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The following is intended as a contribution to the discussions of consciousness, responding to the target article by Crick and Koch. In the interest of providing some clinical input to the subject, I offer here some chapter headings.
If we follow the suggestions of Panksepp (1998), Damasio (1999), and Watt (2000), we may start with the assumption that the evolutionary rudiments of sentience appeared as components of instinct. Presumably the stimulus or need for instinctual response elicited a demand felt as some kind of uncomfortable sensation, and presumably the instinctual response was accompanied by a complementary agreeable sensation that erased the former.
Presumably too, was the effect of this advance to supplement the hard-wired instinctual systems, as well as those systems modified by the flexibility achieved by susceptibility to conditioning, so as to make it possible to select one or more potentially optimal responses in preference to others. That process entailed the capacity to anticipate the consequences of each, that is, to imagine, and, on a higher evolutionary plane, to fantasy. These mechanisms supplement but do not replace the hard-wired and conditionable instincts that still preempt behavior in the presence of adequate or unusually intense stimuli.
These are simple speculations, based upon reasonable assumptions, and they lead us to certain conclusions about conscious experience in the contemporary human. Conscious mentation must include the sensitivity to certain biological (including social) needs, the opportunity to dispel unpleasant stimuli by taking certain actions that will, in turn, replace them with agreeable experiences; and the ability to consider possible responses in order to select the optimal response. Such a mechanism would provide the capacity for imagery, imagination, fantasy, and the ability to anticipate the future.
Fantasy has important clinical significance because it guides the selection of response, but also because it is often