Unrealistic representations of “the self”: A cognitive neuroscience assessment of anosognosia for memory deficit

Three cognitive components may play a crucial role in both memory awareness and in anosognosia for memory deficit (AMD): (1) a personal data base (PDB), i.e., a memory store that contains “semantic” representations about the self, (2) monitoring processes (MPs) and (3) an explicit evaluation system (EES), or comparator, that assesses and binds the representations stored in the PDB with information obtained from the environment.We compared both the behavior and the functional connectivity (as assessed by resting-state fMRI) of AMD patients with aware patients and healthy controls. We found that AMD is associated with an impoverished PDB, while MPs are necessary to successfully update the PDB.AMD was associated with reduced functional connectivity within both the default-mode network and in a network that includes the left lateral temporal cortex, the hippocampus and the insula. The reduced connectivity between the hippocampus and the insular cortex was correlated with AMD severity.     

Valuing Vulnerability: New Definitions of Courage

SUMMARY

In a dominant, Western culture that celebrates strength in separation and holds unrealistic expectations for independent, autonomous functioning, vulnerability is seen as a handicap. This system creates the illusion of an invulnerable and separate self, and uses individualistic standards to measure a person's worth. Since these unrealistic expectations cannot be humanly attained, these controlling images become the source of shame and disconnection. RCT suggests that there is value in embracing vulnerability and in providing support, both at an individual and a societal level, for the inevitable vulnerability of all people. Rather than espousing the individual, mostly mythical, traits of a “lone hero,” RCT moves us toward new and important pathways to resilience and courage through connection. A version of this article was originally presented at the 2002 Learning from Women Conference, co-sponsored by Harvard Medical School and the Jean Baker Miller Training Institute.