What is walking corpse syndrome?

The King of France – thinking he was made of glass – was horrified that it might shatter… and he wasn’t alone in that belief. After the Emperor met his Waterloo, a steady stream of Napoleons appeared in the French refuges, claiming to be Emperor of France themselves and demanding that their orders be carried out. In Paris in 1918, a housewife walked into a police station demanding a divorce on the grounds that her husband had been killed and exchanged for a double.

For centuries we have dismissed delusions as something for doctors to decide behind closed doors. But delusions are more than just weird quirks of the mind—they hold the key to our collective anxieties and traumas. They can even offer us vital protection from harsh realities.

my first book Delusion History: The Glass King, Surrogate Husband, and Walking Corpse is published by OneWorld.

What is walking corpse syndrome?

In 1874, at the Vanves asylum outside Paris, a 43-year-old woman informed her doctor that she had just had a strange and revelatory physical experience. The doctor listens to her as she describes an unusual sensation, something electric, like lightning, that runs all the way up her back to her head, accompanied by a noise that she thinks will split her in two along the spine. The event set off a chain of reflections and revelations about herself, her body and spirit, which led inexorably to the conviction that she was dead.

This eerie scenario is reminiscent of the beginning of a Victorian Gothic story or a mid-fifties Hammer horror film. The image of the living dead looms large in the popular imagination. This woman’s story became one of the case studies included in my book, Delusion History: The Glass King, Surrogate Husband, and Walking Corpse.

The woman’s doctor was the prominent Parisian neurologist and psychologist Jules Cotard, and in 1880, after many interviews with the woman he called “Madame X,” he presented a new disease to the medical community. He believes it is a type of “melancholia” (broadly speaking, what we might now think of as depression).

Madame X, he wrote, complained that she had “no brains, nerves, breasts, stomach, or entrails; all she has left is the skin and bones of her disorganized body.’ God and the devil don’t exist, she said. She didn’t need to eat and could no longer die of natural causes. The only way to end her life was to burn herself alive. Her doctor described her as “like a lost soul”. Beneath the macabre melodrama is a real person who withdraws from the world, both physically and mentally. Cotard calls it “délire de negation”.

As is often the case with delusions, the story feels as if a communique has been inserted into it, the meaning encrypted, requiring an audience and interpretation.

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Historical explanation

The common definition of a delusion is a fixed false idea that is unshakeable despite overwhelming evidence to the contrary. For centuries, delusions were thought to be the result of an imbalance of “humors” (too much black bile to be exact), then they were evidence of demonic possession, then brain disease, and by definition incomprehensible. Historically, they have been presented as curiosities and wonders of the mind.

My project as a historian has been to find traces of real lives and struggles, to try to glimpse the flesh-and-blood people behind the pseudonyms, the poster girls and boys for clinical newly invented disorders like what Madame X suffers from, to see if we can to understand better.

“Varney the Vampire” was the first popular image of the living dead, the star of the 1840s Penny Dreadful gothic horror series and the warm-up act for Bram Stoker’s iconic creation Dracula in the 1897 novel. But walking corpses present themselves to doctors in real life long before these iconic characters were put to paper and centuries before Cotard formally described the phenomenon.

The dead don’t eat…

Petrus Forestus, a 16th-century physician in the Dutch Republic, tells the story of a melancholic patient who believed he was dead and refused to eat anything. What followed was a “deceit” – a trick designed to get a person out of their false belief. The doctor evidently asked his associate to pretend to be another corpse, and to place this puppet “… in a chest like a dead man, by his bed, and made him rise a little and eat: the melancholy man asked the forgery whether dead men they ate meat. He told them yes, and indeed he ate the same way and was cured.”

The farce of a “dead body” sitting in a coffin to shock another person out of delusion has terrible entertainment value. We have to take the success story with a pinch of salt. Doctors were in the habit of talking about their success for the sake of their own reputation. People with the belief that they are dead will not be easily revived by any means, and they continue to rise again and again throughout the ages.

During his career, Cotard encountered many patients with this belief and “strange logic” that they were “neither alive nor dead, or alive-dead.” The conviction is disturbing and predates Sigmund Freud’s 1919 essay. The Uncanny. For Freud, delusions, like dreams, are stories from the unconscious.

Psychoanalysis would soon see trauma as the generator of insanity, and the uncovering of trauma, the bringing of murdered memories back into consciousness, as the path to healing. With her delusion, we can imagine Madame X detaching herself from her traumas. She removes the connections to these experiences one by one, disassembling her body, absenting herself, or performing a vanishing trick. The belief that she is dead makes her immune to blame for her actions or her character.

Is it depression?

In a psychiatric context, what has come to be known as “Cotard’s syndrome” can be read as major depression; one’s explanation to oneself and to others of one’s experiences of dissociation and alienation.

In 1960, RD Laing created his landmark The Divided Self, and researched how to treat his patients with catatonia. Like Madame X, they had completely withdrawn from the world. Some acted as if they were already dead. Laing attributed the catatonia in his patients to claustrophobic families and their demands.

in Sanity, Madness and Family, Laing spoke of withdrawal as “a strategy that one has devised to live in an unlivable situation”. It made a lot of sense psychologically and if one was listened to, natural healing was possible without drugs or restrictions.

There is a deep sense of alienation in Madame X’s delusion. So where does her faith come from? She was admitted to the Vannes asylum just three years after the Siege of Paris, which ended the Franco-Prussian War by starving the population of Paris into submission. She also mentioned a more personal trauma, as well as feelings of guilt and shame, admitting to her doctor that she “got it wrong on my first communion.”

It’s a fuzzy picture.

Zombies in Popular Culture

In popular culture, the living dead have found their most shocking expression in film as zombies.

As with vampires, there was a twist of conceit here. The alienation was not from the perspective of the man who believed he was dead, but from the mind of those who feared him as an external threat.

In the 1968 film Night of the Living Deaddirector George Romero uses zombies to criticize American society and the population’s blind acquiescence. Americans were in the middle of a war they couldn’t win in Vietnam, and audiences packed movie theaters to watch The Walking Dead destroy civilization as we know it.

The zombie archetype originates in Haiti, where a “zombie” is a figure stuck between life and death. These weren’t just the living dead, they were substitutes for loved ones. You recognized them, but they weren’t the real person, provoking a particularly disconcerting cocktail of familiarity and strangeness.

What happens in the brain?

In real life, neuroscientists have continued to investigate the organic causes of delusions through increasingly sophisticated diagnostic technologies such as magnetic resonance imaging (MRI) and have traced them in many cases to right temporal lesions in the brain. There is also a disconnection between the sensory areas of the brain and the limbic system, which is responsible for emotions and memory. This breaks a person’s emotional connection with the outside world and leads to a sense of unreality and delusions of death and negation.

In 2007, various receptor encephalitis caused by an ovarian tumor and associated with delusions were identified by Joseph Dalmau at the University of Pennsylvania. The growth triggers an autoimmune attack and there are certain brain cells that look like the embryonic cells in the ovary that are mistakenly treated as posing a similar threat and are also attacked. The resulting encephalitis inflames the right hemisphere of the brain and delusions result. Characteristic symptoms of this particular encephalitis include grunting and growling with convulsions, and may even help explain historical cases of “demonic possession.”

For many of the people in my book who were alive before the advent of new technologies, undiagnosed organic brain disease may have been part of the story along with any psychological dimension. Cotard recalled that on examination, Madame X “showed reduced sensitivity to pain in most areas of her body: for example, she would show no reaction when pricked with a pin.”

Could this be brain damage or disease?

Jules Cottard tried to cure Madame X, but his time ran out and he died of diphtheria at the age of 49. His patient reportedly starved to death. It’s a desperately sad outcome, but the notes recording her conversations with Kotar remain as evidence that beneath her strange faith is a real and complex woman worthy of attention and interpretation.