Self, Awareness, and the Frontal Lobes: A Neuropsychological Perspective

The concept of self has various definitions. James (1891/1952) stated that, in its widest sense, a person’s self is all that can be called one’s own; there are therefore multiple components or representations of one’s self. This chapter concentrates on awareness of self, the momentary focus or direction of attention to one or more constituents of the self (Carver & Scheier, 1982; Wicklund, 1979). Are these representations of self a localized brain function? The neurological and neuropsychological literature contains terms that appear to be related to a concept of self. These terms include insight (rarely defined); anosognosia (literally, lack of knowledge of the disorder but commonly meaning denial of illness: α—without; gnosis—knowledge; nosos—disease); unawareness (seeming lack of knowledge or lack of attention to the relevant disorder); and unconcern,or anosodiaphoria (intact knowledge but lack of appropriate concern about the presence and implications of the problem) (Heilman, Watson, & Valenstein, 1985; Stuss & Benson, 1986). “Knowledge” and “awareness” are particularly relevant in these definitions. These clinical disorders have been reported after brain pathology in various cortical and subcortical regions but most prominently after damage to prefrontal regions or frontal systems (Stuss & Benson, 1986). I propose that different representations of self, and the awareness of these representations, are related to particular brain structures or regions. The frontal systems appear to be important for the highest representations of self.