I have often heard the phrase, “There is no ‘I’ in ‘Team.’” Whereas that may be true, I think there may be an “I” in “Me.” That is to say that there may be a duality of consciousness operating within me. There is the “me” that thinks and acts, and there is the “I” that observes and influences that “me.”

When I was an undergrad, I used to get drunk and do stupid things. But even when I was in that stupid state, there was a part of me that could say to myself, “I am drunk and acting stupid[ly].” Sometimes, though not as often I’d I now wish, that more sober state of consciousness could convince the stupid drunk to quit drinking and acting stupid. That is what I mean by a duality of consciousness. I am not referring to what Freudians might call the superego and the ego. As I understand it, the superego is a subconscious voice saying (no doubt in my mother’s voice), “No, no! Bad Randy! Sit! Let go!!”

The superego is not self-aware. The “I” that I am referring to is self-aware. It is a level of consciousness that can reflect on other mental states, at least in some ways. It is that part of me that can objectively say, “I am acting inappropriately,” when I am angry and shouting. That “I” can also say to myself, “Please calm down before you do something stupid again.”

Last night, I became very confused. I didn’t know how to operate the microwave. I wanted a bowl of warm oatmeal very much, so it frustrated me that I couldn’t figure out how to work the stupid machine. I became agitated and started pushing buttons at random and telling the microwave how stupid it was. At the time, I don’t think there was an “I” in me, at least not that I was aware of.

But then, my wife Tamara said, “Honey, is there something I can help you with?” I am sure that the “I” in me is named Honey, because he always seems to respond when my wife calls. “Honey, do you need to rest?” That is her way of calming me and gently suggesting that I am getting agitated. Even when I am confused, it seems that she can speak to a part of me – a consciousness that isn’t quite so confused. So when she says, “Honey, are you confused?” I can think, why yes, I am a bit befuddled. And then I can say to myself, “Better not try to fix that stupid microwave right now.”

I wonder how much the “I” in “me” will be affected by dementia. Will Tamara always be able to speak to Honey even if Randy has clocked out for the day? Will there come a time when Honey will behave just as bizarrely as Randy sometimes does? Or is Honey operating in a different state, perhaps one that is not affected by neurotransmitters? When my brain finally dies, will Honey say, “Whew! I’m glad that’s over!”


Randy Graves

Randy, I sincerely hope you are blogging or keeping a diary of your thoughts and experiences as you continue on your LBD journey. What a valuable tool it could be for future patients and their families! Keep posting!!

Randy,

You are a step ahead of me (even with LBD), certainly, in that part of you ("I") is self-aware. When I'm angry or behaving poorly, I don't think I'm self-aware.

There's an article in the March issue of the journal Brain on "insight." It looks at the loss of insight -- awareness of cognitive deficits -- in FTD, CBD, and PSP. Three areas were assessed: "metacognitive knowledge of the disorders, online monitoring of errors (emergent awareness) and ability to accurately predict performance on future tasks (anticipatory awareness)."* FTDers were more "impaired" than PSPers and CBDers. I don't know how LBD would compare. Perhaps you could do a search on LBD and "loss of insight." Maybe if you know what to expect you and your lovely wife can work out an advance plan as to how you two will deal with it.

Robin


*Part of the authors' conclusion is: "higher levels of depression were associated with poor anticipatory awareness, reduced empathy was related to impaired metacognitive awareness, and impaired recognition of emotional expression in faces was associated with both metacognitive and anticipatory awareness deficits."

I haven't read the article, but I would guess that the types of brain function that are affected are related to the specific areas of the brain that are diseased. I find that interesting, because (as I have shared before) I am interested in brain plasticity and specific ways of "exercising" areas of the brain most often affected. One method I'm trying to find out more about is the use of meditation or cognitive rehabilitation training. I know and practice already methods to enhance metacognition. I sit zazen at least forty minutes a day.

I have also started to learn Japanese and how to play the piano. I chose Japanese because it is a relatively easy language to learn (having studied German, French, Greek and Hebrew at college/seminary). I decided to study piano because, well, it couldn't hurt, and because I've always wanted to play the piano. Even if I only have a year or two before my brain short-circuits, at least I will have played the piano before I finally say sayoonara to this life.

Randy

fins,

Thanks for your kind words. I don't really blog anywhere. I just post my thoughts about LBD here in the forums. I started a MySpace page, but I only had two friends (three if you count Tom!), and one of those was my wife Tamara. I used to have a blog, back when I was a pastor, but it got me into trouble with some of my parishioners who really didn't want to know that I have a secret sin: I smoke a cigar once a year. They also took offense when I blogged about encountering God while skinny dipping in the ocean at night under the dazzling stars. The Bishop wasn't too keen on that, either. Go figure.

Randy