Hypothalamic psychosurgery on sexual deviants

Domain XVI · Historical, discredited & harmful · Roeder, Orthner, Dieter Müller · 1962 · West Germany (Göttingen)

What it is

What it was: from about 1962 into the late 1970s, neurosurgeons in a small number of West German university clinics (and, per later accounts, one centre in Slovakia) carried out stereotactic operations that destroyed part of the hypothalamus, the region at the base of the brain that they held to…

Format

• Format and length: individual work is the default; family or descendant sessions by agreement. Session number and length follow the client's needs and the setting.

Who practises it, and how they are trained or regulated

• What it was: from about 1962 into the late 1970s, neurosurgeons in a small number of West German university clinics (and, per later accounts, one centre in Slovakia) carried out stereotactic operations that destroyed part of the hypothalamus, the region at the base of the brain that they held to regulate sexual drive, on people whose sexual behaviour or desire was classed as deviant. About 75 people (74 men and 1…
• Core idea, as its proponents framed it: that sexual drive and its "perversions" could be reduced by destroying part of the hypothalamus, the brain region held to regulate sexual behaviour, and that this could serve as a "last therapeutic option" for people otherwise facing long detention. Critics, among them the Frankfurt sexologist Volkmar Sigusch and colleagues, opposed psychosurgery in the 1970s as an attempt to…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Does it use a device, heat, cold, water or a physical procedure? Has a medical professional checked that it is safe for you?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• the client being used for others' campaigns; it is working when advocacy adds meaning rather than strain.
• drift in either direction; it is working when your notes show balanced attention to harm, risk and recovery.
• re-traumatisation on reading files; it is working when the client feels the account is now partly in their own hands.
• pressure to stay silent in a hierarchical setting; it is working when concerns are recorded and reviewed independently.
• over-apologising that burdens the client; it is working when the client starts testing and then using the relationship.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.