Development of Psychosurgery From the Early 1800’s
Was psychosurgery, also known as brain surgery and neurosurgery, safer before the year 2000 or after? First off, what is psychosurgery? Psychosurgery is surgery on the brain in order to treat a psychotic or mental disorder. In order to treat the patient part of the brain has to be destroyed or expunged. Psychosurgery is generally used to treat severe depression and Obsessive Compulsive Disorder (OCD).
Since the 1800’s, brain surgery was slowly approaching the world. It began with a Swiss psychiatrist, Gottlieb Burckhardt. In the 1930’s a Portuguese neurologist, Antonio Egas Moniz, continued Burckhardt’s work, following the procedure of leucotomy. Leucotomy is the surgical procedure of cutting white nerve fibers within the brain. Within the same period in the United States, neuropsychiatric, Walter Freeman, and neurosurgeon, James Watts, conceived the standard prefrontal procedure. They later named their technique “lobotomy” (https://www.princeton.edu/~achaney/tmve/wiki100k/docs/Psychosurgery.html).
In the 1940’s curiosity of psychosurgery increased, despite the fact that it meant a great chance of death. This surgery also caused permanent damage with personalities. By the end of the decade, up to 5,000 psychosurgical operations were being done annually in the U.S. Going into the 1950’s, the use and thought of psychosurgery diminished, due to new drugs and the awareness of long term damage caused by the surgeries. During the 1960’s and 1970’s psychosurgery became the subject of escalating public concern and debate, concluding in the US with congressional hearings. Mainly divisive in the United States was the work of Harvard neurosurgeon, Vernon Mark and psychiatrist Frank Ervin,...
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...mall minority of neurologists supports the use of very precise surgical techniques to produce small abrasions in defined areas of the brain to treat rare cases of severe mental illness such as life-threatening depression or impaired anxiety or obsessions. However, there is little need for such procedures today. Antipsychotic and antidepressant medications are the treatments of choice for treating mental disorders. Mainstream medicine now classifies psychosurgery as an experimental procedure, and many rules exist to protect patients who might be subjected to it. The majority of mental health professionals believe that psychosurgery is either never justified or should only be considered as a last resort, to be reserved for the most extreme cases of untreatable mental disease when all other therapies have failed (http://www.minddisorders.com/Ob-Ps/Psychosurgery.html).
The early history of mental illness is bleak. The belief that anyone with a mental illness was possessed by a demon or the family was being given a spiritual was the reason behind the horrific treatment of those with mental illness. These individuals were placed into institutions that were unhygienic and typically were kept in dark, cave like rooms away from people in the outside world. The institutions were not only dark and gross; they also used inhumane forms of treatment on their patients. Kimberly Leupo, discusses some of the practices that were used, these included may types of electro shocks, submitting patients to ice bath, as well as many other horrific events (Leupo). Lobotomies, which are surgical procedures that cut and scrape different connections in the brain, were very common practice. They were thought to help cure mental illness, but often ended up with more damage than good.
The clip that was particularly memorable was the story of both Katie Worrick and Michael Rehbein’s hemispherectomy. From a neurological perspective, it was astounding to watch both these children survive and function without a part of their brain and if that wasn’t enough they were functioning remarkably well from a cognitive point of reference. I did wonder at first why Katie was still not speaking, but realized that her surgery was still recent when the documentary was made. Just like Michael, who took about 2 years after surgery to regain some of his speech after persistently working on it, Katie too could hope for the same. Having said that, I am also aware of Neuroscientist Dana Boatman’s conclusion that results and recovery times vary from child to child. I did try to find out more about the two children featured in this documentary to see how much life had improved, but could not find any documented information except for an answer to a blog about hemispherectomy by Katie’s mom that said, “My name is Janie Warrick and I live in Richmond, VA. My daughter, Katie who is now 17, had a left hemispherectomy Aug. 8, 2000 in Baltimore, Maryland at Johns Hopkins
In Sam Kean’s The Tale of Dueling Neurosurgeons, he uses historical events to explore the brain’s many components and qualities. Exposing that several scientific advancements of the human brain are a result of some gruesome incidents and tragic stories. The title is in reference to two brain doctors from 16th century Europe, Ambroise Paré and Andreas Vesalius who were called upon after King Henri II was pierced through the eye and skull during a joust in 1559. The story is written with Kean being the narrator of the cases from the past he then follows the story with current information of the related brain structure and its functioning. The cases include strokes, seizures, infectious diseases, and traumatic accidents followed by how the victim
Snell, Richard S: Clinical Neuroanatomy for Medical Students. Little, Brown, and Company, Boston, 1957, pp. 220--222.
One of the most famous forms of a cure during the 1930s was a surgery called Lobotomy. “Lobotomy, also known as leucotomy which mean cut/slice white in Greek, or its nickname of ice pick, is a neurosurgical operation that involves severing connection in the brain’s prefrontal lobe” according to Freeman. Lobotomy was performed by
The film gives a historical overview of how the mentally ill have been treated throughout history and chronicles the advancements and missteps the medical community has made along the way. Whittaker recounts the history of psychiatric treatment in America until 1950, he then moves on to describe the use of antipsychotic drugs to treat schizophrenia. He critically summarizes that it is doctors, rather than the patients, who have always calculated the evaluation of the merits of medical treatment, as the “mad” continue to be dismissed as unreliable witnesses. When in fact it is the patient being treated, and their subjective experience, that should be foremost in the evaluation. The film backs up this analysis with interviews of people, living viable lives in the town of Geel, Belgium. I would recommend this film to anyone interested in the history of medicine and specifically to those examining mental illness. It provides a balanced recounting of historical approaches to mental illness, along with success stories of the people of Geel, Belgium. And although I had to look away during the viewing of a lobotomy procedure, I give credit to the power of the visual impact the footage
As science has evolved, so have treatments for mental illnesses have over time. The medical model is described as the view that psychological disorders are medical diseases with a biological origin (King, 2010, pg. 413). Abnormal behavior that categorizes some disorders can be impacted by biological factors such as genes, psychological factors such as childhood experiences, and even sociocultural factors such as gender and race (King, 2010). Treatments such as psychosurgery (lobotomy) , drug therapy (pharmaceuticals), electroconclusive therapy, and psychoanalysis are used to treat a wide range of psychological disorders. Back then, the public’s negative views on mental illnesses also went as far to associate with the people who treated it; psychiatrists. “Nunnally (1961) found that the public evaluated professionals who treated mental disorders significantly more negatively than those who treat physical disorders,” (Phelan, Link, Stueve, & Pescosolido, 2000, pg. 189). People back then didn’t see the point in “paying to be told that they were crazy”. However, in today’s society, it is now acceptable to seek help from psychiatric professionals; we are seeing more and more people seek mental health treatment. “In terms of facility-based records of utilization (Manderscheid and Henderson 1998), the data suggest that the rate of utilization of professional mental health services has at least doubled and maybe tripled, between the 1950’s and today,” (Phelan, Link, Stueve, & Pescosolido, 2000, pg. 189). In the 1950’s, neuroleptic drugs like Thorazine were introduced to treat the symptoms of schizophrenia. These drugs block a neurotransmitter called dopamine from getting to the brain, which in turn reduce schizophrenic symptoms, however there are some side effects such as substantial twitching of the neck, arms, and legs, and even dysphoria or lack of pleasure. (King, 2010, pg.
"The History of Mental Illness: From "Skull Drills" to "Happy Pills"" RSS. Web. 09 Apr. 2014. .
As a Psychiatrist, they are to proficiently understand the function of the human mind to be able to penetrate into their patient’s thoughts and feelings. These medical doctors are required to spend approximately twelve years gaining a better insight into the complex structure of the brain. They are trained to understand how specific sections of the brain work together to achieve varieties of functions and how a mutation can cause a severe malfunction (Zorumski and Rubin). As a result of the years spent training, Psychiatrists are to differentiate and categorize physical and psychosomatic stress caused by chemical changes in the special parts of the brain. Psychiatrists are also trained to use neurotic technologies such as deep brain stimulation. Additionally, the medical doctors are equi...
Danvers, an insane asylum in Boston, Massachusetts was the rumored birthplace of the procedure known as lobotomy (Taylor). Dr. Walter Freeman studied lobotomy, and he was the first to practice the procedure. Lobotomy began with electric shock to the forehead. Then the eye lids were folded back and an ice pick was used to sever the frontal lobes. The patient would have black eyes after this awful procedure. This was supposed to cure an insane person (“YouTube”).
The treatment involved passing electrical currents through the brain which would trigger a small seizure and ease the symptoms of certain mental illnesses, however the procedure was used without anesthesia and caused the patient to jerk uncontrollably, this treatment would sometimes result in fractures, memory loss, and other side effects. The treatment is still used today, although with much weaker currents and anesthesia. Another popular treatment used in the asylums was the injection of insulin into a patient to induce a coma. This treatment was thought to reset an individual’s brain and bring them back to “normal”, however, insulin coma therapy proved to be not very effective and was phased out in the 1960s. One of the most inhumane treatments for the mentally ill was the lobotomy, or the prefrontal leucotomy. This surgical procedure involved opening a hole in the head to sever nerve pathways in the prefrontal cortex. The lobotomy was performed at least 15,000 times in Britain before being phased out in the late 1950s. Another type of brain surgery discussed in the film, was one done on patient, Maggi Chapman, who underwent a surgery in which an electrode was attached to a part of her brain and then turned on to fry that part of the brain. Maggi goes on to describe how the next few years she felt like a zombie and had a difficult time going through life (BBC,
Psychiatry is a medical field that deals with the diagnoses, prevention, and treatment of mental disorders. The FDA is constantly approving drugs for psychiatrists to use that are supposed to help with in their practice. For example, Michael Levin-Epstein, who wrote the article “A New Way to Deliver Psychiatric Meds: Drugs for ADHD and Major Depression Now Can Be Delivered with Skin Patches,” shows how pharmacotherapy is continually being advanced by new ideas and approaches. However, Psychiatric drugs are not always the answer. Prescriptions are not a good remedy when it comes to the overcoming of a mental illnesses, because there is not enough information regarding the effects of the drugs, pharmaceutical companies are driven by profits,
Szasz, Thomas. Coercion as Cure: A Critical History of Psychiatry. New Brunswick, New Jersey: Transaction, 2007. Print. Braslow, Joel T. Mental Ills and Bodily Cures: Psychiatric Treatment in the First Half of the Twentieth Century. California: University of California, 1997. Print.
Mental illness, today we are surround by a broad array of types of mental illnesses and new discoveries in this field every day. Up till the mid 1800’s there was no speak of personality disorder, in fact there was only two type of mental illness recognized. Those two illnesses as defined by Dr. Sam Vaknin (2010), “”delirium” or “manial”- were depression (melancholy), psychoses, and delusions.” It was later in 1835 when J. C. Pritchard the British Physician working at Bristol Infirmary Hospital published his work titled “Treatise on Insanity and Other Disorder of the Mind” this opened the door to the world of personality disorder. There were many story and changes to his theories and mental illness and it was then when Henry Maudsley in 1885 put theses theories to work and applied to a patient. This form of mental illness has since grown into the many different types of personality disorder that we know today. Like the evolution of the illness itself there has been a significant change in the way this illness is diagnosed and treated.
Psychiatry has been a science and study, of and for, the treatment of mental illness. Since the 1900s, a cultural and social stigma has solidified the fear of men and women who have been touched by the unpleasant management of the treatment of those with these illnesses. The way we teach the individuals how to cope with and care for the loved ones that have a mental illness, seems to have fallen short of the way we show those how to care for loved ones with diabetes or heart disease. The average person’s response when they are frightened by something in the twenty-first century is that all answers can now be found on the world wide web. Unfortunately, the web can be a source of misinformation, miscommunication, and all sorts of ludicrous opinions