A vessel without a pilot: Bodily and affective experience in the Cotard delusion of inexistence

Abstract

The initial cause of Cotard delusion is pervasive dyshomeostasis (dysregulation of basic bodily function). This explanation draws on interoceptive active inference account of self-representation. In this framework, the self is an hierarchical predictive model made by the brain to facilitate homeostatic regulation. The account I provide is an alternative to two factor accounts of the Cotard delusion that treat depersonalisation experience as the first factor in genesis of the Cotard delusion. I argue that depersonalisation experience and the Cotard delusion are produced by different breakdowns in the process of self-modelling.