Brain Injury and Trauma and Changes in Personality
"Personality Disorders Revisited" (450 pages e-book) - click HERE to purchase!
Click HERE to Watch the Video
Dr. Sam Vaknin
Malignant Self Love - Buy the Book - Click HERE!!!
Relationships with Abusive Narcissists - Buy the e-Books - Click HERE!!!
READ THIS: Scroll down to
review a complete list of the articles - Click on the blue-coloured
Bookmark this Page - and SHARE IT with Others!
Phineas Gage was a 25 years old construction
foreman who lived in Vermont in the 1860s. While working on a railroad bed, he
packed powdered explosives into a hole in the ground, using tamping iron. The
powder heated and blew in his face. The tamping iron rebounded and pierced the
top of his skull, ravaging the frontal lobes.
In 1868, Harlow, his doctor, reported the changes to his personality following the accident:
He became "fitful, irreverent, indulging at times in the grossest profanity (which was not previously his customs), manifesting but little deference to his fellows, impatient of restraint or advice when it conflicts with his desires, at times pertinaciously obstinate yet capricious and vacillating, devising many plans for future operation which are no sooner arranged than they are abandoned in turn for others appearing more feasible ... His mind was radically changed, so that his friends and acquaintances said he was no longer Gage."
In other words, his brain injury turned him into a psychopathic narcissist.
This article appears in my book "Malignant Self-love: Narcissism Revisited"
Click HERE to buy the print edition from Barnes and Noble
Click HERE to buy the print edition from the publisher and receive a BONUS PACK
Click HERE to buy electronic books (e-books) and video lectures (DVDs) about narcissists, psychopaths, and abuse in relationships
Click HERE to buy the ENTIRE SERIES of sixteen electronic books (e-books) about narcissists, psychopaths, and abuse in relationships
Similarly startling transformation have been recorded among soldiers with penetrating head injuries suffered in World War I. Orbitomedial wounds made people "pseudopsychopathic": grandiose, euphoric, disinhibited, and puerile. When the dorsolateral convexities were damaged, those affected became lethargic and apathetic ("pseudodepressed"). As Geschwind noted, many had both syndromes.
In a study titled “Gray Matter Abnormalities in Patients with Narcissistic Personality Disorder” (published June 2013 in the Journal of Psychiatric Research), the authors conclude:
“Relative to the control group,
NPD patients had smaller GM volume in the left anterior insula. Independent of
group, GM volume in the left anterior insula was positively related to
self-reported emotional empathy. Complementary whole-brain analyses yielded
smaller GM volume in fronto-paralimbic brain regions comprising the rostral and
median cingulate cortex as well as dorsolateral and medial parts of the
prefrontal cortex. Here we provide the first empirical evidence for structural
abnormalities in fronto-paralimbic brain regions of patients with NPD. The
results are discussed in the context of NPD patients' restricted ability for
The DSM is clear: the brain-injured may acquire traits and behaviors typical of certain personality disorders but head trauma never results in a full-fledged personality disorder.
"General diagnostic criteria for a personality disorder:
F. The enduring pattern is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., head trauma)." (DSM-IV-TR, p.689)
From my book "Malignant Self-love - Narcissism Revisited":
"It is conceivable, though, that a third, unrelated problem causes chemical imbalances in the brain, metabolic diseases such as diabetes, pathological narcissism, and other mental health syndromes. There may be a common cause, a hidden common denominator (perhaps a group of genes).
Certain medical conditions can activate the narcissistic defense mechanism. Chronic ailments are likely to lead to the emergence of narcissistic traits or a narcissistic personality style. Traumas (such as brain injuries) have been known to induce states of mind akin to full-blown personality disorders. Such "narcissism", though, is reversible and tends to be ameliorated or disappear altogether when the underlying medical problem does. Other disorders, like the Bipolar Disorder (mania-depression) are characterised by mood swings that are not brought about by external events (endogenous, not exogenous). But the narcissist's mood swings are strictly the results of external events (as he perceives and interprets them, of course).
But phenomena, which are often associated with NPD (Narcissistic Personality Disorder), such as depression or OCD (obsessive-compulsive disorder), are treated with medication. Rumour has it that SSRI's (such as Fluoxetine, known as Prozac) might have adverse effects if the primary disorder is NPD. They sometimes lead to the Serotonin syndrome, which includes agitation and exacerbates the rage attacks typical of a narcissist. The use of SSRI's is associated at times with delirium and the emergence of a manic phase and even with psychotic microepisodes.
This is not the case with the heterocyclics, MAO and mood stabilisers, such as lithium. Blockers and inhibitors are regularly applied without discernible adverse side effects (as far as NPD is concerned).
Not enough is known about the biochemistry of NPD. There seems to be some vague link to Serotonin but no one knows for sure. There isn't a reliable non-intrusive method to measure brain and central nervous system Serotonin levels anyhow, so it is mostly guesswork at this stage."
Read more about Narcissism and the Bipolar Disorder - click HERE!
Read more about Narcissism and Asperger's Disorder - click HERE!
Many additional Frequently Asked Questions (FAQs) about Personality Disorders - click HERE!
This material is copyrighted.
Free, unrestricted use is allowed on a non commercial basis.
The author's name and a link to this Website must be incorporated in any reproduction of the material for any use and by any means.