The Modern-Day Lobotomy

Another attempt to adjust reality to fit the neurosis.

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It always happens when the topic of the lobotomy comes up among psychologists. At least one of them will openly lament, with the back of their hand firmly fixed to their forehead, how we, as a profession, ever thought something like a lobotomy was okay.

Except a procedure that’s more damaging, and based on less evidence, is performed if not lauded right now. Nobody wants to condemn it for the same reason nobody wanted to condemn the lobotomy.

The lobotomy, if you haven’t seen One Flew Over the Cuckoo’s Nest, is a procedure that consisted of ramming a veritable ice-pick through the eye socket of a psychiatric patient to disconnect their frontal cortex from the rest of their brain. It was based on the belief—fully accepted without much evidence—that a problem behavior stemmed from poorly-wired circuits of the brain that couldn’t be changed in any other way. Not by therapy, not by behavior modification, not even by meditation. It’s the psychological equivalent of amputating a gangrenous limb during the Civil War. Given what we knew, or didn’t know, about psychology at the time, the lobotomy made perfect sense.

And nobody talks about this, but the lobotomy worked. Well, it sort of worked. It was a whopping 33 percent effective, or about ten times more effective than cognitive behavior therapy. What this means specifically is the patient, after being lobotomized, would stand up and shake the doctor’s hand and express, without any detriment to his speech, how much better he felt.

It was so successful that the guy who invented the lobotomy—if not made it popular—won the Nobel Prize for physiology in 1949.

We’d like to think the lobotomy went out of favor because we found more humane methods to manage the mentally ill, but no. We only developed psychiatric drugs like thorazine—which is a chemically-induced lobotomy. Morally, is it that different? Perhaps it is different, but not by enough to claim ethical victory.

The development of a drug would only be more moral if it gave patients enough psychological breathing room to do the work necessary to recover from their disorder. But this never happened because no further understanding of psychological disorders was elucidated. In fact, the opposite happened. It was declared that schizophrenia, for instance, wasn’t a disorder because we couldn’t point to it. Psychiatric hospitals were shut down and the schizos were left to fend for themselves and to use the thorazine under their own discretion. The success rate ended up being lower than a lobotomy with a homeless problem to boot, but the ideology said it was progress so we felt good about it.

While the lobotomy was implemented by ideology, at least it was continued due to efficacy. A fabricated efficacy due to poor follow-up with patients and confirmation bias, but an efficacy nonetheless.

This makes the lobotomy less reprehensible than the modern-day equivalent of the lobotomy, gender reassignment surgery—which we can refer to as a “sex change” again because Trump is president. It's yet another attempt to adjust reality to meet the neurosis rather than adjust the neurosis to meet reality.

The sex change, like the lobotomy, isn’t based on research. In case you have your head buried in the sand that is academia, there is no evidence that shows gender is wholly a social construct. Rather, the idea was implemented to confirm a neo-Marxist (re human-nature-is-determined-by-society) ideology in the psychological field, an ideology that has no basis in reality, yet an ideology that a psychologist can get de-licensed for not affirming. If gender is nothing more than an imposition placed on you by society, it’s totally reasonably for a sane person to choose a different gender as it would be for an Ohioan to eat at an Ethiopian restaurant.

The sex change, which includes the injection of hormone blockers, is an irreversible surgery performed on patients who are perhaps willing, but no more willing than lobotomy patients. Monks willingly trepan themselves and Kenyan women willingly mutilate their genitals, but that doesn't make it healthy.

As with the lobotomy, there’s little follow-up with a sex change. In the UK, referrals for hormone blockers for children younger than 10 has risen by nearly 2,000 percent in the past 18 years. Yet there’s no evidence these hormone blockers, which not only delay puberty but debauch it, make the children more well-adjusted. There is evidence to suggest hormone blockers mollify the child in the moment, but we saw this same immediate mollification with the lobotomy as well.

The most alarming similarity between the sex change and the lobotomy is how the pushers of both surgeries claim that, to make the surgery more effective, we need to do it on children before they develop fully. The lobotomy was done to avoid the trauma of psychosis that would be aggravated by puberty. And we’re told a child needs hormone blockers before he reaches puberty because the puberty would be traumatic if he were to develop into the wrong sex.

As horrifying as the lobotomy was, and a penoplasty is, they aren’t the problem. The ideology is the problem. The creation of a belief without evidence to soothe us into certainty is the problem. The hackneyed solution that we pretend to be valid is the problem. The refusal to look at facts for the sake of socialization is the problem.

So, to the psychologist who, in a vain attempt to accrue social points, laments “how could we have ever thought the lobotomy was okay?”—you just answered your own question.