Summary of Phantoms in the Brain by V. S. Ramachandran and Sandra Blakeslee

BookSummaryClub Blog Summary of Phantoms in the Brain by V. S. Ramachandran and Sandra Blakeslee

The brain is, without question, a mysterious organ. We have yet to discover its full potential but as research continues we discover more and more about how it works. Historically, when doctors wanted to study what role a certain region of the brain had, they studied patients with damage in the region of interest. It was fascinating the effects that some of these injuries had and in the process, doctors were able to learn more about the brain. 

The symptoms that these people suffered were sometimes strange and even scary to those who did not know what was wrong with them. But for neurologists, they were windows into the brain. So, want to hear more about these strange cases? 

In this book summary readers will discover:

  • Why problems in the brain let us know how it functions
  • Phantom Limb Syndrome
  • What a patient’s delusions can tell you about their brain
  • The man who laughed at his mother’s funeral

Key lesson one: Why problems in the brain let us know how it functions

The brain is divided into two hemispheres with very different functions. Each hemisphere is specialized for its respective tasks. The left focuses on patterns, language and the production of sounds whilst the right hemisphere is focused more on comprehension and reading non-verbal cues. Even though they are distinct in their function, the two hemispheres still work together. 

Previously, discovering what each part of the brain was responsible for only occurred when something went wrong. Injuries or damage to a specific part of the brain usually resulted in a very specific loss of function. Take the hippocampus, for example, doctors only found out it is was associated with the formation of memories after it was removed from a patient with epilepsy. After its removal, the patient could no longer form new memories but could remember everything before the operation. However, discoveries like this can’t happen all the time – doctors cannot go removing parts of the brain to see what happens. Thus, they study neurological disorders which affect specific areas of the brain without causing further damage to patients.

There’s also something called a transcranial magnetic stimulator. As much as it sounds like something out of a sci-fi movie, it is very much real. It is basically a contraption that fits onto a person’s head and can’t stimulate small clusters of neurons. It can cause you to move by stimulating the motor cortex or allow a blind person to experience colours by stimulating the visual cortex. As much as this is a non-invasive method, it still does not produce as much information as studying neurological disorders and their effects.

Key lesson two: Phantom Limb Syndrome

We have all heard about amputees suffering from Phantom Limb Syndrome. It occurs when people who have had a limb removed still have the memory or sensation of the limb for a long time afterwards. Even though it is usually attributed to limbs, there have been cases where phantom appendages have been reported as well. 

So, why does it occur? Lord Nelson believed that his phantom arm was evidence of the soul. To some extent, he was right. Humans possess an internal body image quite distinct from our physical bodies. Over time, although separate, our body image and physical body almost become intertwined so that we don’t realise they are not the same thing. It is only when one loses a limb does it become clear that they are not. 

The frontal lobe of the brain has a vertical strip of tissue called the motor cortex. It is in this region that movement originates. The motor cortex sends signals to the muscles that make them move. This strip of tissue has a representational map of the entire body. The best explanation for phantom limb syndrome is that the motor cortex still sends signals to the muscles even though they are no longer there. The representational map present of the full-body no longer matches the real body with a missing limb.

Key lesson three: What a patient’s delusions can tell you about their brain

Delusions are often thought of as the rantings of a ‘mad’ person. They are often described when talking about clinically insane. However, delusions occur for a number of reasons and can also take several forms. 

Firstly, consider Arthur who had a near-fatal car crash that left him in a coma for weeks. He received a severe blow to the head in the accident and when he finally awoke, he had to relearn how to walk, talk and remember his past. Arthur worked hard and was able to make a full recovery with one slight exception. He believed his parents had been replaced with imposters. No matter what evidence was presented to him and even though he admitted that they looked like his parents, he insisted that they were imposters. This is called Capgras syndrome. The people who suffer from it usually accuse their closest family members of being imposters but there have been some cases where pets, things and even other people are thought to have been replaced. But what could have changed so drastically to make these delusions seem like the patient’s reality.

To study what occurs in the brain to cause Capgras syndrome, researchers look at changes in the galvanic skin response. This is basically a measurement of the sweat on someone’s palms when they are shown familiar faces. When Arthur was shown a picture of his mother there was no response. This meant that his limbic system had not been triggered at all which is not typical behaviour. It is thus inferred that the emotional response of the limbic system has a role in helping the brain identify the face we are looking at. So, when Arthur looks at his mother since there is no emotional response, the brain concludes that she is a stranger. Furthermore, since there is no emotional response, it further implies that this delusion is a reality

The second case to consider is that of Mrs Dodd. She had experienced a stroke in the right hemisphere of the brain. As a result, Mrs Dodd’s left arm was paralyzed but Mrs Dodd believed that it was fully functional. She could not understand what the fuss was about and why doctors were pestering her about her arm. Even when she was asked to perform functions with her hand, she claimed to have completed them all whilst everyone watched her left hand lay simply at her side. Mrs Dodd suffered from anosognosia which is the inability to perceive one’s illness. The question with anosognosia is whether it really is a neurological disorder or is it more psychological? Could Mrs Dodd just be in denial as some sort of defence mechanism from her stroke?

As much as denial can be a strong psychological response, the fact is that most people suffering from anosognosia have had strokes in the right hemisphere. Even more, evidence is that those who have a stroke in the left hemisphere tend to exhibit opposite tendencies. They obsess over their illness and chances of recovery. As more research is done in this area, there may be other neurological disorders that could possibly explain some psychological reactions.

The last case to be discussed concerning delusions and perceptions is that of Paul. Paul was a normal guy with a sturdy job and loved to read and write. His other pastime was talking to God. In his teens, Paul started hearing God around the same time he developed epileptic seizures. Paul’s seizures were not of the variety that we are familiar with. There were no involuntary contractions of muscles or convulsions. Instead, he reported being immersed in bright light and experiencing complete clarity. 

Seizures, like those Paul, suffered from, were extremely localized and if electrical disruptions occur in the limbic system, the seizures tend to take on an emotional experience. There have been numerous cases like Paul’s though when people report connecting to a divine presence when experiencing a seizure. What researchers are eager to find out is if we possess neural circuitry that is specifically concerned with the mystical. Is this why these localized seizures stimulate images or perceptions of conversing with a higher power? It is an interesting theory and one which still needs to be proven. It could just be that the results of the seizure are an accidental by-product of some other interaction.

Key lesson four: The man who laughed at his mother’s funeral

Ther once was a man named Willy who grieved heavily when his mother passed away. They were very close and at her funeral performed every duty a son could honour his departed mother. As her casket was being lowered into her grave, Willy started laughing. He tried to hold it in, to stifle it with his hand but he could not. All he could do was to try and walk away whilst every watched in shock.

Willy had experienced compulsive laughter. Cases of compulsive laughter are very rare and are associated with abnormal behaviour in the limbic system. But what caused Willy’s limbic system to act abnormally? Well, it was most likely the trauma of his mother’s death. Researchers looked at what usually causes laughter as well as its evolutionary development. It has been suggested that laughter could have formed as a form of communication, as a way to communicate a false alarm. For example, if there were a potential threat of a wild animal everyone would be on high alert but when the animal passed by they would laugh to signal that everything was okay. It seems a bit far-fetched but maybe laughter has been adapted over time. It no longer is a sound to signal a false alarm but more of a way to relax after any stressful situations. This would definitely explain Willy’s outburst at his mothers funeral. His body was just asking him to relax after a very traumatic experience.

The key takeaway from Phantoms in the Brain is:

The brain is a remarkable organ that is in more control of us than we can ever imagine. In fact, our very perception of reality is controlled by our brain and any damage could affect us profoundly. Whether it be delusions, conversations with God or even only brushing the hair on the left side of our head, the brain is responsible for everything. These interesting cases give us great insight into the human brain and how much our reality and everyday lives depend on it.

How can I implement the lessons learned from Phantoms in the Brain:

Don’t be quick to judge people because you do not understand their actions. Most people are quick to write off people with neurological disorders as crazy and scary. Unless you take the time to understand what is happening with them, you will abandon someone who may just need some help.

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