The traditional conception of self-deception takes it for an intrapersonal form of interpersonal deception. However, since the same subject is at the same time deceiver and deceived, this means attributing the agent a pair of contradictory beliefs. In the course of defending a deflationary conception of self-deception, Mele [1997] has challenged traditionalists to present convincing evidence that there are cases of self-deception in which what he calls the dual belief-requirement is satisfied. Levy [2009] has responded to this challenge affirming that (...) there is at least one real cases of self-deception that meets this requirement, namely, that of anosognosia. In this family of conditions, the patient apparently believes that there is nothing wrong with her while, at the same time, providing behavioral cues that indicate that the patient is somehow aware of his disease. If Levy is right, then traditionalism about self-deception could be vindicated, after having been widely abandoned due to its need to postulate exotic mental processes in order to make sense of the attribution of contradictory beliefs. In this paper, I assess whether Levy’s response to Mele’s challenge is successful by analyzing his interpretation of the empirical evidence to which he appeals. Finally, I attack the cogency of the underlying commitments about the nature of folk psychology to which one is required to defer in order to draw from conflicting evidence the attribution of contradictory beliefs. (shrink)

This paper reviews the literature concerning the neural correlates of the self, the relationship between self and memory and the profile of memory impairments in Alzheimer’s disease and explores the relationship between the preservation of the self and anosognosia in this condition. It concludes that a potential explanation for anosognosia in AD is a lack of updating of personal information due to the memory impairments characteristic of this disease. We put forward the hypothesis that anosognosia is due (...) in part to the “petrified self.”. (shrink)

Anosognosia is literally ‘unawareness of or failure to acknowledge one’s hemi- plegia or other disability’ (OED). Etymology would suggest the meaning ‘lack of knowledge of disease’ so that anosognosia would include any denial of impairment, such as denial of blindness (Anton’s syndrome). But Babinski, who introduced the term in 1914, applied it only to patients with hemiplegia who fail to acknowledge their paralysis. Most commonly, this is failure to acknowledge paralysis of the left side of the body following (...) damage to the right hemisphere of the brain. In this paper, we shall mainly be concerned with anosognosia for hemiplegia. But we shall also use the term ‘anosognosia’ in an inclusive way to encompass lack of knowledge or acknowledgement of any impairment. Indeed, in the construction ‘anosognosia for X’, X might even be anosognosia for some Y. (shrink)

Proprioception, a sense of bodily position and movement, is rarely the focus of conscious experience. If we are ordinarily conscious of proprioception, we seem only peripherally so. Thus, evidence that proprioception is present in the periphery of at least some conscious experiences seems to be good evidence that conscious experience is fairly rich. Anosognosia for paralysis is a denial of paralysis of one's limbs, usually in the wake of brain damage from stroke. Because anosognosic patients overlook their paralysis, (...) class='Hi'>anosognosia seems be a counter-example to the claim that proprioception exists in the periphery of conscious experience. However, careful consideration of the data shows that anosognosia makes a poor counterexample to a rich theory of consciousness. Thus, we retain reason to believe that proprioception exists in the periphery of conscious experience, and so to conclude that conscious experience is relatively rich. (shrink)

Anosognosia for hemiplegia is the denial of neurologically-caused paralysis, and it often co-occurs with a number of distortions of belief and emotion such as somatoparaphrenia and an exaggeration of negative affect towards minor health complaints. The salience of these latter symptoms led early investigators to propose explanations of AHP which construed it as a process of motivated self-deception against the overwhelming anxiety and depression that knowledge of deficit would otherwise cause, and which was observed in hemiplegic patients without the (...) anosognosia. Since some influential critiques of this approach, however, theories of this kind have largely been rejected on the grounds that they are inappropriately “psychogenic.” What has replaced them are a class of theories which explain the lack of awareness in terms of neurocognitive deficit, with the deficit in question variously described by researchers as involving spatial awareness, motor control, and other capacities. In this paper I argue – contra claims in the literature – that the patterns of explanation which are characteristic of the psychodynamic theory are not incompatible in principle with the notion that the illness involves neurocognitive deficit. That means that these patterns of explanation can be preserved where they make good sense of the obscure attitudinal and emotional symptoms that occur in AHP – symptoms that are otherwise difficult to explain. I suggest some ways in which this fact could be accommodated by deficit theories of the illness which are based on motor deficit. (shrink)

Patients with right parietal lesions often deny their paralysis , but do they have "tacit" knowledge of their paralysis? I devised three novel tests to explore this. First, the patients were given a choice between a bimanual task vs a unimanual one . They chose the former on 17 of 18 trials and, surprisingly, showed no frustration or learning despite repeated failed attempts. I conclude that they have no tacit knowledge of paralysis . Second, I used a "virtual reality box" (...) to convey the optical illusion to the patient that she was moving her paralyzed left hand up and down to the rhythm of a metronome, and yet she showed no sign of surprise. Third, I irrigated patient BM′s left ear canal with cold water, a procedure that is known to shift that patient′s spatial frame of reference by stimulating the vestibular system. Surprisingly, this allowed her "repressed" memory of paralysis to come to the surface; she said she had been paralyzed continuously for several days. I suggest that the vestibular stimulation produces these remarkable effects by mimicking REM sleep. These patients also emply a whole arsenal of grossly exaggerated Freudian "defense mechanisms" to account for their paralysis. To explain this, I propose that in normal individuals the left hemisphere ordinarily deals with small, local anomalies by trying to impose consistency but, when the anomaly exceeds threshold, an interaction with the right hemisphere forces a "paradigm shift". A failure of this process, in patients with right hemisphere damage, might partially account for anosognosia. Finally, I present a new conceptual framework that may help link several psychological and neurological phenomena such as Freudian defense mechanisms, vestibular stimulation, anosognosia, memory repression, visual illusions, anterograde amnesia, REM sleep, dreaming, and humor. (shrink)

There are researchers in cognitive science who use clinical and experimental evidence to draw some rather skeptical conclusions about a central feature of our conscious experience, its unity. They maintain that the examination of clinical phenomena reveals that human consciousness has a much more fragmentary character than the one we normally attribute to it. In the article, these claims are questioned by examining some of the clinical studies on the deficit of anosognosia. I try to show that these studies (...) support a moderate sense of the unity of reflexive consciousness. (shrink)

Somatoparaphrenia is a pathology of self characterized by the sense of alienaton from parts of one’s body. It is usually construed as a kind of delusional disorder caused by extensive right hemisphere lesions. Lesions in the temporoparietal junction are common in somatoparaphrenia but deep cortical regions (for example, the posterior insula) and subcortical regions (for example, the basal ganglia) are also sometimes implicated (Valler and Ronschi 2009). Patients are often described as feeling that a limb belongs to another person and (...) thus attribute ownership of the limb and bodily sensation to someone else. There is also some question as to whether or not the higher-order thought (HOT) theory of consciousness can plausibly account for the depersonalization psychopathology of somatoparaphrenia (Liang and Lane 2009, Rosenthal 2010, Lane and Liang 2010). Liang and Lane argue that it cannot. The HOT theory of consciousness says that what makes a mental state a conscious mental state is that it is the target of a HOT to the effect that “I am in mental state M” (Rosenthal 2005, Gennaro 2012). When the HOT is itself is unconscious, the conscious state is still outer-directed. When the HOT is conscious, we have introspection and so the conscious thought is directed at the mental state. In section I, I briefly review the previous exchange between Lane and Liang and David Rosenthal. In section II, I further explore somatoparaphrenia and the nature of delusion while offering a number of additional replies to Lane and Liang. In section III, I examine the central notions of “mental state ownership” and “self-concepts” in an effort to account especially for the depersonalization aspect of somatoparaphrenia against the background of HOT theory. In section IV, I argue that to the extent that somatoparaphrenia casts doubt on the notion that some thoughts are “immune to error through misidentification” (IEM), the most fundamental aspect of IEM is still consistent with HOT theory. Overall, I argue that HOT theory is left unscathed by the pheneomenon of somatoparaphrenia and can even help to explain what happens in these cases. (shrink)

The study of anosognosia has witnessed an unprecedented increase in interest over the last 20 years. This has resulted in numerous empirical investigations as well as theoretical writings on the nature of human consciousness and how disorders of the brain may influence the person's subjective awareness of a disturbed neurological or neuropsychological function. This edited text summarizes many of the advances that have taken place in the field of anosognosia. It reviews research findings on anosognosia for hemiplegia (...) following stroke, Anton's syndrome, and a variety of disorders in which impaired self-awareness is common. It also provides suggestive guidelines for the management and rehabilitation of persons who have anosognosia or impaired self-awareness. (shrink)

Anosognosia for hemiplegia is a lack of awareness about paralysis following stroke. Recent explanations use a ‘forward model’ of movement to suggest that AHP patients fail to register discrepancies between internally- and externally-generated sensory information. We predicted that this failure would impair the ability to recall from memory whether information is internally- or externally-generated . Two experiments examined this prediction. Experiment 1 demonstrated that AHP patients exhibit a reality monitoring deficit for non-motor information , whilst hemiplegic controls without (...) class='Hi'>anosognosia perform like age-matched healthy volunteers . Experiment 2 explored if this deficit occurs when AHP patients discriminate performed, imagined, or observed movement. Results showed impaired reality monitoring for movements in AHP and nonAHP patients relative to HVs. Findings suggest that reality monitoring processes not directly related to movement, together with a failure to reality monitor movements, contribute to the pathogenesis of AHP. (shrink)

Hysteria has been the subject of controversy for many years, with theorists arguing about whether it is best explained by a hidden organic cause or by malingering and deception. However, it has been shown that hysterical paralysis cannot be explained in any of these terms. With the recent development of cognitive psychiatry, one may understand psychiatric and organic delusions within the same conceptual framework. Here I contrast hysterical conversion with anosognosia. They are indeed remarkably similar, though the content of (...) their respective delusions is the opposite. In hysterical paralysis, patients are not aware of their preserved ability, whereas in anosognosia for hemiplegia, patients are not aware of their disability. Four main explanations have been provided to account for anosognosia: metacognitive, attentional, motor, and motivational views. I will apply each of these accounts to hysterical paralysis and show that, at each level, hysterical conversion is the reverse of anosognosia. I will suggest that hysterical paralysis results from the interaction between attentional somatosensory amplification and affective inhibition of action. (shrink)

Anosognosia for visual deficits—cases where significant visual deficits go unnoticed—challenges the view that our own conscious experiences are what we know best. We review these widespread and striking failures of awareness. Anosognosia can occur with total blindness, visual abnormalities induced by brain lesions, and eye diseases. We show that anosognosia for visual deficits is surprisingly widespread. Building on previous accounts, we introduce a framework showing how apparently disparate forms of anosognosia fit together. The central idea is (...) that, to notice a deficit, individuals need to form expectations about normal vision, compare expectations and visual input, and judge any mismatch at the metacognitive level. A failure in any of these three steps may lead to unawareness of visual deficits. (shrink)

Block's P-/A-consciousness distinction rules out P's involving a specific kind of cognitive access and commits him to a “strong” Pconsciousness. This not only confounds plausible research in the area but betrays an anosognosia about Wittgenstein's diagnosis about our philosophical “introspection” of mysterious inner processes.

Currently, the number of patients diagnosed with impaired self-awareness of their own deficits after brain injury—anosognosia— is increasing. One reason is a growing understanding of this multifaceted phenomenon. Another is the development and accessibility of alternative measurements that allow more detailed diagnoses. Anosognosia can adversely affect successful rehabilitation, as often patients lack confidence in the need for treatment. Planning such treatment can become a complex process full of ethical dilemmas.To date, there is no systematic way to deal with (...) different aspects of anosognosia rehabilitation planning. This is the first article to present a framework for ethical decision making in establishing rehabilitation plans that are focused on increasing patients’ self-awareness of their own deficits after brain injury. It concentrates especially on addressing the ethical dilemmas that may arise, and describes stepwise procedures that can be applied to distinct theoretical approaches, as well as diagnostic and rehabilitation methods. To show the flexibility of the use of this framework, alternative approaches are discussed. (shrink)

Itsaso Colás Blanco, Mónica Triviño Mosquera y Ana B. Chica Martínez Dept. de Psicología Experimental y … Read More →.

This book explores the important yet neglected relationship between the philosophy of time and the temporal structure of perceptual experience. It examines how time structures perceptual experience and, through that structuring, the ways in which time makes perceptual experience trustworthy or erroneous. -/- Sean Power argues that our understanding of time can determine our understanding of perceptual experience in relation to perceptual structure and perceptual error. He examines the general conditions under which an experience may be sorted into different kinds (...) of error such as illusions, hallucinations, and anosognosia. Power also argues that some theories of time are better than others at giving an account of the structure and errors of perceptual experience. He makes the case that tenseless theory and eternalism more closely correspond to experience than tense theory and presentism. Finally, the book includes a discussion of the perceptual experience of space and how tenseless theory and eternalism can better support the problematic theory of naïve realism. -/- Philosophy of Time and Perceptual Experience originally illustrates how the metaphysics of time can be usefully applied to thinking about experience in general. It will appeal to those interested in the philosophy of time and debates about the trustworthiness of experience. (shrink)

This collection of essays focuses on the interface between delusions and self-deception. As pathologies of belief, delusions and self-deception raise many of the same challenges for those seeking to understand them. Are delusions and self-deception entirely distinct phenomena, or might some forms of self-deception also qualify as delusional? To what extent might models of self-deception and delusion share common factors? In what ways do affect and motivation enter into normal belief-formation, and how might they be implicated in self-deception and delusion? (...) The essays in this volume tackle these questions from both empirical and conceptual perspectives. Some contributors focus on the general question of how to locate self-deception and delusion within our taxonomy of psychological states. Some contributors ask whether particular delusions - such as the Capgras delusion or anosognosia for hemiplegia - might be explained by appeal to motivational and affective factors. And some contributors provide general models of motivated reasoning, against which theories of pathological belief-formation might be measured. (shrink)

When a person with dementia (PwD) makes a specific request or behaves in a particular way that is inappropriate or dangerous and based on a false understanding of reality, there is a particular technique that caregivers may use to try and manage the situation. The technique is known as ‘diversion’ and it works by affirming the false beliefs and behaviour of a PwD and creating the false impression that their specific request will be fulfilled. It may take the form of (...) an explicit lie or any other communicative response or provision of care that either explicitly or tacitly affirms their false beliefs. It therefore raises the same kind of ethical issues as when lying (or not telling the truth) is done for so called ‘therapeutic’ purposes. The main type of argument used to justify this so called ‘therapeutic lying’ is that it is primarily aimed at benefiting the patient rather than the liar. The same kind of argument can be made for diversion, which is that it is primarily aimed at benefiting the PwD by aiming to ensure their safety and well-being. I argue that insofar as diversion is practiced in this way, it is consistent with the idea of ‘person-centred care’ (PCC) and can be ethically justified on those grounds. Therefore, however, we must be wary of situations where diversion is not practiced in this way, where it is primarily aimed at benefiting caregivers or care providers, and thus inconsistent with PCC. (shrink)

The sense of embodiment is vital for self recognition. An examination of anosognosia for hemiplegia—the inability to recognise that one is paralysed down one side of one’s body—suggests the existence of ‘online’ and ‘offline’ representations of the body. Online representations of the body are representations of the body as it is currently, are newly constructed moment by moment and are directly “plugged into” current perception of the body. In contrast, offline representations of the body are representations of what the (...) body is usually like, are relatively stable and are constructed from online representations. This distinction is supported by an analysis of phantom limb—the feeling that an amputated limb is still present—phenomena. Initially it seems that the sense of embodiment may arise from either of these types of representation; however, an integrated representation of the body seems to be required. It is suggested information from vision and emotions is involved in generating these representations. A lack of access to online representations of the body does not necessarily lead to a loss in the sense of embodiment. An integrated offline representation of the body could account for the sense of embodiment and perform the functions attributed to this sense. (shrink)

Except for a patina of twenty-first century modernity, in the form of logic and language, philosophy is exactly the same now as it ever was; it has made no progress whatsoever. We philosophers wrestle with the exact same problems the Pre-Socratics wrestled with. Even more outrageous than this claim, though, is the blatant denial of its obvious truth by many practicing philosophers. The No-Progress view is explored and argued for here. Its denial is diagnosed as a form of anosognosia, (...) a mental condition where the affected person denies there is any problem. The theories of two eminent philosophers supporting the No-Progress view are also examined. The final section offers an explanation for philosophy 's inability to solve any philosophical problem, ever. The paper closes with some reflections on philosophy 's future. (shrink)

Mulder and colleagues [Mulder, T., Hochstenbach, J., Dijkstra, P. U., Geertzen, J. H. B. . Born to adapt, but not in your dreams. Consciousness and Cognition, 17, 1266–1271.] report that a majority of amputees continue to experience a normally-limbed body during their night dreams. They interprete this observation as a failure of the body schema to adapt to the new body shape. The present note does not question this interpretation, but points to the already existing literature on the phenomenology of (...) the phantom limb in dreams. A summary of published investigations is complemented by a note on phantom phenomena in the dreams of paraplegic patients and persons born without a limb. Integration of the available data allows the recommendation for prospective studies to consider dream content in more detail. For instance, “adaptation” to the loss of a limb can also manifest itself by seeing oneself surrounded by amputees. Such projective types of anosognosia in nocturnal dreams should also be experimentally induced in normally-limbed individuals, and some relevant techniques are mentioned. (shrink)

Theories of self-deception divide into those that hold that the state is characterized by some kind of synchronic tension or conflict between propositional attitudes and those that deny this. Proponents of the latter like Al Mele claim that their theories are more parsimonious, because they do not require us to postulate any psychological mechanisms beyond those which have been independently verified. But if we can show that there are real cases of motivated believing which are characterized by conflicting propositional attitudes, (...) however, the parsimony argument against incongruent mental state accounts is undermined. I argue that anosognosia presents us with a real-life example of motivated belief together with (sub)-doxastic conflict. (shrink)

Self-knowledge is a difficult thing. Many have had the experience of knowing that a friend or partner is in a bad mood before she herself realizes it. Similarly, with mental illness it seems that a person may be sick without realizing it, or even while denying it outright. Anosognosia, the lack of awareness that one is mentally ill, is most visible in cases of dementia or brain damage, but recent insights in psychology have shown that healthy human beings too (...) generally lack accurate introspective awareness in matters of our own well-being.1 Getting this right—whether or not someone is flourishing2 psychologically—is crucial in psychiatry, and self-report cannot always be relied upon.At the same time, many have been... (shrink)

Tim Bayne and Elisabeth Pacherie (2007) propose an integrated model for agentive awareness that incorporates features from both the narrator and the comparator-based accounts found in the literature. Although they think the comparator system is responsible for generating the bulk of agentive experience, they believe the narrator module is responsible for forming agentive judgments and conceptually-laden intentions. Crucially, they also suggest that in some instances the narrator module may “override” the deliverances of the low-level comparator mechanisms. In this paper, I (...) apply Bayne and Pacherie’s integrated model to account for an issue in the psychopathology literature, namely the presence of anosognosia (i.e. ignorance with respect to one’s illness) in anorexia nervosa. In particular, I show that by implementing the integrated model we can solve a problem that arises out of a recent advancement in the empirical literature concerning anorexia’s pathogenesis and persistence. If my proposal is correct, the explanatory power of implementing an integrated model for agentive awareness would bolster Bayne and Pacherie’s account. It may also be of use to researchers seeking to develop a better understanding of anosognosia in anorexia nervosa, which remains a poorly understood feature of the disorder. (shrink)