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Title: Abnormal%20Psychology%20

Abnormal Psychology TherapyChapters 16 17
Part I Psychological Disorders
A Quick Word before We Begin
  • It is normal phenomenon for students of
    psychology and medicine to unconsciously (or
    consciously) to diagnose themselves or others as
    having a disorder because they may have
    experienced related symptoms in the past (or
    present). It is VERY important to fight that
    urge. We are not doctors or psychologists! Only
    they can make diagnoses!
  • We laugh at the behavior NOT the people!

Defining Psychological Disorders
  • Mental health workers view psychological
    disorders as persistently harmful thoughts,
    feelings, and actions.

When behavior is unjustifiable, maladaptive,
atypical, and disturbing psychiatrists and
psychologists label it as disordered. Remember
Deviant, Distressful Dysfunctional
  • 1. Deviant behavior (going naked) in one culture
    may be considered normal, while in others it may
    lead to arrest.
  • 2. Deviant behavior must accompany distress.
    World-class athletes deviate from the norm but
    that does not cause distress to themselves or
  • 3. If a behavior is dysfunctional it is clearly
    a disorder.

In the Wodaabe tribe men wear costumes to attract
women. In Western society this would be
considered abnormal.
Medical Perspective
  • Philippe Pinel (1745-1826) from France, insisted
    that madness was not due to demonic possession,
    but an ailment of the mind. He suggested humane

Lunatic Ball
Biopsychosocial Perspective
  • Assumes that biological, socio-cultural, and
    psychological factors combine and interact to
    produce psychological disorders.

Classifying Psychological Disorders
  • The American Psychiatric Association rendered a
    Diagnostic and Statistical Manual of Mental
    Disorders (DSM) to describe psychological

The most recent edition, DSM-IV-TR (Text
Revision, 2000), describes 400 psychological
disorders compared to 60 in the 1950s.
The DSM-IV-TR Multiaxial Classification
Is a Clinical Syndrome (cognitive, anxiety, mood
disorders 16 syndromes) present?
Axis I
Is a Personality Disorder or Mental Retardation
Axis II
Is a General Medical Condition (diabetes,
hypertension or arthritis etc) also present?
Axis III
Are Psychosocial or Environmental Problems
(school or housing issues) also present?
Axis IV
What is the Global Assessment of the persons
Axis V
Goals of DSM
  1. Describe (400) disorders.
  2. Determine how prevalent the disorder is.

Disorders outlined by DSM-IV are reliable.
Therefore, diagnoses by different professionals
are similar. Also, insurance companies usually
require a firm diagnosis to cover health care
Others criticize DSM-IV for classifying almost
anything as a disorder/syndrome.
Anxiety Disorders
  • Feelings of excessive apprehension and anxiety
    that cause distress or cause maladaptive
    behaviors to reduce the levels of stress.
  1. Generalized anxiety disorders (GAD)
  2. Phobias
  3. Panic disorders
  4. Obsessive-compulsive disorders (OCD)
  5. Post-Traumatic Stress Disorder (PTSD)

Generalized Anxiety Disorder
  1. Persistent and uncontrollable tenseness and
    apprehension (worrying).

2. Autonomic arousal.
3. Inability to identify or avoid the cause of
certain feelings.
Panic Attack Disorder
  • Minute-long episodes of intense dread which may
    include feelings of terror, chest pains, choking,
    or other frightening sensations.

Anxiety is a major component of panic attack
disorder, making people avoid situations that
cause it. Panic Attack disorder and agoraphobia
(fear of open/public places) usually go together.
  • Marked by a persistent and irrational fear of an
    object or situation that disrupts behavior.

Kinds of Phobias
Phobia of open places.
Phobia of heights.
Phobia of closed spaces.
Phobia of blood.
Obsessive-Compulsive Disorder
  • Persistence of unwanted thoughts (obsessions) and
    urges to engage in senseless rituals
    (compulsions) that cause distress.

Ms. Cohens Obsession!!!
Post-Traumatic Stress Disorder
  • Four or more weeks of the following symptoms
    constitute post-traumatic stress disorder (PTSD)
  1. Haunting memories

2. Nightmares
3. Social withdrawal
4. Jumpy anxiety
5. Sleep problems
Explaining Anxiety Disorders
Freud suggested that we repress our painful and
intolerable ideas, feelings, and thoughts,
resulting in anxiety.
The Learning Perspective
Learning theorists suggest that (classical) fear
conditioning leads to anxiety. This anxiety then
becomes associated with other objects or events
(stimulus generalization) and is reinforced.
Investigators believe that fear responses can
be passed along to others through observational
The Biological Perspective
Natural Selection has led our ancestors to learn
to fear snakes, spiders, and other animals.
Therefore, fear preserves the species.
Twin studies suggest that our genes may be partly
responsible for developing fears and anxiety.
Twins are more likely to share phobias.
The Biological Perspective
  • A PET scan of the brain of a person with
    Obsessive-Compulsive Disorder (OCD). High
    metabolic activity (red) in the frontal lobe
    areas are involved with directing attention.

Dissociative Disorders
  • Conscious awareness becomes separated
    (dissociated) from previous memories, thoughts,
    and feelings.

Depersonalization Disorder
  1. Having a sense of being unreal.

2. Being separated from the body.
3. Watching yourself as if in a movie.
Dissociative Identity Disorder (DID)
  • Formerly called Multiple Personality Disorder
    (MPD), it is a disorder in which a person
    exhibits two or more distinct and alternating
  • (each with its own name, voice, mannerisms,
    occupations, etc).

Chris Sizemore, the basis for the movie The
Three Faces of Eve
Other Dissociative Disorders
  • Dissociative Amnesia amnesia caused by some
    kind of trauma (not by injury)
  • Dissociative Fugue Person totally forgets who
    they are and may develop a completely new
    identity, personality, etc. in a new place.

Mood Disorders
  • Emotional extremes of mood disorders come in two
    principal forms.
  1. Major depressive disorder
  2. Bipolar disorders

Major Depressive Disorder
Depression has been called the common cold of
psychological disorders.
Major Depressive Disorder
Slightly/Situationally depressed mood
Chronic shortness of breath
Gasping for air after a hard run
Major Depressive Disorder
  • Major depressive disorder occurs when signs of
    depression last two weeks or more and are not
    caused by drugs or medical conditions.

Signs include
  1. Lethargy and fatigue
  2. Feelings of worthlessness
  3. Loss of interest in family friends
  4. Loss of interest in activities

Dysthymic Disorder
Dysthymic disorder lies between a blue mood and
major depressive disorder. It is a disorder
characterized by daily depression lasting two
years or more.
Bipolar Disorder
  • Formerly called manic-depressive disorder, it is
    an alternation between depression and mania
  • (highs lows).

Manic Symptoms
Depressive Symptoms
Desire for action
Inability to make decisions
Multiple ideas
Slowness of thought
Bipolar Disorder
Many great writers, poets, and composers suffered
from bipolar disorder. During their manic phase
creativity surged, but not during their depressed
Explaining Mood Disorders
Since depression is so prevalent worldwide,
investigators want to develop a theory of
depression that will suggest ways to treat it.
Lewinsohn notes that a theory of depression
should explain the following
  1. Behavioral and cognitive changes
  2. Common causes of depression

Theory of Depression
  1. Gender differences

Theory of Depression
  1. Depressive episodes usually self-terminate.
  2. Depression is increasing, especially in the teens.

Post-partum depression
The most severe form of behavioral response to
depression is suicide. Each year some 1 million
people commit suicide worldwide.
Biological Perspective
Genetic Influences Mood disorders run in
families. The rate of depression is higher in
identical (50) than fraternal twins (20).
Linkage analysis and association studies link
possible genes and dispositions for depression.
Biological Perspective
Neurotransmitters A reduction of norepinephrine
and serotonin has been found in
depression. Drugs that alleviate mania reduce
Pre-synaptic Neuron
Post-synaptic Neuron
Biological Perspective
  • PET scans show that brain energy consumption
    rises and falls with manic and depressive

Social-Cognitive Perspective
The social-cognitive perspective suggests that
depression arises partly from self-defeating
beliefs and negative explanatory styles.
Depression Cycle
  1. Negative stressful events.
  2. Pessimistic explanatory style.
  3. Hopeless depressed state.
  4. These hamper the way the individual thinks and
    acts, fueling personal rejection.

Explanatory style plays a major role in becoming
Psychotic Disorders
  • Schizophrenia

Nearly 1 in a 100 suffer from schizophrenia, and
throughout the world over 24 million people
suffer from this disease.
Schizophrenia strikes young people as they mature
into adults. It affects men and women equally,
but men suffer from it more severely than women.
Symptoms of Schizophrenia
  • The literal translation is split mind but is
    not the same as DID. Schizophrenia is a group of
    severe disorders characterized by the following
  1. Disorganized and delusional thinking.
  2. Disturbed perceptions.
  3. Inappropriate emotions and actions.

John Nash
Disorganized Delusional Thinking
This morning when I was at Hillside Hospital, I
was making a movie. I was surrounded by movie
stars Im Marry Poppins. Is this room painted
blue to get me upset? My grandmother died four
weeks after my eighteenth birthday.
This monologue illustrates fragmented, bizarre
thinking with distorted beliefs (usually of
grandeur or persecution) called delusions (Im
Mary Poppins). It also demonstrates a principle
called word salad (jumbling up ideas in
Other forms of delusions include, delusions of
persecution (someone is following me) or
grandeur (I am a king).
Disturbed Perceptions
  • A schizophrenic person may perceive things that
    are not there (hallucinations). Frequently such
    hallucinations are auditory and lesser visual,
    somatosensory, olfactory, or gustatory.

Inappropriate Emotions Actions
  • A schizophrenic person may laugh at the news of
    someone dying or show no emotion at all
    (apathy/flat affect).

Patients with schizophrenia may continually rub
an arm, rock a chair, or remain motionless for
hours (catatonia).
Subtypes of Schizophrenia
  • Schizophrenia is a cluster of disorders. These
    subtypes share some features, but there are other
    symptoms that differentiate these subtypes.

Positive and Negative Symptoms
  • Schizophrenics have inappropriate symptoms
    (hallucinations, disorganized thinking, deluded
    ways) that are not present in normal individuals
    (positive symptoms - inward).

Schizophrenics also have an absence of
appropriate symptoms (apathy, expressionless
faces, rigid bodies) that are present in normal
individuals (negative symptoms - outward).
Chronic and Acute Schizophrenia
  • When schizophrenia is slow to develop
    (chronic/process) recovery is doubtful.
  • Such schizophrenics usually display negative
    (outward) symptoms.

When schizophrenia rapidly develops
(acute/reactive) recovery is better. Such
schizophrenics usually show positive (inward)
symptoms .
Understanding Schizophrenia
  • Schizophrenia is a disease of the brain exhibited
    by the symptoms of the mind.

Brain Abnormalities
Dopamine Overactivity Researchers found that
schizophrenic patients express higher levels of
dopamine D4 receptors in the brain.
Abnormal Brain Activity, Etc.
  • Brain scans show abnormal activity in the frontal
    cortex, thalamus, and amygdala of schizophrenic
    patients. Schizophrenia patients may exhibit
    morphological changes in the brain like
    enlargement of fluid-filled ventricles.

Pre-natal/Neo-natal development
  • Schizophrenia has also been observed in
    individuals who contracted a viral infection
    (flu) during the middle of their fetal
  • There is also evidence of people who suffered
    from oxygen deprivation at birth and/or poor
    fetal nutrition may also have higher rates of
  • Malnutrition, methamphetamine and cocaine abuse,
    and social conditions (urban life, racial
    discrimination, adversity and family dysfunction)
    have also been contributed to the development of
    the disorder.

Genetic Factors
  • The likelihood of an individual suffering from
    schizophrenia is 50 if their identical twin has
    the disease.

Warning Signs
  • Early warning signs of schizophrenia include

A mothers long lasting schizophrenia.
Birth complications, oxygen deprivation and
low-birth weight.
Short attention span and poor muscle coordination.
Disruptive and withdrawn behavior.
Emotional unpredictability.
Poor peer relations and solo play.
Personality Disorders
  • Personality disorders are characterized by
    inflexible and enduring behavior patterns that
    impair social functioning. They are usually
    without anxiety, depression, or delusions.

Some Personality Disorders
  • Avoidant Personality Disorder the person
  • withdraws due to fear of rejection
  • Schizoid Personality Disorder the person is
  • disengaged (flat affect)
  • Schizotypal Personality Disorder the person
    enjoys social isolation, usually displays strange
    behavior and thinking
  • Histrionic Personality Disorder the person
    engages in attention-grabbing emotional outbursts
    and tries to gain others approval
  • Narcissistic Personality Disorder the person is
    very self-absorbed and have delusions of grandeur
  • Borderline Personality Disorder the person has
    unstable emotions and relationships and
    ultimately an unstable identity
  • Antisocial Personality Disorder the person
    (usually male) exhibits a lack of conscience for
    wrongdoing, even toward friends and family
    members. Formerly, this person was called a
    sociopath or psychopath.
  • Dependent Personality Disorder the person is
    abnormally dependent on other people
  • Paranoid Personality Disorder the person has
    paranoid thoughts and feelings and doesnt trust

Understanding Antisocial Personality Disorder
  • Like mood disorders and schizophrenia, antisocial
    personality disorder has biological and
    psychological reasons. Youngsters, before
    committing a crime, respond with lower levels of
    stress hormones than others do at their age.

Understanding Antisocial Personality Disorder
  • PET scans of 41 murderers revealed reduced
    activity in the frontal lobes. In a follow-up
    study repeat offenders had 11 less frontal lobe
    activity compared to non-murders.

Understanding Antisocial Personality Disorder
  • The likelihood that one will commit a crime
    doubles when childhood poverty is compounded with
    obstetrical complications.

Somatoform Disorders
  • Disorders that usually involve
  • abnormal bodily sensation or body image
  • Hypocondriasis believing that you
  • have illnesses that you dont really have
  • Pain disorder
  • Conversion disorder developing physical
    symptoms without an actual biological cause
  • Body Dismorphic Disorder belief that one
  • or more of the features/parts of your body
  • are abnormal/grotesque and need to be fixed

Childhood Disorders
  • Attention-Deficit Hyperactivity Disorder (ADHD)
  • 3 key symptoms
  • Inattention
  • Hyperactivity
  • Impulsivity
  • The Big Questions
  • Is it overdiagnosed?
  • Is it a real syndrome at all?
  • How can it be better diagnosed?
  • What causes it?

Childhood Disorders
  • Autistic Disorders
  • Key symptoms
  • Impaired speech or development
  • Impaired social interaction (such as decreased
    eye contact and inability to carry on a
  • Impaired theory of mind (understanding of others
    point of view)
  • Behaviorally inflexible stick to routine
    distress when it changes
  • Tends to occur more in males than in females
  • Asperger syndrome
  • high functioning form of autism with normal (or
    high) levels of intelligence and possible savant
  • yet with decreased social functioning
  • Possible Causes?
  • Differences/damage in the brains
  • neural connections?
  • Genetic Factors?
  • Mercury in Vaccines?

Other Disorders
  • Tic Disorders facial tics, blurted out words or
  • Tourettes Syndrome
  • Factitious Disorders disorders in which the
    person fakes symptoms or inflicts symptoms on
    self or others to gain attention/sympathy
    (malingering sickness for
  • personal or monetary gain)
  • Munchausen Syndrome person claims to have
    symptoms and undergoes many treatments/surgeries
    to receive attention
  • Munchausen Syndrome by Proxy person induces
    illnesses in others (usually parents do this to
    kids) to receive indirect attention
  • Causes? Perhaps person was given great care by a
    doctor growing up and neglected by parents?
    Other, underlying personality disorders?

Rates of Psychological Disorders
Rates of Psychological Disorders
Part II Psychological Treatment/Psychotherapy
History of Insane Treatment
Maltreatment of the insane throughout the ages
was the result of irrational views. Many patients
were subjected to strange, debilitating, and
downright dangerous treatments.
History of Insane Treatment
Philippe Pinel in France and Dorthea Dix in
America founded humane movements to care for the
mentally sick.
Philippe Pinel (1745-1826)
Dorthea Dix (1745-1826)
Psychotherapy involves an emotionally charged,
confiding interaction between a trained therapist
and a mental patient.
Biomedical therapy uses drugs or other procedures
that act on the patients nervous system, curing
him or her of psychological disorders.
An eclectic approach uses various forms of
healing techniques depending upon the clients
unique problems.
Psychological Therapies
  • We will look at four major forms of
    psychotherapies based on different theories of
    human nature
  1. Psychoanalytical theory
  2. Humanistic theory
  3. Behavioral theory
  4. Cognitive theory

Psychoanalytic Therapy
  • The first formal psychotherapy to emerge was
    psychoanalysis, developed by Sigmund Freud.

Edmund Engleman
Sigmund Freud's famous couch
  • Since psychological problems originate from
    childhood repressed impulses and conflicts, the
    aim of psychoanalysis is to bring repressed
    feelings into conscious awareness where the
    patient can deal with them.

When energy devoted to id-ego-superego conflicts
is released, the patients anxiety lessens.
  • Freud developed the method of free association to
    unravel the unconscious mind and its conflicts.
    The patient lies on a couch and speaks about
    whatever comes to his or her mind.

Psychoanalysis Criticism
  • During free association, the patient edits his
  • thoughts, resisting his or her feelings to
  • express emotions. Such resistance becomes
  • important in the analysis of conflict-driven
  • anxiety. Eventually the patient opens up and
  • reveals his or her innermost private
  • thoughts, developing positive or negative
  • feelings (transference) towards the therapist.
  • Psychoanalysis is hard to refute because it
    cannot be proven or disproven.
  • Psychoanalysis takes a long time and is very

Humanistic Therapy
  • Humanistic therapists aim to boost
    self-fulfillment by helping people grow in
    self-awareness and self-acceptance.
  • Unlike psychodynamic therapies,
  • humanistic therapies focus on
  • The present and future, not past conflicts
  • Conscious issues not unconscious conflicts
  • Taking responsibility for ones feelings and
  • not finding what is hidden
  • Promoting individual growth, not curing
  • - Person in therapy called client (not patient)

Humanistic Therapy
  • Developed by Carl Rogers, person-centered therapy
    is a form of humanistic therapy.

The therapist listens to the needs of the patient
in an accepting and non-judgmental way
(unconditional positive regard) , addressing
problems in a productive way and building his or
her self-esteem. Therapist also demonstrates
empathy and genuineness.
Humanistic Therapy
  • The therapist engages in active listening and
    echoes, restates, and clarifies the patients
    thinking, acknowledging expressed feelings.

Behavior Therapy
  • Therapy that applies learning principles to the
    elimination of unwanted behaviors.

To treat phobias or sexual disorders, behavior
therapists do not delve deeply below the surface
looking for inner causes.
Behavior Therapy
  • Counterconditioning is a procedure that
    conditions new responses to stimuli that trigger
    unwanted behaviors. Expose patients to things
    they fear and avoid. Through repeated exposures,
    anxiety lessens because they habituate to the
    things feared.

Mary Cover Jones
Behavior Therapy
  • Aversive Conditioning is a type of
    counterconditioning that associates an unpleasant
    state with an unwanted behavior. With this
    technique, temporary conditioned aversion to
    alcohol has been reported (but doesnt seem to
    work long-term).

Behavior Therapy
  • Exposure therapy involves exposing people to
    fear-driving objects in real or virtual

Behavior Therapy
  • Systematic Desensitization is a type of exposure
    therapy that associates a pleasant, relaxed state
    with gradually increasing anxiety-triggering
    stimuli (commonly used to treat phobias).

Behavior Therapy
  • Operant conditioning procedures enable therapists
    to use behavior modification, in which desired
    behaviors are rewarded and undesired behaviors
    are either unrewarded or punished.

A number of withdrawn, uncommunicative
3-year-old autistic children have been
successfully trained by giving and withdrawing
reinforcements for desired and undesired
Behavior Therapy
  • Therapists may create a token economy in which
    patients exchange a token of some sort (a
    secondary reinforcer), earned for exhibiting the
    desired behavior, for various privileges or
    treats (a primary reinforcer).

Behavior Therapy Criticisms
  • Will the desired behaviors continue and/or
    undesirable behaviors come back when the
    training/reinforcement stops?
  • Is it really ethical for one human being to
    train another?

Cognitive Therapy
  • Teaches people adaptive ways of thinking and
    acting based on the assumption that thoughts
    intervene between events and our emotional

Cognitive Therapy
  • Rational-Emotive Therapy - Albert Ellis developed
    a theory that irrational thoughts led to
    self-defeating emotions.
  • Ellis developed the ABCD model to explain this
  • A Activating event that triggers the emotion
    (e.g. failing a test)
  • B Belief System how person appraises the event
    (e.g. Im stupid and no good at this subject)
  • C emotional/behavioral Consequences of the
    appraisal in step B (e.g. feeling worthless and
  • D Disputing their erroneous beliefs in step B
    (e.g. Im not dumb. I just did not study hard
    enough and go in for the extra help that I
    needed) This is what Ellis wanted to train his
    clients to be able to do through Rational Emotive
  • Therapists present common irrational beliefs to
    clients and help to train them to cognitively
    restructure/reappraise their thinking.

Cognitive Therapy
  • Cognitive therapists often combine the reversal
    of self-defeated thinking with efforts to modify

Cognitive-behavior therapy aims to alter the way
people act (behavior therapy) and alter the way
they think (cognitive therapy).
AP Psych Rocks!
Evaluating Therapies
Group Family Therapy
Group therapy normally consists of 6-9 people
attending a 90-minute session that can help more
people and costs less. Clients benefit from
knowing others have similar problems.
Family therapy treats the family as a system.
Therapy guides family members toward positive
relationships and improved communication.
Marriage counseling is a form of this.
Effectiveness of Different Therapies
  • Which psychotherapy would be most effective for
    treating a particular problem?

Disorder Therapy
Depression Behavioral, Cognitive, Interpersonal
Anxiety Cognitive, Exposure, Stress Inoculation
Bulimia Cognitive-behavioral
Phobia Behavioral
Bad Habits Behavior Modification
Alternative Therapies
  • Seasonal Affective Disorder (SAD), a form of
    depression, has been effectively treated by light
    exposure therapy.

Therapists Training
  • Clinical psychologists
  • They have PhDs mostly. They are experts in
    research, assessment, and therapy, all of which
    is verified through a supervised internship.

Clinical or Psychiatric Social Worker They have
a Masters of Social Work. Postgraduate
supervision prepares some social workers to offer
psychotherapy, mostly to people with everyday
personal and family problems.
Therapists Training
  • Counselors
  • Pastoral counselors or abuse counselors work with
    problems arising from family relations, spouse
    and child abusers and their victims, and
    substance abusers.

Psychiatrists They are physicians who
specialize in the treatment of psychological
disorders. Not all psychiatrists have extensive
training in psychotherapy, but as MDs they can
prescribe medications.
The Biomedical Therapies
  • These include physical, medicinal, and other
    forms of biological therapies.
  1. Drug Treatments
  2. Surgery
  3. Electric-shock therapy

Drug Therapies
  • Psychopharmacology is the study of drug effects
    on mind and behavior.

With the advent of drugs, hospitalization in
mental institutions has rapidly declined.
However, many patients are left homeless on the
streets due to their ill-preparedness to cope
independently outside in society.
Antipsychotic Drugs
  • Classical antipsychotics
  • Chlorpromazine (Thorazine)
  • Remove a number of positive symptoms associated
    with schizophrenia such as agitation, delusions,
    and hallucinations.

Atypical antipsychotics Clozapine
(Clozaril) Remove negative symptoms associated
with schizophrenia such as apathy, jumbled
thoughts, concentration difficulties, and
difficulties in interacting with others.
Atypical Antipsychotic
  • Clozapine (Clozaril) blocks receptors for
    dopamine and serotonin to remove the negative
    symptoms of schizophrenia.

Antianxiety Drugs
Antianxiety drugs (Xanax and Ativan) depress the
central nervous system and reduce anxiety and
tension by elevating the levels of the
Gamma-aminobutyric acid (GABA) neurotransmitter.
Antidepressant Drugs
  • Antidepressant drugs like Prozac, Zoloft, and
    Paxil are Selective Serotonin Reuptake Inhibitors
    (SSRIs) that improve the mood by elevating levels
    of serotonin by inhibiting reuptake.

Mood-Stabilizing Medications
Lithium Carbonate, a common salt, has been used
to stabilize manic episodes in bipolar disorders.
It moderates the levels of norepinephrine and
glutamate neurotransmitters.
Brain Stimulation
  • Electroconvulsive Therapy (ECT)
  • ECT is used for severely depressed patients who
    do not respond to drugs. The patient is
    anesthetized and given a muscle relaxant.
    Patients usually get a 100 volt shock that
    relieves them of depression.

Psychosurgery was popular even in Neolithic
times. Although used sparingly today, about 200
such operations do take place in the US alone.
Psychosurgery (trephination/lobotomy) is used as
a last resort in alleviating psychological
disturbances. Removal of brain tissue changes the
mind and psychosurgery is irreversible
Rosemary Kennedys Lobotomy
  • We went through the top of the head, I think she
    was awake. She had a mild tranquilizer. I made a
    surgical incision in the brain through the skull.
    It was near the front. It was on both sides. We
    just made a small incision, no more than an
    inch." The instrument Dr. Watts used looked like
    a butter knife. He swung it up and down to cut
    brain tissue. "We put an instrument inside," he
    said. As Dr. Watts cut, Dr. Freeman put questions
    to Rosemary. For example, he asked her to recite
    the Lord's Prayer or sing "God Bless America" or
    count backwards. ... "We made an estimate on how
    far to cut based on how she responded." ... When
    she began to become incoherent, they
    stopped. James W. Watts

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