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‘It’s All Done With Mirrors’: V.S. Ramachandran and the Material Culture of Phantom Limb Research

  • Katja Guenther

Abstract

This article examines the material culture of neuroscientist Vilayanur S. Ramachandran’s research into phantom limbs. In the 1990s Ramachandran used a ‘mirror box’ to ‘resurrect’ phantom limbs and thus to treat the pain that often accompanied them. The experimental success of his mirror therapy led Ramachandran to see mirrors as a useful model of brain function, a tendency that explains his attraction to work on ‘mirror neurons’. I argue that Ramachandran’s fascination with and repeated appeal to the mirror can be explained by the way it allowed him to confront a perennial problem in the mind and brain sciences, that of the relationship between a supposedly immaterial mind and a material brain. By producing what Ramachandran called a ‘virtual reality’, relating in varied and complex ways to the material world, the mirror reproduced a form of psycho-physical parallelism and dualistic ontology, while conforming to the materialist norms of neuroscience today.

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Corresponding author

*Email address for correspondence: kguenthe@princeton.edu

References

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1. V.S. Ramachandran and D. Rogers-Ramachandran,‘Synaesthesia in Phantom Limbs Induced with Mirrors’, Proceedings of the Royal Society of London B, 263 (1996), 377–86: 379. They had recruited patients in a number of ways: some had been referred through the orthopaedics department at the UCSD medical school; others they found through contacting local prosthesis manufacturers in San Diego.

2. Paré, Ambroise, Oeuvres complètes d’Ambroise Paré, Vol. 2, ed. J.F. Malgaigne (Paris: Baillère, 1840–1). S. Weir Mitchell, ‘Phantom limbs’, Lippincott’s Magazine of Popular Literature and Science, 8 (1871), 563–9. Aura Satz, ‘ “The conviction of its existence”: Silas Weir Mitchell, phantom limbs and phantom bodies in neurology and spiritualism’, in L. Salisbury and A. Shail (eds), Neurology and Modernity: A Cultural History of Nervous Systems, 1800–1950 (New York: Palgrave Macmillan, 2010), 113–29. See also Douglas B. Price and Neil J. Twombly, The Phantom Limb Phenomenon: A Medical Folkloric, and Historical Study: Texts and Translations of 10th to 20th Century Accounts of the Miraculous Restoration of Lost Body Parts (Washington DC: Georgetown University Press, 1978). Lisa Herschberg, ‘ “True Clinical Fictions:’ Medical and Literary Narratives from the Civil War Hospital’, Culture, Medicine, and Psychiatry, 19, 2 (1995), 183–205. For a stimulating history and sociology of the phantom limb see Cassandra Crawford, Phantom Limb: Amputation, Embodiment, and Prosthetic Technology (New York: New York University Press, 2014).

3. Satz, op. cit. (note 2), 114.

4. The rejection rate since the 1980s has been determined as 39%. See Elaine A. Biddiss and Tom T. Chau, ‘Upper limb prosthesis use and abandonment: A survey of the last 25 years’, Prosthetics and Orthotics International (2007), percentage of 250. On the prevalence of upper limb amputations as opposed to lower limb, see, for example, G. Täger and D. Nast-Kolb, ‘Amputationen und Prothesenversorgung der oberen Extremität’, Der Chirurg, 71, 6 (2000), 727–42, which gives data for the US and Germany. The history of prostheses has primarily been told in a war or post-war context, see, for example, Sabine Kienitz, Beschädigte Helden: Kriegsinvalidität und Körperbilder 1914–23 (Paderborn: Schnöingh, 2008). David Harley Serlin, Replaceable You: Engineering the Body in Postwar America (Chicago, IL: University of Chicago Press, 2004), ch. 1. Laurann Figg and Jane Farrell-Beck, ‘Amputation in the Civil War: Physical and Social Dimensions’, Journal of the History of Medicine and Allied Sciences, 48 (1993), 454–75. For a discussion of ‘phantom–prosthetic relations’, see the chapter in Crawford, op. cit. (note 2).

5. Colker, Ruth, The Disability Pendulum: The First Decade of the Americans with Disabilities Act (New York: New York University Press, 2005). See here also for the backlash that followed the high hopes associated with the 1990 Act.

6. This also improved the reputation of amputation. By 2000, the developments in prosthesis helped re-conceptualise amputation surgery as ‘constructive’, Crawford, op. cit. (note 2), 213.

7. Though I have structured this paper around Ramachandran, I am less interested in the status, influence and critiques of his work than in the ways in which it provides a fascinating and clear example of how mirrors have functioned in the ‘mind sciences’.

8. V.S. Ramachandran et al.,‘Illusions of body image: what they reveal about human nature’, in R. Linas and P. Churchland (eds), The Mind-Brain Continuum (Cambridge, MA: MIT Press): 29–60: 30.

9. Galison, Peter, Image and Logic: A Material Culture of Microphysics (Chicago, IL: University of Chicago Press, 1997), xvii.

10. Galison, op. cit. (note 9), xviii.

11. Rheinberger, Hans-Jörg, Toward a History of Epistemic Things: Synthesizing Proteins in the Test Tube (Stanford, CA: Stanford University Press, 1997), 33. Note that here experimental systems and epistemic things are mutually constitutive.

12. Rheinberger, Ibid., 9.

13. Rheinberger, Ibid., 28.

14. Latour, Bruno, Reassembling the Social: An Introduction to Actor-Network Theory (Oxford: Oxford University Press, 2005).

15. Latour, Bruno, Pandora’s Hope: Essays on the Reality of Science Studies (Cambridge, MA: Harvard University Press, 1999), 119. The entity was later called ‘yeast’.

16. Latour, op. cit. (note 14), 76.

17. Latour, Ibid., 85.

18. For example, Simon Schaffer who accuses him of regressing into ‘hylozoism’, the doctrine that attributes life to matter. Simon Schaffer, ‘The Eighteenth Brumaire of Bruno Latour’, Studies in History and Philosophy of Science, 22, 1 (1991), 174–92: 182.

19. Ramachandran and Rogers-Ramachandran, op. cit. (note 1), 380.

20. Ramachandran et al., op. cit. (note 8), 31.

21. Ramachandranand Rogers-Ramachandran, op. cit. (note 1), 379ff.

22. V.S. Ramachandran and Eric Altschuler, ‘The Use of Visual Feedback, in particular Mirror Visual Feedback, in Restoring Brain Function’, Brain, 132 (2009), 1693–710: 1694.

23. Ramachandran and Rogers-Ramachandran, op. cit. (note 1), 381.

24. Ibid., 380.

25. Ibid.

26. V.S. Ramachandran and Stuart M. Anstis, ‘The Perception of Apparent Motion’, Scientific American254, 6 (1986),102–9.

27. Ramachandran and Anstis, op. cit. (note 26), 102.

28. Note that this brightness is what is called ‘coarse brightness’ or ‘low spatial frequency brightness’, which is the converse of ‘pixel brightness’ or ‘high spatial frequency brightness’. The latter would not be a useful cue because it would require excessive computational power.

29. Ramachandran and Anstis, op. cit. (note 26), 105. In fact, perceptual scientists find the visual system to be remarkably attuned to statistical regularities that occur in the natural world. For a review, see W.S. Geisler et al., ‘Natural Systems Analysis’, Visual Neuroscience, 26 (2009), 1–3.

30. Ramachandran and Anstis, op. cit. (note 26), 109.

31. Ibid., 105.

32. Ibid., 106.

33. Ibid., 102.

34. Ibid., 106.

35. For example, in Ramachandran et al., op. cit. (note 8).

36. Ibid., 30.

37. V.S. Ramachandran and William Hirstein, ‘The Perception of Phantom Limbs: The D.O. Hebb Lecture’, Brain, 121 (1998), 1603–630: 1604.

38. Ramachandran, V. S., ‘Phantom limbs, neglect syndromes, repressed memories, and Freudian psychology’, International Review of Neurobiology, 37 (1994), 291333: 317.

39. V.S. Ramachandran, with Sandra Blakeslee, Phantoms in the Brain: Probing the Mysteries of the Human Mind (New York: Harper Perennial, 1998), 46.

40. Ramachandran and Altschuler, op. cit. (note 22), 1696.

41. Ramachandran and Rogers-Ramachadran, op. cit. (note 1), 382.

42. Ramachandran and Rogers-Ramachadran, op. cit. (note 1), 382, 386.

43. Such persistence also helped explain the phenomenon of neglect, which Ramachandran thought of as the ‘converse of the phantom limb experience’. Here patients would refuse to acknowledge a paralysed limb, because the reality of the body image in the parietal lobe trumped the evidence that an arm, for example, could not move. Ramachandran, op. cit. (note 38), 314.

44. For a scholarly discussion of neuroplasticity, see Nikolas Rose and Joelle Abi-Rached, Neuro: The New Brain Sciences and the Management of the Mind (Princeton, NJ: Princeton University Press, 2013), especially chs 1 and 5, and the work by Tobias Rees, for example, On How Adult Cerebral Plasticity Research Has Decoupled Pathology from Death, in David Bates, and Nima Bassiri (eds), Plasticity and Pathology: On the Formation of the Neural Subject (New York: Fordham University Press, 2016), 309–341.

45. Ramachandran, ‘Phantom limbs’, 314 .

46. Ramachandran and Altschuler, op. cit. (note 22), 1695.

47. Apart from the fourth finger in the example.

48. Ramachandran, op. cit. (note 38), 295.

49. V.S. Ramachandran, ‘Behavioral and Magnetoencephalographic Correlates of Plasticity in the Adult Human Brain’, Proceedings of the National Academy of the United States of America, 90, 22 (1993): 10413–20: 10418.

50. Ramachandran and Altschuler, op. cit. (note 22), 1698.

51. V.S. Ramachandran et al., ‘Shrinking Phantom Pain with Lenses and Shifting Referred Sensations through Volition’, Neuroscience Abstracts (2009).

52. G. Di Pellegrino et al., ‘Understanding Motor Events: A Neurophysiological Study’, Experimental Brain Research, 91 (1992),176–80: 176. For scholarly work on mirror neurons, see also Allan Young, ‘The Social Brain and the Myth of Empathy’, Science in Context, 25, 3 (2012), 401–24; Allan Young, ‘Mirror neurons and the rationality problem’, in S. Watanabe et al. (eds), Rational Animals, Irrational Humans (Tokyo: Keio University Press, 2009), 67–80; Susan Lanzoni, ‘Imaging Emotions: Reconfiguring the Social in Neuroscience’, paper presented at the annual meeting of the American Association for the History of Medicine, 8–11 May 2014; Katja Guenther, ‘Imperfect reflections: norms, pathology, and difference in mirror neuron research’, in David Bates and Nima Bassiri (eds), Pathology and Plasticity: On the Formation of the Neural Subject, Berkeley Forum in the Humanities (New York: Fordham University Press, 2016), 268–308. For a discussion of mirror neuron research from within the field, see Gregory Hickok, The Myth of Mirror Neurons: The Real Neuroscience of Communication and Cognition (New York: Norton, 2014).

53. Di Pellegrino et al., op. cit. (note 52), 176. Two 1996 papers introduced the term ‘mirror neuron’. Another early paper that Ramachandran cites is, M.S.A.Graziano et al., Science 226 (1994), 1051–4: V.S. Ramachandran and Diane Rogers-Ramachandran, ‘Denial of Disabilities in Anosognosia’, Nature, 382 (1996), 501. Mirror neurons were later used to describe the system’s capacity for emotional empathy, a move criticised by Ruth Leys, ‘ “Both of Us Disgusted in My Insula”: mirror-neuron theory and emotional empathy’, in Frank Biess and Daniel M. Gross (eds), Science and Emotions after 1945 (2014), 67–95; an earlier version of the paper appeared atnonsite.org.

54. V.S. Ramachandran, ‘Sensations Referred to a Patient’s Phantom Arm from Another Subject’s Intact Arm: Perceptual Correlates of Mirror Neurons’, Medical Hypotheses, 70, 6 (2008), 1233–4: 1233. See also his 2000 Edge article where he first calls the action of mirror neurons a ‘virtual reality simulation’, V.S. Ramachandran, ‘Mirror Neurons and Imitation Learning as the Driving Force behind “The Great Leap Forward” in Human Evolution’, Edge 2000 (http://edge.org/3rd_culture/ramachandran/ramachandran_p1.html), and an article in 2009: V.S. Ramachandran and David Brain, ‘Sensations Evoked in Patients with Amputation from Watching an Individual whose Corresponding Intact Limb Is Being Touched’, Archives of Neurology, 66 (2009), 1281–4: 1281.

55. See also V.S. Ramachandran, The Tell-Tale Brain: A Neuroscientist’s Quest for What Makes us Human (New York: Norton, 2011), 123.

56. Ramachandran, op. cit. (note 55), 125.

57. Ramachandran and Altschuler, op. cit. (note 22), 1702.

58. Ibid.

59. See also Ramachandran et al., op. cit. (note 51).

60. V.S. Ramachandran and D. Rogers-Ramachandran, Its All Done with Mirrors: Reflections on the familiar and yet deeply enigmatic nature of the looking glass, Scientific American Mind, August/September 2007, 16–18 .

61. Ramachandran, op. cit. (note 54).

62. Ramachandran and Rogers-Ramachandran, op. cit. (note 60), 16 .

63. Baron-Cohen is, in fact, opposed to Ramachandran’s theorisations.

64. V.S. Ramachandran and Lindsay M. Oberman, ‘Broken Mirrors: A Theory of Autism’, Scientific American, 295 (2006), 63–9.

65. For example, throughout his Phantoms in the Brain– see op. cit. (note 39); throughout his recent Tell-Tale Brain – see op. cit. (note 55); in V.S. Ramachandran, A Brief Tour of Human Consciousness (New York: Pi Press, 2004), 1, 7–8; in op. cit. (note 8); in International Review of Neurobiology, (1994); and in Medical Hypotheses, (1996).

66. Ramachandran et al., op. cit. (note 8), 29.

67. Ramachandran et al., Ibid., 30.

68. For a critique of ‘neuro-psychoanalysis’, see Nima Bassiri, ‘Freud and the Matter of the Brain: On the Rearrangements of Neuropsychoanalysis’, Critical Inquiry, 40, Autumn (2013), 1–26.

69. Ramachandran, op. cit. (note 38), 316.

70. Ramachandran et al., op. cit. (note 8), 39.

71. Ramachandran et al., Ibid., 39–40.

72. Ramachandran and Rogers-Ramachandran, op. cit. (note 60), 16 .

73. Mirrors have been fascinating to many scholars although we still lack a history of the mirror within the sciences of the mind. See, for example, Mark Pendergrast, Mirror Mirror: A History of the Human Love Affair with Reflection (New York: Basic Books, 2003); Sabine Melchior-Bonnet, The Mirror: A History (New York: Routledge, 2001).

I would like to thank the following people for their helpful comments and suggestions: Edward Baring, Volker Hess, Leor Katz, Sophie Ledebur, the participants of the ‘Soul Catchers’ Workshop at Princeton in February 2014, the participants of the ‘Pathology and Plasticity’ Workshop at Berkeley in April 2014, and the three anonymous reviewers for Medical History.

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