Another issue surrounding Psychosurgery is the appropriateness of it as a treatment as it is irreversible and could cause significant side effects for the patient. One study that suggests that this treatment is not appropriate is a case study of Mary Lou Zimmerman who had suffered from OCD for many years and had tried drugs to treat her disorder but had been unsuccessful. Therefore doctors performed surgery on this woman and as a result of the operation, she was unable to walk, stand or eat without help. This case study was conducted by Carey (2003) who found that ethical considerations were also an issue as the family had not been fully informed of the dangerous and experimental nature of the surgery. Therefore, if a patient is particularly disturbed, they may not be able to truly give informed consent as they are unable to understand what they are actually agreeing to, meaning that the treatment is not appropriate. However, it could be argued that there are only limited side effects. Cohen (1999) studied 12 patients who underwent surgery and found only mild impairments in attention after 1 year showing that the surgery had limited side effects which decreased over time. Therefore, from this, the side effects do not appear to be an as serious problem as originally thought as they do decrease over time and only have mild effects; therefore it could be argued that for the most severe cases of OCD, psychosurgery is an appropriate treatment.
Another biological treatment of OCD is chemotherapy or Drug therapy which is currently the most commonly used treatment for OCD as found by Gava (2007). The most commonly used drugs are anti-depressant which are used to reduce the anxiety associated with OCD. SSRIs or Selective Serotonin Reuptake Inhibitors are currently the preferred drug which increases levels of the neurotransmitter serotonin which regulates mood and anxiety. Low levels of serotonin are implicated with OCD and therefore an increase in this may reduce anxiety levels. In addition to this, the antidepressant Tricyclic is used for treating OCD and this works by blocking the enzyme reabsorbs both serotonin and noradrenaline into the pre-synaptic cell. As a result, more of these neurotransmitters are left in the synapse prolonging their activity and easing transmission of the next impulse. By blocking the re-uptake of serotonin, there is an increase in the quantity available to excite neighbouring cells therefore reducing the symptoms of depression and anxiety.
Research has shown that drugs are an effective treatment of OCD. For example Soomor (2008) found evidence for the effectiveness of SSRIs in treating OCD. He reviewed 17 studies of the use of SSRIs and found them to be more effective than placebos in reducing the symptoms of OCD as measured by YBOCS. In addition to this Koran (2007) found that Tricyclics are more effective in treating OCD than SSRIs. However, Szechtman (1998) did find that SSRIs were still effective and he suggested that around 50 – 70% of patients reported reduction in symptoms after using SSRIs. Therefore these studies improve the internal validity of the treatments as the studies that the drugs did treat the cause and therefore it shows a casual relationship between the two. However, it could be argued that this treatment is not as effective due to the presence of contradictory evidence. One issue with research into the effectiveness of drugs as a treatment of OCD is that that most treatment studies are only of three to four months duration meaning that very little longitudinal data exists, supported by Koran (2007) therefore we cannot see how effective the drugs are over time. Maina (2001) found that patients relapse after a few weeks in medication is stopped and so drugs do not cure the problem but merely suppressed it, suggesting why there may be no long term data for the effectiveness of OCD. Due to this, even though drugs appear to be effective for a short time, there is no long term data showing that the drugs are not a fully effective treatment of OCD, and merely suppress its symptoms.
Research has been conducted into the appropriateness for Drugs as a treatment of OCD. It could be argued that this is the most humane treatment as it causes no irreversible damage unlike surgery and therefore does not involve any evasive procedures. This is why this is the most commonly used treatment as if there are any ill effects from the drugs then the side effects can be easily stopped by not taking any more of the drugs, whereas this is not the case with psychosurgery. However it has been argued that drugs are dehumanising as it means that responsibility is taken away from the individual and therefore any negative behaviours or actions cannot be blamed directly on the individual but their illness. In addition to this, the drugs may only treat the symptoms of the OCD not actually the cause and therefore are not actually treating the problem. In addition to this, side effects are common when taking these anti depressants the most common being constipation, suicidal thoughts, sexual dysfunction and increased anxiety. Therefore it could be argued that the drugs are causing more problems rather than treating the OCD.
Also, it has been argued that all the treatments sit on the reductionist side of the reductionism against holism debate. Reductionism is when behaviour is reduced down to solely one cause, not looking at how other variables may interact. For example, when using drug treatments, the patients simply take the drugs to reduce OCD symptoms and are not made to look at other aspects of their live that could be influencing their OCD. In addition to this, when undergoing psychosurgery, it is simply a biological procedure and therefore takes away any cognitive element that may be involved in causing the OCD symptoms. This is a weakness because by only looking at one factor, we do not gain a valid, in depth understanding of all possible causes meaning any treatment developed will only treat part of the problem. However, this could also be seen as a strength as by focusing on one factor alone, you can isolate cause and effect and therefore fully understand the role that the one factor in this case biological treatments plays in reducing OCD symptoms.
To conclude it is clear that both treatments discussed clearly have many positive effects and are indeed successful in reducing OCD symptoms, however many argue that these treatments are not appropriate as they have too many negative side effects such as memory loss and also may not actually be treating the cause of the OCD just the symptoms. Therefore psychologists now need to conduct more research to find drugs and surgeries that have reduced side effects and abide by ethical guidelines.
