Review of Descartes' Error by students in Neural and Behavior Sciences, Bryn Mawr and Haverford Colleges

Reviews by Hilary Barth , GD, Craig Geneve , Jessica Kaslow , Deborah Melnick , and Shamir Khan .
Antonio Damasio, in _Descartes' Error_ undertakes an ambitious task: to convince the reader to reconsider the preconceptions he or she is likely to have on the subject of rationality and decision-making. I would say as well that he succeeds in this task, having compiled an impressive array of evidence for his theory of emotion's crucial role in the use of reason.

Damasio introduces the cases of both Phineas Gage and Elliot, who have suffered brain damage that has caused severe impairments of judgment and the general ability to function well in life. Elliot, a living patient who has undergone various brain imaging tests, has damage to the ventromedial prefrontal cortex. His intelligence seems intact, he passes all of the usual tests used to assess neurological damage, and he appears quite normal except for his unusual calm in the face of his misfortune. However, he is completely incapable of making wise decisions; in business and in his personal life he handles affairs disastrously. Phineas Gage's injury had much the same effect, according to physicians' records kept during his lifetime. Indeed, computer reconstruction techniques show that, based on the damage to his recovered skull, his injuries seems to have been to the ventromedial prefrontal area as well.

Damasio, confronted by Elliot, found himself reconsidering his own ideas about reason; now it seemed that perhaps it wasn't so that emotion and reason were at odds with each other. Obviously pure reason, which was quite present in Elliot, was not sufficient for decision-making. A closer look at typical concepts of rationality shows that this does seem likely; after all, we all know that we do not make our decisions by computing possible outcomes of every option, doing statistical analysis, and so on. Damasio points out the impossibility of the strict use of such methods by pointing out that humans do not have the necessary understanding of statistics at all.

The somatic marker hypothesis is Damasio's very sound explanation of the true processes underlying decision-making. Body states and emotions become associated with certain outcomes, influencing our decisions; this is the hypothesis, briefly stated. Damasio claims that the capability to form and access somatic markers is central to the decision process, and this is why Elliot shows the deficits that he does. The tests that Damasio and his associates develop to examine his hypothesis (which also manage to differentiate Elliot's elusive neurological problems from the function of the normal or nonprefrontal brain) are extremely clever, yielding compelling and perhaps surprising results.

I would recommend _Descartes' Error_ without reservation. The writing is clear and effective; the ideas, exciting and well-presented. Damasio does seem to feel an excessive need to excuse his materialist opinions with numerous appeals to his readers that they continue to wonder at the mind/brain even if there is no ethereal soul to perplex science forever. Aside from this, though, it's an excellent book.

Hilary Barth


Damasio provides insight into the relationship between emotion, reason, and the brain by approaching his writing as a kind of conversation. In explaining his view of body, brain, and mind, he admits the limits of science and has not claimed to be positive that his assertions will stand the test of time. I found his writing refreshing, because he discusses hypotheses, ideas, and works in progress as well as the existing scientific evidence.

The case of Phineas Gage provides a dramatic example of the brain as a complex structure that seems to have circuitry dedicated to what Damasio calls the personal and social dimensions of reasoning. I found this case to be particularly dramatic because Gage appeared to be capable and normal on many dimensions, but he was impaired despite his intellectual and linguistic competency. The dissociation that characterized Gage following his frontal lobe trauma brings up many questions about the workings of the mind and the brain. Gage's case makes us aware that qualities that seem intrinsic to a person's personality, like the ability to reason effectively, may be controlled by brain function. The mind and the brain easily become one when discussed in this persuasive manner by Damasio. He continually explores the mind/brain question in a unique and powerful way that causes the reader to question her own preconceived ideas of how the mind/brain functions.

I was also intrigued by Damasio's discussion of free-will in relation to case-studies like Gage, Elliot, and other victims of brain trauma and damage. How do we decide what free-will is when we learn that reason seems to be rooted in the brain? Is everyone who seems to have damaged decision making machinery the victim of brain damage or abnormality? Damasio's arguments force the reader to consider the origin of problems that we normally attribute to psychology alone thereby neglecting possible neurological origins.

I agree with Damasio's claim that "the distinction between diseases of "brain" and "mind," between "neurological" problems and "psychological" or "psychiatric" ones, is an unfortunate cultural inheritance...that reflects a basic ignorance of the relation between brain and mind." When someone has a disease that is a "disease of the mind," there is much less sympathy and understanding and a preponderance of blaming. When a person has a brain disease, the person suffering from the disease is seen as helpless and blameless. Is this the way it should be? If we change the way we think of diseases of the mind, what kind of policies can we create to match this thinking?

Damasio continually explores how our concepts of the brain, the mind, and the body may be inaccurate: It is not only the separation between the mind and brain that is mythical: the separation between mind and body is probably just as fictional. The mind is embodied, in the full sense of the term, not just embrained. (p 118) The brain-body interaction seems to be one that most of us accept, but the mind-body interaction can be less obvious. The idea that someone can die of a broken heart is something we have all heard, but it has more truth to it than many of us would like to admit. I think people are often reluctant to consider the extent that our minds can influence our bodies even though we experience its influence daily. The idea of a love potion is something most of us scoff at, but something causes the prairie vole to stay with its first mate until death. (Our divorce rate would be lower if oxytocin had the same effect in humans!)

Throughout the book, Damasio makes statements about the power of biology over emotion, will, reason, and even altruism, and always qualifies these statements by saying that a biological connection should not make any of these processes any less magnificent, complex, or genuine: Realizing that there are biological mechanisms behind the most sublime human behavior does not imply a simplistic reduction to the nuts and bolts of neurobiology. In any case, the partial explanation of complexity by something less complex does not simplify debasement. (p 125-6) I question Damasio's need to console the reader so often with these statements.

Why do we need so much reassurance to accept a neurobiological explanation for altruism, emotion, etc.? Damasio should have more confidence in his arguments and trust the reader to continue to consider his arguments despite misgivings about jeopardizing the traditional idea of the "soul."

I found the discussion of emotions as an "evaluative filtering process" to be one that I hadn't thought of before. In the discussion of emotion, Damasio also emphasizes differences between "as if" emotions and real ones. I am glad the brain cannot be fooled into thinking that we are truly happy when we are only acting that way. When someone is acting well, are her brain waves, etc. changed to resemble "real emotion" more than they would for a bad actress?

Throughout his writing, Damasio furthers his explanation of the body as a reference for the mind. His hypothetical experiment, "brain in a vat," emphasizes the idea that the brain without body input would not be able to produce a normal mind. This is more of a "mind exercise" rather than an experiment, but I enjoyed thinking about the idea of brain/body dualism in that way. The idea of the production of a neural self also interested me, but I'm not sure that Damasio's explanation of how this is produced truly satisfied me (dispositional representations, primordial representations, reconstruction, etc.). I think that the self is difficult to explain, but the explanation should be attempted despite the challenge presented.

In the postscriptum, Damasio emphasizes the alienation of psychology and the mind's impact on the body in Western Medicine. He discusses growing interest in alternative medicine as society's response to this neglect of the emotional and psychological. I agree with his analysis, but I think that the Cartesian view, as he calls it, is so ingrained that it would be difficult, if not impossible, to change. Society may want these changes, but does the medical community or do the insurance companies want to change their view and practice of medicine to be more all encompassing? An example of a narrow view of medical care is that the effectiveness of treatment for breast cancer is generally solely considered using survival rates rather than any measure of quality of life. This is surprising because there is not a cure, and many women may not want another 12 months to live if their quality of life deteriorates drastically in the meantime.

GD


I believe Descartes' Error is a very interesting and informative book. This is the first thorough treatment of the controversial "mind/body" relationship I have read and I have learned a lot from it. Reflecting back on what I learned as a psychology major at Haverford, I wonder why I have never read anything significant about this topic in any of my other psychology classes. I feel this is an important issue which should be spoken about, even if just briefly, in an intro-psych course because I believe this issue of the mind/body relationship lies at the roots of psychology. To clarify my point, Descartes - one of the founding fathers of psychology - gave us something to ponder about the mind/body relationship when he said: "I think, therefore I am." According to Damasio, Descartes' statement translates into a position in which Descartes believes that the mind and body are independent of each other. Descartes' belief becomes the focus around which Damasio builds his counter-argument suggesting that the mind and body are not independent of each other, but rather very well integrated; hence the title Descartes' Error.

After having discussed many of Damasio's major points in seminar, I have come to the conclusion that mind and body are definitely related, and that biological explanations of emotion and reason do exist. I believe Damasio's theory which posits that the brain constructs evolving representations of the body as it responds to external and internal influences and that these representations (which can be made conscious as images) form the basis of "mind." I also believe Damasio's argument which states that the self equals the mind. This makes sense to me because we are all unique individuals; thus we each have a self (and mind) that is unique from the self (and mind) of any other person. This naturally follows from the fact that no two people will have exactly the same experiences in life. Thus their mind, which is comprised of representations of their body interacting with the external and internal world (comprised of chemical and neural signals) must also necessarily be different. Believing this, I now finally understand what we discussed last class - that if you transplant the brain of one person (A) into another person's body (B), the new hybrid person (C) will not be the same as (A) because body (B) can never be the same as body (A). Thus the new hybrid person will have a different mind and thus a different identification of self.

I enjoyed the overall structure of the book and found Damasio's personal anecdotes and asides very refreshing from the somewhat technical biological explanations of mind, self, emotion, and reason. Although some parts of the book were dense with biological information, I do not feel that Damasio left me in a whirlwind of terms and anatomy because he took the time to thoroughly explain them. I also found the illustrations to be helpful. I think the postscriptum is an excellent finish to Damasio's book because it funnels the reader out from the biological and evidential specifics of mind/body to how the mind/body issue affects people daily in today's world. Specifically, Damasio relates the mind/body issue to Western medical practices, survival, pain and pleasure, and even crime (i.e.: the notion that there may be a biological predetermination of the acts of serial killers was even brought up).

I very much enjoyed our seminar discussions on Damasio's book because they were the first time at Haverford I really let my mind ponder and attack new ideas which try to explain one of the profound mysteries of life - what is mind?. I was not scared by Damasio's attempt to explain mind, reason, emotion, and self in biological terms, but was rather awed by the extent to which he actually succeeded. I am not saying I believe everything which Damasio uses as evidence and support for his theories, but I commend his efforts for clearly presenting a strong argument.

As I mentioned in seminar, one of the areas in which I think Damasio is wrong is when he says that soul and spirit are part of mind (page 252, last paragraph). I believe the focus of Damasio's book, as he initially states, is to explain the mind/brain/body relationship. He does not state that he is going to explain the biological underpinnings and location of the soul and spirit as well. Damasio was very adamant about mentioning that he was not removing the "beauty" of emotion/reason/mind by explaining them biologically and that he was not trying to interfere with religion's views of soul and spirit. That is all very noble of him and because I understand what his goals are, I was not disturbed by these conciliatory remarks. However, I was disappointed when he concludes his book by quickly throwing in the idea that soul and spirit are part of mind. I feel the entire last paragraph can be left out because I see no evidence for this claim in the book nor do I see the explanation of soul and spirit as the reason why I read the book in the first place.

I hope more research is done in this area of mind/brain/body and I would be very interested in reading any other alternative theories which share the same goals as Damasio. I still believe there are many issues which need further discussion and exploration despite Damasio's attempt to present a complete argument (i.e.: Where is mind located? and Why did we evolve to think without emotion in certain instances?).

Craig Geneve


Antonio Damasio's Descartes' Error is a stimulating attempt to convince readers that emotion and reason are not completely separate and, in fact, they are quite dependent upon one another in the "normally" functioning human. Through historical examples as well as his own cases, Damasio provides convincing evidence that impairment to portions of the brain responsible for emotion also impairs the ability to use reason or behave rationally.

He includes a fair amount of biological explanations and hypotheses that are relatively easy to understand, yet are still challenging for the neuropsych concentrator such as myself. He sites evidence that implicates damage to the prefrontal cortices as the cause for problems with both emotion and reasoning.

An interesting idea that Damasio writes about is his somatic-marker hypothesis which closely connects brain and body. This is basically his technical way to describe gut feelings with which we are all familiar. He believes these feelings enable us to narrow down the number of possible choices of action in any given situation. The most important function of such a physical marker would be that it allows us to realize the future (positive or negative) outcomes of our immediate actions (positive or negative). He locates such a marker within the prefrontal cortices because he believes them to be ideally suited for such functions linking reasoning and deciding to body states that reflect emotion. But he is also careful to acknowledge that sociocultural factors interact with biological ones to create many behaviors.

One of the most compelling pieces of evidence that Damasio uses to test his somatic-marker hypothesis involves physiological results. Patients with frontal damage failed to generate the normal skin conductance responses in response to emotional slides (209) while other patients with this damage showed no anticipatory responses to Damasio's gambling experiment (221) and never seemed able to avoid bad outcomes.

These marker ideas may have particular relevance to psychopaths who have plagued society with their impulsive and destructive behaviors and who seem to have no regard for their future when they commit such unfathomable crimes. Their behavior is quite similar to those patients with prefrontal damage. Improperly functioning somatic markers may be part of the psychopath's problem. Perhaps they do not have the physical signs/emotions that keep normal people from commiting crimes. If psychopaths, who are often criminals, were actually suffering from damage to some sort of biologically based somatic marker, the implications would be huge. In fact, our discussions included some debate as to how this would affect the treatment of criminals. If their behavior has a biological cause, can they be held responsible and thus be sent to the electric chair?

While most of Damasio's arguements and ideas were well-supported by and founded in scientific evidence, one less scientific issue kept popping up throughout the book. This was the question of the existence of the human spirit or soul. Damasio seemed to feel the need to reassure himself and/or his readers that there still can be some sort of mystical aspect to the inherent goodness in most people, yet couched in neurological functioning. He says "it's just that soul and spirit, with all their dignity and human scale, are now complex and unique states of an organism" (252).

Nevertheless, towards the end, Damasio stresses that our brains are "body-minded", and I was left feeling that most everything I think, feel or do stems from neurobiological functioning yet in close connection with my body proper. This body-brain idea is what, for me, gave strong support to Damasio's arguement that there is a crucial connection between emotions and rational thinking.

Jessica Kaslow


I decided to discuss the book by chapter because I felt that there were so many issues and I found it difficult to organize them otherwise.

Chapter One (Unpleasantness in Vermont)

Phineas Gage was a goodnatured, rational, hardworking man until a catastrophic accident destroyed areas of his frontal lobe. Damasio points out that Gage survives the accident, but he no longer had the same disposition, dreams, aspirations, "Gage's body may be alive and well, but there is a new spirit animating it." (pp.7) With the Gage incident specifically, there is a question of whether his full intellectual capacity was intact. On one hand Damasio argues that there is this fully functional human (intellectually) who loses most emotional and social capacity. However, those that knew him felt that he was..."a child in his intellectual capacity and manifestation." (pp.8) Even though there was much more deterioration happening in Gage's case because of the extent of the wound, this incident raises some issues that many authors discuss as different types of intelligence: social, emotional, spatial, athletic, etc. Science (and society)tries to divide intellectual thought and emotion. However, there can be highly intellectual people who cannot function socially and emotionally as in Gage's case.

Chapter Two (Gage's Brain Revealed)

Damasio uses computer imagery to show that the area of damage was probably the ventromedial prefrontal region. It was damage to this area that interfered with Cage's ability to plan for the future, to conduct himself according to the social rules he had learned, and decide on a course of action that would be most advantagious to his survival.

Chapter Three ( A Modern Phineas Gage)

Elliot magically appears out of the woodwork, the modern day Gage and allows Damasio the chance to actually study the brain upclose. Elliot went through a radical personality change due to the removal of a meningioma growing around the midline area in the frontal lobe. However because he was coherent and smart, he was refused disability. His flaws seemed more like poor judgement and lack of insight. His actions were unnecessarily detailed; he would plan all day his course of action at work, but get nothing done. Elliot went from being a good husband and father and worked at a business firm to acting inappropriately and ignorantly systematically. Overall, the question is was Elliot and Gage's free will compromised? Damasio makes an interesting point when he says," diseases of the brain are seen as tragedies visited on people who cannot be blamed for their condition, while diseases of the mind, especially those that affect conduct and emotion, are seen as social inconveniences for which sufferers have much to answer. Individuals are to be blamed for their character flaws, defective emotional modulation, etc." (pp.40). Gage and Elliot's free will was compromised, however, socially there is little tolerance or understanding of the more subtle diseases of the "Mind." This is reflected further in that fact that we have no means of even detecting such a problem or abnormality. Elliot's IQ was way above average, he performed well on the memory tests with interference procedures, the Wisconsin Card Sorting Test (frontal lobe tests) and other tests specifically for testing frontal lobe damage, MMPI, etc. Elliot had passed all of the tests for made to pick-up subtle frontal lobe damage. It is unbelievable that there is no existing test that could pick up Elliot's damage. According to the tests, Elliot was fine, but anyone who is observant, would see his inability to function in everyday life. And another important point is that society treated Elliot as if he had no real problem because his problems were not so easily pinpointed and as Damasio had pointed out, diseases of the mind are social inconveniences that must be answered for. It took creativity to go a step further and find out what was actually going on.

Chapter Four (In Colder Blood)

We are all taught to not let your passions interfere with judgement, but lack of emotion also causes irrational behavior. A great example is when someone knows that they have cancer, it is the fear and terror that drives the person to see a doctor. What if that rational fear did not exist? The ventromedial and dorsolateral sectors (sparing the cingulate region) of the frontal region were ablated in monkeys in an experiment by R. Myers. These monkeys could not maintain normal social functioning despite nothing physical in their appearance was changed. They did not groom or interact, etc. These monkeys do not survive. However, an animal with an amputated limb will survive in the group. The complex social interactions prove vital to the survival of monkeys and humans alike.

Chapter Five (Assembling an Explanation)

Damasio outlines the specific outcome of the damage of the patients he studies i.e., reasoning strategy deficits that revolve around goals, options for action, prediction of future outcome, and plans for implementation of goals at varied time scales. Second, Damasio makes an even bigger step by expressing that the processes of emotion and feeling are part and parcel of the neural machinary for biological regulation, whose core is constituted by homeostatic controls, drives, and instincts. His major point of this chapter is to that the processes behind all of these mechanisms are not one part of the brain, but functions as a distribution over many locations. Simultaneous active parts of the brain lead to pyschological phenomena. He also comes to the conclusion that the body and brain are indissociable. Damasio argues that the brain takes the patterns activated in the brain by external stimuli and recapitulates them to create mind or consciousness (which is why come animals have intelligent behavior with no mind). This is an interesting point, but it still is vague. His discussions of architecture and neural representations are intesting, but they do not fully clear up the picture of mind for me.

Chapter Six (Biological Regulation and Survival)

By this point, Damasio has reassured us many times that the human, even though the body and mind are indissociable, is still not one bit less complex, admirable... It is almost as if he is expecting people to reach hysterics because his argument may actually mean that there is no soul carrying out all of the wonderful mysteries of feelings and mind. However, his constance reassurance is almost dishonesty on his part. It is as if he is struggling with the idea on his own part while claming the reader. He does not need to reassure or go into these arguments they are not necessary. He does not need to go into the area of soul because his argument need not take it away. His points about emotion and feelings not being luxuries or playthings of passion, but necessary and vital parts of our survival is an important one. Surviving is necessary not math or logic.

Chapter Seven (Emotions and Feelings)

This chapter is an important core of the book. Damasio resurrects William James' theory of emotion (we react with the body and then we feel) for his argument. Therefore the body leads to emotion and not necessarily the brain. Ironically one of Jame's main criticisms was that we always use the body as the theater for emotion; Damasio believes that in many situations emotions and feelings are operated in that manner, from mind/brain to body, and back to mind/brain. He points out that there are forms of processing that need the mind (taking in inputs from environment and generating outputs) and some that do not need the mind (origin of feelings, sensory inputs reporting states of the body).

Chapter Eight (The Somatic-Marker Hypothesis)

There are two different ways that the brain can get information on the body: sensory nerves and using information on internal image of the body (motor nerves send messages and part of the brain keeps track, therefore, causing an internal image.) He forms an interestinf point when he discusses the issues that the somatic-marker account is compatible with the notion that effective personal and social behavior requires individuals to form adequate "theories" of their own minds and of the minds of others. Primal reactions without emotions causes one to go for the immediate payoff. Willpower draws on the evaluation of a prospect, and that evaluation may not take place if attention is not properly driven to both the immediate trouble nad the future payoff, to both suffering now and future gratification. As Damasio points how would we be able to go jogging or finish medical school (or undergrad for that matter). However, how many times have we done something that we knew we would get in trouble for or would ultimately cause injury and we just kept on going without warning? Where do these situations fall in the middle of Damasio's damaged patients (continuing to play with a sleeping dog after being warned many times, not finishing homework, knowing that we will fail, continuing to throw a ball on the roof, knowing that may crash the window.)

Chapter Nine (Testing the Somatic-Marker Hypothesis)

Damasio and his colleagues came up with experiments that were more true to life such as gambling experiments for the damaged patients. Interestingly enough, Elliot did not do well, he ended up having to take out loans for his mistakes of judgement. Even though he seemed thoughtful, cooperative, fully attentive, he chose disastrously. Was this because he is no longer sensitive to punishment and is only controlled by reward? He has become so sensitive to reward that its presence makes him overlook punishment? or He is still sensitive to reward and punishment, but neither contributes to the automated marking or maintained deployment of predictions of future outcomes, and therefore choose immediately rewarding options. More testing showed that frontal lobe damages patients showed no anticipatry responses whatsoever; their brains showed no sign that it was developing predictions for negative outcomes.

Chapter Ten (The Body-Minded Brain)

This chapter brings in the neural basis of the self. He explains that the self resides within the continuous activations of two representations: key events in an individual's autobiography on the basis of which a notion of identity can be reconstructed repeadedly and representations underlying the neural self consists of the primordial representations of an individual's body. This idea works well for me in the sense that he based it on the idea that we have patients like the anosognosics who have lost the complete and total self, from Damasio's perspective. Also there is the brain in a dish issue (the sense of self should vanish).

Chapter Eleven (A Passion for Reasoning)

Here he directly discusses Descartes' Error. Damasio's concern is for the dualist notion that Descartes split the mind into (brain and body or that mind and brain are related). The idea that they are related and that the mind is the software program run in a piece of computer hardware called brain is what Damasio is trying to change. However, why does Damasio have to throw in the, "The trule emobodied mind I envision, however, does not relinquish its most refined levels of operation, those constituting its soul and spirit. From my perspective, it is just that soul and spirit, wirh all their dignity and human scale, are now complex and unique states of an organism." This statement makes no sense in the scheme of what he is discussing, but again he feels a need to reassure us that he has not taken away spirit and soul and whatever else as if he needs to reassure himself. However, I'm sure if he didn't put these statements in the text, people would fill in those gaps with their own extrapolations for Damsio...He is making a big leap in a sense.

Overall, I enjoyed the book. Damasio does a great job of getting his points across (they are some complicated ideas at some points). However, it gets a little dry at some points when dealing with the neurobiology. However, the ending maked up for the dry parts. He has some vague areas such as the idea of representations and their relationship to consciousness and mind, but he has given us a stepping stone and a place to start in terms of finding Elliot and other patients with the "perfect" damage. I do wonder if he was searching for an Elliot or if this guy sort of stumbled on his lap in the sense of was this something Damasio was working on long before Elliot walked in the door. One thing that goes through my own mind a great deal is how will the sort of evidence put forth in this book change the way that we deal, as a society, with criminals. Are they responsible for what they have done? Can we blame everything on neurobiology? Does environmental damage cause the same major damage as a tumor?

Deborah L.Melnick


In Descartes' Error by Antonio Damasio, Damasio elucidates the woes on patients with damage to the prefrontal cortex in order to demonstrate the tie between rational decision-making and emotions. Patients such as Elliot and Phineas Gage show deficits in their decision-making in everyday life, yet they perform well cognitive and intelligence tests. In particular, these two patients have impairments in terms of making personal, social, and financial decisions.

Elliot is discovered to have damage to his ventromedial prefrontal cortex. In describing Elliot, Damasio says, "..he did not learn from his mistakes. He seemed beyond redemption, like the repeat offender who professes since repentance but commits another offense shortly thereafter" (38). Furthermore, Damasio, also says of Elliot, "I never saw a tinge of emotion in my many hours of conversation with him...no sadness, no impatience, no frustration.." (45). Thus, Damasio argues that a "reduction in emotion may constitute an equally important source of irrational behavior. The counterintuitive connection between absent emotion and warped behavior may tell us something about the biological machinery of reason" (53). As a result of such observations, Damasio starts to build his explanation between rational decision making and emotion (the somatic-marker hypothesis). Patients like Elliot who are dysfunctional in decision-making seem to lack emotion.

In Damasio's somatic-marker hypothesis, he argues that somatic markers, which are involved in emotional learning, help to reduce some options in decision-making and help to highlight others. For example, when we are confronted with many choices (what graduate school should I choose? Which classes should I take next year?), the emotional learning that we have acquired through our lives (such as the memory of graduate school you dislike because the weather in that state is awful or a memory of a lecture class which you hated), helps to eliminate some choices and highligh others. Therefore, you can now choose graduate schools in states that have good weather and classes that are more seminar format because you do worse in huge lecture classes. Thus, there is an important role for emotion as well as thinking in reasoning.

Overall, I really enjoyed reading this book and struggling with views on Damasio's arguments. Most of all though, this book challenged me to think about my views concerning larger societal issues, such as our criminal justice system. In light of what Damasio has claimed in his book through understanding the neuroanatomy and neurchemistry of emotion and reason, how do we deal with criminals who might lack such emotions like Elliot? These include such serial killers as Jeffrey Dahmer, the Son of Sam, and the Hillside Stranglers. America still has not signed the International Declaration of Human Rights (IDHR) because we still have the Death Penalty, a major act that violates the IDHR. When we decide to execute a serial killer, as a society we look at the acts of the individual from a social perspective. Damasio has shown us that there could be a biological basis as to why a serial killer (or serial rapist or just a murder) might commit such horrible acts (when he doesn't learn from his mistakes, like Elliot). Do we ever want to execute individuals when there is a slight possibility that their acts might be due to biological defects? I am not arguing against responsibility for one's actions, I am only thinking about how we can better deal with people who just kill over and over without a senese of remorse.

There could be a biological basis as to why a criminal would not develop empathy (both in a cognitive and affective operational definition). As Damasio argues though in Chapter 4, "consideration of both social and neurochemical factors is required" when we are examining such situations as the execution of a serial killer (78). Damasio also mentions that the impairment of a developmental sociopath could come from abnormal circuitry and abnormal chemical signaling and begin in early development; thus, in uderstanding the neurobiology of sociopathy, we could look towards treatment and prevention(178).

Such a statement by Damasio implies that maybe we might want to start using prisoners in research in order to understand sociopathy. Research could happen either when prisoners are alive, after they are dead, or just examining adolescents in detention halls. As neural and behavioral sciences students, would we feel comfortable joing a movemement for this type of brain/behavior research if it grounded in a somatic marker hypothesis such as Damasio's? Are these criminals/sociopaths who they are because of a dysfunction in emotion, which then interferes with their rational decision-making or are these sociopaths responsible for their own behavior, regardless of the biology of their emotions?

Thus, Damsio's book has made me think not about the exclusion of discussing the social basis of horrible acts, but the inclusion of discussing the existence of possible neurochemical factors.

Furthermore, Damasio mentions in Chapter 9, the notion that "to know does not necessarily mean to feel"---even when you realize what you know ought to make you feel in a specific way, it fails to do so (211). Such a statement has implications for many societal problems such as risk behaviors. This is particularly germane in examining a topic such as AIDS prevention in homosexual teens. A recent study concluded that even though many of these boys and girls were extremely knowledgeable about AIDS prevention techniques (like condom usage, mode of transmission, effects of AIDS, hazzards of sharing needles), they were still engaging in unsafe practices that puts them at risk for AIDS. So for these teens, it seems that what they knew ought to have made them feel in a sepcific way, but it clearly it did not-- they were still engaging in high risk behaviors. I wonder if there just are people in society for which this is true regardless of frontal lobe damage or could it just be a copout excuse for situations in which there is no direct evidence of brain damage?

Again, I would definitely recommend Descartes' Error for neuroscientists, psychologists, philosophers, and anyone interested in the relationship between mind/body and emotion/rationality. The book is well-written and generally easy to understand. As supplementary reading to this book, I would also recommend Daniel Goleman's book, Emotional Intelligence. This book primarily deals with the psychological and social explantions and implications of the ties between emotion and intelligence. In addition though, the book stresses the scientific work of Damasio and Joe LeDoux. LeDoux is a neuroscientist at the Center for Neural Science at New York University who was the first to discover the role of the amygdala in the emotional brain.

Shamir Khan

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