Between the Ego and the Icepick: Psychosurgery, Psychoanalysis, and Psychiatric Discourse

Between the years 1935 and 1965, tens of thousands of lobotomies were performed on Americans in order to treat mental illness. This article reconstructs the relations between the theory and practice of psychosurgery and a dynamic approach to mental illness. The article claims that psychosurgical discourse adopted key concepts from psychoanalytical discourse and that psychodynamically oriented psychiatrists and psychoanalysts incorporated the basic tenets of psychosurgery into their writings. Hence a common, eclectic discourse on psychosurgery was created, used by psychodynamically oriented psychiatrists and psychosurgeons alike and containing elements from both theories. This article addresses the far-reaching effects this discourse had on therapeutic practice and on the widespread mutual acceptance of psychosurgery. The article questions the distinction between somatic and dynamic approaches to mental illness, claiming that the common psychiatric discourse indicates that a spectrum of psychiatric thought would better describe the state of the profession at the time.