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How Lobotomies Work

The lobotomy is a type of neurosurgery, or surgery performed on the brain, known as psychosurgery. The idea behind psychosurgery is that severe forms of mental illness can be treated by changing the way that the brain works. Doctors believed that by severing the connections that the frontal lobes, or prefrontal cortex, had to the rest of the brain, they could calm patients’ emotions and stabilize their personalities without doing away with their intelligence and motor functions.

The prefrontal cortex serves a number of complex functions in the brain, usually called executive functions. (Higher-level decision making and planning, reasoning and understanding, personality expression, creativity and behaving in a socially acceptable way all fit under this category.) The prefrontal cortex is connected to many other regions of the brain, including the thalamus, which receives and relays sensory signals.

The brain is essentially composed of two different types of matter: gray and white. Gray matter includes the neurons, or brain cells, along with their blood vessels and extensions. White matter comprises the axons, or nerve fibers, that connect the areas of gray matter and carry messages between them through electrical impulses. So a lobotomy was intended to sever the white matter between different areas of gray matter. (Another name for lobotomy, leucotomy, means “slice/cut white” in Greek.)

In the United States, about 50,000 patients were lobotomized, most of them between 1949 and 1956. The man who perfected what became the standard of lobotomies, Dr. Walter Freeman, called them “soul surgery” and claimed that they could be used to treat not only schizophrenia, but depression, chronic pain and other mental and physical conditions. Freeman, and other doctors who performed lobotomies, believed that they could relieve suffering. In some cases, they did.

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