Customer Reviews

Great and Desperate Cures: The Rise and Decline of Psychosurgery and Other Radical Treatments for Mental Illness

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This is an incredible story. Thousands of people had their brains mutilated and personalities destroyed in a grand experiment to cure schizophrenia and other mental disorders. What's so incredible is that scientists and physicians, principally Walter Freeman in the book, advocated this procedure based on theories of the brain and mental disorders without much evidence to support their claims. In fact, the theories are almost an afterthought to justifiy the procedure. I'm absolutely amazed at the breathtaking irresponsibility of the medical and psychiatric communities allowed this to go on. Valenstein starts the book by tracing the history of physical "cures" from water treatment to electroshock therapy. What Valenstein proves is that lobotomy is really just another attempt by the psychiatric communitiy to apply specualtive theory and boldly experiment on human beings. This was possible because serious mental disorders, like schizophrenia, seemed hopeless. The medical community and public was willing to try anything. In this context, Valenstein explains the driving forces that helped lobotomy to gain wide popularity: the medical profession's willingness to try anything and uncritical acceptance of advocates' claims of success - even giving the inventor of the procedure a Nobel Prize; the media's fascination with strange medical procedures and the almost universal blind acceptance of doctor's claims; and finally, the public institutions' desire to save money - lobotomized patients were released from institutions or were easier to handle. As a layman, I assume scientists are objective and critical thinkers and, doctors are humane heroes - "to do no harm". This book demolishes those illusions and keeps your skeptical mind razor sharp.

The history of psychosurgery is intriguing to anyone interested in the brain, and it begs two questions (1) How did it happen that surgeons once found it fashionable and helpful to cut the frontal lobes, and (2) What do we know now about those ailments that were once treated by psychosurgery? Valenstein's book provides a comprehensive historical review that answers the first question, and provides important cues to answer the second, including some of the current views on brain and mood disorders. Valenstein's personal biases against some of these theories do not show through, and he maintains an even perspective. The sciences is treated seriously but remains accessible. Background information on the various figures involved in psychosurgery are also provided when needed, but never turn into annoying biopics. I really enjoyed reading it.

This is a very well-written book that gives a balanced account of the history of "somatic treatments" for mental illness. The author places leucotomies/lobotomies into the context of the somatic vs psychoanalytic debate and describes several of the initial somatic treatments such as insulin shock, malarial infection and so on. The author also highlights the laudable motivation on the part of Moniz, Freeman and others to do SOMETHING for people who were otherwise left untreated and miserable - essentially looked upon as society's throwaways. In this way, Valenstein gives a fair account of the initial motivations. At the same time, Valenstein exposes the Emperor's new clothes as he picks apart any semblance of a logical or biological rationale for the destruction of frontal lobe tissue. Moreover, the precipitous slope of sloppiness that Freeman traversed in terms of patient selection, informed consent, and rigorous testing is narrated in excruciating detail. The reader cringes as Freeman's preference for Christmas card and casual social encounters with his former patients over neuropsychological testing is painstakingly described.
This book is a very important contribution to thinking about ethics around neurosurgery. Valenstein also extends his approach to non-neurosurgical procedures such as cardiac bypass operations in a highly thought-provoking manner. In the end, I would love to see two updates. First, how would Valenstein define psychosurgery? Is DBS or pallidotomy for a movement disorder a type of psychosurgery? How about a cingulotomy for depression or pain? I think that one could make the argument that all of the above are psychosurgeries, not because of their intended results but because they all have effects, whether subtle or pronounced, on cognition. Second, I would love to see an update of how common different types of psychosurgeries are today, both in the US and elsewhere around the globe.

I'm so glad to see this book back in print. 'Great and Desperate Cures' describes the history of psychosurgery, commonly known as lobotomy. It's a fascinating and truly mind boggling account of historical events, events that are so astounding it is hard to believe they occurred.

This book is much more, though, than a history of one medical procedure. It's a story of human folly. Most people do not question accepted beliefs. They follow blindly the fashion of the times. In this instance, it was the medical establishment that was blind, quick to espouse a radical and harmful surgical procedure, without examining the evidence and without exercising even a modicum of caution. It's an extremely well researched book that sticks to the facts and never lapses into rhetoric. This is precisely what makes this true story so amazing.

I cannot recommend this book highly enough. It's a must read, not only for those interested in the history of psychiatry, but for anyone who is interested in the evolution of ideas. Five stars do this book no justice.

this is a very interesting book but it is very detailed. so if you're not interested in medical facts, case studies and the history of treatments and "cures" of mental illness, you probably won't like it.
the author is very thorough and some of the treatments tried just make you shake your head and ask "what were they thinking?"

this would make an excellent book for anyone studying psychology or psychiatry. (i could even see it as a textbook.)
excellent!

At one time lobotomy was hailed as a cure for mental illness and the originator even received a Nobel prize for medicine. As should have been clear almost from the start, all it did was quiet patients and render them docile. Thousands of people were deproved of thier higher brain function, often in a few seconds with several strokes of an ice pick.

The rise and fall of lobotomy has many parallels with the rise and fall of other dangerous and ineffective surgeries, particularly gastric bypass for obesity.