The behavioral presentation of an individual with a disordered sense of self

ABSTRACT

There is increased recognition that the brain processes a “sense of self” (best understood as a sense of “mineness”) in the right hemisphere association area and which can be distorted due to neurologic injury. Although there are numerous descriptions of types of disorders of the self (e.g., asomatognosia, anosognosia, mirror misidentification disorder, Capgras syndrome, schizophrenia), there are few descriptions of the subjective experiences of individuals with traumatic brain injury (TBI) who experience a reduced sense of self. This article presents a longitudinal case study of a woman in her early 40s with a primarily right hemisphere TBI and disorder of the self who had difficulties relating her experiences from the perspective of the self. Subjective interviews, neuropsychological test scores, and objective personality testing illustrate how she reported her experiences of a diminished sense of self, and how this sense of self improved over the normal course of recovery following the TBI. This case demonstrates clinically relevant information regarding how individuals with a reduced “sense of self” (i.e., “mineness”) associated with a right hemisphere TBI may report their subjective experiences and perform on objective testing.

KEYWORDS:

• Traumatic brain injury
• sense of self
• disorder of the self
• right hemisphere parietal lobe

Acknowledgments

The authors wish to acknowledge the contributions of the Fort Belvoir Intrepid Spirit Center rehabilitation team.

Disclosure of interest

The authors report no conflict of interest.

Disclaimer

The views expressed in this manuscript are those of the authors and do not necessarily reflect the official policy or position of Fort Belvoir Community Hospital, the Defense Health Agency, Department of Defense, or U.S. Government.