Pain Asymbolia as Depersonalization for Pain Experience. An Interoceptive Active Inference Account

Abstract

“Mineness,” also called “subjective presence” or “personalization,” is the feeling that experiences belong to a continuing self. This article argues that mineness is produced by processes of interoceptive active inference that model the self as the underlying cause of continuity and coherence in affective experience. A key component of this hierarchical processing system and hub of affective self-modeling is activity in the anterior insula cortex. I defend the account by applying it to the phenomenon of pain asymbolia, a condition in which nociceptive signals (of bodily damage) are not attributed to the self. Thus, pain asymbolia is a form of “depersonalization for pain” as Klein puts it. The pain is experienced as happening to my body but is not experienced as mine. Thus, we can describe it as loss of subjective presence or “mineness” for the experience of pain.