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233 of 247 people found the following review helpful
on December 11, 1999
Format: Hardcover
I'm a clinical neurologist myself, and familiar with Damasio's work...there's no doubt he's a first rate behavioral neurologist, who's made many original contributions on both theoretical and clinical levels to neuroscience and neurology. I believe his particular breakdown of consciousness into several levels..."proto" "core" "autobiographical" and "extended"...to be both novel and supported by clinical evidence and intuition. It is inaccurate to say that Damasio equates consciousness with the reticular activating system. In fact, he conceives "core consciousness", the unadorned feeling of self, to be a network function including not only the RAS, but the intralaminar thalamic nuclei and cingulate and primary somatosensory cortex. I also disagree strongly with the reviewer who felt the ideas were largely redundant with previous philosophical attempts at explanations of consciousness. Though I agree the book is at times wordy and could use more detailed scientific backup in places, it is clearly aimed at a popular audience. I look forward to seeing his paradigm used in further neuroscientific research on consciousness, and I'm convinced it will be. This book is definitely on the right track, and one shouldn't hesitate to read it. I'd also note that the book is strongly endorsed by leading scientists and philosophers, such as Eric Kandel, David Hubel, and the Churchlands.
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88 of 93 people found the following review helpful
on September 9, 1999
Format: Hardcover
This is a landmark book, almost irrespective of how accurate all of Antonio Damasio's extensive theoretical formulations turn out to be. He is the first to admit (in the book itself) that things are changing so fast in this area of neuroscience that virtually nothing on the table at this point can be considered doctrinal, or not subject to potentially major modifications. That being said, I suspect that much of Damasio's more original terminology, terms such as "proto-self," "core-self," "autobiographical self," "core consciousness," and "extended consciousness" will quickly become part of the basic lexicon in consciousness neuroscience in many quarters, due to the shear force of his ideas and the volume of original thought in this work. At the heart of this enterprise is Antonio Damasio's supposition (generally not informing much theorizing about consciousness) that the brain can't be conscious unless it represents not just objects, but a primitive self, and also represents the basic manner in which the self is being altered by interaction with the object(s). In other words, consciousness requires that the brain must represent not just the object, not just a basic self structure, but the interaction of the two. This is still an atypical foundation for a theory of consciousness, given that until recently, it was implicitly assumed that the self could be safely left out of the equation. There has been a recent sea change on this crucial point, parallel with the cogent formulations in Damasio's book.
The book will challenge and delight the most sophisticated readers, while rarely leaving the less sophisticated lost or overwhelmed. Damasio makes great use of the rich empirical database provided by the neurology of diseases of consciousness that some theorists of consciousness seem to know almost nothing about, and pay little attention to. The book also addresses in a most thoughtful and sophisticated fashion the problem(s) of self, and carefully unbundles the mostly conflated hierarchical nature of self and consciousness into separate but intimately related systems. It is tightly and carefully reasoned and empirically grounded. It integrates emotion and the body in the story of consciousness. Damasio deals skillfully with conceptual pitfalls in our commonplace terminology of "maps," "neural (neurodynamic) patterns," and "representations" (don't miss it stashed in the appendix!!) The book integrates classical RAS theory and neo-classical ERTAS (extended reticular thalamic activating system) theory into a broader theory about the ventral brain, that of "proto-self mappings and structures." Damasio admits readily this formulation is without the differential functional specificity for the proto-self structures (as perhaps the earliest functionally concerted, distributed system?) that he deeply hopes to see further developed. Further understanding of the functionally concerted and re-entrant operations of the various proto-self structures may be a great frontier in the neurology of consciousness. The core chapter of the book - The Neurology of Consciousness - in which he bridges concepts of proto-self, homeostatic and visceral regulation with traditional RAS and later ERTAS notions into a comprehensive theory of brainstem functions is brilliantly integrative and original, among the two or three finest pieces of neurological writing I have ever read. Added to this impressive menu are the delights of a literary, even at times poetic and moving, writing style.
For an in depth treatment of this book, see my review article coming out in the Journal of Consciousness Studies, or email me for reprints.
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37 of 39 people found the following review helpful
on January 18, 2004
Format: Paperback
Damasio breaks down into minute, qualitative descriptive detail how the boby/brain functions in humans, and ergo, de facto, many mammals. This book's strength is that Damasio backs up his claims regarding neural anatomy, physiology, and function with specific examples from comparative neuropathology. The book's weakness is that he goes on at length with qualitative descriptions for non-intuitive notions like how the body and brain function as a singular unit, and how emotions and feelings are integral along with body/brain physiology. I say this is the book's weakness because Damasio often bogs down and even tries to describe phenomena that are possibly ineffable, but these attempts at qualitative description are also one of the strengths of this book. This may seem contradictory, but possibly the book would have read differently if the author had stuck to purely quantitative case studies. However he did not, so we get through Damasio's several qualitative, alternate descriptions of singular phenomena an attempt to flesh out and make organic the dry clinical data. On the one hand the book could have been more concise without the extended descriptive sections, on the other hand the book possibly becomes richer and more meaningful because of them; this is up to the reader to decide.
Having said this, the book itself endeavors to demonstrate how consciousness emerges from gross neuroanatomy and physiology. In this Damasio is successful in using neuropathology to define terms such as: homeostasis, consciousness, language, mental images, neuronal maps, cathexis, and hedonic tone (although he does not use these two latter terms explicitly). In all honesty Damasio is very strict about defining his terms. Even though the author writes to a popular audience some knowledge of neuroanatomy and physiology is helpful in reading this book for maximum effect; although this book would be a good beginning for those interested in neurology. In General, the appendix, `Notes on Mind and Brain,' should probably be read prior to reading the main body of text, especially if the reader is weak in basic neurology. In any event, Damasio is big on forming neologisms although he spends adequate time defining and explaining them. As a neurologist, he always couches his arguments in materialist, Darwinistic terms.
A good way to describe the structure of this often rambling, inchoate book, is to briefly compare it to Dr. Paul McLean's triune brain model. The triune brain posits the reptilian brain (brain stem) as primary, the mammal brain (thalamus, limbic, etc.) as secondary, and the primate brain (cortex) emerging evolutionarily later as tertiary. Damasio uses a similar foundation in positing the proto-self, the core self, and the autobiographical self (I told you there were a lot of neologisms), but he does so in a way that has them all hang together as a synchronous, functioning unit. The proto-self is rather the sense of homeostatic organism state, where the core self is the `transcient but conscious reference to the individual organism in which events are happening' (to get a taste of Damasio's descriptive effluence), and the autobiographical self is the more cortical, temporal sense of self derived from transcendental yet highly efficacious ideas about past and future. It can all get pretty incoherent, but a complete reading of the book supplies numerous neural correlates which shore up the author's assertions.
In the end it is hard not to recommend this book because, in the reading of it, the author lights upon accurate though transitory descriptions of what it means to have a brain and be conscious. He places emotions and feelings (better see his definitions of these two terms) in their proper place in neural events. Indeed Damasio does well in defining a neural basis for epistemology [p. 130, 137, 138, 296, 305, 316] and idealism [p. 320, 322]. In closing Damasio admits that `we cannot characterize yet all the biological phenomena that take place between (a) our current description of a neural pattern, at varied neural levels, and (b) our experience of the image that originated in the activity within the neural maps.' Indeed we may never be able accomplish such a correlation absolutely, but in the reading of a book such as this one, and say, Edelman's "A Universe of Consciousness," we see we are not very far off either.
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71 of 80 people found the following review helpful
on November 6, 2006
Format: PaperbackVerified Purchase
I studied the topic of consciousness for a biopsychology course, and this book served as my main resource. I enjoyed Damasio's model of consciousness, but it was a painful read. He regularly uses ineffective analogies to classical music and other high-brow topics. Worse, he stretches the information out over 400 pages, despite having written a 25-page review article on the very same subjects. Save yourself a lot of time, and just read that article:

Parvizi J., Damasio A. Consciousness and the brainstem (2001) Cognition, 79 (1-2), pp. 135-160.
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37 of 40 people found the following review helpful
on November 29, 1999
Format: Hardcover
I agree with the reviewer below that Damasio seems a little unclear about who is target audience is. The book has a bright new-agey cover but I doubt too many new-agers will enjoy the frequent 25 cent words. Besides that minor quibble I very much enjoyed this book. It's strong point is that it gives many more case histories and much more experimental evidence than one would find in a typical philosophy of the mind book. I liked the discussions on coma and lock-down syndrome as well as the review of cat experiments. There is also a section distinguishing emotions from feelings where the example was a patient with a calcified amygdala which I thought was very cool. This book gives a very strong case that consciousness should be distinguished from mental use of language. Damasio's argument that consciousness emerges in part of the reticular formation seems pretty believable. I find his argument though about how it emerges as some kind of second-order processing and story-telling of a persons internal senses in relation to objects in the external world as a bit too vague. Namely, he never really seems to say how this secord-order processing works. That is, what is the processing algorithm more specifically? All in all, though,I very much liked this book and can't help but think that true AI where people make machines that can mimic emotions than work up from that (like the facial expression research at MIT) is probably not more than a decade or two away.
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34 of 37 people found the following review helpful
on July 29, 2000
Format: Hardcover
The great value of Damasio's book is that it is written by an expert, but with a general audience very much in view. Damasio is both an experienced practicing psychiatrist and a neurological researcher of considerable standing. I am myself a linguist, and have tried my hand at reaching the general public in a book (in Swedish) on Language and the Brain. That has at least made me realize how difficult it is to make intelligible the biological base of such abstract structures as human language and human thought. On this score I think Damasio succeeds excellently. He may not have the philosophical breadth of Daniel Dennett, or the research brilliance of Nobel laureate Gerald Edelman -- both of them referred to by Damasio. But he achieves a rare balance between clinical experience and sound scientific argument. Whereas most philosophers, since Plato and Aristotle, have laid stress on the connection between consciousness and the very highest functions of the mind -- foresight, logical thinking, creative imagination -- Damasio highlights its humble roots in the body, its connection with feelings and emotions which we share with other animals, as Darwin showed in his treatise on The Expression of Emotions in Men and Animals. This basic "core consciousness", as Damasio terms it, arises from the brain's ability to connect and relate its representations of aspects of the outer world -- objects -- with its continuous representations of the inner world of the organism. This is the foundation of the concept of self, which eventually will incorporate all of the organism's experiences throughout its life: the "autobiographical self". Throughout, Damasio explains how such representations can be identified in the brain. Typically each representation is distributed over many brain structures, not, as the 19th century phrenologist thought, one place for each. In the same way, the second or third order representation of the self is not to be found in one single spot (the pineal gland, as Descartes thought). There is no "homunculus" in the brain, no central representation of a little man, a "ghost in the machine", to use the Oxford philosopher Gilbert Ryle's term back in the 1940s. Damasio does not shun the anatomical and physiological details. He sometimes goes into great detail, which the ordinary reader will find quite demanding. However, the main point about the biological base of consciousness, is never left out of sight, and will whet the appetite for a second or third reading of a rich and rewarding book.
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27 of 29 people found the following review helpful
on June 20, 2000
Format: Hardcover
I much appreciated reading Damasio's book. First and for most because Damasio's study logically combines objective neurologic facts with rigorous introspective analysis. At last, «hard» science can be profitably put to work to tackle global subjective problems. Damasio seems to be at the forefront of this relatively new trend. And his book is a good reference point to help any serious reader to think about the way consciousness works.
Brain injuries mentioned in the book show that, contrary to widespread belief, consciousness does not originate in the cortex, or in a «higher» human faculty; it originates in the more primitive areas of the brain. Damasio stresses that it is a fact, not an hypothesis, independantly of what we may think of his thesis exposed in the book. The core of his thesis is that consciousness originates from the internal representation of perceived modifications to the body (to the «proto-self» ) caused by perceived external objects interacting with the body during that time. We become conscious of ourselves, of the external objects and of the interaction between the two at the same time.
Even if most of the time, the language used is very easy to understand, I had difficulties grasping his multi-levels concepts about the self and about consciousness. At first they seemed to me badly defined and arbitrary. But further attentive reading, further exposure to the neurological facts put forward by Damasio and further thinking made me see the reasons behind those concepts.
However, I still think that Damasio's notion of the self is a too passive one. He doesn't emphasize the essential role of the «inner drive» of the body (instincts, impulses, basic desires, etc.) in the making of consciousness. It seems to me that the concrete feeling of that basic inner drive is a unifying whole in front of the external world and objects. It is much more concrete and real than any other internal representation of our own body. It is that drive that made us (as babies) interact in the first place with external objects, experience with them and distinguish them from us. So, it surely must have a central role to play in the process of consciousness, maybe taking the place of Damasio's more general «proto-self».
Anyway, Damasio's book is a great one that made me think a lot and put order in my own thoughts. He is a courageous scientist trying to explain objectively what is going on subjectively. He is upgrading with the newest science what great thinkers like Hegel and Piaget had been doing (in other fields of knowledge).
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19 of 20 people found the following review helpful
on May 21, 2002
Format: Paperback
Like Damasio, I never believed it when people told me that language produces the conscious mind. Following Damasio's line of thought is actually a lot easier. His central idea, that our sense of self arises from our need to map >relations between the self and other objects, is thoroughly explained in the book. He backs it with numerous medical case stories,
where some are a bit unsettling. After all we are talking about real people here, real people with some serious problems. His model of consciousness works like Lego bricks, where his notions of proto-self, core-self, autobiographical-self etc. gives a very credible account of what is going on. Surely, one could think that consciousness is way to complex to begin to describe - but here you actually get some valuable insights without being thrown into the all to popular explanations!
The vital points begins to sink in, when they are explained from different angles. Still it is not an entirely trivial matter to state something like: Core self is created out of nowhere in the account where an organism is caught in he act of representing its own changing state, as it goes about representing something else.
But Damasio gets away it, and in the end you tend to believe him. It is really a wonderful book about a difficult and extremely interesting subject. A major work that you are really happy to have read.

-Simon
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58 of 69 people found the following review helpful
on November 22, 1999
Format: Hardcover
Somewhat overwritten, the author seems to be uncertain of the audience he is trying to reach -- he varies from addressing the layperson to quickly tossing in concepts without leading explanations, as one would with an expert. The narrative had a knack of not holding my attention, so I generally felt that I was missing key ideas, yet when I reread paragraphs or pages, I found that I hadn't missed all that much. Somehow what the author wanted to say doesn't appear to come across, at least for me. Instead, this is more of a fugue on Philosophy of Mind, and as anyone who reads philosophy may have noticed, it is a field more devoted to imagination and speculation than to practicality, rationality, or applicability. Granted when we think about consciousness, it is one of those topics that we seem to know a lot about but we cannot exactly describe what we know. Consciousness, I suppose, is just something we assume exists since most of us are conscious. Damasio tries to define consciousness by using current terms or relabeling existing terms found in Philosophy of Mind. He wants to give more substance, therefore more credence, to Philosophy of Mind -- to add some sound logic to the analysis. He succeeds. But this is not a clinical book nor self-help. There are surprisingly few clinical examples, and also no substantive answers to be found to questions about clinical/neurological manifestations of consciousness or the lack of it. Damasio does introduce absence seizures and coma/lock-in states, but there is not enough discussion on either of these to prove his point. Basically, the first several pages of the chapter on Neurobiology of Consciousness sum up his theory that the reticular formation in the brain stem, when functioning properly, gives rise to consciousness. This is not a new idea either, since the brain stem is amply studied elsewhere in textbooks and in popular nonfiction for a variety of involuntary/autonomic processes. In the end, despite formulating a hierarchy of terms and concepts on consciousness -- based on and utilizing other philosopher's terms or concepts, Damasio still only describes consciousness but does not tell us what consciousness is. His best discussions are on emotions and "feeling" emotions or being aware of them, but this has been done better elsewhere (Richard Lazarus' numerous publications or Candace Pert's Molecules of Emotion). If you are looking for philosophical discussions on consciousnesss, Daniel Dennett may be the place to start or Paul Churchland, Colin McGinn, and so on. Damasio's book is best viewed as a good but spare summary of previously published ideas or known results. If you are looking for clinical studies on the brain, presented in a completely understandable way, Adams' Change Your Brain/Change Your Life is an excellent presentation of brain studies and behavior. For more details on neuroscience (many more than Damasio provides), Rita Carter's Mapping the Mind is one of the better presentations and also understandable for any level reader.
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19 of 21 people found the following review helpful
on May 21, 2006
Format: Paperback
According to Damasio any convincing account of consciousness must address two, inter-related problems: (1) the problem of how the brain is able to generate images of objects - how the `movie-in-the-brain' is concocted and (2) how the brain simultaneously represents a sense of self in the act of knowing those images. The latter problem has to do with the inherently subjective quality of consciousness, one of its essential attributes. It is unfortunate that this second problem is often overlooked - the old `Cartesian theatre' concept is woefully out-dated.

Damasio links the origin of consciousness to the organism's homeostatic mechanisms. It is a well known fact derived from neuropathology that damage to a circumscribed region of the brain stem can completely obliterate consciousness. However, surprisingly little has been written about the reasons for why consciousness should be so closely associated with the brain's devices of representing and regulating its own body. By his own ingenious use of the clinico-anatomical method Damasio puts forth a fascinating and compelling neurobiological theory of consciousness.

In a nutshell, Damasio's hierarchical theory proposes that the foundation of all consciousness is grounded in a medium of the organism's awareness of its own fluctuating internal `milieu' (the proto-self). The sensory input into the proto-self is both neural and humoral. The integrating centers for this source input are various brainstem, midbrain and telencephalic structures which constantly map the internal state of the organism (as a form of homeostatic regulation). The proto-self is not conscious (or ever capable of being verbally accessible); instead, core consciousness is the basic unit of consciousness and it is generated in `pulses' which integrate the current internal state of the proto-self, the objects being processed and the changes induced in the proto-self either by (a) objects in the external world which are processed in the relevant cortical areas or (b) internal representations of external objects, such as memories, thoughts and so on, which are mediated by the cortical association areas. Thus, there must be a link between the proto-self (the background medium of awareness or what Damasio calls `that to which knowing is attributed') and the object to be represented (what Damasio calls `something-to-be-known' or the specific qualia of a global conscious state). The `something to be known' is referenced to a primitive `self'.

The next step above core consciousness is extended consciousness, which is closely associated with working memory capacity among other things. With extended consciousness, the organism is not only conscious of the here and now, a kind of `Humean' being; instead, each `now' contains a kernel of the past and one is able to anticipate the near (and distant) future. Continuity is established and continuity enables the construction of a personal identity.

For Damasio, the value of consciousness for an organism lies in its ability to function as a further refinement of basic homeostatic mechanisms. Consciousness has a feed-forward function: it enables awareness of the external environment and the formulation of novel action programmes which are not genetically inherited. Thus it permits more purposeful behavior to occur.

The book is written to be accessible to a large audience: it is jargon-free so that it can be read by the general public but also filled with many original ideas so as to be extremely interesting to the more experienced readers as well. Damasio uses some idiosyncratic terminology, but he provides a glossary for these terms as well as a brief neuroscience overview for uninitiated readers. The writing throughout is beautiful and Damasio's theory has a kind of poetic elegance. Granted, there is quite a bit of speculation contained in the book, but Damasio is well aware of this and warns the reader about which material is at this point considered hard fact and which material is considered theoretical speculation. The book provides a solid ground for future lines of research.

For anyone interested in consciousness studies, this is absolutely required reading.
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