Posted by alexandra_k on August 17, 2005, at 18:35:00
In reply to Dead Certainty in the Cotard Delusion, posted by alexandra_k on August 17, 2005, at 18:32:47
While the causes of depression may be hard to pinpoint, it does seem clear that people with clinical depression tend to benefit from psychotropic medications. What people have surmised from this is that in depression something has gone wrong with levels of neurotransmitter in the brain. The medication is thought to assist because it helps rectify the problem. If depression is left untreated, however, then some people can deteriorate over time, becoming more and more depressed. As this happens the persons sympathetic nervous system no longer produces the typical heightened physiological response to various stimuli. Instead, their levels of arousal become progressively dulled, or muted. Subjects begin with making claims that they don’t feel real, or that they feel disembodied, and if they continue to deteriorate they may eventually reach the conclusion that they are dead. The Cotard delusion is now even rarer than it once was as modern advances in psychotropic medications now largely prevent people deteriorating to that level.
In other cases people develop the Cotard delusion in response to cerebral trauma. They may have been involved in an accident that has resulted in damage to parts of their brain, or a blood vessel may have burst which may result in a similar kind of damage. People who develop the Cotard delusion in response to cerebral trauma may suffer from other conditions, some even suffer from other kinds of delusion as well. It has been found that these people also exhibit muted levels of physiological arousal.
Sass considers that in response to the lack of usual autonomic response these people may well no longer feel connected to their bodies, to other people, or to the world in which they inhabit. Sass claims that the person with the Cotard delusion
‘has lost the capacity to experience affect due to a global shutting down of affective processing in which “information derived from perceptual or cognitive channels have no bodily consequences”… such a person is conscious, yet his consciousness lacks a quality that has always accompanied his conscious experience, a quality that is, in fact, intimately allied with his experience as a living subjectivity.’
Although we may not be able to empathise with the delusional experience completely we may be able to grasp something of it by recalling times where we have felt a strange neutrality of mood, or as Sass puts it ‘a diminution in the normal tonality of life’; a period of flattened affect or emotional non-responsivity. He considers that in these cases we do talk of feeling ‘dead’ or ‘deadened’ and thus the delusional subjects utterance would seem to be ‘well within the extended penumbra of comprehensible meanings of this term’. Sass maintains that the delusional subjects experience is just a severe variation on this and that it is this feeling that prompts the delusional utterance.
poster:alexandra_k
thread:543149
URL: http://www.dr-bob.org/babble/write/20050807/msgs/543151.html