From Exorcisms to Electroconvulsive Therapy: The Evolution of Brain Intervention

Ideas & Philosophy · Published 8 October 2026 Swipe more like this →

In short: For centuries, mental illness was treated with supernatural rituals or physical violence. Today, we use precise biomedical interventions to influence the central nervous system. But as our tools moved from drilling skulls to modulating neurons, the line between healing a disorder and controlling behavior has remained a complex ethical frontier.

The history of biomedical treatment is marked by a shift from 'supernatural' theories to biological ones. In ancient and medieval times, practices like trepanation—drilling or cracking holes in the skull—were used under the belief that they could release evil spirits. While these methods eventually fell out of favor, they set a precedent for direct brain intervention. By the 19th century, as psychiatry began to adopt more scientific perspectives, the discovery of biological agents like the syphilis bacteria strengthened the argument for somatogenic (body-based) treatments.

The 20th century saw the rise of psychosurgery, most notably the lobotomy. This procedure involved destroying parts of the frontal lobe or severing its connections to other brain regions to calm symptoms of disorders like schizophrenia. The procedure gained such widespread popularity that António Moniz, a neurosurgeon from Portugal, received a 1949 Nobel Prize in physiology or medicine regarding his research into it. However, the practice was deeply controversial; critics argued it was often used as a tool for behavioral control rather than a clinical necessity, and its effects were irreversible.

The landscape shifted dramatically in the 1950s and 1960s with the development of psychotropic medications—antidepressants, antipsychotics, and mood stabilizers. These drugs work on the principle of chemical balance, aiming to regulate neurotransmitters in the brain. While modern biomedical therapies like electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS), and deep brain stimulation (DBS) are highly sophisticated, they are often used in tandem with psychotherapy. These treatments focus on managing symptoms to improve daily functioning rather than providing a permanent cure.

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