More lobotomy involves severing the neural connections

More controversial than any other treatment for mental disorders, psychosurgery is seldom used today. In this lesson you will learn about the history of psychosurgery along with the various types. Then, test your knowledge with a quiz.

Biomedical Treatments

Biomedical treatments of mental disorders have always been a topic of controversy in the medical and psychological communities. Biomedical treatments involve any type of medical intervention. Most often this involves drug therapy, the safety of which is highly debated due to countless side effects and oftentimes unknown effects of long-term use. Although psychosurgery is rarely used today, it has an interesting history that has advanced our understanding of the human brain.

Primitive Psychosurgery

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The History of Psychosurgery

Psychosurgery is a general label for any surgery that is performed on the brain to alleviate mental illness. Psychosurgery generally involves destruction of specific areas of the brain. Some cave paintings suggest that very early man attempted brain surgery. Although the ancient Egyptians were well known for removing and studying the brain and other organs at death, the earliest form of psychosurgery is recorded in the middle ages. Trephining involved using a trephine tool to cut through portions of a person’s skull. During that time, it was believed that evil spirits caused mental illness and other brain disorders, and cutting holes in the skull would allow the spirits to escape.

A Doctor Performs Trephining
Trephining in the Middle Ages

Psychologists theorize that any results patients felt were due to shock and trauma, as well as drugs that may have been administered for the procedure.It may be surprising, but the practice of trephining still has some supporters, although the tools and practices are far more refined.

The ancient trephine tools were stone which later developed into metal tools. Today, the practice of opening the skull to relieve pressure is called craniotomy. This is a highly-developed procedure that is most often used to relieve large pools of blood in the brain.


The most famous type of psychosurgery is the lobotomy. Lobotomy was first introduced in 1937 by a Portugese neurosurgeon named Egas Moniz.

A lobotomy involves severing the neural connections of the brain’s frontal lobes. Moniz used lobotomy as a treatment for schizophrenia and won a Nobel prize for his work in 1949.Although there is no good scientific evidence as to why lobotomies would work for schizophrenia, the practice grew in the US in the 1940’s and 50’s. In 1945, Dr. Walter Freedman developed a technique to gain access to the frontal lobes of the brain through the eye socket using an instrument much like an ice pick.

Freedman traveled around in a vehicle known as the ‘lobotomobile,’ performing multiple lobotomies daily inside his van. Luckily, development of antipsychotic drugs in the 1950’s replaced the practice of lobotomies that had left thousands of people in a zombie-like state.

Psychosurgery Today

Psychosurgery is still practiced today, although it is very rare and used only in severe cases where patients have not responded to other types of treatments. For example, severely and chronically depressed patients whose symptoms have not been helped by drugs, talk therapy or even ECT (electroconvulsive therapy) sometimes opt for psychosurgery. Today’s psychosurgeries bear little resemblance to psychosurgery practiced during the early part of the 20th century.

Patients are seen in operating rooms where the procedures are done using state of the art tools such as MRI machines and computer driven electrodes. Small lesions are created by burning bits of very specific brain tissue. Patients understand that the procedure involves irreversible brain damage, but still seek the relief that may be brought by creating lesions in the areas of the brain related to emotions.

Learning Outcomes

When you are finished, you should be able to:

  • Recall what psychosurgery is
  • Outline the history of using psychosurgeries to treat mental disorders
  • Describe the two psychosurgery techniques that were popular in the past
  • Explain why psychosurgery might still be used in certain cases today

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