Journal of Cognitive Neuroscience
January 1, 2023
Fabienne Picard
11 citations
Ecstatic epilepsy is a rare form of focal epilepsy where seizures begin with ecstatic or mystical experiences, including feelings of enhanced self-awareness, mental clarity, unity with everything, bliss, and physical well-being. This perspective article describes the phenomenology and historical context of these seizures, identifying the anterior insula as the primary brain structure involved. The authors propose that temporary disruptions to anterior insula activity may interrupt interoceptive prediction errors, leading to an absence of uncertainty and a sense of bliss, as perfect prediction of the body's physiological state is mimicked. An alternative hypothesis suggests the anterior insula processes surprise, and epileptic discharge may interrupt unexpected events, producing a sense of complete control and oneness with the environment.
Cognitive Therapy and Research
March 29, 2025
Federico Seragnoli, Fabienne Picard, Gabriel Thorens et al.
4 citations
The noetic (insightful) quality of mystical-type experiences in psychedelic-assisted therapy may arise from changes in metacognition—the ability to monitor and evaluate one's own thoughts. Drawing on existing metacognition models, the authors propose that psychedelics activate procedural, performance-based metacognitive feelings, producing an 'Aha!' experience interpreted as a feeling of epistemic gain. This framework could help explain therapeutic mechanisms such as intention setting, music's role, traumatic memory recall, and spiritual bypassing. The paper reviews theoretical links between metacognition and altered states like meditation and lucid dreaming, then outlines future research directions.
Current Topics in Behavioral Neurosciences
January 1, 2025
Nina M Sooter, Federico Seragnoli, Fabienne Picard
Ecstatic epilepsy, a rare focal epilepsy tied to the anterior insula, produces a blissful state characterized by physical well-being, mental clarity, oneness with the universe, and time dilation. This chapter examines how these symptoms align with known insula functions and uses the condition as a natural model to deepen understanding of the insula's role in the sentient self, monitoring uncertainty and surprise, and generating metacognitive feelings.
Brain Sciences
October 22, 2021
Fabienne Picard, Peter Bossaerts, Fabrice Bartolomei
Ecstatic epilepsy is a rare form of focal epilepsy where the seizure aura is a blissful state of mental clarity and certainty, often described as religious or mystical. Over the last decade, evidence has located the symptomatogenic zone for this experience in the dorsal anterior insula. The neurocognitive hypothesis proposes that the feeling of mental clarity arises from suppression of interoceptive prediction errors and unexpected surprise from internal or external signals, which are normally processed by the dorsal anterior insula. This mimics a perfect prediction of the world, inducing certainty. Ecstatic epilepsy thus serves as a model for the anterior insula's role in uncertainty and surprise.