Deep brain stimulation — or the practice of using tiny electrodes to send electricity directly into the brain — may sound like science fiction. But it’s been found to help a host of problems, including Parkinson’s disease, epilepsy, and chronic pain.
The procedure may seem cutting-edge, but it actually started more than 60 years ago in the laboratory of a New Orleans-based physician named Dr. Robert Heath, whose story is documented in the new book "The Pleasure Shock.”
The controversial neurologist and psychiatrist started experimenting with early forms of the procedure in the 1950s, partially in an effort to cure schizophrenia.
While Heath initially enjoyed positive press attention for his work, public opinion later turned on him. It became public that he used the therapy to see if he could change a gay man’s sexuality, experimented on state prisoners, and did research with the CIA on behavior modification.
While Heath fell from public favor, the procedure he helped develop has become more and more popular, with researchers using the procedure on numerous conditions.
In “The Pleasure Shock,” science journalist and author Lone Frank explores the story of Heath’s rise and fall and what researchers still get wrong about using cutting-edge technology.
Can you talk about when you first heard about Dr. Robert Heath, and why you wanted to study him?
I was doing a piece on deep brain stimulation a few years ago.
The new thing was they were trying it out for depressed people for Tourette syndrome, and it was coming into psychiatry. I thought that’s interesting — it sounds like the return for psychosurgery in a way. I wanted to write a piece on that. As I did research, I saw just a note about Robert Heath and that he had had something in the 1950s.
And I thought, the 1950s? That was when they believed in Freud — how was he playing about with electrodes in the 1950s? I started digging into that… There was almost nothing about him out there. It was mostly really odd stuff, like ‘Oh, this guy was doing Nazi science and he was in Louisiana, he was exploiting black patients.’
I was like, wow this seems like a story of a scientific monster. And I wanted to dig that out. I saw myself writing this monster story. I tracked down some colleagues he worked with. I talked to them, and the picture started to completely turn around.
I mean, what they all said was this was a really bright and interesting guy who was a pioneer in biological psychology. He had been smeared and just, you know, was sort of written out of history.
Reading this book, you get a sense of why he’d be controversial today, but also that in his time, he was being heralded in the press. In the context of his time, his actions weren’t so outrageous. Do you think we could see history repeat itself with another backlash?
Yeah, first of all, I think it’s interesting that so many people even in the medical profession have such a hard time evaluating research in the context that it was made in not their own present context. And on the other hand, they have big problems looking at themselves.
Maybe everything they’re doing isn’t optimal, and maybe they’ll look back on this and say in 10 years or 20 years, ‘Maybe this wasn’t so great.’
Just deep brain stimulation, for example, I try in Chapter 2 to outline how it’s a field that’s very gung ho about ‘Let’s go out there and try [to help] these treatment-resistant patients because we’ll give them hope and they don’t have anything better.’
That’s exactly the same thing that Robert Heath was doing.
He was applying a new method. He was with treatment-resistant patients that didn’t have any other possibilities. He was trying to help people.
A lot of these experiments that we have… we have consent forms that are 10 to 20 pages long, and as one surgeon tells me in the book, ‘Maybe people don’t understand what they’re consenting for.’
With this book, were you hoping that people would question their actions a little bit more, or have that be addressed by researchers?
I was both trying to stimulate some kind of conversation about this in the medical community and also among people. Because I am sure that deep brain stimulation will be a great technology and of use to many psychiatric patients.
But there’s a risk of some kind of backlash if they do it wrong, so to speak.
If you just look back at the way that people talked about lobotomy: The first 30 years they did it, it was a great technology and everyone loved it, the press loved it.
And suddenly there was a backlash, and then they started to look at ‘Oh God, they did it to all these people’ who had no [results] from it, and after they just had side effects, and then it became a big scandal.
There’s always that risk of backlash when the press and everyone is very, you know, gung ho about something.
I would hope that there could be that debate about the technology and how we are going to use it, and also the medical community ought to, you know, scrutinize themselves a bit more. I think that self-monitoring often is lacking.
Did working on this book and looking at past experiments — where they could switch a button and someone goes into this murderous rage and then turn it off and they stop — affect how you view the sense of self?
I think [it’s] that whole thinking about ‘Who are we?’ What do we consider to be ourselves? I mean, what is disease, for example?
The way you think about psychiatric illness is often that people have an illness and they have a real self under there that… if you take the illness away, their real self emerges.
But, you know, I think that’s difficult to look at it that way. I mean your personality, who you are, is very much also some of those symptoms.
For some people, for example, you see the examples of obsessive compulsive disorder [OCD] patients who have their OCD controlled with deep brain stimulation, and some of them don’t like the new them.
I think the lesson is very much that we really are our brain state and what state our brain is.
Whether we affect it with electrodes or drugs or cognitive technology like mindfulness or meditation, whatever we do, we affect ourselves. There isn’t an inner core, an essential self that is the real us.
We are very much what we make ourselves, what we do to our brains.
This interview has been edited and condensed.