Ecstatic epilepsy is a rare form of focal epilepsy linked to the anterior insula in which patients experience a blissful state with a unique set of symptoms, including a feeling of physical well-being, mental clarity, a sense of oneness with the universe, and time dilation. In this chapter, we reflect on how these symptoms coincide with our current knowledge of the insula’s functions and explore how this stunning natural model can further inform our understanding of the insula’s role in the sentient self, uncertainty and surprise monitoring, and metacognitive feelings.