Academic journal article Journal of Literary and Cultural Disability Studies

Thinking with the Thalamus: Lobotomy and the Rhetoric of Emotional Impairment

Academic journal article Journal of Literary and Cultural Disability Studies

Thinking with the Thalamus: Lobotomy and the Rhetoric of Emotional Impairment

Article excerpt

The article analyzes the role of emotion in discourse about lobotomy in the mid-twentieth century. It shows how the scientific justification for lobotomy relied on a general theory of psychopathology that identified emotion as the root impairment in mental illness, and also argues that a similar rhetoric surfaced in arguments against lobotomy's critics, who were dismissed as emotional and unreasonable when they voiced opposition to the operation. Although lobotomy is no longer a mainstream medical practice, the rhetoric of emotional impairment continues to impact on the lives of people with psychiatric disabilities, which the article suggests might be remedied by valuing emotion and validating emotional argument.

When we think about lobotomy, it is often Randle P. McMurphy's vacant face at the end of One Flew Over the Cuckoo's Nest that comes to mind. We rarely think of someone like Alice Hammatt, the sixty-two-year-old woman who received the first prefrontal lobotomy in the United States.1 Diagnosed with "agitated" depression, Ms Hammatt "complained of nervousness, insomnia, depression of spirits, anxiety, and apprehension," and often "laughed and wept hysterically" (Freeman and Watts, Psychosurgery in the Treatment of Mental Disorders and Intractable Pain, xviii).2 On 14 September 1936, Alice Hammatt's neurologist Walter Freeman and his partner, neurosurgeon James Watts, performed a prefrontal lobotomy in an effort to remove the "emotional nucleus" of Ms Hammatt's distress (Psychosurgery: Intelligence, i).3 The operation took about four hours. Before surgery, her doctors observed, their patient was in a state of severe anxiety. When the anesthetist arrived, "she became panicky: 'Who is that man? What does he want here? What's he going to do to me? Tell him to go away. Oh, I don't want to see him.' Then she cried out, writhing about in bed so that the nurse was scarcely able to control her sufficiently to administer the avertin" (PS 1950, xviii). When Ms Hammatt awoke from surgery, her doctors reported that her face "presented a placid expression"; later that evening, she "manifested no anxiety or apprehension." The next day, when asked about her previous fear and anxiety, Ms Hammatt said she could not remember what she had been afraid of, adding, "It doesn't seem important now." When the anesthetist later returned to Ms Hammatt's room to check on his patient, "she smiled at him, gave him her hand, and greeted him pleasantly without any fear."

Alice Hammatt lived at home until her death from pneumonia in 1941. Her husband later wrote to Freeman to thank him for the operation, and described those five years as the "happiest of her life" (PS 1950, xix). The negative emotions used to describe Alice Hammatt at the beginning of this narrative are striking in their number and intensity, and equally striking is Ms Hammatt's singular emotional state at the end of the narrative: placid happiness. It is difficult to read Freeman's and Watts's account of Alice Hammatt's surgery without visualizing her intense emotional distress and feeling a measure of sympathetic fear and anxiety in response. Considering what we now know about the treatment she was prescribed, however, our emotional reaction to Alice Hammatt's condition after surgery is not happiness and relief-it is likely an unsettling feeling of horror.

Between 1936 and the mid-1960s, lobotomy mutilated the brains and permanently altered the emotional lives of tens of thousands of men, women, and children.4 Lobotomy's primary objective was to "flatten," "blunt," or "bleach" emotion in persons with psychiatric disabilities in an effort to return them to (what were argued to be) productive positions in their families, communities, and the American economy.5 For disability scholars, lobotomy offers arguably the limit case of the medicalization of emotion. As emotion is medicalized, old binaries and hierarchies (reason/emotion, weak emotion/strong emotion, negative emotion/positive emotion) are subsumed under the dominant medical binary of normal/pathological, and intense emotion, negative emotion, and, to a certain extent, emotion itself become characterized as impairments to be remedied by medical intervention. …

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