Correlation vs. Causation
You must read each slide, and complete any questions on the slide, in sequence.
Lobotomies: Past and Present
Psychosurgery has early roots in our history, beginning with cases of trephination, the process of opening the skull in an effort to release demonic
and evil spirits causing psychological illness (Selling, 1940). In the 1930s, a Portuguese neurologist named António de Egas Moniz developed a psychosurgery
procedure that when performed by other physicians and psychiatrists, resulted in irreversible brain damage in thousands of patients. Dr. Moniz could be
considered the “father” of the lobotomy. Years later, Walter Freeman introduced a revised procedure, the transorbital or "ice-pick" lobotomy (Cooper, 2014;
Freeman, 1950). This procedure became a popular treatment method prior to the introduction of psychotropic medications. Freeman (1950) described the procedure
as “a sharp pointed instrument [being] driven through the orbital plate by way of the conjunctival sac and moved about” (p. 270). In other words, an ice pick
was driven through the eye socket and moved in a circular motion to sever nerves and gray matter from the brain in an effort to relieve a patient of the
distress associated with psychological symptoms. Adults with a variety of psychological symptoms (e.g., depression, anxiety, schizophrenia), as well as
children with psychological and behavioral symptoms (e.g., aggression, unruliness, insubordination) were deemed appropriate candidates for transorbital lobotomy
in the 1940s through 1960s (Gostin, 1980). Potential side effects ranged from intellectual and emotional impairment to personality shifts and changes in affect,
including a flat and withdrawn affect. Even “vegetable like states” were noted, among other physical side effects such as incontinence and seizures (Gostin, 1980).
However, because these procedures did not always result in immediate, noticeable deficits, in many cases patients walked away with relief from their
psychological ailments, which in turn resulted in a continued use of the procedure. Howard Dully was one of Dr.Freeman’s patients who received a transorbital
lobotomy when he was 12 years old. Dully wrote a memoir describing the impact of the lobotomy on his childhood and adulthood. Lobotomies are still performed,
but only in rare cases of severe depression and schizophrenia, in which patients are unresponsive to all other forms of treatment.
After reading the article written by Dr. Walter Freeman in 1950, “Psychosurgery,” and the contemporary NPR article, consider the questions below.
(An additional video clip of Howard Dully may also be viewed.) Then submit your responses.
One possible answer might be that individuals suffering from mental illness are willing to try extreme measures for symptom relief, even with the possibility of negative side effects.
One possible answer might be that an extensive operation, indicating a large quantity of frontal lobe disconnection reduced the patient to a state of helplessness. Freeman would describe this patient as lazy, rude, boisterous, restless, and inane; and that he or she was relatively unteachable, having lost those social skills that are necessary for living outside an institution.
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