Brain Damage and Emotional Difficulties

Abstract

Most, if not all, illness has emotional consequences for the patient and those around him or her. In the case of the brain-damaged patient, one can expect to find many of the emotional concomitants of illness in general, but there appear to be some special consequences as well. In this chapter, we will explore some of these consequences, primarily with case examples. Conceptually, we may think in terms of three forms of interaction between brain pathology and emotional reaction. There is first the impact of the premorbid personality on the individual’ s reaction to brain damage; second, there are the direct consequences of the lesion itself; and third, there is the manner in which the individual reacts to the illness and the deficits it produces. With regard to the first point, clinical evidence suggests that many people, after sustaining brain damage, develop exaggerated forms of predamage personality characteristics. In general, the nature of the individual’ s personality and character often plays a significant role in regard to determining the nature of the postdamage outcome. However, the premorbid personality is not the only consideration. As we will see, certain types of brain lesions and lesions in certain areas of the brain have particular implications for the individual’ s affective life. It also seems that over and above premorbid and neuropathological considerations, there are major individual differences regarding how people react to illness in general and brain damage in particular.