In the Mind Fields by Casey Schwartz

Author:Casey Schwartz
Language: eng
Format: epub, azw3
Publisher: Knopf Doubleday Publishing Group
Published: 2015-08-24T16:00:00+00:00

More than a decade after Solms walked into the room of Mrs. S., the famous neurologist Vilyanur Ramachandran published his own thoughts about the curious condition of anosognosia.

“Anosognosia is an extraordinary syndrome about which almost nothing is known,” he begins, in his book Phantoms in the Brain.

Ramachandran is a behavioral neurologist and an expert on the visual system. He doesn’t come from a psychological background. In Phantoms in the Brain, he reports on his breakthrough patient, Mrs. Macken, a woman who had a right-sided stroke and became paralyzed on the left side of her body. In his examination, Ramachandran found Mrs. Macken to be “anosognosic for her paralysis”; she reported that her arms were “equally strong” and that she could move both of them normally. But Ramachandran had read of an experiment by an Italian neurologist, named Bisiach, who’d observed that pouring ice cold water in the patient’s ear—a fairly routine procedure called caloric stimulation—had the effect of temporarily dispelling the patient’s “unawareness.” Ramachandran decided to test this out on Mrs. Macken.

“How are you feeling?” he asked her, after pouring the freezing water into her left ear.

“My ear’s cold,” she said.

“What about your arms? Can you use your arms?”

“No,” she said. “My left arm is paralyzed.”

“Mrs. Macken,” Ramachandran said. “How long have you been paralyzed?”

“Oh, continuously, all these days.”

Within twelve hours, however, Mrs. Macken retreated to her anosognosic position, professing to have no memory of her earlier confession, nor any knowledge of the paralysis itself. The cold water had functioned like hypnosis used to in cases of hysteria: while under its spell, the patient could admit to all kinds of things that normally, consciously, she was unable to acknowledge.

It was the case of Mrs. Macken, Ramachandran writes, that introduced to him the possibility that a Freudian mechanism was at work in these right hemisphere patients. He knew so little about psychoanalysis, but what else could this be if not a good old case of repression?

“It is the vehemence of the denial—not a mere indifference to paralysis—that cries out for an explanation,” Ramachandran writes.

He turned to the literature. It was impossible to ignore: the defense mechanisms Freud so elaborately describes were blatantly at work in the right hemisphere patients Ramachandran was seeing. He recognized denial and repression. Also, reaction formation: the compensatory strategy by which you swear the extreme opposite of what you suspect is actually true. It was common, for instance, for anosognosic patients to make wildly inflated claims about the strength of their left arms, adamant that they could pull off physical feats that they wouldn’t have been able to do even if they weren’t paralyzed. Ramachandran was astonished to find that Freud might have been onto something.

“When I began this research about five years ago, I had no interest whatsoever in Sigmund Freud,” he writes. “And like most of my colleagues, I was very skeptical of his ideas. The entire neuroscience community is deeply suspicious of him because he touted elusive aspects of human nature that ring true but that cannot be empirically tested.

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