Saturday, December 19, 2009

Neurosurgery: does "slice 'n' dice" cut it, when mental disorders are in question?

In "Brain Power: Surgery for Mental Ills Offers Both Hope and Risk" (Benedict Carey, New York Times, November 26, 2006), we learn about attempts to cure mind problems like obsessive-compulsive disorders and phobias through brain surgery. The best face the article can put on it does not disguise the fact that
It is a precise, sophisticated version of an old and controversial approach: psychosurgery, in which doctors operate directly on the brain.
No surprise that the proponents will say it is a great new thing.
In the last decade or so, more than 500 people have undergone brain surgery for problems like depression, anxiety, Tourette’s syndrome, even obesity, most as a part of medical studies. The results have been encouraging, and this year, for the first time since frontal lobotomy fell into disrepute in the 1950s, the Food and Drug Administration approved one of the surgical techniques for some cases of O.C.D.

While no more than a few thousand people are impaired enough to meet the strict criteria for the surgery right now, millions more suffering from an array of severe conditions, from depression to obesity, could seek such operations as the techniques become less experimental.

But with that hope comes risk. For all the progress that has been made, some psychiatrists and medical ethicists say, doctors still do not know much about the circuits they are tampering with, and the results are unpredictable: some people improve, others feel little or nothing, and an unlucky few actually get worse.
I don't even know how much progress has actually been made. The placebo effect guarantees that many people who have put themselves to the trouble of undergoing brain surgery will report feeling better. Maybe they are better. But what if the same effect can be achieved using non-materialist neuroscience techniques, as has been demonstrated.

A friend tells me that at one point, this was the third most e-mailed article at NYT right now. Culturally, it is interesting that so many people wanted to believe that a touch of the knife beats taking control of one's life.

I will not soon forget an interview I once did with a woman who had undergone psychosurgery for mental disorders. She had been a writer but was, at time of interview, a zombie.

She was not incapable of thought. When I suggested she try to get back to writing, she treated it as a new idea that she had never considered. She could have gone back to writing, perhaps, but she no longer had any motivation. She seemed to have given up.

Was the scalpel stronger than she? I don't know, but - apart from removing tumours - I would give a pass on all this scalpel stuff, until we know way more than we do.

Hat tip: Stephanie West Allen at Brains on Purpose

Denyse O'Leary is co-author of The Spiritual Brain.