A vessel without a pilot

Abstract

Abstract In Cotard delusion, the subject believes that she has died or no longer exists. One explanation of the delusion proceeds from the fact that depersonalization is often reported as the experience of feeling ‘as if’ the subject no longer exists. In Cotard delusion, this depersonalization experience is coupled with a metacognitive deficit that leads the subject to endorse the experience or take it at face value. An alternative explanation treats depersonalization and Cotard delusion as products of different impairments to the avatar. Unlike depersonalization in which the avatar is largely intact, in Cotard delusion, the avatar degrades and disintegrates. The result is that the narrative ‘I’ remains as a purely verbal construct detached from an underlying sense of self as a unified persisting entity.