Sunday, January 08, 2012


V.S. Ramachandran's lecture on Anosognosia

This video is almost an hour long, but it is fascinating and it is relevant to religion because it addresses belief systems. In this particular context the belief system is that of a person about his or her own body. The presenting situation is a person (dubbed “Mrs. D”) who has had a right-brain stroke which has caused her left side to be paralyzed. But she refuses to admit this even though her thought processes are not affected and she is perfectly lucid and otherwise rational.

The professor asks her to lift her right arm and she does. Then the same with the left arm. She can’t. But she doesn’t want to admit it, so she tries all sorts of dodges. (Neither consciously nor intentionally.) She “confabulates” -- claims that she IS lifting her arm. Some subjects say their arm is very tired. Some say they have arthritis which is preventing movement. One man said with dignity, “I am a military officer and I am not accustomed to obeying orders.” This is quite common in right brain stroke cases and usually persists several days before the person becomes reconciled and admits there is a problem.

In the meantime, if they are asked to pick up a tray loaded with champagne glasses, they will pick it up by the left edge -- as they would with two working arms -- and dump all the glasses off. If given a choice between two reward tasks, one screwing in a lightbulb for $5 and the other tying a child’s sneaker for $10 -- the first do-able with one hand, the second only feasible with two hands -- the denying person chooses the shoe and will persist in struggling with it until stopped. Even after four episodes of this over a period of days, the deny-er persists.

The doc tries a new angle. “See that big heavy table there? Do you think you could lift it with your right arm?” “Oh, yes.” “How far?” “Three inches.” “What about your left arm?” “Of course.” “How far?” “SIX inches!” No consciousness of lying or exaggerating.

Then the doctor has a new test. He injects the paralyzed left arm with a saline solution which he pretends is an anesthetic that will prevent movement. “Please raise your left arm.” “Why, doctor, you know very well that the arm is paralyzed. I can’t raise it!” (The TRUTH at last!) So another day he tries the injection trick on the good arm and the patient raises his right arm in spite of being told it’s paralyzed. “Oh, look, Doc! Your drug doesn’t work!”

When the stroke is on the left side and paralyzes the right arm, the patient will rarely deny the problem.

The conclusions drawn from all this is a confirmation of Thomas Kuhn’s idea about paradigm shift, which he derived from simple observation and reflection rather than experiment. These experiments confirm Kuhn’s idea and add a split-brain dimension. If there is a “neuronal working platform” on the left side (usually) of the brain, and if a stroke affects its ability to acquire and process information (like paralysis of the left side), then that processing platform will cling to the pre-existing conviction that the arm is in good working order. Over days, as the evidence mounts up and possibly as the brain damage clears a bit, the patient begins to revise his or her mental convictions about his or her own body.

Kuhn proposed that one daily discovers small discrepancies in convictions and is able to revise and include them without disrupting the day’s tasks. But sometimes, when there is a catastrophic change, the person must go the “neuronal working platform” with a problem that takes days or years or a lifetime to solve. Consider the death of a loved person: for days it’s simply unreal. Consider 9/11. Again, it was not real and we watched over and over and over as though trying to grasp it, confirm it. The final result was a massive change in our collective understanding of the world, though the world had not actually changed at all. Some people proposed a planet-wide network of evil-doers just waiting to repeat this event and we have proceeded on that assumption. It is not a testable assumption and yet we are turning our world upside down as though it were real.

The religious system developed two thousand years ago is now challenged by science -- not just the scientific method of testing but also instrumented measurements and vivid photographs never seen before. The limit of what can be worked through on the sub-paradigm level has been passed. Now the world consciously demands a new formulation. The world order of humans is as much on the table as are our ethical systems. Our religions clearly do not prevent evil within or without. They do not reliably tell us about ourselves.

At the beginning of Ramachandran’s talk, he mentions another more cynical explanation of why people might deny a paralysis of their arm -- that they are doing it for emotional reasons to make themselves feel better. They are simply lying, which is our assumption about heretics and competing religious systems. They are liars. They are resisting our truth.

This is explained in evolutionary terms by proposing that a juvenile chimp has a cache of bananas and hides them to keep them from an Alpha male. The big chimp demands to know where the bananas are and the juvenile says, “Oh, way back there under the bridge a mile away.” So Alpha male goes charging off. The trouble with this scenario is that from primates up (and to some extent even lower orders of animals) it is possible to lie. But we can often tell by small cues in muscles, eye dilation, behavior and so on when people are lying, unless they convince themselves as well. Some people propose that the liar actually believes his own lie. Their lie becomes their reality.

To some extent we have seen this happen. There is one trouble with it. The self-convinced junior chimp will no longer know where his bananas are. It is a flawed strategy. Much of the work of psychoanalysis is helping people to figure out, so to speak, where they hid their bananas before it became necessary to lie, to confabulate, to excuse, to confront and deflect. I would suggest it is also a religious task at the core of confession and repentance. A liturgy, like psychotherapy, can provide the safe space in which to shift one’s paradigm.

There’s another implication here. The evolutionary sequence of the brain seems to be the development of an array of small systems each specializing in some crucial function, and then -- to keep order among them -- the development of this “neuronal working platform”, a kind of dashboard. If the small systems have big enough problems, the dashboard platform is forced into addressing them consciously and does that. This is the reason and justification for the kind of consciousness we have.

Here’s the second implication: what is the next step in brain evolution? If unconscious and repressed information can come to consciousness to be dealt with, what is the next step? Can consciousness rise to something above itself? What might that be like? Visions? Trans-personal awareness like mind-reading? Scales falling from our eyes?

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