275. The Disrupted Mind (4)
2 (35m 24s):
I mean, it's, they're conceptual the confusions. They are maybe, maybe sometimes political, I don't know, but there are definitely ways in which we, we also need, I think also psychological and sociological. We need to have solid answers. We need to label our disorders, our not a disorder, sorry. We need to label our unease because if we didn't have a label for it, and somebody tells us this pathology, it's not normal, then we'll sometimes feel better. But is that really always the case? And is that really do as a service? I mean, that's an open question as well. I think that the history of medical labeling and psychiatric labeling this complex, and it's also, again, it's also true that there is this continuum.
2 (36m 17s):
And I agree. I mean, I think as I say, also, we all know we're all potential patients. We're pretty fragile. I mean, we're pretty resilient, but they're also pretty fragile. This both doesn't take much to wipe out a whole memories. Some of the first patient of the book, Vanessa, this happens to her and, you know, she wakes out of this hypo, hypoglycemic coma, H you know, she's 36 or something when she has this. And she wakes up out in the last 10 years of her life, how did that happen? We don't quite know. It's definitely pathological though. When I saw her, she came across as completely normal person, perfectly functional. So these questions are quite complicated. And what happens to us to the sense of self in these cases is, is complex.
2 (37m 2s):
There's another element, which is the interim, which is the self and memory, right. Which is another, another thing. I mean, as you were saying before minute, we can, confabulator about having have a memory that we actually didn't have. That mean if I'm here, something that didn't happen to us, but it's not kind of fibrillation. It's actually, it's Mr. Membrane. And we do it all the time. And the memory is not at all seamless thing. It's a process dynamic. It's never fixed. And so we are constantly creating our meaning. And I think what defines us as humans is the need to create meaning autobiographical, meaning to get back to what you were starting with before. I mean, we need to do that all the time.
2 (37m 45s):
And even then when you were quite ill and it's true, I mean, in the case of the, of the goods, I think as patient, in the case of my mother, we need to have some kind of coherence, always for reasons that also can be interrogated.
1 (38m 4s):
Is it your sense that it is a continuum or a spectrum, but at some point a quantitative difference or decline in memory becomes qualitatively different when you hit a certain line, as they say, if you can't remember where you put your car keys, that doesn't mean you're suffering from dementia, but if you've you've, you hold up your car keys and say, what are these four? You have no idea what a car is. Then you probably have dementia, you know? So where is that line? And, and is, you know, the diagnosis seems pretty important. You know, it's kind of the social nature of science that you have a committee or a group of people that says, well, we've decided if you have eight of the 12 of these symptoms, we're gonna call this schizophrenia or whatever in the DSM.
1 (38m 52s):
And, and so there is something of a subjectivity to it, but at some point there's a biological factor at work and you can kind of track it quantitatively and say there at that point, there's a pathological problem.
2 (39m 6s):
Absolutely. Yes, absolutely. And I saw that in action in the clinical room, I saw exactly how they were conducting their examinations. And it was fascinating. I mean, the, so starting with the NMS, as many of the medical history, the patient presented very detailed way with a kind of, you know, with the, with the history of, for pharmaceuticals, what are the doctors diagnosed with episodes and the chronology being extremely crucial. I mean, I, the patient, the patients, those patients from chronology, wasn't clear with the hardest diagnosis. And then when the patient came in, sometimes with family, there are all these stages of examination starting with, you know, what brings you here to see what the patient themselves, what, what awareness the patient themselves has and then the questioning and then examination of the traditional neurological exams can be clapping, can be walking, jumping can be writing, can be naming animals, all these various things that are really what neurologists, the tools neurologists have, which were developed and standardized.
2 (40m 22s):
And this seems to be pretty solid tools to see where, what a patient is doing. One of the neurologists, there were two neurologists, senior neurologists in that room were both brilliant. One of them was able to surmise what part of the brain might be affected purely by doing these examinations. It was like a living MRI is quite fascinating.
1 (40m 48s):
You mean from behavior,
2 (40m 50s):
From behavior. Yeah. Brilliant. Wow.
1 (40m 53s):
Really
2 (40m 53s):
Brilliant. Yeah, yeah, yeah, yeah, no, I was in the presence of great doctors. Really?
1 (40m 58s):
Yeah. Is it your sense that your mother had some sense that things were starting to slip away? I remember my stepmother had some, some dementia. It wasn't clear what the proper diagnosis was, but, but then I remember having a conversation with her. She had, she was not a college educated woman, but she had seen a Nova program on how the brain works with the little neurons firing and, and she remembered seeing like the little sparks between the gaps between my neurons. And I just feel like they're not working. She had a sense for a while. Things were starting to slip away and she was trying to kind of hang to them and figure out strategies to navigate that. And then at some point it just got, so she wasn't even aware anymore.
1 (41m 40s):
Did you have that experience with your mom? And is that common for something like dementia?
3 (41m 46s):
Yes, sure.
2 (41m 48s):
She would get really upset if we told her she was wrong because she thought, well, do you think I'm crazy? She would say, I'm not crazy. Right. That's what she was. She was, she was very proud person and did not like to feel humiliated. So it was a fine, you know, act to try to figure out how to deal with some issue, some situations, for sure. I think that most people who have dementia in their family have experienced that.
3 (42m 20s):
I think it's sure.
1 (42m 23s):
Yeah. So you also talk again, back to the sense of self, you know, there are philosophers and neuroscientists who think it's an illusion. There is no self there's, no, it's not in the pineal gland. You're not going to do a brain scan. Oh, it's right there. But it, you know, okay. Maybe it's an illusion like freewill and agency, but you know, it's a powerful illusion. It works. And I do have a sense of who I am, you know, and maybe it's fluid, it's flexible, it's changing. But I think of it as like you're in a, like a fuzzy set, you know, it's kind of fuzzy on the border, but th there's kind of boundaries or you're in a canal and there's, there's, you know, walls and you kind of bounce around and move around between the walls. But there's kind of a set of characteristics, a set of memories, a set of personality dimensions.
1 (43m 7s):
I'm extroverted this level and I'm conscientious at that level to go through the big five, something like that. And while it may change a little bit through the life span, it's fairly stable. And I, you know, it may be my memories of being in high school or whatever my 50th anniversary is coming up here for my high school reunion. It's like, yeah, maybe I've kind of distorted things, but I kind of have a general sense that that's who I was then this is who I am now. And there's kind of a continuity to it held together by those memories from one moment to the next. And isn't that a reasonable definition of a self?
2 (43m 44s):
Yes. I think William James, who was the psychologist who really created sidetracked psychology and the states and elsewhere who's be returned to the fore. Now with all this new kind of psychology that's happening now has a fantastic chapter on the self and the principles of psychology 1890, which I love book. I love, I love William James and yeah. The different kinds of ways of defining the self. One of them being, yes, all these various, you know, certain beliefs and, and possession, even things positions are proud of the cell Close, you know, certain modes.
2 (44m 27s):
And even my book on the humorous, I mean, it sends the humor is we're supposed to also, you know, your moral, your major, your moral portrait was a portrait of the cell, even though there was no such concept as the cell for most of the history of that. I think a lot of philosophers today are interested in, especially in the, in the tradition of phenomenology or interested in using certain Buddhist conceptions of the self as actually an illusion, as you were saying before. And then there is, well, this Dunn's a Javier is also phenomenologist who talks about a minimal self and which corresponds broadly to a Demasio calls the core self.
2 (45m 12s):
So those are different from the kinds of the kind of self autobiographical self that we, that is dependent upon continuing to of memory. And you could say that, and, you know, you could say that there are these various levels as the Mazda develops in self comes to mind, as the book read, particularly develops this notion, right from the core self, you have other levels of selfhood, which bloom into consciousness, and self-consciousness eventually it against.
2 (45m 55s):
We define our, the self in relation to the other. And that's a very important notion. So we are more to more than just the minimal or core self, which is that column. I think you're referring to what you could refer it to a Yogi would refer to it as I have to have the breadth, the central column of breath, because even a good image, which is real, which is not much of much of a muchness, but it's basically our sense, our own sense of being alive. The stuff has also just the notion of agency that I am the author of my actions and also of, of body of the body belongs to yourself, having a block on the word.
2 (46m 43s):
But that's, that's a very important aspect of it as well. So that now that I am the author of the action and that my actions actually have made by me, and those are, are there's an, a census is constantly again dynamically then on a process of constant centralizing of everything we do by this thing, we call the self. And I think the self is a process. I don't think it's a thing. I think everything's a process and there's philosopher. John Dupre has developed this very well as a philosopher of biology and it's at the gate, again, an idea that's gaining traction. It's very useful and it does retain, we joined in many ways, some Eastern philosophies like terrorism, certain aspects of what does it mean that all, some aspects of gender is a very, and it's another world, but it does rejoin those ideas.
