Damasio talking at Psychoanalyrtic Association Meeting

Consciousness Continues To Baffle Psychoanalysts
Joan Arehart-Treichel

Former President Bill Clinton used to tell the public that he "felt
their pain." He may have been right-literally. Empathy has been shown
to activate a brain region involved in feeling pain.

A large part of a psychiatrist's day is spent navigating the world of
emotions, feelings, and consciousness. Yet what is actually known about
these ephemeral mental states?



During the past two decades quite a bit has been learned about
emotions, something about feelings, yet very little about
consciousness, two sessions at a recent meeting of the American
Psychoanalytic Association in New York City suggested.

One session was conducted by Antonio Damasio, M.D., a professor of
neuroscience and psychology at the University of Southern California.
The other session included Damasio and Arnold Modell, M.D., a professor
of psychiatry at Harvard Medical School.

Emotions, Damasio explained, are essentially automatic reactions to a
stimulus in the world or in one's mind. Sometimes people's brains
respond with a particular emotion because of evolution-for instance,
a dark form or a loud noise can provoke fear.

Yet other times, people learn to react emotionally. For example, one
individual may be emotionally moved by a Chopin piano concerto, whereas
another person may not. Moreover, emotions can be grouped into three
tiers-background emotions such as enthusiasm; primary emotions such
as fear, anger, and sadness; and social emotions such as compassion.

Scientists have identified specific areas of the brain that trigger
emotions, Damasio noted. The amygdala, ventromedial prefrontal cortex,
anterior cingulate cortex, anterior insula, and basal ganglia are some
of the regions that are known to be involved.

Researchers have also found out that specific brain areas are involved
in processing specific emotions. For example, the ventromedial
prefrontal cortex is involved in the manufacture of social emotions.
About a dozen brain structures are implicated in sparking fear. Also,
investigators have discovered some of the changes that occur in the
brain as a result of emotions. For instance, regardless of whether they
are positive or negative, emotions can influence attention or working
memory, and while a small emotional response can enhance attention or
memory, a large response can impair them.

Feelings Are Not Emotions

As for feelings, Damasio added, they are not the same as emotions, but
are rather composite perceptions about things, situations, or people.
For example, a person might say, "I'm not feeling very well today" or
"I just don't feel that that house is the right one for us." In fact,
an individual can have a feeling about an emotion he or she has
experienced. Also, "You have parts of the brain that lead to emotional
states and parts of the brain that lead to feelings about these
states," and the two may be different. A case in point: A fMRI study
showed that when subjects experienced the emotion of sadness, certain
brain areas became activated, yet when they formed a feeling about
their sadness, other brain domains were aroused.

In contrast, some brain areas may be involved in processing both
emotions and feelings, Damasio suggested. Take the insula. In a recent
experiment, a skin wound was inflicted on subjects while their partners
looked on. The brain activity of both the subjects and their partners
was monitored before, during, and after the wound infliction. Results
revealed that the insula in both the subjects' and partners' brains
became activated right after the wound was inflicted. In other words,
as the subjects felt pain in reaction to the wound, their partners
"felt" their pain as well-in other words, experienced the emotion of
compassion.

Also, feelings have both a mental and physical component, Damasio
pointed out. For example, during combat and while in a great state of
fear, a soldier can become wounded, yet not feel any pain. "We have
this way of fooling ourselves about the body," Damasio said.

Consciousness: The Great Unknown

Finally, when it comes to consciousness, which Webster's New Collegiate
Dictionary defines as "the quality or state of being aware, especially
of something within oneself," a few glimmerings of knowledge been
obtained. For example,"emotions and feelings are obligate presences in
consciousness," Damasio declared. "I think I am on solid ground in
saying that." Nonetheless, a vast number of questions about
consciousness still lack answers.

For instance, what is the evolutionary value of consciousness? No one
is sure, but Damasio speculates that one of its values is that "it can
help you deal with situations that are unpredictable," and one way by
which it can do so is by "allowing you to manipulate images in a
process of thought." Yet another value of consciousness, Modell
believes, is that it benefits "approach behavior." In other words, he
explained, people can engage in avoidance behaviors without being
conscious of it, yet they need consciousness to engage in approach
behaviors-say, selecting a mate.

Are patients in a coma conscious? No one knows, but Damasio thinks not.
Consciousness, he explained, includes not only brain activity but a
sense of self. So even though stimulation can activate parts of the
brain of comatose patients, they probably do not have a sense of self.

When people talk in their sleep, are they conscious? Probably to some
degree, Damasio speculated, because consciousness seems to be necessary
for speaking. And the same holds for sleepwalking, he reasoned. "But
I'm not sure," he confessed. "All I know about consciousness and
sleepwalking comes from Lady MacBeth."

And how about people who assume more than one personality? Do they have
more than one consciousness? Damasio believes not because he has never
heard of anyone simultaneously engaging in multiple personalities. Yet
an analyst in the audience challenged his conclusion: "I have worked
with patients who have exhibited more than one personality at one
time."


http://pn.psychiatryonline.org/cgi/content/full/41/5/13?etoc

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