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Wisdom is knowing I am nothing,
Love is knowing I am everything,
and between the two my life moves. --Nisargadatta Maharaj

The Man Who Wasn't There: Tales from the Edge of the Self

--by Donna Jackel, Sep 13, 2017

What makes you, you or I, I? That is the age-old question science journalist Anil Ananthaswamy tackles in his book, The Man Who Wasn’t There: Tales from the Edge of the Self (Dutton, Penguin Random House, USA, 2015). He examines the nature of selfhood from all angles, turning to philosophy, neuroscience and in-person interviews with people afflicted with neurological conditions that in some way rob them of some aspect of their selfhood.  

In his book, Ananthaswamy, a former software engineer and current consultant for New Scientist Magazine, writes about eight diseases, starting with Cotard’s syndrome, in which deeply depressed individuals become convinced they are dead.

In a chapter about Alzheimer’s disease, the author poses an intriguing question: What remains of a person when their narrative is gone? Alzheimer’s patients initially lose their short-term memory. As the disease progresses, past memories and the ability to think about the future are eroded. “You have to be able to string together episodes to [form] a narrative,” says Ananthaswamy. What we don’t know is what remains of the interior life of someone with advanced Alzheimer’s. “Do they still feel hunger, cold—we don’t know because we can’t ask them questions,” Ananthaswamy says.

In another chapter, he meets a man convinced that one of his legs does not belong to him, a condition known as body integrity identity disorder. The presence of this limb becomes so unbearable to the man that he searches out a physician willing to amputate the healthy leg.

“Our sense of self is created by our brain and body and whatever it is that we feel we are at any given moment,” says Ananthaswamy.  “Ultimately, no matter how severe a neurological condition, there is always an “I” experiencing the condition.”

Over the last few decades, says the author, who divides his time between Berkeley, Calif. and Bangalore, India, science has moved away from the notion that there is a split between the mind and body. He writes, “In just about every condition, aspects of our self that we would normally attribute to the brain, and by extension, to the mind, turn out to be inextricably linked to the body.”

            Our self identity is also shaped by the time and place we live in. “The self is linked to one’s body, one’s story and one’s social and cultural milieu,” says Ananthaswamy. “[Culture] is a very strong aspect of who we are, and who we are influences the culture.”

Questions for Anil Ananthaswamy

What inspired you to write The Man Who Wasn’t There?

AA: I have been interested in questions about the nature of the self for a long time, but mostly from the perspective of philosophy and religion. When I realized that neuroscience and philosophers grounded in empirical science were tackling these questions, I decided I wanted to write about it. During my research it became clear that conditions that cause disturbances of the sense of self have a lot to tell us about who we are.

How did you select which neurological disturbances to focus on? How did you find your subjects? Why do you think they were willing to speak with you and allow you to write about them? Did you use pseudonyms?

I chose to write about a set of conditions, each one of which impacts a different aspect of our sense of self. For example, Alzheimer’s disease erodes our narrative self, and there are conditions that directly impact our sense of agency—the feeling that we are the agents of our actions. Also, the choices were governed by the extent of relevant scientific research on each condition that was specifically looking at the condition as a disturbance of the self.

I came in contact with my subjects via various avenues: for example, either through the neurologists who asked their patients if they’d talk to me, or through friends, who knew of someone suffering from, say Alzheimer’s.

It’s hard to say exactly why they chose to speak to me. All I can say from my side is that I sincerely wanted to understand what it felt like to, say, suffer from schizophrenia. I talked to my sources without any judgment on my part; I wanted to listen and understand their internal experiences.

I used pseudonyms and even obscured some identifying details when my sources requested anonymity—to whatever extent they desired.

You write (paraphrase): “This book doesn’t offer neuroscientific solutions to the hard problem of consciousness—there are none yet. But this book does address the nature of self.” What mysteries of the self are neuroscientists likely to solve first?

The most significant insight from neuroscience is that the self is not one thing—it’s a process that unfolds in which the brain, body, mind and culture are intricately involved. And because it’s a process, there’s no one place in the brain that can be said to be the location of the self; of course, some brain regions are more important than others for creating our sense of self, but it’s a distributed process.

As for the hard problem of consciousness, there’s considerable debate not only about whether science will ever crack the problem, but whether there is such a problem to be solved in the first place. It’s hard to say when and if the problem will be solved.

You write about how tightly the mind and body are integrated: “There is a widespread acceptance in neuroscience about the body’s central role in giving rise to the self. This role manifests itself in emotions and feelings.” Could you give some examples for our readers?

A trivial example that everyone can relate to is that physical activity, exercise, can elevate mood. The state of one’s body is integral to how one feels. In terms of conditions that disrupt one’s sense of self, this integration between body and mind is most evident in something like depersonalization disorder, where people feel detached from their own body and emotions, which in turn results in severe anxiety.

You write about the awareness of the external versus awareness of the internal and how both are pivotal to our sense of self. Is the disturbance of this interconnection what links all the people you write about?

All the people I write about are experiencing some disruption of their sense of self. These disruptions cannot always be linked to the brain circuits that are correlated with external and internal awareness. The disruptions can be at times quite complex and not amenable to speaking in terms of external versus internal awareness networks. So, this is not a common connection between the people I write about.

Which aspect of your research for this book fascinated/surprised you most?

I was surprised by how devastating these disruptions of the self can be. But I was simultaneously surprised by how robust the process of creating and sustaining a self is within each one of us. Even though there are sometimes extremely difficult perturbations of the self that people have to cope with, for the most part, this extraordinarily complex process works and works well.

 

I was drawn to your chapter on Alzheimer’s--the disintegration of the narrative and the question of what remains of a person when the past, present and future no longer exist for he or she. Do you think we’ll ever be able to better understand who is looking out from us from that seeming shell of a person? And how would this knowledge help us care for people with Alzheimer’s more humanely?

By simply studying Alzheimer’s disease, we may not be able to understand what it must be like to suffer from end-stage Alzheimer’s, because the person cannot communicate their feelings with anyone anymore. But it might become possible to infer indirectly, as neuroscientists and neurologists get better at understanding the brain and body and their role in creating the sense of self. For example, we might be able to show that someone with end-stage Alzheimer’s has the necessary neural activity to have a sense of one’s bodily self—so be aware of pain, hunger, etc. In other words, they may have a sense of being an “I” that experiences bodily sensations, even if their narrative self, which depends on short-term and long-term memory, is no more.

Also, the loss of the cognitive aspects of one’s narrative self doesn’t imply that one’s entire “story” is lost—much of that narrative is embodied, and doesn’t need conscious recall, and could still be experienced by the person with Alzheimer’s.[As an example, in the The Man who Wasn’t There, Ananthaswamy describes how composer Aaron Copland was able to conduct his symphony, Appalachian Spring, despite having advanced Alzheimer’s.]

So, yes, all this should cause us to rethink how we take care of people with Alzheimer’s at every stage of the disease. For instance, relocating them to care centers that are foreign to their bodily self may make things far more difficult for the patients, and for the caregivers. Of course, these are complicated decisions for all involved, and there are no simple answers.

Do you see the sense of self-agency as firmly rooted in most people or fragile? And don’t many of us have mild symptoms of the disorders you write about? We’ve all experienced the sensation of having driven for several minutes on autopilot until we are jerked back to our senses.

The sense of agency is very robust. Given that the self is a process, and as with all processes in nature, the outcomes of the process lie over a distribution. So, yes, I think we all, at any time, can experience the kinds of disruptions that may be felt by, say, someone who is dealing with autism or depersonalization. Having said that, we should not trivialize just how difficult it can be for someone who is coping with profound and continuous disruptions of this process.

At the close of your book you write how we as human beings fear losing our sanity, which in turn drives stigmatism against people with mental illness. You go on to say that this fear is also derived from the belief that the mind is superior to the body, which you call false and misleading. You write, “In just about every condition, aspects of our sense of self that we would normally attribute to the brain, and by extension, the mind, turn out to be inextricably linked to the body.” Could you please explain in greater detail what you mean by that and how a better understanding of this connection could help reduce stigma against those with mental illness?

AA: You can ask a similar question about our bodies: without our bodies who/what are we? By thinking of the mind as being separate from the brain and body, we often elevate it to a place from where it’s supposed to work magic. If you are suffering from depression, for example, you are often supposed to think your way out it. And not being able to do so brings stigma.

But the mind is an outcome of the brain and body. It’s all a continuum. By not making a big distinction between the mind, on one hand, and the brain and body on the other, we can avoid fearing disorders of this seemingly otherworldly thing called the mind, and possibly use therapeutic measures that pay attention to the body and its immediate environment in equal measure.

In an interview on NPR’s Fresh Air you mentioned that when you were a software engineer you tended to live in your head too much. Becoming a journalist, you said, has helped you feel more alive and “forced you to pay attention to whatever is happening in the broader culture.” Could you please expand on this observation of how writing turned you outward?

AA: It’s somewhat of a paradox. A writer is solitary. But at the same time, to write well, and to write about things that matter, you have to become more and more aware of your surroundings, the people, the environment, politics, anything, everything. As a software engineer, my focus was narrow. As a writer interested in questions about the nature of our existence, I find that I am thinking about broader issues more and more, and it has indeed turned me outward.

What are you working on now?

AA: I’m working on a popular science book on quantum mechanics. It’ll tell the story of quantum physics through the lens of the double-slit experiment, which is an iconic experiment that has fascinated and mystified us for close to a century (since the birth of quantum mechanics). It continues to be used—in increasingly sophisticated ways—to probe the mysteries of the quantum world, and I’m writing the story of this one experiment.

****

To learn more about Anil's journey and work, join this Saturday's Awakin Call with him. RSVP and more info here.


Donna Jackel is a freelance journalist based in Rochester, NY.  Her work has appeared in Lilith, The Bark, The Chicago Tribune, BBC Travel, The Chronicle of Higher Education and many other publications.  For more visit her website: www.donnajackel.com



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