[teejai]

http://scienceblogs.com/neurophiloso...lobotomy_a.php

A forthcoming PBS documentary called The Lobotomist examines the career of psychiatrist Walter J. Freeman, who performed nearly 3,000 "ice pick" lobotomies during the late 1930s and 1940s.


http://www.pbs.org/wgbh/amex/lobotomist/
Available for viewing online from Jan 22nd.

[pachyderm]

One of the links from

http://www.pbs.org/wgbh/amex/lobotomist/

leads eventually to a discussion of mental illness and John Nash (A Brilliant Madness) at

http://www.pbs.org/wgbh/amex/nash/sf.../sf_forum.html

by an "expert" panel. The "experts" include Laurie Flynn and E. Fuller Torrey, both of NAMI in the old days, and a short perusal of the answers to the questions posed indicates to me that the points of view expressed in the answers are pretty standard psychiatric talking points.

Oh yes: the Portuguese neurologist António Egas Moniz was awarded the Nobel prize in 1949 for his "invention" of the prefrontal lobotomy. So much for the wisdom of the "authorities" in matters of mental illness.

[spiritual_emergency]

<blockquote>
Robert Whitaker offers the following...

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5. Brain Damage as Miracle Therapy

The fourth "brain-damaging" therapeutic that was embraced in asylum medicine in the 1930s and early 1940s was prefrontal lobotomy. This operation was pronounced safe and effective in numerous trials, and in 1949 its inventor, Portuguese neurosurgeon Egas Moniz, was awarded the Nobel Prize in Medicine. Many physicians who tried it concluded that the operation could not possible harm the mentally ill, and during the 1940s newspapers and magazines regularly wrote about this "miracle" therapy for curing mental disorders. Today, this operation is viewed as a mutilating surgery, and its rise and fall provides a cautionary tale about the capacity of a society to delude itself about the merits of its medical treatments for the mentally ill.

Source: Mad In America



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[spiritual_emergency]

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<font size=4>Psyche's Torn Curtain</font>

Now seen as misguided butchery, lobotomies were once the treatment of choice for mental illness. Doctors, patients confront a dark past.

<font size=1>By Benedict Carey, Times Staff Writer</font>

SANTA CRUZ — He is a big man with a sweep of white hair who lives in a small apartment by the sea, not far from the San Jose hospital where a doctor gouged his brain with a steel wand more than 40 years ago.

The doctor had recommended the operation, and Howard's parents agreed to it. They thought it was the only way to relieve their 12-year-old son's "adolescent anxiety," to subdue his anger, to set his life straight.

It didn't work out that way. Howard made far more mischief after the operation than he had before. He has struggled with anxiety, fits of anger and moodiness for much of his life. Eventually, he found a kind of peace. Today, at 55, he has a job, a wife who loves him, a sense of humor and a view of Monterey Bay from his easy chair.

Yet the operation still haunts him. He fears that discussing it publicly could jeopardize his job at a transportation company, and with it the small comforts that have taken a lifetime to find. He agreed to be interviewed only if his last name would not be published.

"It horrifies people when I tell them what happened," he said.

More than half a century after a Portuguese neurologist won the Nobel Prize for inventing the lobotomy, doctors view the procedure as little more than misguided butchery. About 50,000 Americans had the surgery between 1936 and 1960. An estimated several hundred, perhaps several thousand, are still alive.

Silenced for decades by fear or shame, a handful have begun to speak out. Their children and grandchildren are speaking out too, as they struggle to understand the operation's effects on their own upbringings.

"It's like we were all supposed to slink into the shadows, as if it never happened, as if doctors never cut into the brains of people we loved," said Christine Johnson, 34, a medical librarian in Levittown, N.Y. She is writing a book about her late grandmother, who was lobotomized in 1954. Johnson also hosts a website, psychosurgery.org, devoted to memorializing people who underwent the procedure.

A new film, "A Hole in One," offers a fictionalized exploration of the lobotomy era, inspired by a patient's account. A book-length treatment of the subject by poet Penelope Scambly Schott, based on a relative's experience, is due out this year.

Some psychiatrists say it is important for the profession to confront this chapter of medical history because doctors today are pursuing increasingly aggressive, brain-altering treatments, from implantable electrodes to powerful drug combinations.

"We as a profession had one generation of humility after the era of lobotomy, but it's gone," said Jeffrey Schwartz, a research psychiatrist at UCLA. "We're now back to a point where the elite of our society believe that the most sophisticated way to treat mental illness is with drugs, magnetic fields, a knife or radiation beam. It's especially important that we hear the rest of the lobotomy story from people who were there."

To fathom why lobotomy was once widely accepted, an understanding of the state of mental healthcare half a century ago is required. Overwhelmed by sheer numbers, many mental institutions in the U.S. were chaotic warehouses. Patients screamed in the hallways or lay chained to their beds. Drugs to control hallucinations or quiet imaginary voices were not widely available.

Egas Moniz, a neurologist in Lisbon, had reported in 1935 that he "cured" a paranoid patient by destroying a portion of her prefrontal cortex, behind the forehead. Independently, several leading brain researchers in the United States found that an injury to the prefrontal region subdued aggressive behaviors.

...

"In the context of that time, control of behavior became paramount, and any treatment that achieved that control was seen as therapeutic," said Joel Braslow, a UCLA psychiatrist who has written a history of the era, "Mental Ills and Bodily Cures."

"The illness was being defined by the physician, and the outcome — whether it succeeded or failed — was also defined by the physician. The end result was placing the illness only in people's brains, rather than in the context of their lives."

Read the rest of the article here: Psyche's Torn Curtain



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See also: My Lobotomy: Howard Dully's Journey

[pachyderm]

Sterilization of mental patients was also once used here in the U.S. -- not just in Nazi Germany. I met a man in a mental hospital once who claimed that had happened to him. I was not sure at the time, but now I think he probably was right.

[spiritual_emergency]

<blockquote>
Sterilization of mental patients was also once used here in the U.S. -- not just in Nazi Germany.

</font><blockquote><div id="quote"><font class="small">Quote:</font>

Spirit: Is it true that the U.S. eugenics movement deeply influenced Nazi Germany?

Whitaker: Eugenics got its start here in the United States, not in Nazi Germany. So it was here that it was nurtured as a "science." It was here where we first put in social policies based on eugenics. We started saying the mentally ill couldn't marry. We said that the mentally ill have a defective gene, and that mental illness was a single-gene recessive disorder, like blue eyes. They said to keep that "insanity gene" from being passed on, in addition to preventing them from marrying, we need to lock them up.

So asylums changed from places that were, theoretically, shelters and refuges where people could be nursed back to health, which was the original idea in the 1800s. They became places where we would lock up the mentally ill because we didn't want them out on the street where they might have kids and pass on their quote-unquote "insane gene."

As part of that, we started putting people in asylums and not letting them out. As we did that, we started believing that you couldn't ever get better from mental illness. Whereas in the 1800s, you see over 50 percent of people going into a mental asylum being discharged within 12 months, and many never coming back. All of a sudden you see, in the first part of the 20th century, people being put into asylums and not being let out for years or decades until they passed their "reproductive age."

And who are we locking up? Well, it's immigrants who are more likely to be put in asylums, it's the poor, it's African Americans. So, in other words, it's everybody but the ruling class, basically, who is most likely to be so labeled and diagnosed and to be put into these asylums for years. Now if you follow this forward and look at how eugenics absolutely shaped and, in a way, continues to shape our treatment, it's that we devalued those people. Under eugenics policies we said, "They're a threat to us." We started talking about the mentally ill as a social cancer that needs to be cut out of the body politic. In fact, it's here, in this country, where doctors first started talking about killing the mentally ill, mercy killing.

Spirit: Yes. Mercy killing "with proper gases" in "euthanistic institutions" as one American doctor put it.

Whitaker: Yeah, with appropriate gases. As early as 1921, a Connecticut legislature tours an asylum, and a man who was manacled to an iron bed is exhibited as a case for "mercy killing." And this is reported in the New York Times as absolutely understandable. There's no outrage. This is all well before Hitler came to power.

Spirit: And prominent psychiatrists parroted the eugenics line that mental patients were genetically deficient and argued for compulsory sterilization?

Whitaker: Oh, absolutely! Certainly, forced sterilizations had a lot of support among mainstream psychiatrists. I will say that, as the eugenics movement started rolling in the 1920s and really got going, you did have a splinter group of psychiatrists starting to say that it was awful. So you really see psychiatry bifurcate in the late 1920s and 1930s, and some starting to protest against it. But by and large, there are certainly plenty of psychiatrists who are giving support to this idea of forced sterilization and they're doing it.

Spirit: Some of these practices were then emulated in Nazi Germany by their psychiatrists and carried out full force.

Whitaker: Well yeah, exactly. You follow the dominoes forward. What happens is the Nazi movement comes to power in 1933 and the eugenicists that are part of Hitler's government have close ties to American eugenicists. They even talk about going to school on California's sterilization program and - this is fascinating -- the German Nazis say that California has been doing a good job of sterilizing its mentally ill, but there's not enough protection, not enough due process with the California way of doing it!

They wanted to make sure there's some due process in Nazi Germany. They actually said they're going to make their sterilization program more just, more legal. So they thought they were putting in place a more humane and more legal program for forced sterilization. And now they start sterilizing people in good numbers. Well, now the American eugenicists start complaining that the Germans are beating us at our own game.

Spirit: Our eugenicists actually envied the Nazis for outperforming them in sterilizing psychiatric clients?

Whitaker: Absolutely. Our eugenicists here are complaining that they're getting ahead of us. So we actually sent people over there to study how Nazi Germany is ramping up their sterilization process. Who is the first group that Nazi Germany finally does kill? It's the mentally ill. That's where euthanasia got started. Then, of course, they expanded it to Jews and others, but it began with the mentally ill.

So you follow that story forward, and what you have here is an American nourishment of a belief system that horribly devalues the mentally ill. And then you see social policies arise out of that devaluation - forced sterilization and segregation from society. Then you see Nazi Germany pick up on that and implement it. And in those early years of Nazism, 1933, '34, '35, you don't see America saying that it's terrible. American eugenicists were saying we've got to keep up with the Germans!

Something else that's quite amazing. When did sterilizations peak in this country? In the 1940s and 1950s. As we fought the Nazis in the 1940s, we didn't even look into our own selves and see that our own sterilization programs were part and parcel of the same thing.

Spirit: Part of the same value system that looked down on mental patients as subhuman?

Whitaker: Exactly. So we continued with our sterilizations after the Germans stopped. And, in fact, these brain-damaging therapeutics - forced electroshock, metrazol convulsive therapy and lobotomy - they definitely arise out of the eugenics era where you devalue these people.

Well, the Germans, after World War II ended, were trying to come to grips with their Nazi past, and many Germans looked upon lobotomy with horror, because they saw it as consistent with that eugenic past. But meanwhile, we were treating it as a form of medical brain surgery. We were still forcibly sterilizing patients, repetitious electroshock, lobotomy - we didn't examine our own eugenic past, unfortunately.

Source: Psychiatry's Untold Story: An Interview With Robert Whitaker

See also: What They Left Behind


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[pachyderm]

Did anyone see The Lobotomist? Any reactions?

</font><blockquote><div id="quote"><font class="small">Quote:</font>
Did anyone see The Lobotomist? Any reactions?

</div></font></blockquote><font class="post">
Yes, I watched it last night. I can understand firstly how Dr. Freeman was shocked and appalled at the treatment in the psychwards and how he wanted to help change things for those that didn't have a voice. But it seems he let his ego get the better of the situation and thus turned a blind eye to the horrible side effects. (sound familiar-- with some psychmeds?????)

Human arrogance leads to the ruin of many good intentions. (IMO)

This is a good lesson for everyone, don't take a doctors opinion as absolute-- just because they have a degree doesn't make them infallible. The clinical psychologist I'd seen for three years would NOT admit to being in error -- and he WAS a few times--- that caused me to not trust him anymore.

It's kind of sad that his(Dr. Freeman- doing lobotomies) first intentions of helping, didn't really come to fruition-- but what's even more the travesty is how he continued to literally drive around the country(in his aging years) searching for the people that he so believed to have made their lives better-- and then he died, not finding what he convinced himself to be out there somewhere-- he surely helped many-- didn't he? .........................

mandy

[pachyderm]

Thanks, Mandy, for giving your thoughts. Good "intentions" can have bad consequences, when knowledge and "common sense" are lacking.

[pachyderm]

Better: Good "intentions" can have bad consequences, when you do not know what your real motivations are.