Personality changes following brain injury as a grief response to the loss of sense of self: phenomenological themes as indices of local lability and neurocognitive structuring as psychotherapy.

Both theoretical and empirical observations suggest that significant alterations in self-concept should occur following most closed head injuries because of diffuse synaptic modification within the temporofrontal regions; this loss of the sense of self should evoke a grief-like response sequence and should encourage paranormal/religious experiences during the subsequent months to years. The marked consistency between phenomenological experiences and the results of neuropsychological assessments of 56 adults who had sustained brain injuries supported this hypothesis. Subsequent reports by these patients indicated that clinical translation of posttraumatic experiences into rational neurobehavioral terms and interventions tailored for the individual's specific pattern of brain "dysfunction" may facilitate adaptation during the grieving period.