Descartes’ Error: 25 Years After Its Publication

Descartes’ Error: Emotion, Reason and the Human Brain

by Antonio Damasio

AVON Books, 316 pp. (1994)

Welcome to Throwback Reviews, a monthly review of a science book that has been available to the public for some time, and still has a prevalent impact.

Twenty-five years have passed since the publication of Descartes’ Error: Emotion, Reason and the Human Brain by Portuguese neurologist Antonio Damasio. The book opened a new perspective on emotion, specifically on reason and behavior. In fact, the book has been cited over 28,000 times in the following years. Damasio’s beautiful writing and particular examples and studies on cases, including the famous Phineas Gage case, make this book a landmark in the study of the mind, the body and human life in general.

Twenthy-Five Years After Descartes’ Error

Emotion and Rational Thinking

Antonio Damasio’s introduction in 1994 opens with the following statement: “I had been advised early in life that sound decisions came from a cool head, that emotions and reason did not mix any more than oil and water.” He later adds:

“I began writing this books to propose that reason may not be as pure as most of us think it or wish it were, that emotions and feeling may not be intruders in the bastion of reason at all: they may be enmeshed in its networks, for worse and for the better.”

After formulating his plea on why emotions could play a more significant role in the mind and in life, Damasio starts a tour de force that goes from history to an incredible theory that still plays on in many studies and research.

The first part of the book is dedicated to the comprehension of unique neurological cases; the first one being Phineas Gage, the railroad worker who was struck by an iron rod after an explosion. Such accident destroyed part of Gage’s frontal lobe and changed his behavior forever. As science has shown, the frontal lobe is like an executive: it inhibits emotions, controls attention, plays a more significant role in decision making, and can even set goals.

Before Gage was damaged by the iron rod, he was a well-behaved citizen of New Hampshire. A leader in his work, a family man, someone that many look up to. But after the accident, things changed. His behavior became erratic, expelling profanities. He became an alcoholic and couldn’t get his life together. What was more striking was his inability to make good decisions or plan. He worked in many places, but never settled and died in California. As many friends and family said, “Gage was no longer Gage.”

The Modern Phineas Gage

When you read Damasio’s book you question why he would put that story on the front – the story is stable in the history of neurology and science. But, in the ensuing chapters, such case-study begins to blossom into a larger point that Damasio wants to make.

Damasio later throws in the story of his patient – a modern case like that of Gage. Elliot, as Damasio writes, had a lesion in his prefrontal cortex and exhibited almost the identical behavior of Gage. Damasio describes:

“Elliot had been a good husband and father, had a job business firm, and had been a role model for younger siblings and colleagues. He had attained an enviable personal, professional, and social status. But his life began to unravel. He developed severe headaches, and soon it was hard for him to concentrate. As his condition worsened, he seemed to lose his sense of responsibility, and his work had to be completed or corrected by others. His family physician suspected that Elliot might have a brain tumor. Regrettably, the suspicion proved correct.”

Such complaints led to the removal of a tumor the size of an orange that had destroyed tissue from the frontal lobe. After that, Elliot’s life was changed. He made terrible deals and investments that lead his family to economic problems and couldn’t concentrate on one thing or maintain the focus on something that would lead to a decision. Elliot was regarded as a knowledgeable person, but suddenly, he was making irrational decisions.

Feelings and Emotions

From then on, Damasio explains in great details why this case-studies matter and what is the larger point that they bring us. He describes the difference between emotion and feelings, and how they arise. He writes of the first:

“Emotion is the combination of a mental evaluative process, simple or complex, with dispositional responses that process, mostly toward the body proper, resulting in an emotional body state, but also toward the brain itself (neurotransmitter in the nuclei in brain stem), resulting in additional mental changes.”

Damasio distinguishes emotions and feeling stating that “not all feelings originate in emotions.” As the chapter progresses, he introduces the concept of background feelings. “A background feeling corresponds instead to the body state prevailing between emotions”, notes Damasio. He furthers explains, “When we feel happiness, anger, or another emotion, the background feeling has been superseded.”

The Grand Theory

After 165 pages of detailed descriptions of neurological cases, the interplays of mind and body, and the distinction of emotion and feelings, Damasio introduces his grand theory. Such a theory has survived more than 20 years and can apply to many corners of our society. This theory was named The Somatic-Marker Hypothesis.

The theory broke down old scientific “facts” and tackled the infamous mind-body problem of philosopher Rene Descartes. The old mind-body problem stems from the iconic phrase of Descartes, Cogito Ergo Sum or “I think, therefore I am.”

Lisa Feldman Barrett, the author of How Emotions are Made, describes the Somatic-Marker Hypothesis as the following:

“According to the somatic marker hypothesis, an emotion’s unique physical fingerprint (changes in heart rate, breathing, hormones, muscle tone, facial expression, etc.) is a ‘somatic marker’: a source of information used by the brain to make good decisions. Damasio writes that an emotion (including anger, disgust, fear, sadness, joy, shame, contempt, pride, compassion, and admiration) is an “action program” that triggers a biologically preset, stereotypical, and very specific bodily reaction and facial expression (i.e., an emotion fingerprint). The body sends sensory information about these specific bodily patterns to the brain where they are represented as “somatic markers” that can be used to aid decision-making. These body changes can also be experienced consciously as emotional feelings. Emotion, and emotional experience, are different phenomena.”

The somatic-marker theory became apparent for Hanna and Antonio Damasio when some of their patients with frontal lobe damage were put to the test. In a now famous series of “games,” the Damasio laboratory showed a unique pattern of decision making in these patients with frontal damage.

Why Was The Somatic-Marker Theory So Important?

Patients with frontal lobe damage are shown to have a disconnection with their state of emotions. For example, when put to the test of skin-conductance, participants with no frontal lobe damage elicit a reaction (shown in the SC test) when seeing disturbing pictures. Patients with frontal lobe damage, however, didn’t elicit any response at all. The stone-cold mythological creature that doesn’t let emotions get on his way was right in front of Damasio. But how rational were the decisions of these patients?

Hanna Damasio and his colleagues designed the now famous Iowa Gambling Task. Here’s a description of such an experiment:

“The task involves four decks of cards, named A, B, C and D. The goal is to maximize profit on a loan of play money. Subjects are required to make a series of 100 card selections, but are not told ahead of time how many card selections they are going to be allowed to make. Cards can be selected one at a time, from any deck, and subjects are free to switch from any deck to another, at any time and as often as they wish. The decision to select from one deck or another is largely influenced by schedules of reward and punishment. These schedules are pre-programmed and known to the examiner, but not to the subject (Bechara et al., 1994, 1999a). They are arranged in such a way that every time the subject selects a card from deck A or B, s/he gets $100, and every time deck C or D is selected, the subject gets $50. However, in each of the four decks, subjects encounter unpredictable money loss (punishment). The punishment is set to be higher in the high-paying decks A and B, and lower in the low-paying decks C and D.”

What these experiments showed was intriguing. First, since these patients with frontal lobe damage lacked any real ability on future predictability, their decisions tended to go for the now than later in the future. Second, they were still sensitive to punishment, but their decision remained illogical. Third, as Damasio explains, “somatic-state mechanism acts as a booster to maintain and the optimize working memory and attention concerned with scenarios of the future.”

Last Word on the Legacy of Descartes’ Error

Finally, Damasio goes after Descartes, the primary name of his book and the target of his theory. The separation of mind and body has influenced how people view the brain and its relationship with the body. As Damasio proves, such claims are errors and “pervades both research and practice” in medicine. It neglects the psychological effect that one can have during a disease. Moreover, it plains into a distinction which compares how medicine and psychology treat their patients. Damasio unifies the view of the brain (mind) and the body, and how its interactions play a more significant role in how we behave, decide, and react.

Many would think that Descartes’ Error is a flawless book, but it has its critics. Some claim that the attack on Descartes by Damasio wasn’t accurate. Moreover, many philosophers still cling to such view and pronounce that neuroscience can’t close the gap between our rich experiences (like feeling and perceiving the redness of blood) and the biological processes of the brain. Some think that the studies done by Damasio aren’t enough to prove his theory and that new experiments should be done.

Despite this, Damasio’s book is an influential one. He didn’t stop on Descartes’ Error, he further wrote The Feeling of What Happens: Body, Emotion and the Making of Consciousness and Looking for Spinoza: Joy, Sorrow, and the Feeling Brain in the late 1990s and in the early 2000s. Moreover, other books putting emphasis on how emotions play a bigger role than previously thought started to appear after the publication of Descartes’ Error. In 1995, psychologist Daniel Goleman jumped the boat and wrote the now iconic book Emotional Intelligence. Joseph LeDoux also brought into the conversation his piece of the puzzle, with his equally masterful book The Emotional Brain: The Mysterious Underpinning of Emotional Life.

Damasio himself has become a rockstar, and his tackling of the mind and body problem has gathered much attention. The field on the study of consciousness has blossomed in many research institutes. Suddenly, Descartes’ Problem has become everyone’s problem. Moreover, efforts on improving the emotional life of patients, students, and employees are becoming more apparent. It has become more of common sense how important are emotions and the damaging effect of neglecting them. Twenty-five years later, the legacy of Descartes’ Error lives on.

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