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Encyclopedia > Psychosurgery

Psychosurgery is a term for surgeries of the brain involving procedures that modulate the performance of the brain, and thus effect changes in cognition, with the intent to treat or alleviate severe mental illness. It was originally thought that by severing the nerves that give power to ideas you would achieve the desirable result of a loss of affect and an emotional flattening which would diminish creativity and imagination; the idea being that those are the human characteristics that are disturbed. Historically, the procedure typically considered psychosurgery, prefrontal leukotomy is now almost universally shunned as inappropriate, due in part to the emergence of less-invasive or less-objectionable methods of treatment such as psychiatric medication and modified electroconvulsive therapy. In modern neurosurgery however, more minimally invasive techniques like gamma knife irradiation and foremost deep brain stimulation have arisen as novel tools for psychosurgery. A cardiothoracic surgeon performs a mitral valve replacement at the Fitzsimons Army Medical Center. ... In animals the brain, or encephalon (Greek for in the head), is the control center of the central nervous system. ... Mental Illness. ... A human brain that had undergone leukotomy. ... Psychopharmacology is the study of the effects of any psychoactive drug that acts upon the mind by affecting brain chemistry. ... Electroconvulsive therapy (ECT), also known as electroshock, is a psychiatric treatment in which seizures are induced by passing electricity through the brain of an anaesthetised patient. ... In medicine, Leksell Gamma Knife is a neurosurgical device used to treat brain tumors. ... In neurotechnology, deep brain stimulation (DBS) is a surgical treatment involving the implantation of a medical device called a brain pacemaker, which sends electrical impulses to specific parts of the brain. ...

Contents

History

There is evidence that trepanning (or trephining)—the practice of drilling holes in the skull for pseudomedical reasons—has been in widespread, if infrequent, use since 5000 BC. This may have been done in an attempt to allow the brain to expand in the case of increased brain fluid pressure, for example, after head injuries. (Several documented cases of healed wounds indicate that such crude surgery could be survived back then.) However, psychosurgery as understood today was not commonly practiced until the early 20th century. 18th century French illustration of trepanation Trepanation (also known trepanning, trephination, trephining or burr hole) is a form of surgery in which a hole is drilled or scraped into the skull, thus exposing the dura mater in order to treat health problems related to intracranial diseases, though in the modern... // Events 4860 BC - Mount Mazama in Oregon collapses, forming a caldera that later fills with water and becomes Crater Lake, the deepest lake in the United States. ...


The first systematic attempts at human psychosurgery occurred from 1935, when the neurosurgeon Egas Moniz teamed up with the surgeon Almeida Lima at the University of Lisbon to perform a series of prefrontal lobotomies —a procedure severing the connection between the prefrontal cortex and the rest of the brain. 1935 (MCMXXXV) was a common year starting on Tuesday (link will display full calendar). ... António Caetano de Abreu Freire Egas Moniz (November 29, 1874 - December 13, 1955) was a Portuguese physician and neurologist. ... The University of Lisbon (Universidade de Lisboa) is a leading public university in Lisbon, Portugal, and is composed by eight faculties. ... A human brain that has undergone lobotomy. ... The frontal lobe is an area in the brain of vertebrates. ... In animals the brain, or encephalon (Greek for in the head), is the control center of the central nervous system. ...


Moniz and Lima claimed fair results, especially in the treatment of depression, although about 6% of patients did not survive the operation, and there were often marked and adverse changes in the patients' personality and social functioning. Despite the risks the process was taken up with some enthusiasm, notably in the U.S., as a treatment for previously incurable mental conditions. Moniz received a Nobel Prize in 1949. Clinical depression (also called major depressive disorder, or sometimes unipolar when compared with bipolar disorder) is a state of intense sadness, melancholia or despair that has advanced to the point of being disruptive to an individuals social functioning and/or activities of daily living. ... Motto: (Out Of Many, One) (traditional) In God We Trust (1956 to date) Anthem: The Star-Spangled Banner Capital Washington D.C. Largest city New York City None at federal level (English de facto) Government Federal constitutional republic  - President George Walker Bush (R)  - Vice President Dick Cheney (R) Independence from... List of Nobel Prize laureates in Physiology or Medicine from 1901 to the present day. ... 1949 (MCMXLIX) was a common year starting on Saturday (the link is to a full 1949 calendar). ...


The initial criteria for treatment were quite steep—only a few conditions of "tortured self-concern" were put forward for treatment. Severe chronic anxiety, depression with risk of suicide and incapacitating obsessive-compulsive disorder were the main symptoms treated. The original lobotomy was a crude operation and the practice was soon developed into a more exact stereotactic procedure where only very small lesions were placed in the brain. Clinical depression (also called major depressive disorder, or sometimes unipolar when compared with bipolar disorder) is a state of intense sadness, melancholia or despair that has advanced to the point of being disruptive to an individuals social functioning and/or activities of daily living. ... It has been suggested that The Pros of suicide be merged into this article or section. ... Stereotactic surgery or stereotaxy is a minimally-invasive form of surgical intervention which makes use of a three-dimensional coordinates system to locate small targets inside the body and to perform on them some action such as ablation (removal), biopsy, lesion, injection, stimulation, implantation, radiosurgery etc. ... In animals the brain, or encephalon (Greek for in the head), is the control center of the central nervous system. ...


The procedure was popularised in the United States when Walter Freeman invented the "ice pick lobotomy" procedure, which literally used an ice pick and rubber mallet instead of the standard surgical lobotomy. Leaving no visible scars, the ice pick lobotomy was heralded as a great advance in "minimally invasive" surgery, and was eventually done under only local anaesthesia which was accomplished through electroshock admistered to the patient moments before the procedure.[citation needed] Dr. Walter Jackson Freeman II (November 14, 1895 – May 31, 1972) was a physician, born in Philadelphia, Pennsylvania, graduate of Yale and the University of Pennsylvania Medical School, advocate and very prolific practitioner of psychosurgery, specifically lobotomy. ... Icepick. ... A rubber mallet, used in construction, woodworking, and auto-body work. ... A human brain that has undergone lobotomy. ...


In what is widely considered to be a highly invasive procedure, Freeman would hammer the ice pick into the skull just above the tear duct and wiggle it around. Between 1936 through the 1950s, he advocated lobotomies throughout the United States. Such was Freeman's zeal that he began to travel around the nation in his own personal van, which he called his "lobotomobile" .[1] , demonstrating the procedure in many medical centres. He reputedly even performed a few lobotomies in hotel rooms.[citation needed] 1936 (MCMXXXVI) was a leap year starting on Wednesday (link will take you to calendar). ... // Recovering from World War II and its aftermath, the economic miracle emerged in West Germany and Italy. ...


Freeman's advocacy led to great popularity for lobotomy as a general cure for all perceived ills, including misbehaviour in children. Ultimately between 40,000 and 50,000 patients were lobotomised. A follow-up study of almost 10,000 patients claimed 41% were "recovered" or "greatly improved", 28% were "minimally improved", 25% showed "no change", 4% had died, while only 2% were made worse off (Tooth, et al. 1961). Lobotomies gradually became unfashionable with the development of antipsychotics and are no longer performed. The era of lobotomy is now generally regarded as a barbaric episode in psychiatric history. A male Caucasian toddler child A child (plural: children) is a young human. ... The term antipsychotic is applied to a group of drugs used to treat psychosis. ...


It is possible that some patients did benefit from the more precise psychosurgery, but there was a strong division amongst the medical profession as to the viability of the treatment and concern over the irreversible nature of the operation and the extension of the surgery into the treatment of unsuitable cases (drug or alcohol dependence, sexual disorders, etc). Whatever the truth, psychosurgery was offered in only a few centres, and by the 1960s the number of operations was in decline. The signal improvements in psychopharmacology and behaviour therapy gave the opportunity for more effective and less-invasive treatment. Psychopharmacology is the study of the effects of any psychoactive drug that acts upon the mind by affecting brain chemistry. ... Behaviour therapy is a form of psychotherapy used to treat depression, anxiety disorders, phobias, and other forms of psychopathology. ...


Legal restrictions

In 1977, the U.S. Congress created a National Committee for the Protection of Human Subjects of Biomedical and Behavioral Research to investigate allegations that psychosurgery, including lobotomy techniques, was used to control minorities, restrain individual rights or that it had unethical after-effects. It concluded that, in general, psychosurgery had positive effects. However, concerns about lobotomy steadily grew, and countries such as Germany, Japan and several U.S. states prohibited it.[2] For the album by Ash, see 1977 (album). ...


In Australia, psychosurgery is performed by a select group of neurosurgeons. In Victoria, each individual operation must receive the consent of a Review Board before it may proceed. Old German engraving depicting a trepanation, an ancient and still performed neurosurgical procedure Neurosurgery is the surgical discipline focused on treating those central and peripheral nervous system diseases amenable to mechanical intervention. ... Capital Melbourne Government Const. ...


The Soviet Union made lobotomies illegal in 1951.


Neurological effect

The frontal lobe of the brain controls a number of advanced cognitive functions, as well as motor control. Motor control is located at the rear of the frontal lobe, and is usually unaffected by psychosurgery. The anterior or prefrontal area is involved in impulse control, judgement with everyday life and situations, language, memory, motor function, problem solving, sexual behaviour, socialization and spontaneity. Frontal lobes assist in planning, coordinating, controlling and executing behaviour. The frontal lobe is an area in the brain of vertebrates. ... 15:18, 18 December 2006 (UTC)15:18, 18 December 2006 (UTC)~~PT The prefrontal cortex is the anterior part of the frontal lobes of the brain, lying in front of the motor and premotor areas. ...


Thus, the efficacy of psychosurgery was often related to changes in personality and reduced spontaneity (this included making the person quieter and decreasing their craving to be sexually active). Certain processes related to schizophrenia are also believed to occur in the frontal lobe, and may explain some success. However, certain types of inappropriate behaviours increased as a function of reduced impulse control (in some respects they became more childlike). Further, it decreased their ability to function as a member of the community by reducing their problem solving and planning abilities and making them less flexible and adaptive. It usually had no bearing on IQ except with respect to problem solving. IQ redirects here; for other uses of that term, see IQ (disambiguation). ...


Present day

Today, psychosurgery is not as frequently practiced as it was in the 1930s, '40s, '50s, and '60s. It may be a treatment of last resort for OCD sufferers; and anorexic patients in Chile, the United States, Sweden and Mexico. The efficacy is not high; one study of cingulotomy (which usually involves a 2–3 cm lesion in the cingulum near the corpus callosum) found improvement in 5 out of 18 patients (Baer et al., 1995). For other things named OCD, see OCD (disambiguation). ... Eating disorders are a group of mental disorders that interfere with normal food consumption. ...


Psychosurgery is legally practiced in controlled and regulated U.S. centers, or in Finland, Sweden, United Kingdom, Spain, India, Belgium and Netherlands. In France, 32 psychosurgical operations were made between 1980 and 1986 according to an IGAS report; about 15 each year in the UK, 70 in Belgium, and about 15 for the Massachusetts General Hospital of Boston.[2] The Inspection Générale des Affaires Sociales (IGAS), created in 1967, is a French governmental body concerned with health and social policies. ...


Some consider use of endoscopic sympathetic block (ESB) for patients with anxiety disorder to be a psychiatric treatment, despite it not being surgery of the brain[1]. ESB disrupts brain regulation of many organs normally affected by emotion, such as the heart. There also is preliminary finding of its positive effect on the metabolism of serotonin in the brain. A large study demonstrated significant reduction in "alertness" and "fear" in patients with social phobia as well as improvement in their quality of life [2]. ESB for anxiety is advocated as an alternative by surgeons on the internet [3][4], most psychologists, however, prefer medication and counseling. Anxiety disorder is a blanket term covering several different forms of abnormal, pathological anxiety, fears, phobias and nervous conditions that may come on suddenly or gradually over a period of several years, and may impair or prevent the pursuing of normal daily routines. ...


Famous people who underwent lobotomy

Death mask of Phineas Gage Phineas P. Gage (1823 – May 21, 1860) was a railroad construction foreman, who suffered a traumatic brain injury, caused when a tamping iron accidentally passed through his skull, damaging the frontal lobes of his brain, causing the supposed inversing of his emotional, social and personal... Year 1848 (MDCCCXLVIII) was a leap year starting on Saturday (link will display the full calendar) of the Gregorian Calendar (or a leap year starting on Monday of the 12-day slower Julian calendar). ... Josef Hassid was a Polish violinist born on December 28, 1923. ... Rose Marie Kennedy (September 13, 1918 – January 7, 2005) was the third child and first daughter of Joseph and Rose Kennedy, born a year after the U.S. President John F. Kennedy. ... John Fitzgerald Kennedy (May 29, 1917 – November 22, 1963), also referred to as John F. Kennedy, JFK, John Kennedy or Jack Kennedy, was the 35th President of the United States. ... Thomas Lanier Williams (March 26, 1911 - February 25, 1983), better known by the pen name Tennessee Williams, was a noted playwright. ... Thomas Lanier Williams III (March 26, 1911 – February 25, 1983), better known by the pen name Tennessee Williams, was a major American playwright and one of the prominent playwrights of the twentieth century. ...

Fictional examples

  • Frances Farmer: Though Farmer is the person perhaps best associated in the public mind with lobotomy due to its depiction in the fictionalized biographical film Frances, archival medical and other records have conclusively proven Farmer never underwent the procedure. The author who initially alleged the lobotomy later admitted in court he had made it up.[5] (Footnoted site contains court transcripts which are also available through LexisNexis.)
  • Ken Kesey's famed fictional character, Randle Patrick McMurphy, in One Flew Over the Cuckoo's Nest who was, in the movie, played by Jack Nicholson.
  • J. Frank Parnell, erratic driver of the radioactive Chevy Malibu in the movie Repo Man.
  • A Hole in One, a 2004 movie about a young lady who wants an ice pick lobotomy during the height of its popularity.
  • Rat Korga, major character in Samuel R. Delany's science fiction novel Stars in My Pocket Like Grains of Sand, voluntarily opts for psychosurgery to make him content to be a slave.
  • Several victims of a serial killer named Gerry Schnauz in an episode of The X-Files entitled "Unruhe".
  • Session 9, a 2001 horror movie about a group of men hired to remove the asbestos from a defunct mental hospital.
  • Hannibal, in which Hannibal Lecter lobotomizes Paul Krendler, played by Ray Liotta.
  • In the book The Bell Jar by Sylvia Plath, the character Esther Greenwood meets a girl named Valerie in the asylum who has had a lobotomy.
  • Iron Maiden's famous fictional mascot, Eddie, was lobotomised on-stage during one of Maiden's live shows; this concert was filmed for German TV but that particular segment was cut out due to being deemed "Too violent". The cover of their fourth album Piece of Mind (and many of the following releases) shows Eddie after being lobotomised.
  • In the book Cyteen by C.J. Cherryh, psychosurgery involves the use of drugs that bring the mind into a state where it is very receptive to audio and/or visual cues, which help the psychosurgeon to reprogram the individual. This procedure is non-invasive, and involves administering drugs versus actual surgery.
  • In the television miniseries Kingdom Hospital, the character Mary was killed by a botched lobotomy. In the companion book, The Journals of Eleanor Druse, Eleanor had a transorbital lobotomy in her childhood.

Frances Elena Farmer (September 19, 1913 – August 1, 1970) was an American film actress. ... Nexis redirects here. ... Kenneth Elton Kesey (September 17, 1935 – November 10, 2001) was an American author, best known for his novel, One Flew Over the Cuckoos Nest, and as a (counter) cultural figure who, some consider, was a link between the beat generation of the 1950s and the hippies of the 1960s. ... One Flew Over the Cuckoos Nest (1962) is a fictional novel by Ken Kesey. ... This article refers to the actor. ... The four alien bodies. Repo Man is a 1984 cult film directed by Alex Cox, produced by Michael Nesmith, and starring Emilio Estevez and Harry Dean Stanton. ... 2004 (MMIV) was a leap year starting on Thursday of the Gregorian calendar. ... Samuel Ray Delany, Jr. ... Science fiction is a form of speculative fiction principally dealing with the impact of imagined science and technology, or both, upon society and persons as individuals. ... Stars in my Pocket like Grains of Sand (1984) is a science fiction novel by Samuel R. Delany. ... For other uses, see The X-Files (disambiguation). ... This article contains episode information and plot summaries from the television show The X-Files. ... Session 9 is a 2001 psychological thriller/horror film directed by Brad Anderson. ... 2001 (MMI) was a common year starting on Monday of the Gregorian calendar. ... Fibrous asbestos on muscovite Asbestos Asbestos Asbestos (a misapplication of Latin: asbestos quicklime from Greek : a, not and sbestos, extinguishable) describes any of a group of minerals that can be fibrous, many of which are metamorphic and are hydrous magnesium silicates. ... Hannibal is a 2001 film, directed by Ridley Scott about Hannibal Lecters time in Italy following his escape from imprisonment. ... This article or section does not adequately cite its references or sources. ... Paul Krendler is a fictional character appearing in the latter two novels in Thomas Harriss Hannibal Lecter series, The Silence of the Lambs and Hannibal. ... Ray Liotta (born Raymond Julian Vicimarli on December 18, 1954) is an American actor. ... Sylvia Plath (October 27, 1932 – February 11, 1963) was an American poet, novelist, short story writer, and essayist. ... Iron Maiden are an English heavy metal band from east London. ... Eddie, the iconic mascot of Iron Maiden, has been featured on the artwork of almost every Maiden album and single Eddie, whose full name is Eddie the Ead or Edward the Head also known as Edward the Great (see below), is the British heavy metal band Iron Maidens mascot. ... Piece of Mind is the fourth studio album by British heavy metal band Iron Maiden. ... This article needs to be cleaned up to conform to a higher standard of quality. ... C. J. Cherryh is the slightly modified working name of author Caroline Janice Cherry (born September 1, 1942), the sister of artist David A.Cherry. ... Stephen Kings Kingdom Hospital was a thirteen-episode miniseries based on Lars von Triers Riget, which was developed by horror writer Stephen King in 2004 for American television. ...

References

  1. ^ V. Mark Durand & David H. Barlow. "Essentials of Abnormal Psychology, 4th edition", Thomson Wadsworth, 2006.
  2. ^ a b "La neurochirurgie fonctionnelle d'affections psychiatriques sévères", Comité Consultatif National d'Ethique, April 25, 2002.
  • Baer, L., et al. (1995). Cingulotomy for intractable obsessive-compulsive disorder. Archives of General Psychiatry, 52, 384-392.
  • G. Rees Cosgrove, Scott L. Rauch: "Psychosurgery" Neurosurg. Clin. N. Am. 1995; 6:167-176 online version
  • Davison, G. C., & Neale, J. M. (1998) Abnormal Psychology (7th Ed.). New York, John Wiley.
  • Pohjavaara P, Telaranta T, Vaisanen E. The role of the sympathetic nervous system in anxiety: Is it possible to relieve anxiety with endoscopic sympathetic block? Nord J Psychiatry 2003;57:55-60. PMID 12745792.
  • Renato M.E. Sabbatini: The History of Psychosurgery. Brain & Mind, September 1997.
  • Pohjavaara P (2004): "Social Phobia, Etiology, Course and Treatment with Endoscopic Sympathetic Blockade (ESB)" [6]
  • Valenstein, Elliot S. (1986). Great and desperate cures the rise and decline of psychosurgery and other radical treatments for mental illness. New York, NY: Basic Books.

Renato M.E. Sabbatini Renato Marcos Endrizzi Sabbatini, Brazilian biomedical and computer scientist, educator, science writer, entrepreneur and administrator, born in Campinas, State of São Paulo, Brazil, on 20 February 1947. ...

See also

Beginning in the 1960s, a movement called anti-psychiatry claimed that psychiatric patients are not ill but are individuals that do not share the same consensus reality as most people in society. ... The frontal lobe is an area in the brain of vertebrates. ... Insertion of an electrode during neurosurgery for Parkinsons disease. ... Medical torture describes the involvement and sometimes active participation of medical professionals in acts of torture, to either to judge what victims can endure, to apply treatments which will enhance torture, or as torturers in their own right. ...

External links


  Results from FactBites:
 
Psychosurgery - Wikipedia, the free encyclopedia (1648 words)
Psychosurgery is a term for surgeries of the brain involving procedures that modulate the performance of the brain, and thus effect changes in cognition, with the intent to treat or alleviate severe mental illness.
Historically, the procedure typically considered psychosurgery, prefrontal leukotomy is now almost universally shunned as inappropriate, due in part to the emergence of less-invasive methods of treatment such as psychiatric medication.
Psychosurgery should not be confused with the practice of psychic surgery—surgery purportedly performed by paranormal means.
Leukotomy - Wikipedia, the free encyclopedia (495 words)
In 1977, the US Congress created a National Committee for the Protection of Human Subjects of Biomedical and Behavioral Research to investigate allegations that psychosurgery, including lobotomy techniques, was used to control minorities, restrain individual rights or that it had unethical after-effects.
It concluded that, in general, psychosurgery had positive effects.
Psychosurgery -- Brain surgery intended to treat or alleviate severe mental illness.
  More results at FactBites »

 
 

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