Cognitive enhancement with brain implants: the burden of abnormality

Reported clinical cases of patients with neurological disorders who have received brain implants which produced some degrees of cognitive enhancement introduce the possibility of using implantable neurotechnologies in healthy individual brains. However, little is known about the phenomenology of using implants for cognitive gains. Even if brain implants could augment one’s cognitive capacities, it would not guarantee a net benefit for the implanted individual. In this article, we examine the potential psychiatric effects of increased cognitive capacities, namely the burden of abnormality. We draw on a parallel phenomenon, known as the burden of normality, from clinical studies when patients who became suddenly symptom free after treatment with deep brain stimulation experienced psychiatric adverse effects. While we agree that cognitive enhancement could generate important postoperative benefits, we argue that patients augmenting their capacities will likely experience abnormality as much as, or perhaps even more so than normality.