Ask Dr. Drew - Neuroscientist Dr. Antonio Damasio: How Brains Process Decisions & Emotions – Ask Dr. Drew – Episode 58

Episode Date: December 6, 2021

Dr. Antonio Damasio is an internationally recognized leader in neuroscience. He has made seminal contributions to the understanding of brain processes underlying emotions, feelings, decision-making and consciousness. Currently, Dr. Damasio is University Professor, Professor of Psychology, Philosophy and Neurology, and David Dornsife Chair in Neuroscience as well as Professor of Psychology, Philosophy, and Neurology, at the University of Southern California, and, additionally, an adjunct professor at the Salk Institute. Dr. Damasio has written several books, including Descartes’ Error, Self Comes to Mind and The Strange Order of Things. His latest book, Feeling and Knowing – Making Minds Conscious was just released and is an “investigation of the phenomenon of consciousness and its relation to life.” Ask Dr. Drew is produced by Kaleb Nation ( https://kalebnation.com) and Susan Pinsky (https://twitter.com/FirstLadyOfLove). SPONSORS • BLUE MICS – After more than 30 years in broadcasting, Dr. Drew’s iconic voice has reached pristine clarity through Blue Microphones. But you don’t need a fancy studio to sound great with Blue’s lineup: ranging from high-quality USB mics like the Yeti, to studio-grade XLR mics like Dr. Drew’s Blueberry. Find your best sound at https://drdrew.com/blue  • HYDRALYTE – “In my opinion, the best oral rehydration product on the market.” Dr. Drew recommends Hydralyte’s easy-to-use packets of fast-absorbing electrolytes. Learn more about Hydralyte and use DRDREW25 at checkout for a special discount at https://drdrew.com/hydralyte  • ELGATO – Every week, Dr. Drew broadcasts live shows from his home studio under soft, clean lighting from Elgato’s Key Lights. From the control room, the producers manage Dr. Drew’s streams with a Stream Deck XL, and ingest HD video with a Camlink 4K. Add a professional touch to your streams or Zoom calls with Elgato. See how Elgato’s lights transformed Dr. Drew’s set: https://drdrew.com/sponsors/elgato/  THE SHOW: For over 30 years, Dr. Drew Pinsky has taken calls from all corners of the globe, answering thousands of questions from teens and young adults. To millions, he is a beacon of truth, integrity, fairness, and common sense. Now, after decades of hosting Loveline and multiple hit TV shows – including Celebrity Rehab, Teen Mom OG, Lifechangers, and more – Dr. Drew is opening his phone lines to the world by streaming LIVE from his home studio in California. On Ask Dr. Drew, no question is too extreme or embarrassing because the Dr. has heard it all. Don’t hold in your deepest, darkest questions any longer. Ask Dr. Drew and get real answers today. This show is not a substitute for medical advice, diagnosis, or treatment. All information exchanged during participation in this program, including interactions with DrDrew.com and any affiliated websites, are intended for educational and/or entertainment purposes only. Learn more about your ad choices. Visit megaphone.fm/adchoices

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contact Connex Ontario at 1-866-531-2600 to speak to an advisor free of charge. BetMGM operates pursuant to an operating agreement with iGaming Ontario. Susan and I flew back from Costa Rica at 4 a.m. this morning specifically so I could interview my present guest. There's a lot of excitement on Restream and those of you that are on the Clubhouse. I'm not sure if we're going to take questions today. We'll see how this goes. But do listen there. And of course, if you do take questions, you'll be up on the Restream on Twitch, Twitter. We're on Rumble today too, Susan? Yes.

Facebook, everywhere. Everywhere you can be seen, you will be seen. Arriba, arriba, andele, andele. Yes, Dr. Antonio Damasio, probably the leading voice in neuroscience in the world. He has seminal contributions to the understanding of brain processes. His books, many of which are for general consumption, include Descartes' Error, which was really his sort of breakout book, I think. Self Comes to Mind, Looking for Spinoza, Feeling of What Happens.

And the latest book is Feeling and Knowing. Dr. Damasio is the University Professor of Psychology, Philosophy, and Neurology, and the David Dornsife Chair in Neuroscience, as well as Professor of Psychology, Philosophy, and Neurology at the University of Southern California, and Adjunct Professor at the Salk Institute.

In addition to being a physician, he is a research scientist. Our laws as it pertained to substances are draconian and bizarre. A psychopath started this. He was an alcoholic because of social media and pornography, PTSD, love addiction, fentanyl and heroin. Ridiculous. I'm a doctor for f*** sake. Where the hell do you think I learned that? I'm just saying.

You go to treatment before you kill people. I am a clinician. I observe things about these chemicals. Let's just deal with what's real. We used to get these calls on Loveline all the time. Educate adolescents and to prevent and to treat. If you have trouble, you can't stop and you want help stopping, I can help. I got a lot to say.

I got a lot more to say. I want to give a shout out to our good friends at Blue Mics. If you've heard my voice on this show any time over the past year, including right now, you've been listening to Blue Microphones. And let me tell you, after more than 30 years in broadcasting, I don't think I have ever sounded better. But you don't need to be a pro or have a fancy studio to benefit from a quality mic. You may not realize it, but if you've been working from home or using Zoom to chat with friends, you probably spent a lot of time in front of a microphone. So why not sound your best? Whether you're doing video

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now available in ready-to-drink bottles at the Walmart next to the pharmacy. Or as always, you can find it by visiting hydrolyte.com slash drdrew. Again, that is H-Y-D-R-A-L-Y-T-E dot com slash D-R-D-R-E-W. Be sure to use the code drdrew25 for a special discount. Dr. Damasio, welcome to the program. My pleasure to be here. So I've got so much I want to talk to you about today. Are you feeling okay? This is a conversation about feeling. I know this has been frustration and desperation getting you to this point. Are you okay? I'm trying to feel okay,

but we had quite a lot of trouble with the connection, so it's not exactly the most auspicious way to start. But I know that you're going to make it worth my desperation. That's right. We're going to make it worth your time and desperation. It looks good and it sounds good. And that's what counts here. By the way, I don't know if you remember, but I sat with you one afternoon.

I got a chance to meet your wife, who I think I saw lurking around behind you, probably the one solving these technical problems. She was trying to solve the technical problems along with your people and and without her I would not have been able to do it well which is you jump ahead well I have the exact same relationship with my wife which is yes he does fairly helpless let me jump ahead to her research and we'll kind of we're going to I'm going to want to jump around a little bit. And this may, this, my interview sort of style may not be, I've heard you on some other podcasts and interview shows. And I, I thought I, I'm just going to go with what interests me because there's so many things in your new book that do interest me. One of the things you were talking, well, that's what I want to talk about. I learned from your wife, and you

too, that a major component of the dissolution of the self associated with Alzheimer's disease is the dissolution of the posterior or the destruction of the posterior parietal lobes. Did I get that correct? Or that region, the sort of what used to be called the transitional areas uh yes you you got it right and that's that's interesting way to to to start i would have not have started there but here's here's the the fact that's true um and it helps me to say something i think very important when you when you have damage in some of the higher cortices, especially parietal cortices, for sure, when you have damage there, you actually have a major insult to mind processes, to those processes where we put together images, can be images from the visual system, images of things that we see and hear and touch or even smell, but they're images of the things that are in the world that surround

us. Curiously, that same kind of damage does not destroy and does not compromise images that correspond to the interior of our bodies, to the interior of our living bodies, which really means that they're not, they don't impinge on feeling as much as they impinge on the outside world. And they end up being more of a problem for how we construct the mind, either from what we see or from what we remember, than creating a problem for consciousness itself. So it's very complicated because you literally started at the top. higher cortices, the higher parts of the cerebral cortex. You damage primarily structures that are in charge of creating images, of creating the flow of our minds, the stream of our minds. But you don't necessarily damage the kind of images that correspond to life inside the body, which really means that you don't compromise that much feeling and you end up not compromising consciousness,

which really means that I'm already telling you that if you want to understand consciousness, don't start at the top. Don't start by the large picture of our mind stream. Start instead by the lower uh components by what has to do with our body from the interior on out it's actually the the reverse trajectory um but well if you learn that let's continue let's let's let's continue in that reverse trajectory so what you put what you put beneath is something, an extraordinary complex, which, see,

the reason I brought this up, I thought, that looked like what your wife was doing when I was visiting you guys, which was the interconnectivity around the so-called affect complex. The regions, the nuclei, the regions, and the processing that's going on that affect complex, and whether or not that is simultaneously alive, so to speak, at the same time as the parietal cortices, or is there communication or both between the parietal cortices and the affect complex?

There is plenty of communication, but what is interesting, because I know that you're interested in consciousness, obviously, and you're interested in feeling also. So what is, because feeling is, in fact, the main component of what we normally call affect. It includes other things such as emotions, but the main component is feeling. what is interesting is that the kinds of damage to the nervous system that compromise feeling actually happen more at the level of the brainstem and even at the level of the spinal cord than they happen at the level of the cortex. One thing we know for sure is that you can have extensive regions of the cerebral cortex literally disappear, as when you have a large stroke or you have a surgical ablation,

and still you preserve feeling, which is very interesting. On the other hand, we know that if you have even a small stroke in a strategic area of the brainstem, you can produce coma, and that coma will obliterate consciousness, sometimes forever, and you'd have no, you have very, it's very difficult to recover from it. So there's a very strange misalignment here, you have something which is vital to generate consciousness, which is feeling that depends on this beautiful conversation between the nervous system on the one hand and our living body on the other and that

depends on structures that are somewhat lower down than the cerebral cortex the structures in the brain stem and even the spinal cord and many structures that are really in peripheral nerves that go into every nook and cranny of our bodies and bring information into the nervous system. Whereas the sort of big mind, the great picture of the world that we construct with our higher senses such as vision or hearing or or smell or touch those are actually somewhat more uh somewhat more robust uh when you when you have damaging lower structures so i want to keep going down so i'm going to keep going down we started up the parietal regions and we're going down through the affect complex

and I was surprised well I wasn't surprised I was intrigued that the periaqueductal gray was sort of in the center of so much of that affect complex and for me the PAG is kind of a mystery but the question I have is a lot of what comes into that brainstem

region through the afferents of the vagal nerve and through processing of the sympathetic nervous system comes into those brainstem nuclei. And do we really know what they're doing is my question. Because I was surprised there wasn't more about the autonomic nervous system. Well, there are two things that surprise me. Because let me just, these are hard questions to ask because these are complicated issues. The affect complex made perfect sense to me. And I saw that as one of the building blocks of consciousness. It made perfect sense to me.

But I've also been thinking that, did you read Bud Craig's book about how we feel about the, or how do you feel about the insular cortex and the lateral spinal thalamic tract? Essentially he has, what I was trained was a sensory and a sort of a temperature and pain system. He has it as the core input into the insular cortex through some sort of thalamic processing as how we create the sort of body maps of feeling, the interoceptive maps of feeling. It didn't seem like I saw that in your reasoning, in your model. No, no. And I think it's very important that you, you you know if we're going to be really serious about this we have to change that paradigm uh with all due due respect to colleagues that have thought that the cortex was primary and so what i want for you and for everyone that is watching and listening is that it is actually not the cerebral cortex

that is the main provider of the kind of information that allows you to be conscious and we need to start the story at a much simpler level and if you don't mind can i tell you the story my way please yeah do it go ahead um so i would i would tell the story the following way um when first of all when people think about feelings they very often think about feelings of emotions or which is worse they confuse feelings with emotions feelings are entirely subjective states. They are experiences that we have, whereas emotions are acting out. They're collections of actions that we can produce. When you are joyful or when you are angry or when you are in fear, your face and your body adopt a number of postures, a number of small acts. And it's all something that I like to describe as a concert of actions,

which is the reason, by the way, why emotions are directly detectable by others who will know or will presume what is going on in your mind because of the way you act, okay? By the way, the reason why we classify actors as good or not when we see them in the theater or in the movie the great actors are the ones that mimic the actions of emotions in such a way that we believe them and we think they are actually having all of those um states that bring out the joy or the fear or the anger feelings on the other hand at the core are purely subjective purely internal states they are experiences and so you will not know if for example I am hungry unless I tell you that I'm hungry uh and you will not know if I'm thirsty, nor will you know that I am in pain, except that maybe my pain is so huge that it sort of spills out and you will see that I am all distorted by my pain. which are the paradigm for feeling are things such as hunger, thirst, well-being, malaise,

pain, of course, all of those states are internal states. So they are subjective, they're interior. Now, what is very important when you look evolutionarily at what we are and what we have been, is that these states developed in all likelihood very early in the history of life. And they developed and they have a role to play. What do you think is that role? It's information, it's knowledge. That's why my book is called Feeling and Knowing. Feelings, those kinds of feelings bring you knowledge about the state of life in the interior of your organism not only that it's it's they bring you that knowledge and that knowledge is qualitative it goes in the good direction of the bad direction and then feelings do one other thing that is spectacular is that on the basis of that information, you have the incentive to act on it and do something about it.

If you're hungry, you try to get food. If you're thirsty, you drink. And if you have pain, you do something about it. And you try to find out what's the cause. And you treat yourself the best way you can. Okay, so why is it that this spectacular development in nature, which is feeling, which gives you the experience, which is internal, and which pushes you into action and provides you an incentive to act,

why is it that this really works? It works because, to begin with, every feeling is spontaneously and automatically, naturally conscious. And this is something that is sort of quite obvious, quite in front of our eyes, and yet it's completely ignored in discussions about consciousness which on the other hand try to approach the problem of consciousness through the most complicated way now of course I understand why people do that and I did that earlier in my career and that consists of thinking well consciousness is so obviously important. We would not be anything if we were not conscious, both in terms of the consciousness that I just described. For feelings, we would simply die if we were not conscious.

And if we did not have those feelings, tell us what to do. see in the world around what we what we see what we hear the combination of all the spectacular images that we can construct of the world that surround us is so incredibly detailed and rich and so much the compo the big component of our lives that we take feelings for granted we forget that they're there we forget that they're there, we forget that they exist. And so what I'm trying to say is the following, that without feelings, which are at the beginning of my story, you will not have consciousness. And that feelings are, in fact, in my description, the inaugural event of the long history of consciousness it's the inauguration of it it begins there so when people tell me well we will never be able to understand what what consciousness

is i said i'm sorry we have been conscious and lots of creatures before us have been conscious for a very very long time and that's for a very good reason is because they have feelings and this other great spectacle this this scenorama with great audio and other features that dominates our minds is in fact misleading if we want to understand what what consciousness is of course it's not misleading in the sense that it's good to have that world outside and to have that world come to us through highly sophisticated components of the nervous system. when you are dealing with the cerebral cortex you're dealing with the enabler largely with the enabler of the spectacular multi-dimensional multi modality world that you get from the outside in and if we did not have a cerebral cortex you could not create those images you could not put them in memory you could not reason you cannot translate them into language which is what

i'm doing and you're doing on your side but in reverse so the world of the cerebral cortex is spectacular and important but the world that brings us consciousness to begin with is a world that is much simpler and in fact has existed for a long long long time, in all probability, before there were cerebral cortices, and clearly in many, many creatures long before there were humans. So I've spoken my mind. So let's go, I get it, and let's go down to the paramecium or the bacterium, the single-cell organisms, which behave as though they have feelings, as though they have motivation, but they're just following chemical pathways

or reacting to… So is there a threshold, though, for consciousness where we start to talk about it meaningfully? Yeah. Well, you just used the key key words which behave as if that's exactly it so organisms that are fairly simple and that are alive clearly they have a metabolism they need energy they do lots of things like choosing the right part of the environment. But whenever I, when I said the word choosing, I should have put quotes around that word and I can't when I speak. But what happens is that they

behave as if they were conscious, they behave as if they knew what they were doing. As it turns out, they don't. As it turns out, they are are intelligent but their intelligence is covert their intelligence is not we can call it implicit covert non-manifest because they don't have the power in their organisms to represent what's outside or what's inside they are able to do it by a very intriguing mechanism which by the way is partially elucidated but not fully and they do not have the capacity to represent what's going on by the way plants are exactly in the same position so the same way that you have bacteria behaving that way, you also have plants which are obviously alive, which have needs, for example, they bring nutrients from the soil feelings in the proper sense and they do not have consciousness and what's happening there is again an implicit covert intelligence that allows them to behave very intelligently but they do not have a nervous system and here uh comes comes the critical issue, is that in order to create feelings, in order to create any other kind of representation, you need nervous systems to give you the possibility of generating maps, generating patterns.

And it's out of those patterns that you're going to have the possibility of generating images if you're thinking about the outside world and in relation to feelings you do it through a combination to it's very interesting what i propose in my current thinking and in that book what i propose is a marriage of really body and nervous system so I'm not saying we get feelings out of the nervous system. In fact, that's one of the things that I'm trying to fight against is this idea that if you know the brain, if you're a neuroscientist or a neurologist, you're going to have the chance of explaining everything, including consciousness. That's going down a garden path that will not lead to a solution. Because feeling is born out of this interaction between what belongs to the nervous system

and what belongs to the body. There is an intermingling of the two. And if you want, I can even tell you why that intermingling is possible because of the very particular nature of the nervous system when it is confronted with the body. Sorry to go so long. No, which is that the parts of it don't have a blood-brain barrier and there's all sorts of overlap and interactions that are not strictly wiring. You're fully informed. i should be interviewing you um well i i go ahead no it's it's it's true you just touched on some very important aspects so for example if you look at the the the way our visual system operates operates first of all it's very late the visual system was the the

the late arrival in all the systems that bring the world on to us but you look at that system it's really extraordinary you know whether you look at the retina or the optic nerve or the visual cortices what you find is the most modern, quote unquote, neurons that you can find in nature. You find these cables that are perfectly insulated with my it, that nature has taken many, many millions of years to arrive at that huge complexity and perfection. And much the same could apply to the auditory system or to touch and so forth. When you look at the nervous system that participates in the making of feeling, we find exactly the opposite story. So first of all, it's the oldest of all systems. No question.

Here we're not talking about hypotheses. We're talking about certainties. It is the oldest of the systems. And then it shows the age by by its architecture you know it's like a it's like a poorly built house um but a poorly built house is very convenient and that nature has kept that way because it's convenient and because it delivers the goods and what you find is that there's no myelin in the in the axons you find which allows for example the the the neurons to respond to chemicals that are around it and then you find something quite extraordinary that i i mentioned in the book and you just mentioned the blood-brain barrier so for example when you look at our cerebrum

our brain the cortex is protected by a set of membranes that form what we call the blood-brain barrier and it's there to avoid that the ups and downs of a variety of chemical molecules that is part of our day with digestion different hours what we work our excitements and so forth our efforts sleep all of that is being very well protected by the presence of this blood-brain barrier that eliminates an interaction between the neurons that are there in the nervous system and all this bath of chemistry that is around the nervous system. Lo and behold, when you go to the ganglia that bring information from the body into the spinal cord or into the brain stem, what you find is huge gaps of the blood-brain barrier, which means, once again, that there is a possibility for the body, meaning the chemical molecules on the side of the body, commmingling with the structures of the nervous system, who are there sort of

able to receive them and interact. And once again, my idea that this is an intermingling, it's a cooperation of two components that yields something new, and was something new in evolution when it first appeared, which is feeling this this ability to experience what is going on and and I think you mentioned also of course the pituitary is part of the central nervous system is intimately involved in the blood let's say interacting with absolutely absolutely and the the entire thing what is so important here is to see that this was a beginning of a story that, of course, it's not simple in any way, but it is simpler than what many people have tried to imagine it would be like. So people have the tendency, which I did, when I when I began studying this, these problems, and saying, well, your consciousness is so important

that it has to be associated with the most refined parts of our nervous system. Lo and behold, it's not that way, as far as I can see, it's opposite of that it starts with the simpler parts now of course the simpler parts of our nervous system are anything but simple they're extremely complicated obviously i i don't need to insist on that but but it it yields something different and the other thing that is so interesting is that the possibility that we have of understanding uh or and being conscious of for example for example i'm conscious right now of being looking at a screen where unfortunately i see myself i don't see you completely uh which i could but i don't see you completely and all of this is extremely complex and rich and is done in a very different way from the simpler parts of feeling. that I'm seeing or the images that I have of my study right now, connect those images with that

core of feeling that is allowing you to be conscious. It's that marriage of every image that you can have to the core of feeling which constitutes your core self that is what allows you to be conscious so in in a way complicated as it is the problem i think is solvable now of course i could be entirely wrong which i doubt i am but uh well let me i wanted zero in on consciousness in a second, but before we do, is it oversimplification to say the way we evolved is from a neurobiological standpoint is not by evolving old systems into new, but piling new systems upon old? Is that an oversimplification? Not at all. Not at all. I think you said it and you said it beautifully.

And that's an extremely important idea. We create these novelties, you know, quite amazing to think we could go back to the time of the first feelings. And the time of the first feelings, I imagine, was actually with very simple nervous system, nervous systems that were literally just beginning to do its thing. But you know what, what it produced something extraordinary. From the moment you had feelings, suddenly, you had knowledge being brought into the system, factual knowledge, because if you have pain, that's factual knowledge. And the nervous system was allowed to respond to that knowledge. Prior to that, it couldn't. You had to know that in order to respond in a more intelligent way. And being

hungry or being thirsty or having pain or being well, by the way, all of those are informative. Being well gives you license to do other things rather than curating your body. So if you're well, you can have a good time and you can worry about procreation and other such things so the this is informative and that knowledge yeah carries enormous weight because it allows creatures to start responding not just automatically with that kind of bacterial intelligence that we mentioned that implicit covert stuff now you're going to start responding with some knowledge, with some assertion that comes from you being aware of you. You know, it really is the bringing of the self at its very, very timid beginnings. In an embedded world.

It's a self embedded in a world, which is kind of interesting. And my bet is the endocrine piece was linked deeply to this evolution because I'm imagining catecholamines and fear, the hunger enzymes and eating. They're just how the priorities of life, it's eating and getting away and then reproducing. Exactly.

You just got it you're perfectly correct and make no mistake you just said something extremely important is that these things probably began mostly at the chemical level so there were things that were being done by our organism or with our organisms that were being done by chemical molecules. It didn't start with actions from striated muscles pushing people around or embracing people. This starts at a modest chemical level, except that the word modest probably does not apply, except in comparison with what we do now with our with our reason and creativity it was modest only by comparison because it was already extremely complex is it appropriate to

call feelings cognitions ah you see that that's a beautiful question it's very interesting nobody has ever asked me that and i like that question very much because to me feelings that produce cognition feelings are an early part of the story of cognition because feelings bring you knowledge so that's again why it's i call it feeling and knowing. But, of course, when you think about knowing, what occurs immediately is the idea of cognition. Cognition is about knowing. So the answer should be, I think, yes, feelings bring on a kind of cognition. Although in the way our disciplines have evolved academically, for example, and in all of the research enterprise, people have always tried to make a separation between affect and cognition.

And of course, when we talk about affect, the words that occur to you immediately, the concepts are feeling and emotion. So there you have more of a separation because people who call themselves cognitive scientists, there's no reason why they should not study feelings, but many of them don't. And there are people that call, for example, in discussions on this matter, it's common to say, well, so-and-so is too cognitivist. And that simply means that that person is not paying due attention to things that have to do with affect, which means feeling.

So cognition and feeling are from an artificial division of labor, especially in the academic world and in philosophical traditions. They are separate. But in the end, they're not. The historical anachronism, both about epistemology and metaphysics, and then the way psychoanalysis evolved, and then cognitive disciplines just grew separate from whatever that was. Interesting. And also, I noticed you seem to assiduously avoid

mood. Is that true or did I miss it? No, no, no, no. It's certainly not assiduously. No, it's just that the, you know, by the way, how should I address you?

Through to that? Okay, just like that. Okay, just like that. So the you know, I think that one is trying when one is trying to explain things that are as complicated as consciousness and feeling, the more words you bring into the mix, the less clear you're going to be. So it's not that I'm ignoring moods. That's a very interesting concept and it describes important things like for example most of my my day i have been in almost a bad mood uh and uh and by the end i was even in a worse mood because i was desperate about the other connection so when you tell me that i'm insidiously avoiding moods i can tell you two answers yes i

don't want more moods like today's but no i'm not i'm not avoiding that there are plenty of words just keeping it clearer give me it keep it keep it as it's interesting you know it's funny i i it's jumped out of me because i i started thinking about how Heidegger, you know, epistemological phenomenologically thought about moods as things that are part of the environment that we, again, it's something that happens to us because the environment, the room has a mood and we're affected by it. That was his construct,

but I got to take a quick break here. And when we get back, what I want to do is get in and let's start, let's get into conscious. Let's define consciousness and really get into specifics. Okay. Very good. Here with my daughter, Paulina, to share an exciting new project. Over the years, we've talked to a ton of young people about what they really want to know about relationships. It's difficult to know who you are and what you want, especially as a teenager. And not everyone has access to an expert in their house like I did.

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It doesn't have to be awkward. On sale September 21st. So, yes, of course, Doesn't That Be Awkward is out. The other book we're talking about is Feeling Annoying with Dr. Antonio Damasio. And let's jump right back into it with the topic of consciousness. Shall we try to define it? And I'll get later into whether it's a hard problem or not. Very good. So consciousness is what allows us, putting it in as simple a way as possible, what allows us to experience, obviously from the inside, the state of our life, to experience the fact that we are alive in our bodies, and to connect that experience with the kinds of things that we see or hear

or touch or smell or taste around us. So it really, the critical words are experience, subjectivity, because it's from the subject. There is a subject that is doing this. And the fact that there is a valence to it, there is a quality. So whatever it is that we are conscious of, we have, in most circumstances, a sense of whether that is agreeable or disagreeable at some point in those two extremes. So I'm now having this conversation and I have all sorts of reasons why

intellectually this is an agreeable conversation and I like it. And I like the idea that I'm having this conversation for several reasons. At the same time, my consciousness of it also has this element that is negative because we had a problem with our connection and we had to delay your program. So it was, there's that mixture mixture but that mixture is what life is more often than not about life is not just unpleasant or pleasant there's a constant modulation that is happening at any moment and consciousness is what allows us to be uh experiencing our life with all of that effect component that is so important. I want to try to differentiate self from consciousness or how self figures into consciousness. And as you were speaking, I started thinking that the William James's I am and the William James me sort of break down into your consciousness versus self categories, right? Isn't the conscious subjectivity is the I am and the me is the self?

A little bit, yeah. I think the self actually is probably the most difficult to define of these terms. I mean, the idea of consciousness, the idea of an experience, and an experience that feels like something, I think is, you know, it's not exactly easy, but it's something that you can you can conceptualize you can get around that when you think about self is that what is that is it the notion of your body in its entirety is it a notion of a sort of me an eye inside that is much more tricky to define and in fact there are all of these different kinds of self depends on the gradation the the important thing is that the most important of the selves is the basic one is the one that provides the authentication of whose body you're in um just for you and for your viewers just think about this is it ever the case that when you feel hungry you ask the question could it be that it's not me that feels hungry there is somebody else does this hunger belong

to me you never ask that question for a very good reason is that the feeling of hunger is so interwoven with the sort of core representation of who you are as a human being as a body a life that you automatically know that it's you having the hunger or the thirst or the desire for whatever um and you're not going to have any hesitation. Now, what is interesting is that there are other selves that are more complex, more intellectually complex. So, for example, if you ask me something about my life as a citizen or my life as an academic, my life as a scientist. The self that I have as a scientist is much more complicated because there are elements that are the core self, which has to do with our lives, and how they're being lived moment by moment. And then there are other aspects which have to do with a lot of cognitive stuff that has to do with our professions our societies uh how we go about doing the work uh the comparison for example between doing science now or doing science at the

time of william james all of that is a still about a self but it's much more complex and that one is very richly mental uh in the quote unquote term because it's full of all this this bits of knowledge that you procure from different uh cerebral cortices and you put together in this great image of what it is a human being living now in 2021 after a pandemic or in a pandemic. So it's the self is complicated if you bring in all of that story. But if you stay with a core self, then I find it relatively easy to define and to defend. It's what allows you to be certain that what's happening to you is happening to you and not to somebody else. That authentication, that certification

that your feelings are in your body, in your life, and not in somebody else's. You had once defined it as repeatedly reconstructed neurobiological processes that endow experience with subjectivity. Yes, that's very beautiful. That's all Damasio. I loved it too.

That's why I always remember it. But I still think it's relevant in this. No, I think it is. I still think it's, because I want to, you mentioned valence and feeling like something, which is really the, the, the concept of qualia, right? And so there, the famous quality is the famous quality is what does it feel like to be a bat? Somebody is having that feeling that we have this whole second order thing that humans experience that there is an awareness of an awareness or some. But they're an awareness that somebody, not just some bat, but somebody, Antonio, somebody drew is having these experiences. Yeah. Right.

And you have that it gets into a very interesting diversion, which is not only do we know about ourselves, and that's the great gift of feeling and core self, but we also can imagine the states of others, which we can imagine from a variety of clues. And then we can sort of put ourselves in the state of others by drawing on this big process of empathy, which which is a very curious thing in which some of us can get, and others apparently can't, there are plenty of people that are not very empathic, and don't don't cannot imagine what it is like to be suffering or in pain so that they cannot imagine that somebody can be uh can be happy either uh and that we can do and it's part of our humanity so not only do we have access to our own states but then because we do and because now now we come back to where we began,

Drew, which is that very complicated cortex that allows us to have memories of many things, including states of feeling, and then create a connection and create a way of describing this and so if i empathize with somebody who is in pain because the person was just was just in an accident i'm going to feel a little bit of the person's pain if i'm a really empathic person and and and that will make me i will not have the same the same suffering exactly but i i will have a a little bit of it so that i can truly connect with that other human being that is suffering through something that i have suffered before in different circumstances and that's a very good guide to my actions now again think of the fact that here we have a kind of feeling in this case, a feeling that is extremely high level and complex, which is putting myself on the shoes

of somebody else, which I can do naturally. And that is guiding my actions. It's interesting, I just caught myself saying these words words because this is a repetition of the theme that i gave you earlier in our conversation when i said this is feelings are actions i'm sorry feelings are experiences that guide our actions it's that knowledge that points us, gives us an incentive to go in a certain way. So if you see somebody that just fell on the street and is hurting probably from a broken leg, the thing that we do automatically is to empathize with that situation and realize that we could be in that situation and then do something about helping the person. So again, you're not helping the person because in school, somebody told you

when people fall on the street, you're supposed to go and help them. Well, I mean, I hope somebody told us that in school. I don't remember that they did, but that's not the way we do it we do it because something inside of us through the feeling system is telling us to do it and it becomes inevitable so that's the beauty of empathy for you and and you can see how the evolutionary advantages you know of the exact human being which is otherwise relatively defenseless in terms of

the survival of those species so it is so interesting yeah i'm going going back to the higher cortical foot go ahead please i was going to say that that's evolution is is helping us both ways so in this particular example of it's helping us because it's doing something good for us because by doing that good action, you actually did something that satisfied inner needs if you're a well-structured human being, but it also helps another human being. So it's interesting how in our history, at a certain point when you have cultural developments, those cultural developments are largely modeled on what individuals are like. It's not an invention from scratch. And because of that, we can be both good to others and good to ourselves

i i just wanted to just quickly harken back to the the higher cortical functions that you mentioned which was that um i was uh i kept thinking in the book when you were talking about those functions about how unfortunately you know if you're not a physician, you never get exposed to waking comas. And you can see people who have all kinds of cortical dysfunction but are in a coma but are wide awake. And so it would help people understand that consciousness is not just about alertness and awakeness. There are many levels to it to uh consciousness exactly yeah and you you have all this very we have this very complicated uh you know it's it pays to to go and look at the kinds of situations in which

consciousness can be obliterated and it is obliterated when, of course, feeling is highly compromised. And that happens in strange situations. The coma, for example, as you mentioned, and of course the very close connection between that and the brainstem, which we mentioned earlier. Then you also have, we didn't talk about anesthesia,

did we? yet uh the anesthesia no i was going to mention that when you brought when you brought when you brought up the plants i was going to bring it in there but go ahead yeah so anesthesia is also a very interesting situation in which a consciousness can be lost now um through let me tell you a story about anesthesia, which I like to tell people. I've been through lectures on anesthesia in which people talked with great detail and with good facts about the fact that, well, in anesthesia, you're not going to see things, you're not going to hear things, all of that goes. And then I want to ask this, why is it that we want to have anesthesia in the first place? Why is it that we want to lose

consciousness, thanks to an anesthetic? And the answer is very obvious. We want to lose consciousness because we don't want to feel the knife of a surgeon, right? Correct. So we don't want to interfere. Exactly. And so it's very interesting, because in the conversation about anesthesia, being a way of losing, once again, the external world, people forget that what they're losing foremost and what they want to lose for sure is the feeling of pain and suffering and fear and all the disquiet because that's exactly what the surgeon is going to do to you. He's going to cut your flesh. So it's quite interesting how some of these things have actually been looking at us in in the eyes but we tend not to see because you look at other parts of the discussion and the discussion on consciousness is so often loaded towards the outside world and avoiding the inside world as

if it were not you know it's really taken for granted it's taken for granted and not given the due that it needs to to have and when you think about anesthesia it was caused yeah go ahead sorry or not it does just say we don't make it explicit we don't make it because we don't think about it yeah yeah and and uh we pay no attention to it but but so interesting also because anesthetics of course there are a huge variety of anesthetics but they they actually are i like to say that they're rather blunt instruments so anesthetics do not actually obliterate consciousness primarily and one way in which you know this is actually the rapidity with which they act.

I'm sure you've had anesthesia for something in your life, haven't you? Right, and so what happens? You have- Oh yeah, a couple times. I do poorly with it. I'm wiped out for three months afterwards. Well, but what is interesting is that there you are,

and then the anesthesiologist asks you, for example, is interesting is that there you are, and then is the zoologist asks you for them to count, and you start counting and that's the count of two or three, you're gone. And it's, it's a switch, something was turned off. Well, what is turned off actually is not consciousness, what is turned off is a variety of processes that undergird consciousness, such as sensing and detecting. So do you know that? Actually, you know because you read the book.

Plants can be anesthetized. And what that happens, since they don't have feelings, since they don't have nervous system, obviously they're not going to be in a coma and they're not going to be in a state of loss of consciousness they don't have it to lose what they do though is that they become like frozen you know it's like a frozen image and nothing much is going on in their metabolism uh and uh and if if they have for example if roots can grow which is one way in which plants have movement growth of roots then roots stop growing everything is in suspension

uh so it's interesting and this can also happen at the level of bacteria so it's not to say that anesthetics compromise our consciousness is true in general terms, because they do, obviously, as a sort of later consequence. But what they do is hit at something much more basic that compromises everything, and compromises everything so extensively that lo and behold you you also lose consciousness freezing a little a little closer to it exactly exactly yeah that's interesting i never thought about it that way i i heard you in a and before you very even very uh generous with your time so i'm going to let you go in just a second but before i do i heard you on a another podcast i like very much called Brain Science with Ginger.

I forget Ginger's last name. She's a neurologist, I think. And I detected this is a totally different topic very quickly. A certain amount of, I don't know if it's a dissatisfaction or concern or it might've been the stronger feelings. Speaking of feelings that I was detecting as it pertains to our, as it pertains to our profession. And in that conversation,

you were specifically telling her that, you know, if you wanted to research, get a PhD, don't, don't bother with this thing. We call being a doctor. It used to be,

it used to have a, you used to use the word gentlemanly or something to describe what it used to be. Like it's lost something. And I thought, boy, you're right. I'm just wondering what, Ginger Campbell, that was her name. Yes, thank you. And I was wondering what it was that you were really thinking. You see, I almost picked up, I would say even a little disgust maybe.

No, no, no. Well, I don't think I share that. Tell me what I think. First of all, I think that the the the medical profession is noble and beautiful. And it is something that I admire tremendously. It's just that the medical profession is not the best means to arrive at scientific results today. But I can I can be equally critical of having people that have no idea of what an entire human organism is like and are doing research

on topics that they have not seen uh they have not experienced firsthand so i i know i i think it was probably a miss um i must have said something that made you think that, but no, I, what I think is that these professions, these activities have a very high degree of specialization. So if you are going to be a good neurologist today you know, I, I would not be practicing neurology today. I am not practicing neurology and I decided not to do it. Because not only that I had other things to study, that I needed time for, but because I decided that you had to make a choice. And you either do one thing or the other if you want to do it well.

But likewise, if you want to be a scientist, and you want to talk about things that are intimately human and that have to do with medicine and you have never had the experience of having the responsibility for a sick human being in your hands, then I don't like that either. So I think I'm a very, I'm a fair player here. I think that they're to each his own you have, I think, in the best of circumstances, you do science, or you do medicine, and you can have an opportunity of being great at either. Now, granted, there are people that managed to do both. And I managed to do both for a long time. And I thought I was good at it. But I think the times were different. And the responsibilities were different. And what we know now is much more on both sides. Not only is the science more complicated, but the medicine is more complicated, too. So

you have a growth in complication at a certain point uh you know I I wouldn't like to to be to be on an aircraft uh with a pilot that said you know by the way part of my day I I spend doing whatever else and I don't train regularly and I you know you you, you want that regular exposure. Wouldn't you agree with this? Okay, so yeah, I do agree with that. And it must have been something in my internal homeostatic feeling state

that I was mobilized or motivated from something you said that was not something that I was properly empathically attuned to. But I thought you were complaining about our professional a bit but maybe not so um well listen uh you have been very generous i love the book feeling and knowing please do get it it's worth your time i i i cannot stress enough but if somebody were to read your opus you well to get a feeling for your current understanding of psychology and philosophy of the human experience as you know it, would it be Descartes' error in this book?

What books would you read of Antonio Damasio's to get a sense of the landscape as you know it? I think that the book that I wrote before this one is called The Strange Order of Things, which I don't think you mentioned. I did not read it. I didn't even know about it. There you go. Writing it down. 2018, I think. Same publisher, Pantheon, and same editor.

And that book, I was um was was the beginning i mean it's coincided with my orientation in the direction that i have now so uh i think that's that that's the one that would expand on on this one and uh and then what you should do is get the next one, which I promise I will write. All right, fantastic. I would look forward to that. No, I'm very proud of the books that I've contributed something, but they're older.

Descartes remains the book that brought together affect and reason in a very close way. And so that's, but Strange Order of Things. I still think of Descartes' era as kind of a primer to get people going. And then Strange Order of Things, Feeling and Knowing. And Dr. Damasio, do you want people to go

anywhere else a website or a twitter any place else we can find you oh you i i know you can find me through my books through the papers i published um i think the website of my publisher will have plenty of information about this book. And I think that Twitter will also have it. Yeah. But thank you very much for having such interesting questions. You ask very complicated i i i hope i i was able to to answer a few they they were great and i i feel like i'm i'm standing at the oracle when i'm asking these questions i love the books and uh i please keep writing and i can't get enough of them uh and uh dr masio also has a twitter handle at damasio usc dracio, thank you for spending time with us. My great pleasure.

Thank you very much for asking good questions. And sorry for the delays I caused. Oh, don't worry. And we'll say farewell to Dr. Demacio. And then, Caleb, I'm going to hang back a little bit and talk to the Clubhouse people and the Restream people who have been buzzing away here. I'm sort of trying to keep an eye on you guys. It seems like there was lots of questions in many areas that were not related to the material Dr. Damasio and I were talking about.

So I thought I might try to get a couple of questions off Clubhouse very quickly. Leopold, how are you doing? How are you? Well, doing okay. Day one of my trials. Still got a couple more to go, but fascinating guest that you have on. He's the best.

I know that. Yeah, amazing. Just amazing. And, you know, I did a little workc urbain in the psychobiology department and uh wanted to ask a couple of thoughts and i think also in vocals i might post posted a couple of articles regarding you know your thoughts perhaps on the you know the quantum fix oh i saw you talking about that. I saw you on recent putting that out there. And that was so far from what we were talking about.

I thought I better not, you know what I mean? I saw that and I thought, wow, that's a great question. So ask it now. I don't have an answer, but ask it so people can think about it out there. Well, yeah. I mean, it's just, it's interesting. I mean, so, you know, the idea of, you know, what happens when you brought up people could think about it out there well well yeah i mean it's just it's interesting i mean so

you know the idea of you know what happens you brought up anesthetics and you know do you actually know the actual mechanism of anesthesia we don't and and we don't right right and i know that there's some thought out there that what can happen is, you know, that there might be a quantum element of consciousness. In other words, that shift, perhaps, you know, the electron shifts and such. Right. Does it? Does it? Does. Well, there's so many layers to that question. One is, is there is there a monad of consciousness, the way Leibniz would say it, right? So does everything have monads of consciousness in it?

Or is there a quantum explanation around consciousness? And it gets very weird when you start going towards the newer quantum theories about there really not being many different electrons, but we're all just one electron. Not likely, but that's where quantum goes. And then it gets very weird. And, you know, additionally, Dr. Drew, you know, so my fiance and I, I say that we're connected. And I mean, Dr. Drew, I'm talking about weird stuff. Yeah, I listen.

We'll talk to Susan about that. She spends all her time with her friends talking about that stuff. But listen, the one thing I know is that we are emergent properties of a giant wave function, right? There you go. And thereby, much like a computer screen screen there may be a source on that that is connected in ways that we just can't our little brains can't figure out dr do if yeah and and you know there's a you know einstein said it you know how does one you know how to determine uh such a complex system with the brain that we have this see that's what when i saw your question

that's where my head went when i was thinking we're trying to we're trying to talk about the evolution of this little thing and what it's designed to do and it's getting because of some quirk of nature probably that pyramidal layer that sixth whatever it is layer of our cerebral cortex we start getting into stuff that has nothing to do with our evolutionary purpose. But it also, we can't really understand it, even though we can describe it

and sort of talk about it. And real quickly, last night, I don't know if you saw 60 Minutes, he was talking about and they've done a study somewhere I'm sure it's in the U.S., but it was the I think it was the amygdala, am I saying it correctly?

And that empaths, you know, are actually heroes that, you know, will be impulsive to help people. they have a much bigger amygdala and then psychopaths have a much smaller yeah so so the way i think about the amygdala is they want to make it a fear center they i mean you'll talk about in the colloquial terms it's not that it's it's the valence center it's it's kind of a relay center it's the it's the way to think about it is that's the part of your brain that goes, that's important. And if you are able

to prioritize other people's experiences, you're going to be heroic. I see. And with the empaths. Yeah, so very interesting. Extremely interesting. we need more of these types of guests. I know. Go back and look at, I think you were, you might've been sick back when I talked to my other big hero, Alan Shore. And, but go look at that one, because that's about the personal neurobiology,

but there's so much good stuff out there. I'll try to find some of this stuff. Thanks, Apple. Appreciate it. Of course. uh and susan are you are you good i know your hamburger's here that's what the dog barking was about yeah i'm eating it eating it now okay i i throw a little ayahuasca in there too and you can really get into the consciousness so this is a long story we just got back from costa rica we went down to a place called rhythmia and observed their their what they're doing which is some wild stuff we're going to a place called Rhythmia and observed their there's what they're doing which is some wild stuff we're going to do a little tv program about it I'll let you know when that is available a little tv thing about it yeah but it was quite an experience quite interesting

I think I'm we're going to try to maybe interview some of the staff on this thread coming up soon so I'm going to hold all that until we get more information. No, but like this consciousness, this collective consciousness that was in there was kind of weird. That was somewhat what they were talking about. When they got on the ayahuasca, they were all connected somehow, is that? Well, and they were also talking about

the dissolution of the self, which is a whole complex question, you know, that we were sort of, that's somewhat what Dr. Damasio was talking about. Get closer to Mike, honey. That's somewhat what Damasio was talking about. Get closer to my kind of, some of what Damasio was talking about, but, but, um, oh crap. Where was I going with this? Oh, uh, Susan had, uh, stem cells in the course of all this. And so we're going to investigate that a little bit and sort of talk more about that as well. So anyways, whatever we'll talk about when we can. We'll talk about it. I'm a new younger woman.

A new younger conscious version of myself. All right. We'll see. But Clubhouse, we didn't want to take many calls today because I was going to just chat with Dr. Masi. We appreciate you guys hanging there. His voice is magical. I'm going to end the Clubhouse room right now. Thank you.

And for those of you on Restream, we've seen you there. Yeah, ego death, mock disaster. That's what they call that stuff. And if I had end-of-life issues, I would want to have that experience. It tends to really help people with their dread of these things. I don't know what's happening here, Mike. It's going in and out. That's interesting.

Okay. Well, let's wrap this up. We appreciate you all being here. Susan and I. Let's turn sideways.. Well, let's wrap this up. We appreciate y'all being here. Susan and I, Susan and I are, we are in our time zone two hours ahead here. So we're all screwed up. We've been flying all day. I had a quick little nap in there. Caleb, thank you for setting this all up. It's, it's always a, an honor of mine whenever I get to have contact with Dr. Damasio. So thank you all for joining me on that. He was so funny. He was so upset. He was late. I know he's very perfectionistic

about this stuff. And I was in a bad mood, but I was in a worse mood because I was late. All right, Caleb, everything good with the baby? Oh yes. He's doing great. He's growing. Good. He's growing. You're going to put a picture up here for us. Of course I will. Where is it? There's my baby. He needed to be helped. There we go. Look at that. He's sitting there in bed watching The Simpsons with me in the morning.

He looks like he's watching TV, I got to say. This will be a new pose. And Susan, I had dinner last night. Why are you letting him watch The Simpsons at that age? I'm like, he doesn't know what's going on. Just let him watch the bright yellow colors. That's all he cares about right now don't worry he'll he will insist on watching soon enough that was a mistake i made earlier it doesn't have to be awkward uh right

and susan put up a picture on her instagram last night of our we speaking of simpsons now i'm going to flip into south park we thought we saw the bear pig, but it was actually a raccoon bear dog called a... What are they called? I don't know. Did you see the picture she put up? Caleb, you're laughing. I saw it. It looked like it was a Photoshopped thing. I don't have it prepped here,

but go look over it. It's on Susan's Instagram. It's like a bandit sloth looking thing. Yeah, it had a four foot tail and it had a long snout like a, I don't know, it looked like a possum nosed dog raccoon. Bear pig raccoon. It was crazy. And apparently it's related to raccoon.

And it was begging for food the entire time we were sitting at dinner. And this woman was feeding them next to us. There apparently are so many of them on Costa Rica. They just don't even like, they're huge animals. And it was just, it was kind of an old one, but it was,

it was very interesting. Yeah. All right. Entertained. Thank you guys. Thank y'all for being here. I'm going to be traveling again this week, but we'll get back on a normal path towards beginning of next week um back to your mom's house studios i'm going to austin to visit with

talk about people's browns and whites and and yellows little holes in the wherevers and so send me your emails and your voice messages there uh not here i believe it's 1-800-253-1693. Don't send those to me. I don't want to know about your D or your P. Send those to your mom. Dr. Drew after dark. All right, guys,

thank you all for being here. Thank you. It was a thrill for me to talk to Dr. Masio. We appreciate it. That was great. And we will see you towards the end of the week. Ask Dr.

Drew is produced by Caleb Nation and Susan Pinsky. As a reminder, the discussions here are not a substitute for medical care, diagnosis, or treatment. This show is intended for educational and informational purposes only. I am a licensed physician, but I am not a replacement for your personal doctor, and I am not practicing medicine here. Always remember that our understanding of medicine and science is constantly evolving. Though my opinion is based on the information that is available to me today, some of the contents of this show could be outdated in the future.

Be sure to check with trusted resources in case any of the information has been updated since this was published. If you or someone you know is in immediate danger, don't call me. Call 911. If you're feeling hopeless or suicidal, call the National Suicide Prevention Lifeline at 800-273-8255. You can find more of my recommended organizations and helpful resources at drdrew.com slash help.