Imagine you woke up one day and felt that you didn’t exist…here we examine the common understanding of phenomenal consciousness in relation to Cotard’s syndrome and how we can better explain it.
Taken from New Scientist 31.03.17 Cover article on ‘knowledge and epistemology.’ See the section of ‘self-knowledge.’
Sufferers of Cotard’s syndrome report that they feel as if they do not exist. They may express the conviction that are dead or dying, that parts of them don’t exist or are putrefying. This is a haunting, terrible mental affliction.
In philosophical circles, it is sometimes quoted to substantiate the notion that there, therefore, cannot be any kind of Cartesian person inside us. That it somehow contradicts the notion of a phenomenal self. Most of us operate on the basis that we believe ourselves to be the subject of our experience. We have the notion that we are the coherent, unchanging and autonomous self who is now, and always has been throughout our life, the ‘person’ or ‘entity’ experiencing the events of our existence.
But, if it is possible to exist without that conviction, then it questions whether or not such a conviction is absolute or intrinsic within all humans. And, if not, this may nullify philosophical analysis of the conscious self that depends on that conviction.
However, this is a poor argument for several reasons.
When such people report: “I feel I do not exist” – they inadvertently establish themselves as the ‘I’ who is having this weird experience. Who is the ‘I’ reporting the problem? Or who feels that it is a problem? If they actually did not exist as a subjective person, would it be an issue that they felt they didn’t?
If there is no self – as with, say, a robot or zombie, how do you ask it if it doesn’t exist? How would you regard any statement by them on this topic?
Obviously, ‘normal’ people think those who claim non-existence need help. So we certainly operate on the surety of the subjective self. And, this view is supported by the fact that those reporting Cotard’s syndrome haven’t always felt that way. The neurological causes aren’t fully understood, but seem to relate to the type of misidentification similar to the idea that one’s body has been overtaken by an imposter. It is commonly experienced by those suffering various forms of psychosis, including schizophrenia. In some cases, it has been set off as an adverse reaction to a medicinal drug, or by a brain tumour. And that in most cases, it is treatable or can be reasonably managed by medication, mostly of the antidepressant type.
So, the syndrome is often termed Cotard’s delusion – something that a person, as the subject, may fall prey to. But it takes a real observer to be deluded by a delusion.
One question that does not seem to feature in the material on Cotard’s delusion is: Do they still experience qualia? Of course, we have plenty of issues trying to understand the nature of qualia and the experiences of those other than ourself. But, reading the descriptions offered by the patients of their predicament seems to indicate that they are experiencing qualia, though not necessarily feeling stimulated by it. There is a sense of depersonalisation and distance from that which is perceived. But, a sense of emotional detachment or distance is also a form of experience, even if unfulfilling and fearful.
What this use of the syndrome indicates, when applied to the philosophy of consciousness, is the confusion over what is called the self – phenomenal and epistemic selves mixed with psychological notions.
However, this is an important form of experience and it should be carefully studied. From what I’ve read so far, I suspect that such persons suffer from issues of their sense of the ‘ahankara’* – the person they feel themselves to be. The conscious self is having trouble identifying with the persona self of the ‘ahankara’. Usually, consciousness is able to form an image of who we think we are in this life based on our apprehension of our body and mixed in with all our aspirations, hopes, beliefs, comprehension of the world and everything we enjoy, fear, hope for, etc.
The AP model would suggest a neurological causal component to the disorder. The brain is not firing on data that is routinely interpreted by mental processing as supportive of the psychological ahankara concept. The patient’s issue is the loss of that identification. Even though their body remains otherwise healthy, the conscious self has lost the fundamental concept upon which it bases all its subjective qualia experiences, and through which it expresses it subjective will. This manifests as a depleted state of existence, interpreted by the conscious self as a form of death.
I would suggest that Cotard’s may also be linked to Alzheimer’s, and seems similar to cases of stroke victims who lose particular functions of speech or memory and feel that they aren’t the same person anymore. Treatment may be a combination of neuro-active drugs along with psychological therapies aimed at reestablishing identification with the persona self.
We can’t leave this subject without noting how quickly a disorder which is rare, apocryphal and scantily researched has been widely cited within articles to argue against phenomenal consciousness. One wonders why the same generous consideration of personally reported evidence isn’t granted to that which substantiates the irreducible nature of consciousness and its ability to function independent of the physical brain.
* The term ‘ahankara’ is a borrowed Sanskrit word used to distinguish the features of the persona self – the concept of the person we believe we are – from the subjective conscious self who is the observer and the experiencer of the persona self. It incorporates many of the aspects of physical, psychological and social aspects of selfhood. But it is distinct from the self who is the subject of conscious experience.