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Lesson Plan

Psychology: The Lobotomy and Understanding the Brain

About this Video
This 11-minute video chronicles the rise and fall of the prefrontal lobotomy as a form of treatment for a range of mental health disorders. It shows students how Dr. Walter Freeman became a medical celebrity by championing the use of lobotomy, and how the lobotomy’s growth as a treatment option was stanched by Freeman’s ethical lapses and the arrival of the first generation of antipsychotic drugs. After explaining the decline of psychosurgery and Freeman’s eventual disgrace, the video discusses cutting-edge research that is fueling a renewed interest in physical manipulation of the brain as a form of treatment. Useful for lessons on biological approaches in clinical psychology or on the biological bases of human behavior, the video can spark a discussion about medical ethics, and how mistakes of the past can help scientists make better decisions in the rapidly unfolding future of psychiatric neurosurgery.
Content Advisory: This video contains historical footage of brain surgery.
Objectives
  • How the limitations of psychiatric care in the early decades of the 20th century contributed to the growth of lobotomy as a form of treatment.
  • How ethical and medical problems surrounding the administration of lobotomies caused psychosurgery to enter into decline.
  • How psychiatric neurosurgery is reemerging as a potential treatment option.
Subjects
  • Science
  • Psychology
Topics
  • Cultural and Social Change
  • 1940s America
  • 1950s America
  • 1960s America
  • America After 2000
  • Health
For Teachers
Introducing the Lesson

In the 1930s, Dr. Walter Freeman became the leading spokesman for a new brain surgery that promised hope for the thousands of people with mental illness who were living in state hospitals and asylums across the country.

Dr. Freeman claimed that the new surgery, lobotomy, was relatively simple to perform and could provide relief for a range of mental disorders. At a time when there were few treatment options available for the mentally ill, the public and press were quick to embrace the lobotomy as a miracle cure.

But there was a darker side to the procedure, which often used a surgical tool modeled on an icepick to sever the frontal lobe from the rest of the brain. Many physicians – as well as psychoanalysts – were strongly opposed to the experimental operations, which were performed without the support of any randomized testing or consistent follow-ups that would have revealed that many patients were left worse off rather than better, with some disbled for life.

The development of antipsychotic drugs like Thorazine dampened the popularity of lobotomies. But Dr. Freeman persisted, performing them until he was forced to stop in 1967 after a patient died during her third surgery.

Today, as brain research continues on many fronts, Dr. Freeman’s example illustrates the wisdom of the adage “First, do no harm.”

Essential Questions
  • In the early decades of the 20th century, what were common treatments for mental illness? How did the limitations of psychiatric care at the time give rise to lobotomies?
  • What is a prefrontal lobotomy? How did it affect cognitive function? How did it affect the lives and personalities of patients?
  • How was it decided which patients would undergo lobotomy? What symptoms were seen as sufficient grounds for performing the surgery?
  • How did the development of antipsychotic drugs like Thorazine in the 1950s affect the status of prefrontal lobotomy in the medical community?
  • What is deep brain stimulation?
Lesson Procedure
  • Given the symptoms that lobotomy was meant to treat, do you know anyone who might have undergone lobotomy if Dr. Freeman had been their doctor in the 1940s and 50s?
  • From the standpoint of medical ethics, what lessons can we learn from the story of Dr. Walter Freeman and the history of prefrontal lobotomies?
  • Dr. Freeman was very successful in manipulating the news media to make himself a medical celebrity and to popularize the lobotomy as a form of treatment. Is this a problem we are confronting in modern times? Are there doctors today whose fame has given them undue influence?
  • Psychiatric neurosurgery (or psychosurgery) is re-emerging as a treatment option. As this form of treatment expands, how can the history of the lobotomy help us to make better decisions about the future of psychosurgery?
Additional Resources
Transcript for "Lobotomy: A Dangerous Fad's Lingering Effect on Mental Illness Treatment" Retro Report
“The Quest for a Psychiatric Cure” Retro Report
Audio Interview: "The Tragic History of the Lobotomy" WNYC

Describe how biological, psychological, and sociocultural factors influence behavior.

Skill 1.C: Apply theories and perspectives in authentic contexts.

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