Psychology Pill Vs Knife

[medicalifragilistic]

Not sure if this is the right place to post this.

I apologise if this is a bit rambly. I've only just started thinking about this topic and my knowledge of it is patchy at best. I find it quite fascinating though so if anyone else can add/direct the topic, I'd be much obliged.

I've been reading a bit about lobotomies and its modern day derivatives.

From what I can gather both medical and surgical treatments for psychological disorders have unwanted side-effects. First of all, both assume a physiological basis for pschological disorders, both are criticised for their "normalisation" of people. They seem to remove in someway a vital spark of personality that exists. One of the first american practitioners of lobotomy Freeman said "lobotomy patients may make good citizens", which is rather scary.

My first question is to what extent is it acceptable to remove one disorder if in that process you change the personality of the patient? Should we be paying more attention to quantifying personality changes as a side-effect? Not an easy task I'm sure, but I know several people who had stopped taking medication because they felt like they weren't themselves when taking it.

My second question is what criteria must be met in order to warrant neurosurgery, as opposed to a drugs based treatment?

We seem to shy away from surgery, partially I imagine because of the invasiveness and potential complications that ensue, but I also think that it is also because the procedures suffer from the bad reputation of the original lobotomy experiments. From what I have read however, they can yield extremely successful results.

Any thoughts on this?

Medi

[weegie neurosurgeon]

For a start psychosurgery as it's called is a last ditch attempt to control otherwise debilitating mental health problems such as obsessive compulsive disorder and depression. Lobotomies are not as such performed, its more usually specific structures within the brain which are carefully resected in order for the patient to have some quality of life. I know of only one surgeon in scotland who undertakes this kind of work. He's based at ninewells hospital and does less the a handful of these operations a year from what im told by fellow neurosurgeon colleagues.

For some people a life time of medication which hasnt work results in them seeking more extreme measures to lead a normal life. As much as with any brain surgery the person is never the same as they were personality wise pre procedure. Personality is not something that is kept in one part of the brain but is more a complex set of team work between different areas which makes us all very individual. Take even a little bit of that away and it can make anything from a small change to something more dramatic.

Im happy to answer any questions you have on this subject, just drop a pm or i'll check this thread.

P.S. Have done surgery on a lady for depression which involved inserting one of the vagal nerve stimulators which we use for chronic, long standing epilepsy. I have no idea if this worked or changed her mood at all but i know she had considered psychosurgery should it be unsuccessful.

HTH

[medicalifragilistic]

Hey Weegie,

I had a feelin' you might reply. Cheers for that. I do have more questions, but not got much time to write them right now.

I've been reading about Cingulotomies in a book called "Opening Skinner's Box - Great Psychological Experiments of the 20th Century". Have you read it? Its really good. Does anyone do those in the UK?

Anyway, I will write more as soon as I get some time.

Cheers,

Medi