Epileptic seizures originating in this part of the brain can also produce these dreamy states of Deralisation and Depersonalisation. And, intriguingly, we know that during the actual seizure when the patient is experiencing Derealisation, you can obtain a Galvanic Skin Response and there's no response to anything. But once he comes out of the seizure, fine, he's normal. And all of this supports the hypothesis that I'm proposing.
OK, finally let's talk about another disorder, the one that jumps into people's minds when they think of madness - namely schizophrenia. These are patients who have bizarre symptoms. They hallucinate, often hearing voices. They become delusional, thinking they're Napoleon - or George Bush. Or they're convinced the CIA has planted devices in their brain to control their thoughts and actions. Or that aliens are controlling them.
Psycho-pharmacology has revolutionised our ability to treat schizophrenia, but the question remains: why do they behave the way they do? I'd like to speculate on this based on some work we've done on anosognosia (denial of illness) - which you see in right-hemisphere lesions - and some very clever speculations by Chris Frith and Sarah Blakemore. Their idea is that unlike normal people, the schizophrenic can't tell the difference between his own internally-generated images and thoughts versus perceptions that are evoked by real things outside.
If anyone of you here conjures up a mental picture of a clown in front of you, you don't confuse it with reality partly because your brain has access to the internal command you gave. You're expecting to visualise a clown, that's why you see it and you don't hallucinate. But if the mechanism in your brain that does this becomes faulty, then all of a sudden you can't tell the difference between a clown you're imagining and a clown you're actually seeing there. In other words, you hallucinate. You can't tell the difference between fantasy and reality.
Similarly, you and I momentarily entertain the thought it would be nice to be Napoleon. But in a schizophrenic this momentary thought becomes a full-blown delusion instead of being vetoed by reality.
What about the other symptoms of schizophrenia - the fact that aliens are controlling you? When you move your finger voluntarily, you know you sent the command, the motor centres in the brain sent the command. So you experience willing the movement. You don't say, Oh the finger moved on its own. But if the mechanism that performs this comparison is flawed, you no longer experience YOU willing the movement. So you come up with this bizarre interpretation. You say your movements are controlled by aliens or brain implants - and of course that's what paranoid schizophrenics do. How do you test a theory like this?
I want you all now to try an experiment. I mean that. I want you to try an experiment on yourselves. Using your right index finger - all of you try it - tap repeatedly your left index finger, keeping your left index finger steady and inactive. So you're all tapping your left index finger using your right index finger - left index finger is perfectly steady. Now you'll feel the tapping only on the left finger, very little on the right finger. OK, how many of you feel that? Yes, raise your hands. OK, 99 per cent of you. There are a few mutants, but we won't pursue that.
Now why is that? That's because the brain has sent a command from the left hemisphere to the right hand saying, Move. So the brain knows, it's tipped off the sensory areas of the brain, saying, Look you're going to move your right finger up and down so it's going to get some touch signals. But ignore them. It's not important. On the other hand, the left hand is perfectly steady so you feel the sensation only on the left finger, even though the tactile input is exactly the same.
Now try it the other way. Hold the right finger steady. Tap with the left finger. And you should now feel it mostly on the right, not on the left. Now the prediction is, if a schizophrenic tries this experiment, since he does not know the difference between internally generated actions and externally generated sensory stimuli, he will feel the sensations equally in both the fingers. It's a five-minute experiment - nobody's ever tried it.
Another prediction. I can come here and tickle anyone of you and you start laughing. Now interestingly, you can't tickle yourself. Try as hard as you want, you cannot tickle yourself. That's because your brain knows you're sending the command. Prediction: a schizophrenic should be able to tickle himself.
OK, it's time to conclude now. I hope that I've convinced you that even though the behaviour of many patients with mental illness seems bizarre, we can now begin to make sense of the symptoms using our knowledge of basic brain mechanisms. You can think of mental illness as disturbances of consciousness and of self, two words that conceal depths of ignorance. Let me try to summarise in the remaining five or ten minutes what my own view of consciousness is. There are really two problems here - the problem of the subjective sensations or qualia (а) and the problem of the self. The problem of qualia is the more difficult one.
The question is how does the flux of ions in little bits of jelly in my brain give rise to the redness of red, the flavour of marmite or mattar paneer, or wine. Matter and mind seem so utterly unlike each other. Well one way out of this dilemma is to think of them really as two different ways of describing the world, each of which is complete in itself. Just as we can describe light as made up of particles or waves - and there's no point in asking which is correct, because they're both correct and yet utterly unlike each other. And the same may be true of mental events and physical events in the brain.
But what about the self? The last remaining great mystery in science, it's something that everybody's interested in - and especially if you're from India, like me. Now obviously self and qualia are two sides of the same coin. You can't have free-floating sensations or qualia with no-one to experience it and you can't have a self completely devoid of sensory experiences, memories or emotions. For example as we saw in Cotard's syndrome, sensations and perceptions lose all their significance and meaning - and this leads to a dissolution of self.
What exactly do people mean when they speak of the self? Its defining characteristics are fourfold. First of all, continuity. You've a sense of time, a sense of past, a sense of future. There seems to be a thread running through your personality, through your mind. Second, closely related is the idea of unity or coherence of self. In spite of the diversity of sensory experiences, memories, beliefs and thoughts, you experience yourself as one person, as a unity.
So there's continuity, there's unity. And then there's the sense of embodiment or ownership - yourself as anchored to your body. And fourth is a sense of agency, what we call free will, your sense of being in charge of your own destiny. I moved my finger.
Now as we've seen in my lectures so far, these different aspects of self can be differentially disturbed in brain disease, which leads me to believe that the self really isn't one thing, but many. Just like love or happiness, we have one word but it's actually lumping together many different phenomena. For example, if I stimulate your right parietal cortex with an electrode (you're conscious and awake) you will momentarily feel that you are floating near the ceiling watching your own body down below. You have an out-of-the-body experience. The embodiment of self is abandoned. One of the axiomatic foundations of your Self is temporarily abandoned. And this is true of each of those aspects of self I was talking about. They can be selectively affected in brain disease.
Keeping this in mind, I see three ways in which the problem of self might be tackled by neuroscience. First, maybe the problem of self is a straightforward empirical problem. Maybe there is a single, very elegant, Pythagorean Aha! solution to the problem, just like DNA base-pairing was a solution to the riddle of heredity. I think this is unlikely, but I could be wrong.