I overthink—Therefore I am not: An active inference account of altered sense of self and agency in depersonalisation disorder

Depersonalisation disorder may arise when the brain fails to modulate sensory precision, leading to a loss of the normal sense of control over one's own perceptions and actions. The paper proposes that individuals with depersonalisation adopt the hypothesis that they are embodied perceivers who are not in control of their perception, while still recognizing that the controlling agent is themselves. This account uses predictive processing to explain the phenomenology of depersonalisation, including the feeling of being detached from one's own thoughts and actions. The analysis suggests specific psychophysical and physiological abnormalities that could underlie these experiences.

Study at a glance

Abstract

This paper considers the phenomenology of depersonalisation disorder, in relation to predictive processing and its associated pathophysiology. To do this, we first establish a few mechanistic tenets of predictive processing that are necessary to talk about phenomenal transparency, mental action, and self as subject. We briefly review the important role of 'predicting precision' and how this affords mental action and the loss of phenomenal transparency. We then turn to sensory attenuation and the phenomenal consequences of (pathophysiological) failures to attenuate or modulate sensory precision. We then consider this failure in the context of depersonalisation disorder. The key idea here is that depersonalisation disorder reflects the remarkable capacity to explain perceptual engagement with the world via the hypothesis that "I am an embodied perceiver, but I am not in control of my perception". We suggest that individuals with depersonalisation may believe that 'another agent' is controlling their thoughts, perceptions or actions, while maintaining full insight that the 'other agent' is 'me' (the self). Finally, we rehearse the predictions of this formal analysis, with a special focus on the psychophysical and physiological abnormalities that may underwrite the phenomenology of depersonalisation.