Photo: Mediaphotos

One of the least helpful ideas that the ancient Greeks gave to the modern West is that decisions are best made as far away from emotions as possible. It can be seen across pop culture, in the Star Trek race the Vulcans (of which Spock is one-half), whose culture suppressed emotions in favor of “the complete mastery of logic,” and in the Atlanta rapper TI, who said that he wouldn’t vote for Hillary Clinton as president because he knows that women “make rash decisions emotionally.”

University of California, Los Angeles, neuroscientist Antonio Damasio calls this the “high-reason view.” It assumes, he writes in his seminal book Descartes’ Error, that when people are at their decision-making best, that they’re the “pride and joy” of Plato, Rene Descartes, and Immanuel Kant, all of whom espoused a coolly computational mode. “An important aspect of the rationalist conception is that to obtain the best results, emotions must be kept out,” Damasio observes. “Rational processing must be unencumbered by passion.”

The patient: If the title of his book didn’t give it away, Damasio discovered that the “high-reason view” might be a compelling idea, but it doesn’t hold up when you look at the biological mechanics of decision-making. The main case study in this is a patient that Damasio refers to as “Elliot” (as with most psychology case studies, the actual name of the patient isn’t divulged). Before a brain tumor wounded the frontal lobe tissue in his brain, Elliot had a good job at a business firm, was a role model to his colleagues and younger siblings, and a dutiful husband. Then he started getting headaches, and eventually had to get the tumor removed.

The problem: When he met Damasio, Elliot was still pleasant, charming, and well-aware of the day’s news and the area of business that he worked in; he also still had a fantastic memory for his life story. But at the same time, his life had fallen apart. Any projects he did on the job were either left incomplete or had to be corrected, eventually leading to the loss of his job. He got involved in a moneymaking scheme with a “shady character” that ended up in bankruptcy. He got divorced, then married again to someone his family strongly disapproved of, and divorced again. By the time his referring doctors sent him to Damasio, he was living with a sibling, and, as a final blow, was denied disability assistance. The docs wanted to know if Elliot had a “real disease,” Damasio recounts, since “[f]or all the world to see, Elliot was an intelligent, skilled, and able-bodied man who ought to come to this senses and return to work. Several professional had declared that his mental faculties were intact — meaning that at the very best Elliot was lazy, and at the worst a malingerer.”

So, as a good doctor does, Damasio started looking for clues. He learned that when Elliot was at work, he might spend an entire afternoon trying to figure out how to categorize his documents: Should it be by date, pertinence to the case he’s working on, the size of the document, or some other metric? Yet his cognitive faculties were ace: He tested well when given an IQ test and other measures of intelligence; Elliot’s long-term memory, short-term memory, language skills, perception, and handiness with math were all still present. He was not stupid. He was not ignorant. But he acted like he was both. He couldn’t make plans for a few hours in advance, let alone months or years. And it had led his life to ruin.

Then, a lightbulb went off: Damasio realized that he had been preoccupied with Elliot’s intelligence. But what was missing was not intellect. “Elliot was able to recount the tragedy of his life with a detachment that was out of step with the magnitude of the events,” Damasio writes. “He was always controlled, always describing scenes as a dispassionate, uninvolved spectator. Nowhere was there a sense of his own suffering, even though he was the protagonist.” The neuroscientist found that he was suffering more about hearing his patient’s life story than his patient was. Then there was another revelation: Elliot took a test with lots of emotionally charged images, like pictures of burning buildings, gruesome accidents, and people about to drown. After the test, Elliot told Damasio that he could sense that those images used to give him strong emotions, but now they were neutral. The reaction was neither positive nor negative.

And with that, Damasio had a better picture of Elliot’s interior life:

Try to imagine not feeling pleasure when you contemplate a painting you love or hear a favorite piece of music. Try to imagine yourself forever robbed of that possibility and yet aware of the intellectual contents of the visual or musical stimulus, and also aware that once it did give you pleasure. We might summarize Elliot’s predicament as to know but not to feel.

What was even more confounding is that Elliot could think up lots of options for a decision. When given assignments of assessing ethics (like whether or not to steal something for his family, Les Miserables–style), business (like whether to buy or sell a stock), or social goals (like making friends in a new neighborhood), he did great. But, even with all the idea generation, he could not choose effectively, or choose at all. “I began to think that the cold-bloodedness of Elliot’s reasoning prevented him from assigning different values to different options,” Damasio writes, “and made his decision-making landscape hopelessly flat.”

He dug back into case histories, and found some antecedents. In the 1930s, New York University neurologist R. M. Brickner had a patient — also with frontal lobe damage — who was a stockbroker before his life unraveled. He never left the house: just stayed at home formulating his big professional comeback (though he did not work) and bragging about his sexual prowess (though he no longer had sex). That same decade, the Portuguese neurologist Egas Moniz developed a surgical procedure that targeted the same part of the brain to treat anxiety and schizophrenia — and destroyed the affect in the patient as well.

The diagnosis: Looking at Elliot and medical history, Damasio discovered what, to Plato and TI, would be strange bedfellows: When emotion was impaired, so was decision-making.

This led Damasio to formulate what might be his great contribution to the understanding of the brain (and the human body): what he calls the somatic (as in body) marker hypothesis. Essentially, he reasons, when you’re thinking about a course of action, you imagine your body to be in the potential situation, and you get, in layman’s terms, a “good” or “bad” feeling about it. It’s not that right decisions come from that sort of feeling alone, but, Damasio argues, those “somatic markers” filter away lots of alternatives; they’re a shortcut to decision-making. While Elliot’s landscape of potential realities all had “flat” values, healthy people weigh the potential outcomes that are left after “somatic markers” filter the other possibilities out.

As Damasio said in a later interview, wisdom, if you choose to accept it, is what happens when you accrue lots of somatic knowledge in your life: If you’ve been through lots, then you know how you would feel in a wide variety of situations, allowing you to make better decisions (and give, as one does, better advice). Therein lies the problem of the high-reason view: without the filtering provided by emotions and their somatic markers, the data sets for any given decision — whether it’s what to get for lunch or whom to marry — would be overwhelming. The working memory can only juggle so many objects at once. To make the right call, you need to feel your way — or at least part of your way — there.