Home » From lobotomy to lithium: The progression of mental health treatment

From lobotomy to lithium: The progression of mental health treatment

Posted on: May 4th, 2015 in Mental Health No Comments

the progression of mental health treatment

Recalling the shocking scenes 1970s movies such as “Francis” or “One Flew over the Cuckoo’s Nest,” which depicted the heinous treatment methods for the mentally ill, the public psyche was left with an indelible negative impression of mental health treatment. Most people had no knowledge that such barbaric measures were being performed in real life. These were the scenes only viewed in B-grade horror films which depicted electroshock therapy, straightjackets, mind altering drugs and lobotomies. These two movies, however, were based on shocking, real life stories.

Mental health treatment in the media

In “Francis,” the film told the story of Francis Farmer, an actress. She at times exhibited unstable behavior, was considered “difficult” and abused alcohol. Farmer was found to be mentally ill following a DUI in 1942 and was institutionalized for seven years, enduring countess horrific procedures, including electroshock therapy.

Likewise, the author of the 1962 book, “One Flew Over the Cuckoo’s Nest,” Ken Kesey, based the book on his real life experience working as an attendant in the psychiatric ward at a veteran’s hospital, where he witnessed patients being subdued and controlled using lobotomies and electroshock therapies in the late 1950s.

A horrific history

As seen from these two examples, the history of treatment for mental illness is littered with examples of good intentions gone bad.

In an effort to sever the white matter of the brain from the gray matter, the first lobotomies were performed in Portugal in 1935 by Dr. Antonio Egas Moniz and Dr. Almeida Lima. These lobotomies involved drilling holes in the skull on each side of the patient’s prefrontal cortex, then injecting alcohol to destroy the connecting fibers.

Due to complications of the original lobotomy approach which included damage to other parts of the brain, a new technique was introduced in 1936 by American neurologist, Dr. James Watt. He performed transorbital lobotomy on patients by using a tool that resembled an ice pick, entering the brain through the eye sockets. He then tapped lightly on the orbitoclast with a hammer to break the thin bone, and then twisted it to disable the fibers that connected the prefrontal cortex to the rest of the brain.

Electroconvulsive shock therapy (ECT) involves placing electrodes on the patient’s temples and an electrical stimulus is delivered. The stimulus levels recommended for ECT are in excess of an individual’s seizure threshold, otherwise the therapy won’t be effective. ECT was introduced in 1938 by an Italian neurologist named Ugo Cerletti. Cerletti understood that electric shocks across the head produced convulsions, so after experimenting with several devices and animals, they began to administer ECT to human subjects with acute-onset schizophrenia.

Although there were successful outcomes in treating severe depression and schizophrenia, eventually ECT became abused as a measure to control patients, with patients sometimes being administered several shocks a day without proper restraint or sedation. Memory impairment and cognitive difficulties are common side effects of this form of treatment, contributing to the

Modern mental health treatment

With the introduction of the psychotropic drugs such as Thorazine and Lithium in the 1950s, the popularity of psychosurgery and shock therapies, which by this point were garnering negative reputations, rapidly diminished. Fortunately, as new drugs were added to the treatment arsenal for mental health professionals over the past few decades, medication became the primary mode of treatment for mental illness.

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