Descartes' Error: Emotion, Reason, and the Human Brain

by António Damásio

perspective to be rooted in a relatively stable, endlessly repeated biological state. The source of the stability is the predominantly invariant structure and operation of the organism, and the slowly evolving elements of autobiographical data.

The neural basis for the self,

At each moment the state of self is constructed, from the ground up. It is an evanescent reference state, so continuously and consistently reconstructed that the owner never knows it is being remade

Present continuously becomes past, and by the time we take stock of it we are in another present, consumed with planning the future, which we do on the stepping-stones of the past. The present is never here. We are hopelessly late for consciousness.

a process we could call “metaself”

convergence zone,

greater knowledge about the physiology of emotion and feeling should make us more aware of the pitfalls of scientific observation.

What worries me

the attempt to explain bruised feelings or irrational behavior by appealing to surface social causes or the action of neurotransmitters,

It is precisely this lack of understanding of the nature of feelings and reason (one of the hallmarks of the “culture of complaint”2) that is cause for alarm.

the strengthening of rationality probably requires that greater consideration be given to the vulnerability of the world within.

Descartes

modern variants

For us then, in the beginning it was being, and only later was it thinking. And for us now, as we come into the world and develop, we still begin with being, and only later do we think. We are, and then we think, and we think only inasmuch as we are, since thinking is indeed caused by the structures and operations of being.

(The inscription Descartes chose

Augustine’s “Fallor ergo sum”

Cartesian disembodiment also behind the thinking of neuroscientists who insist that the mind can be fully explained solely in terms of brain events, leaving by the wayside the rest of the organism and the surrounding physical and social environment—and also leaving out the fact that part of the environment is itself a product of the organism’s preceding actions.

disembodied mind also seems to have shaped the peculiar way in which Western medicine approaches the study and treatment of diseases (see the postscriptum). The Cartesian split pervades both research and practice. As a result, the psychological consequences of diseases of the body proper, the so-called real diseases, are usually disregarded and only considered on second thought. Even more neglected are the reverse, the body-proper effects of psychological conflict.

from Hippocrates to the Renaissance. How annoyed Aristotle would have been with Descartes, had he known.

the most general idea with which I introduced the book: that the comprehensive understanding of the human mind requires an organismic perspective;

however, does not relinquish its most refined levels of operation, those constituting its soul and spirit. From my perspective, it is just that soul and spirit, with all their dignity and human scale, are now complex and unique states of an organism.

And this is of course the difficult job, is it not:

The scientist’s voice need not be the mere record of life as it is; scientific knowledge can be a pillar to help humans endure and prevail.

MODERN NEUROBIOLOGY AND THE IDEA OF MEDICINE

There is something paradoxical about the conceptualization of medicine and about its practitioners in our culture.

The net result of this tradition has been a remarkable neglect of the mind as a function of the organism.

it is indeed astonishing to realize that students learn about psycho-pathology without ever being taught normal psychology.

I am aware of commendable exceptions to this panorama, but they simply reinforce the idea I am giving of the general situation.

It should not be surprising that, by and large, the consequences of diseases of the body proper on the mind are a second thought, or no thought at all.

we have no idea about the degree of error the placebo effect has created for so-called double-blind studies.

The Cartesian-based neglect

great physicians

we would be deluding ourselves if we thought that the standard of medical practice in the Western world is that of those notable physicians we all have known.

Medicine hardly needed the additional problems that have come from its economics, but it is getting those too, and they are certain to worsen medical performance.

The problem with the rift between body and mind in Western medicine has not yet been articulated by the public at large, although it seems to have been detected.

foolish to ask medicine alone to heal a sick culture, but it is just as foolish to ignore that aspect of human disease.

so much of what can be said about the brain is best stated as working hypotheses.

If there is any cause for worry, it comes not from a lack of progress but rather from the torrent of new facts that neuroscience is delivering and the threat that they may engulf the ability to think clearly.

Contemporary medicine races from descriptive scientific findings to prescript8ve technoloĝies at the same time it insistently demands and delays implementation of centuries old but valid observations which are not mediated by its mechanical, chemical and lab-rat truncations of the human being and our alienation from the environment and each other.

The most elaborate social conventions and ethical structures by which we live, however, must have arisen culturally and been transmitted likewise.

was the trigger for the cultural development

Second,

Third,

the same simple device, applied to systems with very different orders of complexity and in different circumstances, leads to different but related results. The immune system, the hypothalamus, the ventromedial frontal cortices, and the Bill of Rights have the same root cause.

When many individuals, in social groups, experienced the painful consequences of psychological, social, and natural phenomena, it was possible to develop intellectual and cultural strategies for coping with the experience of pain and perhaps reducing it.

Pain and pleasure occur when we become conscious of body-state profiles that clearly deviate from the base range.

two components in pain and pleasure.

first,

second

What we call pain or pleasure, for example, is the name for a concept of a particular body landscape that our brains are perceiving.

pain processing.