Nineteen Eighty-Four (1949), George Orwell’s political satire on the totalitarianism, was written between 1946 and 1948, at a time when new thinking in forensic psychiatry coincided with scientific breakthroughs in neurology to bring questions of criminality, psychotherapy and mental health to the forefront of the popular imagination. This paper considers the novel’s dystopian vision of total surveillance and mind control in the context of the history of neurological research and brain scanning techniques in the mid-twentieth century. Not only does this context provide new insight into the enduring power of Orwell’s novel, it also locates it within a historical moment when technological interventions into the brain seemed to offer a convenient paradigm of mental health and illness as a simple, knowable binary. The paper will demonstrate how Orwell’s critique of this innovation in diagnosis and treatment coincided with clear statements of clinical unease, by psychiatrists such as Donald Winnicott, about the reductionism implicit in the uptake of ECT and the related practices of lobotomy and leucotomy. Did Orwell’s novel help to inaugurate the anti-psychiatry movements of the later twentieth century?