Is UNconscious cognition more impaired than conscious cognition in ME/CFS?

Hip

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ME/CFS patients sometimes have days when their cognitive dysfunction (aka: clouding of consciousness or brain fog) substantially abates. On the rare occasions when I have a day of greatly reduced brain fog, I notice that I become more able to perform ordinary household tasks unconsciously, ie, on "automatic".

Whereas when my brain fog is more severe, I find I tend to approach even simple routine tasks with conscious attention (or what remains of my conscious attention). When brain fog is present, of necessity I perform the tasks with as much conscious attention as I can muster in the haze of brain fog; this is because with brain fog, I notice that it is harder for me to perform tasks in an automatic and unconscious way.

Could it be that the brain fog of ME/CFS impairs unconscious mental functioning more than conscious functioning?



We are all aware that humans are able to perform tasks both consciously and unconsciously.

For example, experienced drivers will usually navigate through the traffic unconsciously, by using unconscious cognition and unconscious physical responses. That is to say, normal healthy people usually drive on "automatic", often focusing their conscious attention on something else while driving (such as planing in their mind what to do later in the evening). Only if a hairy situation crops up while driving do drivers instantly bring their full conscious attention to bear on the road.

And the same applies to simple routine tasks in the home, like cooking, cleaning, brushing your teeth, etc: healthy people will invariably perform these tasks using unconscious mental processes, while thinking about something else more interesting, or while talking to others. Most of the routine tasks humans do each day are delegated to the unconscious to fulfill.



Could it be that brain fog significantly hampers unconscious cognition, such that ME/CFS patients are then forced to laboriously perform tasks using conscious cognition?

If so, this may explain why even simple tasks can often seem tiring and laborious to ME/CFS patients, because we have to consciously think through every step of the way, rather than delegating the task to our unconscious mind to perform effortlessly and automatically, while our conscious mind is focussed on more interesting or important matters.

On the very occasional days where my brain fog does transiently improve, I notice that I start performing routine tasks in a more effortless and unconscious way, which feels much more efficient, as it releases my conscious mind to simultaneously work on more interesting things (or just allows me to daydream on something nice, while my unconscious performs the humdrum routine task automatically for me).

So I am wondering whether in the brain fog of ME/CFS, there might be a specific brain dysfunction that impedes unconscious cognition, more than it does conscious cognition?

Or alternatively, maybe it is just the impairments of working memory, task switching and divided attention functioning found in ME/CFS that force patients to focus consciously and intently even on simple mundane tasks, just in order to be able to do the task (because otherwise the poor memory may make you forget what you were doing). Maybe unconscious cognition does not work very well when your memory and task switching is impaired.



This impairment of unconscious cognition that I suggest might be occurring in ME/CFS could explain the general feeling I get with ME/CFS, which is that this disease imprisons or straightjackets your mind in a way that makes your world seems narrow and limited. Perhaps this feeling of mental limitation comes from ME/CFS patients' cognition being only capable of focusing on one consciously performed task at a time; whereas healthy people are able to focus on multiple activities at once, using both conscious and unconscious cognition, and so experience a more airy cognitive landscape of greater dimension.

I know on those occasional days when my brain fog substantially improves, I can walk into a room while thinking about some matter, and unconsciously (subliminally) observe that that the room is a bit untidy and that items need to be put back into their cupboards or draws, and I will unconsciously start clearing up the mess, while still engaged in my thought processes on other matters. In this way, the healthy brain is always multidimensional and multitasking in its functioning.

But when my brain fog is significant, I will not even notice that there is a mess, let alone be able to clear up the mess in this automatic and unconscious way while thinking about something else.



What parts of the brain are involved unconscious cognition and unconscious motor control?

This paper says that the basal ganglia and thalamus are involved. The basal ganglia is a brain area found to be working under par in ME/CFS.

And this article says:
Your conscious actions eventually become subconscious habits. The basal ganglia, a brain organ, is believed to "automate thinking and acting, turning focally conscious activities into quick, reliable, unthinking habit."


If ME/CFS brain fog involves not just problems in conscious cognition, but also an impairment of unconscious cognition and unconscious motor action, this could help explain why brain fog is such an all-encompassing debilitating condition.
 
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alex3619

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I am not sure that we know enough to do more than speculate about unconscious versus conscious issues. I know we can talk about capacities though. The clue here would be to discuss what capacities decline as we get sicker or become more exhausted. In my case its language, mathematics, spatial reasoning, noise tolerance, light tolerance, episodic memory, semantic memory, working memory, concentration, orthostatic regulation, and circadian regulation.

I suspect large areas of the brain are affected, and we know they keep finding both subtle and less subtle alterations in our brains, so looked at this way its almost certain there are issues with a great many cognitive capacities, though this cannot be separated from a discussion of ME severity.
 

Moof

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Really interesting thoughts, I think it very likely that there's something in this. I have to process all social interaction intellectually instead of instinctively because of an autism spectrum disorder; it's absolutely exhausting, and I can only process one thing at once (not unusual for autistic brains, though). Having ME, HEDS and inflammatory arthritis as well makes life really fun!
 

Wonkmonk

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This paper says that the basal ganglia and thalamus are involved. The basal ganglia is a brain area found to be working under par in ME/CFS.
I find this idea very interesting because I think HSV and VZV establish latency in the ganglia:

https://www.ncbi.nlm.nih.gov/pubmed/12707850

Has there ever been an investigation of brain fog or cognitive impairment specifically vs. titers of VZV and/or presence of HSV?

Maybe in many patients the actual trigger or sustaining factor of the CFS isn't HSV or VZV, but once the other factor triggers the CFS, the HSV or VZV virus also start misbehaving and messing up the ganglia, and create brain fog.
 

Hip

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The clue here would be to discuss what capacities decline as we get sicker or become more exhausted. In my case its language, mathematics, spatial reasoning, noise tolerance, light tolerance, episodic memory, semantic memory, working memory, concentration, orthostatic regulation, and circadian regulation.
Yes, those impaired mental capacities will be familiar to most ME/CFS patients.

But in addition to those, I am wondering if there may be an impairment in the way the simple routine tasks ME/CFS patients perform are delegated to the unconscious, habit-based mind.

If someone wants to make a cup of tea, for example, they will start the process, but very quickly delegate the various steps required to accomplish that task to the unconscious, habitual mind.

An analogy would be the way a CEO of a company decides to instigate a particular course of action, and then hands over the responsibility of accomplishing that action to his subordinates. In that way, the CEO does not need to get bogged down in all the minutiae of the task, and can focus on more important things, thus enabling him to function efficiently and effectively.

If every task humans do had to be performed consciously, it would be like the CEO trying by himself to perform every single task that the employees of his company perform. So delegation is crucial for efficiency, and seems to be the rationale for mind's conscious executive control to hand over routine tasks to the unconscious habitual mind for completion.
 

Hip

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I find this idea very interesting because I think HSV and VZV establish latency in the ganglia:

https://www.ncbi.nlm.nih.gov/pubmed/12707850
I think the ganglia referred to in that study are the peripheral nerve ganglia of the autonomic nervous system, which are located outside of the brain. The basal ganglia is located within the brain.

Though ME/CFS patient brain biopsies have found enterovirus infection in various parts of the brain.
 

rel8ted

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Whereas when my brain fog is more severe, I find I tend to approach even simple routine tasks with conscious attention (or what remains of my conscious attention). When brain fog is present, of necessity I perform the tasks with as much conscious attention as I can muster in the haze of brain fog.
I agree. With the most severe brain fog, I sometimes forget (simple) automatic things like how to run the shower or flush the toilet or where the butter belongs (obviously it's not in the microwave). Also, the broom is not for mopping the floors and does not work well when wet. :bang-head:
If I don't pay an extra measure of attention under brain fog, these are the kinds of things that happen.
 

alex3619

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If someone wants to make a cup of tea, for example, they will start the process, but very quickly delegate the various steps required to accomplish that task to the unconscious, habitual mind.
I would call this habitual, learned, behaviour. I have lost most of my habits. I have to think about every little thing, step by step. It can be exhausting to do this for too long. If I do not pay attention I get problems ... like in making a cup of tea I recently discovered I frequently pour the water all over the table top if I am not paying attention.

This is also how we make mistakes. I can still recall the coffee I made some years ago when I added salt instead of sugar.
 

alex3619

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I agree. With the most severe brain fog, I sometimes forget (simple) automatic things like how to run the shower or flush the toilet or where the butter belongs (obviously it's not in the microwave). Also, the broom is not for mopping the floors and does not work well when wet.
Using the wrong thing is what is sometimes called the variable binding problem in academic AI (artificial intelligence) discussions. Hypothetically, in this case you are looking to mop the floor. So you need a mop. A broom is kind of like a mop, so your brain assigns something close to the right idea, a broom.

My personal bugbear is mixing up east and west. I have also been known to mix up library and bookshop. I have lost count of the times I put the wrong ingredient in my cooking. Mixing up frozen potato with frozen vegetables winds up with a different dish. Forgetting my main (not so secret) ingredient in curries (cardamom) had me making funny tasting curries for six months.

I actually suspect this is a function of consciousness. Consciousness provides a framework on which we hang things. If we have a deficit in this capacity we hang the wrong things, or the right things by chance or the occasional success. However consciousness in turn relies on memory, which is not a conscious process, its the end result of recall that winds up in consciousness.

Consciousness also often relies on correct visual interpretation, which is linked to both spatial detection and memory.

What is being called unconscious behaviour here is still dependent on consciously assigning the right things. Which requires adequate unconscious processing. Its all loops.
 

Wolfcub

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@alex3619 oh gosh....I know what you mean. Sometimes I have to concentrate hard to do things. I still have "automatic pilot" but if there are alterations in the way things have to be done, I have to stop and think.
It's important because I live alone with no-one to run behind me to show me any mistakes, and have no wish to set the house on fire or flood myself out! haha

I still remember finding a pot of soft brown sugar at somebody's party after volunteering to make coffee for everyone at 4am!
Only the sad thing was....it was a pot of grated Parmesan cheese. No-one thanked me for making coffee!!
 

alex3619

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PS I used to forget how to walk. I could stand up and put one foot forward after another, but each step was conscious, and without fluidity. It was like something out of the Ministry of Silly Walks. Fortunately that is rare now, I cannot even recall how long its been ... but then I cannot trust my memory either.
 

alex3619

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Only the sad thing was....it was a pot of grated Parmesan cheese. No-one thanked me for making coffee!!
Look at the bright side, you have an amusing anecdote you can bring up far into the future. Though it works the other way too ... some of my friends occasionally remark about the time I could not count to 3.
 

Wishful

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Certainly an interesting question. I'm not aware of a conscious/subconscious problem, but I haven't paid attention to it. I'll try to remember the question next time I feel particularly brainfogged or clear-headed. Hmmm, I guess the latter case is more likely to be successful. :lol:

I do notice that sometimes I notice that I start to do some housecleaning...and realize that I'm feeling particularly well that day (reduced ME symptoms). I'm not sure if that the increase in energy or a congitive improvement that makes me more aware of messiness and how my home should look.
 

Hip

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Certainly an interesting question. I'm not aware of a conscious/subconscious problem, but I haven't paid attention to it. I'll try to remember the question next time I feel particularly brainfogged or clear-headed.
I only observed this in myself recently, the last time that I had a good day with low brain fog. I noticed that not only was I performing routine mundane tasks effortlessly on that day, but also that I was doing them automatically, without needing to focus so much of my conscious attention on the task.

I also noticed on this good day that I was no longer bored doing mundane tasks. I guess this might be because my brain was performing these tasks on automatic, so that I was free to focus my conscious attention on more interesting thoughts.

Normally I find mundane tasks like brushing my teeth quite boring under brain fog conditions, perhaps because this rather dull activity consumes your whole conscious attention when you have brain fog.
 
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Richard7

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I think this rings true for me. I have often noticed that the house just starts to get clean whenever I get a bit better. A month or so ago I noticed this in action when I caught myself absently minded cleaning the stove.

I caught myself doing it because I had something in the oven, and realised what I was doing/had done when I pulled away suddenly from the hot floor of the grill compartment (the one above the oven) and decided to go no further.

And its not that I had no idea, I was not sleepwalking or anything, I was just on autopilot and not particularly aware of what I was doing.

I think this could also go some way to explain why doing something like (hand) washing dishes is so hard. I have usually explained it to myself as a combination of dealing with PoTS and the complex visual task of not smashing glasses or other ceramics into the tap or the side of the sink or making some similar error of judgement when placing them in the dish rack. Both of these explanations are true, but miss the point that one can usually have a conversation while cleaning and drying and putting dishes away.

but is this all related to the usual autonomic issues or is it a different system?
 

Richard7

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@alex3619 I understand the forgetting how to walk thing too. Pre-CFS that used to be a common migraine postdrome symptom for me. Indeed it was so obvious it may have been a sign not a symptom. I know a doctor once took some delight in diagnosing me with a migraine from signs before I had opened my mouth. I guess he could have diagnosed the postdrome by watching me try to walk or make a sandwich.

Migraine is inflammation in the brain, and for me chronic migraine seems to have been what set the CFS off.
 

Hip

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It's possible that this dysfunction in the automatic unconscious performance of simple tasks in ME/CFS might just be due to short-term or working memory problems, as I mentioned above.

Just now, while I was reading these forums, I started the process of taking my morning supplements. I keep my jars of supplements on my computer desk along with a bottle of water, and so while glancing at these forums, I started the process of opening my jars, taking out the pills, and lining up these pills that I need to take on my desk.

But then it seemed that my brain forget about this task, because 10 minutes later I looked down on my desk, and saw I had started to line up my pills on the table ready to swallow, but somehow I my brain abandoned and forgot about this task. And it was only when I glanced down and saw my pills did I notice that the task was unfinished.

This kind of thing happens to me all the time. So it could be that because short-term or working memory in ME/CFS is unreliable, this makes tasks that a healthy person would normally do on automatic, without even thinking about it, much harder to do if you have ME/CFS.

Thus when you have ME/CFS, you may of necessity need to bring your full conscious awareness to bear on even the most simple tasks that healthy people will perform automatically, just in order not to forget what you were doing halfway through the task.

In other words, you cannot reliably delegate tasks to your unconscious habitual mind for automatic processing, because the chances are that your unconscious mind will lose track of the task and forget to complete it.

It's like having an employee in a company who is so useless, that you cannot rely on him to complete any task delegated to him.
 
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I had a neuropsychologist evaluation and the issue was translating auditory cues into information, sometimes I struggle with visual clues. So your processing converting what you hear for brain to process was the was the problem.

I have to concentrate harder to translate ( be more conscious) so
Might appear but is becuase you are working harder to make the brain do tasks that ussually you do without thinking.