Put your right hand on your head. Unless you are near a mirror, you can no longer see your hand, but you know where it is, right? You know what position it is in. You know how far away it is from most of the other things around you. I’m using the word “know,” but that’s just for convenience, because you don’t actually know those things. That is, you can’t be 100 percent certain your hand is on your head. You assume it is, and that’s as good as it is going to get – a best guess. We’ll come back to that. You can put your hand down now.
I once interviewed the great neuroscientist V.S. Ramachandran, and asked him about a condition known as anosognosia. This is the term for a disorder that causes the sufferer to deny another disorder. Blind people will sometimes believe they are not, for example. I asked him about this because I had learned that he once treated a patient with paralysis of one arm who denied that the arm was paralyzed even though she couldn’t move it when asked. She could no longer make an emotional connection to her arm. She denied that the arm was even a part of her. That biological connection, that feeling of ownership, was missing from her mind, and when asked whose arm it was she would say it was her mother’s or her brother’s. She said someone was playing a prank on her from under the table. Patients like this will explain away obvious things, but never seem to come out and say something like “it is my arm but I can’t feel ownership of it.” If she looked at her arm she could see the facts of the matter, but facts couldn’t alter her narrative. This is a form of anosognosia, and in these cases family and friends who are on one side of reality have a difficult time understanding how those on the other can continue to believe as they do. Inside the head of the sufferer, it’s not an easy thing to realize they are wrong. One of the defining features of anosognosia is that facts often don’t work on those who suffer under its terrible spell. I asked Ramachandran how that could that be possible.

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