COGNITIVE NEUROPSYCHIATRY, 1996, 1 (2), 181±184

A Reply to McGilchrist’s Review of Descartes’ Error Antonio R. Damasio University Iowa College of Medicine, USA

I had agreed to provide the Editors of this Journal with a comment on a possible review of Descartes’ error. After reading McGilchrist’ s review (McG heretofore) I was reluctant to reply. This is because hardly a paragraph goes by without revealing some misprision of the text and producing some misrepresentation of my words. But the Editors insisted and so here is my answer, focused on the most salient misjudgements. To begin with, McG reviews the book as if it were about Descartes and about philosophy. The Introduction however makes clear that the book is, instead, about the neurobiology of reason and emotion. In the last page of the Introduction I specifically clarify that the text is ``. . . neither about Descartes nor about philosophy. . .’ ’ and that it is ``. . . about mind, brain, and body’ ’ . I also indicate, in conversational tone, that the text is ``under the sign of Descartes, since there was no way of approaching such themes without evoking the emblematic figure who shaped the most commonly held account of their relationship’’ . The discussion on Descartes’ error itself, in Chapter 11, also makes clear that, as a frame to a text on the neurobiology of emotion and reason, I am not so much attacking Descartes (whom I even credit with the possibility of not having fully meant what he wrote), as calling attention to the fact that Descartes’ key ideas on the issue of mind and body have had, and continue to have, a negative influence on scientific thinking. McG states that there are two aspects to my book. ``One is the reporting of findings derived from the careful study of a handful of individuals with lesions in the ventromedial prefrontal cortex; this work is ingenious, painstaking, original, but in itself necessarily circumscribed’ ’ . This is very nice but I fail to see why it is ``circumscribed’ ’ . He goes on: ``The other [aspect] is the expansion of these findings into the realm of philosophical speculation about the way in which we make choices and decisions’ ’ . This is a complete misrepresentation of my work. In a volume of over 300 pages I find one paragraph and four-and-ahalf pages dealing with philosophical issues (though none actually with what 1996 Psychology Press, an imprint of Erlbaum (UK) Taylor & Francis Ltd

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McG calls ``philosophical speculation’’ ). The book is through and through about findings from my laboratory and from others’ , drawn from the fields of neurology, experimental neuropsychology, cognitive psychology, and a host of other areas in biology. There is indeed an ``expansion’ ’ of the key findings but it is not into the realm of philosophy. The expansion is, rather, into the realm of testable hypotheses and theoretical frameworks within systems biology. The hypotheses address the explanation of complex behavioural and cognitive phenomena in organismic, biological terms and part of the book is even concerned with reporting on the validation of such hypotheses in ongoing experimental work. McG has apparently reviewed a nonexisting book which he imagined after reading a small part of mine. Perhaps the most astonishing misrepresentation comes with McG’ s statement that I show ``a reluctance to acknowledge that feelings play anything other than a supporting role’ ’ . McG lectures me and the reader on the idea that ``feeling is not just an add-on, a flavoured coating for thought; it is at the core of our being, and reason emanates from that central core of the emotions, in an attempt to limit and direct them, rather than the other way around’ ’ . He concludes this comment with an epiphany: ``. . . your feelings are yours alone; I feel therefore I am.’ ’ McG’ s words are quite astonishing considering that they sum up precisely the substance and point of my book, and the motive behind its subtitle: ``Emotion, reason, and the human brain’ ’ . There have been about 100 reviews of my book and virtually all understood this. So did the book’ s many readers. Some reviewers have in fact summarised my book with the words ``I feel, therefore I am,’ ’ which was one of the working titles of the manuscript for a long time. The book is replete with paragraphs making this point, and why McG did not get the idea is a mystery. But here is a clueÐ McG states: ``Yet later we find him stating rather limply: emotions are not a luxury . . .’ ’ ``Later’ ’ then what? This sentence of mine appears on the fifth page of the Introduction. Did McG read on? And why is the statement that emotions are not a luxury ``limp’ ’ or timid? Another unfortunate misinterpretation appears after McG transcribes the following passage of mine: ``In a departure from current neurobiological thinking, I propose that the critical networks on which feelings rely include not only the traditionally acknowledged collection of brain structures known as the limbic system but also some of the brain’ s prefrontal cortices, and, most importantly, the brain sectors that map and integrate signals from the body.’ ’ His take on this statement is that ``most brain researchers in psychiatry are familiar with the idea that we cannot think in terms of isolated regions’ ’ . It is wonderful to learn that psychiatry researchers know about distributed systems, but of course that is beside the point. The point, which McG misses, is the substance of my proposal for what constitutes the critical network. McG continues, ``So I would see Damasio’ s contribution here as guiding our attention to specific areas rather than, as he seems to see it, revolutionising our conception of how the

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brain works.’ ’ Nowhere do I claim to revolutionise anything, but I do claim that the understanding of the neural systems which subserve emotion has not included the brain structures which integrate signals from the body, and have, only infrequently, focused on the prefrontal cortices. McG fails to understand what is at issue. Less astonishing but quite grievous is McG’ s idea that my proposals require ``an ultimate executive centre somewhere’ ’ . Again McG did not grasp the ideas in Chapters 5 and 10. I clearly state that there is no ultimate executive centre; that there is no ``Cartesian theatre’ ’ ; that there is no homunculus; that subjectivity is generated in a bootstrapping process that occurs over time; that subjectivity is an organism ``state’ ’ . It is apparent that McG did not understand the somatic marker hypothesis. For instance, after quoting my statement that ``. . . feelings point us in the proper direction, take us to the appropriate place in the decision-making space, where we may put the instruments of logic to good use’ ’ , he wonders ``why stop at this point?’ ’ But of course we do not stop at this point! The engagement of somatic markers occurs for the triggering situations, for the possible options of action, and for the possible immediate and long-term outcomes. The process of ``marking’ ’ is continuous over time. Emotion and reason, overtly or covertly, are engaged continuously, along parallel lines. Not surprisingly, McG’ s description of my ``as if’ ’ mechanism is a complete distortion. McG wonders aloud: ``I suppose an obvious question is whether all reasoning is so easily tied in. Damasio carefully restricts himself to reasoning in the social and personal domain.’ ’ Obvious question indeed and one that I debate and answer in Chapter 8 although McG missed the relevant passage. Says he: ``What it does not cover, obviously, is abstract reasoning such as mathematical and some kinds of scientific and philosophic, reasoning.’’ Well, maybe so and maybe no. I clarify that I began by thinking that the hypothesis would be applicable only to the social and personal domain, but ultimately I favour a more ample application and even invoke Henri PoincareÂas a support of this view. (Incidentally, McG offers part of the quote by Henri PoincareÂwhich I included in my book without properly indicating that it comes from my text and allowing the reader to think that this is McG’ s counter of my view.) McG believes that ``the overall thesis of the book [that feelings have a role to play in reason] is one that most people would accept’’ but then he opines: ``The really interesting question is why Damasio should have to say itÐ and I do not doubt that someone did have to.’ ’ Perhaps if McG would consider the history of neuroscience, the history of artificial intelligence, and even the history of psychology, as far as reason and emotion are concerned, he would not puzzle over the need to defend such an idea, about the value of it being understood, and about the advantage of grounding it on scientific observation rather than on common sense views of how human beings behave. McG seeks to devalue my proposals by implying that the essence of my ideas has been in the minds of

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some poets and philosophers for centuries. But again that is precisely the point I make clear throughout the book when I refer to Aristotle, or Pascal, or Hume. My goal is to allow scientific evidence to test the poetic idea and perhaps make it more acceptable if it can be empirically supported. What a pity McG overlooked this. Upon encountering my statement that ``certain sceptics who objected that they lacked experience of anything bodily as they went about their own thinking’’ , McG wondered if these sceptics were schizophrenics or just philosophers? WOW! Alas, they were not, they were just unpretentious, smart folk, with far fewer certainties than McG. Manuscript received 26 January 1996