Reasons for the Decline

The decline in lobotomies as acceptable treatment for the mentally ill can be attributed to several factors: the increasing politicization of the treatment, the rise of new treatments, and the death of Freeman. Rumors spread that Joseph Stalin and the Chinese used lobotomies to control their enemies. While these rumors remained unconfirmed, it was evident that lobotomies were no longer only a medical treatment but an agent of political control.[1] US CIA psychiatrist, Henry Laughlin, proposed lobotomies as a “neutralizing weapon” after observing Freeman perform a lobotomy in 1952.[2] The rumors in correspondence to Laughlin’s reports fuelled the Red Scare. Americans were increasingly concerned about Communism and were determined to avoid any activity that could be linked to Communism. By the 1960s, the anti-Communist and anti-war sentiments deterred American public support of lobotomies.

Secondarily, in the early 1950s, Smith Kline and French Laboratories began trials on a drug called 4560 R.P. or chlorpromazine. Surgeon Henri Laborite first experimented with the drug in order to prevent surgical shock. The experiments revealed a side effect which, as Dr. Laborite puts it, ‘does not produce any loss of consciousness, no alternation of psychic activity, but only a certain tendency to sleep and especially to lack of interest by the patient for what is going on around him.”[3] The drug proved to have similar effects to a lobotomy but was less invasive or extreme. In 1953, the Food and Drug Administration approved chlorpromazine as a tranquilizer under the name Thorazine. Initially, even Dr. Freeman embraced Thorazine for its tranquilizing effects but other side effects included diarrhea, tremors, hyperactivity, and stiffness which resulted in most patients refusing to take the medicine.[4] Slowly, medical experts began to chip away at the positive perception of psychosurgeries as a cure. By the late 1960s, doctors ran trials on a new drug Clorazril which showed remarkable results improving the condition of schizophrenic patients who were unresponsive to other drugs. Furthermore, the cost for the drug was reduced as more states began to adopt Medicaid.[5] Doctors, including Freeman, believed drug therapy should the first attack on mental illness followed by psychosurgery as a last desperate attempt to make the patient more manageable.

Freeman travelled around the country visiting former patients in his “lobotomobile”; a last ditch effort to prove the medical success of lobotomies.

Finally, with Dr. Freeman’s death in 1972 and the death of numerous other pyschosurgeons, lobotomies disappeared from the list of acceptable medical treatments altogether. The anti-psychosurgery movement no longer had to fight the most passionate advocate and expert of lobotomies, Dr. Freeman. By 1973, Oregon became the first state to enact a law restricting the practice of lobotomies. The statue stated that psychosurgery may be performed if six of the nine review board members voted in favor of the procedure.[6] Similarly, committees were established by the American Psychiatric Association and the National Commission for the Protection of Human Subject of Biomedical and Behavioral Research which would review any research involving human experimentation.[7]  In 1973, the Department of Health, Education, and Welfare was created and reaffirmed the need for patient consent and proper procedure in medical research.[8] The ethical review boards were put in place to specifically monitor at risk populations such as children, prisoners, and the mentally ill. In an effort to gain more patient rights, patients and their families sued for malpractice in lobotomy cases in the late 1970s. In 1975, Dr. Watts was called to testify in the defense of Dr. Groff who was being sued for malpractice by Stanley Chase after undergoing a lobotomy which left him partial paralyzed.[9] In another example of a malpractice lawsuit, Kaimowitz v Department of Mental Health 1973,  the courts ruled that a criminal could not legally consent to psychosurgery.[10] The anti-psychiatry movement was able to gain legal standing due to the death of a generation of the group of medical experts who were the biggest advocates of psychosurgery.

Below is a short film shown in the Toronto International Film Festival. The video mocks Freeman’s lobotomobile (pictured above). While in modern society we believe Dr. Freeman to be monsterous and the lobotomy to symbolize the danger of science, I caution the viewer to remember how desperate hospitals and families were when they approved to the operation.

[youtube]http://www.youtube.com/watch?v=VIT9B0M-xFQ[/youtube]

“Dr. Walter Freeman believed he’d found an answer for mental illness. Nearly 3,500 operations later, his techniques were universally discredited.”

– Jack El-Hai, author of The Lobotomist byline as posted in the Washington Post, Feb 2001

Media References

Lobotomobile. Directed by Sara St. Onge, Paul Aucoin, Laura Bolton, and Brave! FACT/CCA. Produced by Magnet Film and Digital Production Company. Performed by David Ludwig, Kenneth Ward, Nathan Macintosh, and Stephanie Eby. Screened at Toronto International Film Festival and Toronto After Dark. Film. September 19, 2011. Accessed October 26, 2013. http://www.youtube.com/watch?v=VIT9B0M-xFQ.

Walter Freeman’s Postcard. In Last Resort: Psychosurgery and the Limits of Medicine. Cambridge [England]: Cambridge University Press, 1998. 406.

[youtube]http://www.youtube.com/watch?v=VIT9B0M-xFQ[/youtube]