Are You Anosognosic?

An interesting thing happened to me yesterday, probably related to what happens with anosognosia. I was in my room at night, with computer turned on, in the opposite side of the room from the computer. Suddenly, the light went off. I looked around, and noticed that the light indicators around the computer were still on. "Circuit breaker must've overloaded on one of the lines, turning the light off, but not the computer", I thought. Then I heard a characteristic noise caused by the CRT monitor turning off. "Interesting coincidence", I thought, "exactly 15 minutes must've passed since I last touched the keyboard, just when the circuit breaker overloaded on another line". I went to a light switch and flipped it absent-mindedly. The lights went on. "Strange", I thought, "The switch must be to blame, it never happened before." This is all in the span of a few seconds.

Then it hit me: the lights were never on.

The room was illuminated only by the monitor, so when it switched off after 15 minutes of inactivity, it became dark. My mind confused this single thing for the light turning off, and then produced a whole sequence of complex thoughts around this single confusion, all the way relying on this fact being true. Inability to convince yourself that an equally simple fact is false must result in similarly complex justifications. There is nothing unnatural about justifications being long and detailed, the point of failure is where a fact can't be accepted, not where it just can't be noticed.

I'll bet that even though argument doesn't move anosognostics, they get argued with anyway, at least a little bit initially. The fact that no one has tried to convince me my arm is paralyzed is sufficient evidence for me to proclaim that the odds of it actually being paralyzed are significantly lower than 1 in 10 million.

The prior probability of 1 in 10^7 is already lower than I can handle in a well calibrated manner, and it would only get smaller after accounting for the evidence that I observe my left arm moving when I try to move, and I am successfully using it to type right now, and from the descriptions I read, anosognosiacs do not claim to make these observations, but attempt to make excuses for the lack of such observations.

In any event, it is not something I am too concerned about.

I enjoy fencing, which only requires the use of one arm. That seems like pretty strong evidence of anosognosia; if I could use both of my arms, I would have picked a sport that engages me more fully.

I wonder if the paradoxical undressing effect is a form of anosognosia.

Paradoxical undressing is when the person removes warm clothing while in a state of hypothermia, which further increases heat loss. Because they are suffering from the cold and their body temperature is below the safe threshold, it seems incongruous that they would be removing warm clothing and causing themselves to become even colder.

To be sure, the phenomenon of paradoxical undressing is an enigma counter to expected behavior. With their core temperature below 90 degrees F, hypothermia sufferers frequently undress themselves. Urban victims of hypothermia that are found in a state of undress are often thought to be victims of assault.

Paradoxical undressers remove their warm clothing even as they are freezing to death.

Suppose I put in a nerve block to artificially paralyze my left arm, and I notice that my left arm is indeed paralyzed. I then remove the nerve block and notice that my left arm is no longer paralyzed. Would that be sufficient to prove (to myself) that I don't have left-arm paralysis with anosognosia?

BTW, I'm not sure I understand the current fascination on this blog about anosognosia. Where is this train of thought going?

My estimated probability is extremely low because unlike the patient with anosognosia, I observe movement in my left arm. The patient did not observe motion and invoked absolute denial in inventing explanations for it.

Still, I'm not a diagnostician so I'll assume patients with anosognosia think they can actually observe motion in their left arms. In this case, it seems the popular proof is in doing something that requires both arms, like JulianMorrison did. Still, it seems that if you can deceive yourself about your arm moving, you can deceive yourself about such an experiment. It strikes me that one way to prove your left arm still works is to disable your right arm. After all, you have no illusions about your right side - if you disable your right arm, you'll know it. Therefore, I shall tape my right arm to the arm of the chair I'm sitting in, and finish typing this post with my left. There. It is currently 10:52 EST. The post timestamp will agree that this post was submitted before I released my right arm.

I'd expect that for a rationalist afflicted with anosognosia, denial would manifest itself in the form of absurdly low base rate estimates, maybe one in a thousand or rarer.

Ignoring, for the moment, the deeper metaphorical question of how many of us are any given brain failure, does anyone know whether anosognosics actually think that they're using their paralyzed arm? Because I have a very strong sense of using my arms, and I suspect from the earlier description that anosognosics deny their arm being paralyzed, but wouldn't claim that they are actually typing with two hands, for example. Anybody know more on that?

If agnosognosics by definition place a probability of zero on their arm being paralyzed, and thus on being agnosognosics...

It seems that if I were an anosognosic, I would make some observations only indirectly related to the affected limb that they don't seem impaired at making. For instance, even if I didn't notice that I was typing with one hand, I would probably remember having been to the hospital, or hearing a friend point out that one of my limbs looks awfully limp (even if I didn't know what they were talking about). Since I haven't made such observations, my probability that I'm anosognosic (at least about a limb or anything that observable) is lower than the prior.

1 in 10 million is almost low enough for me to feel annoyed that this article exists.

And people actually play the lottery!

I guess I can imagine someone being awakened by your analogy. It would be swell if this article actually had enough millions of readers that we might experience some spectacularly delusional one-handed comments.

Does the absence of people around me pointing towards my arm insisting it does not move, while believing that I have done plenty of activities in which I used 2 arms mean I am an extreme Anosognosic. One who rewrites massive quantities of 1 arm experiences to 2 arm experiences on the fly?

Hrm... I wanted to say 10^-7, but then I realized I actually do have evidence that is different from the type of false justifications associated with anosonosia.

The latter, as I understand it, tends to be associated with making excuses for why one isn't moving the arm, etc... I notice though that I actually can move my arms. That is, I observe myself waving both arms freely, typing using both hands, etc.

I'd have to spend a bit more type to work out reasonable numbers associated with it, but these observations are different from the "making excuses for why one can't move the arm in question"

See Added: "This interests me because it seems to be a special case of the same general issue discussed in The Modesty Argument and Robin's reply Sleepy Fools - when pathological minds roughly similar to yours update based on fabricated evidence to conclude they are not pathological, under what circumstances can you update on different-seeming evidence to conclude that you are not pathological?"

1 in 10,000,000. If I decrease that estimate I must increase it and vice versa.

Given the odds of 1 in 10 million, I'm confident that not only am I free of this condition, but no one I've ever met has it either. I'm not even going to take a typing test to prove that I still type at 70wpm (which may be possible to do with one hand, but I don't think anyone could learn it without being conscious of having done so). I will reevaluate this conclusion if a doctor (or anyone, really) tells me they think my left arm is paralyzed.

EDIT: As for an exact number, I am > 99% confident about this, which is high enough that it is not worth it to calculate a better estimate.

Some evidence supporting me having both fully functional hands:

• I'm good at typing. In particular I beat all my friends' scores at Facebook's Typing Maniac game, what a few of them find highly annoying and tried to beat my score. If I was paralyzed that would imply all my friends are also paralyzed, or truly outrageous at typing, or alternatively I came up with some amazingly efficient way of one-hand typing that beats normal two-hand typing.
• I play a lot of first person shooter games which by design require use of both hands, and some other games that require use of both mouse and keyboard. On the other hand I tend to suck at multiplayer mode, so perhaps I only imagine being good at them.

Can anosognosia patients remember being in a hospital, being told that they are paralyzed or failing at a simple two-handed task? I don't remember any of those things. I'm even writing this last sentence while holding my keyboard up in the air.

From the popularity of the "Strangest thing an AI could tell you" post, and anosognosia tidbits in general, this topic seems to fascinate many people here. I for one would find it freakishly interesting to discover that I had such an impairment. In other words, I'd have motivation to at least genuinely investigate the idea, and even accept it.

How I'd come to accept it, would probably involve a method other than just "knowing it intuitively", like how I intuitively know the face of a relative to be that of a relative, or how I know with utter, gut level certainty that I have three arms. Considering that we are, well, rationalists, couldn't we be supposed to be able to use other methods, to discover truth, than our senses and intuitions ? Even if the truth is about ourselves, and contradicts our personal feeling ?

After all, it's not like people in the early 20th century had observed tiny pictures of atoms, they deduced their existence from relatively nonintuitive clues glued together into a sound theoretical framework. Observing nature and deducing its laws has often been akin to being blind, and yet managing to find your way around by using indirect means.

If I had to guess, I'd still not be certain that, even being a rationalist using scientific methods and all those tools that help straighten chains of inference, as well as finding anosognosia to be more of a treat than a pain to be rationalized, would make it a sure bet that I'd not yet retain a blindspot.

Maybe the prospect of some missing things could be too horrid to behold, not matter how abstractly, perhaps beholding them may require me to think in a way that's just too complicated, abstract and alien for me to ever notice it as being something salient, let alone comprehensible.

Still that's really not what my intuition would lead me to believe, what with truth being entangled and so forth. And such a feeling, such an intuition, may be exactly part of the problem of why and how I'd not pay attention to such an impairment. Perhaps I just don't want to know the truth, and willingly look away each time I can see it. Then again, if we're talking rationalization and lying to oneself, that has a particular feeling, and that is something one could be able to notice.

Evidence that I have anosognosia: my left arm doesn't seem to be paralysed to me; if it did, I'd be sure I don't have anosognosia.

Evidence that I don't have anosognosia: the title of this post (see Betteridge's law). :-)

My estimated probability is too low to consider alone without additional evidence. I like this probability. If you require a number, 1/10,000,000.

Now, I currently appear to be typing with both hands, and there is nobody else in sight. Does this evidence lower the probability that my left arm is paralyzed as much as you might expect? If my left arm is paralyzed, there's a good change that this is just a rationalization.

See if you can think of a statement S that contradicts a statement of high probability such that no observable phenomenon is evidence against it. (Of course, nothing will be evidence for it, either.)

let's say the base rate is 1 in 10,000,000 individuals
Supposing this to be the prior, what is your estimated probability that your left arm is currently paralyzed?

1 in 10,000,000

Very low, because I can (and just did, to make sure) easily contrive situations where the visible present is determined by the recent past presence of two arms and where I would have been forced to strain credulity if I were justifying a negative result. In this case, the experiment was dropping two things at once causing two other objects to roll and meet in the middle (and not on one side, indicating an asymmetric drop).

yawn

Most people who devote the necessary thought to the matter eventually realize that they are pathological, deeply so, and that significant work-arounds are the only way to compensate for the irrevocable faults hardwired into their minds.

It's not a question of whether, it's a question of how.