View Full Version : Head Injury and Sociopathy

09-22-2015, 06:30 AM
Okay, I've been spit-balling, kicking around a few ideas regarding my book-in-progress. I've had the idea that, well, one of my characters remembers her twin brother fondly, but that after he hit his head after falling out of a tree, his personality changed and not for the better. He was always somewhat reckless and impatient, but he had limits; he'd sometimes be insensitive, but wouldn't be outright cruel. After the fall...it probably didn't help that their father, who had grown increasingly distrustful of doctors after his wife died from cancer, didn't take his son to a hospital, deciding to treat him at home. My character, privately disagreed with said decision, but she was ten and lacked the will needed to go against her papa. So she just prayed as her brother languished for days. I have the idea that while he was sick, he developed a high fever, but am not entirely sure whether that would work with a head injury or not. Tried doing some research on Google to educate myself somewhat (I have no medical background but I still want my stories to have a degree of plausibility), but am still not sure.

Just that after her brother recovers from his injuries/fever, basically he starts demonstrating sociopathic tendencies. Growing up off the grid, she and he had grown up hunting in the woods, but she starts to notice that for him, it's not really so much about the hunt, more about inflicting suffering on creatures smaller than him. He seems to delight in hurting things afterwards. She keeps hoping that things will go back to what they used to be, but as you probably guessed...yeah, things aren't going to end well.

But I thought before I waste too much time and energy, I should check with the good people here and make sure my stuff has a veneer of plausibility. So talk: is the scenario I sketched out semi-plausible or am I full of shit? Feel free to tell me if I am full of shit, but understand that I don't have a medical background. So in other words, if you're going to explain it to me, explain it to me like I'm stupid because I am.

Also, while I'm not going to waste too much time giving specific technical details (because chances are, I will likely get stuff wrong, which will irritate the readers who do know stuff, or I'll bore the readers senseless), I would like to be able to describe said symptoms a little bit more than just "Fell out of a tree, hit his head, and developed a bad fever afterwards."

09-22-2015, 06:56 AM
Traumatic Brain Injury (TBI) can change a person's personality to some degree, yes. However, most of the time this is either an exaggeration/amplification of treats that were already there and/or a reduced impulse control. If your character was occasionally mean before, but not cruel, it could be possible for him to become cruel in the aftermath of the traumatic brain injury.

It is, however, more likely that certain cruel thoughts, urges and/or tendencies were already present below the surface and that he repressed them before. A reduced impulse control could definitely cause him to show behaviour he (mostly) suppressed before. For example, if he already felt somewhat empowered by hunting smaller animals, this feeling may strengthen and he may go further in such behaviour than he did before. Brain injury can also lead to other changes that would make him feel generally more frustrated (irritability and temper problems are very common post-injury, both because the injury may cause changes that leave the injured person frustrated and because, depending on the exact injury, the part of the brain that controls the expression of emotions may have sustained damage) and he may be taking out this frustration on those animals and/or rejoice in the feeling of being empowered more than before, for example if he feels weak as result of the injury.

A few sources that may be useful for you:
http://www.nasponline.org/publications/cq/39/7/traumatic-brain-injury.aspx (http://www.nasponline.org/publications/cq/39/7/traumatic-brain-injury.aspx)

EDIT: And in general, googling TBI + personality change

09-22-2015, 01:10 PM
Aside from a head injury either ferried in with a pile of other tortures and otherwise life-changing events (changing for the bad i mean), in which case you might end up with a psychotic character (someone not in present time, acting on past evils/events, insane, etc.), but someone turning sociopathic? i have never heard of. I cant even see it. Sociopathy is something you are born with, a trait (arguably, not even necessarily a bad one), not something acquired. Both psychopaths and sociopaths are either lacking in empathy, or have the ability to just 'turn it off', but the former is also someone not living in present time, ie: someone still actively dealing with/living out past traumas/evils. To stay realistic, you'd be better opting for the former.

Or... you could just give the brother latent (and undiscovered - yes, it happens) sociopathy, and let the trauma bring it out. Head injuries can damage any aspect of personality, and pertinent to this case, that could be restraint and impulse-control (a common one actually), or just 'tear the nice out of him' and leave you with only the negative aspects he possessed. Believe it or not, there are sociopaths out there who are plenty nice, honest, caring individuals living happy successful lives. They're not all burning kittens with magnifying glasses at 8 and playing Patrick Bateman at 30. The difference, is that they know they could be bad, but choose not to, usually, because they understand its not right to be a psychotic prick. Give someone like that head trauma...??? Hmmm...

There have been cases of twins, even identical twins being separated at birth (i cant think of anything crueller than this) and being thrust into diametrically opposite environments. The 'good' environment one grows up nice, educated, loved, with many friends and opportunities, etc. While the 'bad' environment one grows up in some ghetto, with a crackhead 'mom', criminal friends, no schooling, etc. One has the potential to be a lot harder and meaner than the other. Doesn't make him a psycho, but can certainly make him a total bastard. There are many ways you could realistically do what you want here.

One thing though, concerning twins, especially identical ones. I have no idea how rare a pair of sociopathic twins would be, but it would certainly be very very rare. I'd imagine it would be exceedingly rare, or even impossible, for one to be sociopathic, and the other not. Keep that in mind if you go the 'one was a sociopath and we didn't know it' route.

King Neptune
09-22-2015, 04:08 PM
I agree with Silenia. What you propose is not a common thing, but it is within the realms of possibility.

09-22-2015, 05:03 PM
Or... you could just give the brother latent (and undiscovered - yes, it happens) sociopathy, and let the trauma bring it out. Head injuries can damage any aspect of personality, and pertinent to this case, that could be restraint and impulse-control (a common one actually), or just 'tear the nice out of him' and leave you with only the negative aspects he possessed. Believe it or not, there are sociopaths out there who are plenty nice, honest, caring individuals living happy successful lives. They're not all burning kittens with magnifying glasses at 8 and playing Patrick Bateman at 30. The difference, is that they know they could be bad, but choose not to, usually, because they understand its not right to be a psychotic prick. Give someone like that head trauma...??? Hmmm...
It doesn't even have to be the result of actual brain damage. It can simply be a choice. When people realize that they are mortal it can make them decide that, "Hey, I need to have some fun while I can and these things that I've wanted to do, but the religious people told me not to...I'm going to start doing those things."

Katharine Tree
09-22-2015, 06:51 PM
To re-word what others have said, brain injury that leads to frontal lobe damage tends to remove inhibitions more than anything else. A person might sing, laugh, cry, fight, eat, drink, masturbate, or spend money to excess, but the behaviors will be ones they tended to before the injury (and most of what I just listed are behaviors we all tend to.)

So to some degree, a person who was already a stinker becoming a seriously problematic person is plausible. Actual sociopathy is a personality disorder, though. It's something the person couldn't have repressed entirely before, though the brain injury might make the manifestations worse.

I like GeorgeK's suggestion that you make it a conscious choice. Adds depth and nuance to the situation.

Also, about the brother lying in bed with fever: that isn't the recovery path I would expect (though I am not a medical doctor, just another author who wrote a novel about the outcome of traumatic brain injury). For lasting damage to the brain I'd expect one of two things to have happened.

Either the fall severed a vessel in his head, leading to a brain bleed, which put pressure on the brain. Because he survived without surgery, it was a minor bleed. Loss of consciousness, seizures, a wide pupil on the damaged side, and a period of motor and speech difficulties would be a typical course of recovery for that.

The second--which sounds not at all what you're looking for, but which I'll throw out there--is that the force of impact snapped off his pituitary gland. It sits in a little cup of bone and it's fairly common for collisions etc. to throw the brain forward in the skull with such force that it comes off. This results in all kinds of hormonal deficiencies, including loss of testosterone in males.

Maybe a real MD can come in and confirm, deny, or expand on these.

Dennis E. Taylor
09-22-2015, 07:14 PM
I have to disagree with adversary (I'm being adversarial :tongue ) about twins not turning out one and t'other. Some things are genetic, some things are developmental. For instance, identical twins have different fingerprints, and different freckle patterns. That's because the genes specify the existence of those, but the development is fractal. Things like brain development are specified in general terms, but twins have been, for instance, known to have different personalities and interests, despite having identical genes. If psychopathy is caused by something like underdeveloped or disconnected mirror neurons, then it might not take much to have that happen.

Regarding changes in personality due to brain injury, read An Anthropologist on Mars (or just about anything else) by Oliver Sacks. Or read up on Phineas Gage. Okay, you're probably not putting a spike through the character's head, but the point is that brain injuries can cause significant changes in personality and behavior.

09-24-2015, 07:57 AM
I would disagree that TBIs simply exaggerate premorbid traits. For one thing, TBIs vary a lot depending on where the damage is. There can be damage to one focal area or the impact ;may be diffuse. Damage to frontal lobes causes one set of behaviors, whereas damage to the occipital lobes causes other problems (blindness, hallucinations), and the damage to the temporal lobes still more problems (issues with language, humor, sometimes hearing/auditory perception. Frontal lobe damage gets the most press and that can impact our ability to delay gratification and prioritize (I need to do homework before I go out, I need to stop at a red light even though it's inconvenient), to problem solve, to see alternatives and importantly, assess risk. In addition, many people can have seizures following a TBI.

A family member of mine had a TBI when he was 18. He had a been a gregarious, fun loving, warm kid, but after wards he was paranoid, difficult, wildly labile, sometimes violent.He had been a great sailor but could not sail (or do much) without supervision. He had seizures (a lot) , he was impulsive. he wound up dying from a drug overdose. It was tragic. Hardly an exacerbation of pre existing traits.

So, the good thing is, you can figure out what your story needs, then work out what kind of TBI would get you there. I would not have wanted my family member anywhere near a firearm.

And yes, recovery will involve a neurologist and (maybe) a psychologist to determine the extent of damage--what was compromised, what's retained, and so on. There are a lot of testing batteries to see where people are, very interesting stuff. And sometimes a physical therapist, and sometimes a social worker.

But functioning will depend on where the injury was sustained.

Good luck with your story!

09-24-2015, 07:59 AM
and the story of Phineas gage is remarkable anyway. Great reading.

09-24-2015, 08:39 AM
Eadweard Muybridge, also :)

09-24-2015, 02:42 PM
And for your story, not full of shit at all!!!!! I don't think sociopath though...but certainly impatience and again,depending on the injury, lack of empathy. So anything--animal, child, a loud clock, could set someone off and without the this-is-not-a-big-deal, I-can-handle-this brakes, really go off (again, depending on the nature of the injury, it sounds like your are thinking more frontal lobe problems) because they'd have trouble with self soothing Again, not being able to moderate one's behavior is a real handicap, as is not being able to accurately assess social cues and nuance.

A former client was very promiscuous (and was not so previously)--she'd go up to complete strangers and say, "Wow, you're awesome! wanna go <have sex>?" she was extremely attractive so extremely vulnerable to exploitation. She really couldn't determine the nuances of those kinds of interactions (but is in a veryhappy, stable and monogamous relationship at the moment, so has responded well to treatment and a ton of support). She had plenty of empathy though, never struggled with depression (also common) but the problem solving...

Of course, as your story hints at, this person can then become the focus of the family--people worry about where they are and what they're doing, if they're safe, and so on. It can be exhausting!

09-24-2015, 03:15 PM
The only thing I can recall along those lines in real life is years ago I worked with a woman whose husband had recently suffered a serious head injury (I don't remember how now). Afterwards, he wasn't sociopathic but he would fly into violent, unpredictable rages at her and their young sons and she was in a panic wondering if she should get a divorce. She said he was nothing like that before, fwiw.

09-14-2017, 06:17 AM
I know this thread was quite some time ago, but in response, I have a 12 year old daughter that had an 80kg TV fall on her when she was just 4 yrs old. Unfortunately her head took the entire impact, causing frontal lobe damage, 4 skull fractures, all the bones shattered in her nose, cheeks, jaw and both eye sockets. The lining of her brain was torn and he had a blod clot removed from her brain. She also damaged C1-5 in her neck. She spent a week in a coma, and 3 months in the Children's Hospital, learning to walk, talk etc. While she was in a coma, she had a fever, and was placed on a special 'frozen mat', to keep her temperature down. She had a brain pressure monitor inserted after having part of her skull removed to allow for brain swelling. We still have regular visits with her rehab team, and just recently I have started to think she has developed Autism and Aquired Sociapothy. If you didn't know about her accident, you would think everything is fine, but she has recently started showing very worrying signs. Her younger sister seems to be her main target, and she quite often physically hurts her. Any time I question her or try to deal with the situation, she denies anything happened and flies off the handle at me. She loses her temper very very easily, often over what seems very trivial things. She is very much a loner, basically having 2 or 3 close friends. She documents EVERYTHING daily on her ipod, and apart from the time she is at School, she spends every minute from the time she gets home, in her room, completely hidden under a blanket (as in head to toe). To the point, she eats and gets dressed under the blanket.

09-14-2017, 06:52 AM
My heart goes out to you, Raebow. I can't even begin to imagine how difficult and heartbreaking this must be.

09-14-2017, 09:41 AM
Have you seen a doctor about the recent behavioural issues? Frequently losing temper/flying off the handle and avoiding social situations/people/interaaction and frequently wanting to hide following a trauma could be PTSD (post-traumatic stress disorder), which is usually treatable with an appropriate, qualified therapist. Even if these things didn't start right after the trauma, sometimes the onset of PTSD can be delayed (i.e. start several months or years after the traumatic event, though usually it starts directly after). People tend to assume that PTSD is something only war veterans get, but anyone can get it, and children are particularly vulnerable.

That's not to say that possible brain damage isn't the explanation. I'm not a doctor and there's not enough information in your post for even a doctor to say for sure. But going by what you've said, PTSD is a possibility and you haven't mentioned her seeing a doctor since these behavioural issues have started so I've no idea whether or not you've seen a doctor about it. A lot of people think that these things can't be treated, but they can. Whether there's actual brain damage, acquired autism or if it's PTSD there's a lot that can be done. Even when nothing can be done medically, there's support and help.

Apologies if you have already seen a doctor and got help/support etc - I have no way to know from your post whether you have or not and would hate to think of anyone struggling alone with something like this, thinking nothing can be done. :Hug2:

09-14-2017, 07:12 PM
It is plausible (but the Phineas Gage story is not as clear cut as it is often presented).