Anosognosia

From: Richard Wein (rwein@lineone.net)
Date: Mon May 15 2000 - 05:08:37 EDT

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    *** Warning: creationists are liable to be offended by this post, so they
    may wish to avert their eyes now. ;-) ***

    Channel 4 television broadcast a very interesting documentary programme last
    night, called "Phantoms in the Brain", about the work of neuropsychologist
    Dr V S Ramachandran.

    Dr Ramachandran explores the workings of the brain by studying patients with
    a variety of neurological conditions, such as phantom limb pain. One of the
    less well known conditions covered was a mysterious one called
    "anosognosia". Typically this results from damage to the right parietal lobe
    of the brain. We were shown a patient suffering from this condition. He was
    paralyzed in the left side of his body, but was convinced that that side of
    his body was functioning normally. When asked to clap his hands together, he
    waved his right hand against empty air or clapped it against his chest, yet
    was still convinced that his left hand was working too!

    Dr Ramachandran has developed a theory to explain how such patients come to
    believe things which are so obviously untrue. See below for some info that I
    found on the web. The theory may give some insights into how it is that
    intelligent, well-educated people can fail to see their logical errors even
    when those errors are obvious. Of course, I'm thinking specifically about
    creationists here, but we see it also with other groups of people who hold
    powerful dogmatic beliefs. And, to a lesser degree, the phenomenon affects
    all of us.

    I find this subject fascinating, and I'm impatiently awaiting next week's
    program (Sunday 8.00pm, for any other Brits out there). Dr Ramachandran has
    also written a book on the subject
    (http://www.amazon.com/exec/obidos/ASIN/0688172172/neurosoftinccomp/103-2995
    682-3675829).

    Richard Wein (Tich)

    -------------------------------------------------------------------

    Coherencing of consciousness: lessons from anosognosia, supernumerary
    phantom limbs, multiple personalities, and freudian defense mechanisms

    V.S. Ramachandran (UCSD, La Jolla, CA 92093 0109, USA)

    We present a new theory of human nature based on our experiments on
    anosognosia and phantom limbs. Some right hemisphere stroke patients will
    vehemently deny that their left arm or leg is paralyzed (`Anosognosia') even
    though they are mentally lucid and intelligent. We present several new
    experiments and a new theory to account for the syndrome. Specifically, we
    suggest that in normal individuals the left hemisphere orchestrates a
    coherent and internally consistent `belief system' and folds new experiences
    into this pre-existing belief system. When a discrepancy threatens the
    belief system, one option would be to ignore it, i.e. preserve the status
    quo by engaging in denial, repression, reaction-formation, rationalization
    and other Freudian `defense mechanisms'. The purpose of this is to ensure
    stability and avoid indecisive vacillation. When the discrepancy, or
    `anomaly', becomes too large, however, a devil's advocate in the right
    hemisphere, performs a global consistency check and steps in to force a
    complete revision of the internal, i.e. a Kuhnian paradigm shift. In
    anosognosia, this devil's advocate is non-functional, and without it there
    is no limit to the delusions that the left hemisphere will engage in. As an
    analogy consider a military general in the heat of battle. Based on the
    information provided by several scouts (e.g., `We have 600 tanks but the
    enemy has only 500 tanks'), he decides to launch battle at dawn, at 6 am. A
    single scout then shows up at 5:59 am with the information that he had
    spotted 700 enemy tanks. Obviously, the general has no time to completely
    revise the battle plan and he may decide to ignore the scout instead
    (`denial'). But if the scout claims that the enemy had nuclear weapons the
    general would be foolish to adhere to the original plan. Instead of a single
    anomaly, if there are several anomalies inconsistent with the original
    belief system (A), but consistent with each other, they may coalesce -- like
    soap bubbles -- into a new belief system (B) that is insulated from (A);
    creating multiple personalities. A phantom limb usually arises from multiple
    sources (Ramachandran, PNAS, 1993, Nov.), e.g., stump neuromas, reafference
    from motor commands, `memory' of the original limb and activity of
    `remapped' sensory zones. These ordinarily convey mutually consistent
    information but if the information from one source is inconsistent, the
    dominant source prevails (`winner-take-all'). But if the inconsistent
    information is too salient to ignore, another option would be to hallucinate
    a non-existent limb -- a supernumerary phantom. The phenomenon is seen in
    brachial plexus avulsion, as an illusion (Ramachandran, 1995 in press) in
    that the patient recognizes its illusory nature. But in right hemisphere
    stroke, even though the source of the illusion is the same (i.e., multiple
    mutually inconsistent sensory inputs); the patient becomes convinced of its
    reality since he has no `devil's advocate' to check global consistency. Many
    enigmatic aspects of human nature such as caprice, innovation and creativity
    may be manifestations of `complexity at the edge of chaos emerging at the
    transitional zone between stability and deterministic chaos. Furthermore,
    our theory is a viable alternative to Triver's `concealed lie' theory of
    self deception and it also provides a Darwinian framework (Ramachandran,
    Int. Rev. of Neurobiol., vol. 37, 1994) for interpreting a wide range of
    seemingly unrelated clinical oddities such as anosognosia, supernumerary
    phantoms, multiple personalities, Freudian defense mechanisms and the
    creative surges of manic-depressives. It may even account for otherwise
    inexplicable phenomena such as `misoplegia' (hatred for one's own left arm)
    and the evolutionary origins of laughter and humor.

    (http://www.maurer.demon.co.uk/SPECIAL/02_05.html#121)



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