Understanding Psychology (10th Ed)

antianxiety drugs
Drugs that reduce 
the level of anxiety a person experi-
ences essentially by reducing excitabil-
ity and increasing feelings of well-being.
electroconvulsive therapy (ECT)
A procedure used in the treatment of 
severe depression in which an electric 
current of 70–150 volts is briefl y 
administered to a patient’s head.
transcranial magnetic stimulation 
(TMS)
A depression treatment in 
which a precise magnetic pulse is 
directed to a specifi c area of the brain.
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568 Chapter 
16 
Treatment of Psychological Disorders
Psychosurgery
If ECT strikes you as a questionable procedure, the use of  psychosurgery  —brain 
surgery in which the object is to reduce symptoms of mental disorder—probably 
appears even more dubious. A technique used only rarely today, psychosurgery was 
introduced as a “treatment of last resort” in the 1930s. 
The initial form of psychosurgery, a prefrontal lobotomy, consisted of surgically 
destroying or removing parts of a patient’s frontal lobes, which surgeons thought 
controlled emotionality. In the 1930s and 1940s, surgeons performed the procedure 
on thousands of patients often with little precision. For example, in one common 
technique, a surgeon literally would jab an ice pick under a patient’s eyeball and 
swivel it back and forth (El-Hai, 2005; Ogren & Sandlund, 2007). 
Psychosurgery often did improve a patient’s behavior—but not without drastic 
side effects. Along with remission of the symptoms of the mental disorder, patients 
sometimes experienced personality changes and became bland, colorless, and unemo-
tional. In other cases, patients became aggressive and unable to control their impulses. 
In the worst cases, treatment resulted in the patient’s death. 
With the introduction of effective drug treatments—and the obvious ethical ques-
tions regarding the appropriateness of forever altering someone’s personality— 
psychosurgery became nearly obsolete. However, it is still used in very rare cases 
when all other procedures have failed and the patient’s behavior presents a high risk 
to the patient and others. For example, surgeons sometimes use a more precise form 
of psychosurgery called a cingulotomy in rare cases of obsessive-compulsive disorder 
in which they destroy tissue in the anterior cignulate  area of the brain. In another 
technique, gamma knife surgery,  beams of radiation are used to destroy areas of the 
brain related to obsessive-compulsive disorder (Shah et al., 2008; Carey, 2009c; Lopes 
et al, 2009; Wilkinson, 2009). 
Occasionally, dying patients with severe, uncontrollable pain also receive psy-
chosurgery. Still, even these cases raise important ethical issues, and psychosurgery 
remains a highly controversial treatment (Mashour, Walker, & Martuza, 2005; Steele 
et al., 2007).
Biomedical Therapies 
in Perspective
In some respects, no greater revolution has occurred in the fi eld of mental health 
than biological approaches to treatment. As previously violent, uncontrollable patients 
have been calmed by the use of drugs, mental hospitals have been able to concentrate 
more on actually helping patients and less on custodial functions. Similarly, patients 
whose lives have been disrupted by depression or bipolar episodes have been able 
to function normally, and other forms of drug therapy have also shown remarkable 
results. 
The use of biomedical therapy for everyday problems is rising. For example, one 
survey of users of a college counseling service found that from 1989 to 2001, the 
proportion of students receiving treatment who were taking medication for psycho-
logical disorders increased from 10% to 25% (Benton et al., 2003). 
Furthermore, new forms of biomedical therapy are promising. For example, the 
newest treatment possibility—which remains experimental at this point—is gene 
therapy. As we discussed when considering behavioral genetics, specifi c genes may 
be introduced to particular regions of the brain. These genes then have the potential 
to reverse or even prevent biochemical events that give rise to psychological disor-
ders (Sapolsky, 2003; Lymberis et al., 2004; Tuszynski, 2007).