Cotard syndrome, self-awareness, and I-concepts
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Keywords

Consciousness
Cotard syndrome
Higher-order thoughts
I-concepts
Self-awareness
Somatoparaphrenia
Thought insertion

How to Cite

Gennaro, R. J. (2020). Cotard syndrome, self-awareness, and I-concepts. Philosophy and the Mind Sciences, 1(I), 1–20. https://doi.org/10.33735/phimisci.2020.I.41

Abstract

Various psychopathologies of self-awareness, such as somatoparaphrenia and thought insertion in schizophrenia, might seem to threaten the viability of the higher-order thought (HOT) theory of consciousness since it requires a HOT about one’s own mental state to accompany every conscious state. The HOT theory of consciousness says that what makes a mental state a conscious mental state is that there is a HOT to the effect that “I am in mental state M.” I have argued in previous work that a HOT theorist can adequately respond to this concern with respect to somatoparaphrenia and thought insertion. There is also Cotard syndrome which is a rare neuropsychiatric disorder in which people hold the delusional belief that they are dead, do not exist, or have lost their blood or internal organs. In this paper, I argue that HOT theory has nothing to fear from it either and can consistently account for what happens in such unusual cases. I analyze Cotard syndrome in light of my previous discussion of somatoparaphrenia and thought insertion, and argue that HOT theory can provide a somewhat analogous account without the worry of inconsistency. It is crucial to recognize that there are multiple “self-concepts” and levels of HOTs which can help to provide a more nuanced explanation. With regard to the connection between consciousness and self-consciousness, it is proposed that Cotard patients are indeed capable of having some “I-thoughts” about their bodies and mental states.

https://doi.org/10.33735/phimisci.2020.I.41
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Copyright (c) 2020 Rocco Joseph Gennaro