On 2/21/07, Jesse Mazer <lasermazer.domain.name.hidden> wrote:
>
> Stathis Papaioannou wrote:
> >
> >
> >It is a complicated issue. Patients with psychotic illnesses can
> sometimes
> >reflect on a past episode and see that they were unwell then even though
> >they insisted they were not at the time. They then might say something
> >like,
> >"I don't know I'm unwell when I'm unwell, but when I'm well I know I'm
> >well". OK, but then how do you know that you're not unwell now? How do I
> >know I'm not unwell now? We rely on other people telling us (although of
> >course we won't believe them if we lack insight into our own illness),
> but
> >in the example of fading qualia we would (a) not notice that the qualia
> >were
> >fading, a kind of delusion or anosognosia, and (b) no-one else would
> notice
> >either, because by whatever mechanism the external appearance of
> conscious
> >behaviour would be kept up. So how do I know I'm not that special kind of
> >zombie or partial zombie now? I feel absolutely sure that I am not but
> then
> >I would think that, wouldn't I? The fact is, it happens all the time, to
> at
> >least 1% of the population.
> >
> >Stathis Papaioannou
>
> But are you claiming that psychotic patients not only are mistaken about
> what's going on in the external world, but are mistaken about the actual
> qualia they experience? i.e. if a psychotic says he's hearing voices and
> thinks they are martians sending him messages via microwaves, not only is
> he
> mistaken that the voices come from martians as opposed to being
> hallucinations, but he's mistaken that he's having the subjective
> experience
> of hearing voices in the first place? I've never heard of a condition like
> that...your example of recognizing one was unwell in the past is more like
> recognizing the things one was hearing and seeing were hallucinatory
> rather
> than accurate perceptions of the external world, not recognizing that one
> was not hearing and seeing anything at all, even hallucinations.
>
> Jesse
A patient says that his leg is paralysed, behaves as if his leg is
paralysed, but the clinical signs and investigations are not consistent with
a paralysed leg. The diagnosis of hysterical paralysis is made. A patient
claims to hear voices of people nobody else sees, responds to the voices as
if they are there, but the clinical signs and response to antipsychotic
treatment is not consistent with the auditory hallucinations experienced by
peopel with psychotic illness. The diagnosis of hysterical hallucinations is
made: that is, they aren't hearing voices that aren't there, they only
*think* they're hearing voices that aren't there. As with the leg, some of
these patients may be malingering for various reasons, but there will be
some who genuinely experience the symptom.
However, that's a digression. My point was simply that people can be
deluded, for example thinking that they can see when they in fact are blind,
despite extremely strong evidence that they are deluded. If this is the
case, then surely it would be possible to maintain the delusion that nothing
remarkable is happening as your qualia gradually fade if there were *no*
external evidence of your blindness, because electronic chips are taking
over your brain function. I don't actually think this is likely to happen,
and the real examples I gave are presumably due to specific (though
ill-understood) neurological dysfunction causing lack of insight, since
generally we *do* notice when our perceptions are affected due to
neurological lesions. Nevertheless, the examples do show that it is possible
for qualia to fade away without the patient/victim noticing, and presumably
without anyone else noticing if the unconscious component of the
functionality of the neuron is replaced.
Stathis Papaioannou
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Received on Wed Feb 21 2007 - 01:45:34 PST