Tuesday, May 3, 2011

Anosognosia and Partisan Politics

V.S. Ramachandran has produced a fascinating book discussing the brain and how it functions: The Tell-Tale Brain: A Neuroscientist’s Quest for What Makes Us Human.

Ramachandran’s main approach to research seems to be the study of people with brain injuries to evaluate how their behavior has changed, and from that deduce something about how the processes taking place in the brain are localized and organized. Given that focus, it is not surprising that the author has encountered a number of strange phenomena. One in particular gives us a clue as to why it is so difficult to change a person’s mind once it is made up.

We’ve all had arguments with people of other political faiths. We’ve all constructed exquisite arguments for our point of view that only the dimmest of intellects would fail to find compelling—only to realize that there are a lot of people out there with exceptionally dim intellects. To provide an appreciation for how and why people can cling so tenaciously to cherished beliefs, Ramachandran introduces us to a condition he refers to as anosognosia.
“Information arriving through the senses is ordinarily merged with preexisting memories to create a belief system about yourself and the world. This internally consistent belief system, I suggest, is constructed mainly by the left hemisphere. If there is a small piece of anomalous information that doesn’t fit your “big picture” belief system, the left hemisphere tries to smooth over the discrepancies and anomalies in order to preserve the coherence of self and the stability of behavior. In a process called confabulation, the left hemisphere even fabricates information to preserve its harmony and overall view of itself....”

“But there has to be a limit. If left unchecked, the left hemisphere would likely render a person delusional or manic....So it seems reasonable to postulate a “devil’s advocate” in the right hemisphere that allows “you” to adopt a detached, objective (allocentric) view of yourself. This right-brain system would often be able to detect major discrepancies that your egocentric left hemisphere has ignored or suppressed but shouldn’t have. You are then alerted to this, and the left hemisphere is jolted into revising its narrative.”
The author defines anosognosia as a denial of disability. It shows up in patients who have suffered brain damage—generally from a stroke— to one or the other hemispheres.
“If the stroke is in the left hemisphere, then the right side of the body is paralyzed, and as expected the patient will complain about the paralysis and request treatment. The same is true for a majority of right-hemisphere strokes, but a significant minority of patients remain indifferent. They play down the extent of the paralysis and stubbornly deny that they cannot move—or even deny ownership of a paralyzed limb! Such denial usually happens as a result of additional damage to the postulated “devil’s advocate” in the right hemisphere’s frontoparietal regions, which allows the left hemisphere to go into an “open loop” taking its denials to absurd limits.”
Ramachandran provides this encounter with a patient as an illustration of the extent of self-deception possible.
“Nora, how are you today?” I asked
“Fine, Sir, except the hospital food. It’s terrible.”
“Well, let’s take a look at you. Can you walk?”
“Yes.” (Actually, she hadn’t taken a single step in the last week.)
“Nora, can you use your hands, can you move them?”
“Both hands?”
“Yes.” (Nora had not used a fork in a week.)
“Can you move your left hand?”
“Yes, of course.”
“Touch my nose with your left hand.”
Nora’s hand remains motionless.
“Are you touching my nose?”
“Can you see your hand touching my nose?”
“Yes, it’s almost touching your nose.”
So determined is her brain to preserve its sense of self that it will send lies up to her consciousness in order to relieve any feeling of discrepancy. Ramachandran says that patients eventually come to recognize their true condition.

So the next time you are arguing politics with a longtime Republican—or Democrat—and not making much headway, try to be patient. The person in front of you probably has a construct inside him/her that causes emotional distress every time he/she considers a viewpoint inconsistent with an imprinted one. The best approach to getting your point across involves time and calm persistence. It would not be wise to try anything that could be deemed threatening to this subconscious self.

What a concept! Calm and reasoned political discourse is most effective. Perhaps, someday, someone will actually try that approach.

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