Introductory essay: Perseveration happens!

Abstract

Patients with recurrent perseveration as part of a fluent left temporal lobe aphasia often consciously intend to produce a requested target on confrontation testing in the clinic. However, suddenly and quite unexpectedly, they will have a perseveration happen to them. Being focused on the task at hand, and having no discernable attention deficit, the modular and automatic utterance of a whole‐word perseverate will startle patients, leaving them puzzled and at a loss to explain such a blunder. In this paper the claim is made that, in a sense, these patients have found themselves at the nexus of the conscious and the unconscious. This phenomenon is discussed based on data from a longitudinal study of a patient who has classical conduction aphasia with severe word‐finding deficits, but intact comprehension and attention. He perseverates only in the response modes that have been compromised by his brain damage.

Notes

1. “Qualia” refers to the inner contents of the “feel” of sensing things. What it is to “see” a red object as red must somehow be characterised and the rather nebulous notion must at least have a label, so that whatever it may turn out to be, it can at least be subject to scientific and philosophical consideration. In psycho‐physical parallelism or identity theory, the claim is often that the physiological activity stimulated by the physical characteristics of the red object run in parallel with or can be identified with the perceiver's qualia of “seeing red” (Buckingham, 1986). The qualia would be quite different in an agnosic who “perceives” but does not realise he/she perceives or is unaware—he/she simply can make no sense of the object “seen”. Jason Brown's (personal communication) model of microgenesis does not restrict qualia to the individual self; rather he links qualia with subjectivity and claims that subjectivity is limited by the world. I will continue to incorporate the term “qualia”, but I will be referring to inner “feels” of the human and the occasionally offered self‐reports of these states‐of‐mind “feels”. It would be an interesting project to inquire more deeply into perseveration through the lenses of Brown's microgenesis of cognition, where the intransitive verb “to feel” is paramount in describing mentality at multiple levels of processing.

2. I thank Nadine Martin for reminding me of this time‐worn distinction. It also accords with the fact that the deafferented phonological buffer memory predicted all the recurrent perseveration and that there was no perseveration at all on the nonverbal, passive pointing task, which pressed the operating memory for semantics only.