To be “lobotomized” means a person has undergone a now-discredited form of brain surgery known as a lobotomy or leucotomy. This psychosurgical procedure involved severing the neural connections in the brain’s prefrontal cortex. The prefrontal cortex is the area associated with complex planning, personality expression, decision-making, and moderating social behavior. The surgery was historically performed as a treatment for various severe mental health conditions when other options were unavailable. The procedure’s legacy is controversial, marked by initial medical enthusiasm followed by devastating and irreversible patient outcomes.
The Surgical Mechanism and Intended Purpose
The flawed medical theory behind the lobotomy posited that severe mental illness, characterized by intense anxiety, agitation, or psychosis, was caused by fixed, abnormal thought patterns. Proponents believed that cutting the white matter fibers connecting the prefrontal lobes to other brain regions, particularly the thalamus, would break up these destructive circuits. The intended result was to calm the patient’s emotional responses by diminishing their capacity for deep feeling and complex thought.
Two primary methods of performing the procedure evolved. The first, known as the prefrontal or standard lobotomy, required drilling two holes into the side of the skull, above the temples. A surgical instrument called a leucotome was then inserted through these holes to cut the connecting nerve fibers within the frontal lobe.
A later, more expedient method was the transorbital lobotomy, often referred to as the “ice-pick lobotomy.” This technique involved using a sharp instrument, like an orbitoclast, inserted through the thin bone of the eye socket, above the eyeball. A mallet was used to drive the instrument into the frontal lobe tissue, where it was then manipulated to sever the connections. This method was faster and did not require a neurosurgeon, which contributed significantly to its popularity.
The Era of Widespread Acceptance
The lobotomy was introduced in the mid-1930s by Portuguese neurologist António Egas Moniz, who developed the initial surgical technique. Moniz hypothesized that the procedure could alleviate symptoms in patients suffering from conditions like severe depression and schizophrenia. His work was inspired by animal studies suggesting that removing parts of the frontal lobe could reduce aggressive or agitated behavior.
The procedure was later championed and popularized in the United States by neurologist Walter Freeman. Freeman refined the technique, including the development of the rapid transorbital method. Since psychiatric hospitals were overcrowded and effective treatments for severe mental illness were largely nonexistent, the lobotomy was quickly embraced as a “miracle cure.”
Between the late 1930s and the early 1950s, tens of thousands of lobotomies were performed globally. The procedure was applied to a wide range of psychiatric conditions, including chronic depression, obsessive-compulsive disorder, and behavioral problems. Moniz was awarded the Nobel Prize in 1949 for his work on the therapeutic value of leucotomy, cementing its temporary status as an accepted medical practice.
Patient Consequences and Ethical Abandonment
The long-term effects of the surgery were often devastating, resulting in a profound transformation of the patient’s personality and cognitive function. Common adverse outcomes included emotional blunting, meaning a severe reduction in the patient’s ability to experience deep feelings. Patients frequently suffered from a loss of inhibition and a profound apathy, exhibiting a lack of motivation.
Many people who underwent the procedure experienced significant cognitive impairment, a reduced capacity for complex problem-solving, and a loss of personal initiative. In some cases, the surgery resulted in death, seizures, or permanent incapacitation, leaving patients completely dependent on others.
The practice began to face intense ethical scrutiny as the high frequency of severe, negative consequences became undeniable. The final abandonment of the lobotomy was precipitated by two major factors in the mid-1950s. The first was the inherent dangers and poor patient outcomes; the second was the introduction of the first effective psychotropic medications, such as the antipsychotic drug chlorpromazine. The lobotomy is now medically discredited and considered an obsolete procedure worldwide.