October 8, 2000

In his book, Descartes’ Error Emotion, Reason, and the Human Brain, Antonio Damasio discusses the connection between feelings, reason and the body. His hypothesis is that the three are completely interconnected and that it is impossible to discuss the functions of one without realizing that the other two play a role. This is an important idea as for centuries, scientists considered the body to be a separate entity from the brain. Damasio presents case studies in which he attempts to demonstrate his findings of the connection between emotion and reason and these examples prove to be accurate for what they are. He does not state, however, in the end that he has, beyond a doubt, demonstrated that his hypothesis is true. He, in fact, leaves his hypothesis open to further consideration and questioning by the reader and other scientists. Damasio makes it clear that not only does he want the reader to comprehend what he is talking about but he also wants the reader to think about his hypothesis and come up with some questions and hypothesis of their own.

Damasio’s hypothesis is a very significant statement because it has the potential to change the way that doctors and others regard illness as well as the role of emotions in the body and in decision-making. Damasio says, "this is Descartes’ error: the abyssal separation between body and mind…the suggestion that reasoning, and moral judgment, and the suffering that comes from physical pain or emotional upheaval might exist separately from the body." (p. 249-250). Damasio suggests that the things and events that affect the body will also have an affect on the mind. He states that the reverse would be true as well. This implies that physical diseases or deformities, such as the loss of a limb, can have repercussion seen on both a physical and mental level. Damasio discusses the "phantom limb" (p. 152) in which "after surgical amputation, some patients imagine the missing limb as if it were still there. They are even capable of perceiving imaginary modifications in the state of the nonexistent limb, such as a particular motion, pain, temperature, and so on." (p. 152). Although the limb is no longer in place, and the patient it well aware that the limb is no longer there, they still can feel its presence as though that limb is just where it always was. They can feel things in the missing limb because their mind tells them that they can. Damasio also states that the patients get worried and upset when they begin to loose the sensation of the limb. This example is one that shows that the mind has control over some of the sense that the body feels. It is not only the physical senses with which we feel because if it were, it would not be possible to have sensation in the limb after it was removed.

Damasio also discusses how changes in the brain can have repercussions on the body. In discussing the neurochemistry of primates, Damasio states that, "Serotonin is one of the main neurotransmitters…one of the roles of serotonin in primates is the inhibition of aggressive behavior…when neurons in which serotonin originates are blocked from delivering it, one consequence is that the animals behave impulsively and aggressively." (p.76). This change in brain chemistry ends up having a great effect on the physical aspect of behavior. The animals began to act differently and ended up putting their bodies in different situations than they normally would have. For example, simply because there was a lack of serotonin in the brain, a primate might get into a physical altercation and might end up getting wounded when, if his brain chemistry had been normal he would never have entered into the fight. This is just one example though of the way that changes in the mind can, and almost always do, have some affect on the body.

Damasio spends a long time discussing patients that he worked with who had frontal lobe damage. It was through these patients that Damasio realized that emotion and reason were bound together to create a full, happy life. Damasio uses two main examples, Phineas Gage and a man who Damasio called Elliot. Both of these men had had some sort of frontal lobe damage, Phineas had had a three foot seven inch long iron rod shot through his skull damaging the frontal lobes, and Elliot had had a brain tumor which had destroyed parts of his frontal lobes and the damaged parts were removed along with the tumor. Damasio was Elliot’s doctor and so he had first hand experience with Elliot and he realized that "the structures destroyed in both Gage and Elliot happened to be those necessary for reasoning to culminate in decision making" (p. 39). Because of this inability to make decisions, both men were unable to hold jobs and were unable to maintain the lifestyle that they had had before the accident. Also, in working with Elliot, Damasio realized that Elliot had, in a sense, lost his emotional ability. "We might summarize Elliot’s predicament as to know but not to feel." (p. 45). Damasio realized that there was a strong connection between living a complete life and having both emotions and reason. "Reduction in emotion may constitute an equally important source of irrational behavior" (p. 53). Emotion and reason are so interwoven that one cannot behave "normally" if one of the aspects is missing. Damasio holds that emotion is crucial to making decisions because not all of the decisions that we make can be reasoned out. Damasio discusses the "somatic marker" (p. 173), which is a basic, emotional response, a "gut reaction", to things, and this somatic marker serves as a guide to making decisions. Damasio holds that all decisions cannot be made solely on reason and therefore the absence of emotion and the "somatic marker" lead to the inability to make decisions because one aspect of the decision-making process is missing.

Damasio presents the reader with a great deal of evidence regarding his findings with his patients and the evidence is very strong considering that there is so much that is unknown about the brain and its parts. Damasio discusses in depth what happened to Phineas Gage and what was done about it. He also describes the experiments done on Elliot and their outcomes. Damasio then backs up his findings with examples of patients who had similar frontal lobe damage to Elliot’s and Gage’s and whose outcomes on certain experiments were as expected. One set of experiments that Damasio describes in detail is the "Gambling Experiments" (p. 212). Here, people were split up into groups, those who had frontal lobe damage and then the control group, and they were told to pick cards from piles A, B, C, and D. In two of the piles, the player would receive money and in two of the piles, the player would loose money. The only catch was that the player stood a chance of loosing a large sum of money when he picked from the piles that normally gave money. The behavior of the patients with frontal lobe damage "was diametrically opposed to that of normal individuals" (p. 214). They took more risk in loosing money and the patients with frontal lobe damage were more likely to go bankrupt than those whose brains were normal. Damasio attributes this to the fact that the patients with frontal lobe damage are no longer capable of feeling emotions. Damasio states "you cannot formulate and use adequate "theories" for you mind and for the mind of others if something like the somatic marker fails you" (p. 219). The gambling experiment appears to be good evidence of Damasio’s hypothesis that emotion and reason are interwoven.

That is not to say that the evidence that Damasio presents is complete. There is still a great deal of things that we do not know about the brain and so there is no way that there can be complete evidence. There are too many unknowns in the experiments that are done. For example, there are many other factors in life that could affect the outcome of the experiments on the brain like the patient’s upbringing, whether or not he was abused as a child, as well as their sex. There is much discussion about how male and female brains are different and if there are differences then these differences could have a strong affect on the outcomes of the tests. There is no way to get a perfect control group in which there are no other outside factors because there is too little known about the brain to be able to specify which outside factors have influence on which parts of the brain. There is no solid evidence yet that can prove that emotion and reason are tied together because there is so little known about the brain, yet Damasio is able to work with what knowledge he has to present the reader and other scientists with pretty strong evidence that emotion, reason and the body are interwoven.

Damasio, however, does not try to convince the reader that his hypothesis is absolutely correct. He, in fact, encourages the reader to take a step further and to come up with ideas and questions of their own. One of the questions that Damasio’s hypothesis raised in my mind is if one cannot live a well-balanced life without emotions, can one live a well-balanced life without reason? It seems unlikely that one would be able to have a complete life without reason and with only emotion though, because whereas one cannot make decisions without emotions, or the somatic marker, one probably cannot make decisions with only emotions and without reason because the decision making process demands both instinct and analysis and it is not possible to make good decisions without one or the other. Another question that Damasio’s hypothesis raises is how much is physical health dependant on mind set? There is something that has been called the "will to live" which implies that if one’s mind is strong enough and if one has enough drive to live, it is possible to recuperate. This idea implies that the mind is able to control the health of the body because if the mind wills the body to be strong, it becomes strong. It is amazing to think that the mind has that much power, but Damasio’s hypothesis implies that the mind and body are so connected that it could be possible.

Damasio presents the reader with an interesting hypothesis: that emotions and reason are connected and it is impossible to live a complete life in the absence of one of these factors. He presents adequate evidence backing up his hypothesis, considering that there are so many unknowns about the brain. It is with these unknowns that Damasio is able to raise the curiosity of the reader because he does not stipulate that his hypothesis is the only correct one. Damasio knows that those unknowns will stay that way unless more people question the mind and question the existing hypothesis. He asks the reader to take his statements and expand and question them in order to progress in the study of the brain in the hopes that eventually, all those unknowns will disappear and the brain will cease to be a mystery.