More such cases have since been discovered, and this year Owen and Laureys described a vegetative-state patient who was able to use the tennis/navigation alternation to give yes-or-no answers to five of six basic questions like “Is your father’s name Alexander?” These results are strong evidence — though not proof — of phenomenal consciousness in some of those who showed no behavioral signs of it. But Damasio scoffs, saying that these results “can be parsimoniously interpreted in the context of the abundant evidence that mind processes operate nonconsciously.” His skepticism appears to be grounded in the fact that these patients show no clear sign of self-consciousness and thus constitute a potential roadblock in front of his theory.

Damasio also stumbles over dreaming. In dreams, phenomenal consciousness can be very vivid even when the rational processes of self-consciousness are much diminished. Damasio describes dreams as “mind processes unassisted by consciousness.” Recognizing that the reader will be puzzled by this claim, he describes dreaming as “paradoxical” since the mental processes in dreaming are “not guided by a regular, properly functioning self of the kind we deploy when we reflect and deliberate.” But dreaming is paradoxical only if one has a model of phenomenal consciousness based on self-consciousness — on knowledge, rationality, reflection and wakefulness.

Contrary to Damasio’s point of view, there is good evidence that vivid conscious experience may be antithetical to self-reflective activity. In one experiment, the Israeli neuroscientist Rafi Malach presented subjects with pictures and asked them to judge their own emotional reactions as positive, negative or neutral — a self-oriented, introspective task. He then presented different subjects with the same pictures and asked them to very quickly categorize the pictures as, for example, animals or not. Of course these subjects were seeing the pictures consciously, but Malach found that the brain circuits involved in scrutinizing self-reactions (as indicated by the emotional reaction task) were inhibited in the fast categorization task. Subjects also rated their self-awareness as high in the emotional reaction task and low in the fast categorization task. As Malach puts it, these results comport with “the strong intuitive sense we have of ‘losing our selves’ in a highly engaging sensory-motor act.”

Damasio argues that a creature without sensory integration and control of thought and action would be unconscious. But even if that is true, it does not show that phenomenal consciousness requires self-awareness, reflection, wakefulness, or awareness of one’s existence or surroundings. This argument conflates the minimal self with the inflated self.

Is this discussion of any practical importance? Yes. Phenomenal consciousness is what makes pain bad in itself and pleasure good. Damasio’s refusal to regard phenomenal consciousness (without the involvement of the inflated self) as real consciousness could be used to justify the brutalization of cows and chickens on the grounds that they are not self-conscious and therefore not conscious. Damasio, in response to those who have raised such criticisms in the past, declares that in fact he thinks it “highly likely” that animals do have consciousness. But this doesn’t square with the demanding theory he advances in his book, on the basis of which he denies consciousness in dreams and in “vegetative state” patients who can answer questions. He owes us an explanation of why he thinks chickens are conscious even though dreamers and the question-answering patients are not.