Saturday, September 15, 2007

Seeking the Self

It seems that we have all the ingredients to create a human or “self”, mind, soul, personality and brains, but we cannot figure out the recipe. Theories and research done by philosophers, theologians, scientists and psychologists are virtually useless separately, but we inch closer to the “self” when we view them as a whole. I think The Synaptic Self may prove to be the most productive of our reading materials thus far because of its diverse insights. The Man Who Mistook His Wife for a Hat is very entertaining but after reading in the order: LeDoux, Sacks, Hirstein, I felt like LeDoux set up the necessary background information and posed important ideas that the Sacks reading supported by example. Brain Fiction sort of felt like I was conducting an experiment as I was reading because it was written in such an organized list-like manner, but I think the discussion of confabulation was significantly thought provoking.

I agree with LeDoux when he said that philosophy was the most improbable source for discovering the “self”. Descartes said that the “mental” and “physical” were two separate things, but how could this be so? The physical is a direct result of the mental; they have to be interrelated. The Sacks cases show us that any deterioration of the mind plays out in the body, with the ability to make or break a person. Some of the people have illnesses and some of the illnesses have people. For example, Witty Ticcy Ray was “fixed” after his medication. But he wasn’t himself anymore; not as quick or competitive or as “ticcy” because Tourette’s syndrome was a part of his identity. The haloperidol became a switch on his personality. This brings me back to a question LeDoux asked. Can a human lose personhood as a result of brain damage, insanity or moral transgression? What about, can a human gain personhood from said things?

In the first chapter of Brain Fiction, Hirstein explores every inch of what confabulation is. Although some diseases that cause confabulation can be some of the most awful degenerations that could happen to a person (e.g. Alzheimer’s, schizophrenia…), aren’t they intriguing? It sure is devastating when someone you know is completely altered by one of these illnesses, but do they gain a strange new personhood because of this new character they have taken on? It is clear that they have no intent to deceive you when you are told a lie, but to be so creative on the spot with a story… Frankly, I am a bit jealous of such imagination.

I think it’s strange how some diseases make you who you are, and some have nothing to do with who you are. But who are we to say that a human becomes less of a person when they transgress from a disease? Some of the most interesting people I know are the ones with tics or the ones that confabulate!

Weeks Readings

While reading 'What is Confabulation?' in Brain Fiction I find the accounts to be haunting and yet humorous. How is a doctor able to keep a straight face in defence of the illness that the persons' brain has? That is it isn't it? These are misfunctionings of our brains not our selves, so where does the blame lie? And who is responsible? Perhaps these questions are redundant, but I am wondering who suffers more the patient or the doctor and which out of pity.
Confabulation indentifies its relativity to lieing, but a different kinship. It cannot be a lie because the person is not concious of it.
What I didn't understand is how can it not be considered lieing in those who are not mentally ill? In the case of the placebo pill, obviously those people were just making themselves believe that the pill was making them tired, when in fact it was all in their heads.

In LeDoux's 'Synaptic Self' the actual words of philosophers, authors, and artists caught my interest the most. Our individual relationship with God adds a different dimension as well, because although God presents different ideas in each we must have this understanding that 'God interacts, but does not interfere.'
When Descarte says 'The only thing he could know with certainty was his own mind.' it is a beautiful statement. I agree that even though we are not certain of many things and doubt and denial play a large rule in self-confidence we are indirectly responsible for knowing ourselves and our capabilities. Then when Bob Dylan says that the self that he wakes up with is not the self that he falls to sleep with, and something said by Philip Roth along the same lines of not really knowing oneself, is it that we choose not to know, or we are just unsure of what exactly 'knowing thyself' means?
Also when it is said that stress is known to impair explicit memory while doing the opposite to implicit, I had trouble identifying exactly what this meant, so maybe someone can help me out. To put it very simplictically I took it to mean that although our stress is represented externally in an uncomfortable physical form it takes shape in us creatively, and more concretely places a memory implicitly?

As for the readings of 'The Man who Mistook his wife for a hat' Those stories leave the question open for fright as many have said already and hope. In 'A passage to India' this image of watching a young girl dream her way to death and in that find eternal life, is beautiful. Horribly sad, but in that small example we are lead to believe that the mysteries of the brain are those all to their own.
In 'The President's Speech' the episodes of aphasia are so delicate. It is like another form of language. It stopped me for a moment when the nurses of aphasia patients relate them seeming most of the time fine. Then I was lead to the reading 'Witty Ticcy Ray' and it just proves that 'fine' and 'normal' can only be defined by the patient. It is hard to say whether or not we are living our lives wrong, if we are still living them. Like when Ray takes Haldol during the week to maintain 'normality' and then dismisses it on the weekends to be himself, the different Ray. The aphasiacs are the same, they just function differently. Maybe these comments are too obvious, but I find in trying to understand the complexity of situations like these stories it just easier to find the beauty.

Witty Ticky Ray and A Passage to India

The exploration of tourette's synodrome by Sachs in the chapter entitled "Witty Ticky Ray" was a facinating look at how some people use their illness as form of identity. As in "The Lost Mariner" self expression frees these disabled people from their illnesses. Without Haldol, Ray was sharp, erratic, and could fly off into wild improvisations on the jazz drums, but still couldn't lead a normal life because of his violent ticks. Ray describes being on Haldol as "...dull, makes one square and sober, and neither state is really free". The most interesting and moving part of this chapter, was Ray's decision to take himself off of Haldol during the weekends, but "dutifully" take it during the week. Ray split himself into two people and as he describes neither one is balanced, but he must do the best with this imbalance to lead a life more like normal people. Reading all these different accounts of patients definately makes me appreciate all that I have and that I am not lost in another world that is not this one. As in "A Passage to India", Bhagawhandi P., a girl of just 19, gets lost in a fantasy world, because of a malignant brain tumor. In a trance like state, as Sachs describes, Bhagawhandi P. would drift off into fantasies of India. She says just weeks before she died: "I am drying..I am going home. I am going back to where I came from- you might call it my return". This story is almost romantic in its description and extremely saddening, because of course it is truth and not fiction. It's hard to think that a girl just a year younger than myself could die so abruptly and tragically. Sach's writes in a very direct and clear manner and really makes the reader understand and empathize with his patients.

The Horror

Several readings this week—to me—exemplified in beautiful ways the horror I feel at facing such disorders as Korsakov’s and Capgras’ syndromes. The true wonder that we feel when imagining and learning about the worlds of patients with these disorders is, perhaps, fundamentally derived from the fact that they horrify us to some extent.

We read about Jimmie D., who remarked, “‘I cannot say I feel ill. But I cannot say I feel well. I cannot say I feel anything at all’” (Sacks, 36). Surely there is nothing more strange or frightening than feeling nothing at all. The memories that Jimmie lost are coupled with a loss of much, much more. Sacks himself said, “The fact that one can lose the greater part of a lifetime has peculiar, uncanny horror.” (40)

We read—for a very short while in “The President’s Speech”—about Emily D. Here we find a woman who has developed tonal agnosia, an inability to detect alterations in a person’s tone of voice. She copes with it by requesting that people speak in proper, non-expressive prose. The horror in this is that she was once, herself, a poet!

Then, of course, there’s Witty Ticcy Ray, who—while he finds ways to cope with it—must always be bouncing back and forth between two unnatural modes of existence, never really confident of which is the real Ray.

There are many more in these readings that scare me, but this is a diverse enough sample. In all of these cases, the root of fear—my fear at least—seems to be traceable to a commonality between the cases: all of them, in some way, force us to reassess the definition and nature of identity. How is a man himself when he forgets himself, forgets his life, forgets how to feel? How is a poet herself any longer if the only thing she can understand now is prose? Which of the Rays is the real Ray—the one with the deficits caused by Haldol or the one with the deficits caused by Tourette’s? And for God’s sake, how can you retain your identity if you—like those in certain cases of Capgras’ syndrome—have a desire to kill the ones you love the most, thinking they are imposters?

There are no answers to these questions, and that frightens me. But we can look to Jimmie D. when he is at Communion, look to Ray when he transcends his sickness, or to José who learned to express his feeling through art when he could not effectively talk. These can help to alleviate the fear and hopelessness that seems to plague some of these cases. They may be short moments of reprieve, but they are enough to make it all worthwhile.

Friday, September 14, 2007

In Response to LeDoux

I was quite reassured by the emphasis LeDoux places on what he calls "an interdisciplinary approach to the understanding of how the mind works" in his first chapter of "Synaptic Self". It is always wonderful to begin a book with the knowledge that the author understands the value of a balanced and all-encompassing perspective of the material covered.
I once heard a story about the way in which Descartes's taught the concept of consciousness and sentience; apparently to demonstrate his theory that animals were not truly conscious organisms the philosopher would nail a live dog to a board of wood in front of his class of horrified students. He would then dissect the animal, exposing it's beating heart and dismissing it's whimpers of pain as merely the sounds of a machine that was functioning improperly. As the animal literally died before his eyes, Descartes maintained that it's cries were no different then the whining of a gear that needed to be oiled. Not a pretty picture.
In a slightly melodramatic sense, I've often felt that reading scientific texts can be equated to spending time in Descartes' classroom. All too often I feel that advances in science are portrayed as a final answer to the more complicated questions we have about ourselves and our bodies. Just as Descartes simplified the dog, we (human beings) are presented as purely machines, rather then a complicated collection of variables and determining factors. Textbooks often treat human life in general as a sort of mathematical equation; these nerves plus those chemicals equal the entirety of your person. It can sometimes feel a bit like reading Vonnegut, with all that talk of "bad chemicals" and "faulty wiring".
Thus, I was impressed with LeDoux's approach to his subject. His insistence that multiple branches of Neuropsychology be used in conjunction in order to achieve a more complete understanding of what makes us who we are seemed both intuitive when I originally read it (of course we should take everything into account!) and at the same time remarkably novel. I don't think I've ever read anything quite like it before. He takes his conversation of the self past the basics of cognitive science and the nature vs. nurture argument, in order to "consider the whole mind" and how every aspect contributes to the self we become.

Some questions

To paraphrase LeDoux, the idea that the self is created by and depends upon synaptic connections should not diminish who we are. I understand this point, and I agree. Nothing is actually changing here – the what remains the same – but our understanding of the why develops into something greater.

At the same time, I think that our (often misguided or ill-informed) ideas of what makes us who we are vary. For this reason, his statement most likely has a different effect on each person, and for me, it is a slightly disappointing, though illuminating, one. I like the idea of the magical, unknowable, mystical. There is a certain romance to nineteenth century attempts to make scientific sense out of a confusing world. Electricity and innovation seemed like something thrilling, wholly captivating, at that time, but they have since lost their romance and are now simply the flip of a switch that we take for granted. I like having the freedom to wonder about my soul, a part of me that doesn’t seem to physically exist anywhere, exactly, but is still (seemingly) present. I guess, simply, I like asking questions.

That desire for mystery exists in me with another interest, a contradictory force that is scared by the overwhelming nature of feeling unknowable and wants to explain and understand and classify. Hopefully, the more I learn, the more I will be able to grow, to control or change undesirable thought patterns or unhealthy parts of my personality. As LeDoux himself states, “Learning allows us to transcend our genes.”

So I do think it’s important, and better, to unlock pieces of the “mystery” of who we are, but there is a certain bittersweet quality to it, one that has characterized my on-going process of growing up.

I still have questions, though they may be answerable. I understand that our learned experiences will build upon and change our genetic predisposition, so that “learning allows us to transcend our genes,” but wouldn’t your genetic makeup influence how and what you learn in the first place? Or what you are receptive to learning? Do we ever have a freedom of choice, or is the combination of who we are and what we learn in control of our fate? And if we do have freedom of choice, can we trace where it comes from, or is there any part of our personality that does not point back to a specific part of our brain? Are there gray areas?

Wednesday, September 12, 2007

Science and The Self: Contradictory or Complementary?

When I consider the three books we were asked to read this week (due on 9/10), I categorize them in the following way:

Synaptic Self represents the most scientific reading, with its discussions of neurons, synapses, and brain development.

"The Bear Came Over the Mountain" represents the least scientific, and most personal reading. Note the absence of any talk of pathology in the story; is the word "Alzheimer's" even mentioned? Grant and Fiona don't talk to doctors and don't discuss the physical expression of Fiona's disease in her brain. On the contrary, "Bear" focuses exclusively on personalities, emotions, inter-personal relationships - the pathology of Fiona's disease is excluded, irrelevant.

Lastly, Oliver Sacks' "The Man Who Mistook His Wife For a Hat" represents a union of cold science and human emotion. Sacks, as a neurologist, is interested in the pathology of Dr. P's disease. As a sympathetic human being, Sacks is interested in P as a person and what emotions he feels in response to his condition. And lastly, as a writer, Sacks looks to combine his two perspectives into a coherent and compelling narrative. Out of all three authors, Sacks is in the best position to give the reader the most comprehensive understanding of his character, having both the scientific understanding of a neurologist and the ability to empathize that allows him to create "richly human clinical tales" (Sacks, xiv).

That is not to say that Synaptic Self does not have a human element, or that disease plays no part in the story of "The Bear Came Over the Mountain." On the contrary, an understanding of Alzheimer's (at least on a basic level) enhances one's reading of "Bear," and Joseph LeDoux seems committed to illuminating "the self" as a "psychological, social, moral, aesthetic, [and] spiritual" being as much as a "neural" one.

But I am saying that Sacks achieves the balance between the pathological and the personal most successfully out of the three authors. Synaptic Self, at least so far, lacks the human element of Sacks' tale because LeDoux has not brought us into the life of any specific human being, like Sacks brought us into the life of Dr. P. Munro, conversely, does not include a discussion of Fiona's pathology.

Both "Bear" and Synaptic Self offer great insight into the self - what it is, how it works, how certain conditions can change it, and how in some ways it is constant. But Oliver Sacks' story is the one that best fits the concept of "Narrative Neuropsychology" as I perceive it. He illuminates the life and personality of a human being, and at the same time invites us to wonder at the working of that person's brain as a physical thing - "a machine and a computer" (18). As we gain interest in the brain as a mechanism of great genius and mystery, we never forget that there is a person attached to that brain, "a human subject at the center," and that it is this person, his "essential being," who is most "relevant in the higher reaches of neurology" (xiv).

Monday, September 10, 2007

The Bear Came Over the Mountain

I enjoyed meeting with you today, even in the Andrews sauna. Stephanie and Madeline were right that there is more to be gleaned from the title of Munro's story. I found a review of the film 'Away From Her' that makes it explicit. The title comes from an old folk song and another perspective on the story comes clear from the lines that follow:
The bear came over the mountain
to see what he could see
and all that he could see
was the other side of the mountain

The review's online at