Much of the research in clinical and experimental neuropsychology appears to be a scattered amalgam of intellectual pursuits all aiming to discover the holy grail of how the human brain operates. Shallice and Cooper draw from clinical and experimental evidence, integrating cognitive psychological approaches with brain imaging, to offer an amazingly valuable service to all who join the search for this elusive intellectual treasure. Their treatise, The Organisation of Mind, is essential reading for all scholars of brain science. Furthermore, it should be a mandatory read for all neuropsychology graduate students in clinical and research programs as a textbook on modeling, conceptualizing, and designing meaningful hypotheses for their investigations.
Treasure maps, however, are not easy to decipher. This book is no exception; it is not easy to comprehend despite being replete with color imaging pictures and schematic diagrams illustrating proposed cognitive models. The issues presented are complex, the text often is turgid, and the density of ideas can be overwhelming. However, invoking the “no pain, no gain” cliché seems apropos. The mental exercise is definitely worth it, and the content will help build strong bodies of work 12 ways to paraphrase the Wonder Bread advertisement.
The 12 ways are defined by twelve chapters categorized into three parts. Part one, consisting of five chapters, introduces the conceptual foundations of cognitive neuroscience, the investigative problems posed by applying assumptions derived from behavioral observations of lesioned individuals with circumscribed cognitive deficits, and the relative strengths and weaknesses of commonly employed experimental designs (e.g., for imaging studies). Digesting this section is indispensable for graduate students and other professionals new to the fields of neuropsychology and related disciplines. However, more senior colleagues may choose to skip ahead to chapter 4.
One critique of this section is that the authors appeared temporally biased in dismissing historical contributions by seminal neuroscience researchers as not sufficiently scientific (i.e., with regard to their contributions to the discipline of cognitive neuroscience). As such, it appeared that Shallice and Cooper didn't do justice to the richness of our theoretical heritage about “the general organisation of the mind” prior to 1970 (i.e., before the advent of computer modeling and imaging technology). This was particularly evident by not elaborating upon the work of the late Ulric Neisser whose contribution to the field of cognitive psychology was monumental (Neisser, Reference Neisser1967).
Part two, comprised of three chapters, covers basic cognitive processes and offers very interesting and useful clinical material. Chapter 6 reviews studies that isolated cortical subregions specific for language processes underlying the syndrome of semantic dementia. Additionally, chapter 7 presents interesting clinical material on double dissociations for cognitive processes associated with working memory (e.g., priming and recognition). The same characterization applies to chapter 8, focusing instead on praxis.
Seemingly adding complexity to the authors’ reasoning across the chapters of this section, although perhaps a problem only for the reader trained in clinical neuropsychology, is their exclusive reliance upon cognitive modeling to predict and interpret deficits arising from focal cerebral lesions. For example, when attempting to link the phonologic problems of some focally lesioned patients with their inability to understand complex sentences, it appeared more difficult to anticipate these clinical associations by applying the construct of a phonologic input buffer than by tapping conventional diagnostic and brain-behavior models (i.e., knowledge of the diagnostic formulation of Rapin, Reference Rapin1982, for a mixed phonologic-syntactic syndrome and of the underlying anatomical sites).
Part three, containing the last four chapters, presents the clearest roadmap for ultimately discovering the holy grail of how the human brain operates. Using lesion and imaging studies, these chapters address the cerebral mediation of executive and inhibitory performance (i.e., contention scheduling and supervisory processes), novel information processing (i.e., active monitoring and checking), episodic memory, recollection, confabulation, consciousness and its neural correlates, unconscious processes (including neglect and vegetative states), and thinking (i.e., reasoning, deductive inference, problem solving, and insight).
Chapter 12, on thinking, appeared to be the least engaging in this section (perhaps because it followed the authors’ exploration of consciousness). Additionally, it seemed to suffer from relatively weak empirical support. Although an argument for accepting “some form of modular organisation of function” to account for the processes underlying complex thought was advanced, the authors acknowledged that a clear picture of the processes mediating thinking has yet to emerge.
The greatest strengths of this landmark book are its comprehensiveness and uniqueness. The authors integrate a vast literature spanning disparate subdivisions of neuroscience research. Furthermore, by critically assessing models explaining cognitive processes observed across behavioral and imaging studies, they fill a theoretical void that is a requisite step for eventually permitting neuroscientists to decipher the complexity of the human mind beyond contemporary notions of cerebral function.
Apart from its heuristic and research value, this volume will help clinicians to better understand the neural pathways underlying expressed impairment in individual patients. For illustrative purposes, consider the syndrome of disturbed inhibition that often follows anterior cerebral lesions. As neuropsychologists, we typically feel the explanation of this phenomenon lies within our comfort zone of knowledge about frontal circuitry. However, in discussing the modulation of contention scheduling, Shallice and Cooper provide even the experienced clinician with a much richer understanding of: a) what normally may be occurring within the medial part of the prefrontal cortex to energize inhibitory behavior, and b) how these operations are altered (e.g., losing the ability to use “intentional markers” to set up and to hold intentions) in the aftermath of focal lesions to this cortical area. Similar contributions are made for understanding individuals with: executive dysfunction, semantic dementia, aphasias, disorders of praxis, memory dysfunction (including the generation of confabulations), visuoperceptual disturbances (including agnosias, dyslexias, and nonverbal learning disability), sensory deficits (i.e., field cuts and hemispatial neglect), and disorders of arousal (e.g., vegetative states).
Perhaps the most conspicuous indication of having not yet discovered the holy grail of human brain function is our inadequate understanding of human consciousness. Shallice and Cooper address this problem in chapter 11 and, despite expressing lack of certainty, offer a plausible model (i.e., that of the global neuronal workspace). Nevertheless, despite their hopeful message that “it should not be long before a definitive theory is developed,” the quest for understanding consciousness remains elusive. A novel concept, however, that seemed self-evident (i.e., from the studies reviewed on perceptual awareness and extinction) was that consciousness might be a threshold phenomenon akin to other perceptual states (i.e., expressed on a continuum from detection to awareness). All told, how close are we to adequately understanding human consciousness? To paraphrase the logical eloquence of Yogi Berra, we won't know it until we know it.
