Psychology2016

Psychological Therapies 621

Freeman & Watts, 1937). Walter Freeman and James W. Watts modified Moniz’s tech-
nique and developed a procedure called the transorbital lobotomy, during which an
instrument resembling an ice pick, called a leucotome, was inserted through the back
of the eye socket and into the brain to sever the brain fibers. It was this technique that
became widely used, and unfortunately sometimes overused, in the pursuit of relief for
so many people suffering from mental illness.

But I thought lobotomies left most people worse off than

before—didn’t it take away their emotions or something?

Although it is true that some of the early lobotomy patients did seem less agi-
tated, anxious, and delusional, it is also true that some early patients did not survive
the surgery (about 6 percent died, in fact), and others were left with negative changes
in personality: apathy, lack of emotional response, intellectual dullness, and childish-
ness, to name a few. Fortunately, the development of antipsychotic drugs, beginning
with chlorpromazine, together with the results of long-term studies that highlighted
serious side effects of lobotomies, led to the discontinuation of lobotomies as a psy-
chosurgical technique (Cosgrove & Rauch, 1995; Swayze, 1995). In the last decades
lobotomies were used, some famous recipients (and the disorders for which the pro-
cedure was performed) were Rosemary Kennedy, sister of John F. Kennedy (mild
intellectual disability), and Rose Williams, sister of playwright Tennessee Williams
(schizophrenia).

Are there any psychosurgical techniques in use today since the

lobotomy is no longer used?

The lobotomy is gone, but there is a different and more modern technique called
bilateral anterior cingulotomy, in which magnetic resonance imaging, to
Learning Objective 2.9, is used to guide an electrode to a specific area of the brain called
the cingulate gyrus. This area connects the frontal lobes to the limbic system, which con-
trols emotional reactions. By running a current through the electrode, a very small and
specific area of brain cells can be destroyed. This process is called lesioning. to
Learning Objective 2.8. Cingulotomies are relatively rare and only used as a last resort,
but they have been shown to be effective in some cases of major depressive disorder
and obsessive-compulsive disorder that have not responded to any other therapy tech-
niques (Nuttin et al., 2014). Because this is deliberate brain damage and quite perma-
nent, all other possible treatments must be exhausted before it will be performed and,
unlike the early days of lobotomies, it can be performed only with the patient’s full and
informed consent (Nuttin et al., 2014). Given that not all individuals respond positively
to this invasive procedure, current research efforts are ongoing to better predict who will
respond to this treatment versus those that may not (Banks et al., 2015).

Emerging Techniques

15.12 Identify some of the newer technologies being used to treat
psychological disorders.

Some newer noninvasive techniques for effecting changes in the brain were discussed
in Chapter Two, including repetitive transcranial magnetic stimulation (rTMS), in which
magnetic pulses are applied to the cortex, and transcranial direct current stimulation
(tDCS), which uses scalp electrodes to pass very-low-amplitude direct currents to the
brain. These new and exciting strategies are being evaluated as possible treatment options
for a variety of psychological disorders or in assisting researchers to better understand

bilateral anterior cingulotomy

psychosurgical technique in which

an electrode wire is inserted into the

anterior cingulate gyrus, with the

guidance of magnetic resonance imag-

ing, to destroy a very small portion of

that brain area with electric current.

The woman on the left is Rosemary

Kennedy, sister of President John F.

Kennedy. The man on the right is her

father, U.S. Ambassador to Great Britain

Joseph Kennedy. About 6 years after this

photograph was taken, Rosemary, who

had mild intellectual disability and whose

behavior had become difficult to control,

was subjected to a transorbital lobotomy.

The results were disastrous, and she

remained institutionalized until her death on

January 7, 2005.