Medicine: Psychosurgery

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New Personalities. After psychosurgery a patient requires months, sometimes a year or more, before he is mentally reintegrated and can lead a useful life. His personality is changed: he is neither his psychopathic nor his pre-psychopathic self.

His capacity to project himself into the future is reduced. He is less self-critical, more extroverted. Say Drs. Freeman and Watts of their patients: "The freedom from painful self-consciousness, and also from preoccupation with former conflicts, repressions, frustrations and the like, and the associated elevation in mood, renders life particularly agreeable to them and they enjoy it to the fullest."

After recovery a patient's emotional responses are vivid but somewhat superficial. He is indifferent to social amenities, may speak his mind and joke so tactlessly that he embarrasses his family and friends. Yet he will apologize for his behavior with real sincerity. His foresight is impaired. Some of these changes would be undesirable if the alternative—an unchanged psychotic personality leading to complete insanity—were not much worse.

Of their 136 cases, Drs. Freeman and Watts regard 98 as greatly improved, 23 as somewhat improved, twelve as failures. Only 13 patients are still in mental hospitals; most are back at their jobs or housekeeping after one to six years of psychotic incapacity.

Drs. Freeman and Watts by no means think that psychosurgery should be used on all psychotics. They make clear the risks—possible death, possible mental dullness from too much brain-cutting. Psychosurgery, they say, is a last resort after less drastic therapy has failed.