Why this book: Selected by Jay H’s reading group – an eclectic group of about 10 fascinating and curious people – baseball coaches, teachers, businessmen, veterans, consultants.  We met weekly to discuss this book – one chapter at a time.

Summary in 3 Sentences: In Descarte’s Error, Damasio argues against Descarte’s famous epigram Cogito, ergo Sum – “I think, therefore I am” to make the point that who we think we are, is much more than our ability to think and reason.  From many different directions, Damasio argues against the traditional mind-body dualism, that mind and body are fully integrated, and our existence is defined by much more and much more complicated than simply THAT we think. Our physiology and biology have a much greater affect on our thoughts, our sense of identity, our ability to reason, exercise judgement and make decisions than most of us realize. 

My Impressions: Damasio is a neuroscientist who has studied the brain and mind and explored the various bio and neural mechanisms that help explain how we think, decide, and behave. He describes Descarte’s error as the “dualist notion with which Descarte split the mind from the brain and the body…and the modern variants of this notion.” p247.  He says he wrote the book as an exercise to help him see if he could explain his insights and research in simple, non-medical terms to a lay person, and in so doing possibly find holes in his thinking.  Being that lay person, he only partially succeeded – I believe I understood his main points, but when he got into more detailed explanations, he often lost me. 

It is NOT a simple book to read, and I sometimes felt like a 3rd grader trying to read a book on – well – neuro-biology, but in parts,  his prose is clear and flows easily; in other parts I struggled to follow him. That said, I learned a lot – especially from the conversations we had in our reading group with smart lay people from multiple walks of life, many of whom also often felt like third graders reading Descarte’s Error, but each of us got different insights out of each “assigned” chapter that enriched our discussion. He certainly achieved his goal of convincing all of us that our thinking and decision making processes includes subtle (and some not-so-subtle) interventions from emotions and other biological functions, and that the human mind is much more complex than simply a bunch of interactions inside our brain housed inside our skull, operating independently of but supported by the body.

The main point of his book is probably summarized here: “The action of biological drives, body states and emotions may be an indispensable foundation for rationality …These lower levels maintain direct and mutual relationships with the body proper, thus placing the body within the chain of operations that permit the highest reaches of reason and creativity.  Rationality is probably shaped and modulated by body signals, even as it performs the most sublime distinctions and acts accordingly.”   p.200

He begins the book with fascinating chapters about two men who had significant injury to their pre-frontal cortices, who could think rationally, and one-on-one in-person, behaved in what seemed a perfectly normal way.  But after it was determined that in spite of outward appearances, their behavior was often irrational, their judgment was severely compromised, and their social interactions were destructive,  they were both studied extensively by doctors and psychologists.  Though both performed well on conventional tests of memory and intellect, this was not reflected in their decision making in real life.  They were emotionally detached from people, and often from the consequences of their decisions, and were unable to predict consequences (good or bad) from their decisions. Damasio points out that though many people try to take emotion out of decision making, these two men were living proof that emotional detachment from decision making  severely compromised the quality of their decisions. 

Damasio used the examples of these two men with apparently intact reasoning and rational faculties,  but who were dysfunctional in their social lives and dealing with the real world,  to show that for successfully adapted humans, there is much more going on in their thinking and decision-making than simply the ability to think logically. 

In his chapter Biological Regulaton and Survival he argues that “For most ethical rules and social conventions,” there is a “meaningful link to simpler goals and to drives and instincts. …Because the consequences of achieving or not achieving a rarefied social goal contribute (or are perceived as contributing) albeit indirectly, to survival and to the quality of that survival.” p125  Yep – our genetically driven biological imperative to survive and thrive is ultimately behind nearly all that we do. 

His chapter Somatic-Marker Hypothesis was for me the most interesting chapter in the book,  in that he explores how the body seems to have its own separate awareness and decision making capacity, and it subtly injects its subconscious insights and desires into our conscious minds and decision making.  He explores the “gut feeling” or intuition, that comes from outside our rational faculties to help us decide what to do – or in some cases decide for us,  when our brains are overwhelmed or acting too slowly to make a life-saving decision.  

He attributes intuition to the body, “the mysterious mechanism by which we arrive at the solution of a problem without reasoning toward it.” p188

He calls these bodily interventions into our thought processes “somatic” markers, after the Greek word for body – soma – and he notes that these somatic interventions increase the accuracy and efficiency of decision making – especially when we are faced with a decision with a possible strong negative outcome. Without the body’s subtle and sometimes not-so-subtle injection of itself into our decision-making, decisions would take an inordinately long time, or our careful and rational consideration of all options could inhibit decision-making entirely.

He points out that when faced with a wide variety of options, “a preselection is carried out for you, sometimes covertly, sometimes not.  A biological mechanism makes the preselection, examines candidates and allows only a few to present themselves for a final exam.” p189 This biological mechanism is part of our innate survival instinct, injecting itself into how we evaluate options and decide.

In his chapter The Body-Minded Brain he argues that “the body provides a ground reference for the mind, “(p223) and that  “when we see or hear or touch or taste or smell, body proper and brain participate in the interaction with the environment.” p224 The body is not merely a life support system for the brain – it is a fully engaged participant in how we think, feel, decide. 

In that same chapter he explores the neural basis for the subjective self,  discussing  the concept of “self,” stating that   “…the self is a repeated reconstructed biological state; it is not a little person, the infamous homunculus, inside your brain contemplating what is going on … not a central knower and inspector of everything that happens in our minds.” p217  What in fact is the self, after we deconstruct so much of what we personally identify with?  A complex question which Damasio spends some time exploring, but not really answering, noting that “today there are plausible if not yet proven hypotheses for the neural basis of the self.” p244  Sam Harris, whose podcasts I listen to frequently, will say that the “self” is an illusion, an artificial construct of all the processes that Damasio describes, that together, give us a “sense” of self and identity.

Several times in the book, he wants to ensure that we do not regard his theories as a purely mechanistic explanation of human behavior and accomplishments. “Realizing that there are biological mechanisms behind the most sublime human  behavior does not imply a simplistic reduction to the nuts and bolts of neurobiology.  In any case, the partial explanation of complexity by something tells complex, does not signify debasement.” p125-6

This is a fascinating book, but not one that can be read quickly.  Each chapter is full of insights and challenges.  I liked reading it with others, a chapter at a time. As a result, I now have a much better appreciation for how my brain operates, how my body is engaged with my brain and the many factors that unconsciously determine how I feel, and how I arrive at decisions.  I also have a much better appreciation for how complex the brain and mind are – and how little even the best neuroscientists understand of how it works.