Customer Reviews

Altered Egos: How the Brain Creates the Self

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I love books like these because I am fascinated by the brain, so I had to try it when I heard Dr. Feinberg on NPR. He does not disappoint those of us who enjoy books on the wilder side of neurology. He is very good at explaining all the most bizarre behaviors in fairly simple language, and his drawings of the brains of his patients were an outstanding addition.

I felt his theories of how the brain constructed the self were thought-provoking, but I don't think he spent enough time on them. If he had fleshed them out a little more, I would have given the book five stars.

However, if you like Oliver Sack's accounts of his patients, you'll like this book, too.

Altered Egos by Todd Feinberg is a superbly written, fascinating account of a doctor's observations of his brain injured patients. Dr. Feinberg compassionately portrays their histories in riveting case reports and subsequently anchors the rich case material in philosophical and neuroscientific theories. Examination of alterations in the self that result from damage to the brain provides the basis for Dr. Feinberg's groundbreaking discussion of the complexities of the self. Dr. Feinberg artfully presents his theory of the nested hierarchy of consciousness. This book is a must read.

There has been a good deal of writing about the brain and mind of late, but I can't recall a more enjoyable and thought provoking read than Dr. Feinberg's new book "Altered Egos".I first heard Dr Feinberg on NPR radio and I went right out to buy his book. The first part relates numerous fascinating case studies of patients with brain damage who experience an alteration in their sense of self.For example, some patients misidentify their spouses,as in the Talking Heads song Once in a Lifetime ("This is not my Beautiful Wife"). Other cases don't recognize their own arms; still others who suffer from a condition known as "alien hand syndrome", might even attack themselves. In the later sections of the book, Feinberg uses these cases to explore how the many areas of the brain that contribute to the self combine to create a unified self and an "inner I". In simple language that is accesible to the non-professional, Feinberg draws on basic principles in neurology and philosophy and presents his case that the brain/mind is a "nested hierarchy of meaning and purpose." He argues convincingly that this nested hierarchy is the final irreducible reality of what and who we are. I personally found the combination of neurology and philosophy in this book exciting, and the best part was that I found the writing not just understandable, but fun. Feinberg's book is a must read for anyone who has wondered what it really is to be a person.

I have taken the time to read Dr. Feinberg's book not once, but twice, in order to get its full flavor. As one practices law and who deals with clients with neurological injuries, both as injury victims and the elderly I am amazed at how well the author explains the nuances between mind and "self" or as I like it: the way one presents him or her self to the world.

The book is very readable and does not contain any pedantic phrases or highly technical scientific terms that are often replete in such texts. Instead it very ably explains much of what needs to be known about the brain.

Dr. Feinberg's insight should inspire other researchers and academics to continue their inquiry into the function of the brain so that we can all become more aware and knowledgable about ourselves and those around us.

To present an overview of some of the more spectacular examples of neurological disorders, to define and elaborate on a notion of the 'self' or 'I', and to weld together a solution for the mind-body problem (now become, for many scientists, the mind-brain problem), all in 150 pages, is a very tall order. Todd Feinberg takes a stab at it in this book, and though I found it highly readable and very thought-provoking in places, I found it unbalanced and the 'theory' or solution to the mind-brain problem entirely unoriginal.

This book was assigned for a grad seminar in Cognition that I'm taking and served as a launching pad for discussions of various disorders alongside scholarly papers, and the relation of disorders in specific subsystems to higher cognitive processes and indeed the 'sense of self', and in this capacity it served really well. Even though in many ways my program's (Psychology/Neuroscience) bread and butter is strange disorders resulting from unlikely brain lesions, Feinberg threw quite a few new ones at me I'd never heard of, such as people who have the specific disorder of not being able to recognize their own face in mirrors or other reflective surfaces - but only their own! In that respect too, it was great for getting an overview of some of the very bizarre disorders that can affect people and how these relate to sense of body, personal goals, etc.

Where I began to lose some admiration for the book is in its strange pacing. The first third reads like straight case studies of odd disorders. In the second third Feinberg starts drawing on mythology and popular folklore and contrasting these beliefs (such as that of the Doppelganger or the shadow) with perceptual disorders due to brain damage, sometimes with great insight, sometimes - not so much.

I was still with him until the final section of the book, where these aspects are essentially dropped and he tries to come up with a solution to the age old mind-body problem in about 30 pages. The really interesting parts in here are actually the quotations from many eminent psychologists and neuroscientists of the past, such as those of Charles Sherrington and William James. These pointers alone have convinced me that the history of my field is severely overlooked in our education - we learn all the names, dates, and major discoveries - but it has certainly been a 'discovery' for me that many of these thinkers were also great writers and highly insightful people who had much to say about life, the world, and the spirit beyond their thoughts on neurons and perception (which, pardon my cynicism, seems a lot less true of the field today).

Feinberg's own contribution here, though, falls flat. It is basically a harking back to elementary systems theory: complexity, emergence, nested hierarchies, etc. These are all wonderful ideas and vital areas of study, but pointing out, ad nauseum, that the 'self' is a nested hierarchy and irreducibly personal, doesn't contribute much to the discussion. He takes William James to task for suggesting that the self, if anything, is but a constantly-flowing stream (as asserted by Buddhists as well, though Feinberg seems unaware of their ideas on these subjects) and has no permanent core or 'I'. Early on I got the creeping feeling that Feinberg's exploration of the concept of the self was really a vindication of his own certainty of the existence of a soul. Unsurprisingly, he says almost as much in this final section - "The soul of each brain is indeed a unique, one-of-a-kind thing," Judeo-Christian dogma shining brightly. He embraces a strange kind of pseudo-dualism, claiming that he is indeed a materialist and that the mind cannot possibly be anything nonphysical - but that it can't possibly be physical either. Out of the blue, he starts talking about Artificial Intelligence and roundly declares that a computer, not being 'alive' (though in fact we have no good definition of life, nor an agreed upon boundary between the animate and inanimate) can never be 'conscious' and have a self (or soul, we realize Feinberg is really saying). Not only could AI never approach human levels of consciousness - the humble frog, in fact, will FOREVER be more conscious than any AI ever could be, regardless of its capabilities or claims about itself. Why? How could that be? "It is more likely that the particular material substance of our brains is essential to the quality of our consciousness." What "particular material substance" would that be? Carbon? Oxygen? Iron? What about some Parkinson's patients, for example, who now have pea-sized computer devices implanted into their brains and wired into their neurons, directly replacing the function of their deteriorated dopamine neurons??? You can even update the software on these neural implants over wi-fi, so that no further invasive surgery is necessary! These people are, undeniably I think, 'part computer' - and they don't seem to have lost 2% of their souls, or what have you. If the brains of conscious beings MUST be made of neurons and glial cells, how can this be explained? Monotheistic dogma, of course!

Feinberg's vitalist and (I dare say) Creationist leanings in this last section are a disturbing and saddening ending to an otherwise insightful and eclectic book. I'm reminded of a book by Jeffrey Schwartz (The Mind and the Brain: Neuroplasticity and the Power of Mental Force) which follows a very similar trajectory: excellent, excellent review of the history and discovery of neuroplasticity (far more engrossing than this, actually, and this was pretty good) followed by a bone-headed final section trying to explain free will and the mind with hackneyed and vague interpretations of quantum physics.

All said though this is still worth a read in terms of the neurology, but get your philosophy of mind elsewhere.

Feinberg is clearly a master teacher. Reading this book is like being on well-organized, interesting rounds. While not assuming that his audience is familiar with medical or philosophical terms, he is able to lead you from the simple to the complex.

His patients are presented with kindness and respect. We wonder why patients no longer recognize their limbs or family members or even their own reflection in a mirror. Feinberg clearly explains the areas of brain specilization whose loss contributes to these problems.

He then extends his discussion to problems of consciousness. He traces philosophic discussions and current developments with simplicity and precision. For the uninitiated, such as I, he provides a glossary which is easy to access and understand.

I was amazed at the extent of the bibleography and truly grateful to be able to benefit from Feinberg's scholarship. In addition, I have made notes on many of the pages which I hope to discuss further.

A highly recommended book!!!!!!

A facinating account of how the mind operates. I was captivated by the stories of Dr. Feinberg's patients, whose odd behavior makes compelling reading. I could not put it down!!! I especially liked the story about the patient who identified her own image in the mirror as a woman who was stalking her.

Dr. Feinberg's eloquent and compassionate stories are instructive as well as entertaining. A must read for anyone who is interested in the subject, from the professional to the layperson. I simply loved it!!! Thank god for enlighted and sensitive author/doctors like Feinberg!!! This book deserves a Pulitzer Prize!!!

I enjoyed reading this book for a number of reasons. First, it is well thought out. Dr. Feinberg takes the time to explain the mind-body problem from the point of view of the clinician as well as the philosopher. If you are in neuroscience, I think that it is generally assumed that one is familiar with the controversies that surround the Cartesian view of the mind. However, I don't think that most clinicians, scientists, or lay readers are quite as familiar with the fundamental issues or the philosophical controversies as they might suppose. Dr. Feinberg's approach is to carefully bring out the basic philosophical issues and then, through examination of text and clinical material, conduct a lucid and thorough examination of how mind and more specifically, self, could arise from our understanding of the brain. Second, it is well written. Dr. Feinberg has a direct and conversational prose style that helps the reader connect the clinical case material with his theory of self. The illustrations are also excellent. In sum, for either the clinician (me), the neuroscientist, or the lay reader, Dr. Feinberg's book provides an accessible and cogent account of a difficult and important area.

There is no doubt Dr. Feinberg is an excellent communicator of very complex ideas. He stays away from technical language and manages to keep the interest of the reader throughout most of his fascinating narratives of the bizarre clinical behavior of his patients with right fronto-parietal brain damage to the neocortex. This exposition takes about half the number of pages of his short book and does not give a clear hint about his intention of resting his theory of consciousness on this clinical data. Unfortunately, the remaining space and his adherence to non-technical language makes it very difficult for him to elaborate a credible account of how a physical brain may evolve a mind. His deep philosophical insight is there but his important conclusions lack the necesarry theoretical development to back them up. Without saying so he identifies with the functionalist branch of neurophilosophers. For them it is no longer required to scrutinize the chemical or quantum physical properties of the physical brain to explain the conscious state. This approach has many advantages in that the model emphasis is in `functional', not structural organization, i.e., how many abstract components there are and the different possible states they can assume under boundary conditions, plus a definition of the causal relationship controlling state transitions. It looks as if `functionalists' have adopted information theory as their front line of attack and defense. Wherever the same conditions are to be met, in a neuronal or silicon array, you will expect identical results, the principle of organizational invariance for `functional isomorphs'. In his book a patient's inability to maintain the integrity of his concept of self (herein equated with his consciousness)is the result of a disruption in the homeodynamic balance programmed in the nested hierarchical multineuronal control system (that we call the 'metabrain')now damaged by disease. His conclusions are to be considered more as another model for the brain control of 'first order judgements' or awareness than an explanation of a logical supervenience of 'second order judgments' (that we call 'metaconscience') on the physical brain. In the opinion of this reviewer, when he implies that the 'will' to act is in itself an unconscious act arising from those cognitive combinatorial structures we have called the 'metabrain' and directed to the `homeodynamic' preservation of the psychological integrity of the self, he is making an unwarranted assertion not supported by his clinical data. In his model it is not expected that a `normal' person would display an aberrant behavior that is contrary to his physical or psychological best interests. Yet we do witness this behavior in individuals involved in heroic sacrifices or unselfish acts of altruism. Mother Theresa of Calcutta is a recent good example of such personal sacrifice for the benefit of others.

I felt the same way about the book as Kieran Fox, and felt her review the most spot-on regarding the final third of the book in how it is indeed exactly a materialistic pseudo-dualism. Mind is not [material, i.e. the brain], but the mind is not immaterial either. Read Kieran's review for more. The first 70% of the book however was fascinating and I recommend that part of it.