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The Feeling of What Happens Body and Emotion in the Making of Consciousness

The Feeling of What Happens Body and Emotion in the Making of Consciousness

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How is it that we know what we know? How is it that our conscious and private minds have a sense of self? A gifted medical clinician and scientific thinker, Damasio helps readers to ask and answer questions about what it is to be human. His elegant investigation of feeling and emotion offers a new understanding of the conscious mind and, as the New York Times has noted, “will change your experience of yourself.”
How is it that we know what we know? How is it that our conscious and private minds have a sense of self? A gifted medical clinician and scientific thinker, Damasio helps readers to ask and answer questions about what it is to be human. His elegant investigation of feeling and emotion offers a new understanding of the conscious mind and, as the New York Times has noted, “will change your experience of yourself.”

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  • T. S. ELIOT "Dry Salvages" from Four Quartets
  • JORIE GRAHAM "Notes on the Reality of the Self" from Materialism
  • Stepping into the Light • Absent without Leave • The Problem of
  • chapter four The Hint Half Hinted 107
  • Unconsciousness and Its Limits • The Merits of Consciousness •
  • Will We Ever Experience the Consciousness of Another? • Where Does
  • Bv Feeling and by Light • Under the Light
  • PART I
  • Chapter Two Emotion and Feeling
  • The Brain Knows More than the Conscious Mind Reveals
  • Sharpening the Definition of Emotion: An Aside
  • The Substrate for the Representation of Emotions and Feelings
  • Chapter Three Core Consciousness
  • The Music of Behavior and the External Manifestations of Consciousness
  • Chapter Five The Organism and the Object
  • One Body One Person: The Roots of the Singularity of Self
  • The Organism's Invariance and the Impermanence of Permanence
  • A Note on the Disorders of the Something-to-Be-Known
  • The Need for a Second-Order Neural Pattern
  • The Nonverbal Nature of Core Consciousness
  • Chapter Seven Extended Consciousness
  • The Neuroanatomical Basis for the Autobiographical Self
  • Chapter Nine Feeling Feelings
  • The Obligate Body-Relatedness of Feeling
  • Chapter Ten Using Consciousness
  • Where Does Consciousness Rank in the Grand Scheme?
  • Some Pointers on the Anatomy of the Nervous System

The disorders of the something-to-be-known fall into two broad categories: perceptual
disorders and agnosias. In perceptual disorders, a lack of signals from a sensory
modality such as vision or hearing or the somatosensory division of touch prevents
the sensory representation of an object from being formed—acquired blindness or
deafness are examples. Under those circumstances, an object X, which was to be
represented by a particular sensory channel, can no longer be represented, fails to
engage the organism in the usual manner, and does not modify the proto-self. The
result is that no core consciousness ensues. Now for the second category, the
agnosias. Agnosia is an obscure but well-formed word that denotes an inability to
conjure up from memory the sort of knowledge that is pertinent to a given object as

object is being perceived. The percept is stripped of its meaning, as an old and
lapidary definition stated so well. The exemplary form of agnosia is the condition
known as associative agnosia, to use technical neurological terms. Associative
agnosia occurs with respect to the main sensory modalities, e.g., there are cases of
visual agnosia, auditory agnosia, and tactile agnosia. Because of their exquisite
specificity, these are some of the most intriguing cases encountered in neurology. As
you will discover in the illustration below, a perfectly sane and intelligent human
being can be deprived of the ability to recognize familiar persons by sight but not by
sound (or vice versa).

It Must Be Me because I'm Here

That is what Emily said cautiously as she contemplated the face in the mirror before
her. It had to be her; she had placed herself in front of the mirror, of her own free will,
so it had to be her; who else could it bel And yet she could not recognize her face in
the looking glass; it was a woman's face, all right, but whose? She did not think it was
hers and she could not confirm it was hers since she could not bring her face back into
her mind's eye. The face she was looking at did not conjure up anything specific in
her mind. She could believe it was hers because of the circumstances: She had been
brought by me into this room and asked to walk to the mirror and see who was there.
The situation told her unequivocally that it could not be anyone else and she accepted
my statement that, of course, it was her.

Yet, when I pressed "play" on the tape deck and let her hear an audiotape of her own
voice, she immediately recognized it as hers. She had no difficulty recognizing her
unique voice even if she could no longer recognize her unique face. This same
disparity applied to everyone else's faces and voices. She could not recognize her

husband's face, her children's faces, or the faces of other relatives, friends, and
acquaintances. However, she could easily recognize their characteristic voices.

Emily was not unlike David in the sense that "nothing came to mind" when certain
specific items were shown to her. But she was

vastly different in the sense that her problem pertained exclusively to the visual world.
Nothing came to mind only when she was shown the visual aspect of a unique
stimulus with whom or with which she was perfectly familiar—a person's face, a
particular house, a particular vehicle. The nonvisual aspects of the same stimulus—
say, sound or touch—brought to mind everything they were supposed to bring.16

Emily did better with the less than unique. Remarkably, she could easily tell that a
face whose identity she could no longer access expressed an emotion. The same was
true of the age and gender of the person who owned a certain face.17

Her problem was

confined to unique items in the visual medium.

How does Emily fare on my core consciousness checklist? The answer is, perfectly. I
do not need to tell you that she is awake and attentive in every way. Her attention
focuses easily and is sustained for all sorts of tasks. Her emotions and the feelings she
reports are entirely normal, too. Her behavior is purposeful and appropriate for all
contexts, immediate as well as long term, limited only by her visual difficulties. In
fact, even in spite of those difficulties, she can do remarkable intellectual feats. She
sits for hours observing people's gaits and tries to guess who they are, often
successfully; she can hold perfect conversations with guests at the receiving line of
her parties, provided her husband whispers the name of the visually unknown person;
and she can find her visually unrecognizable car in the supermarket parking lot by
checking systematically all the license plates.

I do want to call your attention to something quite revealing, however. Not only is she
conscious of what she knows perfectly well, but she is also conscious of what she
does not know. She generates core consciousness for every stimulus that comes her
way regardless of the amount of knowledge she can conjure up about the stimulus.
Emily, as well as the many other patients like her that I have studied over the years, is
perfectly conscious of the things she does not know and she examines those things, in
reference to her knowing self, in the same way she examines the things she does
know. Consider the following experiment we customized for Emily.

We had noted, purely by chance, as we used a long sequence of photographs to test
her recognition of varied people, that upon looking at the photo of an unknown
woman who had one upper tooth slightly darker than the rest, Emily ventured that she
was looking at her daughter.

"Why do you think it is your daughter?" I remember asking her.

"Because I know Julie has a dark upper tooth," she said. "I bet it is her."

It wasn't Julie, of course, but the mistake was revealing of the strategy our intelligent
Emily now had to rely on. Unable to recognize identity from global features and from
sets of local features of the face, Emily seized upon any simple feature that could
remind her of anything potentially related to any person she might be reasonably
asked to recognize. The dark tooth evoked her daughter and on that basis she made an
informed guess that it was indeed her daughter.

To check on the validity of this interpretation, we designed a simple experiment. We
modified a few photos of smiling men and women so that they would show a slightly
darker upper incisor and interspersed them randomly in a stack of many other photos.
Whenever Emily came to a modified photo of any young woman—never the men or
older women—she proclaimed it to be her daughter. She had a keen awareness for the
whole and for the parts of the photos she was shown, or she would have had no
possibility of reasoning as intelligently as she did, item after item, and would have
had no chance of spotting the target stimuli. In the very least, Emily and those like her
demonstrate that one does not require specific knowledge of an item at a unique level
in order to have core consciousness of the item.

When a patient with face agnosia fails to recognize the familiar face in front of her
and affirms that she has never seen that person, that she has no recollection of
anything related to that person, the pertinent knowledge is not being deployed for
conscious survey, but core consciousness remains intact. In fact, once you confront
the patient with the fact that the face before her is that of a close friend, the patient is
not only conscious in general but conscious also of her failure,

Figure 5.2. The lesions that caused prosopagnosia in patient Emily were located at the
junction of the occipital and temporal lobes of both hemispheres. This is the typical
location of lesions in patients with associative prosopagnosia.

conscious of her inability to conjure up any knowledge useful to recognize the close
friend. Her problem is not one of consciousness but of memory. The specific
something-to-be-known is missing—she cannot represent the knowledge of who it is
she is looking at, she cannot be conscious of something now present. But core
consciousness is present as generated by other layers of something-to-be-known —
for instance, the face as face, as opposed to the face of a unique person. It is precisely
because normal core consciousness is present that the recognition void comes to be

Emily's problem was caused by bilateral damage in the early visual cortices,
specifically in the visual association cortices located at the transition of occipital and

temporal lobes in the ventral aspect of the brain. Brodmann's areas 19 and 37, in a
region known as the fusiform gyrus, bore the brunt of the damage.

On the basis of our early neuroimaging correlations regarding face agnosia, almost
two decades ago, we suggested that these cortices were normally involved in the
processing of faces and of other visually ambiguous stimuli that made similar
demands on the brain.18

Current functional neuroimaging experiments support this
idea: normal individuals consistently activate the region damaged in Emily's brain
when they are aware of processing a face.19

It is important to note that activation of

this area in a functional neuroimaging experiment should not

be interpreted as meaning that "consciousness for faces" occurs in the so-called face
area. The image of the face of which the subject is conscious cannot occur without a
neural pattern becoming organized in the face area, but the remainder of the process

that generates the sense of knowing that face and that drives attention to the pattern is

occurring elsewhere, in other components of the system.

The significance of the above qualification is nowhere more clear than when we
consider the following fact: when an unconscious patient in persistent vegetative state
was shown familiar faces, the so-called "face area" (at the occipitotemporal junction,
within the fusiform gyrus) lit up in a functional imaging scan, much as it does in
normal and sentient persons.20

The moral of this story is simple: the power to make
neural patterns for the something-to-be-known is preserved even when consciousness
is no longer being made.

bilateral damage to auditory cortices yields the same results as damage to visual
cortices as far as core consciousness goes. In the same way that Emily does not
conjure up specific knowledge pertinent to unique items, such as the previously
familiar person or object, patients with damage within selected regions of the auditory
sector of the cerebral cortex lose the ability to conjure up specific knowledge
pertinent to, say, a previously familiar melody or the previously familiar voice of a
unique person. The patient known in my laboratory as patient X. illustrates the
situation. He is a highly accomplished and successful opera singer who, as a result of
a stroke, lost the ability to recognize the singing voices of the colleagues with whom
he had performed around the world. As for his own singing voice, he could no longer
recognize it, either. He also lost the ability to identify familiar melodies including
those of arias he had sung hundreds of times in his long career. Just as was the case
with Emily, he had no problem outside the auditory realm and, just as was the case
with Emily, he properly generated core consciousness for the stimuli that he was no
longer able to know in the proper sense of the term. He scrutinized each unrecognized
piece with keen awareness, searching within every

tone, within its color and mode of production, for a possible clue to the identity of the
singer producing it. The only voice he was ever able to recognize unfailingly was that
of Maria Callas, perhaps one more bit of evidence that Callas was indeed a breed

Both Emily and X. have damage within the association cortices, respectively visual
and auditory association cortices. It is apparent, then, from the study of numerous
cases like theirs, that extensive damage in those sensory cortices does not compromise
core consciousness. When it comes to extensive damage of early sensory cortices,
only damage to the somatosensory regions causes a disruption of consciousness, for
the reasons adduced earlier: the somatosensory regions are part of the basis of the
proto-self, and their damage can easily alter the basic mechanisms of core

now that we know how the brain can put together the neural patterns that represent an
object, and the neural patterns that represent an individual organism, we are ready to
consider the mechanisms that the brain may use to represent the relationship between
the object and the organism—the causal action of the object on the organism and the
resulting possession of the object by the organism.

Chapter Six

The Making of Core Consciousness

The Birth of Consciousness

How do we ever begin to be conscious? Specifically, how do we ever have a sense of
self in the act of knowing? We begin with a first trick. The trick consists of
constructing an account of what happens within the organism when the organism
interacts with an object, be it actually perceived or recalled, be it within body
boundaries (e.g., pain) or outside of them (e.g., a landscape). This account is a simple
narrative without words. It does have characters (the organism, the object). It unfolds
in time. And it has a beginning, a middle, and an end. The beginning corresponds to
the initial state of the organism. The middle is the arrival of the object. The end is
made up of reactions that result in a modified state of the organism.

We become conscious, then, when our organisms internally construct and internallv
exhibit a specific kind of wordless knowledge — that our organism has been changed
by an object—and when such

knowledge occurs along with the salient internal exhibit of an object. The simplest
form in which this knowledge emerges is the feeling of knowing, and the enigma
before us is summed up in the following question: By what sleight of hand is such
knowledge gathered, and why does the knowledge first arise in the form of a feeling?

The specific answer I deduced is presented in the following hypothesis: core

consciousness occurs when the brain's representation devices generate an imaged,

nonverbal account of how the organism's own state is affected by the organism's

processing of an object, and when this process enhances the image of the causative

object, thus placing it saliently in a spatial and temporal context. The hypothesis
outlines two component mechanisms: the generation of the imaged nonverbal account

of the object-organism relationship—which is the source of the sense of self in the act
of knowing — and the enhancement of the images of an object. As far as the sense-of-
self component is concerned, the hypothesis is grounded on the following premises:

1. Consciousness depends on the internal construction and exhibition of new
knowledge concerning an interaction between that organism and an object.

2. The organism, as a unit, is mapped in the organism's brain, within structures that
regulate the organism's life and signal its internal states continuously; the object is
also mapped within the brain, in the sensory and motor structures activated by the
interaction of the organism with the object; both organism and object are mapped as
neural patterns, in first-order maps; all of these neural patterns can become images.

3. The sensorimotor maps pertaining to the object cause changes in the maps
pertaining to the organism.

4. The changes described in 3 can be re-represented in yet other maps (second-order
maps) which thus represent the relationship of object and organism.

5. The neural patterns transiently formed in second-order maps can become mental
images, no less so than the neural patterns in first-order maps.

6. Because of the body-related nature of both organism maps and second-order maps,
the mental images that describe the relationship are feelings.

I note, again, that the focus of our inquiry here is not the matter of how neural patterns
in any map become mental patterns or images— that is the first problem of
consciousness as outlined in chapter 1. We are focusing on the second problem of
consciousness, the problem of self.

As far as the brain is concerned, the organism in the hypothesis is represented by the
proto-self. The key aspects of the organism addressed in the account are those I
indicated as provided in the proto-self: the state of the internal milieu, viscera,
vestibular system, and musculoskeletal frame. The account describes the relationship
between the changing proto-self and the sensorimotor maps of the object that causes
those changes. In short: As the brain forms images of an object—such as a face, a
melody, a toothache, the memory of an event—and as the images of the object affect
the state of the organism, yet another level of brain structure creates a swift nonverbal
account of the events that are taking place in the varied brain regions activated as a
consequence of the object-organism interaction. The mapping of the object-related
consequences occurs in first-order neural maps representing proto-self and object; the
account of the causal relationship between object and organism can only be captured
in second-order neural maps. Looking back, with the license of metaphor, one might
say that the swift, second-order nonverbal account narrates a story: that of the

organism caught in the act of representing its own changing state as it goes about

representing something else. But the astonishing fact is that the knowable entity of the
catcher has just been created in the narrative of the catching process.

This plot is incessantly repeated for every object the brain represents, and it does not
matter whether the object is present and interacting with the organism or is being
brought back from past memory. It also makes no difference what the object really is.
In healthy individuals, as long as the brain is awake, the machines of image making
and consciousness are "on," and we are not manipulating our mental

state by doing something like meditation, it is not possible to run out of "actual"
objects or "thought" objects, and it is thus not possible to run out of the abundant
commodity called core consciousness. There are just too many objects, actual or
recalled, and often there is more than one object at about the same time. The same
imaged plot is supplied in abundance to the flowing process we call thought.1

The wordless narrative I propose is based on neural patterns which become images,
images being the same fundamental currency in which the description of the
consciousness-causing object is also carried out. Most importantly, the images that
constitute this narrative are incorporated in the stream of thoughts. The images in the
consciousness narrative flow like shadows along with the images of the object for
which they are providing an unwitting, unsolicited comment. To come back to the
metaphor of movie-in-the-brain, they are within the movie. There is no external

Now let me conclude my presentation of how I think core consciousness arises, by
addressing the second component in the hypothesis. The process which generates the
first component—the imaged nonverbal account of the relationship between object
and organism— has two clear consequences. One consequence, already presented, is
the subtle image of knowing, the feeling essence of our sense of self; the other is the
enhancement of the image of the causative object, which dominates core
consciousness. Attention is driven to focus on an object and the result is saliency of
the images of that object in mind. The object is set out from less-fortunate objects —
selected as a particular occasion in both the Jamesian and Whiteheadian senses. It
becomes fact, following the preceding events which lead to its becoming, and it is part
of a relationship with the organism to which all this is happening.

You Are the Music while the Music Lasts: The Transient Core Self You know that you
are conscious, you feel that you are in the act of knowing, because the subtle imaged
account that is now flowing in the stream of your organism's thoughts exhibits the
knowledge that your pro to-self has been changed by an object that has just become

salient in the mind. You know you exist because the narrative exhibits you as
protagonist in the act of knowing. You rise above the sea level of knowing, transiently
but incessantly, as a felt core self, renewed again and again, thanks to anything that
comes from outside the brain into its sensory machinery or anything that comes from
the brain's memory stores toward sensory, motor, or autonomic recall. You know it is

you seeing because the story depicts a character— you—doing the seeing. The first
basis for the conscious you is a feeling which arises in the re-representation of the

nonconsaous proto-self in the process of being modified within an account which

establishes the cause of the modification. The first trick behind consciousness is the
creation of this account, and its first result is the feeling of knowing.

Knowing springs to life in the story, it inheres in the newly constructed neural pattern
that constitutes the nonverbal account. You hardly notice the storytelling because the
images that dominate the mental display are those of the things of which you are now
conscious—the objects you see or hear—rather than those that swiftly constitute the
feeling of you in the act of knowing. Sometimes all you notice is the whisper of a
subsequent verbal translation of a related inference of the account: Yes, it is me
seeing or hearing or touching. But, faint as it may be, half guessed as the hint often is,
when the storytelling is suspended bv neurological disease, your consciousness is
suspended as well and the difference is monumental.3

T. S. Eliot might as well have been thinking of the process I just described when he
wrote, in the Four Quartets, of "music heard so deeply that it is not heard at all," and
when he said "you are the music while the music lasts." He was at least thinking of
the fleeting moment in which a deep knowledge can emerge—a union, or incarnation,
as he called it.

Beyond the Transient Core Self: The Autobiographical Self Something does last after
the music is gone, however; some residue does remain after many ephemeral
emergences of core self. In complex organisms such as ours, equipped with vast
memory capacities,

the fleeting moments of knowledge in which we discover our existence are facts that
can be committed to memory, be properly categorized, and be related to other
memories that pertain both to the past and to the anticipated future. The consequence
of that complex learning operation is the development of autobiographical memory,
an aggregate of dispositional records of who we have been physically and of who we
have usually been behaviorally, along with records of who we plan to be in the future.
We can enlarge this aggregate memory and refashion it as we go through a lifetime.
When certain personal records are made explicit in reconstructed images, as needed,
in smaller or greater quantities, they become the autobiographical self. The real
marvel, as I see it, is that autobiographical memory is architecturally connected,
neurally and cognitively speaking, to the noncon-scious proto-self and to the emergent
and conscious core self of each lived instant. This connection forms a bridge between
the ongoing process of core consciousness, condemned to sisyphal transiency, and a
progressively larger array of established, rock-solid memories pertaining to unique
historical facts and consistent characteristics of an individual. In other words, the
body-based, dynamic-range stability of the nonconscious proto-self, which is
reconstructed live at each instant, and the conscious core self, which emerges from it
in the second-order nonverbal account when an object modifies it, are enriched by the
accompanying display of memorized and invariant facts—for instance, where you
were born, and to whom; critical events in your autobiography; what you like and
dislike; your name; and so on. Although the basis for the autobiographical self is
stable and invariant, its scope changes continuously as a result of experience. The
display of autobiographical self is thus more open to refashioning than the core self,
which is reproduced time and again in essentially the same form across a lifetime.

Unlike the core self, which inheres as a protagonist of the primordial account, and
unlike the proto-self, which is a current representation of the state of the organism, the
autobiographical self is based on a concept in the true cognitive and neurobiological
sense of the term.

Table 6.1. Kinds of Self

AUTOBIOGRAPHICAL SELF: The autobiographical self is based on
autobiographical memory which is constituted by implicit memories of multiple
instances of individual experience of the past and of the anticipated future. The
invariant aspects of an individual's biography form the basis for autobiographical
memory. Autobiographical memory grows continuously with life experience but can
be partly remodeled to reflect new experiences. Sets of memories which describe
identity and person can be reactivated as a neural pattern and made explicit as images
whenever needed. Each reactivated memory operates as a "something-to-be-known"
and generates its own pulse of core consciousness. The result is the autobiographical
self of which we are conscious.

CORE SELF: The core self inheres in the second-order nonverbal account that occurs
whenever an object modifies the proto-self. The core self can be triggered by any
object. The mechanism of production of core self undergoes minimal changes across a
lifetime. We are conscious of the core self.

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