Friday, October 10, 2025

Seeing Right and Wrong with a TBI

    This semester, Dr. Nick Baker and our class explored how our brains make sense of this chaotic world, how we perceive shapes, patterns, and sounds. During his presentation on shape detection, Dr. Baker explained how the brain automatically tries to understand a pattern or make sense of the whole. When I read “The role of vertical mirror symmetry in visual shape detection” I was fascinated with the idea that our brains don't want to see part of the puzzle and how our vision system has a preference for symmetry. For class Dr. Baker had us read “The Role of Vertical Mirror Symmetry in visual shape detection” by Machilsen et al. (2009) experiment, where individuals were trying to make sense of random, striped dots called Gabor elements, when the dots were aligned, participants knew. This got me thinking, if the brain works so hard to organize and interpret visual information meaningfully, what happens when we apply that same process to moral decisions? Does an injury change not only what we see but what we feel is right or wrong? 

    In 2017, a study by Rowley et al. researched this very question. Rowley et al.’s study investigated how traumatic brain injury (TBI) changes moral judgment, honing in on whether patients with TBI make decisions that feel wrong even if they seem to have a logical outcome. The study consisted of 30 adults with moderate to severe TBI and 30 healthy control participants. Each participant was given a moral judgment task consisting of 10 moral dilemmas. They chose what they would do (yes/no) and then rated the difficulty of each decision on a scale of 1-10. Participants also completed the Theory of Mind battery. In Machilsen et al's., experiment and article, he used the term "noise" to describe any moving or altering of the dots' orientation, making it harder for the participant to perceive a shape. Just like Machilsen's "noise", Rowley's experiment used moral "noise".The "noise" in this case is the participants' struggle to choose between using emotional instinct or logical reasoning when answering each given dilemma. What made Rowley et al's study different from others is that they separated utilitarian vs rule based (moral content) from what felt right or wrong (intuitiveness). Here, the goal was to determine if TBI caused participants to make decisions that were less guided by emotional intuition than the control group. The results confirmed what researchers' predicted "There was a main effect of group, with more counterintuitive judgments in the TBI group" (Rowley et al., 2017, p.208), participants of the study with a TBI were significantly more likely to choose decisions that went against their emotional instincts.

    The TBI group made significantly more counterintuitive judgments, or in plain English, choices that people usually find emotionally difficult to make. However, what was interesting was that overall, TBI patients were not more utilitarian. This means that TBI patients lost their emotional resistance; for people without TBI, this resistance makes certain choices feel wrong. In terms of the control group participants, "exhibited a higher mean difficulty cost than the TBI group" (Rowley et al., 2017, p.209). Counterintuitive decisions that were asked, for example, would involve questions about killing one to save many. TBI patients found them no more or less difficult than other questions asked by Rowley et al. The most intriguing part of this study was discovering affective Theory of Mind, the brain's way of understanding how someone else feels, and cognitive Theory of Mind, which is the ability to understand others' intentions and beliefs. Participants took multiple Theory of Mind assessments, or ToM Rowley et al, 2017. The TBI group scored significantly lower on the Reading the Mind in the Eyes test (affective), suggesting greater emotional detachment Rowley et al. Affective ToM (measuring emotional empathy) was a key predictor of moral judgment (less emotionally driven). Low RME scores are correlated with more counterintuitive moral decisions. The more emotionally detached an individual was in the dilemma, the easier it was for that individual to make a decision that was harmful if the outcome made logical sense. 

    Researchers confirmed from brain scans that damage in these patients was clustered in the vmPFC (ventromedial prefrontal cortex) and the OFC (orbitofrontal cortex). Key areas such as the prefrontal cortex and the limbic system combine emotion signals and cognitive rules into a single integrated moral "shape".. Traumatic brain injuries disrupt those connections, their meaning becomes fragmented. Both regions help integrate emotional feedback received from the amygdala, which forms moral reasoning and our choices. When emotional input is disconnected or altered from a TBI, one's logic and reasoning will stay, but one's feelings of wrongness will fade. Being that it is the TBI group, they were not able to integrate the information like a healthy brain would because their emotional network had been damaged. This is an example of what Dr. Baker was referring to, the Gestalt principle, in which the whole is greater than the sum of its parts. In healthy brains, emotion and logic form a whole puzzle. In TBI’s, the balance between emotion and cognition breaks down, disrupting the moral Gestalt that makes moral reasoning and judgment whole.. Patients with a TBI can still think logically, facts, rules, and outcomes, but lose the wholeness or feeling that indicates what is right or wrong. Your brain has moments when it clicks and you see the shape or know the right answer. At first participants had trouble recognizing shapes when they were paired with visual noise, eventually they saw a shape. TBI patients face a similar challenge, struggling to see or feel that emotional intuitiveness. In both studies, integration is key. Whether you're identifying a shape or judging a moral act, a lack of emotion perception can change moral judgments.

    As we know, feelings come from our neural circuits, but if these circuits are injured, the injury can alter one's ethics. Rowley's study even suggests that in order to improve moral judgment after a TBI, it requires rebuilding the neural connection between emotional empathy and cognitive reasoning. Essentially, this is retraining the brain to integrate emotional empathy and cognitive reasoning, instead of relying solely on cognitive reasoning, like many TBI patients in Rowley's study. These concepts parallel Dr. Baker's article on how the brain's visual networks can adapt and reorganize after disruption, a process better known as neuroplasticity. If the brain's visual system can relearn to understand patterns, what's stopping the moral brain from relearning how to integrate feelings and thoughts? 

    

    The article did a great job of explaining morality as a comparable neural process. Initially, it was surprising how much the visual system and moral judgment align. The most surprising thing that I took away from Rowley's study was that when an individual's emotional depth fades, like in TBI, right or wrong feels like a trick question, as opposed to an inherent sense. When emotion is taken out of the equation, ethical judgment turns into only a cognitive process, taking away its wholeness. It's not just about seeing a pattern as a whole, it's about the gut feeling you get when your intuition is telling you something is right or wrong. 





References:



Machilsen, B., Pauwels, M., & Wagemans, J. (2009, November). The role of vertical mirror symmetry in visual shape detection                        | Jov | arvo journals. ARVO Journals. https://jov.arvojournals.org/article.aspx?articleid=2122115 

Rowley, D. A., Rogish, M., Alexander, T., & Riggs, K. J. (2017, February 7). Counter-intuitive moral judgement following                                                     traumatic brain injury. The British Psychological Association.                                     https://bpspsychub.onlinelibrary.wiley.com/doi/epdf/10.1111/jnp.12117

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