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A Dark History: Memories of Lobotomy in the New Era of Psychosurgery

Deep brain stimulation has recently been identified as the “new frontier” in the surgical treatment of major depressive disorder. Powerful memories of the lobotomy era, however, pose a rhetorical challenge to clinical researchers who wish to make a case for its therapeutic future. For DBS advocates, establishing the relationship between these two treatments is not just a matter of telling a history; it also requires crafting persuasive arguments for the lineage of DBS that relate the new psychosurgery in some way to the old. Working from a rhetorical perspective, this article identifies and analyzes three strategies employed by DBS advocates to manage the memory of lobotomy, which it terms evolutionary, genealogical, and semantic. In conclusion, this article suggests that a rhetorical perspective might be brought to bear on the frequent calls for dialogue with regard to psychosurgery, which are meaningless without attention to the persuasive dynamics such dialogue entails.

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1. Freeman and Watts differed in their opinions on transorbital lobotomy, a disagreement that “strained” their relationship (Pressman 1998, p. 337) and contributed to their professional split. See also Freeman and Watts 1950, pp. 51–61, for a discussion of their disagreement about transorbital lobotomy’s stature as a “minor” or a “major” surgical operation.

2. One 1949 letter to The New England Journal of Medicine describes what was lost in these patients:

   Even in consideration of a certain general vagueness concerning just what constitutes a soul, some observers have described post-lobotomy patients as persons who had lost this ill defined but apparently indispensable part of their individuality. Perhaps it would be more acceptable to say that many of them had lost the vital spark of their personality, or the particular spiritual value compounded of the emotions and the reasons, and consisting of the ability to know sorrow and happiness, peace and anxiety, compassion and understanding that puts the final touches on the human being (p. 249).

3. There is considerable disagreement about whether DBS ought to be classified as “psychosurgery,” a question that I believe should be answered in the affirmative. I address this issue later in the article, and give reasons for my position in the conclusion.

4. The rise of psychosurgery in the early 1970s is one of the reasons cited for the formation of the US National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. Psychosurgery was included “in response to widespread public concern” (Quality…1973, 26318; United States 1977).

5. In rhetoric, assumptions in argument are often discussed as a form of enthymeme, a kind of truncated syllogism that assumes, rather than expresses, one of its premises. To use the famous example, a syllogism looks like this:

   All men are mortal.

   Socrates is a man.

   Socrates is mortal.

   An enthymeme, in contrast, might look like this: “Socrates is a man. Therefore, Socrates is a mortal,” which suppresses the common knowledge that “all men are mortal.”

6. This assumed evaluation is characterized well in a comment by psychiatrists Daniel Stewart and Kenneth Davis in The American Journal of Psychiatry: “If someone today were to suggest a frontal lobotomy as a means of relieving mental anguish, the responses might include sardonic laughter, revulsion, or even outrage” (2008, p. 457).

7. This “monster” rhetoric is displayed most notably in discourse surrounding Walter Freeman, recently the subject of a biography by Jack El-Hai (2005) who comments, “aside from the Nazi doctor Josef Mengele, Walter Freeman ranks as the most scorned physician in the twentieth century” (p. 1).

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1. Louisiana State University, 260 Allen Hall, Baton Rouge, LA, 70803, USA

   Jenell Johnson

Correspondence to Jenell Johnson.

Johnson, J. A Dark History: Memories of Lobotomy in the New Era of Psychosurgery. Medicine Studies 1, 367–378 (2009). https://doi.org/10.1007/s12376-009-0031-7

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• Received: 14 April 2009

• Accepted: 12 November 2009

• Published: 09 December 2009

• Issue Date: November 2009

• DOI: https://doi.org/10.1007/s12376-009-0031-7

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