Neuroscience: In the blink of an I

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Douwe Draaisma is impressed by a study on the science behind 'maladies of the self'.

The Man Who Wasn't There: Investigations into the Strange New Science of the Self

Anil Ananthaswamy Dutton: 2015. ISBN: 9780525954194

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Eloy Gomez Photography/Getty

It might happen while you are lecturing. All of a sudden, you hear yourself talking: an autopilot version of yourself seems to have taken over. With rising panic, you struggle to get back in, praying that what this autopilot has to say makes sense.

Who — or what — is the 'yourself' that does the talking? And who is the 'I' that anxiously tries to regain control? Are there temporarily two selves? Or is there still a single self, experienced from the outside? In most cases, the 'split' dissolves quickly and you slip back into the driver's seat. You have experienced a brief spell of depersonalization.

Depersonalization can also be pathological, sometimes linked to epilepsy, and can last for minutes or even hours. To science writer Anil Ananthaswamy, chronic types of dissociation belong to “maladies of the self”, a set of experiences, conditions and syndromes that offer a window on what constitutes a self. For The Man Who Wasn't There, Ananthaswamy interviewed patients, psychiatrists and neuroscientists, charting how the self is affected in people with autism spectrum disorder, dementia, epilepsy or schizophrenia, and examining out-of-body experiences, doppelgänger hallucinations and phantom sensations. Much of the book reads like a travelogue, an exploration of the fringes of human experiences with Ananthaswamy a dependable guide, as in his celebrated The Edge of Physics (Gerald Duckworth, 2010). However elusive the experiences may seem, he keeps analysis close to the findings of modern neuroscience and psychiatry.

“Ananthaswamy hears intimate, sometimes heartbreaking stories about what it means to experience symptoms.”

Ananthaswamy hears intimate, sometimes heartbreaking stories about what it means to experience a condition's symptoms. He has a gift for weaving these through the technicalities of neuroscientific literature. Autobiographies hinging on conditions such as Asperger's syndrome and schizophrenia are proliferating, but there is little to fill the void between such accounts and the scientific literature. Linking experiences with experiments, and individuals with numbers, Ananthaswamy bridges that gap convincingly.

Possibly the most harrowing malady of the self is Cotard's syndrome, in which a person, often with severe depression, believes that he or she has died. Ananthaswamy presents the case of 48-year-old Graham. After a failed attempt to electrocute himself, he became convinced that he was brain dead. Scans showed severe loss of activity in the frontal and parietal regions of the brain — structures supporting the 'default mode network', which allows one to remember and maintain the feeling that there is an 'I' that acts and experiences. Investigators speculated that antidepressants — or depression — could dampen activity in these brain areas but held that neither hypothesis could explain the extent of the lowered metabolism. Cotard's syndrome is philosophically unsettling, because it questions the axiomatic certainty of the Cartesian 'I think, therefore I am'. Yet, Ananthaswamy observes, there must still be an 'I' that experiences the delusion of being dead.

More common, but equally ghostly, are phantom experiences. After amputation of a limb, some people still feel itching or pain from it, probably due to activity in the now-vacant part of their cortical 'map', the neurological representation that supports their body image. Lesser known is the inverse, body integrity identity disorder, in which a person feels that a healthy body part is foreign to them. The disorder may cause severe suffering. Quite a few desperate people have taken it into their own hands to get rid of the problematic body part, and have bled to death.

In a moving chapter, Ananthaswamy travels with 'David' to an Asian surgeon who relieves him of a leg that has felt odd since childhood. Afterwards, David finally feels at one with his bodily self. Swiss neuropsychologist Peter Brugger suggests that a limb that feels foreign may be the result of a cortical map that never included it in the first place.

There are many such inversions in The Man Who Wasn't There. They make intriguing associations. Could the feeling of a split self in depersonalization be the inverse of the ecstatic feeling of oneness with the world sometimes experienced during an epileptic seizure originating in the temporal lobe? (The brain region that is hyperactive during ecstatic seizures, the anterior insula, is underactive during chronic depersonalization, which seems to point in this direction.) Is the loss of a self supported by personal memories in Alzheimer's disease analogous to the scrambling of the self in schizophrenia? And could the trouble that some people with autism spectrum disorder have in intuiting the mental states of others — which has been called a deficient theory of mind — also cause the less sophisticated introspective skills that they may have?

Ananthaswamy does not end with a list of conclusions about the location, structure or organization of a hypothetical self. One could hardly expect him to: most of the research is in flux, and has been especially so since the introduction of sophisticated imaging techniques. Instead, he gives a sense of the many forces — hormonal, chemical, psychological, social — that modulate the self-as-experienced. One finishes the quest with a sense of paradox that the concept of self, often seen as elusive if not illusory, is so eminently suited to tightening these various narrative threads.


  1. Report this comment #66869

    Rodney Bartlett said:

    Mental illness and quantum-mechanical distance healing

    Here's something for us all to think about – is mental illness really mental illness? Perhaps it is and isn't at the same time. Let me explain -

    In 1911 Vladimir Vari?ak asserted that length contraction is ?real? according to Lorentz, while it is ?apparent or subjective? according to Einstein 1. Einstein replied:
    ?The author unjustifiably stated a difference of Lorentz?s view and that of mine concerning the physical facts. The question as to whether length contraction really exists or not is misleading. It doesn?t ?really? exist, in so far as it doesn?t exist for a comoving observer; though it ?really? exists, i.e. in such a way that it could be demonstrated in principle by physical means by a non-comoving observer.? 2

    The trend of discoveries in physics is towards unification of the whole universe, and all time, into one thing ... one event. Start with 19th century scientist James Clerk Maxwell uniting electricity and magnetism into electromagnetism. Then consider Albert Einstein's attempt in the 20th century to unite electromagnetism with gravitation and produce a Unified Field Theory. Lastly, think of modern physics' dream to unite everything into the TOE (Theory of Everything). One day, the Unified Field or TOE will be successfully achieved and it might extend far beyond the wildest hopes of today's science.

    Just suppose that what we call mental illness results from insights into the unification, with the insights producing inability – to a greater or lesser degree – to cope with what society deems normal activity. For example – look at the conditions listed in "In the blink of an I" by Douwe Draaisma (Nature journal – 6 August 2015). (This article is a review of the book "The Man Who Wasn't There" by Anil Ananthaswamy – Dutton, 2015.)

    An epileptic seizure originating in the brain's temporal lobe and giving an ecstatic feeling of oneness with the world might be a link to the true nature of reality: an insight into the unification of space-time that is unfortunately accompanied by a change in brain waves that is not compatible with normal activity. The loss of self in Alzheimer's, and scrambling of self in schizophrenia, could similarly result from insight into universal unification in which the self has no existence separate from anything or any other self. Regrettably, the knowledge of the schizophrenia or Alzheimer's patient has come too soon – before they can understand it, or integrate it into their life. Their psychology and social lives are ruined – their hormones and biochemistry are upset. As for autism, how can anyone easily intuit the mental states of others when torn between society's belief that there is no other way and reality telling them only one mind can ever exist when all time and the entire universe are unified.

    Someone living in the far future would have incorporated unification into the daily life they lead as a seemingly distinct individual. Returning to the early paragraph about Einstein explaining length contraction – they could therefore be seen as a co-moving observer with unification, and mental illness could not really exist in their eyes. There would be a different evaluation of what we term illness. Not just mental, but also physical disease or injury, must necessarily be viewed alternatively if every mind and body is part of one thing and one event, and can never possess the separateness our unreliable senses attribute to them.

    This different evaluation and alternative view relate to the process being more holistic. In today's medicine, PNI (psychoneuroimmunology) is interaction of a person's psychology, neurology and immunology ie of the mind, nervous system and immune system. PNI can be regarded as a more holistic approach than any one of its 3 components. Similarly, the non-separateness of minds and bodies represents an even more holistic quantum-mechanical approach in which healing can be conducted without consideration of distance (neither space's light-years nor time's centuries are impenetrable barriers).

    Einstein always maintained that quantum mechanics (QM), though not incorrect, is incomplete. He famously called its ideas "spooky action at a distance" and would likewise have denied medicine's potential to heal at a distance. However, the decades since his death have repeatedly seen quantum mechanics confirmed experimentally. While our understanding of QM may indeed be incomplete, I like to think that Einstein in his afterlife has decided that '"spooky action at a distance" is possible after all ... and so is distance healing.

    To a non-comoving observer (such as someone living today, who has not seen unification verified), mental and physical illness truly exist – that is, in such a way that they could be demonstrated in principle by physical means (like, in the early 21st century, a test in a hospital or an experiment in a lab).


    1 Miller, A.I. 1981, ?Vari?ak and Einstein?, Albert Einstein?s special theory of relativity. Emergence (1905) and early interpretation [1905?1911], Reading: Addison? Wesley, pp. 249?253.

    2 Einstein, Albert 1911. ?Zum Ehrenfestschen Paradoxon. Eine Bemerkung zu V. Vari?aks Aufsatz?. Physikalische Zeitschrift 12: 509?510

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