The Frontal Lobe: Manager of Personality

The brain is an organ that’s very sensitive to trauma. Brain damage can lead to significant gaps in functioning. Following a blow to the head, various functions can be affected, including language, vision, and memory. It all depends on the area of the brain that receives the impact.

Each lobe of the brain has its own functions. The frontal lobe is especially important for executive functions, mental flexibility, and problem solving, but it’s also responsible for various personality features.

Although it might seem strange at first that an accident can change your personality, it really can happen. Personality is a set of more or less stable characteristics that are influenced both by genetics and experience. After an accident, some people experience changes in these characteristics, which are explained precisely by the damage caused by the accident.

The case of Phineas Gage

In one of the most famous cases in the field of neuropsychology, Phineas Gage suffered a work-related accident and was never the same again. In an unfortunate turn of events, an 1-meter long iron bar impaled his head. Surprisingly, not only did he live, but he didn’t even lose consciousness.

He completely recovered physically, but something in him changed. He became unrecognizable to the people in his life. The people who knew him said he was a responsible man, but after the accident he became erratic, profane, aggressive, and impatient. His social relationships took a toll, as did his performance at work.

As a consequence of these changes, he stumbled from job to job until he ended up becoming a living museum exhibit. Both his skull and the iron bar are now in a museum at Harvard Medical School. Because of what happened to him, people started to view the frontal lobe as the manager of personality, emotions, and social relationships.

The frontal lobe and personality

In the past, people thought the frontal lobe had no function, but after the Phineas Gage case they resumed research on its functions. The frontal lobe is pretty big and is tasked with many different functions, such as movement and word articulation (Broca’s area).

But the prefrontal cortex is the area responsible for shaping our character. It’s responsible for personality, emotional regulation, initiative, and judgment. It also plays an important role in the process of attention. Overall, the fundamental role of the prefrontal cortex seems to be the coordination of thoughts and actions according to our personal goals.

Executive function refers to the ability to distinguish between conflicting thoughts, make judgments on good and bad, and predict the future consequences of current actions. It also involves managing work according to previously set goals, predicting results, creating expectations, and controlling impulses in social situations (inhibition of inappropriate behaviors).

Damage to the prefrontal cortex that affects personality

Brain damage that affects the prefrontal cortex can lead to drastic changes in personality, whether it’s caused by a traumatic brain injury, a car accident, or a surgical tool. Changes in personality depend on the affected area.

For example, the patient could develop an apathy syndrome, which involves:

• Reduction in motor and verbal spontaneity.
• Lack of initiative.
• Slower motor and verbal activity.
• Emotional indifference.
• Limited emotions.
• Lower sex drive.

A disinhibition syndrome could also develop, which involves:

• Difficulty suppressing certain behaviors.
• Lack of self-criticism.
• Inappropriate social conduct.
• Indifference towards others.
• Sexual disinhibition.

Lobotomies

Psychiatrist and neurologist Egas Moniz was a pioneer in the use of lobotomies in 1935. A lobotomy consists of surgically severing the connection between the prefrontal cortex and the rest of the brain. For years, lobotomies were used to treat depression and other psychiatric disorders.

Although Moniz said that his interventions were successful, they had devastating side effects. In addition to the death of 6% of the patients, they noted adverse changes in personality and social functioning in the majority of patients. Despite these rather questionable results, he won the Nobel Prize for Physiology or Medicine.

Walter Freeman popularized this practice in the United States. Through the “ice pick” technique, a similar tool was hammered into the patient’s brain through the tear duct until the prefrontal cortex was separated from the rest of the brain. It was used as a treatment for any known psychological illnesses for a long time. Today, it considered to be a barbaric technique in the history of psychiatry, and fortunately it was eradicated in 1967.