Humans have a long, and sometimes disturbing history of biomedical treatment of disorders. In ancient and medieval times, the process of trepanation—drilling or cracking a hole in the skull to expose the brain—was sometimes used to free evil spirits or demons from within a person’s head.

Trepanation ultimately fell out of favor as a treatment for psychological disorders. However, in the 20th century another biomedical procedure, lobotomy, gained in use. Lobotomy is a form of psychosurgery in which parts of the frontal lobe of the brain are destroyed or their connections to other parts of the brain are severed. The goal of lobotomy was usually to calm symptoms in people with serious psychological disorders, such as schizophrenia. Lobotomy was widely used during the twentieth century – indeed, it was so mainstream that Antonio Moniz won a Nobel Prize in physiology for his work on one lobotomy procedure. However, lobotomy was always highly controversial, and widely criticized as a tool of behavioral control of people who were engaged in behaviors that were not clinical in nature. By the 1960s and 1970s lobotomy fell out of favor in the United States.

Today, the approach to mental health treatment has vastly changed compared to the times of trepanation and lobotomy. The field has largely shifted towards more holistic, patient-centered care that emphasizes a combination of biological, psychological, and social factors. With advancements in neuroscience, our understanding of the brain and its role in mental health disorders has evolved considerably. Modern treatments now rely more heavily on evidence-based interventions such as psychotherapy, medication, lifestyle changes, and community support systems.

This is not to say that the field is without controversy or room for improvement, but progress has indeed been made. Diagnostic tools have become more refined, and the introduction of neuroimaging techniques has enabled clinicians to better understand and treat a wide variety of mental health disorders. Furthermore, there’s a growing emphasis on preventive care and the reduction of stigma associated with mental illness, fostering a culture of understanding and empathy. While we must remember the past and the lessons it has taught us, it’s also vital to recognize the strides made in the mental health field and continue to work towards better, more compassionate care for all individuals.