Talk:Psychosurgery/Archive 1

"Lobotomy"
This is quite good! I have two questions: 1. why no mention of the common or garden name lobotomy? Even if the name is entirely incorrect, it's the one people know (I myself didn't come across 'leucotomy' until I was reading some pop-neurology a few years ago). 2. why the scare quotes around 'scientific'? I think the line between science and pseudo-science deserves a sentence of explanation here, not dismissal with a scare quote - hell, Moniz got a Nobel Prize. MichaelTinkler


 * 1. lobotomy is a term in its own right for a surgical incision into the lobe of any organ so to use it here would be incorrect.
 * 2. scare quotes because survival rates were initially very poor (7 out of 20 isn't science it is slaughter) and the acceptance of a technique on that basis is desperation. But it had, for the time, an edge that could be called scientific without that being the correct phrase. Nobel prizes are not a indicator of correctness - they have been handed out for research subsequently proved wrong. -- TwoOneTwo

The likely reason that 'lobotomy' has not been used in the article is that it is a term for a procedure that is no longer practiced (and hasn't been for decades). Even though most people are familiar with the term, to call all neurosurgical procedures for mental disorder 'lobotomies' is fundamentally incorrect. The term 'psychosurgery' is arguably outdated as well, since one cannot perform surgery on the 'psyche'. It was coined by Egas Moniz in 1937 and has unfortunately remained in common usage. In 1976, the World Health Organisation defined 'psychosurgery' as, "the selective surgical removal or destruction…of neural pathways…with a view to influencing behaviour". A similar description was offered by Chorover (1974): "selective destruction of areas of the brain for the primary purpose of altering thoughts, emotional reactions, personality characteristics of social response patterns". The most appropriate term for such procedures is Neurosurgery for Mental Disorder (NMD), which has been defined by the UK Royal College of Psychiatrists as, "a surgical procedure for the destruction of brain tissue for the purposes of alleviating specific mental disorders carried out by a stereotactic or other method capable of making an accurate placement of the lesion."

I should also add that although Moniz received his Nobel Prize for the development of leucotomy for psychosis, he was also responsible for the the development of cerebral arteriography.

--DChristmas 11:27, 2 February 2006 (UTC)

-

Chorover, S. L. (1974) Science, 184, 669.

Freeman, C., Crossley, D. & Eccleston, D. (2000) Neurosurgery for mental disorder. Report from the Neurosurgery Working Group of the Royal College of Psychiatrists. London: Royal College of Psychiatrists.


 * The problem with the term neurosurgery for mental disorder (NMD) is that it remains rather a British term and is less commonly used in the US, where even doctors who are involved with psychosurgery still use the term psychosurgery. For example, doctors at Galveston, Texas, recently published an article called "Psychosurgery for Self-Injurious Behavior in Tourette's Disorder"; and the psychosurgery team at Harvard University/Massachusetts General Hospital have a webpage entitled "Psychosurgery". Even in Britain the term NMD isn't used by everyone. For example, although the Mental Health Act Commission replaced psychosurgery with NMD in 1997, the Joint Parliamentary Committee on the Draft Mental Health Bill last year used the term psychosurgery, not NMD. I think, for the time being at least, psychosurgery remains the most widely used and understood term, and most appropriate as the title for this article (with perhaps a note on terminology?)Staug73 18:02, 12 February 2006 (UTC)


 * I have to agree with you regarding the transatlantic differences in terminology, and it may be a difficult obstacle to overcome when the US undoubtedly outnumbers the UK in terms of readership of Wikipedia. It is probably worthy of a page in itself to attempt to describe the evolution of different terms! Perhaps, as you suggest, a note on terminology would help to clarify such issues. The Draft Mental Health Bill does indeed refer to psychosurgery under 'Type A' treatments, and the flaws in that Bill certainly don't help to inform the debate on mental health treatments such as NMD/ psychosurgery. -- --DChristmas 17:00, 19 February 2006 (UTC)

Psychosurgery today
I thought psychosurgery was, in a very few cases, still performed today for very severe OCD. There's also the history of surgery for epilepsy, though that's not really psychosurgery I suppose. --Robert Merkel
 * Cingulotomy is still performed, whereby the cingulate gyrus is ablated in some way. It remains fairly rare - see -- FP  20:47, May 15, 2005 (UTC)
 * Deep brain stimulation and stereotactic ablation is becoming more common by the day, and is by many believed to be a "coming star" in the next decade or so.--Lipothymia 20:59, 20 March 2006 (UTC)

Also notably, it has recently been tested by the chinese in drug addiction, by removing the areas that would normally perceive pleasure and well-being, roughly speaking. Other countries are considering following suit, as there is a very high success rate, with success defined as the patient not using illicit drugs again. I'd like someone who knows more about it to chime in. Zuiram 23:29, 22 October 2006 (UTC)


 * It has been used in both Russia and China to treat addiction, but both countries have abandoned these programmes. I will put something in the present day section. In the meantime you can read something about it here (China) and here (Russia)Staug73 12:39, 1 November 2006 (UTC)

This is from a western point of view. I just read of a Dr in China claiming to have done near 1000, one thousand "mostly for schizophrenia". wall street journal http://online.wsj.com/article/SB119393867164279313.html?mod=googlenews_wsj —Preceding unsigned comment added by Mark v1.0 (talk • contribs) 05:09, 4 November 2007 (UTC)

General comments
This article seems to be a bit disorganised. In particular the paragraph:
 * The initial criteria for treatment were quite steep, only a few conditions of "tortured self-concern" were put forward for treatment. Severe chronic anxiety, depression with risk of suicide and incapacitating obsessive-compulsive disorder were the main symptoms treated. The original leucotomy was a crude operation and the practice was soon developed into a more exact, stereotactic procedure where only very small lesions were placed in the brain.

This seems out of sequence as the next paragraph goes on to talk about "icepick lobotomy", the very opposite of stereotactic surgery. Also I think the "initial criteria" given look like the current criteria for surgery but I don't know enough about this subject to know if they were also the initial critera. Cosgrove and Raunch in their excellent article do not really go into the early indications. Certainly the criteria widened to include many conditions during the heydays of its use.

The other thing that doesn't come across clearly in this article is that the use declined after the introduction of effective treatments but a very small number of people still have psychosurgery performed on them for intractable psychiatric conditions. The current indications for psychosurgery should be listed.

If anyone is looking after this please have a go at fixing it. --CloudSurfer 09:44, 14 Sep 2004 (UTC)

-- My comment is a fairly superficial complaint but was kind of irritating- it's about the addition/revision made in the section about examples of psychosurgery in media/entertainment. I think it's premature to include the film "Sucker Punch" in this section. The movie is only a couple months old- it's not even out on DVD or Bluray- unlike the other examples given, which are pretty well established. There was also no spoiler warning, which I know is a topic of much debate among users/posters since it's stated in the guidelines that the reader may come across revealing info. But all this addition does is say there's a lobotomy, but in the process gives away the whole ending of the film out of no where! I think that with a bit of re-phrasing the problem could be solved: Instead of "In Sucker Punch the main character gets lobotomized at the end" why not "The movie Sucker Punch takes place at a mental hospital and shows a patient being lobotomized in detail." or something like that? I know it's not a huge issue or a major edit that would massively change the article for the better, but it's one little thing I think would really improve it. Thank you for your time and consideration, and I really enjoyed the rest of the article. NeurotiCallie (talk) 08:38, 18 May 2011 (UTC)
 * Perhaps you could change it thenStaug73 (talk) 06:07, 22 May 2011 (UTC)

Request for more info
As someone who is both curious and horrified by this kind of thing, I would like to know (a) why it was theorised that severing the prefrontal cortex from the rest of the brain would have any effect (b) what effect it was supposed to have and (c) what effect it actually had, apart from death in some cases. What does psychosurgery actually achieve? Presumably it alters the mood, but how, and to what extent? Were the thousands who were lobotomised able to lead relatively normal lives thereafter? (I assume it would be hard to distinguish the results of lobotomy from the 'noise' of the patient's original illness, however). Ashley Pomeroy 21:51, 19 Nov 2004 (UTC)


 * I second that, this article is majorly useless for anyone wanting to learn, perfect for someone who loves gossip. --Kintaro 15:33, 15 May 2005 (UTC)

It was theorized that the nerves connecting the frontal lobe to the thatlamic region were defective and by severing them the defective thoughts could be removed, thus allowing new, healthy nerves to regenrate in their place.

NPOV?
Now, I confess I'm not an expert in these things (medicine, science), but I think the article's tone isn't very neutral. It actually took me three reads of this article to figure out that lobotomy may have had any effect besides severe impairment. Putting things in context, mentioning the effects of the operation, and some more useful links might be in order. -- 193.166.89.77


 * It seems this article has had problems for a while, as expressed above. I guess I'll give it an overhaul in the next few days, if nobody else will. -- FP 20:47, May 15, 2005 (UTC)

POV?
The article is definitely judgemental of psychic surgery, which isn't even what it is about. -- 66.32.73.120


 * This article is not about about psychic surgery and there is no basis to make the assumption it is representing psychosurgery falsely as psychic surgery Rotovia (talk) 00:09, 6 March 2008 (UTC)

Does this really need a mention
This term should not be confused with the allegedly fraudulent, sleight-of-hand practice of psychic surgery.

This term should not be confused with the practice of psychic surgery. would do just fine. --Kintaro 15:33, 15 May 2005 (UTC)

Ancient trepanning
" [Trepanning] may have been done in an attempt to allow the brain to expand in the case of increased brain fluid pressure, for example after head injuries; several documented cases of healed wounds indicate that such crude surgery could be survived back then." The fact that the wounds healed, indicating the surgery was survived, is documented and IMHO should be added to the article. I'm less sure about the claim that trepanning may have been attempted to address brain fluid pressure; can we get citation for that theory? -- ~
 * I very much doubt that as well -- it's more likely it's about releasing spirits. Actually, I'm not even sure that the paragraphs on trepanning even belong on this page. They don't really fit with the definition of psychosurgery. Actually, I don't think the surgery referred to at the bottom of the page does either. Psychosurgery is really about smashing up the frontal lobe and its variations Limegreen 04:36, 15 July 2005 (UTC)

ETS/Psychosurgery
Can anybody verify that Endoscopic thoracic sympathectomy is in fact 'psychosurgery'? To me this article seems a real misnomer. While I understand that 'lobotomy' from a scientific perspective means the removal of a lobe, in common use it means the surgery described on this page. Thus, I think this page should be re-named 'Lobotomy', with some mention of psychosurgery. It should then have a See Also section referring people to Neurosurgery, ETS, trepanning etc. Any comments?? Limegreen 00:16, 20 July 2005 (UTC)

The largest and most famous ETS clinic in Eurpoe, the Privatix clinic in Finland and Italy, headed by Timo Telaranta, president of the International Symposium on Sympathetic Surgery, is dedicated almost exclusively to using the procedure to treat psychiatric disorders. They have psychosurgery patients numbering in the thousands. They have repeatedly published significant psychiatric effects from the surgery, and those documents are referenced in the article. I think psychosurgery is a fine title for the article, as a reader who is interested in surgeries that affect the personality will find an excellent resource here, rather than having to click around several articles. 69.228.47.7 01:15, 9 August 2005 (UTC)


 * Psychosurgery is indeed a good title for the article, but I think that Endoscopic thoracic sympathectomy (ETS) doesn't belong here. Every definition of psychosurgery that I have been able to find refers to surgery on the brain for the treatment of mental disorder.
 * ETS isn't surgery on the brain. It involves the spinal cord, not the brain. Normally it is done in an attempt to control sweaty hands, facial blushing and things like that. Yes, surgeons in Finland have started operating on people with social phobia but that doesn't make it psychosurgery if psychosurgery is defined as an operation on the brain.


 * Egas Moniz, who is generally credited with the invention of psychosurgery although a few operations had been done previously by other people, coined the terms psychosurgery and leucotomy. And modern operations are still called psychosurgery http://neurosurgery.mgh.harvard.edu/Functional/psysurg.htm
 * So it seems to be a good title that covers everything from the earliest operations to those being done today. As well as in the USA, psychosurgery is still used on a small number of people every year in the UK, and some other countries as well, although in other countries it is no longer used. Incidentally psychiatrists in Britain are now trying to get people to use the name NMD - neurosurgery for mental disorder. And to further confuse things, they sometimes call operations cingulotomies or capsulotomies etc which just refers to the bit of the brain they are aiming for and is still psychosurgery.


 * The term lobotomy was coined by Walter Freeman in the USA who thought that it was a better way of describing the operation than Moniz's term leucotomy. The name "lobotomy" became popular in the US, whilst "leucotomy" remained in favour in Europe. The problem with "lobotomy" is that is has come to be associated with just one type of operation, Walter Freeman's transorbital, or "ice-pick", lobotomy so people say that it stopped being used in the 1970s, whilst of course psychosurgery has continued this day.Staug73 19:08, 27 January 2006 (UTC)

"lobectomy"
According to Wikipedia, "lobectomy" redirects to Pneumonectomy, which defines it as the removal of one lobe of the lung. This article defines it as removal of one lobe [of the brain]. Does lobectomy simply mean removal of a lobe? If so, Pneumonectomy is incorrect and this article is in need of clarification. Which is correct?


 * Lobectomy = removal of a lobe, whether of lung, liver or brain. It may need to be a disambig. JFW | T@lk  07:45, 17 November 2005 (UTC)

Anorexic patients lobotomized
Added the fact that psychosurgery is practiced in anorexic patients. Phrase “Lobotomy is no longer used as a treatment for schizophrenia” deleted because it is still practiced for schizophrenic patients, in Mexico for sure (and probably in other countries as well). —Cesar Tort 18:43, 6 April 2006 (UTC)

Present day
I think the sentence It may be a treatment of last resort for (...) anorexic patients in Chile, the United States, Sweden and Mexico needs revision, or at least a citation!


 * Psychosurgery is certainly used in the treatment of anorexia in Mexico . Chile - I have found an article from about 15 years ago . I thought though the current use of psychosurgery in the USA was limited to the treatment of OCD and depression, and in Sweden OCD, depression and anxiety.Staug73 08:58, 18 June 2006 (UTC)

I removed this phrase about pain "In the case of people suffering chronic pain, the surgery does not act on the perception of pain" as the Baer study is about OCD not pain.Staug73 12:50, 26 October 2006 (UTC)

Proposed merge: Lobotomy and Psychosurgery
These two pages have very little difference between them in content; the Psychosurgery page has no real discussion of surgeries other than other than Lobotomy. The latter is the more familiar concept, so it seems the right page to merge into. --Ogdred 22:28, 9 September 2006 (UTC)
 * Lobotomy has redirected for over to years to this page until 2 days ago . I'm inclined to agree that it should probably be the other way round. --Limegreen 23:12, 9 September 2006 (UTC)
 * I would suggest they not be merged, but that this one be cleaned up.Trilobitealive 03:12, 23 December 2006 (UTC)
 * Disagree. Psychosurgery is a neologism that lacks precision, and is moreover behefted with considerable stigma. What is discussed in this article is neurosurgical procedures for psychiatric disorders, whereas psychosurgery in reality also entails other therapeutic modalities, e.g. surgical procedures for cosmetic/psychological reasons. I propose that this article should briefly enlist the different procedures done for psychiatric/psychological reasons, with links to each and every procedure listed. A move to lobotomy would firstly be simply wrong (as lobotomy simply means removing a lobe of any organ, could also be removing part of the lung for instance), and even more bias to the article itself. --88.250.10.109 10:41, 20 February 2007 (UTC)

It's a little late for this comment, and as it is the proposed merger did not go through, but for the record: (1) Merging Lobotomy with Psychosurgery would be like merging Automobile with Transport vehicles; (2) the previous paragraph (beginning "Disagree") says a number of completely strange things e.g. that cosmetic surgery can sometimes be classed as psychosurgery. EEng (talk) 21:56, 28 November 2009 (UTC)

Phineas Gage
I altered the part about Phineas Gage. It read: "The effects were comparable to a surgical lobotomy." The effects of the accident to Mr.Gage's personality were not comparable to a surgical lobotomy. The effects were documented as: "Gage was fitful, irreverent, indulging at times in the grossest profanity (which was not previously his custom), manifesting but little deference for his fellows, impatient of restraint or advice when it conflicts with his desires, at times pertinaciously obstinate, yet capricious and vacillating, devising many plans of future operations, which are no sooner arranged than they are abandoned in turn for others appearing more feasible. A child in his intellectual capacity and manifestations, he has the animal passions of a strong man. " I doubt that the frontal lobe lobotomy would have been so successful if it had these effects on the patients. -- Old unsigned comment

Phineas Gage and lobotomy are indeed unrelated, but not because of somebody's "doubts." See the text as it stands currently or if you prefer Phineas Gage. EEng (talk) 22:04, 28 November 2009 (UTC)

Trans-orbital Lobotomy Redirect to Psychosurgery
Would it not be more appropriate and accurate if Trans-orbital lobotomy redirected to the lobotomy article rather than to this one?Freekra (talk) 21:21, 28 November 2009 (UTC)
 * Absolutely. Do it (I don't know how). EEng (talk) 21:26, 28 November 2009 (UTC)

I think you need to be admin to do it. How do I find an admin? Freekra (talk) 03:24, 29 November 2009 (UTC)


 * Done. No need for admin. Pretty simple.Freekra (talk) 03:28, 29 November 2009 (UTC)

Move Gottlieb Burckhardt Section from Lobotomy article over to here
Suggested at Talk:lobotomy that the section on Gottlieb Burckhardt in the Lobotomy article (and perhaps other sections) might be moved to this article. —Preceding unsigned comment added by Freekra (talk • contribs) 23:39, 30 November 2009 (UTC)

Gottlieb Burckhardt
OK. Burckhardt has been moved again to his own article page which will now need a considerable rewrite to reflect the fact that it's being used for biography. I'm not really sure if the movement has improved the article. The contention in the lede is wrong. Modern psychosurgery is commonly seen as beginning with Burkhardt and not with Moniz. That's the point - that Moniz's intervention, while by no means identical, follows much the same rationale as that employed by Burckhardt. Changes to lede and elsewhere to reflect this in the near future.FiachraByrne (talk) 10:11, 10 August 2011 (UTC)

Also, there's evident confusion here between psychosurgery and lobotomy/leucotomy. Lobotomy is a sub-category of psychosurgery; they are not synonyms.FiachraByrne (talk) 10:20, 10 August 2011 (UTC)


 * Where is the confusion? The only possible confusion I could find is the section entitled Individuals who underwent lobotomy. Technically it is true - all these people I think underwent the standard Freeman-Watts leucotomy/lobotomy, but it might be better to change it to psychosurgery and include some people who had other types of operation. And I wonder if the link back to the lobotomy page would be better when you get to the bit about Freeman-Watts, rather than the bit about Moniz? Otherwise the distinction seems pretty clear. Staug73 (talk) 20:54, 10 August 2011 (UTC)


 * Hi. The confusion, as I saw it, was mostly in the lede which I've since partly rewritten where at times the terms were used interchangeably. It's not an issue now I think. In terms of linking back to the lobotomy article, I think it works better if it goes to the start of the article entitled Lobotomy rather than jumping to Freeman and Watts. Moniz is a critical part of the story. Also, mostly the traffic will be coming from the lobotomy article to this one:

1 2
 * Also, looking at it, this article is obviously more balanced with a truncated section on Gottlieb. As long as they all link to each other it should be fine.
 * I think the section on individuals who have undergone psychosurgery would benefit from the inclusion of more recent examples.
 * In the Lobotomy article I'd also like to cover some regions such as Italy and Japan and greater detail. Also, due to complaints on the talk page, I thought I might add a section after the lede in that article outlining what the procedure was in some detail. It would be nice if someone else could handle a treatment of the function of the frontal lobes based on present day knowledge.
 * In terms of this article, I wonder if it might be better to look at present day theories underlying the procedure and a closer examination of what diagnoses or symptoms are deemed suitable for a given operation. Additionally, some of the details of what the present day operation physically entails might be instructive. Also perhaps some of the legal conditions governing its usage (i.e. where can psychosurgery be used involuntarily).FiachraByrne (talk) 00:17, 11 August 2011 (UTC)


 * I was actually talking about where the link starts not where it goes to (no problem with its destination). I will move it just one line, to the first use of the word 'lobotomy'. Neither the word nor the technique was around when Moniz did his original operations.Staug73 (talk) 07:08, 11 August 2011 (UTC)


 * I have changed it, but I am still not 100% happy with the wording. I know Freeman was the first to use the word "lobotomy" with respect to psychosurgical operations, but did he apply it just to his own technique of did he rename Moniz's operations "lobotomies"?Staug73 (talk) 07:30, 11 August 2011 (UTC)


 * I have changed "renamed" to named as the source (Freeman's 1942 book) has a chapter entitled Egas Moniz and leucotomies or something like that - Freeman and Watts were only describing their own technique as lobotomy and not renaming Moniz's operations. Yes, the article needs more about present-day operations.Staug73 (talk) 08:25, 11 August 2011 (UTC)


 * Freeman and Watts intended it to refer to their procedure to distinguish it from Moniz's although both procedures and subsequent variants had approximately the same end in mind - that is the severance of the frontal lobes, to a greater or less degree, from the rest of the brain. However, both leucotomy and lobotomy came to be used as generic terms for any such operation with leucotomy generally preferred in the UK and the rest of Europe (Scandinavia?) and lobotomy preferred in North America. For example: "The operation of prefrontal leucotomy or, as some call it, prefrontal lobotomy, is one of the most startling of modern therapeutic procedures. It was introduced in Portugal by Moniz (1936) - the actual operation being performed by Lima - and was subsequently developed in Italy and in America." - G.W.T.H. Fleming (1944). 'Prefrontal leucotomy' in Journal of Mental Science, 90(378): 486-500.FiachraByrne (talk) 12:25, 11 August 2011 (UTC)
 * Your changes are good. I'm going to sort out the Gottlieb Burckhardt article first. Will you keep plugging away at this one?FiachraByrne (talk) 12:28, 11 August 2011 (UTC)


 * Have I missed something? As far as I am concerned the fact that Burckhardt carried out psychosurgical operations isn't disputed. There isn't any need for a lot of references. There are a couple in the intro and that is enough. Nothing else in the article has a long list of references. So I am moving it here.


 * Well, until I changed it, the article History of psychosurgery in the United Kingdom stated that modern psychosurgery began with Moniz. There are few sources that support this position. Is there a problem with listing a lot of sources in support of a statement? Besides which, I will be adding many more sources to this article. FiachraByrne (talk) 21:08, 12 August 2011 (UTC)
 * OK. I've removed many of the citations. That footnote now has three of the most authoritative sources supporting the contention. And it retains the two other sources that point to alternative ways of conceiving of the start of the history of psychosurgery. It's still a long footnote but this is mostly due to the text that it contains rather than the citations.FiachraByrne (talk) 21:29, 12 August 2011 (UTC)
 * I should add that the statement that Burckhardt was the founder of modern psychosurgery was not supported by the source that it cited (Kotowicz). That source discusses alternative origins for the history of psychosurgery but offers no definitive opinion as to which is correct. FiachraByrne (talk) 21:33, 12 August 2011 (UTC)

.

However, Kotowicz notes a difference, irregularly observed, among medical historians and medical practitioners in their location of the origin of psychosurgery. The latter group, he contends, tend to favour beginning the narrative with Burckhardt whilst the former group favour starting with Moniz.

In the context of early psychosurgery, Berrios unusually also refers to the the operations performed in 1889 by a surgeon (Harrison Cripps) at the behest of the British psychiatrist Thomas Claye Shaw in which fluid was drawn from the brain of a patient diagnosed with General Paralysis of the Insane. While the purpose of the operation was aimed towards the alleviation of mental symptoms attendant on the condition the procedure did not aim to interfere directly with brain tissue and therefore it has been excluded from most conventional accounts of psychosurgery.

Staug73 (talk) 20:11, 12 August 2011 (UTC)

article mismatch
The section "Individuals who underwent lobotomy" does not match, let alone duplicate that for the lobotomy article itself, e.g. Alys Robitaille.

G. Robert Shiplett 20:24, 11 January 2013 (UTC)

Fiction
I have removed this section as most of the examples are trivia and not appropriate for an article about a medical treatment. Leaving them here in case anyone wants to rescue any and write something about why they are important in the history of the treatment Staug73 (talk) 17:16, 30 January 2013 (UTC)

Fictional examples

 * In Unruhe, Ep. 4 Season 4, of the television series The X-Files, serial killer Gerry Schnauz performs lobotomies on women he intends to save from mental 'unrest.'
 * Frances Farmer: Though Farmer is the person perhaps best associated in the public mind with lobotomy due to its depiction in the fictionalized biographical film Frances, archival medical and other records have conclusively proven Farmer never underwent the procedure. The author who initially alleged the lobotomy later admitted in court he had made it up. (Footnoted site contains court transcripts which are also available through LexisNexis.)
 * Ken Kesey's famed fictional character, Randle Patrick McMurphy, in One Flew Over the Cuckoo's Nest who was, in the movie, played by Jack Nicholson.
 * J. Frank Parnell, erratic driver of the radioactive Chevy Malibu in the movie Repo Man.
 * A Hole in One, a 2004 movie about a young lady who wants an ice pick lobotomy during the height of its popularity.
 * Rat Korga, major character in Samuel R. Delany's science fiction novel Stars in My Pocket Like Grains of Sand, voluntarily opts for psychosurgery to make him content to be a slave.
 * Session 9, a 2001 horror movie about a group of men hired to remove the asbestos from a defunct mental hospital.
 * Hannibal, in which Hannibal Lecter lobotomizes Paul Krendler, played by Ray Liotta.
 * In the book The Bell Jar by Sylvia Plath, the character Esther Greenwood meets a girl named Valerie in the asylum who has had a lobotomy.
 * Iron Maiden's famous fictional mascot, Eddie, was lobotomised on-stage during one of Maiden's live shows; this concert was filmed for German TV but that particular segment was cut out due to being deemed "Too violent". The cover of their fourth album Piece of Mind (and many of the following releases) shows Eddie after being lobotomised.
 * In Episode 6 of Mortal Kombat Legacy, Raiden is captured at a psychiatric hospital and given a crude lobotomy to "cure" him of his "violent outbursts and delusions" of being a god.
 * In the book Cyteen by C. J. Cherryh, psychosurgery involves the use of drugs that bring the mind into a state where it is very receptive to audio and/or visual cues, which help the psychosurgeon to reprogram the individual. This procedure is non-invasive, and involves administering drugs versus actual surgery.
 * In the television miniseries Kingdom Hospital, the character Mary was killed by a botched lobotomy. In the companion book, The Journals of Eleanor Druse, Eleanor had a transorbital lobotomy in her childhood.
 * In the novel Project 17, the Denver State Hospital is rumored to have been the founding of lobotomy.
 * In science fiction, psychosurgery is typically presented as far more advanced than its modern day counterparts, often including such things as selective memory erasure, direct alteration of thoughts, and generally having a higher effectiveness than in reality. Examples of it can be found in books by Alastair Reynolds, Richard Morgan, and others.
 * In Suddenly Last Summer (1959 adaptation of the Tennessee Williams play), a wealthy woman named Violet Venable (Katharine Hepburn) wants her niece Catherine Holly (Elizabeth Taylor) lobotomized to silence her talk about Violet's son Sebastian's homosexuality.
 * In From Hell, set in Victorian London, Queen Victoria herself (Liz Moscrop) is implicated in ordering lobotomies for several characters in order to "silence" them if they knew too much information. Characters who underwent these crude lobotomies (including Sir William Gull played by Ian Holm), were depicted with shaved heads and in vegetative states. However, in 1888 (the year the story takes place), the lobotomy procedure had not been invented yet.
 * In the fourth season of Melrose Place, Kimberly - under the influence of one of her multiple personalities - has Peter committed to a mental institution under false pretenses. She begins to perform a lobotomy on Peter, but is interrupted by Amanda and Michael's rescue attempt.
 * In the science fiction series Firefly, child prodigy, River Tam, is assumed to have undergone some form of lobotomy against her will, leaving her in a mentally unstable state.
 * In the novel Shutter Island and its film adaptation it is indicated that the main character, Teddy Daniels, will undergo a transorbital lobotomy.
 * In the movie Sucker Punch, the main character of Babydoll undergoes a frontal lobotomy at the end of the film.

Early fictional portrayal
I removed the following from "Fictional Portrayals" section of [[Lobotomy] because lobotomy hadn't been invented at the time of writing -- but it may find a home in this article:
 * The 1921 novel We by Yevgeny Zamyatin depicts the narrator D-503 being lobotomized in the climax of the novel, where he undergoes the 'Great Operation' to ensure he is kept in order and free from obtrusive thoughts against the One State's authority.

I'll take this opportunity to pitch my personal criterion for what to include/exclude from "in pop culture / in fiction / etc"" lists:
 * A fictional or semifictional portrayal, or appearance in a creative work (e.g. song or painting), of an article's subject is worth noting or discussing in the article about that subject to the extent that reliable secondary sources demonstrate that the portrayal either adds to an understanding of the subject itself, or of the subject's place in history or popular perception.

I'm not taking a position on whether this particular work qualifies under that standard.) EEng (talk) 21:10, 26 April 2013 (UTC)(

"Neurological effects and recent research" section
I have removed the following section because it appears to be taken from this brief review http://www.ajol.info/index.php/ajpsy/article/view/90900/80320 and doesn't add anything useful to the article. Some of the sentences have been changed so as to become meaningless, for example: the authors say: "Surgical techniques generating lesions to brain tissue are associated with two main types of adverse effects namely general surgical and procedure specific." which has become: "the two most common surgical techniques utilized with patients are classified under general psychosurgery and procedure specific psychosurgery." The footnotes are also taken from the review and I think the guidelines are to only reference what you have actually read, rather than second-hand footnotes. Staug73 (talk) 19:40, 13 November 2013 (UTC)


 * ''Adverse surgical effects for the treatment of psychiatric illnesses is due to lesions created in the brain. The two most common surgical techniques utilized with patients are classified under general psychosurgery and procedure specific psychosurgery. The use of these two surgical techniques bring up bioethical dilemmas as to whether or not a physician should recommend surgery due to the risk/reward benefits toward a patients behavioral state post-surgery, versus the patients current behavioral state. Psychosurgery requires removal or destruction of nerve pathways, and in most cases removal of brain tissue that may also cause permanent behavioral changes. Some research has found that advocates in favor of psychosurgery as an effective way to treat emotional illness, may do so without regard for the patients permanent behavioral changes. Recent research studies have linked adverse neurological effects to both surgical techniques with their own specific set of risks. For example surgeries categorized under general psychosurgery such as, Anterior capsulotomy, Anterior cingulotomy, Stereotactic tractotomy, and Limbic leucotomy, are preformed under general anesthesia, and lesions must be made in target fibers near the regions of the hippocampus, corpus callosum, cortex, and subcaudate white matter areas of the brain. The associated risks and side effects to operating in these regions are as followed, anesthetic vascular injury, transient confusional states, infection, post-surgical epilepsy, and weight gain had been reported by women mostly following surgery. It should also be noted that there is little evidence linked to personality changes when looking at Limbic leucotomy cases. In addition to this patients undergoing Stereotactic tratotomy surgeries were able to maintain their general intelligence and in some cases intelligence had been improved. In comparison to these broader general psychosurgical techniques, neurological researchers have also developed more symptom specific surgeries known as procedure specific that are also associated with their own side-effects and risk factors. The first listed here is known as Vagus nerve stimulation (VNS) and is utilized to treat Major depressive disorder (MDD). The second procedure is known as deep brain stimulation (DBS) mainly used to treat severe cases of obsessive compulsive disorder (OCD). In both cases a device is implanted into the subclavicular region of the body and small pulses of energy are run through electrodes stimulating either ones hypothalamus (VNS for MDD), or neural white matter (DBS for OCD). However, for Vagus nerve stimulation (VNS) side-effects and risks include voice alteration, headache, neck pain, and cough. Behavioral changes linked to deep brain stimulation (DBS) include, anxiety, hypersexuality, and aggression.

I had earlier removed the same passage -- didn't notice the copyvio/plagiarism, but as you say it had become an unintelligible jumble.

-- EEng (talk) 01:42, 14 November 2013 (UTC)
 * And WP:NOT (news), WP:RECENTISM and WP:MEDRS. This appears to be student editing; see WP:ENB.  Sandy Georgia  (Talk) 23:23, 20 November 2013 (UTC)

Limited Point of View
Despite the controversial nature of this topic, the point of view in this entry has been restricted by the number of sources cited. This is an important subject and with the recent calls for the reexamination and the application of ethics in neuroscience neuroethics, different points of views on this issue are needed. Evaluation, diagnosis,  neuro-imaging, as well as ethical guidelines for surgical treatment of patients with identified psychopathology as well as psychopathy have been written and published in reliable sources and notable journals, and this information and citations are needed to improve this article.LeBassRobespierre (talk) 23:18, 18 May 2014 (UTC)

While I agree that most of the references are reliable sources, I believe they still represent one point of view, not different point of view, and new developments have not been added by different and newer sources. Before removing the tag, the user should have address al the issues I brought up and sought consensus or the opinion of a senior editor or administrator. We are here to improve Wikipedia, not to defend entries one considers his own!LeBassRobespierre (talk) 10:13, 20 May 2014 (UTC)


 * The most often cited sources in this article are several reviews published in recent years in journals. If you know of any more recently published articles then please add something (though not just copied text) or make a suggestion. But Miguel Faria's article which you have been trying to promote is an "essay-editorial" and contains a lot of irrelevant material (about trepanation, etc) and therefore is a less suitable source. If you think there are any POV passages in the article, then please point to them. Staug73 (talk) 11:56, 20 May 2014 (UTC)
 * Psychosurgery has a long and controversial history. I find the article lacking in clear descriptions of the effects (both positive and negative) of the different procedures. In addition, I am sure that sufficient material must exist on the debates surrounding these controversial procedures. The ethical aspects of these procedures most definitively need addressing. --Randykitty (talk) 12:00, 20 May 2014 (UTC)


 * Thank you. That's what it says in the second sentence of the introduction - controversial. Following your suggestions I think it would be a good idea then to add 2 new sections: effects and ethical questions. Funnily enough I have just done a section on effects for the Lobotomy article. I can adapt that and add some stuff about the effects of later forms of psychosurgery. Ethical questions shouldn't be too difficult as psychosurgery has been a topic of the sort of "two sides of the debate" articles which are fairly easily summarised. But I think it is also important to keep the factual stuff in, as many people seem unclear about even basic things such as the extent to which psychosurgery is still performed, etc. Staug73 (talk) 12:31, 20 May 2014 (UTC)


 * I agree with Randykitty and the tag should be replaced until those additions are made and other authors cited. Yes I did try to add several references on reliable secondary sources, including Dr Faria, Dr Walker, Dr Mark, Dr Salloway and others were removed. All those sources and information which included data on the effect and results may have needed editing but not removal. All this material with updated information  came from reliable sources and notable journals. The only one that was kept was the one from World Neurosurgery, incidentally an entry I created. Surgical Neurology International is another notable journal entry I created. All those references need inclusion. Moreover, neuroscience ethics Neuroethics  are badly needed. Exactly the same thing happened with the other entry. And work needs to be done there as well.LeBassRobespierre (talk) 14:28, 20 May 2014 (UTC)


 * No need for a clean-up tag. The article in its present form does not meet the requirements for a clean-up tag. A suggestion was made to add a couple of sections, which was a good idea. That is all. There is no problem with sources, POV, etc. If you can see an example of POV then please point it out. Staug73 (talk) 15:14, 20 May 2014 (UTC)


 * As long as those two sections are added to include missing material that is fine. But capriciously leaving major sources out is not acceptable. As to POV, You say "point it out" —That is what I meant by POV, using some sources and not others, especially declining to use newer material in reliable sources. We will leave the tag off but I will follow this, as we understand each other. LeBassRobespierre (talk) 15:33, 20 May 2014 (UTC)

Correction
A couple of weeks ago I posted this on the Talk page of User:Randykitty "Hello Randykitty. Do you remember you removed (16 February 2014) a reference to Miguel Faria’s article in the external links section of Psychosurgery, with a comment about a spamlink to a non-notable journal (although I think you have since changed your mind about the journal)? Did you, I wonder, at the time check the IP address from which it came Special:Contributions/166.205.68.22? There are only a few edits from this address, and several of them are vandalism. I know an IP address can be shared, but it is interesting that the first edits (promptly removed from the article) are on a subject that is one of Miguel Faria’s interests... Staug73 (talk) 16:54, 2 June 2014 (UTC)" Correction - this IP address in fact inserted some categories. The IP address that inserted a link to Miguel Faria's article made only this one edit. Staug73 (talk) 09:14, 18 June 2014 (UTC)

Cavoli riscaldati
In regards to "Correction," it should be stated recurrent malicious allegations have been insinuated before by Staug 73, the expropriator of this entry as well as History of psychosurgery, and the accusations have already and thoroughly been answered. Since it has been brought up again, I 'm re-posting here what had been said before. It is now obvious that what I thought was professional rivalry is actually professional jealousy on Staug73's part! Here is the previous discussion on this issue:

"There is no secret of those articles; they are posted in my user page as Creation or Edits, no Sherlock Holmes necessary to find that. Yes I feel Faria's work brings the subject up to date in a variety of ways. I don't know about any vandalism (another false accusation). I don't know about that IP address. It is certainly not mine! ..." LeBassRobespierre (talk) 17:33, 2 June 2014 (UTC)

"And "Here we go again! From one accusation to another... to calumniate a fellow Wikipedian (so much for assuming good faith) and also the author (Faria) he is citing, just to keep me from editing two entries Staug73 thinks are his alone. He forgot the rules of wikipedia. In those articles (all of which are related to psychosurgery and neuroscience), which are presently my areas of interest, I added several references in addition to Faria's. Once again, Staug73 left information out to malign. I added several other references to both entries, which he neglected to mention: 1) Delgado, Jose (1986). Physical Control of the Mind: Toward a Psychocivilized Society. New York: Harper and Row and again: 2) Robison, RA; Taghva A; Liu CY; Apuzzo ML (2012). "Surgery of the mind, mood and conscious state: an idea in evolution". World Neurosurg 77: 662–686 3) Penfield, Wilder (1974). Speech and Brain Mechanisms. New York: Atheneum. 4) Mark, Vernon (1970). Violence and the Brain. New York: Harper and Row. "I added essential information (that was actually requested) from the above articles to the two related and deficient entries: Deep brain stimulation and Electrical brain stimulation, both of which had TAGS asking for additional citations and improvements:

" Deep brain stimulation: 'This article may require cleanup to meet Wikipedia's quality standards. No cleanup reason has been specified. Please help improve this article if you can.' "Electrical brain stimulation (which only had a single reference!): 'This article needs additional citations for verification. Please help improve this article by adding citations to reliable sources.'

"So improvements were asked for and were needed, and to do so I added information with those specific references because they needed inclusion, just as Faria's — all of them that I consider important...

"There has never been ANY vandalism by me there or anywhere else. It is not my style, as Randykitty himself should be able to testify! Staug73's professional vendetta with Faria has now extended to me because I edited the entries on Psychosurgery and History of psychosurgery, that he has expropriated and keeps under lock and key! "Finally, I repeat, I have no connection whatsoever to Special:Contributions/166.205.68.22, whoever he is or to any vandalism. I'm sure no connections of that IP address will be associated with me, and if there is, it would be a tenuous coincidence. My contributions to Wikipedia have been sterling and proud of them.So much so I listed them in my User page. What this vendetta is, I don't know, except Staug73 is adamant I can not edit his History of psychosurgery or Psychosurgery, no matter what references I add, and certainly not Faria or Surgical Neurology International, as sources with whom he also seems to have professional vendettas. I'm sorry Randykitty if we are crowding your page, but this is where Staug73 he is now posting.LeBassRobespierre (talk) 20:00, 2 June 2014 (UTC)"

You [Staug73] have also accused me of being 173.187.98.34, for which I admitted I was as I had forgotten to log in at times. I wrote:

" I must have forgotten to log in at those times. No big deal, those are entries I listed in my user page in non-contested entries. And for the first time you also imply good faith! So, as you can see those unsigned edits by me were innocent unsigned posts in uncontested territory. But you did try to lump me with some other IP user who had performed some vandalism, and you are still trying to link me now with some other unknown users, but those other IPs are not me. I did not make those other edits! As far as the chapter in HW Haggard’s The Doctor in History reference, it supports what I wrote: “Treatment in insanity has evaded practitioners from ancient times to the 20th century, as a result the mentally ill have been treated harshly, and in the 18th and 19th centuries mostly committed to crowded hospitals and asylums.” This has already been alluded to as been useful by WhatamIdoing, who correctly writes: "I don't see any good reason to omit this. The source appears to meet plain-vanilla WP:RS (which is all that is required for non-biomedical information like this), Staug appears to admit to its verifiability and accuracy in a back-handed way, and it is not unreasonable or UNDUE to say that this technique was promoted by the experts of the day, rather than by quacks or random physicians who didn't know much about the subject. So I'd include this." You have also gone over an administrator, who suggested that my additions were appropriate. Randykitty wrote, "Much depends on whether you accept Faria's article as a valid source for WP. If it is, then there is nothing wrong with adding it to the articles that you list." As far as the Deep brain stimulation, it still needs work, just as Electrical brain stimulation, which only had one reference when I got to it also needs work. My edits significantly improved those entries as anyone here can witness if they visit. The Faria and other references were essential to improve those articles. Other references are still needed, as the tags in both entries testify. And if my good faith additions needed polish, it could have been very easy for you to make minor edits. We should be here to help Wikipedia, not to start deletion fights. That was the reason I quit editing, after having done quite a bit of useful work in the two months I have been a contributor. LeBassRobespierre (talk) 21:05, 9 June 2014 (UTC)"

I conclusion I have simply stopped editing as I have not the time or inclination to resuming an editing war with you. It is regretfully a loss to Wikipedia. A lengthy discussion on these issues was also posted under Wikipedia talk: WikiProject Medicine under Talk:History of psychosurgery LeBassRobespierre (talk) 18:15, 10 July 2014 (UTC)

Reference to Miguel Faria's article
Explanation of why I am removing it. This is just someone with a couple of accounts and several IP addresses trying to promote Miguel Faria (take a look at the article they wrote about him). And this is why I think it is unsuitable as a source. It is an "essay-editorial" published in a journal set up by MF and friends and used as a vehicle for his political opinions. The article actually has very little about psychosurgery in it. The author has not done much reading on the subject - just a couple of articles which he then closely paraphrases (as I explained with examples previously). Here is outline of article. I have used italics for bits that are actually about psychosurgery. There are plenty of decent articles about psychosurgery out there. No need to use Wikipedia to promote views of MF. Staug73 (talk) 17:22, 29 April 2015 (UTC)
 * Part 1
 * Long section on trepanning, Phineas Gage, frontal lobe syndrome
 * Very short section on Moniz and first operations
 * Section on problem of mental illness
 * Section on Freeman and Watts
 * Another section on cost of mental illness
 * Conclusion - mentally ill poured on to streets (the author's language, not mine)
 * Part 2
 * Section on Kluver-Bucy syndrome
 * Long section on limbic system
 * Section of cingulotomy
 * Section on agressive behaviour in childhood and adolescence
 * Long section on DBS and Jose Delgado
 * Part 3
 * Another section on DBS
 * Long section on amygdala and Delgado
 * Section of reminiscences, Ervin and Mark
 * Section on stereotactic techniques and DBS (perhaps partially about psychosurgery)
 * Section of political stuff about criminals
 * Conclusions - more political stuff

And brief biography of Miguel Faria
He is a spokesman for the anti gun-control lobby in US and also for group in US that are anti regulation in medicine. He started off with promising career in neurosurgery - co-authored a couple of articles in medical journals, etc., and became editor of a small but legitimate medical journal (Journal of the Medical Association of Georgia). He had to leave the journal because he used it as a platform for his opinions on guns, etc. And he seems to have given up practising medicine at about the same time about twenty years ago when he was fortyish. Since then he has been writing; prolifically but almost all self-published (and I count as self-published anything by an on-line journal he set up and edits or by a publishing company he set up). I think I found one article that was published in a regular journal - something about the death of a French King. He was also editor for a while of the in-house magazine of the above group that is opposed to any regulation in medicine. All edits by the editor in question on Wikipedia are attempts to get MF's article mentioned or revolve around him and friends. Staug73 (talk) 17:43, 29 April 2015 (UTC)

Not sure if the hyphen helps. What I mean is that someone is pro guns and opposed to the control of guns. Some information about SNI here: http://blogs.discovermagazine.com/neuroskeptic/2015/02/22/right-wing-surgical-neurology-international/ "'After SN became SNI, the politicization of the journal has progressed further (although most papers are still normal science). Faria’s editorials, for instance, have become straightforwardly ideological. Many of them no longer have even the slightest connection to medicine. After the Sandy Hook shootings, for instance, Faria defended gun rights in the pages of SNI. Other Faria articles in the journal include “America, guns, and freedom” and an article on the Russian elections of 2012.'" That was the point I was trying to make about the reference to the SNI "essay-editorial" an editor is trying to put into Wikipedia articles: it is only marginally about psychosurgery and more about MF's political views, and what is more says nothing about psychosurgery that hasn't been said better by someone else in a proper medical article without all the political stuff. Staug73 (talk) 18:52, 29 April 2015 (UTC)

..
 * please read Identifying_reliable_sources_(medicine)--Ozzie10aaaa (talk) 20:09, 1 May 2015 (UTC)
 * I have refreshed my memory with Identifying_reliable_sources_(medicine). One of the problems is that, for psychosurgery, there simply are not the sources available that there are for say, prostate cancer (I think that is an example used in Identifying_reliable_sources_(medicine)). As it says in the psychosurgery article in the effectiveness section "There are no systematic reviews or meta-analyses" (followed by sources published in 2004 and 2005). Perhaps there have been some published since then? Well actually no. In England there have been perhaps 3 psychosurgical operations carried out since then - a few more in the rest of the UK but not enough for the sort of metanalyses that you may find in other areas of medicine. Numbers in US, Australia, etc are also small. I think it is used more widely in China. The current references in the psychosurgery article include several guidelines and reviews. There are also some newspaper articles which of course would not be reliable sources for statements about a treatment's risks or benefits, but they are the only sources available to show that psychosurgery is still being used in a particular country. It would be nice if a journal had published an article with a title like "Survey of psychosurgical practice around the world" but they haven't (oops just spotted one "The contemporary practice of psychiatric surgery: results from a global survey of functional neurosurgeons") so sometimes the only evidence is a newspaper article. Identifying_reliable_sources_(medicine) says it is preferable to use reviews (rather than editorials) which is exactly what this article does. It cites Mashour and Robison, which are both reviews. The Faria article is an "essay-editorial" not a review and is POV (that latter point has been agreed by 75.91.15.229 on RandyKitty's talk page). I don't think it even merits being included as a point of view because there is little current debate about the use of psychosurgery for violence (what the Faria article is all about) and, if there was, Faria would not be relevant as he is not a player in the field. By the way the Faria article was published in a journal he set up himself and where he writes political editorials (check them out on PubMed). A genuine review, like the Robison article, will cite a large number of relevant sources. I think Robison cites 132. There are just a few sources about psychosurgery in the Faria article (most of the article is not actually about psychosurgery but about DBS, surgery for epilepsy, etc). Most of the material on psychosurgery Faria has taken from Robison's review. He cites a couple of other articles as sources for a sentence or two but ignores most of the literature, so it is not a review. Although the Faria article was published a year after Robison I don't think he cites a single article on psychosurgery that has been published since Robison's article. That is why Robison is a better source for this article. Staug73 (talk) 14:30, 3 May 2015 (UTC)


 * Hi . Are these COI allegations or relevant to MEDRS? FiachraByrne (talk) 22:20, 1 May 2015 (UTC)

Mainly COI. This editor, with a couple of accounts and various IP addresses, has done no editing (other than a few extremely minor edits for example adding a link) that does not promote the interests of Miguel Faria and revolve around him and a small group of friends. All their edits on psychosurgery and related topics include this same reference to Miguel Faria's editorial and no other references (except for copying one or two footnotes from MF) showing that their primary concern is to promote MF and not to improve the articles. Staug73 (talk) 14:44, 2 May 2015 (UTC)

When the editor first inserted a link to MF's article I glanced at the first page or two, thought that it wasn't very good, but saw that it was written by someone whose name was not familiar in the field of psychosurgery studies and thought new kid on the block give them a chance. RandyKitty then removed it as a spam journal. There followed a long debate between RandyKitty and the journal's supporters about whether or not SNI should have a Wiki article about it. I wasn't involved and didn't follow the debate but the upshot was I think that SNI passed due to being on a particular database and RandyKitty and I then had a sort of role reversal - RandyKitty supporting the inclusion of references to MF's article while I, having actually read the article to the end, am not. Regardless of the status of the journal, the article in question is an editorial and, as the editor has admitted on RandyKitty's talk page, POV (their exact term). If you search for Miguel Faria on Pubmed you will see a list of his editorials in SNI that are political and have nothing to do with neurosurgery. The article in question is the same - mostly political stuff and what little there is about psychosurgery is gleaned from a handful of articles and says nothing new or well-analysed and is definitely not a review of the literature because the author hasn't read 99 per cent or more of the literature. I gave a brief summary of the article in the section above. By the way I agree about trepanation not being very relevant. Here is an extract from the conclusions of MF's 3-part editorial.

"'Criminal repeat offenders, on the other hand, who during medical examination are shown to have neuropathology discernible by the current state of medical knowledge, should, after the appropriate informed consent, be further evaluated and treated by qualified medical and nursing personnel trained in the management of 'psychopathy.' Their management should include the usual treatments, for example, removal of brain tumors, control of seizure disorders with anticonvulsants, etc., as well as the administration of psychotropic drugs, ECT, and functional neurosurgery for their associated psychopathy in private facilities by private and academic physicians, but not government doctors or facilities…. Management should be left entirely in private hands, as the situation existed a century ago…'"

That is what it is about. Staug73 (talk) 15:36, 2 May 2015 (UTC)

DBS
User:84.50.77.240 DBS is absolutely used to stimulate neurons. Depending on where you do and the signal, you can (get ready) activate neurons that tamp other ones down, that have a normal effect of tamping things down. By activating the inhibitor of the inhibitor, you turn everything else on. This is the mechanism by which ambien can sometimes wake people up who are in a minimally conscious state. Brains are complicated. But DBS gives electrical stimulation. That is all it can do. Jytdog (talk) 08:26, 15 December 2016 (UTC)