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Imagine opening your eyes tomorrow morning and realizing that you died in your sleep.
想象一下：你明天早上睁开眼睛，意识到自己在睡梦中死去了。
It's not like in a horror movie; you're not a ghost or a zombie.
这不像恐怖电影的场景；你不是鬼，也不是僵尸。
You're just very, very sure that you're not alive anymore,
你只是非常非常地确信你不再活着，
even though you're still walking and talking. That's Cotard's Syndrome.
即使你仍在走路和说话。这就是科塔尔综合症。
First described in 1880, people with Cotard's Syndrome believe they're dead, never existed,
第一例描述是在1880年，科塔尔综合症患者认为自己死了，不存在了，
or that parts of their own body have spontaneously vanished or been destroyed.
或者自己身体的那些部位已经自发地消失或被摧毁了。
It's rare, and there hasn't been a whole lot of research into it.
这种病症很罕见，而且没有太多研究。
But studying Cotard's Syndrome has helped psychologists
但对科塔尔综合症的研究已经帮助心理学家
gain a better understanding of how our brains create what we consider reality.
更好地理解大脑是如何创造我们对现实的认知的。
According to case reports, being dead is a very stressful experience.
病例报告上说死亡是一种非常有压力的经历。
It dominates everything in your life, socializing, self-care,
它主宰着你生活的方方面面，
and even eating become far less important when you're no longer part of the land of the living.
你不再活着时，社交、自理，甚至吃饭也变得不重要了。
And the fact that your friends and family don't seem to notice only adds to the anxiety.
你的朋友和家人似乎没有留心你的事实只会增加你的焦虑感。
In one case published in a 2009 study,
在2009年研究公布的一项病例中，
an 88-year-old man was admitted to the hospital for a severe depressive episode.
一名88岁的男子因严重抑郁而入院。
He explained that he was depressed because he had passed away recently,
他解释说他很沮丧，因为他最近去世了，
but none of the people he knew had bothered to bury him.
但他认识的人中没有一个人愿意埋葬他。
In another case from the same study,
在同项研究的另一个案例中，
a 46-year-old woman explained that she was 'a body without content',
一个46岁的女人解释说她“身体是空的”，
that her brain and intestines had vanished, and that she was translucent.
她的大脑和肠子都消失了，她是半透明的。
She refused to bathe because she believed that she was soluble,
她拒绝洗澡，因为她相信自己可溶，
and her body might wash away if she did.
如果洗澡的话，身体可能被冲走。
Cotard's is very distinctive, but it's not listed as a standalone disorder in the DSM 5,
科塔尔综合症非常独特，但它并没有被列为DSM 5中的独立障碍，
the guide mental health professionals use for diagnosis.
DSM 5用来指导精神卫生专业人员进行诊断。
Instead, it falls under the category of somatic delusions, untrue beliefs about the body,
相反，它被归类为躯体妄想，即对身体有不真实的信念，
and is usually seen as a rare symptom of depression and psychosis.
通常被认为是抑郁症和精神病的罕见症状。
That makes it hard to estimate the exact prevalence of Cotard's,
这让科塔尔综合症的确切发病率变得很难估计，
but we know it's uncommon, and seems to become slightly less rare as people get older.
但我们知道它不常见，随着人们年龄的增长，它似乎变得不那么罕见了。
One study looked at two years of general psychiatric admissions to hospitals in Mexico
一项研究调查了墨西哥医院两年来的一般精神病人数，
and found that only around 0.62% of patients exhibited Cotard's.
发现只有大约0.62%的病人表现出了科塔尔综合症。
And another, which looked at the elderly population in Hong Kong,
另一项研究调查了香港的老年人口，
found that around 3.2% of those with severe depression showed symptoms of Cotard's.
发现3.2%严重抑郁症患者表现出科塔尔综合症的症状。
Psychologists still don't know exactly how the delusion develops,
心理学家仍不知道这种错觉是如何发展的，
but understanding the root of Cotard's Syndrome
但是了解科塔尔综合症的根源
can help them piece together the psychological and neurological components
能帮助他们找出心理和神经方面的因素，
behind our connection to our body and our sense of being alive.
这些因素隐藏在身体与活着的感觉的联系中。
Research suggests that the symptoms most likely come from problems
研究表明，这些症状很可能是
with the parts of the brain associated with facial recognition and emotional response.
与面部识别和情绪反应相关的大脑部分出得问题。
When you look at another person, or even yourself,
当你看着另一个人甚至你自己时
a bunch of separate areas of your brain work together to process the specific physical features of that person,
你大脑的一堆独立区域开始协同工作，来处理那个人的具体身体特征，
and your memories associated with them, bringing it all together into one complete perception.
以及与他们相关的记忆，并把所有东西整合在一起形成一个完整感知。
With Cotard's, scientists think the part of the brain
科学家们认为科塔尔综合症患者
that connects those bodily perceptions to previously established emotions isn't working the way it's supposed to.
将身体感觉与先前确立的情感联系起来的大脑部分并没有按照预期方式运作。
It's likely that when people look in the mirror and recognize their own face
就像人们照镜子识别自己的面孔时，
but feel no emotional connection to it,
并没有感觉到情感上的联系，
their brain misinterprets that disconnect as a more fundamental change.
他们的大脑错误地将这种脱节视为一种更根本的变化。
And people with depression might be more likely to believe
而抑郁症患者更有可能相信
that this intangible change must mean they've passed away.
这种无形变化一定意味着他们已经去世了。
But not all patients, not even all depressed ones,
但并不是所有认知与情感脱节的患者，甚至是所有认知与情感脱节的抑郁症患者
with this kind of disconnect between recognition and emotion exhibit Cotard's Syndrome.
都表现出科塔尔综合症。
That's where the association with psychosis comes in.
这就是科塔尔综合症与精神病的关联之处。
Psychosis is when someone loses touch with reality,
精神病是指一个人失去了与现实的联系，
which means their rational thinking is impaired.
这意味着他们的理性思维受到了损害。
And it takes that kind of cognitive impairment to believe something that's obviously not true.
它利用认知障碍去相信一些明显不真实的东西。
Since someone with psychosis isn't thinking rationally,
因为精神病患者不能理性思考，
they don't automatically reject that gnawing "I must be dead" feeling
他们不会自动拒绝痛苦的“我一定是死了”的感觉。
they get when they don't feel emotionally connected to their own reflection.
当他们没有感受到与反射的情感联系时，他们就会有这种感觉。
So once they realize something feels unfamiliar about themselves,
所以他们一旦意识到对自己的某些事不熟悉，
they end up with a prolonged, upsetting delusion that they're dead,
就会最终产生一种长期的“他们死了”的痛苦错觉，
instead of shrugging off the idea as impossible.
而不是尽可能摆脱这一想法。
Since Cotard's Syndrome is fairly rare, there haven't been any clinical studies on the best way to treat it.
由于科塔尔综合症非常罕见，还没有任何临床研究用最好的方式来治疗它。
Doctors usually treat Cotard's similarly to psychotic depression,
医生们通常用治疗精神抑郁症的方法治疗它，
with a combination of medications, and sometimes electroconvulsive therapy,
用结合药物治疗，有时用电休克疗法，
which uses electricity to stimulate the brain.
即利用电流刺激大脑。
Sometimes it works; sometimes it doesn't.
这种方法有时有效，有时不起作用。
This is one of those illnesses that reminds us just how powerful and bizarre the brain is.
科塔尔综合症是提醒我们大脑有多么强大和怪异的疾病之一。
It's hard to imagine losing the feeling that you're still alive.
很难想象失去你还活着的感觉。
But studying Cotard's Syndrome can teach us a lot about our brains:
但研究科塔尔综合症可以告诉我们很多大脑知识：
the emotional connection that preserves our sense of being alive,
保持我们活着的感觉的情感联系，
and how losing that connection can make someone believe they've died.
失去这种联系会让人相信他们已经死了。
And hopefully, with more research, we'll also find better ways to treat it.
希望通过更多研究，我们能找到更好的治疗方法。
Thanks for watching this episode of SciShow Psych.
感谢您收看本期的心理科学秀。
If you're interested in learning more about how our minds work,
如果你对了解更多的大脑工作感兴趣，
you can go to youtube.com/scishowpsych and subscribe.
可以登录youtube.com/scishowpsych点击订阅。
