Phineas Gage Case Study

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Phineas Gage, 25-year-old male with apparent head injury. Gage is a railroad worker and as he was packing an explosive it detonated and the tamping iron backfired. The iron which was 43 inches long, 1.25 inches thick penetrated Gage’s left cheek through his brain and exited out his skull landing a few feet away from the explosion. This accident left Gage blinded in one eye and everyone started to notice a change in who he was after the injury.

Gage began to show the classic signs of someone who has a frontal lobe injury. He was not this easy going quiet person anymore, he begins to use foul language much more. He could not multi-task and he was not wanted around because of his changed personality, his old job at the railroad ended up firing him because of his behaviors. Soon after, Phineas starts to have problems with drinking and coping with the injury as well seizures which all have happened because of the accident.

Psychoeducation
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The frontal lobe is one of the last parts of the brain to fully develop so with consistent and constant exercise for brain functioning Gage will regain some of those functioning features.

Long term goals:
Develop Trust with Gage
Understand Gage’s Behavior
Recognize and Respond to the precursors of the maladaptive behavior.
Decrease Maladaptive Behaviors

Short term goals:
Psychological evaluation
Treat Gage with love and give him him honest, caring and consistent interactions each time we meet.
Make no promises, just be consistent in treatment.
Build a relationship
Identify triggers
Know when to reinforce and not reinforce behavior
Identity non-verbal and verbal signs of behavior
Include family in treatment
Teach Gage coping skills for current stressors
Discourage any negative talk and reward positive talk
Improve self-esteem about appearance.
Encourage social activities
Cognitive Training