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(p. 209) Letter to The Lancet: Prefrontal Leucotomy 

(p. 209) Letter to The Lancet: Prefrontal Leucotomy
(p. 209) Letter to The Lancet: Prefrontal Leucotomy

Donald W. Winnicott

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Subscriber: null; date: 23 October 2018

Sent to The Lancet on 15 May 1943 but not published.

Sir: Mr McKissock and Dr J. B. S. Lewis have replied to my letter of April 10th, and my reply to their letters, if you are able to find space for it, is easy to write. I absolutely believe in the good faith of those who give insane people fits, and who cut their association fibres, and I recognise the shift towards sanity that such treatments can bring about. Nevertheless I personally hold the view that the insanities are disorders of emotional development, and not diseases of the brain, and therefore I am bound by truth to seek the hospitality of your correspondence columns to express clearly and emphatically my view that the empirical treatment of mental disorder is on the wrong lines if it goes for the brain. (I do of course admit the existence of syphilitic and degenerative brain diseases, but these are not under discussion.)

In my opinion Mr McKissock’s letter, in which he repeats his view that utmost caution should be used in the selection of cases for operative treatment, is well worth having. A recent leader in the BMJ (24 April 1943, p. 510, ‘Cutting the Frontal White Fibres’) shows that we are in for a Leucotomy phase, and I should hate to think that not one member of our profession had made a protest. The fact that relief is given to thousands of sufferers by this method is no argument in favour of its being good as a procedure to be sponsored by psychiatry. Surely our refutation is built on the attempt we have made to put truth, as far as we can see it, above the appeal of quick returns.

I suppose it is too much to hope that the profession may yet be saved from what I definitely consider to be a set-back to psychiatry, the revival of the theory that insanity is a disease of brain tissue or neurological function.

D. W. Winnicott (p. 210)