Therapy

• What is the therapy of the biological approach?

  Psychosurgery
• Pre-frontal leucotomy procedure 


  Drill a hole in each side of the skull and inserting an instrument with a retractable wire loop to sever nerve fibres.
• Pre-frontal leucotomy effectiveness 


  Moniz & Lima operated on nearly 40 patients by 1937 with mixed results. Some improved whilst others showed no change and some relapsed still.
• Pre-frontal leucotomy side effects

  Apathy

  passivity

  Lack of initiative

  Poor ability to concentrate

  Generally decreased depth and intensity of their emotional response to life.
• Pre-frontal leucotomy ethical issues

  Serious risk of complications.

  Has affect on the patients whole being (emotions, personality, memories).
• Transorbital lobotomy procedure 


  Pick-like instrument (orbitoclast) forced through back of eye sockets to pierce the thin bone that separates the eye sockets from the frontal lobe.

  Pick’s point then inserted into the frontal lobe and used to sever connections in the brain.

  Took approximately 10 minutes.
• Transorbital lobotomy effectiveness 


  Large proportion of patients exhibited reduced tension or agitation.
• Transorbital lobotomy side effects

  Apathy

  Passivity

  Lack of initiative

  Poor ability to concentrate

  Generally decreased depth and intensity of their emotional response to life.
• Transorbital lobotomy ethical issues

  Serious risk of complications.

  Having an affect on the patients while being (emotions, personality, memories).
• Bilateral cingulotomy procedure 


  MRI used to find target area.

  Gamma knife focusses beams of radiation at target site.
• Bilateral cingulotomy effectiveness 


  2016 review concluded that 41% of patients who had undergone it had responded to the procedure with 14% experiencing short-term side effects and 5% experiencing serious side effects.
• Bilateral cingulotomy side effects 


  Generally mild, with some experiencing headaches, nausea and vomiting in the days following the surgery.

  May trigger seizures in some, although usually to those with previous history of seizures.
• Deep brain stimulation procedure

  Surgeons thread wires through the patient’s skull. The wires are connected to a battery pack implanted to the patient’s chest. The batteries produce an adjustable high-frequency current that interrupts the brain circuits involved in eg ocd.
• Deep brain stimulation side effects

  Temporary tingling in the face or limbs.

  Feeling of pulling in the muscles.

  Speech or vision problems.

  Loss of balence.
• Szaz (1978)


  Criticised psychosurgery in general as he believes that a person’s psychological self is not something physical and therefore it does not make sense to suggest it can be operated on.
• Ethical considerations of psychosurgery

  The effects cannot be reversed.

  Can a person with an unmanageable mental illness provide informed consent?

  Last resort.

  Is it appropriate to be done on people who’s brain isn’t fully developed (doesn’t fully develop until mid 20s).