23.01.2021

How a head injury could make you see yourself differently

A traumatic injury can damage your brain and change your personality – sometimes for the better.

In the new movie, I Feel Pretty, that is just what happens to Amy Schumer‘s character after a hard fall in exercise class.

Previously insecure and unsure of herself, Schumer’s character, Renee Bennett, awakes a new woman – at least to her own eyes – after her head injury and suddenly sees herself as gorgeous and capable.

If it sounds a little too good to be true, in most cases, it is – but not all, as scientists have found.

Amy Schumer plays Renee Bennett, an insecure woman who awakes from a head injury and suddenly sees herself as beautiful - and research shows that it could (rarely) really happen

Amy Schumer plays Renee Bennett, an insecure woman who awakes from a head injury and suddenly sees herself as beautiful – and research shows that it could (rarely) really happen

In 2014, Dartmouth University researchers traced the neurological roots of our insecurities or confidence to a network in the brain called the frontostriatal pathway.

This road to self-assurance connects the region of the brain that handles our knowledge of self – the prefrontal cortex – to the brain’s reward system, the ventral striatum.

The more activity there was along this path, the more confidence someone had, meaning that their frequent thoughts of self were closely tied to the dopamine-releasing system that gives us the sensation of pleasure when we do something good for our survival.

A thick connection meant someone had solid long-term self-esteem, while highly active neurons firing frequently along the pathway indicated  short-term confidence.

The Dartmouth researchers observed these self-fulfilling neural firings when people rated themselves using positive terms.

When people rated themselves negatively (choosing to describe themselves as ‘depressed’ or ‘pessimistic,’ for example) the frontostriatal pathway stayed dark and still.

This simple distinction in the brain seemed to separate those who were proud of themselves from those who suffered from low self-esteem.

The research ‘provides evidence that changes in self-esteem during early adulthood…pointing to a possible biological mechanism underlying the trajectory of self-esteem changes,’ the authors wrote.

We know that with changes in our thinking come changes to the structures and activity in our brains, as well as to our mental health and personalities.

But these alterations take place over many years – a lifetime, in fact – and may be almost imperceptible, or inconsistent.

Wouldn’t it be great to just wake up with your brain matter suddenly shifted around for the better?

Scientists have documented some version of this happening in traumatic brain injury patients, as does to Amy Schumer’s character, Renee.

Dartmouth University researchers found that when people describe themselves confidently, the frontostriatal pathway of the brain is activated (shown in red and yellow) 

Dartmouth University researchers found that when people describe themselves confidently, the frontostriatal pathway of the brain is activated (shown in red and yellow)

It is not uncommon for traumatic brain injury victims to experience personality changes after sustaining their wounds.

Studies on the prevalence of these changes vary, but numbers of those who become slightly – or very – different people after their injuries range anywhere from 40 percent to over 80 percent.

The majority of these changes are negative ones, like the aggression, mood swings that football players like the late Aaron Hernandez experienced due to chronic traumatic encephalopathy (CTE), which drove several – including Hernandez – to suicide.

But there are some shining exceptions to this pattern, as University of Iowa researchers found in a study they published in 2017.

In their examination of nearly 100 patients who had sustained some form of brain damage, they found that the friends and family members of a number of them identified positive changes to at least one personality trait.

Those that had changed for the better – according to the assessments of their loved ones – tended to have injuries affecting two particular parts of their brains: the bilateral frontal polar regions and the right anterior dorsolateral prefrontal region.

The former part of the mind is thought to control complex, higher order thinking and behavior.

The latter region sees to our fine-tuned thinking, including short term recall, decisions about what behavior is appropriate and the regulation of emotions.

Researchers have also looked to this region of the brain as a promising target for stimulation therapy for depression.

The University of Iowa investigators wrote that their findings ‘support the conclusion that improvements in personality and behavior can occur after a neurological event.

One study found that traumas to the front of the head can change elements of a person's personality, making them less moody, as is Renee's case in I Feel Pretty 

One study found that traumas to the front of the head can change elements of a person’s personality, making them less moody, as is Renee’s case in I Feel Pretty

Both of these two brain regions sit at the front of the head.

Intentionally or not, I Feel Pretty may have even gotten this anatomical detail right.

In the movie’s trailer, Schumer’s character Renee falls off her bike in a spin class, gets her ponytail stuck in a wheel, which (somehow) causes her head to snap forward, smacking her forehead on the wheel of the bike next to her.

In the next scene, Renee sees herself in the mirror and screams ‘I’m beautiful,’ something she seems never to have seen in her own reflection before.

Positive personality changes, according to science, could indeed have come out of Renee’s head trauma, and the area the Dartmouth researchers identified as the hub of self-confidence rests toward the front of the head too.

But don’t go knocking yourself off a bike at your next Soul Cycle just yet (or ever).

Of course, the brain is an incredibly intricate organ, and self-confidence is built through multiple experiences as interpreted by the mind.

But, if the Dartmouth team is right, there is no evidence to suggests that a head trauma will make white matter to spontaneously generate or neurons to suddenly go off like fireworks along the frontostriatal pathway.

On the other hand, the Dartmouth researchers believe that their discovery of the brain’s confidence structure ‘may be useful in both objectively measuring an individual’s risk for these disorders as well as evaluating the efficacy of treatments targeting them,’ they wrote.

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