personal relevance and the human right hemisphere · discoveries in fields such as behavioral...

BMIN AND COGNITION 17, 64-92 (1991)

Personal Relevance and the Human Right Hemisphere

DIANA VAN LANCKER

Veterans Affairs Outpatient Clinic, and University of Southern California Medical School

Brain damage can selectively disrupt or distort information and ability across the range of human behaviors. One domain that has not been considered as an independent attribute consists of acquisition and maintenance of personal relevant entities such as “familiar” faces, persons, voices, names, linguistic expressions, handwriting, topography, and so on. In experimental studies of normal mentation, personal relevance is revealed in studies of emotion, arousal, affect, preference and familiarity judgments, and memory. Following focal brain damage, deficits and distortions in the experience of personal relevance, as well as in recognizing formerly personally relevant phenomena, are well known to occur. A review and interpretation of these data lead to a proposal that the right hemisphere has a special role in establishing, maintaining, and processing personally relevant aspects of the individual’s world. 8 1991 Academic Press, Inc.

For purposes of cognitive assessment and rehabilitation, it is customary to use objective and impersonal materials. The underlying assumption is that context-free tests and lesson plans, generally neutral with respect to idiosyncratic subjective preferences, offer the best vehicles for probing and rehabilitating mental processes. Accordingly, testing materials designed to measure use of words, concepts, knowledge, and abilities, aiming toward the generic, are “sanitized” and made free of references to unique, individual circumstances. Published treatment materials are similarly pan- generic. The subjective is scrupulously avoided. In this way (according to the doctrine of neutrality), the most “basic” of cognitive abilities are addressed for the clinical goals of assessment and treatment. Moreover, performance can be compared across subjects and groups of subtests,

I am grateful for comments by Joseph E. Bogen, Wayne Hanson, Daniel Kempler, Marianne Regard, John Sidtis, and two anonymous reviewers on early versions of this paper, for library assistance by Nancy Hammond, Sara Jensen-Fritz, and Claire Nicklay, and for help from Sandra Dooley and Evelyn Wullner in preparing the manuscript, This work was supported in part by the Veterans Administration. Address all correspondence and reprint requests to Diana Van Lancker, VA Outpatient Clinic (126), 425 S. Hill Street, Los Angeles, CA 90013.

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0278-2626l91 $3.00 Copyright 0 1991 by Academic Press. Inc. All rights of reproduction in any form reserved.

PERSONAL RELEVANCE IN RIGHT HEMISPHERE 65

normative values can be established, and more information obtained for a general model of brain function.

As successful as this approach is, it has systematically shut out an important feature of everyday cognitive experience: personal relevance. Nonetheless, experimental and clinical studies continue to reveal this aspect of mental life. Clinicians working with patients who have suffered head trauma and stroke informally report greater success in utilizing personally relevant materials, especially in early stages of treatment. Further, recent discoveries in fields such as behavioral neurology, neuropsychology, speech pathology, and neurolinguistics point to-and sometimes explicitly acknowledge-the importance of personal relevance in mental processing. In many cases, the phenomenon of personal relevance, or “familiarity,” as it is generally referred to, has been compelling, constituting the focal point in preserved function or in disease. The aims of this paper are (1) to review these various observations, sometimes obscure and far-flung in the medical and psychological literature, in order to highlight the importance and clarify the operation of personal relevance in many aspects of neurobehavior; and (2) to present evidence for a preeminent role of the right hemisphere (RH) in establishing, storing, and processing personally relevant, or personally familiar, elements of the environment.

DEFINITION AND CLARIFICATION

The term “personally relevant” is obvious in meaning, and the operative term in common use is “familiar,” as in familiar faces, familiar voices, familiar names, familiar surroundings. Entailed in this notion, as I wish to elaborate it, is not, as is implied by the term “familiar” alone, common or frequently occurring (as the term is commonly used in studies of word recognition (e.g., Boles, 1989))) although personally familiar things might also be frequent. Personal relevance requires a relationship, which I shall sometimes call valence, which is defined as “the capacity of something to unite, react, or interact with something else.“’ In more usual use in neuropsychology, valence is a kind of affect. Some examples will clarify the notion. A key is a familiar object, and the word “key” is frequent in the lexicon. In contrast, personal familiarity includes the valence between oneself and one’s own set of keys. I am proposing, as others have implied (reviewed below), that this experiencing of personal familiarity be viewed properly as an affective state. “Recognition” used in this context is exemplified by the cognitive/affective inner state associated with finding one’s own lost set of keys.

This kind of familiarity, involving personal relevance, comes from private and cultural experience alike. Environmental objects and persons may be familiar (in the sense of personally relevant) because of the role

’ American College Dictionary. Boston: Houghton Mifflin, 1985.

66 DIANA VAN LANCKER

they play in one’s private life (e.g., key, wallet, home, spouse) or because of the role they play in the culture (e.g., Empire State Building, American Flag, Elvis Presley). The faces and voices of one’s friends and family members are familiar-intimate, whereas public figure-their voices, faces, handwriting, names, signature verbal expressions, possibly their gestures and gaits-whatever characteristics can be stored as representative, all of which are also personally familiar+an be referred to as familiar-famour. Intrinsic to these cognitive experiences is affect-valence, which may at- tract or repel. The personally familiar object acquires for each person an historical, unique relationship, be it trivial, as in the case of a keepsake; temporary, as with clothing or keys; remote, as in the case of public figures; or deeply and intimately attached, as in friends, lovers, and family members. The importance of personally familiar phenomena to everyday life can hardly be overestimated. I shall use the terms “personally relevant” and “personally familiar” interchangeably to refer to this kind of familiarity.

While all of these relationships may occur in varying degrees of intensity, personally relevant phenomena form a distinctive class in the life of each individual. It is true that new and novel stimuli, infinitely and creatively varying, impinge upon us continually, requiring operations of perception, memory, language, and attention; it is also true that much of the world we live in is personally relevant. One can presume that the ability to establish, maintain, and recognize personally relevant objects in the environment is highly valuable to biological development and survival (hence in evolution). Moreover, it appears early in ontogenesis, and it appears in many guises. For example, Brown and Kulik (1977) describe how flashbulb memories (very clear, long-lasting memories of surprising and consequential events) have a high selection value biologically, and they present evidence from studies comparing flashbulb memories in persons of different racial backgrounds that personal relevance is a major determinant in the establishment of these memories for each individual.

Mundane familiar recognition events are continuous and multimodal; I will mention only a few well-known facts here. Studies of primate behavior in captivity have shown over and over that the infant’s tie to its own mother is the strongest relationship (Mason, 1964) and that mutual recognition of unique family members is common. In the wild, Vet-vet monkeys recognize their own offspring by voice quality alone (Cheney & Seyfarth, 1980, 1990). For humans, DeCasper and Fifer (1980) reported that 3-day-old infants recognize their own mother’s voice from an array of voices of their nursery-mates’ mothers. Olfaction studies reveal similarly early development of aspects of such personal familiarity. By 2 weeks of age, human infants recognize their own mother’s breast pad over those of unfamiliar women (McFarlane, 1975). The “sudden appearance of the familiar mother” displaces negative emotion in the infant (Tomkins, 1962).


It is well known that infants go through a normal phase of “stranger anxiety,” when they are able to know whom they do not recognize. These few examples are mentioned merely to remind the reader of the role of personal relevance in evolution and in ontogenesis rather than to attempt a full discussion of this important topic here.

While the experience of personal familiarity occurs in degrees, so that we can say that some stimuli seem vaguely and some intensely familiar, for purposes of this review, consider the notion that the two cognitive categories, personally familiar and nonfamiliar, are essentially separable. In normal mentation, there is seldom a problem distinguishing personal familiar from nonfamiliar (novel, newly appearing) objects in the flow of ones’ experience, and judgments either way are made with certainty in most cases. This is so despite the apparent size of the class of personally relevant entities. Cursory introspection reveals a staggeringly large quan- tity of idiosyncratically familiar phenomena that qualify as personally relevant in the way defined here. Studies attempting to quantify ones’ storehouse of personally familiar faces (Bahrick, Bahrick, & Wittlinger, 1975), names (Keenan & Baillet, 1980; Williams & Hollan, 1981), or voices (Ladefoged & Ladefoged, 1980) suggest that one’s repertory of familiar-intimate phenomena alone is immense, even limitless, and that ones’ ability to recognize these personally familiar objects from sketchy and brief visual and auditory cues is prodigious. Add to this the extended set of culturally familiar (familiar-famous) phenomena with which each one of us has a personal relationship: persons, symbols, edifices, songs, books . . . and we are confronted with an enormous set. To refer to these personally familiar elements of one’s world, I shall simplify the terms “personal relevance” and “personaily relevant” to the semiacronym PERL.

I will present evidence that personal relevance (PERL) is an attribute which can be selectively impaired or spared in cerebral dysfunction. The impression or sense of PERL, often identified in the behavioral literature as familiarity, is itself occasionally disrupted in some kinds of cerebral dysfunction, yielding overall sensations of deja vu or of strangeness (e.g., jamais vu). Most often, the attribute intersects with other behaviors. Thus, the ability to establish, maintain, and recognize sets of personally familiar elements or objects of experience (broadly considered to include persons, places, scenes, proper names, familiar phrases, sounds, cars, personal effects, livestock, pets, and so on) is distinguishable from processing of unfamiliar, and therefore personally neutral or irrelevant, members of these same classes.

Impediments to Investigating Personally Relevant Processing The lack of work on PERL in psychology, perhaps of concern to his-

torians of science, need not be explored in depth here, except to identify


two obvious impediments to PERL research, one theoretical and the other pragmatic. The theoretical bias underlying the emphasis on objective (rather than subjective) and neutral (rather than personally relevant) research topics holds that subjective and personal responses are ancillary and idiosyncratic in a population. They are, at best, nonrepresentative of the common denominator of mental processes and, at worst, they make up more noise than signal. While this view is understandable for learning theory, mathematics, and for the grammatical component of language, it is questionable for studies of perception, and it places troublesome shack- les on memory research, where surprisingly few studies have utilized personally relevant stimuli (even though these are surely the most mem- orable), preferring instead to test subjects on their ability to remember objects especially selected to be neutral, impersonal, and unrelated to their personally emotional lives. Of course, because common “neutral” objects may occasionally inadvertently have high personal relevances, researchers can never be sure that all stimuli are sanitized of personal relevance for all subjects, but they can and usually do try.

The pragmatic constraint impeding PERL research is also obvious. Designing individualized test protocols is difficult and time consuming, and comparing performance scores obtained from customized tests across and between subjects is awkward. Moreover, it is probably inherently impossible to equate degree of familiarity across subjects. Thus, questions pertaining to PERL cannot readily be answered by traditional research methods designed to obtain mean performance values from groups of subjects. Individual subjects must be treated uniquely. The value of view- ing individual subjects as closed, unique systems has been cogently argued elsewhere (Caramazza, 1986; Caramazza & McCloskey, 1988).

Despite an unwelcoming theoretical climate and methodological incon- venience, PERL has reared its irrepressible head in the form of familiarity in various guises and thus has had its students and scholars in experimental psychology, neuropsychology, and behavioral neurology. I will selectively review this eclectic literature, citing exemplary findings in order to present a case for the importance of PERL in mental life. This review of observations from neuropsychology and related disciplines will lead to the notion of personal relevance as an independent neurocognitive function.

PSYCHOLOGICAL STUDIES

Frequency, Familiarity, and Affect

The experiments by Zajonc and his colleagues (1968, 1980) on the role of event frequency (see Howell, 1973), or frequency of exposure, in perception and memory are important to this review because they address the relationship between a more limited notion of the term familiarity and affect. In his paper of 1968, reviewing work using subliminal judg-


ments (i.e., judgments not reflected in verbal awareness), Zajonc claimed that “mere repeated exposure . . . to a stimulus is a sufficient condition for the enhancement of [one’s] attitude toward it” (p. 1); in other words, using the term “familiarity” in the more traditional meaning of frequency of occurrence, Zajonc’s and related work led to the conclusion that frequency and affect are correlated, such that “familiarity breeds preferring.” At first it was believed that recognition memory was closely tied to frequency information (Howell, 1973) and that “familiarization” (through frequent exposure) increased positive affect (Maslow, 1937). However, further research expanded these views. It was seen, for example, that mere exposure enhanced attraction toward persons whether embedded in a negative or positive context (Saegert, Swap, & Zajonc, 1973). Other studies (Matlin, 1971; Wilson, 1979; Moreland & Zajonc, 1977, 1979) indicated that beliefs about familiarity alone did not affect preference judgments: people preferred stimuli they actually had seen more often (Kunst-Wilson & Zajonc, 1980) over stimuli they merely believed to have seen more often, and other work indicated that frequency and recognition judgments rely on different information in memory (Proctor, 1977).

Taking these ideas a few steps further, it was shown that stimuli with more affect Seem more familiar than stimuli eliciting less affect (Gerard, Green, Hoyt, & Conolley, 1973; Moreland & Zajonc, 1982). For example, making judgments of honesty in faces-a “deep” judgment-resulted in better recognition memory for faces than judgments of gender (“shallow”) (Strand & Mueller, 1977). In these studies, again, both liking and disliking were positively correlated with perceived familiarity. Nor was “distinctiveness” of faces a major contributor to familiarity ratings when familiar (instead of unfamiliar) faces were used (see Bartlett, Hurry, & Thorley, 1984); instead, distinctiveness of faces and familiarity ratings were found to be independent (Valentine & Bruce, 1986). These various results suggest that better recognition is not based on better discrimination of affect- laden stimuli, but that the presence of affect induces a sense of familiarity with a stimulus, such that an affective response can be mistaken for familiarity (Stephens, 1988). Even exercise-induced arousal can be mis- labeled as the familiarity feeling (Stephens, 1988). Thus, the role of affect in recognition performance, noted in early studies of memory (Myers, 1915), is now well accepted. Although not yet treating genuine PERL stimuli, by showing a relationship among the sense of familiarity, affective content, and preference judgments, these studies hint at the important relationship between affect and PERL.

PERL and Self in Experimental Design

In this regard, even more intriguing are the findings by Moreland and Zajonc (1982) that familiarity ratings increased with subjects’ rating of stimuli as similar to themselves. “Mere belongingness to self” was revealed

70 DIANA VAN LANCKJZR

as a powerful, albeit unaware, determinant of attractiveness in studies by Nuttin (1985, p. 353; see also Nuttin, 1987), in which subjects preferred letters belonging to their own names over all other letters. Similarly, Irwin and Gebhard (1946) reported that children expressed preferences for toys assigned to themselves over toys designated for their schoolmates. Here is a creative attempt at an experimental imitation of PERL using the self as an encoding device (Rogers, Kuiper, & Kirker, 1977). In related work, recognition memory and decision times were found to be correlated with a subject’s personal knowledge of people and places used in judgment tasks, and this was true whether the targets were negatively or positively evaluated (Keenan & Baillet, 1980). Likewise, in a study of recognition memory of conversations, statements high in interactional content-those which engaged the interlocutor through the use of emotive or confron- tational language-were better remembered (Keenan, MacWhinney, & Mayhew, 1977). Thus, it seems clear that affect, positive or negative, is an essential ingredient for successful familiar recognition and that relat- edness to self is a parameter which can imitate PERL in laboratory- induced “familiarity” studies.

Veridical Recognition verws Discrimination

Studies in which familiarity and preference judgments are obtained for generic or self-related stimuli are related to a genre of research that utilizes a “train to familiarity” technique. That is, some investigators have attempted to experimentally establish familiarity by training subjects in the laboratory to distinguish familiar from unfamiliar objects. In this experimental method, subjects are instructed to become familiarized with a set of faces, voices, words, pictures, objects, scenes, or what have you, by seeing, studying, or hearing them repeatedly or more often than other stimuli. Confusion has resulted, as the term “recognition” has been used to refer to these trained-to-recognition stimuli in studies of face and voice perception, as well as to genuine PERL stimuli.

The term “recognition” has even been used to refer to matching of unfamiliar stimuli. One of the earliest studies of facial “recognition” in brain-damaged patients (DeRenzi & Spinnler, 1966) is actually a study of medium-term memory (15 min) for unfamiliar faces presented in two different orientations (full and profiled). As Ellis (1986) states in his review of studies of normal face recognition, “. . . the vast majority of experimental work on face memory has exclusively concerned memory for unknown faces and very little has been concentrated on the processing of familiar faces” (p. 9). Similarly, in early studies of hemispheric specialization for facial processing, previously unfamiliar faces have been used to determine levels of processing leading toward “recognition” (Benton & Van Allen, 1968; DeRenzi, Faglioni, & Spinnler, 1968; Moscovitch, Scullion, & Christie, 1976; Patterson & Baddeley, 1977). The well-known


Facial Recognition test (Benton, Hamsher, Varney, & Spreen, 1983) uses exclusively unfamiliar faces in a discrimination task. More recently, however, using familiar-famous faces in comparison to unfamiliar faces in veridical recognition versus discrimination tasks, important differences between those two classes of stimuli in various measures of cerebral processing have been reported (e.g., Carey, 1981; Barrett, Rugg, & Perrett, 1988; Young, Hay, McWeeney, Flude, & Ellis, 1985; Klatzky & Forrest, 1984; Leehey & Cahn, 1979; Malone, Morris, Kay, & Levin, 1982; Young, McWeeney, Hay, & Ellis, 1986).

The distinction between veridically (or personally) familiar and unfamiliar is a crucial one, because with recognition of personally relevant persons, places, or things “a sudden change occurs in consciousness” (Titchener, 1916), accompanied by “the feeling of familiarity” (p. 407). Yet recognition can be covert+ccurring in the absence of awareness (De Haan, Young, & Newcombe, 1987). And the notion that recognition (e.g., of faces) in this sense can be “wholly a matter of the feeling” (Titchener, 1916, p. 408) (in the sense of unconscious physiological responses) has been tantalizingly suggested by psychophysiological measures of skin conductance in normal subjects (Tranel, Fowles, & Demasio, 1985) and in patients with familiar face recognition deficits (Bauer, 1984; Tranel & Damasio, 1985; Bauer & Verfaellie, 1988). In these studies, autonomic nervous system responses were elicited to previously known but not to unknown faces without conscious recognition by the subject. There are also measurably greater physiological responses to one’s own voice (Oli- vos, 1967), in comparison to other (unfamiliar) voices, whether or not consciously recognized (Holzman, Rousey, & Snyder, 1966).

Voice identity research parallels that for faces. In early studies of voice “recognition” deficits associated with brain damage, unfamiliar voices (having dialectal and gender differences) were employed in discrimination tasks (Assal, 1969). Similarly, with a few exceptions using familiar-famous voices (e.g., Van Lancker, Kreiman, & Emmorey, 1985; Van Lancker, Kreiman, & Wickens, 1985), unfamiliar voices have been used almost exclusively in phonetic studies of voice “recognition” (see Bricker & Pruzansky, 1976). In the considerable literature on voice perception, only a handful of studies have used familiar voices, all but a few using familiar- intimate voices (those of colleagues and friends of the listeners). Again, for voices as for faces, when familiar and unfamiliar voice tasks are compared, distinct differences in processing abilities appear. Mann, Diamond, and Carey (1979), using PERL stimuli, showed that children performed as well as adults in recognizing voices of their peers and caretakers, but not as well as adults on a comparable task requiring discrimination of unfamiliar voices.

Attempts to breed familiarity in the laboratory have been made also for voices. In one study using mostly PERL stimuli, possible differences


in degree of familiarity were accommodated by having subjects listen to repetitions of the voices coupled with the identifying names (Dukiewicz, 1970). In others, subjects are trained to recognize previously unfamiliar voices to a certain criterion level. The purpose is then to investigate various parameters of human voice “recognition” abilities by presenting these artificially familiarized voices under different conditions of acoustic a]- teration.

These expediently designed experiments are indeed useful in showing differences in performance between stimuli manipulated following familiarization with them and unfamiliar stimuli. However, personal features- history and experiential context-are absent in this artificial setting, and hence there is lack of affect and a true “feeling of familiarity” (Titchener, 1916). Nonetheless, creative researchers have found ways to study PERL stimuli. In an interesting study using veridically familiar versus novel spatial stimuli, Kirasic (1990) found that elderly adults performed as well as young and middle-age groups on tasks requiring perspective taking and mental rotation of locations from their hometowns, but were less accurate given unfamiliar locations. In this study familiarization with the stimuli was provided for both hometown and novel locations. Yet this author suggests that “familiarity (PERL) of task setting is one of several contextual variables that have a profound impact on elderly adults’ cognitive performance” (p. 186). Thus, going well beyond the effects of manipulated familiarization, PERL involves an affective interaction between subject and object, along with historical, sociological, and other contextual associations. What is lacking in trained-to-recognition stimuli is PERL, being achievable only under conditions drawn from (or perhaps simulating) normal living. Experimental training-to-familiarity might foreshadow the real thing, but it is not PERL.

For veridical recognition to occur, as described by Bartlett (1967), two different functions must be “aroused” coincidentally: “(1) a specific sen- sory reaction, and (2) an attitude, or orientation, which we cannot ascribe to any localized physiological apparatus, but which has to be treated as belonging to ‘the whole’ subject, or organism, reacting” (p. 191). Thus, from this perspective, the notion of recagnizing unfamiliar stimuli is an oxymoron. We note, like Bartlett, that the act of recognition “carries a significance which goes beyond the specific identification which it involves. Zt tells us something about the preferential psychological reactions of the person who performs the act” (p. 191; italics mine). These preferential reactions are based on personal knowledge and experience, and they form a large, unique and important repertory in each individual.

Recognition events occur in many forms frequently and, like other behaviors, they are subject to error. For example, a study of slips of familiar person identification in normal subjects’ daily interactions indicated that the familiarity judgment can fail such that one familiar person


is misidentified for another, a known person seems unfamiliar, or a stranger seems familiar (Young, Hay, & Ellis, 1985), and tip of the tongue phenomena in familiarity recognition events also occur (Yarmey, 1973). In the next section, examples of deficits in veridically personally relevant processes resulting from brain injury are described.

NEUROPSYCHOLOGICAL STUDIES BEARING ON PERSONAL RELEVANCE

PERL Attributes and Brain Damage

Deficits in perceiving familiar stimuli, or in familiarity perception (again using the term “familiar” in the sense of personally familiar and relevant), as well as in the closely related attributes, affect and appreciation of context, are frequently reported in association with brain damage. First, we note again that recognition includes a feeling of familiarity, associated to “previous psychological material” (Bartlett, 1967). Processing of both affective and contextual material has been associated with intact RH function.

RH damage has been associated with impairment of processing of affective experience in linguistic content of stories (Wechsler, 1973; Brow- nell, Carroll, Rehak, & Wingfield, 1989), as well as in perception of affective information from facial expression (Borod, Koff, Larch, & Ni- cholas, 1986). Similar claims about RH function have been made for affective prosody in speech (Heilman, Scholes, & Watson, 1975; Tucker, Watson, & Heilman, 1977; Ross, 1981; Heilman, Bowers, Speedie, & Coslett, 1984) but later studies cast doubt on this claim (e.g., Cancilliere & Kertesz, 1990). However, at least some prosodic cues show a left ear advantage in dichotic listening by normal subjects, again pointing to a RH specialization (Bryden, 1982). It has been suggested that patients with severe aphasia due to left hemisphere (LH) damage rely in part on paralinguistic (prosodic) and gestural cues for limited communicative functioning (Boller, Cole, Vrtunski, Patterson, & Kim, 1979). In a study using EEG and EMG measures, subjects responded significantly to emotion- evoking stimuli processed out of conscious awareness, and while LH responses were greater to conscious than unconscious processing, the RH responses did not differ as a function of awareness (Wexler, Schwartz, Bonano, Warrenburg, Jamner, & Michaelis, 1989). Further, a diminished ability to verbally express mood and emotion (alexithymia) has been reported in commissurotomized patients who have reduced access to RH processing during verbal expression (TenHouten, Hoppe, Bogen, & Wal- ter, 1985, 1986).

Experimental research using commissurotomized patients provides valuable information on the behavioral abilities of the isolated hemisphere (see Bogen, 1985a). Interesting results touching on PERL and the RH


along with the roles of affect and associational context were reported using two of such patients. Sperry, Zaidel, and Zaidel (1979) tested the ability of the surgically separated RHs of these commissurotomized subjects to recognize “personally relevant” items, including “subject’s self, family, relatives, acquaintances, pets, belongings, samples of subjects’ writing, familiar scenes, objects, emblems [e.g., flags], and pictures of public, historical [e.g., Nixon, Hitler] and religious figures, entertainers, etc.” (p. 154). Using the scleral contact lens, personally relevant stimuli in an array of four to nine items were presented first to the isolated RHs. Subjects selected the correct item by pointing and indicated feelings about the stimulus by gestures and emotional expressions. Personally relevant stimuli were “readily recognized by either hemisphere” (p. 155) and it was clear from follow-up questioning of the subjects that the RH “was not only differentiating between familiar and unfamiliar items but was making exact identifications with which it had appropriate cognitive associations” (p. 156). When emotional responses were elicited, Sperry et al. observed that “the emotional responses from the right hemisphere were somewhat more intense and less restrained and qualified than those from the left” (adding that the stress of using the mute hemisphere may have accounted in part for this difference) (p. 156). Subjects correctly identified a broad spectrum of personally relevant stimuli presented to their RHs “accompanied by appropriate cognitive and conative associations” (p. 163). This study highlights the interdependence of personal relevance on affective and contextual associations and dramatically reveals the RH’s ability to process these complex entities. From what has been reported about a possible RH involvement in affective experience (reviewed above) since the publication of Sperry et al., we might now be more likely to accept (as valid) the observation of the RH as “somewhat more intense” in emotional response.

The proposal here is that affective processing and the attribute of familiarity are not independent, but that the feeling of familiarity includes affective features which are idiosyncratic and personal. It may be, as several researchers have suggested, that the hemispheres differ in affective valences (Sackeim, Greenberg, Weiman, Gur, Hungerbuhler, & Gesch- wind, 1982; Regard & Landis, 1986) and in preference judgments (Regard & Landis, 1989); doubtless, much more is to be learned about this issue. However, there is considerable evidence to suggest that familiarity and affect join with cognitive associations to form a rich context for each personally relevant item. For the moment, we note that deficits in affective experience involving perception and recognition occur commonly in RH damage; and so, also, do deficits in the perception of familiarity. We will see further examples below that deficits in processing of contextual phenomena also occur in RH damage.


Prosopagnosia

Prosopagnosia, or deficient recognition of familiar faces, provides a prime example of a neuropsychological deficit involving PERL (Hacaen & Angelergues, 1962). Persons with this affliction can describe details of faces and tell faces apart, but there is no attribute of familiarity, and hence no recognition of individuals. Clinical research studies have repeatedly shown a dissociation between recognizing familiar faces and dis- criminating unfamiliar faces (Warrington & James, 1967; Tsavaras, He- caen, & LeBras, 1970; Malone et al., 1982). As mentioned above, extended work on prosopagnosic patients indicates that PERL occurs at different levels of awareness (Bauer, 1984; Tranel & Damasio, 1985); autonomic nervous responses were observed in prosopagnosic patients when shown previously known, but not previously unknown, facial photographs. Prosopagnosia in right-handers generally requires and typically appears with posterior RH damage (e.g., Meadows, 1974; Whiteley & Warrington, 1977; DeRenzi, 1986; Landis, Cummings, Christen, Bogen, & Imhof, 1986; see also Bogen, 1985b, pp. 31, 35), often in association with spatial disorientation but also occurring as a unique deficit (Michel, Perenin, & Sieroff, 1986; Landis & Regard, 1988), and deficits are found for both familiar-famous and familiar-intimate exemplars (Benton, 1980; Landis, Regard, Bliestle & Kleihues, 1988). A right-hemispherectomized patient studied by Sergent and Villemure (1989) could perform cognitive operations specific to faces but could not identify familiar-intimate or familiar-famous faces nor did she experience a sense of familiarity in seeing faces of persons known to her. In contrast, problems with perceiving unfamiliar faces do not show the strong association with RH function. On the Facial Recognition test, a test of unfamiliar face discrimination, patients with either LH or RH damage perform poorly (Benton et al., 1983), although an earlier version of the test showed greater involvement of the RH (Benton, 1980). Studies in normal subjects using evoked response measures have also associated familiar face recognition (more than unfamiliar face discrimination) with RH function (Barrett et al., 1988; Uhl, Lang, Spieth, & Deecke, 1990); most visual half-field studies support this view (Ellis, 1983), especially when decisions did not involve verbal processing (Young, Hay, McWeeney, Ellis, & Barry, 1985) and when visual recognition is required within short exposures (Glass, Bradshaw, Day, & Umilta, 1985; Leehey & Cahn, 1979). Finally, an increase in RH superiority with increasing familiarity of facial stimuli has been reported (Ross & Turkewitz, 1982; Ross-Kossak & Turkewitz, 1986). Phonagnosia

There is a parallel finding for phonagnosia, or defective voice recognition (Van Lancker & Canter, 1982). Brain damage affects abilities to


recognize familiar voices and abilities to discriminate unfamiliar voices differently; both functions may be separately preserved or impaired, such that a patient may be able to discriminate unfamiliar voices normally, while being severely impaired in recognizing familiar voices, or vice versa (Van Lancker & Kreiman, 1987; Van Lancker, Kreiman, & Cummings, 1989; Van Lancker, Cummings, Kreiman, & Dobkin, 1988). Phonagnosia (deficit in familiar voice recognition) is associated with RH damage. Spe- cifically, significant difficulties with recognizing familiar-famous voices occur following right lateral parietal damage, while deficient unfamiliar voice discrimination is not lateralized (Van Lancker et al., 1989).

Dichotic listening provides a method for examining laterality of auditory function in normal subjects. An earlier study testing dichotic listening of unfamiliar spoken voices in a discrimination paradigm had reported a right ear advantage for voice identity judgments (Doehring & Bartho- lomeus, 1971). In that study using seven different spoken voices, a match- to-sample task was employed in which a binaural stimulus (sample) pre- ceded a dichotically presented pair of voices. If the sample appeared in the dichotic pair, subjects responded by naming the correct ear, naming the correct stimulus, or circling an answer on an answer sheet. (The sample appeared as one in the dichotic pair about 17% of the time.) Half of the subjects received a prefamiliarization of the stimuli by binaural presen- tation of a prose passage in a limited trained-to-familiarity procedure. In a result that supports arguments against training-to-familiarity mentioned in the “veridical recognition versus discrimination” section above, such training “did not result in greater accuracy or larger ear differences” (p. 428). Later, Bartholomeus found a nonsignificant trend toward a left ear advantage for recognition of singers’ voices, in contrast to a right ear advantage for identification of letter sequences produced by the four singers, but whether the singers were previously familiar, or how they were trained-to-familiarity to subjects, is not described (1974a). In a later trained-to-recognition study using four previously unfamiliar speakers producing syllables, no significant ear differences for speaker judgments were observed (Tartter, 1984). Thus, the effects of familiarity with sung versus spoken voice samples on cerebral laterality remain to be studied (Bar- tholomeus, 1974b). In a recent study using familiar-famous voices, dichotic listening showed a trend toward a left ear advantage for recognition of famous voices in contrast to a right ear advantage for identification of the words spoken by those same famous persons (Kreiman & Van Lancker, 1988)

Familiar Nonliteral Expressions and the Role of Context in PERL A possible role of familiarity in language processing appears in the

distinction between novel (i.e., propositional and literal) and familiar nonliteral language (Bolinger, 1976). Familiar nonliteral language includes


idioms, proverbs, interactional speech formulas, expletives, slang, indirect speech acts, and other stereotyped expressions (Van Lancker, 1988,199l). There is considerable evidence suggesting that these two kinds of language, novel and familiar, are learned (Peters, 1977, 1983; Vihman, 1982; Kem- pler, Van Lancker, Marchman, & Bates, 1990), stored, and processed differently (Gibbs & Gonzales, 1985; Van Lancker & Kempler, 1987; Gibbs & Nayak, 1989). The key difference between a novel expression such as “he takes his pets in the car” and a linguistically matched idiom such as “he has his head in the clouds” is that the idiom is learned as a whole, without normal registration of the constituent parts of the expression, and will be recognized as familiar by a native speaker. Studies of recall and recognition memory (Achilles, 1920; Simon, 1974) indicate that subjects are able to recall and recognize as many (multiword) familiar idioms and proverbs as single words. The factors of affective content, holistic structure (or “chunks”), and personal familiarity may combine to account in part for this striking result.

Although familiar nonliteral expressions do not have subjective PERL in the same sense as persons and places, they have similar attributes. They induce a “feeling of familiarity” and they are rich in idiosyncratic contextual meaning. The role of context appreciation in processing of nonliteral familiar phrases and of familiar personal names (described below) is important to this discussion. Idioms, proverbs, and social formulas represent meaning scenarios tightly bound to sociolinguistic contexts, rather than denotations or referential meanings. Consider the idiom “She has him eating out of her hand.” The scenario projected by this expression is remarkable for its intricate detail and its depth: it includes suggestions about interpersonal history and politics, emotional interactions, and so on, and it is likely to include personalized imagery. It is now believed that the RH is preferentially involved in processing various kinds of linguistic and social contextual material, achieving inferences (Brownell, Potter, Bihrle, & Gardner, 1986), and appreciating thematic and hu- morous material (Gardner, Brownell, Wapner, & Michelow, 1983) and indirect requests (Molloy, Brownell, & Gardner, 1990). All of these involve complex associational material. Perusal of individual subjects’ ma- nipulation of PERL information reveals something about these associational networks.

From a detailed study of a head-injured patient with prosopagnosia, who was able to associate semantic information to familiar faces that he could not recognize, Young and De Haan (1988) suggest a modular organization of familiar face recognition, which relates such boxes or “nodes” as person identity, word recognition, name retrieval, and so on (p. 331). It is likely that recognition of any PERL entity involves this kind of associational process. In a study of retrieval from long-term memory, Williams and Hollan (1981) asked subjects to think aloud while


recalling names of past classmates. The thousands of pieces of information were “categorized as names, partial names, locations, activities, physical characteristics, and personal and social information” (p. 95). Analyses of these data led the authors to conclude that “information stored in memory can be thought of as a collection of records or packets of limited capacity [accessed in a] global act of retrieval” (p. 97). This experiment thus explored what has been referred to as the “contiguous associates” of the “penumbra of recognition” involved in the sensation of familiarity, as discussed by James (1980).

Such a “penumbra” is suggested by a compelling account of the ability of a partially isolated RH investigated shortly following the first stage of surgical section of the corpus callosum (Sidtis, Volpe, Holtzman, Wilson & Gazzaniga, 1981). This right-hander had a posterior callosal section producing left hemialexia. Even so, semantic information after RH processing of a written word was rich in contextual information which was used by the LH in inferring the lexical item. For example, the word “onion” presented to the RH yielded a LH description of a family garden and then of a root cellar (vegetable storage cellar) before leading to identification of the stimulus word “onion.” In an example even more suggestive of a PERL response, the word “rug” presented to the RH first elicited a description of an amorous encounter with a former girlfriend in front of a fireplace.

Contextual attributes play a very different role in familiar nonliteral language when compared with novel language processing. It may be, in language learning, that the perceived conflict between the literal (rep- resenting a possible but implausible interpretation) and the contextually appropriate nonliteral meanings of familiar idiomatic expressions (Mueller & Gibbs, 1987) stimulates an affective response on initial exposures to the phrases, leading to special (i.e., nonpropositional) processing and storage of idioms, proverbs, and like expressions. Further, most idioms, speech formulas, and proverbs themselves contain inherently strong valences. In addition, PERL expressions of dramatic significance often pro- liferate within small groups, such as families, friends, working groups, and other sociological units. These idiosyncratic phrases signal rich contextual meanings, uniquely utilized as terms of endearment, reminders of past events, political slogans, emotional expressions, and a myriad of other cultural experiences. Slang, of course, is another obvious example of PERL familiar language. Much remains to be understood about the processing of this kind of language.

As mentioned previously, some work has been done on cerebral laterality in the comprehension of familiar nonliteral expressions. And like familiar faces and voices, studies in unilaterally brain-damaged subjects suggest that familiar nonliteral language, including idioms, proverbs, and


speech formulas, has more right hemispheric representation than does novel language (Van Lancker & Kempler, 1987; Van Lancker, 1991).

Familiar Personal Names

Proper (or personal) names differ in many ways from other lexical items, as has long been noted by philosophers and linguists (e.g., Miller & Johnson-Laird, 1976;’ Cutler, McQueen, & Robinson, 1990). From these ideas, we note that a familiar personal name differs from a common noun in having a unique referent and having a personal history, properties which have been identified by Damasio, Damasio, and Van Hoesen (1982) as distinctive to familiar face recognition. Thus, it is relevant to mention here recent observations involving personal name recognition in brain- damaged patients.

Patients with severe auditory-verbal comprehension deficits associated with global aphasia have been observed to recognize familiar proper nouns on tests requiring them to match spoken or written personal names to photographs of familiar-famous persons, including celebrities in sports, entertainment, and politics, while performing poorly on comprehension of high-frequency lexical items, such as nouns, adjectives, and verbs. The contrast in ability was striking, given the well-known linguistic deficits in all modalities seen in global aphasia and poor prognosis for recovery. The extensive LH damage seen on CT scans for four patients tested, together with relatively preserved performance on tests of RH function in these patients, suggested a RH role in PERL name recognition ability (Van Lancker & Klein, 1990). Similar observations on a patient with severe global aphasia were reported by Warrington and McCarthy (1987), using a spoken word to printed word matching task. Although the patient was severely impaired in most verbal categories, “the most strking finding [was] the remarkable preservation of her comprehension for the names of famous people and geographical place names as compared with the comprehension of familiar Christian names and surnames [without a unique referent] for which her performance was no better than chance”

* Miller and Johnson-Laird comment as follows: “Since the semantics of proper names is so different from the semantics of common nouns, combining them into a single semantic domain seems inappropriate. The kind of information people associate with various persons they know, like the kind of information they associate with various episodes they have lived through, differs from the kind of perceptual and functional information they associate with common nouns in semantic memory. To the extent that this difference implies a difference in how they address their memories for such information, we may be justified in thinking of person memory, episodic memory, and semantic memory as differentiable. That is to say, a proper name for a person can give access to information retrievable from person memory, whereas a generic term gives access to information retrievable from semantic memory” (1976, pp. 310-311).


(p. 1283). Similarly, Wapner and Gardner (1979) found better recognition of geographical names than other lexical items in patients with global aphasia. In clinical descriptions of globally aphasic patients, Collins (1986) has described preserved abilities to recognize the names of patients’ own body parts (pp. 146-147) and to recognize named familiar persons and places (p. 57).

Comparable results on familiar-famous name recognition were subse- quently obtained from left-sided (as contrasted with right-sided) unilaterally brain-damaged stroke patients with milder deficits (Van Lancker, Lanto, Klein, Riege, Hanson, & Metter, 1991). Subjects listened to names of famous persons in politics, entertainment, and sports and pointed to a facial picture from an array of ten. The RH-damaged group performed significantly worse (than the LH group) on the personal name recognition task. Thus, a RH preference can be inferred for proper noun comprehension, but hemispheric specialization for proper noun production is less clear. One report described preserved confrontation naming of proper (but not common) nouns (i.e., geographic locations) in a patient with LH damage and severe anomia (McKenna & Warrington, 1978, 1980) while another reported a selective impairment in proper naming following damage to the left temporal lobe (Semenza & Zettin, 1988).

Familiar-famous and familiar-intimate names are extreme examples of PERL language, appearing to function differently from nonpersonal language. PERL language relative to patients’ personal lives has also been considered. Speech pathologists working with severely impaired aphasic patients, as well as patients’ family members, have frequently noted how language performance improves in familiar environments (Schuell, 1953; Holland, 1977). In many cases PERL phenomena account for the im- provement, A recent study by Hunt and Square-Storer (1991), comparing lexical comprehension by severely impaired aphasic patients in familiar versus neutral environments, found a significant effect of familiarity on performance ability. Familiar natural environments included subjects’ own living rooms. Collins (1986) states that globally aphasic patients are frequently better able to respond to questions related to self than nonpersonal questions (pp. 22, 37). Wallace and Canter (1985) compared repetition, naming, auditory comprehension, and reading comprehension of personally relevant language materials with nonpersonal materials and found significantly better performance on the PERL than nonpersonal items in all four modalities. In this study, PERL items intermixed proper names (“Is your name -“) with familiar common nouns (“did you drink

today?“). It remains to be determined which of these kinds of language contributes most potentially to the advantage seen for PERL language in severe aphasia, but it is likely that the PERL proper names elicited the better performance.


Capgras Syndrome

Behavioral deficits involving distortions of familiarity judgment are well known, and some implicate the RH. Deja vu sensations in temporal lobe epilepsy have been associated with damage to either hemisphere (Brickner & Stein, 1942; Ardila, Montanes, Bernal, Serpa, & Ruiz, 1986), but some investigators have found a predominance in cases of RH disorder (Cole & Zangwill, 1963). Another of these disturbances of the familiarity feeling is Capgras syndrome (Cummings, 1985; Christodoulou, 1978a; Alexander, Stuss, & Benson, 1979). Capgras syndrome involves a belief that relatives and friends are strangers or imposters. In a case reported in detail by Christodoulou (1978b), behavioral testing suggested RH impairment; in another, neuroradiological and EEG measures indicated primarily posterior right-sided damage (Shaw & Pool, 1990); in a third, CT scan indicated RH damage (Staton, Brumback, & Wilson, 1982). These cases and related deficits of the familiarity judgment wherein strangers seem psychologically or physically identical to another (familiar) person, which have been called the illusion de Fregole and the illusion d’intermetamor- phose (Christodoulou, 1976; Silva, Leong, Shaner, & Chang, 1989), or identical to the patient himself-these all involve “pure” misperceptions of familiarity-a distortion of the “feeling” accompanying the familiarity judgment. These observations suggest the possibility that PERL can be viewed as an independent attribute of cognitive function.

According to Cummings (1985), evidence from a review of Capgras cases suggests that “right-sided dysfunction may predispose to this par- ticular delusional misinterpretation” (p. 169). In a related disorder called reduplicative paramnesia, the patient claims to be present in two locations simultaneously, one of them usually the familiar residence or domicile of the patient. In some cases the more familiar reality (not the hospital) is dominant. This delusion has been observed in many kinds of brain disorders, but in the case of focal lesions, damage to RH and/or to both frontal lobes is the most common (Regard, personal communication; Cum- mings, 1985).

Topagnosia

A more frequently occurring misperception of the personal familiarity sense, loss of topographic familiarity, may be instructive here (Wilbrand, 1892). This syndrome, too, has been associated with RH damage. Landis, Cummings, Benson, and Palmer (1986) reported on 16 patients suffering from a loss of a sense of familiarity with their surroundings. All patients had posterior RH lesions (three had bilateral lesions). Specific case examples are strikingly illustrative. One of these patients began having difficulty finding his way to and from his neighborhood grocery store,

82 DIANAVANLANCKER

stating that he could deduce which building he wanted but “could not recognize it” (p. 133). A second reported case was suddenly unable to recognize anything around her in formerly familiar surroundings. She reported that “her apartment of 20 years seemed totally unfamiliar.” While the first patient did not have prosopagnosia, the second was afflicted by a more widespread deficit in personal familiarity judgments: she could no longer recognize familiar-intimate faces, her own and other personally familiar handwriting, her pets, or her personally familiar belongings.

From these and similar cases, Landis et al. (1986) conclude that an agnosia, rather than an amnesia, must be accountable, because patients could process and recall details of the actual (formerly familiar) physical landscapes for which they now “experienced no sense of familiarity” (p. 136). In another description of the second case mentioned above, Landis and Regard (1988) marked that the patient’s own apartment seemed “strange and emotionally unfamiliar.” Although she had no difficulty recognizing (i.e., perceiving and classifying) furniture and objects, they “lost their usual appeal” (p. 91). These comments recall the comments of Titchener regarding the familiarity feeling discussed earlier. Further, these patients did not establish new familiar faces or surroundings in the next few years, and their deficits do not include visual agnosias for common objects (Scheller, 1966; Hecaen, Goldblum, Masure, & Ramier, 1974; Pillon, Signoret, & Lhermitte, 1981; Ferro & Santos, 1984; Larrabee, Levin, Huff, Kay, & Guinto, 1985; Landis et al., 1988).

SUMMARY AND CONCLUSION

PERL as Independent Attribute

Many of the observations described above can be accounted for by the view that the subjective impression of familiarity or personal relevance is associated with selected visual and auditory stimuli and that this attribute can be selectively disrupted by brain damage. The attribution of PERL is experienced as a sensation of familiarity and confirmed by recognition. In recognition, as succinctly stated by Bartlett (1967), “. . . psychological material which persists ‘matches’ some immediately present sensing pat- tern” (p. 196). The point to emphasize here is the persisting psychological material. That a simple agnosia, or uncoupling of the stimulus from its meaning, is not explanatory of these neurobehavioral observations is apparent from various descriptions of recognition deficits. The content (referential meaning) of the stimulus is appreciated. What is lacking is the feeling of familiarity with its concomitant affective features which we have called negative or positive valence, and contextual associations. The ac- counts of patients described above compellingly suggest that the experiencing of PERL is a separably disruptible cognitive function. Further, the familiarity judgment can be defective either by being too weak or ab-


normally strong. Hanley, Young, and Pearson (1989) described a case of “defective recognition of familiar people”: following an illness of herpes simplex encephalitis, a patient could not identify familiar persons from face, name, or voice, but he had some correct knowledge of these target persons, such as their profession. In contrast, Regard (personal communication) has described “hypergnostic” patients who have an erro- neous sense of familiarity for stimuli never previously seen. But whether PERL is disturbed by specific cerebral disruptions common to all cases of dys-familiarity or whether PERL is a property of certain kinds of stimuli (faces, names, voices, and so on) and is therefore common to many lesions remains to be studied. It will be of great interest to pursue questions about the specific neuroanatomical structures or systems associated with the processing of PERL as an independent attribute.

Understanding PERL as a Neuropsychological Function

The foregoing suggests that PERL is an important attribute of human behavior and that it is a unique and free standing function, not to be viewed merely as a sum of its component parts (e.g., affective experience, holistic processing, familiarity, and context). This view of PERL may lead to a beginning look at what neuroanatomical structures or systems are responsible for this important attribute of neuropsychological function. Evidence further suggests that the RH is preferentially involved in es- tablishingpersonal relevance of a variety of stimuli, using affective valences toward stimuli, while tending to manage these stimuli as unanalyzed or unitary (Bogen, 1969; Bever, 1975; Bradshaw & Nettleton, 1983), and utilizing rich contextual information. The proposal here is that the RH distinguishes familiar from unfamiliar input in the environment and main- tains classes of PERL phenomena in the manner just depicted.

Recalling the observations of Sperry et al. (1979) in callosal-sectioned patients that both hemispheres recognized PERL phenomena, we might inquire about the exclusivity of RH representation of PERL. We note that disturbances in PERL perception are not seen in aphasia and that common object agnosia is seen more frequently in association with LH than with RH damage. When a familiar recognition deficit is associated with a LH lesion, RH damage is usually also present (Damasio et al., 1982). In contrast, as we have seen, many kinds of PERL deficits are associated with damage confined to the RH. Recall, also, the findings of Sergent and Villemure (1989) in the right hemispherectomized patient who could process relevant semantic information, judge age and gender, and retrieve the names of persons known to her, but could not identify their faces or experience them as familiar. We might speculate that the LH categorizes and labels the objects, including PERL objects, and does so correctly, while the RH has a greater role in experiencing PERL affect and in PERL recognition in the special sense used here.


The fact that the RH has been associated with superior recognition of “novel” stimuli (Goldberg & Coast, 1981; Regard & Landis, 1989) is not troublesome to the proposal that the RH is specialized for establishing a PERL world. It seems reasonable that novel stimuli would indeed be more salient in such an environment than in LH modes, where rule governed activities prevail, yielding ever new combinations, as in phonol- ogy, syntax, and mathematics, Further, noting that the RH can be specialized for alerting and vigilance (Posner & Petersen, 1990; Heilman, Watson, & Valenstein, 1985) lends further interest here. Vigilance considered one way would consist primarily of the process of identifying personally relevant entities. Finally, some time ago, Bogen (1973) pro- posed that the cerebral hemispheres were complementary in how they interrelate the self and the external world in cognitive processing. Inves- tigation of the role of PERL in RH versus LH functioning may help to further elucidate these notions.

We have seen that various categories of stimuli can receive the personal familiarity attribute. Proper names, faces, voices, persons, phrases, and topography all commonly occur in familiar and unfamiliar variants, and all are differentially affected by disease. Less common but reported can- didates are cows and cars, and thus it is obvious that any class of objects- art works, collectors’ items of all kinds, buildings, landscapes-can move into the domain of PERL. Items in the class each have a “personal history” and affective valence relative to the subject, thus evoking the special sense of personal familiarity. These personal histories, connotations, associations, and affective features compose the contextual material important in PERL processing. It is these attributes that are not easily simulated in the laboratory and that are missing in sufficient degree in trained-to- familiarity studies. The sense of personally relevant familiarity is conferred on objects in the environment as an independent attribute. This function- establishing a personally relevant universe-represents an organizing prin- ciple that is common to many modality-specific processes for which the RH appears to be specialized. Clinically, it is important that a PERL deficit be identified, so that counselling and compensatory techniques can be offered to patients with this problem. Thus, whether in terms related to notions of cognitive style, processing mode, or as an autonomous ability, PERL may prove to be a behavioral function that relies heavily on the RH.

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