What is a lobotomy Uses, procedure, and history Health ConditionsHealth ConditionsAlzheimer's & DementiaAnxietyArthritisAsthma & AllergiesBreast CancerCancerCardiovascular HealthCOVID-19Dermatology & SkincareDiabetesEnvironment & SustainabilityExercise & FitnessEye HealthHeadache & MigraineHealth EquityHIV & AIDSHuman BiologyInflammatory Bowel DiseaseLeukemiaLGBTQIA+Men's HealthMental HealthMultiple Sclerosis (MS)NutritionParkinson's DiseasePsoriasisSexual HealthWomen's HealthDiscoverNewsLatest NewsOriginal SeriesMedical MythsHonest NutritionThrough My EyesNew Normal HealthPodcastsHow to understand chronic painWhat is behind vaccine hesitancy?The amazing story of hepatitis C, from discovery to cureNew directions in dementia researchCan psychedelics rewire a depressed, anxious brain?Why climate change matters for human healthToolsGeneral HealthDrugs A-ZHealth HubsHealth ToolsBMI Calculators and ChartsBlood Pressure Chart: Ranges and GuideBreast Cancer: Self-Examination GuideSleep CalculatorHealth ProductsAffordable Therapy OptionsBlood Pressure MonitorsDiabetic SuppliesFitness TrackersHome GymsGreen Cleaning ProductsHow to Shop for CBDQuizzesRA Myths vs FactsType 2 Diabetes: Managing Blood SugarAnkylosing Spondylitis Pain: Fact or FictionConnectAbout Medical News TodayWho We AreOur Editorial ProcessContent IntegrityConscious LanguageNewslettersSign UpFollow UsMedical News TodayHealth ConditionsDiscoverToolsConnectSubscribe What is a lobotomy Uses history and moreMedically reviewed by Seunggu Han, M.D. — By Mary West on August 16, 2022A lobotomy is a type of brain surgery that became popular in the 1930s as a treatment for mental health conditions. It involves severing the connection between the frontal lobe and other parts of the brain. Doctors performed this procedure on people with conditions such as schizophrenia and depression. At the time, there were no effective or widely available treatments for these conditions. However, lobotomies are dangerous. They carry several serious risks, including seizures and death. Due to the impact of this procedure on people who were lobotomized and their families, it fell out of use in the 1950s, according to 2013 research. Keep reading to learn more about the history, procedure, and uses of lobotomies, as well as the effects and risks. What is a lobotomy Share on PinterestA surgeon using a brace and bit to drill into a patient’s skull before performing a lobotomy, at a mental hospital in England, November 1946. Kurt Hutton/Getty ImagesThe word “lobotomy” refers to several brain surgeries that break connections between the frontal lobe and different parts of the brain. The frontal lobe is involved in many brain processes, including language, voluntary motion, and many cognitive abilities. The different types of lobotomy include:topectomy, in which a surgeon removes parts of the frontal lobeleucotomy or leukotomy, in which a surgeon severs connections between the frontal lobe and the thalamusneuro-injection of sclerosing agents, in which a surgeon injects drugs that harden the fibers connecting the frontal lobe to the thalamus Do doctors still perform lobotomies According to 2017 research, lobotomies are rare today. Although the techniques have advanced and improved, most doctors consider the surgery obsolete. However, lobotomies are still legal in some places. A 2019 study reports that after lobotomies became unpopular, most states enacted laws to regulate the use of surgery for mental illness. However, despite this effort, the laws across the United States are inconsistent. History of lobotomies Doctors developed the lobotomy in the late 19th and early 20th centuries, at a time when there were no drug therapies for mental health disorders, and psychotherapy was still in its early stages. As there were no standardized or effective treatments, people with severe symptoms often lived in psychiatric hospitals and asylums. In Europe, many of these facilities were overcrowded, which led doctors to look for a solution. Lobotomies in Europe The inception of lobotomies dates back to 1891 when the Swiss psychiatrist Gottlieb Burckhardt performed surgery on several people with severe schizophrenia. He removed parts of their brains, and noted that after the procedure, those people were quieter. Burckhardt intended for this treatment to be palliative. It was not a cure. Instead, it was a last resort for people whose conditions did not respond to other treatments. At the time, the medical community rejected his idea. However, in the 1930s, some doctors revived the idea. The Portuguese neurologist António Egas Moniz collaborated with his colleague, Almeida Lima, to develop the leucotomy. The two began promoting the procedure across Europe, despite a lack of convincing evidence that it was beneficial. Lobotomies in the U S The popularity of the lobotomy in Europe led to its introduction in North America. Neurologist Walter Freeman and neurosurgeon James Watts modified the procedure to make it slightly less invasive than the European method. At first, Watts was the member of the duo who performed the surgery. Later, Freeman “simplified” the surgery and began performing it in non-sterile conditions. In response, Watts severed his ties with Freeman due to concerns about the lack of sterility and the crudeness of the simplified procedure. Lobotomies became a popular treatment in the U.S., with thousands of people undergoing the procedure. Around 1949, doubts increased about the safety of the procedure, as critics felt it did grievous harm. When the schizophrenia medication chlorpromazine (Thorazine) came onto the market in the 1950s, lobotomies fell out of favor. The drug was a safer and noninvasive treatment option. Uses of the lobotomy The main use of the lobotomy was to treat mental health conditions or reduce their symptoms. Burckhardt used it to reduce aggression in people with schizophrenia, believing that the frontal lobe was responsible for this symptom. When Moniz and Lima revived the lobotomy in the 1930s, it was with the explicit goal of changing the disposition of people with mental health conditions. Often, the procedure made people quiet and docile, which they interpreted as a sign of success. However, what doctors consider a mental health disorder has changed over time. Prejudice and biases also played a role in how doctors used the procedure. In addition to people who meet current definitions for mental illness, practitioners also performed lobotomies on people:with intellectual disabilitieswho were gaywho were in prison for crimes, which some blamed on “criminal insanity” A 2018 study also states that most lobotomized people were women. One analysis of a U.S. hospital revealed that out of 245 lobotomies doctors performed between 1947–1954, 84% were on women, despite the fact that the hospital had more men as patients, and more men had schizophrenia diagnoses. Often, the reason doctors gave for this was that they needed to “maintain order” in the hospital. Other reasons included a lack of interest in child care and “strange behavior.” Rarely, doctors used lobotomies in an attempt to treat physical conditions, such as ulcerative colitis or brain tumors. Learn more about gender bias in medical diagnosis. Lobotomy procedure There was a range of approaches to performing lobotomies. The first lobotomies involved open brain surgery. When the procedure regained popularity in the 1930s, neurologists refined the technique to make it less invasive. In the U.S., Watts promoted a technique that involved drilling or cutting a hole in the skull to sever the connection between the frontal lobe and the thalamus. This involved the participation of a surgeon and surgical assistants. Later, Freeman altered the procedure. Instead of drilling a hole, he used an instrument similar to an ice pick to enter the skull through the eye socket and pierce the brain. This is known as the transorbital lobotomy. Freeman claimed this method did not require surgical assistants, sterile operating rooms, or scrubs. According to him, doctors could perform lobotomies anywhere with very little equipment. Later, doctors tried other techniques, such as injecting radioactive iridium through the eye socket. What do lobotomies do to people Proponents of lobotomies thought that the procedure could address the root cause of mental health symptoms by cutting off the part of the brain they believed was responsible for them. For example, Freeman theorized that psychosis stemmed from excessive self-reflection. He felt this was due to thoughts that circled repeatedly in the brain. In his view, lobotomies provided a literal way of cutting off these circling thoughts. However, lobotomies do not treat the causes of mental health conditions. Instead, they reduce the functionality of the frontal lobe, resulting in:apathydistractibilitylack of initiativelack of restraint, such as in social situationseuphoria, a feeling of intense happinesssignificant changes in personality In some cases, people’s symptoms did seem to ease as a result of the procedure, and some were able to return to work. However, the effects varied. One of the criticisms of the procedure was that it was for the benefit of those looking after the lobotomy recipients rather than for the people themselves, by making them easier to manage. Risks and long-term impact of the lobotomy Many people who underwent lobotomies experienced severe side effects and complications, such as:chronic headachesseizuresintracranial hemorrhages, or bleeding inside the skulldementia, a condition that causes memory decline and personality changesbrain abscessesdeath Summary A lobotomy is a surgical procedure that doctors developed as a treatment for mental health conditions in the late 19th and early 20th centuries. It involves breaking the connection between the frontal lobe and the thalamus. While lobotomies caused some people with mental illnesses to become calmer, they also frequently caused significant changes in personality, such as apathy and social disinhibition. The procedure had very serious health risks, and doctors sometimes used it in ways that were unethical. Last medically reviewed on August 16, 2022Mental HealthSurgeryPsychology / Psychiatry 9 sourcescollapsedMedical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Caruso, J. P., et al. (2017). Psychosurgery, ethics, and media: A history of Walter Freeman and the lobotomy.https://thejns.org/configurable/content/journals$002fneurosurg-focus$002f43$002f3$002farticle-pE6.xml?t%3Aac=journals%24002fneurosurg-focus%24002f43%24002f3%24002farticle-pE6.xml&tab_body=fulltextFaria, M. A., Jr., (2013). Violence, mental illness, and the brain – A brief history of psychosurgery: Part 1 – From trephination to lobotomy.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3640229/Gallea, M. A. (2017). A brief reflection on the not-so-brief history of the lobotomy.https://bcmj.org/mds-be/brief-reflection-not-so-brief-history-lobotomyGarnett, C. (2019). When faces made the case for lobotomy.https://nihrecord.nih.gov/2019/11/01/when-faces-made-case-lobotomyKragh, J. V. (2021). The apostles of the knife-Lobotomy, the directorate and the general public, 1946–1956 [Abstract].https://link.springer.com/chapter/10.1007/978-3-030-65306-4_8Kunzel, R. (2017). Queer history, mad history, and the politics of health [Abstract].https://muse.jhu.edu/article/663330Nadler, R., et al. (2019). Legal regulation of psychosurgery: A fifty-state survey [Abstract].https://pubmed.ncbi.nlm.nih.gov/31940252/Terrier, L.-M., et al. (2019). Brain lobotomy: A historical and moral dilemma with no alternative?https://www.sciencedirect.com/science/article/abs/pii/S1878875019324222Tone, A., et al. (2018). (F)ailing women in psychiatry: Lessons from a painful past.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5962395/FEEDBACK:Medically reviewed by Seunggu Han, M.D. — By Mary West on August 16, 2022 Latest newsWhat sets 'SuperAgers' apart? Their unusually large neuronsOmega-3 may provide a brain boost for people in midlifeSeasonal affective disorder (SAD): How to beat it this fall and winterCDC: Monkeypox in the US 'unlikely to be eliminated in the near future'Why are more women prone to Alzheimer's? 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