Introduction

Although brain surgery for the control of explicitly antisocial behavior comprises a tiny fraction of all psychosurgical operations, it nevertheless occupies a central place in the fierce controversy surrounding what Breggin (1972) called the “second wave” of psychosurgery. In our analysis of published reports, encompassing some 15,000 psychosurgical cases, about 2½% of the operations were for the control of antisocial behavior (O'Callaghan & Carroll, 1982). In this chapter, we shall present a more detailed review of these, concentrating on the control of sexual “disorders” and aggressive behavior.

Genesis of psychosurgical procedures for the control of antisocial behavior

Aggressive behavior

Although psychosurgery can be briefly defined as the interruption of histologically normal brain tissue for the control of behavior, there are those who suggest that there is indeed some abnormality of brain function that gives rise to antisocial behavior. Mark and his colleagues, for example, proposed that some acts of aggression reflect behavioral dyscontrol arising from an amygdala-based pathology. For evidence they relied heavily on the existence of an orderly relation between episodic aggressive behavior and temporal lobe epilepsy (Mark & Ervin 1970; Mark & Ordia, 1976), although it must be noted that it is the aggressive behavior and not the epilepsy that affords the major impetus for surgery (Mark, Sweet, & Ervin, 1972). In addition, it is perhaps worth noting that not everyone is convinced of this epilepsy–aggression link (Rodin, 1973).