The movie, One Flew Over the Cuckoo’s Nest won many awards and that scene of the post-surgery effects of a lobotomy is haunting. What happened there?

A frontal , prefrontal or transorbital lobotomy is a form of psychosurgery done in the field of psychiatry where the purpose of the procedure (in the past) was not to remove or repair injured sections of the healthy brain but to change the person’s mental and emotional state.

Early years of psychiatry was not about ‘helping’ people so much as it was about removing undesirable behaviors. Making docile and controllable people was mainly the true goal of early psychiatric practices. Practical administration of overcrowded and underfinanced asylums and reducing costs of mental illness was often a more pressing concern rather than studying the causes and cures for insanity.

Drilling holes through skulls and chemically damaging brain tissues, inserting long steel implements, surgical removal of lobes, piercing behind the eye sockets were some of the ‘techniques’ that were quite popular. All psychiatric methods of treatment were done exclusively within the walls of mental asylums without obtaining consent or without a person’s knowledge. Rendering a person unconscious with shock treatment to perform the lobotomy procedure was recommended for asylums unable to afford anesthetics.

Destruction of healthy frontal lobe brain tissue may have resulted in reduced violent behaviors, depressed people weren’t so depressed and manics may calm down somewhat but they would wander aimlessly, drool uncontrollably, lose ability for self-care, be psychologically immature, death and suicide mortality rates rose up to 20% (considered a success), infections leading to meningitis (serious infectious disease in the brain), infectious inflammatory bone disease aka osteomyelitis of the skull, cerebral hemorrhages , loss of bowel and bladder control , epileptic seizures in more than 50% of recipients, over all were in a irreversible vegetative state and emotionally empty.

During the 1940's-1950's, thousands of people were ‘lobotomized’ and often without obtaining consent. These included drug addicts, alcoholics, hyperactive children, juvenile delinquents, homosexuals and the mentally challenged.

Post-lobotomy syndrome arose as a new term in reference to people whose brain tissues had been too deeply cut. Post surgery effects would last only temporarily in some people and they would exhibit worse behaviors and still others, degenerated to a irreversible vegetative state.

Surgery is performed with cuts of the nerve clusters connecting a lobe of the brain with the thalamus affecting the prefrontal or frontal lobes believing a ‘cure’ was achieved by disconnecting emotion from thought. It was a highly popular treatment method for persons with mental illness that were violent, anxious, depressed, and the ‘moody’ to undergo lobotomy procedure.

The past, psychosurgery was performed by ‘physicians’ that were not required to have a ‘medical’ degree and is considered the reason for the extreme symptoms of ‘post-lobotomy’ syndrome survivors. Today, psychiatrists are required to have medical school training, diagnose and assess abnormal behavior, give medical treatment and able to prescribe drugs.

The rise of psychology and Sigmund Freud and many others, would change the field in addressing the approach and treatment of mental illness.

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