The second patient is a 39 year old American philosopher who has been epileptic since he was 18. The seizures stopped around 23 and his MRI looked normal. He described his ecstatic seizures as such:

“Everything would be joined together into one whole, as if every single thing in my surroundings were deliberately placed by an artist with the vividness which derived, not from any dramatic hallucination or visual “trick”, but from the fact that each object in my visual field was emphasized, so to speak, by everything else. When these boundaries are erased, a second phenomenon begins – all the ordinary facts about the environment seem suddenly to become infused with certainty and a sense of inevitability.”

Both patients had an enormous feeling of confidence and well-being, no rush and a feeling of time moving very slowly. So what exactly is happening in their brains?

In order for the mind to function clearly, the brain scans the environment and makes inferences about future states with “the greatest possible precision of certainty.” The brain in essence, predicts the future based on several variables to remain at optimal homeostasis. It dislikes uncertainty because the unavailability of information is negative and manifests as worry. Both patients’ main cognitive phenomenon was a sense of “clarification/certainty.” In other words, the brain was functioning at its peak.

Deep inside the brain, a region called the insula works to predict the future and allows for error-based learning. Activation in this area can generate

Emotional negative arousal or anxiety in case of anticipation of negative outcome, anticipation of uncertain outcome, or in case of mismatch between anticipated and actual state.

It has also been suggested that your “gut feeling” actually arises in your brain, in the insula. It is used when the brain doesn’t have enough information from the environment to make a decision. So the role of the insula is to “fill in” the gaps, in order to help make a decision. The info graphic below shows that after receiving the experienced outcome, the brain compares it with a prediction and generates prediction errors. It should be noted these mechanisms serve a valid purpose for adaptation – fire is hot, don’t touch. In the case of ecstatic seizures, the insula can no longer generate an error, which leads to --> unchanged prediction --> unchanged behavior – possibly leading to a long lasting blissful state. This implies adaptation is unnecessary for an enlightened state, or perhaps – the final step in adaptation.