Discussion: lobotomize the patient or lobotomize the system

Whispera, MSN, RN · Jan 12, 2009

:yeahthat: I agree with the former poster...no more lobotomies!!!!!

Jo Dirt · Jan 19, 2009

The reason forced lobotomies were stopped was because they were not felt to be effective.

They call it lesioning now. It's also done to try to control seizures.

Jo Dirt · Jan 19, 2009

I cannot believe you are actually advocating for lobotomies. At first I thought it was just a joke in very poor taste. Our mental health system needs a lot of work, I won't argue with that. But look how far we have come. I am the mother of a bipolar child. I thank God every day that he wasn't born 50 years ago, or even 20 years ago. With the help of atypical antipsychotics he is a healthy, normal child. Without these drugs he would be totally nonfunctional, maybe even violent. My hope for others is that there is hope for them, too, in the new research that is going on even now. I know drugs are not the answer to everything, but they sure help! I think you need to consider that these are PEOPLE you are talking about doing forced brain surgery on. I hope you are just feeling discouraged right now and that is what has led you to feel this way, because that means that you can regain some hope.

Well, actually, no. I'm still an advocate, just because I cannot stand the idea of people being hurt at someone else's hands, even if they are supposedly not in control of themselves. If I was a violent person toward others I would want this done to me. It sounds barbaric but it is not nearly as barbaric as some 6' tall 210 pound psychotic with a machete or other weapon.

Of course, if a behavior can be controlled with medications I wouldn't suggest a lobotomy.

Lesioning has been done for migranes and seizures as well.

inthesky · Jan 20, 2009

Who gets to the person who decides whether medications will work or what is the definition of lobotomy-worthy behavior?

morte, LPN, LVN · Jan 20, 2009

Well, actually, no. I'm still an advocate, just because I cannot stand the idea of people being hurt at someone else's hands, even if they are supposedly not in control of themselves. If I was a violent person toward others I would want this done to me. It sounds barbaric but it is not nearly as barbaric as some 6' tall 210 pound psychotic with a machete or other weapon.
Of course, if a behavior can be controlled with medications I wouldn't suggest a lobotomy.
Lesioning has been done for migranes and seizures as well.

please checking out dr Abram Hoffer.....and orthomolecular psychiatry.....

Jo Dirt · Jan 21, 2009

I don't think there would be any dispute someone like Jeffrey Dahmer was lobotomy material.

Whispera, MSN, RN · Jan 21, 2009

Sometimes (hard to believe) I just don't have words that fit the situation.....

Quilter0225 · Jan 21, 2009

I think the previous poster hit the nail on the head. Who gets to decide? What invests someone with the authority to make that decision? Do you go with a committee of experts in mental health? How about putting it through the courts? I can see this stretching to become a punishment for violent crimes. The slope is just too slippery. There has to be another way.

Whispera, MSN, RN · Jan 21, 2009

Well, I've found words.... Lobotomy is just too iffy a "treatment" as far as results go to even consider for people who are mentally ill. I have my own opinions about mentally ill vs. evil and don't think they intersect each other. Anyway, I could say that I think a person should be duct taped to a tree, smeared with honey, and the bears should be let loose, AND that someone should drop hot soldering between their fingers, but while that is a feels-good venting thing, it's not something that would help either. There, I said it and I'm glad!

makawiliwili · Jan 25, 2009

The system is already lobotomitized.

I have a patient who had a lobotomy, he is a sad case. Very disoriented. Dangerous people have rights, just look at Paulson and Bernanke hahaha.

Our hospital uses wrist to waist, ankle restraints, and alot of needles. Staff get hurt daily. It's the system (society) that has created these monsters who suffer and make others suffer ... we get paid to keep them locked up... and as safe as possible.

"Normal" people snap and hurt others... should we just lobotomize everyone? Put prozac in the water? Or maybe tie the dangerous people to trees and let them starve as they still do in primitive cultures?

It is a sad profession to be in. Sigh.

Mr Ian · Jan 25, 2009

Violence in Mental Health is one of the most misrepresented and stigmatised aspects of mental illness. It's prevalence is not anywhere near as high as the media or the lay person asserts.

There are studies to suggest people with mental illness are twice as likley as other violent people to become violent (vis 7% v 16%) but such studies are fraught with co-morbidities and confounders that it does not serve to inform us well. (See here for more discussion)

But there is a causal link. Quite evidently there are times where positive mental health symptoms can cause violent behaviour. These are most often command hallucinations or threats to self based in delusional beliefs. Now these in and of themselves do not cause violence every time.

Becoming violent varies depending on the person's ability to morally reason; as it does for any person.

Someone with a predisposition for violence (eg exposure to an abusive childhood; normaitve cultural or social group behaviour) will more easily become violent as it is a 'taught' behaviour.

If the person is better equipped to morally reason - as are the majority of people - there either has to be a greater perceived risk to self (as we would all do) to cause someone to assault another person in an act of self-defence - such as when a person delusionally believes the person in front of them is part of a great conspiracy and about to inpregnate them with alien spawn -

Or if the person has suffered significant ego-depletion (loss of self-regulation - or 'emotionally worn out') by the constant psychpological dissonance of command hallucinations or delusional torment then they simply do not have the reserves to resist the impulsion and become aggressive.

Having said (or written) that - it must be remembered that violence can ba an act on someone else - or an act on oneself. Many people with mental illness that reach these stages elect to be violent on themselves rather than another person. Such are the reasons for high suicide; self harm or drug and alcohol abuse rates in mental illness.

Unfortunately, a far greater reason for violence in mental illness is intoxication with drugs and alcohol. This disinhibition simply accelerates the 'ego depletion' process whilst also diminishing (moral) judgement.

Most other violence from people with mental illness is due to any combination of:

reacting to disempowerment (especially when liberty is taken from them);

self defense;

community stigmatisation;

injustice;

institutional violence (as occurs in prisons);

social intolerance

- all reasons that anyone with or without mental illness might become violent and only existant secondary to the circumstance of mental health treatment.

In the full analysis - the evidence suggests that only a small number of poeople with mental illness are violent. And of those people in the whole of our society who commit violence, the mentally ill are again only a small number.

If this is to be of any use to you GoLytely, I'd suggest you review from within these reasons those which you might find most likely to affect you and perhaps take steps now to avoid them.

Above all - there is absolutely no certainty that having a mental illness will make you violent.

Whispera, MSN, RN · Jan 25, 2009

It seems to me that a mentally ill person is more likely to experience violence from someone else than to commit a violent act....