Personality changes often accompany traumatic brain injuries (TBIs). In fact, there is a threefold increase in personality changes following a TBI. It’s not a specific personality syndrome, but rather a range of changes that reflect the challenges and coping strategies developed by TBI patients. These changes can involve amplifying existing personality traits or developing entirely new ones. Some common changes reported include impulsivity, irritability, emotional instability, and apathy (Garcia et al., 2011).
These changes can be really confusing and make TBI survivors feel like they’ve lost a part of themselves. This feeling of losing one’s sense of self is often described as a significant aspect of brain injury. It’s about the mental processes that make us feel like a unique and coherent individual. Addressing this loss of self is crucial for TBI rehabilitation. People with TBI may perceive themselves very differently from how they were before the injury, feeling more bitter, dependent, frustrated, or irritable, and this can cause psychological distress (Wright & Telford, 1996).
Studies have looked at a process called interoception, which is essential for our sense of self. It’s related to certain brain structures and how we feel our emotions in the background. Damage to these areas can make a person feel like they’ve changed fundamentally. Personality changes following a head injury result from various factors, including neurological deficits, psychological mechanisms, and social influences (Yeates, Gracey, & McGrath, 2008).
To help individuals regain a sense of self, it’s important to work on rebuilding their personality traits so they can accept their limitations and find meaning in their lives after the injury.
In a case study (Banerje et al., 2021) examined the story of a 25-year-old woman named K.S., who experienced a traumatic brain injury following a road accident. K.S was first taken to an emergency neurosurgery unit, where she received non-surgical or conservative management for their condition but six months later, she exhibited a range of cognitive deficits and personality changes. These changes included increased irritability, anger outbursts, and mood dysregulation, which were reported by both K.S. and her family members. K.S. also reported a profound loss of her sense of ‘self’.
K.S. struggled with remembering who she used to be and the skills she had, like her education, dancing, and her cheerful personality. She often mentioned in therapy that she used to be known as “the cheerful and bubbly type,” but now she felt grumpy and confused. It was unclear whether her memories of her past self were based on what others had told her or what she knew about herself. The therapist also noticed that there was a kind of stigma or negative feeling attached to this new version of herself, making her feel even worse.
Social narrative therapy played a crucial role in helping K.S. recover a new sense of self. This form of therapy focused on reconstructing and strengthening K.S.’s ability to engage in social interactions effectively. The traumatic brain injury had impaired K.S.’s cognitive skills, making it challenging for her to process and manage these interactions. Through social narrative therapy, K.S. engaged in structured exercises and discussions aimed at improving her understanding of social cues, emotional expressions, and appropriate responses. This helped her regain her capacity to navigate social situations with greater ease.
Additionally, the therapy aimed to re-establish a coherent and confident social narrative about K.S.’s past. The brain injury had left her feeling disconnected from her former self, leading to confusion and frustration. By revisiting and reconstructing K.S.’s personal history, achievements, and relationships, she could create a more robust and positive self-identity. This process allowed K.S. to bridge the gap between her pre-injury and post-injury selves, ultimately resulting in a renewed sense of self.
In essence, social narrative therapy provided K.S. with the tools and strategies needed to rebuild her social competence and, in parallel, reconstruct a more positive and confident self-concept. This holistic approach was essential for her recovery and the development of a new, integrated sense of self after the traumatic brain injury.
Colorado Brain Injury LLC recognizes the essential role of mental health therapy in addressing personality and self-identity changes following traumatic brain injury (TBI). We offer comprehensive support to individuals coping with the profound challenges of TBI, emphasizing the importance of mental health therapy in our holistic approach. We firmly believe that this approach is central to the overall healing process for TBI survivors.
If you or a loved one are seeking effective strategies and a supportive environment to navigate life after a traumatic brain injury, Colorado Brain Injury LLC is here to help. Our commitment to a holistic approach, incorporating mental health therapy, provides a promising path toward recovery and personal growth. Contact us for further information and resources to support your journey to healing and self-discovery. Your well-being is our priority, and together, we can navigate the challenges of life post-TBI.
- Banerjee, M., Hegde, S., Thippeswamy, H., Kulkarni, G. B., & Rao, N. (2021). In search of the ‘self’: Holistic rehabilitation in restoring cognition and recovering the ‘self’ following traumatic brain injury: A case report. In Advances in the Role of Music in Neurorehabilitation: Addressing Critical Gaps in Clinical Applications.
- Garcia PG, Mielke MM, Rosenberg P, Bergey A, Rao V. Personality changes in brain injury. The Journal of Neuropsychiatry and Clinical Neurosciences. 2011;23(2):E14. doi: 10.1176/appi.neuropsych.23.2.E14.