Antonio Damasio: How Can Somebody Be Both Awake and Not Awake?

In Descartes' Error (1994), neurologist Antonio Damasio argued that we should not try to treat reason and emotion as separate. Rather, both are essential to decision-making. Our choices are not wholly rational.

The classical dichotomy is of head and heart, reason and emotions. Good decisions, according to classical thinking result from good reasoning. Instead, Damasio says good rational decisions depend on feelings.

His patient, Elliot, had prefrontal damage, and was smart, pleasant, and engaging. He scored normal on a battery of personality tests. Yet he made horrible, life-ruining decisions. Why? Because his intellectual capacity was severed from his emotions, so to speak.

In The Feeling of What Happens: Body and Emotion in the Making of Consciousness (1999), Damasio takes a different argument--that the key to consciousness lies with the body's ability to sense and react to its own processes and its environment. The problem of consciousness, he maintains, has two related components. One is the question of how the "out there," the outside world, finds a parallel imagery in the brain. The other is how a sense of self arises from a "map" that correlates inside with outside.

He gains his theory from practice. His examples derive from real people with serious problems, He wants to understand how we know things about the world through our senses and also how at the same time we are aware of a self experiencing things. This is part of what he calls "the feeling of what happens."

In dealing with patients with brain damage, he developed insight into questions he had. As Damasio puzzled over effects to a patient's brain during an epileptic seizure, he sought an answer to a classic question among scientists and philosophers: What is it about the human brain and its networks of neurons that give rise to consciousness?

In The Feeling of What Happens he concludes that consciousness is layered. At its base lies a vague, animalian sense of self arising from the brain's "diagram" of the body. This proto-self props up the higher layers.

Even snails, have proto-selves, says Damasio, but they aren't really conscious. As to the seat of consciousness, the brain is a parallel processor, designed with redundant neuron networks. No single region of the brain has the seat of consciousness. Consciousness, he says,"is the feeling of knowing that we have feelings."

If his theory gains from practice, his practice was frought with troubled questions over real people. When young, he had a patient who was both there and not there, both conscious and not conscious. The man's consciousness became so empty that he could not respond to his name. At the same time, he recognized a cup of coffee and picked it up to drink it.

"This incident occurred more than three decades ago, when Dr. Antonio Damasio was a medical student in Lisbon, Portugal, and he has never forgotten it. How was it possible, he wondered, for someone to be there and yet not be there, to be awake and yet not be awake, to be aware of his surroundings and at the same time be oblivious to them?" More