Is pain where you feel it in the body, or in the brain? Neurophenomenology and the spatial aspect of nociception

Pain is interesting, salient, mysterious. It may feel like it is in one specific place in or on the body. It may feel diffuse, with gradations, or it may seem referred from one area to another. What is happening in the brain and in the body as these spatial aspects of pain are experienced? How much of the causation of pain occurs where we feel it, and how much occurs in the brain? Below is a series of probes and thinking aloud about where pain is, with speculations to stimulate my thinking and yours.  I’m not a “pain expert”, nor a bodyworker that heals clients, nor a physiologist with a specialization in nociception, but a cognitive scientist, with clinical psychology training, interested in body phenomenology and the brain.  Please do post this essay to Facebook, share it, critique, respond, and comment (and it would be helpful to know if your background is in philosophy, neuroscience, bodywork, psychology, medicine, a student wanting to enter one of these or another field, etc). Pain should be looked at from multiple angles, with theoretical problems emphasized alongside clinical praxis, and with reductionistic accounts from neurophysiology juxtaposed against descriptions of the embodied phenomenology and existential structures.  As I have mentioned elsewhere, it is still early in the history of neurophenomenology…let a thousand flowers bloom when looking at pain. We need data, observations, insights and theories from both the experience side as well as the brain side. Francisco Varela aptly described how phenomenology and cognitive neuroscience should relate:

“The key point here is that by emphasizing a codetermination of both accounts one can explore the bridges, challenges, insights, and contradications between them. Both domains of phenomena have equal status in demanding full attention and respect for their specificity.”

We all know what pain is phenomenologically, what it feels like, but how to define it? The International Association for the Study of Pain offers this definition: “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.” Of particular interest to neurophenomenology and embodied cognitive science is their claim that “activity induced in the nociceptors and nociceptive pathways by a noxious stimulus is not pain, which is always a psychological state.” Good that they do not try to reduce the experience of pain to the strictly physiological dimension, but I wonder how Merleau-Ponty, with his non-dualistic ontology of the flesh would have responded. Pain seems to transgress the border of mind and body categories, does it not? I am slowly biting off chucks of the work on pain at the Stanford Encyclopedia of Philosophy. Lots of provocative angles, including this one:

“there appear to be reasons both for thinking that pains (along with other similar bodily sensations) are physical objects or conditions that we perceive in body parts, and for thinking that they are not. This paradox is one of the main reasons why philosophers are especially interested in pain.”

Right now I am particularly interested in the spatial aspect of where pain seems to be, what I might label the spatial phenomenology of nociception. When I introspect on aching parts of my feet, it seems as if the pain occupies a volume of space. Using manual pressure I can find places on my feel that are not sore, right next to areas that are slightly sore, which are in turn near focal areas of highest pain. It seems as if the pain is locatable “down there” in my body, and yet what we know about the nociceptive neural networks suggests the phenomenology is produced by complex interactions between flesh, nearby peripheral nerves, the central nervous system, and neurodynamics in the latter especially. A way of probing this this would be to examine the idea that the pain experience is the experiential correlate of bodily harm, a sort of map relating sensations to a corresponding nerve activated by damage to tissue. So, is the place in my body where I feel pain just the same as where the damage or strain is? Or, Is pain caused by pain-receptive nerves registering what is happening around them, via hormonal and electrical signals? Or is pain actually the nerve itself being “trapped” or damaged, yet in a volume of undamaged tissue one can feel hurts? Could the seeming volume of experienced pain-space be a partial illusion, produced by cognizing the tissue damage as some place near or overlapping with yet not spatially identical to where the “actual” damage is, in other words a case of existential-physiological discrepancy? One scenario could be, roughly, that pain “is” or “is made of” nerves getting signals about damage to tissue; another would be that pain “is” the nerves themselves being damaged or sustaining stress or injury. Maybe pain involves both? Maybe some pain is one, or the other? In terms of remembering how my heel pain started, it’s not so easy, but I love to walk an hour or two a day, and have done so for many years. I recall more than ten years ago playing football in the park, wearing what must have been the wrong sort of shoes, and upon waking the next day, having pretty serious pain in my heel. Here are some graphics that, intuitively, seem to map on to the areas where I perceive the pain to be most focal:

from bestfootdoc.com

from setup.tristatehand.com

from plantar-fasciitis-elrofeet.com

If I palpate my heel, I become aware of a phenomenologically complex, rich blend of pleasure and pain. I crave the sensation of pressure there, but it can be an endurance test when it happens. Does the sensation of pressure that I want reflect some body knowledge, some intuitive sense of what intervention will help my body heal? How could this be verified or falsified? It is not easy to describe the raw qualia of pain, actually. I can describe it as achey and moderately distressing when I walk around, and sharp upon palpating. Direct and forceful pressure on the heel area will make me wince, catch my breath, want to gasp or make sounds of pain/pleasure, and in general puts me in a state of heightened activation. But I love it when I can get a therapist to squeeze on it, producing what I call “pain-pleasure”:

from indyheelpaincenter.com

This diagram below helps me map the sensations to the neuroanatomy. We need to do more of this sort of thing. This kind of representation seems to me a new area for clinical neurophenomenological research (indeed, clinical neurophenomenology in general needs much more work, searching for those terms just leads back to my site, but see the Case History section in Sean Gallagher’s How the Body Shapes the Mind).

from reconstructivefootcaredoc.com

What is producing the pain-qualia, the particular feeling? Without going too far into varying differential diagnosis, it is commonly attributed to plantar fasciitis.  There the pain would be due to nociceptive nerve fibers activated by damage to the tough, fibrous fascia that attach to the calcaneus (heel bone) being strained, or sustaining small ripped areas, and/or local nerves being compressed or trapped. A 2012 article in Lower Extremity Review states that “evidence suggests plantar fasciitis is a noninflammatory degenerative condition in the plantar fascia caused by repetitive microtears at the medial tubercle of the calcaneus.” There are quite a few opinions out there about the role of bony calcium buildups, strain from leg muscles, specific trapped nerves and so forth, and it would be interesting to find out how different aspects of reported pain qualia map on to these. Below you can see the sheetlike fascia fiber, the posterior tibial nerve, and it’s branches that enable local sensations:

from aafp.org

Next: fascia and the innervation of the heel, from below:

from mollyjudge.com

Another view of the heel and innervation:

from mollyjudge.com

Below is a representation of the fascia under the skin:

from drwolgin.com

There is a very graphic,under the skin, maybe not SFW surgeon’s-eye perspective on these structures available here. Heel pain turns out to be very common, and is evidently one of the most frequently reported medical issues. Searching online for heel pain mapping brings up a representation purportedly of 2666 patients describing where they feel heel pain: I can’t find where this comes from originally and can’t speak to the methodology, rigor, or quality of the study, but the supposed data are interesting, as is the implicit idea of spatial qualia mapping:  the correspondence of experienced pain to a volume of space in the body. It also quite well represents where the pain is that I feel. The focal area seems to be where the fascia fibers attach to the calcaneus, an area that bears alot of weight, does alot of work, and is prone to overuse. So, where is the pain? Is it in the heel or the brain? Is it in the tissue, the nerve, or both? Is there a volume of flesh that contains the pain? I am going to have to think about these more, and welcome your input. What about the central nervous system that processes nociceptive afferents coming from the body? A good model of pain neurophenomenology should involve a number of cortical and subcortical areas that comprise the nociceptive neural network: -primary somatosensory cortex (S1) and secondary somatosensory cortex (S2): -insula -anterior cingulate cortex (ACC) -prefrontal cortex (PFC) -thalamus Here are some representations of the pain pathways, or the nociceptive neural network:

from Moisset and Bouhassira (2007)

Moisett el (2009)

 

from Tracey and Mantyh (2012)

Broadly speaking, pain seems to be generated by tissue damage, inflammation, compromising the integrity of tissue, stress on localized regions, and so forth being processed by peripheral afferent pain pathways in the body, then phylogenetically ancient subcortical structures, and then the aforementioned cortical regions or nociceptive neural network.  As I have mentioned many times, making a robust account of how various regions of the brain communicate such that a person experiences qualia or sensory phenomenology will need to reference neurodynamics, which integrates ideas from the physics of self-organization, complexity, chaos and non-linear dynamics into biology.  It is gradually becoming apparent to many if not most workers in the cognitive neurosciences that there are a host of mechanisms regions of the brain use to send signals, and many of these are as time dependent as space dependent. Michael Cohen puts it thusly: “The way we as cognitive neuroscientists typically link dynamics of the brain to dynamics of behavior is by correlating increases or decreases of some measure of brain activity with the cognitive or emotional state we hope the subject is experiencing at the time. The primary dependent measure in the majority of these studies is whether the average amount of activity – measured through spiking, event-related-potential or -field component amplitude, blood flow response, light scatter, etc. – in a region of the brain goes up or down. In this approach, the aim is to reduce this complex and enigmatic neural information processing system to two dimensions: Space and activation (up/down). The implicit assumption is that cognitive processes can be localized to specific regions of the brain, can be measured by an increase in average activity levels, and in different experimental conditions, either operate or do not. It is naïve to think that these two dimensions are sufficient for characterizing neurocognitive function. The range and flexibility of cognitive, emotional, perceptual, and other mental processes is huge, and the scale of typical functional localization claims – on the order of several cubic centimeters – is large compared to the number of cells with unique physiological, neurochemical, morphological, and connectional properties contained in each MRI voxel. Further, there are no one-to-one mappings between cognitive processes and brain regions: Different cognitive processes can activate the same brain region, and activation of several brain regions can be associated with single cognitive processes. In the analogy of Plato’s cave, our current approach to understanding the biological foundations of cognition is like looking at shadows cast on a region of the wall of the cave without observing how they change dynamically over time.” But what of the original question? Is pain where you feel it in the body, or in the brain? It seems to me the answer must be both.  The experience of pain being localized there or a little on the left is a product of local tissue signals and receptor activation, which produces peripheral afferent nerve firing, which gets processed by spinal afferent neurodynamics, brainstem activation, thalamic gating, and then somatosensory, insular, anterior cingulated, and prefrontal cortical regions. Yet the real model of pain, one that invokes mechanisms and causes, remains elusive. And a good model of pain must account for the possibility of pain without suffering as well! For now, what I can offer are probes to get us speculating, thinking critically, and eventually building a clinical neurophenomenology of pain. If that interests you, by all means get involved.

An excerpt from the foundational text of neurophenomenology: Varela, Thompson, and Rosch’s The Embodied Mind

It is very,very gratifying to see interest in neurophenomenology increasing. Welcome! Exciting things are happening. If you feel like you could make a contribution to the field, do it! We are still in the early phase, though probably at the “end of the beginning”. In 1996 you could find about three references online (in mid 2013, Google shows 35,400 results). Around then I got a copy of neurophenomenologist/cognitive scientist Francisco Varela, philosopher Evan Thompson, and cognitive psychologist Eleanor Rosch’s The Embodied Mind: Cognitive Science and Human Experience. To this day I am struck by the lucidity of the writing, the patient willingness to explore the virtues of opposing viewpoints, and especially the depth of the challenge to mainstream cognitive neuroscience and psychology. The basic idea is that the science of cognition and the brain needs to somehow reckon with human experience, in all it’s phenomenological, fleshy, ecologically situated complexity. The science of human cognition requires an account of how life seems to us, how it feels, what it means. Not doing so amounts to a shortcut, though an understandable one, given the difficulties routinely encountered. The authors painstakingly present the case for why failing to include the role of the evolutionarily developed phenomenological body and the meaningful, experiential, existential dimensions will hamper scientific accounts of cognition and the brain. Varela, Thompson and Rosch present a radical challenge to the idea that the mind is best modeled based on data and measurements only from the outside, or purely objectively. Cognitive neuroscience describes cognition and consciousness as machinery emerging from the hardware of the brain, and Varela, Thompson and Rosch carefully explore the benefits of this view, but opt for a radical alternative. I am convinced it is the foundational and definitive work in neurophenomenology. Interestingly, Daniel Dennett, a staunch defender of cognitivist orthodoxy, had substantive criticism but went on to say: “the authors find many new ways of putting together old points that we knew were true but didn’t know what to do with, and that in itself is a major contribution to our understanding of cognitive science.” The term “neurophenomenology” does not appear in this book. As I have mentioned elsewhere, the term emerges around 1990 from the work of Charles Laughlin (though there seems to be one mention in a hard-to-find publication from 1988). I had considered directly contacting Varela around 1996 to convince him of the helpfulness of the term “neurophenomenology”, and I must admit to an utter dopamine blast of pleasure when around that time I found his 1996 paper “Neurophenomenology : A Methodological Remedy for the Hard Problem“. Kismet! It was an exciting time, and helped push me towards doing a PhD on one narrow aspect of clinical neurophenomenology: modeling how accurate patients are at reporting on their cardiac rhythm states, and how the brain both enables knowledge and mistaken beliefs about heartbeats . With new people showing an interest in and perhaps coming into this field, we might as well make sure to examine the core text: The Embodied Mind. There is a copy online and here is an excerpt, but I highly recommend getting a physical copy. Here is a section entitled The Retreat into Natural Selection, from Chapter 8: Enaction: Embodied Cognition (for what it’s worth, in my last class as a PhD student, I had my colleagues in David Buss‘ Evolutionary Psychology seminar read and discuss this chapter, and they hated it!) . “In preparation for the next chapter, we now wish to take note of a prevalent view within cognitive science, one which constitutes a challenge to the view of cognition that we have presented so far. Consider, then, the following response to our discussion: “I am willing to grant that you have shown that cognition is not simply a matter of representation but depends on our embodied capacities for action. I am also willing to grant that both our perception and categorization of, say, color, are inseparable from our perceptually guided activity and that they are enacted by our history of structural coupling. Nevertheless, this history is not the result of just any pattern of coupling; it is largely the result of biological evolution and its mechanism of natural selection. Therefore our perception and cognition have survival value, and so they must provide us with some more or less optimal fit to the world. Thus, to use color once more as an example, it is this optimal fit between us and the world that explains why we see the colors we do.” We do not mean to attribute this view to any particular theory within cognitive science. On the contrary, this view can be found virtually anywhere within the field: in vision research, it is common both to the computational theory of Marr and Poggio and to the “direct theory” of J. J. Gibson and his followers.  It is prevalent in virtually every aspect of the philosophical project of “naturalized epistemology.”  It is even voiced by those who insist on an embodied and experientialist approach to cognition. For this reason, this view can be said to constitute the “received view” within cognitive science of the evolutionary basis for cognition. We cannot ignore, then, this retreat into natural selection. Let us begin, once again, with our now familiar case study of color. The cooperative neuronal operations underlying our perception of color have resulted from the long biological evolution of the primate group. As we have seen, these operations partly determine the basic color categories that are common to all humans. The prevalence of these categories might lead us to suppose that they are optimal in some evolutionary sense, even though they do not reflect some pregiven world. This conclusion, however, would be considerably unwarranted. We can safely conclude that since our biological lineage has continued, our color categories are viable or effective. Other species, however, have evolved different perceived worlds of color on the basis of different cooperative neuronal operations. Indeed, it is fair to say that the neuronal processes underlying human color perception are rather peculiar to the primate group. Most vertebrates (fishes, amphibians, and birds) have quite different and intricate color vision mechanisms. Insects have evolved radically different constitutions associated with their compound eyes. One of the most interesting ways to pursue this comparative investigation is through a comparison of the dimensionalities of color vision. Our color vision is trichromatic: as we have seen, our visual system comprises three types of photoreceptors cross-connected to three color channels. Therefore, three dimensions are needed to represent our color vision, that is, the kinds of color distinctions that we can make. Trichromacy is certainly not unique to humans; indeed, it would appear that virtually every animal class contains some species with trichromatic vision. More interesting, however, is that some animals are dichromats, others are tetrachromats, and some may even be pentachromats. (Dichromats include squirrels, rabbits, tree shrews, some fishes, possibly cats, and some New World monkeys; tetrachromats include fishes that live close to the surface of the water like goldfish, and diurnal birds like the pigeon and the duck; diurnal birds may even be pentachromats).  Whereas two dimensions are needed to represent dichromatic vision, four are needed for tetrachromatic vision (see figure 8.6), and five for pentachromatic vision. Particularly interesting are tetrachromatic (perhaps pentachromatic) birds, for their underlying neuronal operations appear to differ dramatically from ours.

 

Figure 8.6 Tetrachromatic vs. trichomatic mechanisms are illustrated here on the basis of the different retinal pigments present in various animals. From Neumeyer, Das Farbensehen des Goldfisches. When people hear of this evidence for tetrachromacy, they respond by asking, ”What are the other colors that these animals see?” This question is understandable but naive if it is taken to suggest that tetrachromats are simply better at seeing the colors we see. It must be remembered, though, that a four-dimensional color space is fundamentally different from a three-dimensional one: strictly speaking, the two color spaces are incommensurable, for there is no way to map the kinds of distinctions available in four dimensions into the kinds of distinctions available in three dimensions without remainder. We can, of course, obtain some analogical insights into what such higher dimensional color spaces might be like. We could imagine, for example, that our color space contains an additional temporal dimension. In this analogy, colors would flicker to different degrees in proportion to the fourth dimension. Thus to use the term pink, for example, as a designator in such a four-dimensional color space would be insufficient to pick out a single color: one would have to say rapid-pink, etc. If it turns out that the color space of diurnal birds is pentachromatic (which is indeed possible), then we are simply at a loss to envision what their color experience could be like. It should now be apparent, then, that the vastly different histories of structural coupling for birds, fishes, insects, and primates have enacted or brought forth different perceived worlds of color. Therefore, our perceived world of color should not be considered to be the optimal “solution” to some evolutionarily posed “problem.” Our perceived world of color is, rather, a result of one possible and viable phylogenic pathway among many others realized in the evolutionary history of living beings. Again, the response on the behalf of the “received view” of evolution in cognitive science will be, “Very well, let us grant that color as an attribute of our perceived world cannot be explained simply by invoking some optimal fit, since there is such a rich diversity of perceived worlds of color. Thus the diverse neuronal mechanisms underlying color perception are not different solutions to the same evolutionarily posed problem. But all that follows is that our analysis must be made more precise. These various perceived worlds of color reflect various forms of adaptation to diverse ecological niches. Each animal group optimally exploits different regularities of the world. It is still a matter of optimal fit with the world; it is just that each animal group has its own optimal fit.” This response is a still more refined form of the evolutionary argument. Although optimizations are considered to differ according to the species in question, the view remains that perceptual and cognitive tasks involve some form of optimal adaptation to the world. This view represents a sophisticated neorealism, which has the notion of optimization as its central explanatory tool. We cannot proceed further, then, without examining more closely this idea in the context of evolutionary explanations. We cannot attempt to summarize the state of the art of evolutionary biology today, but we do need to explore some of its classical foundations and their modern alternatives.

How to operationalize the “body-knowledge” construct so it can be analyzed and measured

I started using the term “body-knowledge” a few years back as a way to label the extent to which people can accurately report symptoms or interior sensations. It is not as of 2010 a popular term. The earliest citation of the term I know of is from a clinical neurology paper by Sirigu, Grafman, Bressler, and Sunderland, (1991): Multiple representations contribute to body knowledge processing: Evidence from a case of autotopagnosia

“Body knowledge” does quite not have the same meaning as “embodied cognition”, “body image”,”body schema”, “interoception”, “visceral perception”, or even “body cognition”, though there is considerable overlap. I typically use the concept body-knowledge to emphasize the verbal reporting of internal states. My epistemology teacher years ago taught me a great idea:

To know something, you have to know that you know it, and to know that you know it, you have to be able to say it.

I wouldn’t defend that as the end-all be-all theory of knowledge, but it works as a heuristic at the least. For now, I use “body-knowledge” to refer to how well people can know and verbally report on what is happening to their physiological states.

To analytically probe this construct, I started looking very deeply at a particular domain: symptom reporting about cardiovascular processes. I have found some useful results from earlier studies that serve as a guide to help approximate how accurate people are when they feel and report palpitations: their heart is racing, they feel irregular beats, heart thumping or pounding, skipped beats, and so forth. Evidently a fair amount of the time people suffering from panic disorder or anxiety “cognize” otherwise benign sensations and report heart problems, and such false positives adds a great deal of expense to the healthcare system.

Symptom report accuracy is a largely unexplored area for the young field of neurophenomenology: how much of what is happening inside our bodies is accessible to our minds? Very little of the existing neurophenomenology literature deals with these issues.

How can the “body-knowledge accuracy” construct be operationalized, analyzed and measured? For the particular domain of palpitations reporting, here are some useful core metrics:

From ‘The Validity of Bodily Symptoms in Medical Outpatients,” (Barsky, 2000) Chapter 19 in The Science of Self Report (Stone, A, ed): -When patients complaining of palpitations undergo 24-hour, ambulatory, electrocardiographic monitoring, 39% to 85% manifest some rhythm disturbance; the vast majority of these arrhythmias are benign, clinically insignificant, and do not merit treatment). Although as many as 75% of these patients with arrhythmias report their presenting symptom during monitoring; in only about 15% of cases do these symptom reports coincide with their arrhythmias.

From Barsky, Ahern, Delamater, Clancy & Bailey (1997): -145 consecutive outpatients referred to an ambulatory electrocardiography (Holter) laboratory for evaluation of palpitations were accrued, along with a comparison sample of 70 nonpatient volunteers who had no cardiac symptoms and no history of cardiac disease. A symptom was considered accurate when it followed within 30 seconds after any demonstrated arrhythmia.

-average positive predictive value (PPV)… is equal to the number of reported symptoms that were preceded by an arrhythmia divided by the total number of symptoms reported (true positives / [true positives + false positives]).

-Ninety-nine palpitation patients (68%) reported at least one palpitation during monitoring. Among those patients who were symptomatic, the mean number of diary symptoms reported in 24 hours was 3.7. The mean PPV for all symptom reports among palpitation patients was 0.399, compared with a mean PPV = .118 for the nonpatient volunteer sample (p = .01).

-the palpitation descriptors most likely to be accompanied by electrocardiographic abnormalities are heart stopping, fluttering, and irregular heartbeat. The least predictive descriptive terms used by the patients were racing and pounding.

-34% of the symptomatic palpitation patients and 11% of the asymptomatic comparison subjects were classified as accurate reporters

questions about information-processing theories of body-knowledge

Cognitive science explains mind and brain in terms of computation, information-processing, and representationalism: the ability of a cognitive system to change internal microstructure so as to correspond with important features of the internal or external world. One could do worse than to sum up the cognitivist model of the mind as “computations over representations”, in which features of the world or body are coded by the brain as symbols.

Whatever merits this “cognitivist” research program may have for models of syntactical production, the consolidation of short-term memories into long-term, the recognition of familiar faces, logical problem-solving, and other phenomena, I suspect that critical aspects of how people have knowledge of their bodies are not adequately accounted for by cognitivist approaches. I maintain that a careful analysis of the evidence reveals cognitive science has a flawed approach to modeling how well people know what is happening inside their bodies, and what mental and biological processes underlay this knowledge.

There are many aspects of psychological life that have never been the focus of cognitive science, and this absence is at it’s foundation the Cartesian rift at the heart of objective models that depict mind as machine. People experience a world of meaning framed by temporality and grounded in the lived body, but cognitive science focuses on a subpersonal realm of symbols, algorithms, information processing, representation, where mind is reduced to computation. To the extent that this approach yields results, it should be pursued, but cognition outstrips what cognitivism can model. There are aspects of cognition that are characterized by the existential questions, embodied experience, consciousness, meaning, and other phenomena, but it is precisely these that objectivistic, Cartesian cognitive science has not, for the most part, tried to explain. The difference is that of between worlds, like the gap between music grasped as experienced and meaningful, compared to music understood as a system that can be analyzed through abstract system-centered objectivistic modeling. It is true that science is typically understood in the latter terms, but neurophenomenology aims at a dialog between psychological life as experienced and cognition understood as a mechanism produced by te brain. There is not an immediate move toward reduction nor a premature assumption that embodied experience can be automatically modeled as a byproduct of systems.

In everyday life, and especially in conditions of sickness or disease, people notice aspects, qualities, and states of their bodies, and seek to get information about and from their bodies. Getting information about body-state can involve perception of a symptom, focused attention or introspection toward specific body regions or parts, remembering the way one’s body felt previously and comparing this to a current assessment, attempting to verbally express feelings about the way one’s body seems, paying close attention to a body part that is usually indistinct or in the background but suddenly is painful, and many other similar activities. Consider the following examples:

• a subject in a clinical trial of a medical device is asked whether or not they notice anything unusual or different about the way their body feels, and if so, to rate how much on a numeric scale;

• a person taking psychiatric medication for depression tells their psychiatrist about adverse side effects, such as a decline in libido, and an inability to grieve the loss of a loved one while at a funeral;

• someone who is drinking alcohol may calibrate their intake based on the memory of nausea from previous episodes of over-consumption;

• an obese woman is reported by American media to have been shocked upon finding she was in labor and on the verge of giving birth, having no previous knowledge of her pregnancy.

• a person who is being massaged, when asked to describe the sensation, reports a mixture of significant pleasure and mild pain when pressure is applied to very specific regions of their upper-back

In these and in similar cases, individuals involved are sensing, perceiving, remembering, and judging about their symptoms, body states, feelings, and sensations, and in some examples, reporting their experience to others. These are cognitive phenomena, but can ideas derived from symbolic logic and representationalist epistemology suffice to explain them? I would argue that there are a number of open questions about the utility of information-processing theories of body-knowledge.

Are the introspective reports, assessments, and statements generated by people about their body-state generally accurate, or not? What mechanisms account for the accuracy, or lack thereof?

To what extent do legacy concepts from cognitive science or information-processing models help or hinder the development of an understanding of how people access information and gain knowledge about their bodies?

How are we to understand the meaning(s) of the term “information” used to explain how and how well people know their own mental and physiological states? What is the relationship of “information” in the sense of physiological or biological systems to consciously reportable sensation, such that a person is getting information about their body state?

Are there many kinds of “information” involved in these models of internal state perception or “body cognition” found in clinical neurology, medicine, experimental psychology, and theoretical cognitive neuroscience? Or is there but one type of “information”, with different qualities or aspects that are described or measured in different ways?

Part II of Leder’s The Absent Body

“Spatiotemporal Continuity

The mysterious quality of our visceral space is based not only on such experiences but on all that is not experienced of our inner body, I have hitherto focused on what interoceptions we do have; they are marked by a limited qualitative range and a spatial ambiguity that together restrict our perceptual discriminations. Furthermore, as I will now address, there is a paucity of even such limited experiences.

Exteroception, at least during the waking state, manifests a certain spatiotemporal continuity. My eyes scan a visual world that is without sudden gaps or crevices. If I abandon one sense, perhaps closing my eyes, the other senses help to maintain the continuity of world. Similar­ly, proprioception traces out a completed sense of my surface body, allowing me to adjust every limb, every muscle, in appropriate motoric response to tasks. Though usually this sense is subliminal, I can close my eyes and proprioceptively hone in on the position, the level of tension or relaxation, in any region of the muscular body.

By way of contrast, the stream of interoceptive experience is marked by ineluctable discontinuities. In the above example, after eating the ap­ple it largely disappeared from perception only to resurface in an exper­ience of heartburn. This then faded away to silence, broken some time later by insistent cramps. This too passed. Finally, hours later I become aware of sensations from a new region signaling the need to defecate. But these are intermittent punctuations in a shroud of absence. Most of the intricate digestive process—its enzymatic secretions and peristaltic waves, its diffusions and active transports—proceeds without the pos­sibility of conscious apprehension. This is equally true of circulation, respiration, thermal or fluid regulation. By far the greatest part of my vegetative processes lies submerged in impenetrable silence.

Causal relations are rendered uncertain by these spatiotemporal lac­unae. I cannot be sure if my cramps are caused by an apple I previously ate, for this apple has, in the interim, disappeared from experience. Mo­ments of discomfort are noted while the baseline of ordinary functioning is largely invisible, it is as if my eyes only reacted to flashes of blind­ing light, the rest of the time residing in darkness.

This darkness is never absolute. When I focus inward at even the qui­eter times I still find some vestigial sense of my midsection enveloped in a sort of sensory neutrality, neither full nor empty, pleasured nor in pain. And this vague aura is not devoid of meaning. It shows that any hunger or illness has subsided. The very absence of discomfort is tinged by a positivity.

Moreover, through a heightened focusing of attention, I can increase my awareness of visceral processes. Certain dim sensations that I had never noticed—the feeling of my pulsing blood, the depths of respira­tion, the subtler reactions of my stomach to different foods—can be brought into experience by conscious effort. As cultural variations show, a certain degree of visceral disappearance can be attributed to Western insensitivities and overcome by a systematic development of powers. The awareness of and control over the inner body exhibited by trained yogis has far surpassed what used to be thought possible in the West.

Yet even such achievements take place only within an overall context of experiential disappearance. The very need for highly specialized training is evidence of the perceptual reticence of our viscera as com­pared to the body surface. And just as it is possible to speak of null points in relation to the surface body, the corporeal depths have their own phenomenological null points. That is, there are visceral regions that are almost entirely insensitive. In focusing upon stomach and gut I have ac­tually chosen two of the more loquacious organs. The kidney, gallblad­der. bone marrow, spleen, yield far less interoceptively. The par­enchyma of the liver, the alveolar tissue of the lung, are virtually with­out sensation. Unlike the completed perception of the proprioceptive body, our inner body is marked by regional gaps, organs that although crucial for sustaining life, cannot he somesthetically perceived.

We rarely thematize this sort of disappearance. Upon introspecting, I do not feel an emptiness in my body where my liver should be. This would make the absence into a presence-as-concealed hovering before my awareness. Rather, the absence of the liver parenchyma is so total that few would ever come to realize or remark upon it. Yet a medical mishap can suddenly awaken us to the significance of such bodily lac­unae. The vast gaps in our inner perception may conceal potentially damaging processes until they are far advanced. For example, while I may feel pain once damage to the liver has progressed to the point of affecting its membranous capsule, the initial process can go unper­ceived. Similarly, hypertension is experientially hidden through much of its career. As with my surface body, I can bring to bear upon these depth organs certain strategies of reflective observation. A blood sample can tell me a good deal about my liver function. Through a sphygmomanometer I can read off my blood pressure. I can look at an X ray of my lungs. I can even gaze through a colonoscope at the lumen and folds of my own colon. Such techniques enable me to gain knowledge concerning my viscera. Yet, as with my surface body, the absences that haunt my bodily depths are not effaced by these reflective maneuvers. Though I can visu­ally observe my colon, its processes still elude experience from within, The magical power my body has to absorb water and electrolytes is not perceived as I gaze through the endoscope upon this furrowed, tubular space. The mystery of my body is only heightened by the very strange­ness of the organ before me, its phenomenological noncoincidence with my body-as-lived.

Moreover, unlike the body surface, my inner organs tend to resist even these partial reflections. My viscera are ordinarily hidden away from the gaze by their location in the bodily depths, there is aspect of withdrawal may seem contingent, resulting from a sheerly physical harrier rather than an existential principle. Ye t this is to draw a false distinction; in the lived body, the physical and existential always intertwine.

The depth location of the viscera is no more contingent than the sur­face placement of the sensorimotor organs. Eye and hand could not perform their perceptual role unless they opened onto the external world- Thus, in order to perceive they must take their place among the perceptibles. They must be located at the body surface available to the gaze of myself and others, By way of contrast, my visceral organs, not constructed for ecstatic perception, disappear from the ranks of the per­ceived, I do not perceive from these organs; hence, they can hide beneath the body surface such that I do not perceive to them either. In fact, they require this seclusion just as the sensorimotor body requires exposure. My stomach, neither an organ of exteroception nor voluntary move­ment, could not screen the environment, secure appropriate foods, repel threats. It depends on a mediating surface, active and intelligent, to stand between it and the world, selecting what is needed for metabolic maintenance and protecting the vise us from hostile impacts. The hiddenness of vital organs, though frustrating at limes of disease, is essen­tial to healthy functioning.

Thus it is quite rare for the viscera to be exposed in life. This can happen, as in surgery, wartime injury, or violent accidents, yet these are pathological and dangerous occasions, Most commonly, the direct ex­posure of the inner organs implies or threatens the death of the person, Hence, as Foucault notes in The Birth of the Clinic, when nineteenth-century medicine made the direct perception of diseased organs an epistemological goal, the corpse, not the live patient, became the paradigmatic figure of truth. For the “anatomo-clinical” gaze, “that which hides and envelops, the curtain of night over truth, is, paradox­ically, life; and death, on the contrary, opens up to the light of day the black coffer of the body.”” While Foucault addresses this as a historical devel­opment, it manifests my phenomenological point; life itself is allied to a certain concealment, a withdrawal and protection of its vital center.

Body-knowledge: what is it?

I use the term“body-knowledge”  in my dissertation research primarily to refer to the experience of knowing about one’s own body, and especially embracing perception and assessments of the body through the body.  It is meant to straddle the classic cognitive psychology distinction between explicit knowledge that is verbalizable, and implicit knowledge that may only be revealed through experiments. Trying to define the term brings up a number of questions:

-How is “neurophysiological information-processing” related to “body- knowledge”?

-To what extent does the distinction between conscious and unconscious knowledge need to be invoked to explain that relationship?

-Should beliefs about the body be understood as part of body knowledge? What about attitudes, expectations, and desires concerning one’s body?

-Do the properties of the body vis-à-vis external objects and the external environment factor in, such as my knowledge of my ability to lift x kilograms of weights, or to effect changes in the world with my body?

-How is body-knowledge related to body-state information access?

This latter phrase can be thought of as “internal perception of information about the body”. For present purposes a heuristic understanding probably should suffice: body-state information access refers to what content an individual can perceive, sense, or detect about their body, but also to putative notions of information-processing in the afferent or other nerves that produce the content. As the term “cognition” signifies both mind as a collection of unconscious systems and (however problematically) mind as consciously experienced, body-state information access, as I use the phrase, straddles the divide between subjective and objective aspects of the body (compare to Merleau-Ponty’s (1968) notion of the “corporeal” or “the flesh”). One might extend the concept to mean that body-state information access also refers to a sort of “information gain” in bodily perception: for instance, being aware of digestive processes where one was not previously.

Interoception is another term needing examination: while classically interoception refers to perception of the visceral organs in the inside of the body, consider Bud Craig’s (2002) proposed redefinition (pg.655):

“Interoception should be redefined as the sense of the physiological condition of the whole body (including pain and temperature), and not just of the viscera”

Even if this broader sense becomes accepted, interoception will still include the sense of “interior perception”.  The more expansive signification should then overlap with somatic cognition, a term deployed by neuroscientists (Tanosaki, Suzuki, and Kimura, 2002) who use it to signify perception using body parts such as fingers, and also internal cognition, or even visceral cognition, labels used by researchers who model the relationship of the internal organs to the nervous system and perception (Adam, 1998, pg 156-159).

Compare these to body cognition, which might not only embrace the idea of knowledge of one’s lived, experienced body, “thinking with the body,” but also the somatic, visceral,  neurophysiological, and cognitive systems making the perception and knowledge possible. “Body cognition” would seem to have experiential or phenomenological (that is, felt) dimensions, but should also refer to what are commonly understood to be unconscious mental, neural, and other physiological processes enabling this knowing. The profusion of terms may reflect the inherent complexity of the systems involved, our partial and provisional understanding, or both. Analyzing how the notion of information relates to models that explain how unconscious neurophysiological processes give rise to conscious ones is a particular focus of my project.

As I will be use the term, body-knowledge embraces the notion of using the body as the means to perceive or assess itself, such as with symptom perception. The study of body cognition involves perspectives from many fields, but could be understood as a subset of embodied cognitive science, which differs from standard approaches to the extent that it emphasizes overcoming the Cartesian split between subject and object implicit in cognitive science, and the coupling of human mental activity to a meaningful world. One of the goals of a cognitive science of embodiment would be to construct a model of body knowledge good enough to explain how the embodied brain and mind make knowledge of the body, sensing or perceiving using the body, and the ability of people to use directed attention and introspection to gain “true information” or validated knowledge (compare to beliefs) about the body.

As I use the terms, body-knowledge and body-state information access refer to both experiential-phenomenological knowledge (“I feel hungry” or “I have an itch on my scalp, but not as bad as earlier”) that may form the basis of verbal reports as well as the unconscious, and presumably not explicitly stateable, underlying information processes comprising cognition. This distinction between stable and explicit and non-stateable or implicit knowledge is not a trivial one. Cognitive science, neuroscience, and psychophysiology propose that our conscious awareness and experience of information about the body to be to be somehow made of or caused by unconscious information, because cognitive processes are understood to be mostly unconscious.  Varela, Thompson, and Rosch (1991, pg. 49) point out that cognitive science:

“…postulates processes that are mental but that cannot be brought into consciousness at all. Thus we are not simply unaware of the rules that govern the generation of mental images or of the rules that govern visual processing; we could not be aware of these rules. Indeed, it is typically noted that if such cognitive processes could be made conscious, then they could not be fast and automatic and so could not function properly”

A critical look at the information-processing theories used to explain body-knowledge

The psychologist Raymond Gibbs (2006) in Embodiment and Cognitive Science asks (pg. 28) “What underlies people’s abilities to move as they do and have any awareness of their bodies?”

The conventional answer given by psychology, medicine, and cognitive neuroscience is physiological and cognitive systems using information-processing. Gibbs cites the work of Bermudez, Marcel, and Eilan (1995) who list a series of multiple internal physiological information sources that enable motor activity and somatic perception (pg. 13):

“(a) Information about pressure, temperature, and friction from receptors on the skin and beneath the surface.

(b) Information about the relative state of body signals from receptors in the joints, some sensitive to static position, some to dynamic information.

(c) Information about balance and posture from the vestibular system in the inner ear and the head/trunk dispositional system and information from pressure on any parts of the body that might be in contact with gravity-resisting surfaces.

(d) Information from skin stretch and bodily disposition and volume.

(e) Information from receptors in the internal organs about nutritional and other states relevant to homeostasis and well-being.

(f) Information about effort and muscular fatigue from muscles.

(g) Information about general fatigue from cerebral systems sensitive to blood composition”

These formulations follow the contemporary scientific trend of explaining systems, processes, entities, and relationships in terms of computation and information (and, often enough, representation).  It is relatively rare in such contexts to encounter authors worrying overmuch about the meaning of the term “information” though there are attempts to effectively operationally define it via metrics, i.e. to quantify the information content of a system via Shannon-style or other measurements (Gardner, 1985). Perhaps “information” is indispensable as a term of convenience, but a critical reader should ask what the term means in context, when the term is used as a heuristic, what value the term adds, whether ambiguity is lessened or increased, and whether it would be better to emphasize the provisionality of information concepts.

Probably it would be better to refer to “information” much of the time, but this becomes stylistically cumbersome very quickly.

In any event, current theories of psychophysiological processing, clinical studies of symptom-perception accuracy, cognitive models using mechanisms explaining explicit, verbally-stateable knowledge, and other theories conceptualize our knowledge of our bodies in terms of information-processing, though the connection between “knowledge” and “information” is often not explicit.

How are we to understand the meaning(s) of the term “information” used to explain how and how well people know their own mental and physiological states? What is the relationship of “information” in the sense of physiological or biological systems to consciously reportable sensation, such that a person is getting information about their body state? Are there many kinds of “information” involved in these models of internal state perception or “body cognition” found in clinical neurology, medicine, experimental psychology, and theoretical cognitive neuroscience? Or is there but one type of “information”, with different qualities or aspects that are described or measured in different ways? What metrics or formalisms are most appropriate for each type?

Information-processing, computational, cognitivist, and representational formulations may privilege objective “system-centric” meaning of information, performing an implicit reduction of information in an experiential/phenomenological sense, without calling attention to the reduction. It may be useful, or even true, that quantities can be mapped on to qualities, following the accepted principle in philosophy of science that the ontology (known elements, entities, processes, features, properties and their relations) from one domain can be reduced to that of another domain, with properties from the one domain or level of scientific description to more fundamental explanatory ones in another domain (Churchland, 1989). In this view, the mechanistic and reductionistic work that the ontology of genes and DNA (and possibly information-processing theory) does in explaining cell biology will hold for the relationship between brain and cognition. Indeed, a standard view in psychology and neuroscience (and to an extent philosophy of mind) holds that concepts from cognitive neuroscience, computer science, and information-processing theory can mechanistically explain particular aspects of bodily awareness, and at some point law like or nomological generalizations will become apparent, effectively performing a reduction.

I maintain that we should be careful in using an overdetermined term such as “information” to prematurely unite concepts from different domains. Traditionally, the philosophy of science has had a role in calling attention to instances where the use of concepts from one domain are used to explain another without careful explication of the move that is made (what one might call “stealing a base”), but unfortunately, the specialized nomenclature of philosophy leaves some scientists and clinicians alienated from such discourse.

Stretch your imagination, take the long view, remember Thomas Kuhn: do you think people in 100 years will be explaining body-knowledge as an information-processing system?

History of the development of neurophenomenology-pt.1

(Part II is here, and Part III is here)

I will attempt in three essays to outline the sweep of ideas, researchers, and works that lead a few of us to speak of “neurophenomenology” as a more or less distinct field.  Part I traces 19th century psychology, neurology, and phenomenology roughly up to World War II. Part II examines the impact of cognitivism, the continued development of clinical neurology and basic neuroscience, the progression of phenomenological thought in psychology and medicine, and criticisms of cognitive science. Part III explores the early 1990’s origins of the emerging field of neurophenomenlogy within the broader context of interest in embodied cognition and consciousness studies. Any corrections, suggestions, or criticisms are welcome.

It may be too early to attempt a definitive characterization of the constitutive elements, at the least it is a combination of clinical studies by neurologists, psychiatrists, and psychologists, experimental work on the brain and mind, and philosophical analysis of consciousness and cognition. While the term “neurophenomenology” has a recent (early 1990’s) origin, the project of understanding the mysterious and profound relationship between brain events and awareness goes back at least as far as classical Greek philosophy. Physicians and philosophers have grappled with the enigma of existence and of consciousness for millenia. Psychology has roots in medicine, ethics, and the philosophy of mind and epistemology, but by the late 19th century,  the overlapping fields of biological psychology, psychiatry, behaviorism, and the psychophysiology and psychophysics of perception emerged. We can trace the series of research traditions that eventually developed  into “neurophenomenology” in the 1990’s through ideas and practices of  19th century researchers.  Understanding how these traditions drew from various sources, and subsequently interacted, requires we situate each field in then-current European disciplines. Elites were schooled in the Gymnasia, and acquired a broad and deep education before later specialization.  Physicians and/or laboratory experimentalists were expected to be familiar with classical and to an extent modern philosophy, and gentleman scholars would dabble in but also contribute to numerous fields: highly unlike the current hyper-specialization of academia. Psychology was very pluralistic at this stage: not yet fully divorced from philosophy, still possessing a sense that a field focusing on the richness and complexity of the human psyche must involve a study of consciousness.

There were numerous German psychophysics and psychological researchers looking for how consciousness and the brain were related, such as Herman von Helmholtz (1821-1894), Gustav Fechner (1801-1887), and Wilhelm Wundt (1832-1920).  Much effort was expended on rigorously correlating physiological and psychological measurements, resulting in establishing thresholds of perception and the limits of just noticeable differences. A number of laboratories used experimental methods where subjects told researchers what they were perceiving through verbal reports based on introspection.

Bold innovators like the justly renowned philosopher, psychologist and physician William James (1842-1910) also looked for the physical basis of experience. He pioneered research into neurology, performed psychological experiments, and made creative, yet disciplined, investigations into experiential aspects of mind. James’ use of crisp, lucid language describing consciousness and awareness pushed the threshold of what science, psychology, and philosophy could say about consciousness. James helped establish American experimental psychology, but really hit his stride with his still-fresh writings.  He described how memory and the enigmatic quality of the moment-by-moment flow of experience, and even wrote about altered states of consciousness. His central concept of consciousness being like a stream is still influential, and there is now a renewed appreciation for his work on how emotions are coupled to the physiological state of the body.  All in all, he is probably the most important figure in the history of American psychology. Yet his interdisciplinary boldness, penetrating curiosity and at times virtuostic powers of description of complex mental phenomena were not easily replicated by those researchers and younger colleagues he influenced.

William James, master theorist of consciousness

In the Principles of Psychology, James provided an admirably straightforward account of what introspection is:

“Introspective observation is what we have to rely on first and foremost and always. The word introspection need hardly be defined – it means, of course, looking into our own minds”

 

Fin-de-siecle psychophysics was in its golden years during his time, and while James’ wrote admiringly of the “philosophers of the chronometer” and other technically adroit experimental psychologists in his lab that measured perception and other phenomena, James himself continued his project of probing and describing the phenomenology of consciousness itself. While considered a father of introspectionist psychology and a forefather of both behaviorism and cognitive neuroscience, perhaps because of his hard-to-imitate brilliance, James did not leave a school of younger researchers to follow through on his research into consciousness.

In America, Europe, and Russia, generations of research into the organic basis of pathologies was reaching new heights of explanatory power. The German psychiatrist Emil Kraepelin (1856-1926) was formulating sophisticated theories of the physiological basis of mental illness in the early 20th century, in retrospect a crucial step in the early development of the now accomplished field we know as clinical neuropsychology. After each war, neurologists noted the correlations between location of trauma to the brains of the injured with deficits in speech, memory, movement, perception, affect,  emotion,and “body knowledge”. The Russian tradition culminated later in the influential work of Alexander Luria (1902-1977).

The force of new findings in clinical studies, physiology,  and experimental laboratory research eventually produced a scientific psychology that established itself as independent from moral philosophy, epistemology, metaphysics, and the philosophy of language. The success of  19th century psychophysics and neurophysiology, with breakthroughs such as Hermann von  Helmholtz‘s (1821-1894) measurement of the speed of the nerve impulse, provided ample justification for the fissure. Psychophysics experiments painstakingly produced data on the “just-noticeable difference” in light or stimulus intensity, etc. but there were real difficulties in establishing a consensus between the different laboratories on methodologies for dealing with subject’s reports on their perceptions.

While towering figures like Ernst Weber (1795-1878), Wilhelm Wundt (1832-1920), and Edward Titchener (1867-1927) were establishing a canon of principles and techniques for psychology, it proved extremely difficult to come up with one standard way to operationalize measurements that involved verbal reports about  subjective judgments and conscious experience. For all the brainpower deployed in various laboratories, by the 1930’s the tide was turning against scientific research into consciousness due to the influence of behaviorism, which reacted against the lack of an agreed-upon methodology in the German psychophysics-based psychology, especially involving introspection. The behaviorists marshaled an impressive array of experimental measurements techniques to establish causal relationships between stimulus and response, and then to infer lawlike generalizations. They stringently opposed the use of any mental concepts as inherently subjective and thus unscientific, and eschewed using first-person reports as much as possible. Within fields like the psychology of visual perception it was necessary to get verbal reports from subjects, but the behaviorists strove mightily to build a scientific psychology on purely physical principles. But if the behaviorists’ reacted against psychophysics for being insufficiently liberated from concerns with cognitive processes, others argued precisely the opposite. The philosopher Franz Brentano (1838-1917) wrote Psychology From An Empirical Standpoint in 1874, where he popularized the notion that the contents of experience constituted an important field of inquiry in their own right. Brentano’s influential theories of intentionality stressed the need to investigate the contents of awareness and their constitutive operations. Researchers working on cognition who were dissatisfied with the limitations of psychophysics ,and unpersuaded by the soon-to-be dominant anti-mentalist strictures of the behaviorists (such as physiologist Ivan Pavlov (1849-1936) and psychologist/advertising specialist John Watson (1878-1958))  rallied around this line of inquiry. Brentano made an impact among philosophers and psychologists and certain influential clinicians, and in some sense there is a diverse “School of Brentano“.

Arguably the most  influential among the students and followers of Brentano was the mathematician and philosopher Edmund Husserl (1859-1938). Husserl was fascinated (obsessed?) with the foundations of logic, mathematics, epistemology, and cognition.  Convinced by direct criticism from the celebrated logician Gottlob Frege (1848-1925) that psychological principles were epistemologically inadequate to foundationalize mathematical and logical truths, Husserl would eventually synthesize Brentano’s research into the primacy of intentional awareness within cognition with a quest for the undoubtable (or “apodictic”) core principles of mathematics, logic, and philosophy.  After producing light-reading classics such as Philosophie der Arithmetik, he developed a research program  into the first principles of cognition, logic, and epistemology called phenomenology.  While Husserl attracted many philosophers and certain psychologists to his cause with the 1900-1901 publication of the highly influential Logical Investigations, his continual probing of the constituent ideas underlying mathematical and logical truth was to an extent a solitary quest.

His acolytes and disciples found the Logical Investigations of great importance, yet they did not take up Husserl’s overarching project of a securing a logical foundation for all science, math, and philosophy. In the case of Martin Heidegger, phenomenology was redefined as the means for a still more fundamental investigation into ontology.

Edmund Husserl: logician, philosopher, and phenomenologist

Before WWII Husserlian phenomenology was perhaps the most important development in European philosophy, and influenced a number of other fields, such as psychology and medicine.Because his phenomenology took conscious experience as a source of data (following Brentano) many researchers interested in consciousness and cognition were excited by Husserl’s radically rigorous approach and penetrating exploration of how mental processes constitute, shape,  and structure the phenomena of which we are aware. His notion that cognition actively constructs the contents of awareness (compare to Jacob von Uexkull‘s (1864-1944) notion of the umwelt) would be familiar to modern cognitive neuroscientists but to early 20th century psychologists and philosophers was revolutionary. Husserl  influenced the philosophers Martin Heidegger (1889-1976), Jean-Paul Sartre (1905-1980), and Maurice Merleau-Ponty (1908-1961), the logician/mathematician Kurt Godel (1906-1978), the philosopher-theologian Karol Wojtyla (1920-2005), as well as (in more recent years) the prescient critic of Artificial Intelligence philosopher Hubert Dreyfus, and the cognitive neuroscientist Francisco Varela (1946-2001).

In America and Britain, these developments in Continental thought were generally of no interests to the behaviorists, who aside from biologically/medically-based critiques of the sort offered by neurologist Karl Lashley (1890-1958), enjoyed near-hegemony in scientific psychology. But eventually, the rise of computers led to the “cognitive revolution” : the  development of symbolic or information-processing theories of the mind that did not respect orthodox behaviorist’s strictures against the use of mental concepts.  In time, this  willingness to use mental concepts again would open the door to the study of consciousness in psychology and neuroscience . After WWII, the introduction  of computers led to cybernetic,  information-processing, symbolic-logical, and representational models of language, memory, behavior, reasoning, and even awareness.

(Part II is here, and part III is here)

Gallagher and Coles on body schema vs. body image and the body percept

The philosopher Shaun Gallagher has collaborated with neurologist Jonathan Coles on the significance of patients with enigmatic body-knowledge problems (Gallagher and Coles, 1998).  Gallagher has analyzed this clinical data in the light of phenomenology and neuroscience, and has  an essential book  for anyone interested in neurophenomenology: How the Body Shapes the Mind

Gallagher is formulating a sophisticated take on embodied cognition that redresses the relative lack of attention by Varela and others to clinical studies of body knowledge disorders .  I have believed for some years that the wealth of neurological case studies  presenting puzzling data needs more focus in neurophenomenology. Since the early 20^th century, numerous patients with body knowledge based disorders and pathologies have come to light, leading to the notion of a body schema (Head and Holmes, 1911), which Gallagher and Coles (p.372) say involves:

“…a system of motor capacities, abilities, and habits that enable movement and the maintenance of posture. The body schema is not a perception, a belief, or an attitude. Rather, it is a system of motor and postural functions that operate below the level of self-referential intentionality, although such functions can enter into and support intentional activity. The preconscious, subpersonal processes carried out by the body- schema system are tacitly keyed into the environment and play a dynamic role in governing posture and movement. Although the body-schema system can have specific effects on cognitive experience…it does not have the status of a conscious representation or belief”

Gallagher and Coles maintain that progress in understanding embodied cognition requires a distinction between this body schema and the notion of the body image (p.371):

“The body image consists of a complex set of intentional states-perceptions, mental representations, beliefs, and attitudes–in which the intentional object of such states is one’s own body. Thus the body image involves a reflective intentionality. Three modalities of this reflective intentionality are often distinguished in studies involving body image:

(a) the subject’s perceptual experience of his/her own body;

(b) the subject’s conceptual understanding (including mythical, cultural, and/or scientific knowledge) of the body in general; and

(c) the subject’s emotional attitude toward his/her own body”

Gallagher emphasizes the wide variety of ambiguous and contradictory ways these terms have been used, and while noting some critics have proposed that deploying new terms could eliminate such confusion, he labors to develop a dependable, standard use of the technical terminology that can serve to make sense of clinical neurophenomenology such as that of the patient I.W, who suffered damage to nerves below the neck. This man now has to consciously will in order to perform actions people normally take for granted (p. 374):

“Maintaining posture is, for him, an activity rather than an automatic process. His movement requires constant visual and mental concentration. In darkness he is unable to control movement; when he walks he cannot daydream, but must concentrate constantly on his movement. When he writes he has to concentrate on holding the pen and on his body posture. IW learned through trial and error the amount of force needed to pick up and hold an egg without breaking it. If his attention is directed toward a different task while holding an egg, his hand crushes the egg”

The usefulness of the crisp distinction between body schema and body image becomes apparent when trying to explain the patient’s body experience and body knowledge (though Gallagher states that there is not in fact such a simple distinction possible in many cases). Normal people can perform such acts without much explicit attention, which is to say such common actions are enabled by the subconscious processes characterizing the body schema. I.W, on the other hand, must carefully and consciously go through the necessary steps to perform everyday acts. Adopting Gallagher’s distinction, we could say in the absence of the unconscious body schema, the patient must now depend on his conscious body image. To the extent this distinction is true; it should help a great deal in unpacking the various meanings of body-knowledge.

neurophenomenology and body alienation in cognitive science

It is worth exploring the historical, Cartesian “body alienation”, or default privileging of depersonalized, dismebodied, system-centric theories of mind, of much or most of the fields grouped under the label of cognitive science and neuroscience. Psychologists, linguists, philosophers, and neuroscientists have spent decades using computational and information-processing metaphors and models to explain behavior, problem-solving, memory, syntax, and other phenomena. The need to construct a theoretical bridge from brain-biology to mind-science led to the deployment of high-level abstractions such as “symbol,” “algorithm,” “information,” and “representation.” A standard view would be that recognizing features of the world, generating language, rational problem solving, recognizing patterns, and other cognitive operations are enabled by “computations over mental representations.” This may be a useful construct, and the notion of representation need not be solely of the symbolic and rule-based sort that apeared in the 1950-s and 1960’s, but the idea that cognitive scientists, linguists, and pychologists can be “implementation agnostic” and unconcerned with the biological details underlying the mind seems very dated.

Neurobiologists and experimental psychologists took note of the interdisciplinary cybernetics movement in the post-war period, and also adopted such (arguably under-defined) notions to make sense of otherwise low-level systems and phenomena (Werner, 2005). The multi-disciplinary cognitive science research program used core ideas of computation, representation, and information-processing to model a variety of mental systems and phenomena, but the behaviorist influence remained, typically constraining research to the more-readily modeled “objective” aspects of mind.

The theoretical and methodological difficulties associated with modeling emotions, conscious awareness, perception, and body knowledge disorders provided openings for a revised cognitive science and psychology that has come to be called neurophenomenology, or enactive cognitive neuroscience, which emphasizes:

-in contrast to representationalist theories, human cognition does not so much represent features of the outside world as it enables the mind to enact, co-constitute, or co-construct an experienced, perceived environment (Varela, Thompson, and Rosch, 1991) (Merleau-Ponty, 1962) via evolutionarily-selected sensorimotor systems (Lewontin, 1983)

-unlike many traditional cognitive models which look at mental activity “objectively” or from a Cartesian outside standpoint, as a system, the notion of embodiment in cognitive science privileges the notion that mental life is grounded in the lived body, which is to say, cognition has aspects which we are personally aware of and of which we experience consciously and bodily, (or, better, that are phenomenologically lived and felt)

-a recognition that verbal reports from people may very well be a critical and necessary source of data and insight for understanding the conscious, embodied character of mental and neural activity.

-an insistence that data developed from traditional, externalistic, “system-centric” based ideas and models of “mind” or “mental activity” or “cognition” psychology, cognitive science, neuroscience, and other disciplines such as informatics, human-computer interaction need to be re-examined in the light of the above concepts.

A succinct description of how mind and brain are understood in the embodied cognition mode of thinking was offered by Varela (1999, pp. 71-89):

“We tend to think that the mind is in the brain, in the head, but the fact is that the environment also includes the rest of the organism; includes the fact that the brain is intimately connected to all of the muscles, the skeletal system, the guts, and the immune system, the hormonal balances and so on and so on. It makes the whole thing into an extremely tight unity. In other words, the organism as a meshwork of entirely co-determining elements makes it so that our minds are, literally, inseparable, not only from the external environment, but also from what Claude Bernard already called the milieu intérieur, the fact that we have not only a brain but an entire body“