrong' color ink, such as 'red' written in blue" (Newsweek, April 20, 1992, p. 70). In other words, the cingulate gyrus is responsible for some aspects of intelligence.
"WE HAVE NO UNDERSTANDING OF THE MECHANISMS
OF WHY THIS WORKS."
The choice of the cingulate gyrus or other parts of the limbic system in the brain as the target of modern psychosurgery is based on the belief that the limbic system is responsible for emotions that are often considered the corpus or body or substance of mental "illness". However (overlooking the humanistic costs of damaging these parts of the brain), destroying a person's ability to experience emotions isn't necessarily that simple. An article published in 1988 points out the following:
...when it comes to fear, anger, love, sadness or any of the complicated mixtures of feeling and physical response we label emotions, a loose network of lower-brain structures and nerve pathways called the limbic system appears to be key. ... The most recent research, however, indicates that the experience of emotion has less to do with specific locations in the brain and more to do with the complicated circuitry that interconnects them and the patterns of nerve impulses that travel among them. "It's a little like your television set," says neuroscientist Dr. Floyd Bloom of the Scripps Clinic and Research Foundation. "There are individual tubes, and you can say what they do, but if you take even one tube out, the television doesn't work." [U.S. News & World Report, June 27, 1988, p. 53]
This would seem to explain why victims of "psychosurgery" are often so incapacitated by the surgery they are not able to live outside a hospital or nursing home after psychosurgery even if they were able to do so prior to the surgery.
In her book Psychosurgery—Damaging the Brain to Save the Mind, published in 1992, Joann Ellison Rodgers, Director of Media Relations for The Johns Hopkins Medical Institutions, which she calls "the home of biological psychiatry", defends psychosurgery but acknowledges that "within the limbic system are the tangible roots of what make us essentially human." She says "everything that goes on in the limbic system to regulate mood, drive, and emotional reactions actually creates our conscious world, the 'real' world we must deal with every day." Yet she and other advocates of psychosurgery defend psychosurgeons destroying parts of this very same limbic system or its connections to other parts of the brain. Modern psychosurgery destroys less of the brain than prefrontal lobotomy but more specifically targets the parts of the brain that make us human. It is for this reason psychosurgery is sometimes said to be surgery that removes the soul of a human being. Ms. Rogers says "lobotomy's safer, less mutilating approximations, amygdalotomy and cingulotomy ... have consistently good outcomes" and that "Cingulotomies and related operations have helped hundreds of psychiatric patients". She quotes psychiatrist Michael Jenike of Harvard Medical School saying "the side effects" of psychosurgery "are very minimal." She quotes H. Thomas Ballantine, who she says was "one of the nation's most vocal psychosurgeons" saying "one thing we do know at least about cingulotomy is that it is safe, even if it is not always effective" (HarperCollins, pp. xi, 29, 31, 129, 184, 58, 192, 177, 181).
Similar false claims were made about prefrontal lobotomy, the original psychosurgery (unless you count trepanning by prehistoric man, which was chipping holes in the skull to allow evil spirits to escape). Prefrontal lobotomy is now thoroughly discredited. Even Joann Ellison Rodgers in her defense of psychosurgery, Psychosurgery—Damaging the Brain to Save the Mind, admits how bad prefrontal lobotomies were: She says "Lobotomies and all of early psychosurgery were experiments that failed" (p. 219). Yet a highly esteemed medical reference and medical school textbook, Anatomy of the Human Body, also known as Gray's Anatomy (by Henry Gray, F.R.S., 28th edition edited by Charles May Goss, A.B., M.D., Lea & Febiger 1966, reprinted 1970, pp. 849-850, italics in original), a required text in my Legal Medicine class in law school, says this:
The frontal area [of the brain]...contains extensive associations with other parts of the cortex and with the thalamus. The surgical operation of lobotomy, which isolates the area from the rest of the brain, especially the thalamus, has been used in the treatment of severe psychosis with generally favorable results (Freeman & Watts '48).
Obviously, the fact that a supposed therapy is endorsed in a standard, widely-used medical reference book or by our most highly esteemed specialists in human biology, health care, and medicine is not a reliable indication. Gray's Anatomy saying lobotomy has "generally favorable results" illustrates why I sometimes have more faith in common sense than in the supposed experts who write medical textbooks.
How bad the outcomes of modern psychosurgery can be and how safe modern psychosurgery isn't is illustrated by the case of Mary Lou Zimmerman, a 58 year old former bookkeeper who had a combined cingulotomy and capsulotomy in 1998 at the Cleveland Clinic in Ohio to relieve severe (so-called) obsessive compulsive disorder (washing her hands and taking showers frequently). This psychosurgery "left her without control of her limbs or bodily functions." In 2002 a jury awarded her and her husband a $7.5 million in damages (Peter Page, "7.5 Million—Jury slams Cleveland Clinic," The National Law Journal, June 24-July 1, 2002, p. A4; Benedict Carey, "New Surgery to Control Behavior", Los Angeles Times, August 4, 2003, ; "7.5 Million Psychosurgery Verdict", breggin.com).
Psychosurgery being brain damage and nothing but brain damage is even more obvious than in the cases of psychiatric drugs and electroshock. Each of these "therapies" achieve approximately the same end, albeit by different means. When I started my library research on psychosurgery I thought psychosurgery is worse, but the evidence indicates that isn't necessarily true: It depends on what drugs are used and for how long, how many electroshock "treatments" are given, the voltage and shock duration used, and on how much cutting (or burning) the psychosurgeon does.
According the Handbook of Clinical Psychopharmacology for Therapists, Sixth Edition (New Harbinger Publications 2010, by Preston et al., p. 5-6) "Psychosurgeries were carried out by the thousands in the 1940s, resulting in rather effective behavior control over agitated psychotic patients but at great human cost. Many, if not most, lobotomized patients were reduced to anergic, passive, and emotionally dead human beings." In his book The Brain, Richard M. Restak, M.D., clinical professor of neurology at George Washington University, says "psychosurgical operations turned out to have exacted an unacceptable cost. Many of the patients were changed so utterly that their friends and relatives experienced difficulty accepting them as the same individuals they knew before the operation." This contributed to what he calls "the decline of psychosurgery" (Bantam Books 1984, p. 151). That it is, or was, a decline rather than abolition is unfortunate. In his book, The Second Sin, psychiatry professor Thomas Szasz says "When a person eats too much, his intestines are short‑circuited: this is called a 'bypass operation for obesity.' When a person thinks too much, his brain is short‑circuited: this is called 'prefrontal lobotomy for schizophrenia.'" (Doubleday 1973, pp. 61‑62).
In his autobiography My Lobotomy—A Memoir, written with the help of former Newsweek correspondent Charles Fleming, Howard Dully describes being lobotomized in California in 1960 when he was 12 years old not only without his consent but without his knowledge. He refers to the hospital record:
[Dr. Walter] Freeman [the psychosurgeon] had a warning for the [hospital] nurses: "Avoid escape. The patient is full of tricks. Nurse not to leave him alone at any time. Is not to know why he is in the hospital except for examinations."
Escape? Why would I try to escape? Where would I go? I was a twelve-year-old kid in a hospital gown. My father and stepmother and doctor had all told me I was in the hospital for tests. I had no reason to believe they were lying to me. They were treating me like the Birdman of Alcatraz, but I was just a kid who had been looking forward to Jell-O [for dinner]. ... I remember waking up the next day, which would have been Saturday [after the lobotomy]. I felt bad. My head hurt. ...
Freeman's notes tell the story: "Howard entered Doctors Hospital on the 15th and yesterday I performed transorbital lobotomy. ..." [Crown Publishers 2007, p. 96-97]
Howard was lobotomized after his stepmother, with whom he had an unpleasant and adversarial relationship, contacted the lobotomist, Dr. Walter Freeman. Dully says "My father thought I was fine. Lou [his stepmother] thought I was crazy" (My Lobotomy, p. 79). He recalls this incident (Id., p. 30):
Lou was cutting all the boys' hair. I was last. I was sitting on a little stool, waiting for her to finish. She was cleaning up, using an old Electrolux vacuum cleaner to pick up the hair. For some reason, she took the metal end of the vacuum cleaner hose and hit me on the top of my head with it.
She said, "Oh, did that hurt?"
I said no. I wouldn't admit that anything hurt.
So she hit me again, but harder this time. I flinched again. She said, "How about that? Did that hurt?
I said no.
So she hit me again, real hard this time. I felt dizzy. She said, "How about that? Did that hurt?
I didn't answer. I figured if I said no again she'd hit me again. I thought she was going to knock me out.
Howard says of his stepmother, "she hated me" (Id., p. 31) and "I remember Lou being mad at me all the time" (Id., p. 81). Eventually Lou, his stepmother, came up with what she thought would be a solution:
Lou met with six psychiatrists during the spring and summer of 1960. She wanted to know what was wrong with me and what she should do about it.
But all six of the psychiatrists, I found out later, said my behavior was normal. Four of them even said the problem in the house was with her. They said she was the one who could benefit from treatment. ... That wasn't the answer she was looking for. ... So she kept looking for a doctor who would agree with her.
Sometime that fall, someone referred her to a doctor named Walter Freeman. [Id., p. 60]
In Dr. Freeman, the cruel stepmother found a doctor who agreed with her that it was not her but her stepson who was the problem, and they decided to solve the problem by lobotomizing him. After initially opposing it, Howard's father consented to the operation, giving in to the wishes of his wife.
Lobotomizing anyone, particularly a 12 year old, because he was moody, messy, rambunctious, and defiant (or any other reason), is an example of why I call psychiatry evil.
Dr. Walter Freeman, who lobotomized Howard Dully, was the leading advocate and practitioner of psychosurgery in America. According to Howard and his co-author, it was Dr. Freeman who "proposed changing the name of the procedure from leucotomy to lobotomy" (Id., p. 65), and that became the name by which most people know psychosurgery. Howard and his co-author tell us in 1946 Dr. Freeman "conducted America's first transorbital lobotomy", also known as the ice-pick lobotomy, which is, or was, done without drilling or cutting into the skull but by punching through the thin bone at the back of the eye socket known as the orbit with an ice-pick and waving the ice-pick around in the brain (Id., p. 70), hence the term "transorbital" lobotomy. This type lobotomy is so simple Dr. Freeman "began doing lobotomies in his office" (Id.) He traveled around the U.S.A. in a specially equipped vehicle he called "The Lobotomobile" (Id., p. 71). A "Lobotomy PBS [Public Broadcasting System] documentary on Walter Freeman" available on YouTube.com says "By 1967, Dr. Freeman had personally performed more than twenty-nine hundred (2,900) lobotomies." A biography of Dr. Freeman says he did the first lobotomy in the United States and that "In the United States alone, the number of lobotomized patients would soar to about forty thousand over the next four decades, and Freeman would take part in nearly thirty-five hundred of these surgeries (Jack El-Hai, The Lobotomist—A Maverick Medical Genius and His Tragic Quest to Rid the World of Mental Illness, John Wiley & Sons 2005, pp. 1, 14) It is reported that Dr. Freeman even lobotomized a patient against his will:
Freeman was ready to do the surgery whenever, wherever. One of his surgical assistants—Jonathan Williams...later told a story about a patient who had been brought to Freeman for a lobotomy. The day before the surgery, though, he'd gotten cold feet and refused to go through with the operation. He locked himself in his hotel room. Freeman, contacted by the patient's family, drove to the hotel and convinced the patient to let him in. Using a portable electroshock machine he had designed and built for himself, he administered a few volts to the patient to calm him down. According to Williams, "The patient was . . . held down on the floor while Freeman administered the shock. It then occurred to him that since the patient was already unconscious, and he had a set of leucotomes in his pocket, he might as well do the transorbital lobotomy then and there, which he did."[My Lobotomy, pp. 72-73]
Is lobotomizing a person against his will evil? Is it a more intimate kind of assault than a sexual assault? Is it more acceptable if the brain is damaged with electricity or neurotoxic and cytotoxic "medications" administered against the "patient's" will, as is commonplace today? Is it more acceptable if the patient consents to brain-damaging "therapy" after being falsely assured no harm will be done?
In her book Psychosurgery—Damaging the Brain to Save the Mind (pp. 54, 141) Joann Ellison Rodgers says "Oregon and California outlawed the practice of psychosurgery—Oregon in 1973 and California three years later ... Oregon and California passed laws establishing psychosurgery review committees, which resulted in making both voluntary and involuntary procedures virtually impossible to perform." (Should a psychosurgery review committee, or even a court, be empowered to authorize involuntary psychosurgery?) Oregon's physician licensing statute, §677.190 says this:
The Oregon Medical Board may refuse to grant, or may suspend or revoke, a license to practice for any of the following reasons: 1(a) Unprofessional or dishonorable conduct. ... 22(a) Performing psychosurgery. ... "psychosurgery" means any operation designed to produce an irreversible lesion or destroy brain tissue for the primary purpose of altering the thoughts, emotions or behavior of a human being.
By its terms even if not intent, Oregon's above definition of psychosurgery includes electroconvulsive "therapy" (ECT).
An ABC news report dated March 3, 2011 says psychosurgery has been banned by law in the Australian state of New South Wales. The report includes an interview with Richard Bittar, a neurosurgeon from the Royal Melbourne Hospital, and Dennis Velakoulis of the Australian and New Zealand College of Psychiatrists, lamenting the psychosurgery ban in New South Wales and advocating psychosurgery for severely depressed persons.
A contrary trend exists in other parts of the world: A psychiatric textbook published in 2014 titled Psychosurgery: New Techniques for Brain Disorders, says "Psychosurgery, or the surgical treatment of mental disorders, has enjoyed a spectacular revival over the past 10 years" (Springer Int'l Publishing, back cover) and "Psychosurgery is a rapidly expanding field" (Id., p. xi). A March 4, 2010 article in Science Daily says "Psychosurgery is making a comeback." A Medical Xpress article in 2012 includes the results of a study of 63 adult patients at Massachusetts General Hospital who underwent a type of psychosurgery called stereotactic anterior cingulotomy as a treatment for obsessive compulsive disorder (OCD) between 1989 and 2010. The aforementioned psychiatric textbook about psychosurgery published in 2014 and four medical journal articles about psychosurgery published in 2012 verify the sad reality of psychosurgery's return to prominence:
• Psychosurgery: New Techniques for Brain Disorders by Marc Leveque (Springer International Publishing 2014)
• "Strategies for the return of behavioral surgery", by Eljamel S., Surg Neurol Int. 2012:3(Suppl 1);S34-9. Epub 2012 Jan 14
• "The amygdala as a target for behavior surgery", by Langevin J.P., Surg Neurol Int. 2012:3(Suppl 1);S40-6. Epub 2012 Jan 14
• "Surgery of the mind, mood, and conscious state: an idea in evolution", by Robison R.A., et al, World Neurosurg. 2012 May-Jun;77(5-6);662-86. Epub 2012 Mar 21
• "Psychosurgery: Review of Latest Concepts and Applications", by Aydin S. & Abuzayed B., J Neurol Surg Cent Eur Neurosurg 2012 Oct 26. (Epub ahead of print)
Like most quack therapies, "psychosurgery" has supporters not only among its practitioners but also among at least a few of those who have received it—or perhaps I should say at least a few of those who have physically and psychologically survived it. I once met a woman who'd had a lobotomy, which was apparent at first glance because of the indentations on each side of her forehead at the hairline. She told me her husband left her when she needed what she called "brain surgery." When I asked what kind of brain surgery, she replied, "a lobotomy." She seemed surprisingly normal. Howard Dully retained enough mental capacity and memory after his lobotomy to write his autobiography, My Lobotomy—a Memoir, with the assistance of a co-author. He has also made videos about his experience you'll find by doing a search for "Howard Dully" at YouTube.com. The amount of damage done by so-called psychosurgery varies widely. The extent of damage depends on how much and what parts of the brain are severed or damaged. Psychosurgery kills some people. In The Noonday Demon—An Atlas of Depression, Andrew Solomon says "In the heyday of lobotomies, about five thousand were performed annually in the United States, causing between 250 and 500 deaths a year" (p. 163). That's a death rate of between 5% and 10%. Psychosurgery paralyzes some, causes seizure disorders in a few, and wipes out emotionality, personality, and mentality in many. However, if the psychosurgeon cuts or destroys very little of the brain it may affect the "patient" little or in no noticeable way except for power of suggestion or placebo effect. Much like those who believe their lives have been lengthened by coronary bypass surgery, contrary to scientific evidence showing no increased longevity from the operation for most people who undergo it (see Thomas J. Moore, Heart Failure: A Critical Inquiry Into American Medicine and the Revolution in Heart Care, Random House 1989, pp. 113-125), the survivors of "psychosurgery" sometimes emerge from the ordeal of the operation with a strong psychological need to believe they have benefited from the surgery and so may claim they have. But it is hard to believe they really have, for the same reason it would be hard to believe a computer programming error was corrected not by altering the programming but by disabling a part of the computer.
While brain damage from psychiatry's drugs or "medications" may not have been apparent from the start, it is or to any person with normal intelligence and common sense should have always been obvious that electroshock and psychosurgery are brain damaging. Electroshock and psychosurgery are therefore especially sad chapters in psychiatry's history of senselessly searching for physical causes of and physical treatments for problems that have not been shown to be the result of a physical or biological problem or abnormality. Just as bloodletting said something about incorrect theory and the state of ignorance in health care in the past, brain damaging "therapies" such as "psychosurgery", electroshock, and psychiatric drugs reveal much about incorrect theory and ignorance in psychiatry today. The shamefulness of the psychosurgical part of psychiatry's history—and in some quarters its present—is generally recognized, even by most psychiatrists.
Like psychiatric drugs and electroshock, "psychosurgery" may seem to some to be helpful if it eliminates the so-called symptoms of so-called mental illness. If a person is disabled enough, all of his or her "symptoms" of everything (including desirable personality traits) will be "cured". But changing or damaging a computer's hardware is not a logical or reasonable way to respond to the fact that the computer is running a program you dislike, and likewise, neither would be hiring a TV repairman to work on your TV set because there are too many annoying commercials on TV (paraphrasing Thomas Szasz in his book The Second Sin, Anchor Press 1973, p. 99). In a similar sort of way, changing a person's brain despite there being no evidence of biological abnormality is not a logical or reasonable way to respond to the fact that he is thinking, feeling emotions, or performing behavior you dislike—whether you use drugs, electroshock, or "psychosurgery".
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The author is a volunteer (pro bono) attorney for the Law Project for Psychiatric Rights (psychrights.org) and may be reached at wayneramsay (at) mail (dot) com