Lobotomy as a Mental Health Treatment

Table of ContentsView AllTable of ContentsHistoryPrevalence of LobotomiesEffects of LobotomiesNotable LobotomiesWhy Were Lobotomies Performed?Are Lobotomies Still Performed?Alternatives to Lobotomy

Table of ContentsView All

View All

Table of Contents

History

Prevalence of Lobotomies

Effects of Lobotomies

Notable Lobotomies

Why Were Lobotomies Performed?

Are Lobotomies Still Performed?

Alternatives to Lobotomy

Close

A lobotomy is a surgical procedure that involves severing the nerve pathways in the prefrontal cortex. The procedure is intended to help with psychiatric and neurological conditions but can have serious risks and unwanted outcomes.

In the mid-20th century, the lobotomy was a popular “cure” for mental illness. It was part of a new wave of treatments for neurological diseases, includingelectroconvulsive therapy(ECT).

Lobotomies were typically performed on people with the following three conditions:

The aim of this procedure was to sever nerve fibers in the brain that connect the frontal lobe—the area of the brain responsible for thinking—with other regions of the brain.

Let’s discuss a few of the prominent types of lobotomies that were practiced during the mid 20th century.

Egas Moniz’s “Leucotomy”

The operation was deemed a success.

He thought that damaging the connection between the front of the brain and other parts of the brain, would stop “abnormal” behaviors and distressing thoughts.

Later, Moniz began to use an instrument of his own design, called a leucotome, to remove chunks of tissue from the frontal lobes.

Moniz was awarded the 1949 Nobel Prize for Physiology or Medicine for his discovery of the prefrontal lobotomy as a radical therapy for mental disorders.

The “Ice Pick” Lobotomy

Within a year of Moniz’s procedure, neurologist Walter Freeman and neurosurgeon James Watts performed the first prefrontal lobotomy in the United States. Although Freeman found this procedure great, he wanted to develop a procedure that would be faster, more effective, and require fewer resources and specialized tools.

But Freeman wanted lobotomies to be a more streamlined process. So, in 1946—10 years after performing his first lobotomy in the U.S.—Freeman developed a new method called the transorbital lobotomy.

Instead of drilling into the skull to sever the connections in the frontal lobes, Freeman used a hammer to drive an ice pick into his patients’ brains through their eye sockets.

Once the ice pick was inside, he literally wiggled it around, severing the nerves connecting the prefrontal cortex to the thalamus. This adapted procedure became known as an “ice pick lobotomy.”

Though his first transorbital lobotomy was done with an ice pick, Freeman later made his own instrument based on the ice picks design—the orbitoclast.

While the prefrontal lobotomy took over an hour, Freeman’s transorbital lobotomy could be done in 10 minutes or less. Because it didn’t require anesthesia—patients were knocked out before the operation using ECT—it could be performed outside of the hospital.

Shortly after doing his first ice pick lobotomy, Freeman began traveling the country performing lobotomies on all who were willing. Though lobotomies were initially only used to treat severe mental health condition, Freeman began promoting the lobotomy as a cure for everything from serious mental illness to nervous indigestion.

About 50,000 people received lobotomies in the United States, most of them between 1949 and 1952. Freeman himself is said to have performed about 3,500 patients, including 19 children. The youngest was just four years old.

What happens to a person after a lobotomy varies considerably. While the intention was to reduce mental health symptoms and improve functioning, the procedure did not always produce such effects.

Some people did improve and were able to go on and live relatively independent lives. However, others often experienced effects such as sudden changes in behavior, problems with mood, and lack of impulse control.

In other instances, people lost functioning and became emotionally numb and apathetic. Some people who were lobotomized became catatonic following the procedure. Lobotomies were also fatal in some cases.

Other serious risks included:

As for what the procedure felt like, some reported experiencing severe pain,while others report having no memory of the procedure at all.

Freeman reportedly felt that the lobotomy was “only a little more dangerous than an operation to remove an infected tooth.” Unfortunately, this was not the case for the majority of patients. In many instances, lobotomies had negative effects on a patient’s personality, initiative, inhibitions, empathy, and ability to function on their own.

Here are a few people who underwent lobotomies and the impact the operation had on their lives.

Alice Hood Hammatt

Freeman and Watts performed the first lobotomy in the U.S. on Alice Hood Hammatt, a woman diagnosed with agitated depression

When Hammatt awoke postoperatively, she stated that she was “happy."

Six days after the operation, Hammatt experienced transient language difficulties, disorientation, and agitation. Nevertheless, Freeman considered the outcome a success.

Rosemary Kennedy

Probably the most notable person to have undergone a lobotomy is Rosemary Kennedy, sister of U.S. President John F. Kennedy.

As a child and young adult, Kennedy has mild developmental delays that impaired her performance in school. As Rosemary got older, she reportedly began to experience violent seizures and temper tantrums, lashing out at those around her.

Seeking a treatment to ease her outbursts and fearing that Rosemary’s behavior would create a bad reputation for herself and for the whole family, Rosemary’s father arranged a lobotomy for Rosemary when she was 23 years old.

Throughout the entire procedure, Rosemary is said to have been awake, speaking with doctors, and reciting poems to nurses. Doctors knew the procedure was over when she stopped speaking.

The lobotomy is considered one of the most barbaric treatments in the history of modern medicine. Even in the 1940s, lobotomies were the subject of growing controversy. But despite it’s ethical issues regarding the procedure, it gained widespread popularity for several reasons:

Performing lobotomies to address symptoms of mental disorders began to subside in the mid-1950s when scientists developed antipsychotic and antidepressant medications that were much more effective. They are rarely, if ever, performed today, and when they are you can rest assured that ice picks and hammers are not involved.

Today’s treatments for serious mental illness typically focus on the use of psychotherapy, medications, or a combination of the two. The specific type of treatment that is recommended depends on a number of factors, including the type of symptoms a person is experiencing, the nature of their diagnosis, and the severity of their symptoms.

Psychotherapy

Talk therapy can be an effective tool in the treatment of mental health problems. One of the most researched and recommended types of therapy is cognitive-behavioral therapy (CBT), which involves identifying negative thoughts and replacing them with more helpful and adaptive thought and behavior patterns.

Other types of therapy that might be used include psychodynamic therapy, dialectical behavior therapy, family therapy, and group therapy.

Medication

Medications are also often prescribed to help relieve symptoms of mental disorders. Such medications may include antidepressants, anti-anxiety medications, stimulants, antipsychotics, and mood stabilizers.

Psychosurgery and Other Procedures

Moniz' and Freeman’s work paved the way for other forms of psychosurgery, such as theanterior cingulotomy. Procedures such asdeep brain stimulationare sometimes used to treat severe MDD and OCD, and neurological conditions like Parkinson’s disease.

Electroconvulsive therapy (ECT), a procedure that involves inducing a seizure while a person is under anesthesia, is also sometimes used for treatment-resistant depression, bipolar disorder, and psychosis.

Treatments for Obsessive-Compulsive Disorder

7 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Strandell B.Nobel lectures. Physiology or medicine 1942-1962.Acta Med Scand. 2009;176(6):800-800. doi:10.1111/j.0954-6820.1964.tb00690.xThe Guardian.He was bad, so they put and ice pick in his brain…NPR. ‘My lobotomy’: Howard Dully’s journey.Scull A.Madness in civilization: A cultural history of insanity, from the Bible to Freud, from the madhouse to modern medicine. Princeton University Press; 2015.Shobe FO, Gildea MC.Long-term follow-up of selected lobotomized private patients.JAMA. 1968;206(2):327-332. doi:10.1001/jama.1968.03150020043008Robison RA, Taghva A, Liu CY, Apuzzo MLJ.Surgery of the mind, mood, and conscious state: An idea in evolution.World Neurosurg. 2012;77(5-6):662-686. doi:10.1016/j.wneu.2012.03.005Brejot A.Place de la lobotomie dans le drame familial. Paris, France: Medical Doctor Thesis; 1951.

7 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Strandell B.Nobel lectures. Physiology or medicine 1942-1962.Acta Med Scand. 2009;176(6):800-800. doi:10.1111/j.0954-6820.1964.tb00690.xThe Guardian.He was bad, so they put and ice pick in his brain…NPR. ‘My lobotomy’: Howard Dully’s journey.Scull A.Madness in civilization: A cultural history of insanity, from the Bible to Freud, from the madhouse to modern medicine. Princeton University Press; 2015.Shobe FO, Gildea MC.Long-term follow-up of selected lobotomized private patients.JAMA. 1968;206(2):327-332. doi:10.1001/jama.1968.03150020043008Robison RA, Taghva A, Liu CY, Apuzzo MLJ.Surgery of the mind, mood, and conscious state: An idea in evolution.World Neurosurg. 2012;77(5-6):662-686. doi:10.1016/j.wneu.2012.03.005Brejot A.Place de la lobotomie dans le drame familial. Paris, France: Medical Doctor Thesis; 1951.

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Strandell B.Nobel lectures. Physiology or medicine 1942-1962.Acta Med Scand. 2009;176(6):800-800. doi:10.1111/j.0954-6820.1964.tb00690.xThe Guardian.He was bad, so they put and ice pick in his brain…NPR. ‘My lobotomy’: Howard Dully’s journey.Scull A.Madness in civilization: A cultural history of insanity, from the Bible to Freud, from the madhouse to modern medicine. Princeton University Press; 2015.Shobe FO, Gildea MC.Long-term follow-up of selected lobotomized private patients.JAMA. 1968;206(2):327-332. doi:10.1001/jama.1968.03150020043008Robison RA, Taghva A, Liu CY, Apuzzo MLJ.Surgery of the mind, mood, and conscious state: An idea in evolution.World Neurosurg. 2012;77(5-6):662-686. doi:10.1016/j.wneu.2012.03.005Brejot A.Place de la lobotomie dans le drame familial. Paris, France: Medical Doctor Thesis; 1951.

Strandell B.Nobel lectures. Physiology or medicine 1942-1962.Acta Med Scand. 2009;176(6):800-800. doi:10.1111/j.0954-6820.1964.tb00690.x

The Guardian.He was bad, so they put and ice pick in his brain…

NPR. ‘My lobotomy’: Howard Dully’s journey.

Scull A.Madness in civilization: A cultural history of insanity, from the Bible to Freud, from the madhouse to modern medicine. Princeton University Press; 2015.

Shobe FO, Gildea MC.Long-term follow-up of selected lobotomized private patients.JAMA. 1968;206(2):327-332. doi:10.1001/jama.1968.03150020043008

Robison RA, Taghva A, Liu CY, Apuzzo MLJ.Surgery of the mind, mood, and conscious state: An idea in evolution.World Neurosurg. 2012;77(5-6):662-686. doi:10.1016/j.wneu.2012.03.005

Brejot A.Place de la lobotomie dans le drame familial. Paris, France: Medical Doctor Thesis; 1951.

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