Anosognosia

Anosognosia is a condition in which a patient has a total lack of awareness about an impairment. A famous example of this is Supreme Court Justice William O. Douglas, when a debilitating stroke in 1974 paralyzed his left side and confined him to a wheelchair.  However, Justice Douglas completely denied his very obvious disability - calling it a myth.

Once again, the elegant writing of David Eagleman explains this syndrome effortlessly.  In his book, Incognito, he explains that “it’s not that Justice Douglas was lying – his brain actually believed that he could move just fine….The point about anosognosia is that the patients are not lying, and are not motivated by neither mischievous nor by embarrassment; instead, their brains are fabricating explanations that provide a coherent explanation about what is going on with their damaged bodies.”

As I hope you can realize, this is not a defense mechanism like denial.  These patients have a true syndrome rooted in physiological damage.  Anosognosia is common following brain injuries like strokes, but can occur in combination with other neurological impairment, too. However, it is not related to global mental disabilities like dementia or Alzheimer’s.  “Anosognosia can be selective in that an affected person with multiple impairments may seem unaware of only one handicap, while appearing to be fully aware of any others*.”

*Re: Hirstein, William (2004). Brain fiction: self-deception and the riddle of confabulation. MIT Press.