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Descartes' Error : Emotion, Reason, and the Human Brain

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Damasio's book will be somewhat tough sledding for the non-specialist, but it's still a good book and worth sticking with to the end. Using Descartes's famous dictum as a departure point, and through a discussion of current theory and detailed case studies, he demonstrates the intimate relationship between the brain, mind, and body.

The case studies of sensory agnosia were very interesting, especially the one where the patient had apparently lost the functioning of the part of his brain that stored the awareness of one side of the patient's body, to the point where the patient had no awareness or perception of that half at all, and even denied that he even had a problem with it. There can be no clearer demonstration of the fact that our consciousness and awareness depends entirely on that 3-pound, convoluted mass of nerve cells we call the brain.

As someone with a pretty fair background in the area myself (I did a master's and almost completed a Ph.D. in psychobiology) I can vouch for Damasio's command of the scientific and technical issues and details (notwithstanding that fact that Damasio is both an M.D. and a Ph.D.) so he has a good command of the medical issues also. The book is very well written, although not easy, but Damasio does a fine job of explaining the more difficult ideas.

One further comment, I read one review that was critical of Damasio for supposedly misinterpreting Descartes's dictum, "I think, therefore I am," and then spent the whole review discussing Descartes instead of Damasio's book. The reviewer also stated that because of this Damasio lacks scientific objectivity. Since his comment is itself a good starting point for discussing the most important aspect of Damasio's book, I thought I'd write a little more on it here.

Whether or not Damasio's interpretation of Descartes dictum is wrong or not, (and from the other reviewer's disjointed discussion, that itself isn't very clear), this is a minor detail, since Damasio simply uses this as a point of departure and from there on the vast majority of the book is devoted to a discussion of the neurological and brain issues, not to the technical details of the philosophy of mind-body dualism, for which there are already plenty of other discussions out there (having read many of them myself).

However one should precisely interpret Descartes's famous statement, Damasio is completely correct in pointing out the most important aspect of Descartes's idea--that the mind is fundamentally different from the brain itself and that one needs a dualistic theory to explain the separation of the apparently immaterial mind from the more material body--is wrong.

Although echoes of this theory can still be seen in modern philosophy, and were an important influence on idealist philosophers that followed Descartes, such as Kant, and even continue to have an influence on modern neo-Kantian theory and other thinkers, the advance of modern neurobiology has shown that these theories are fundamentally wrong.

Since we're on the subject--and to be completely fair--I will that say that one aspect of Kant's theory is quite accurate--that the mind is actively involved in organizing the data of the senses--and that ideas about the external world could not exist unless there were corresponding mental capabilities and constucts to match. Our understanding of sensory information processing and of advanced cortical abilities certainly show that the brain has evolved in a way that reflects the need for specific capabilities to enhance our survival in a dangerous world. Kant's idea that there are inborn mental faculties that allow us to form ideas about the external world isn't so different from this idea, and in that sense, Kant was right. (This would have been a good point for the other reviewer to make, but he got lost in the trivial details, and failed to see "the forest for the trees" (as he himself incorrectly said of Damasio)).

Anyway, returning to Damasio's book, this is well-written book on a fascinating aspect of modern neurobiology, and which has profound implications for western philosophies of idealism and dualism. Although not an easy book for the non-specialist, it's worth the effort.

I have one final suggestion to make, and that is you might want to read Michael Gazzaniga's more general introduction to neurobiology: "Nature's Mind: The Biological Roots of Thinking, Emotions, Sexuality, Language, and Intelligence," before tackling this one. It's also an excellent book and you'll have a more well-rounded understanding of the brain field which should stand you in good stead to tackle this book, or any other brain-oriented books, after reading it.

Other reviewers have surely summarized and analyzed this fine book far better than I could, so here are some hints that may help you productively enjoy it:
1.) scan sections of the book before and after you read them. The author's simple expositions are terrific but the organization and data blending can be confusing, and the pace of such a book often slows uncomfortably. 2.) If you are new to this subject (and any non-professional who hasn't had a CNS course recently is probably a beginner) I'd supplement this book with a good but lighter introduction to brain research (I'd strongly recommend the NYT Book of the Brain). 3.) I'd advise using a good neuroanatomy text or atlas like Barr or Hanaway. The author's maps are surprisingly skimpy and I strongly hope he includes a few pages of neuroanatomical diagrams in any future editions. 4.) You may want to underline terms and definitions, and note the reference at the back of the book -- the book has no glossary and the index is annoyingly weak. 5.) I thought the most valuable sections were on the Somatic Marker Hypothesis, the Body-Minded Brain, and the Postscriptum -- consider scanning these sections first.
Good luck and enjoy. The author's credentials are superb, his perspective complements other authors such as Edelmann and LeDoux, and he brings the unique and empathetic perspective of a neurologist who has specialied in analyzing the changes associated wtih discrete neuropathological conditions. The ideas you may receive from this wonderful book should be well worth the effort, and you should gain some insight into the miracle of how we think/feel/are.

Damasio brings some some fascinating cases to bear on one of the oldest problems in philosophy and psychology. It's a good read and an important subject. It would be a mistake, however, to think that "Descartes' error" was just now being pointed out. In fact, practically no contemporary philosopher worth his or her salt subscribes to the Cartesian two-substance theory of body and mind. In his 1949 masterpiece, The Concept of Mind, Gilbert Ryle argued that Descartes' view was fatally flawed (and he wasn't really the first to point this out, either), and called it the "ghost in the machine" view of the body/mind relationship. If you get right down to it, Descartes himself would agree with Damasio that the emotions are not radically different kinds of things from the reasoning faculties, since he believed that experiencing an emotion was simply another mode of thought, just as drawing an inference is a mode of thought. But Descartes must be used to being a whipping boy by now, 350 years after his death; and the historical perspective aside, Damasio's book is an excellent contribution to scholarship on the effects of emotion on rationality.

Damasio attempts nothing less than the quantification of the soul by identifying the likely structures of the brain -- the prefrontal lobes among others -- responsible for logic, reason, emotion and personality. He recounts several stories of patients with prefrontal damage and the peculiar symptoms they display -- then tests his theories with a number of clever experiments carried out in his lab at the University of Iowa. His conclusions are persuasive and well-thought out, and will cause you to re-evaluate much of what you THINK you know about the role of emotion in logical reasoning.

However, the book is flawed in a couple of different directions.

1. The text alternates between well-written, smooth-flowing, extremely readable sections and dense, highly-technical, grammatically-gnarled sentences such as, "In terms of the prefrontal cortices, I am suggesting that somatic markers, which operate on the bioregulatory and social domain aligned with the ventromedial sector, influence the operation of attention and working memory within the dorsolateral sector, the sector on which operations on other domains of knowledge depend [page 198]." Too many sentences of this opacity slowed reading speed to a crawl, and made me wonder about his intended audience.

2. Numerous and frequent references are given to other researchers in the field, but he very rarely elaborates on the directions or results of their research. As a non-academic I am not going to dig out the original articles for myself, and would have preferred Damasio himself provide the summaries.

3. One researcher frequently cited is named "Hanna Damasio" (who coincidentally is also the illustrator of the book) but no mention is made of her relationship to the author. A courtesy explanation would have been in order.

4. The author expresses the usual scientific caution about over-generalizing or drawing broader implications from his work. However, it seems to me the most exciting possibility deriving from his research is exactly that, a biological basis for emotion. I think he would have been forgiven for throwing caution to the winds in the last chapter or two and speculating wildly about the connections between emotional exuberance and brain structure abnormalities, or oppositely emotional monotony and the biologic cause. As it is, his work is solid but measured, which downplays the truly groundbreaking nature of it.

Damasio has a fascinating style. I have quite an adequate background in neuropsychology and was able to follow Damasio's explantions of neural circuitry. However, I believe that a person without such a background, but with a keen interest in the subject, would still appreciate Descarte's Error.This book brings humanity to the structure and function of man's brain and the impact of this mysterious and fascinating organ on the individual and society. Many will concentrate on the author's attack on the mind/body dualism. Yes, he does a splendid job of this. But what was fascinating to this reader were the case histories he uses to gain the reader's attention and interest. I have read about Phinneas Cage in almost every psychology text I've read, but never had an indepth look at this man(Cage) and the impact of his impairment on our understanding of how the brain works. The other case histories are just as fascinating and effectively illustrate their contributions to the field of neuroscience.

A "negative" title such as this carries unfortunate implications. The "error" must be identified, then explained and refuted. For newcomers to cognitive studies, Descartes "error" might seem an obscurity . Yet it has been the basic tenet of education and social thinking in the Western world for three centuries. "Cogito ergo sum" was translated into the belief that the mind and the remainder of the body were separate entities. Behaviour was controlled by the mind, while the body went about its own business. Damasio demolishes that long-standing mistake for good in this superbly written groundbreaking study.

The first indication of the relationship of the mind and body was the bizarre penetration of a railway worker's skull in 1848. The worker lived, but the damage to his brain left him with severe personality changes. The case opened the door to research leading to mapping areas of the brain that reflected various personality traits. Damasio recounts the incident, matching it with numerous clinical studies of his own. Additional work, some of it strongly innovative led Damasio and his colleagues to a reformulation of how the mind and body interact.

He reminds us that the brain is much more than a collection of electrically interacting cells. The body is sending information to the brain almost continuously, with the brain replying or initiating communication. These signals are both electrical and chemical. More importantly, Damasio reflects on the evolutionary origins of these conditions. For him, it is inevitable that the mind and body interact intimately. His proposed appellation for Emotions aren't separated from our reasoning processes, but are an integral part of them. The attempts by parents and educators to "train out" emotions in children are thus doomed to fail.

Damasio's thesis hinges on what he calls "somatic markers." The markers are areas of the brain which continuously interact with the body, particularly those areas we associate with emotions. If confronted with emotionally charged choices, the stomach "knots," the face may "flush" warmly, and perspiration may increase markedly. These body/brain functions begin developing early in the embryo. Indeed, they have a long evolutionary history, which firmly establishes their roots. In humans, the brain not only controls/reacts with the body in addressing stressful circumstances, but retains some level of memory of the events causing the reactions. Hence, even thinking about such circumstances can lead to bodily reactions associated with them. You need not be confronting an emotional situation to be able to express the feelings associated with it. This, of course, is most notably seen in actors or other performers. Damasio offers the excellent example of orchestra conductor Herbert von Karajan, whose pulse rate was higher while conducting than when confronted with an emergency situation in an airplane. To Damasio, "Descartes' error" was that he placed all these controls in a central location of the "mind" where, in fact, they are scattered over much of the brain.

The implications from this book will be far reaching. Besides impacting academic courses on behaviour, there will be changes in how we parent, how we deal with education, and even in the realm of law. Binding reason and emotion will revise uncountable long-standing ideas about how the mind deals with our surroundings. It is a work addressing fundamental questions about what make us human. Read it with care, aware that many preconceptions are likely to be challenged. The rewards for this effort will be great in years to come. [stephen a. haines - Ottawa, Canada]

This book is already a classic of its kind. Yes, the hypotheses are not new, and yes, there is some speculation. So what?!

Damasio takes the abstruse and technically demanding field of neuroscience and turns it into a novel. The book is not dumbed down, nor is it patronizing.

Damasio's main contention is that logic and reason are impossible without emotion. That is why intuitions are called gut feelings. He goes over many case studies, experiments, and introspection, to drive this point home.

Our body is where the action takes place. Only after (or sometimes concurrent with) the body makes up its mind, does the mind follow. For a quick example, suppose you are sitting down in a college classroom. There is an open seat next to you. Suddenly, you spot a voluptuously delightful young lady walking toward you. What happens to you? Your heart starts to beat faster, your palms sweat a little, your body tenses up; and neurotransmitters release a cascade of chemicals into your blood stream which modulate your body's internal viscera. You focus your attention on this women. Do you invite her to sit next to you? Or, are you to nervous to do so? If you are too nervous, think about what is going on. Is it because your brain is telling you that you are? No. Your body is sending signals to your brain and vice versa in a feedback loop. Your brain then 'reads' the signals comming from your body as nervousness. Without a body, you could 'feel' nothing. There would be no emotion.
Thus, to a large degree, your decision was made prior to conscious awareness, and you could not control it.

This way of thinking seems anathema to Westerners who love to believe that rationality means pure logic without emotion. You know what happens to decision making when your emotions become blunted due to brain damage? It goes completely out the window.

As Damasio says: "No body, never mind."

I think the take home message of this book is that we are biological organisms through and through. There is no Cartesian soul: Nothing that makes humans unique machines of deduction. We are at the mercy of our passions.

This should not be surprising. Great thinkers from Augustine to Hume have suspected as much. Now we have the science to confirm such insights.

N.B. some of the material in this book is dated. Consult Damasio's later books and Journal articles by Ledoux, Damasio et al. For the latest progress in neuroscience.

This is an obviously important book. The author has developed a solid, profound argument for the key role emotion plays in affecting reason. His examples are interesting and convincing. However, I urge the reader to forego the audio edition. It is presented in uninspiring, monotone speech that is really quite boring. If one is particularly motivated to learn this material (as I am), then the audio cassette may be a useful accompaniment to the text. For less motivated listeners, I urge you spend your money on something else, unless you need a sleep aid.

This question has been pondered by many, from Descartes to William James to Morrissey, and more recently, Antonio Damasio. As a neuroscientist, I share Damasio's conviction that emotion is absolutely central to understanding the mind. Unfortunately, that is the extent of my sympathy for this book. Damasio takes this starting point, notes the correspondence between emotions and body states, and from it constructs his ill-conceived 'somatic marker hypothesis', casting his lot with the body-ruled mind.

This book fails on a number of levels. To begin with, it is almost unreadable. Such tangled and confused writing would never make it past the editing of any decent journal. It is not merely dull, it really obfuscates the issue unnecessarily. Thus, to the reader interested in Damasio's theory I suggest his published paper "The Somatic Marker Hypothesis and the Possible Functions of the Prefrontal Cortex", 1996, which can be found freely online.

My main objection to the theory is the excessive role that it gives the body in influencing brain states. Undoubtably, the brain is capable of sensing and being influenced by changes in the body state. However, Damasio gives this pathway a primary role in emotion. Presumably Damasio imagines a stimulus activating some part of the brain (e.g. amygdala), which then triggers an emotional body state, which in turn is observed by the brain, creating an emotional 'feeling'. While such feedback loops are possible, they would be incredibly inefficient - why wouldn't the amygdala just communicate the emotional state directly to other brain regions instead of relying on the 'somatic markers' of a body feedback loop? Damasio's view is not parsimonious, nor is it supported by much evidence.

Damasio's attempts to justify this Jamesian hypothesis are an elementary exercise in distinguishing correlation and causation. He begins by discussing patients with prefrontal lesions, noting that they have altered skin conductance responses. But to quote the neuroscientist Edmund Rolls: this "does not prove the hypothesis that behavioural responses elicited by conditional reinforcers are mediated via peripheral changes... Instead the much more direct neural route from the orbitofrontal cortex and amygdala to the basal ganglia provides a pathway which is much more efficient..." Next, Damasio reviews the effects of prefrontal lesions on a decision-making task known as the Iowa gambling task, and notes how the 'modern Phineas Gage' is lacking in an anticipatory skin response. Again, intriguing, but causal? Since this publication, patients with autonomic nervous system failure have been tested and found to be unimpaired on this task, raising a serious challenge to Damasio's assertion that heightened body response is causal. Today, these effects are largely considered within the computational framework of reinforcement learning.

One final point: Damasio repeatedly attempts to justify his hypothesis by references to unconscious learning, as though unconscious learning necessarily requires his hypothesis. But there too, the brain is well-equipped for subcortical unconscious modeling (e.g. cerebellum). There is simply no need for 'somatic markers' to account for any of these effects, and the reader would be misled to believe that Damasio's hypothesis is widely believed by many of today's neuroscientists.

Have you ever left the massage table with a clear head and lots of energy? Damasio thinks he knows why. His idea is that the mind cannot be conceived without some sort of embodiment (hence Descartes' Error). There is no Self which gives rise to a unified Mind; instead there are just so many synchronized systems of the body (the visceral, musculo-skeletal etc.) whose combined output results in a background "feeling". It is that feeling which represents the self ; self can therefore also be defined as a continuous experience of the body. During massage we relax the mind by relaxing the body .

According to Damasio, each movement (of the limbs or bowels) results in a specific "feeling" loaded into our subconsciousness. These feelings and associated emotions are at the very core of cognition. Indeed, this book is intended to prove to the lay public Damasio's belief that he has experimentally deconstructed the wittgensteinian/russelian illusion (which claims that formal logic will get us to the best available solution for any problem). On the contrary, D. found that certain patients whose emotional centers are disabled by stroke but whose logical abilities remain intact become functional invalides: they cannot decide and when they do, they tend to make wrong decisions (they cannot use their "gut feelings" and therefore end duped or easily misled). The integration of emotions and reasoning is orchestrated by the prefrontal cortex and a large part of the book is devoted to explaining the specific neural circuits dedicated to this task.

In my opinion, D. has not been able to prove Descartes was wrong. It is obvious that our minds depend on (internal and external) sensory input to generate "representations" which ultimately result in "decision-making"; however, Plato would say that an absence of a functional brain region does not necesarily disprove the existence of the Self - it merely prevents that Self from expressing itself.

The book has interesting and important things to say. I think, however, that it will be of limited use to an average reader. I often found it to be unnecessarily technical; moreover, unlike, say, Ramachandran's book, which is a veritable explosion of provoking ideas and speculations, Desartes' Error is basically about one single idea... as a result, the same thing is repeated over and over again and i had to clench my canines to maintain interest. It would definitely benefit from good editing.