Brain injuries do not always lead to undesirable changes in the character of the victim, the BBC Future columnist learned. It happens that the character improves. But should we be happy about this?
In the 1980s romantic comedy Overboard, the protagonist, an arrogant and selfish billionaire, falls overboard in her luxury yacht and loses her memory with a head injury. In addition, her character is changing for the better - she becomes caring, attentive and not as mercantile as before.
At first glance, such a positive change triggered by a brain injury looks far-fetched, doesn't it?
However, let's take a real case. A woman (let's call her for ethical reasons "patient 3534") at the age of 70 had a brain tumor removed. In this operation, the frontal lobes of her brain were damaged.
According to her husband, who had known his wife for 58 years, before the operation she was irritable and grumpy, with a tough character. After the operation, "she became more sociable, more satisfied with her life and much more talkative."
Patient 3534 is not the only one whose personality has changed since her brain injury. We now have evidence that (at least for a small subset of patients) positive character changes are reality.
And this is a kind of revelation that allows you to take a fresh look at how brain damage affects a person.
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Although it has long been known that brain injury can change a person's character, the scientific literature has almost always described extremely dire consequences for the individual.
Take the famous case of Phineas Gage, an American construction worker who suffered a severe brain injury in 1848 while laying a railroad. (Gage was in charge of a team of explosives. In an accidental explosion, scrap metal entered Gage's skull under the left eye socket and exited just above the forehead. Due to the injury, the builder lost most of the frontal lobe of the left hemisphere of the brain. - Approx. Translator.)
As the friends of the victim said then, "this is no longer Gage." After what happened, he simply became a different person: previously smart and perceptive, Gage became aggressive and impulsive, his psyche changed radically (however, according to some testimonies, later Gage was able to overcome these problems, began a new life as a coachman of a mail coach - and lived another 12 years old).
In modern medical literature, many similar cases are described - when patients, after damage to the frontal lobes of the brain, began to behave inappropriately and even psychopathically.
However, according to a recent study published in the journal Neuropsychologia, such dire circumstances may not convey the full picture.
A group of scientists led by psychiatrist Marcy King of the University of Iowa found that of 97 previously healthy patients who suffered permanent damage to a specific part of the brain, 22 experienced positive changes in character.
In 54 people, character deteriorated, while the rest did not notice any changes.
Scientists have established this by interviewing relatives and close friends of victims on 26 different aspects of personality - before and after the injury.
It must be admitted that in the past, some studies have indirectly indicated that damage to some areas of the brain can sometimes have a positive effect on the personality.
For example, a 2007 American study of Vietnam War veterans found that those who suffered damage to areas of the brain believed to be responsible for developing PTSD were less likely to develop PTSD.
A similar study found that patients with damage to the emotional regions of the brain were less likely to be depressed as a result.
Yet the most recent study we are talking about documented for the first time such a wide range of positive changes in character in a large group of patients.
As another example, consider the case of “Patient 2410,” a 30-year-old man who required surgery for a brain aneurysm.
Both he and his wife described that before the operation, the man was quick-tempered, easily lost his temper and was prone to depression. After the operation, he jokes and laughs a lot and generally became calmer.
What's going on? How does brain damage have such an unexpected effect?
The likelihood that a patient's character will change for the better does not depend in any way on gender, age, educational level or intelligence.
What matters is past personality problems: difficult temperament, hot temper and other negative traits combined with the specifics of brain damage.
To understand this, King and her colleagues performed brain scans of all of their patients.
They found that those with positive personality changes were more likely to suffer from damage to the frontal lobes of the brain (areas involved in making decisions and understanding other people's perspectives).
These results, however, are very preliminary, and the authors of the studies call for caution in their interpretation.
Scientists have found only general trends, and further work will help to more accurately determine which parts of the brain are associated with specific changes in human character.
In addition, while the changes in the personality of some patients can be regarded as positive, the danger of any brain damage should not be underestimated.
Full recovery from serious brain injuries is extremely rare, and even when the patient seems to be feeling fine, he may sooner or later face hidden problems - for example, the difficulty of assimilating new information.
The resulting brain injury can also make a person more vulnerable to various neurological diseases, including very serious ones.
Thus, it is simply amazing that such a dangerous thing as brain damage can lead to beneficial changes in character.
However, when you realize that brain surgery is sometimes used as a last resort in treating mental disorders such as obsessive-compulsive disorder, it no longer looks too ridiculous or strange.
Here you can, of course, recall the so-called psychosurgery, now banned in most countries, an extremely controversial method of treatment. Many of us know about her special case - a lobotomy with massive tissue destruction, which was widely used in the middle of the 20th century in the United States.
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However, King and her colleagues emphasize that modern technology allows surgeons to act much more carefully and accurately, and often the purpose of such interventions is to reduce the activity of those brain currents that cause certain mental problems (for example, there is evidence that depression is associated with too active exchange between the frontal regions of the brain and other neural networks responsible for cognition and emotion).
The fact that with the help of surgical intervention it is possible to correct the functioning of the human brain, to some extent explains why brain injuries in some cases lead to favorable changes in the character of the victim.
In addition, the findings of King and her colleagues' research are helping to better understand the neurological basis of human character.
However, in conclusion, it is worth repeating: any brain injury (including a "light" concussion) should always be treated with great seriousness.
Even in infrequent cases of positive changes in character after trauma, the clinical picture almost always contains a lot of hidden problems for the patient for the time being.
And while positive changes in character are good, let's not forget that our character reflects our essence. Getting used to the fact that a person has changed - even for the better - will not be easy for friends and family, and for this person himself.
In any case, what happens to the brain and to the person after trauma is much more complicated and surprising than we previously imagined.
Dr. Christian Jarrett is editor of the Research Digest blog of the British Psychological Society. His new book, Personology, will be out in 2019.