Brain implants, such as Deep Brain Stimulation (DBS), which are designed to improve motor, mood and behavioural pathology, present unique challenges to our understanding of identity, agency and free will. This is because these devices can have visible effects on persons' physical and psychological properties yet are essentially undetectable when operating correctly. They can supplement and compensate for one's inherent abilities and faculties when they are compromised by neuropsychiatric disorders. Further, unlike talk therapy or pharmacological treatments, patients need not ‘do’ (...) anything for the treatment to take effect. If one accepts, as we argue here, that brain implants are unique among implantable types of devices, then this can have significant implications for what it means to persist as the same person and be the source of one's thoughts and actions. By examining two of the most common indications for DBS in current use, namely in the motor (Parkinson's Disease) and psychiatric (Major Depression) domains, we further argue that although DBS, as it is currently applied, does not necessarily represent a unique threat to personal identity and agency per se, it introduces an unprecedented ‘third party’ into the debate on these concepts. In this way, DBS can be used as a tool to begin probing, both conceptually and empirically, some of philosophy's most perennial metaphysical questions. (shrink)

This article evaluates whether personal identity should be sought only in the biological or embodied existence of the person or exclusively in psychological existence. It suggests that whatever the answer turns out to be, it would involve causality. It argues against the animalist view of personal identity and defends the classical neo-Lockean view by arguing that the thick properties of person are psychological or mental ones. The author's answer to the question of what we are is in part that we (...) are creatures having certain kinds of mental properties as the thick properties whose causal profiles determine their persistence conditions. (shrink)

In his paper ‘Minimal self and narrative self: A distinction in need of refinement?’ Dan Zahavi argues that we need more notions of the self then the common dichotomy between minimal and narrative self. Zahavi proposes an ‘interpersonal self’ to bridge the gap between the embodied, but not yet social minimal self, and the narrative self that is obviously social, but through an emphasis on language. The interpersonal self would include pre-linguistic forms of sociality as well. His notion of the (...) interpersonal self is, however, ambiguous. It can refer both to 1) the ability to be aware of being an object of attention for another person and 2) to the ability to take the perspective of another person towards oneself. I argue that the pre-linguistic forms of sociality in the first sense are already part of the minimal self, and that hence the minimal self is a social self. (shrink)

An important shift is taking place in social cognition research, away from a focus on the individual mind and toward embodied and participatory aspects of social understanding. Empirical results already imply that social cognition is not reducible to the workings of individual cognitive mechanisms. To galvanize this interactive turn, we provide an operational definition of social interaction and distinguish the different explanatory roles – contextual, enabling and constitutive – it can play in social cognition. We show that interactive processes are (...) more than a context for social cognition: they can complement and even replace individual mechanisms. This new explanatory power of social interaction can push the field forward by expanding the possibilities of scientific explanation beyond the individual. (shrink)

This paper argues that self-consciousness and moral agency depend crucially on both embodied and social aspects of human existence, and that the capacity for practical wisdom, phronesis, is central to moral personhood. The nature of practical wisdom is elucidated by drawing on rival analyses of expertise. Although ethical expertise and practical wisdom differ importantly, they are alike in that we can acquire them only in interaction with other persons and through habituation. The analysis of moral agency and practical wisdom is (...) framed by Dennett's proposal that moral personhood requires satisfaction of six conditions, including self-consciousness. (shrink)

It is my view that one essential difference between persons and other creatures is to be found in the structure of a person's will. Besides wanting and choosing and being moved to do this or that, men may also want to have certain desires and motives. They are capable of wanting to be different, in their preferences and purposes, from what they are. Many animals appear to have the capacity for what I shall call "first-order desires" or "desires of the (...) first order," which are simply desires to do or not to do one thing or another. No animal other than man, however, appears to have the capacity for reflective self-evaluation that is manifested in the formation of second-order desires. (shrink)

Although philosophical approaches to the self are diverse, several of them are relevant to cognitive science. First, the notion of a 'minimal self', a self devoid of temporal extension, is clarified by distinguishing between a sense of agency and a sense of ownership for action. To the extent that these senses are subject to failure in pathologies like schizophrenia, a neuropsychological model of schizophrenia may help to clarify the nature of the minimal self and its neurological underpinnings. Second, there is (...) good evidence to suggest that although certain aspects of the minimal self are primitive and embodied, other aspects may be accessed only in reflective consciousness. Employing a modified concept of the minimal self, it may be possible to construct a robotic form of non-conscious self-reference that depends on an interaction between the robotic body and its environment. In contrast to the minimal self, the narrative self involves continuity over time and is directly relevant to discussions of memory and personal identity. There is growing consensus among philosophers and cognitive scientists about the importance of narrative and its relation to episodic memory and left-hemisphere functions. There are, however, at least two different views of how the narrative self is structured. On one model it is nothing more than an abstract point. On a more extended view, proposed here, the self is a rich amalgam of narratives that allows for the equivocations, contradictions, and self-deceptions of personal life. Even in this case, however, neurocognitive models contribute to our understanding of how narrative identity is structured. (shrink)

Little, Brown, 1992 Review by Glenn Branch on Jul 5th 1999 Volume: 3, Number: 27.

This paper takes a new look at an old question: what is the human self? It offers a proposal for theorizing the self from an enactive perspective as an autonomous system that is constituted through interpersonal relations. It addresses a prevalent issue in the philosophy of cognitive science: the body-social problem. Embodied and social approaches to cognitive identity are in mutual tension. On the one hand, embodied cognitive science risks a new form of methodological individualism, implying a dichotomy not between (...) the outside world of objects and the brain-bound individual but rather between body-bound individuals and the outside social world. On the other hand, approaches that emphasize the constitutive relevance of social interaction processes for cognitive identity run the risk of losing the individual in the interaction dynamics and of downplaying the role of embodiment. This paper adopts a middle way and outlines an enactive approach to individuation that is neither individualistic nor disembodied but integrates both approaches. Elaborating on Jonas’ notion of needful freedom it outlines an enactive proposal to understanding the self as co-generated in interactions and relations with others. I argue that the human self is a social existence that is organized in terms of a back and forth between social distinction and participation processes. On this view, the body, rather than being identical with the social self, becomes its mediator. (shrink)

Argues that educators should help students piece together authentic narratives about themselves and about society, and not to focus so much on teaching students to process information.

'Most of us are still groping for answers about what makes life worth living, or what confers meaning on individual lives', writes Charles Taylor in Sources of the Self. 'This is an essentially modern predicament.' Charles Taylor's latest book sets out to define the modern identity by tracing its genesis, analysing the writings of such thinkers as Augustine, Descartes, Montaigne, Luther, and many others. This then serves as a starting point for a renewed understanding of modernity. Taylor argues that modern (...) subjectivity has its roots in ideas of human good, and is in fact the result of our long efforts to define and attain the good. The modern turn inwards is far from being a disastrous rejection of rationality, as its critics contend, but has at its heart what Taylor calls the affirmation of ordinary life. He concludes that the modern identity, and its attendant rejection of an objective order of reason, is far richer in moral sources that its detractors allow. Sources of the Self provides a decisive defence of the modern order and a sharp rebuff to its critics. (shrink)

Self to Self brings together essays on personal identity, autonomy, and moral emotions by the distinguished philosopher J. David Velleman. Although each of the essays was written as an independent piece, they are unified by an overarching thesis, that there is no single entity denoted by 'the self', as well as by themes from Kantian ethics, psychoanalytic theory, social psychology, and Velleman's work in the philosophy of action. Two of the essays were selected by the editors of Philosophers' Annual as (...) being among the ten best papers in their year of publication. Aimed primarily at professional philosophers and advanced students, Self to Self will also be of interest to psychologists and others who theorize about the self. (shrink)

Deep Brain Stimulation (DBS) is a relatively new, experimental treatment for patients suffering from treatment-refractory Obsessive Compulsive Disorder (OCD). The effects of treatment are typically assessed with psychopathological scales that measure the amount of symptoms. However, clinical experience indicates that the effects of DBS are not limited to symptoms only: patients for instance report changes in perception, feeling stronger and more confident, and doing things unreflectively. Our aim is to get a better overview of the whole variety of changes that (...) OCD patients experience during DBS treatment. For that purpose we conducted in-depth, semi-structured interviews with 18 OCD patients. In this paper, we present the results from this qualitative study.We list the changes grouped in four domains: with regard to (a) person, (b) (social) world, (c)characteristics of person-world interactions, and (d) existential stance. We subsequently provide an interpretation of these results. In particular, we suggest that many of these changes can be seen as different expressions of the same process; namely that the experience of anxiety and tension gives way to an increased basic trust and increased reliance on one’s abilities. We then discuss the clinical implications of our findings, especially with regard to properly informing patients of what they can expect from treatment, the usefulness of including CBT in treatment, and the limitations of current measures of treatment success. We end by making several concrete suggestions for further research. (shrink)

People suffering from Obsessive-Compulsive Disorder (OCD) do things they do not want to do, and/or they think things they do not want to think. In about 10 percent of OCD patients, none of the available treatment options is effective. A small group of these patients is currently being treated with deep brain stimulation (DBS). Deep brain stimulation involves the implantation of electrodes in the brain. These electrodes give a continuous electrical pulse to the brain area in which they are implanted. (...) It turns out that patients may experience profound changes as a result of DBS treatment. It is not just the symptoms that change; patients rather seem to experience a different way of being in the world. These global effects are insufficiently captured by traditional psychiatric scales, which mainly consist of behavioural measures of the severity of the symptoms. In this article we aim to capture the changes in the patients’ phenomenology and make sense of the broad range of changes they report. For that we introduce an enactive, affordance-based model that fleshes out the dynamic interactions between person and world in four aspects. The first aspect is the patients’ experience of the world. We propose to specify the patients’ world in terms of a field of affordances, with the three dimensions of broadness of scope (‘width’ of the field), temporal horizon (‘depth’), and relevance of the perceived affordances (‘height’). The second aspect is the person-side of the interaction, that is, the patients’ self-experience, notably their moods and feelings. Thirdly, we point to the different characteristics of the way in which patients relate to the world. And lastly, the existential stance refers to the stance that patients take towards the changes they experience: the second-order evaluative relation to their interactions and themselves. With our model we intend to specify the notion of being in the world in order to do justice to the phenomenological effects of DBS treatment. (shrink)

Discusses contemporary notions of the self, and examines their origins, development, and effects.

This article examines the narrative approach to self found in philosophy and related disciplines. The strongest versions of the narrative approach hold that both a person's sense of self and a person's life are narrative in structure, and this is called the hermeneutical narrative theory. This article provides a provisional picture of the content of the narrative approach and considers some important objections that have been raised to the narrative approach. It defends the view that the self constitutes itself in (...) narrative and argues for something less than the hermeneutical view insofar as the narrative is less agency-oriented and without an overarching thematic unity. (shrink)

Recent significant research in a number of disciplines centers around the concept of the sense of agency. Because many of these studies cut across disciplinary lines there is good reason to seek a clear consensus on what ‘sense of agency’ means. In this paper I indicate some complexities that this consensus might have to deal with. I also highlight an important phenomenological distinction that needs to be considered in any discussion of the sense of agency, regardless of how it gets (...) defined, and I offer some critical comments on some current models tied to the notion that the sense of agency has an ambiguous phenomenology. (shrink)

This article explores the notion of the dislocated self following deep brain stimulation (DBS) and concludes that when personal identity is understood in dynamic, narrative, and relational terms, the claim that DBS is a threat to personal identity is deeply problematic. While DBS may result in profound changes in behaviour, mood and cognition (characteristics closely linked to personality), it is not helpful to characterize DBS as threatening to personal identity insofar as this claim is either false, misdirected or trivially true. (...) The claim is false insofar as it misunderstands the dynamic nature of identity formation. The claim is misdirected at DBS insofar as the real threat to personal identity is the discriminatory attitudes of others towards persons with motor and other disabilities. The claim is trivially true insofar as any dramatic event or experience integrated into one’s identity-constituting narrative could then potentially be described as threatening. From the perspective of relational personal identity, when DBS dramatically disrupts the narrative flow, this disruption is best examined through the lens of agency. For illustrative purposes, the focus is on DBS for the treatment of Parkinson’s disease. (shrink)

In this article, I explore select case studies of Parkinson patients treated with deep brain stimulation in light of the notions of alienation and authenticity. While the literature on DBS has so far neglected the issues of authenticity and alienation, I argue that interpreting these cases in terms of these concepts raises new issues for not only the philosophical discussion of neuro-ethics of DBS, but also for the psychological and medical approach to patients under DBS. In particular, I suggest that (...) the experience of alienation and authenticity varies from patient to patient with DBS. For some, alienation can be brought about by neurointerventions because patients no longer feel like themselves. But, on the other hand, it seems alienation can also be cured by DBS as other patients experience their state of mind as authentic under treatment and retrospectively regard their former lives without stimulation as alienated. I argue that we must do further research on the relevance of authenticity and alienation to patients treated with DBS in order to gain a deeper philosophical understanding, and to develop the best evaluative criterion for the behavior of DBS patients. (shrink)

" In Being No One, Metzinger, a German philosopher, draws strongly on neuroscientific research to present a representationalist and functional analysis of...

Christopher Frith is a research professor at the Functional Imaging Laboratory of the Wellcome Department of Imaging Neuroscience at University College, London. He explores, experimentally, using the techniques of functional brain imaging, the relationship between human consciousness and the brain. His research focuses on questions pertaining to perception, attention, control of action, free will, and awareness of our own mental states and those of others. As the following discussion makes clear, Frith investigates brain systems involved in the choice of one (...) action over another and in the understanding of other people. Such investigations are aimed at understanding brain basis of autism and schizophrenia. In his widely cited study of schizophrenia, The Cognitive Neuropsychology of Schizophrenia , Frith argues that many of the positive symptoms of schizophrenia, such as delusions of control, auditory hallucinations, and thought insertion, involve problems of self-monitoring. Patients, in effect, lose track of their own intentions and mistakenly attribute agency for their own actions to someone else. Frith employs models of motor control, involving comparator mechanisms and efference copy, not only to explain delusions that involve movement, but also to develop a neurocognitive explanation of delusional cognition. (shrink)

Deep brain stimulation (DBS) is a developing technology. New generations of DBS technology are already in the pipeline, yet this particular fact has been largely ignored among ethicists interested in DBS. Focusing only on ethical concerns raised by the current DBS technology is, albeit necessary, not sufficient. Since current bioethical concerns raised by a specific technology could be quite different from the concerns it will raise a couple of years ahead, an ethical analysis should be sensitive to such alterations, or (...) it could end up with results that soon become dated. The goal of this analysis is to address these changing bioethical concerns, to think ahead on upcoming and future DBS concerns both in terms of a changing technology and changing moral attitudes. By employing the distinction between inherent and noninherent bioethical concerns we identify and make explicit the particular limits and potentials for change within each category, respectively, including how present and upcoming bioethical concerns regarding DBS emerge and become obsolete. Many of the currently identified ethical problems with DBS, such as stimulation-induced mania, are a result of suboptimal technology. These challenges could be addressed by technical advances, while for instance perceptions of an altered body image caused by the mere awareness of having an implant may not. Other concerns will not emerge until the technology has become sophisticated enough for new uses to be realized, such as concerns on DBS for enhancement purposes. As a part of the present analysis, concerns regarding authenticity are used as an example. (shrink)

How we narrate our lives can affect us, for good or ill. Our narrative practices make an undeniable difference to our psychosocial well-being. All so-called "talking cures" – including traditional psychoanalytic and psychodynamic approaches to therapy and newer techniques – are motivated by this insight about the power of personal narratives. All therapies of the discursive ilk make use of narratives, in one way or another, as a means of enabling individuals to frame, or reframe, and to manage their life (...) circumstances in richer or new ways.Narrative Therapy, an important sub-class of talking therapies, breaks faith with more traditional psychodynamic approaches in adopting a... (shrink)

Does DBS change a patient’s personality? This is one of the central questions in the debate on the ethics of treatment with Deep Brain Stimulation (DBS). At the moment, however, this important debate is hampered by the fact that there is relatively little data available concerning what patients actually experience following DBS treatment. There are a few qualitative studies with patients with Parkinson’s disease and Primary Dystonia and some case reports, but there has been no qualitative study yet with patients (...) suffering from psychiatric disorders. In this paper, we present the experiences of 18 patients with Obsessive-Compulsive Disorder (OCD) who are undergoing treatment with DBS. We will also discuss the inherent difficulties of how to define and assess changes in personality, in particular for patients with psychiatric disorders. We end with a discussion of the data and how these shed new light on the conceptual debate about how to define personality. (shrink)

It is both an ideal and an assumption of traditional conceptions of justice for liberal democracies that citizens are autonomous, self-governing persons. Yet standard accounts of the self and of self-government at work in such theories are hotly disputed and often roundly criticized in most of their guises. John Christman offers a sustained critical analysis of both the idea of the 'self' and of autonomy as these ideas function in political theory, offering interpretations of these ideas which avoid such disputes (...) and withstand such criticisms. Christman's model of individual autonomy takes into account the socially constructed nature of persons and their complex cultural and social identities, and he shows how this model can provide a foundation for principles of justice for complex democracies marked by radical difference among citizens. His book will interest a wide range of readers in philosophy, politics, and the social sciences. (shrink)

We develop a version of a direct perception account of emotion recognition on the basis of a metaphysical claim that emotions are individuated as patterns of characteristic features. On our account, emotion recognition relies on the same type of pattern recognition as is described for object recognition. The analogy allows us to distinguish two forms of directly perceiving emotions, namely perceiving an emotion in the absence of any top-down processes, and perceiving an emotion in a way that significantly involves some (...) top-down processes ; and, in addition, an inference-based evaluation of an emotion. Our model clarifies the epistemology of emotion recognition. (shrink)

The principle of patient autonomy dominates the contemporary debate over medical ethics. In this examination of the doctor-patient relationship, physician and philosopher Alfred Tauber argues that the idea of patient autonomy -- which was inspired by other rights-based movements of the 1960s -- was an extrapolation from political and social philosophy that fails to ground medicine's moral philosophy. He proposes instead a reconfiguration of personal autonomy and a renewed commitment to an ethics of care. In this formulation, physician beneficence and (...) responsibility become powerful means for supporting the autonomy and dignity of patients. Beneficence, Tauber argues, should not be confused with the medical paternalism that fueled the patient rights movement. Rather, beneficence and responsibility are moral principles that not only are compatible with patient autonomy but strengthen it. Coordinating the rights of patients with the responsibilities of their caregivers will result in a more humane and robust medicine.Tauber examines the historical and philosophical competition between facts and values in medicine. He analyzes the shifting conceptions of personhood underlying the doctor-patient relationship, offers a "topology" of autonomy, from Locke and Kant to Hume and Mill, and explores both philosophical and practical strategies for reconfiguring trust and autonomy. Framing the practicalities of the clinical encounter with moral reflections, Tauber calls for an ethical medicine in which facts and values are integrated and humane values are deliberately included in the program of care. (shrink)

We propose an action-oriented understanding of emotion. Emotions are modifications of a basic form of goal-oriented striving characteristic of human life. They are appetitive orientations: pursuits of the good, avoidances of the bad. Thus, emotions are not truly distinct from, let alone opposed to, actions -- as erroneously suggested by the classical understanding of emotions as 'passions'. In the present paper, we will outline and defend this broadly enactive approach and motivate its main claims. Our proposal gains plausibility from a (...) literature- and interview-based investigation of emotional changes characteristic of clinical depression. Much narrative evidence from patient reports points towards the conclusion that many of those changes might result from a catastrophic alteration of the basic form of goal-pursuit at the root of human emotionality. The experience of profound depression could in this respect be a kind of inverted image of non-pathological emotionality--a highly unnatural passivity, giving rise to a profound -- and quite horrifying -- sense of incapacity. (shrink)

This article focuses on mirror self-recognition, the ability to recognize one's own image in a mirror. It presents the result of the first experiment on mirror self-recognition which showed that chimpanzees are able to learn that the chimps they see in the mirror are not other chimps, but themselves, as evidenced by self-directed behaviour. It reviews evidence for neural network for self-recognition and self-other differentiation and cites evidence that frontal cortex and cortical midline structures are implicated in self-recognition tasks. It (...) also suggests that the mirror self-recognition ability correlates to large brain size relative to the animal's body size. (shrink)

Ethical evaluation of deep brain stimulation as a treatment for Parkinson’s disease is complicated by results that can be described as involving changes in the patient’s identity. The risk of becoming another person following surgery is alarming for patients, caregivers and clinicians alike. It is one of the most urgent conceptual and ethical problems facing deep brain stimulation in Parkinson’s disease at this time. In our paper we take issue with this problem on two accounts. First, we elucidate what is (...) meant by “becoming another person” from a conceptual point of view. After critically discussing two broad approaches we concentrate on the notion of “individual identity” which centers on the idea of “core attitudes”. Subsequently we discuss several approaches to determine what distinguishes core attitudes from those that are more peripheral. We argue for a “foundational-function model” highlighting the importance of specific dependency relations between these attitudes. Our second aim is to comment on the possibility to empirically measure changes in individual identity and argue that many of the instruments now commonly used in selecting and monitoring DBS-patients are inappropriate for this purpose. Future research in this area is advised combining a conceptual and an empirical approach as a basis of sound ethical appraisal. (shrink)

I argue that Axel Honneth, reappropriated Colwyn Trevarthen's distinction between primary and secondary intersubjectivity,into his critical social theory. How the concept of primary intersubjectivity gets re-incorporated, or indeed, re-cognized in Honneth’s conception of recognition, however, is a complex issue that Iexplore in this essay. It is linked to questions not only about child development, but also about whether one should understand recognition in terms of a summons, following Fichte, or in terms of a struggle, as Honneth, following Hegel, suggests, or (...) in terms of a gift, as Ricoeur, following Hénaff suggests. (shrink)

This paper explores the impacts of neurological intervention on selfhood with reference to recipients’ claims about changes to their self-understanding following Deep Brain Stimulation for treatment of Parkinson’s Disease. In the neuroethics literature, patients’ claims such as: “I don’t feel like myself anymore” and “I feel like a machine”, are often understood as expressing threats to identity. In this paper I argue that framing debates in terms of a possible threat to identity—whether for or against the proposition, is mistaken and (...) occludes what is ethically salient in changes from DBS. Rather, by adopting a relational narrative approach to identity and autonomy, I show that the ethically salient issue from DBS is impacts on autonomous agency—whether one’s actions and beliefs are one’s own, and how DBS may hinder, or foster, embodied, relational autonomy competences. This approach recognizes that if sufficiently significant, impacts on autonomy competences may pose a threat to one’s ability to contribute to the process of authoring one’s own life and so pose a threat to identity formation. I argue this approach resolves the confusion in the literature about whether and how DBS threatens identity and provides a complex picture of how DBS may affect selfhood by disrupting narrative identity formation and revision, distorting agency and/or undermining autonomy. (shrink)