Making Sense of the Cotard Syndrome: Insights from the Study of Depersonalisation

Abstract

AbstractPatients suffering from the Cotard syndrome can deny being alive, having guts, thinking or even existing. They can also complain that the world or time have ceased to exist. In this article, I argue that even though the leading neurocognitive accounts have difficulties meeting that task, we should, and we can, make sense of these bizarre delusions. To that effect, I draw on the close connection between the Cotard syndrome and a more common (and better studied) condition known as depersonalisation. Even though they are not delusional, depersonalised patients seem to have experiences that are quite similar to those of Cotard patients. I argue that these experiences are essentially characterised by a (more or less important) lack of subjective character and of two other structural features of experience, which I call ‘the present character’ and ‘the actual character’. Cotard's nihilistic delusions simply consist in taking these anomalous experiences at face value.