Your self and your brain

“The distinction between diseases of “brain” and “mind,” between “neurological” problems and “psychological” or “psychiatric” ones, is an unfortunate cultural inheritance that permeates society and medicine. It reflects a basic ignorance of the relation between brain and mind. Diseases of the brain are seen as tragedies visited on people who cannot be blamed for their condition, while diseases of the mind, especially those that affect conduct and emotion, are seen as social inconveniences for which sufferers have much to answer.” Antonio Damasio

In this short aside, Damasio spoke about something that I’ve noticed and wondered about in each of our readings so far. It makes sense that ideas about identity and the self keep coming up in a class about how our brains formulate our individual narratives and moments in which they are disrupted. I agree with Lauren’s post – each reading is so linked with the others. I thought of Sacks’ patients with Korsakov’s Syndrome when, in The Echo Maker, Karin acknowledged that Mark was getting better, which made him “worse than hopeless.” That paradox stood out to me as extremely unsettling. What calm or peace could he find when so many of his brain functions were in tact but the one he was missing made his life a constant struggle? Would he be better off if he were back in the coma? What did it matter if you could function on nearly every level if you were missing your “self”? Would you adapt to the new self?

As I read The Echo Maker, I kept waiting for Mark’s brain to resume its normal functions, so that his true “self” could return. Implicit in this statement is the idea that healthy brain activity actually is a person’s identity. At the point where Mark begins to speak but can only curse, Karin thinks to herself that “this was injury, not her brother.” Where, then, is her brother? If he disappears when his brain is injured and will reappear (hopefully) if his brain heals and restrengthens, then what separates him from his brain? Does anything?

This is very similar to Gage and Elliott, in Descartes’ Error. Actually, to connect this to Sacks again, I thought of Temple while reading about Elliott. Damasio described “Elliot’s predicament as to know but not to feel.” I remembered the way that Temple would look at a beautiful scene and note that people found it beautiful but she could not understand what that meant. Or the brief mention Sacks made of a child who very simply explained that his mother died, but he did not feel a sense of loss. Elliot and Gage, of course, were different in many ways. It’s incredible how the brain can actually work against itself instead of for its own survival.

I understood their situations better after reading the LeDoux chapter about motivation and the prefrontal cortex. When he wrote about the complexity of motives and decision making, how drives, incentives, and reinforcers work on a biological and emotional level but constantly shift within the context of an ever changing environment, I felt for someone like Gage or Elliott so much. As competent as they both were, even of extraodinary intelligence, they lost something vital to who they were. LeDoux explains how, “cognitive processing will be accompanied by emotional arousal,” and this seems to be exactly what Elliott lost. I was glad that we read the selection from Descartes’ Error after reading chapters in LeDoux on working memory and executive functions, because it made use of that material.

The questions I’m still left with are... Is every personality change accounted for in the brain? (I’m interested to know if autopsies have been performed on particularly cold-blooded killers. I feel like I have some memory of this happening and would be interested in the results. Does the brain of a sociopath look different than the brain of a compassionate person?) Also, if the brain controls personality, do we have free will? (Yes, I seem to ask this in every post.) What role does consciousness play? Do we have control over our consciousness? Since we seem to have little or contradictory information about consciousness and subjective experience, can we actually trace this to specific brain activity? And finally, when can you hold people accountable for who they are – or can you ever?