What is Cotard’s syndrome? The rare mental illness which makes people think they are dead

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Cotard's syndrome, delusion, denial, self-existence, Walking Corpse Syndrome

What is Cotard’s syndrome? The rare mental illness which makes people think they are dead

A rare mental illness can make the sufferer believe they are dead, partly dead or do not exist.

Chronicled in the Washington Post by Meeri Kim, Cotard’s syndrome — sometimes dubbed ‘Walking Corpse syndrome’ — is a condition where patients believe they are dead, parts of their body are dead or that they do not exist. Any evidence to support the fact they are alive is “explained away” by sufferers, according to the Post.

It is not classified under the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) but is recognised as a “disease of human health” in the International Classification of Diseases. According to Mind: “It is linked with psychosis, clinical depression and schizophrenia”.

A spokeswoman for Mind told The Independent the syndrome was “certainly rare”.

“Cotard’s syndrome is a type of delusion that is usually associated with denial of self-existence,” she said.

“The person experiencing the delusion might believe that they are dead, dying, parts of their body do not exist or they do not need to do activities to keep themselves alive (drink, eat, basic hygiene etc.)”

French neurologist Jules Cotard identified the first case in the 1800s. He described a woman suffering from the condition as affirming “she has no brain, no nerves, no chest, no stomach, no intestines… only skin and bones of a decomposing body”.

Esmé Weijun Wang spoke to the Post about her experience of the condition, which she suffered from for two months, explaining that after weeks of losing “her sense of reality” she woke up and told her husband she had actually died a month before, when she had fainted on a plane.

She said: “I was convinced that I had died on that flight and I was in the afterlife and hadn’t realised it until that moment.”

Ms Wang, who was previously diagnosed with a form of bipolar-type schizoaffective disorder, later recovered and “no longer saw herself as a rotting corpse”.

A Mind spokesperson said “in terms of prevalence, there seems to be very few studies” meaning it is difficult to assess how many people are affected by the condition.

The Washington Post says “what causes Cotard’s syndrome and other delusions is a matter of debate” and speculates on a range of possibilities including brain impairment.

Professor and clinical psychologist Peter Kinderman told The Independent: “This syndrome is extremely rare so there’s not much known about it, most literature on it is individual case studies over many years.”

He says one theory about the condition’s cause is that when “conditions exist to make someone feel confused or distressed” the individual can combine all their thoughts and beliefs – some of which may be distressing and unusual, with the feeling that they don’t recognise themselves.

He said this could mean “people come up with the best conclusion they can to explain the experiences they’re having, which may be that they’re dead.”

In 2013, a British man called Graham was interviewed in the New Scientist. He was diagnosed with Cotard’s syndrome after believing his “brain was dead”. He believed he had killed it after a suicide attempt following severe depression.

Graham said he visited a graveyard during this time as “it was the closest I could get to death”.

He said: “I didn’t need to eat, or speak, or do anything.”

Graham’s condition gradually improved with psychotherapy and drug treatment.

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‘Culture of denial’ leaving UK children at risk of serious abuse

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abuse, blame, child abuse, child sexual exploitation, Children, denial, gangs, perpetrators, rape, sexual exploitation, silence, violence

‘Culture of denial’ leaving UK children at risk of serious abuse

Children are at risk of serious abuse across England because of a culture of “wilful blindness” about the scale and prevalence of sexual exploitation across swaths of local government and in police forces, the deputy children’s commissioner warns.

In a highly critical interview given in the aftermath of the Rotherham abuse inquiry, which concluded that hundreds of children may have been abused there over a 16-year period, Sue Berelowitz said she had been “aghast” at the examples of obvious errors and poor practice she found.

Berelowitz told the Guardian she had discovered that police and council officers were in some cases still either looking the other way, not asking questions or claiming abuse was confined to a certain ethnic group – such as Asian men – or a particular social class.

Berelowitz is the author of a detailed report into child sexual exploitation in gangs and groups last year following a series of high-profile cases in towns such as Rochdale and Oxford as well as Rotherham.

On a recent field visit to a police force, Berelowitz was surprised to learn that the officers’ top search on their internal computer profiling system was “Asian male”. When she asked what would happen if the perpetrators were not Asian, the officer in charge replied that the force was “not looking for those”. “I was astonished. I said: ‘I think you better start looking.'”

She said that in other cases a culture of blaming the victims remained prevalent: “I had another case when I met the chair of the safeguarding board of a large city [meant to co-ordinate the protection of children from abuse or neglect]. When I mentioned cases of child sex exploitation, he said: ‘Oh yeah, those two girls are prostitutes always walking up and down this street.’ I won’t mention the city as you’d be aghast to learn who it was.”

Berelowitz said she was shocked to discover that although “there had been progress” by authorities in the aftermath of the grisly series of gang-rape and trafficking scandals, “there are still instances of not looking, of wilful blindness. We have to be careful none of us is in denial about the terrible reality of what happened in places like Rochdale and Rotherham.”

Because the subject matter is uncomfortable and scrutiny damaging, Berelowitz added that there was a “culture of denial” that had been exposed by Prof Alexis Jay’s inquiry into the handling of child abuse in Rotherham. It found at least 1,400 children were sexually exploited by predominantly Asian criminal gangs between 1997 and 2013.

A day after the Jay report was published, South Yorkshire’s police and crime commissioner Shaun Wright, a former Labour councillor who was cabinet member for children and youth services on Rotherham council between 2005 and 2010, came under intense pressure to resign his post.

On Wednesday night, after the Labour threatened to suspend him, he resigned from the party but insisted he remained committed to his police role. He said: “I was elected to deliver the people’s policing and crime priorities in South Yorkshire, and I intend to see that duty through.”

Theresa May, the home secretary, and Wright’s party, Labour, both said he should go. Wright’s former colleague and council leader, Roger Stone, resigned following publication of the Jay report.

Berelowitz’s comments, however, are intended to broaden the issue beyond Rotherham and similar cases of abuse. She cautioned that despite the emphasis placed on the fact that most of the victims in the northern towns were poor and white, while the perpetrators were Asian, she said that the issue affected “all communities, all races”.

“Usually people say to me that it was an issue of Asian males and white girls. When we dug deeper we found Afro-Caribbean girls and sometimes boys as victims, or Roma perpetrators. There’s a culture of wilful denial to the reality out there. It’s white people, it’s Asians. Parts of every community are involved.”

Most troubling was the rise of peer-to-peer sexual abuse and exploitation, where both victims and perpetrators are minors. She said that in another extremely disturbing case, police officers had caught a gang of 14- and 15-year-olds who had gang-raped an 11-year-old over a number of days. “The police caught the offenders and charged them not with rape, but with drugs offences. I told them that the message was ‘don’t do drugs but rape is fine’. The force is now working to bring the case back.”

She also warned that the rise of technology had enabled children to be seduced and controlled more easily than before, with young girls texted threats to “murder their mother, whom a gang leader has just seen pull up in a new car, if they talk about an attack” or blackmailed with an incriminating video taken on a mobile of their own rape, filmed to ensure their silence.

There was also a gap in the research explaining what led apparently otherwise normal men to commit rape and torture on often vulnerable girls, Berelowitz said.

“Most of the research into adult males who sexually abuse children in paedophilic mode has been on white males serving long sentences in prison. There’s no research into the particular model of Rotherham or Oxford or Sheffield.

“My own personal hypothesis is that they live in a patriarchal environment and are likely to have grown up with a fair amount of domestic violence.”

The scale of abuse, too, was alarming. The office of the Children’s Commissioner estimated that 16,500 children are at risk from abuse from criminal gangs. In London there are about 3,500 street-gang members, Berelowitz’s most recent work says, adding that estimates that one in 20 of the population had suffered intra-familial abuse “are far too low”. “In London alone there are about 3,500 young people aged between 13 and 25 involved in street gangs. There is a level of extraordinary violence involved. Now any girl living in a neighbourhood is at risk. I’d say there was more than one girl for every gang member at risk,” she said.

Reinforcing the point that the problem is not easily categorised, a report from University College London and Barnardo’s reveals that the number of boys affected by child sexual exploitation may be much higher than previously thought. The report – which looked at 9,042 children affected by childhood sexual exploitation and supported by Barnardo’s since 2008 – reveals that 2,986, or one in three, were male.

Society, said Berelowitz, was only just coming to terms with the disturbing nature of the problem and the scale of the abuse. “I think we are facing a public health problem here. We need to mount a public information campaign like that done about seatbelts and get money for therapy. We cannot arrest our way out of this problem.”

Anorexic Images – Who Needs Them?

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anorexia, competitiveness, denial, Eating Disorders, emaciation, images, media, misconceptions, symptoms, weight

Anorexic Images – Who Needs Them?

I recently spoke to a journalist who was interested in covering my row to London for Beat. Her first question, before she even asked about what I was doing or why, was “Do you have any images of yourself at a low weight?” As soon as I calmly explained Beat’s guidelines on the topic, which advise ambassadors not to provide these sorts of images, she launched into a heated speech about how she “simply couldn’t understand why that was necessary” because if I was “claiming to have been anorexic” I would “need to prove it”!

I thought to myself that that is precisely the problem with the current state of the media: too many people assume they understand eating disorders by sight alone, rather than stepping outside of their comfort zone to consider the reality that they run much deeper than skin level.

Given the recent controversy on Twitter surrounding the portrayal of eating disorders on popular TV programmes, it is important to recognise that their basis lies in the psychological symptoms, NOT the physical alone!

Displaying images of sufferers in their skin-and-bone state puts too much focus on weight loss, which is in fact just one of many symptoms of eating disorders – and actually only applies to anorexia which accounts for just 10% of cases under the umbrella term ‘eating disorders’.

As a result this feeds the common misconception that in order to have an eating disorder one must be drastically underweight. In fact, many people who are diagnosed as having an eating disorder never fall below a healthy weight!

In my own fight for treatment I was turned away because I was not underweight enough, even though I had already reached the stage of amenorrhoea. It seems so dismissive to believe that anorexia in particular is categorised by emaciation; in my last blog I explained how even after three years of maintaining a healthy weight – and therefore by the media’s definition being recovered – I can still encounter the distorted cognition associated with the illness. The weight is simply a by-product of the thoughts, and so the thoughts are just as much present once the weight has been gained, and take far longer to work through.

Another common justification is that seeing such graphic images of starvation will make an anorexic ‘think twice’ about ‘what they are doing to themselves’. Anorexia is NOT a lifestyle choice that can simply be opted out of! They are not doing anything to themselves, they are being dictated to by the malicious voice of a genuine illness.

Susan Ringwood, CEO of Beat, has said: “Eating disorders are more hard wired than was first known to be the case… people with anorexia can know they are at risk of dying and can find that less terrifying than gaining a few pounds in weight”.

The ‘shock factor’ which is experienced by the typical reader, and is exploited by the media, does not affect someone with an eating disorder. Susan continued: “These images do not shock them, they excite, encourage and motivate them to get as thin if not thinner than the person depicted”.

‘Triggering’ can sound like such a trivial word, but the truth is that presenting emaciation as a validation of anorexia not only promotes the denial of being ill because a sufferer will never feel like they look like the person in the picture – and so they can’t have the same illness – but also brings out the innately competitive side of the illness and drives the need to restrict food further because they take the image as evidence that they can (and in their mind should) be thinner!

It is understandably difficult to comprehend the danger of these graphic images when to most people they serve as a catalyst for disgust, but I would urge anyone viewing such an image to consider it from the point of view of a person who is caught in the deadly grasp of an eating disorder. To these people, opening that magazine in which they sought a momentary escape from their own reality only to be faced with a representation of the idol who they feel they can never replicate merely reinforces the feeling of inadequacy, self-hatred and depression.