This paper explores the creation of (a sense of) reality in Richard Powers’ 2006 novel The Echo Maker and Jean Baudrillard’s theory of simulacra, especially as that latter is applied by Kevin Casper to the 2010 movie Jackass 3D. The focus is on neurology, or perhaps neurophilosophy, rather than literary criticism or film studies, or even Baudrillard’s cultural theory: the various cultural texts are interrogated for what their explicit and implicit neurological theories can tell us about how we “realize” (organize, make real) our selves and/ in the world. Key in this process, the paper shows, are “fiction” for Powers (as it arises out of ubiquitous human “confabulation” as an attempt to impose coherence on the self and the world) and “simulacra” for Baudrillard; both become primary channels of social construction. The Capgras Delusion, which Powers places at the center of his novel, is especially useful in its tracking of the effects damage to our emotional circuits has on the creation of a sense of reality; Powers even seeks to universalize Capgras as a general human failure to accept the kinship of all living things, or what Arne Naess calls “the Self-realization of the ecological self.” This universalized deficit is close enough to Baudrillard’s (faux?-)apocalyptic conception of simulacra subsuming reality into virtuality in postmodernity to make it a useful test for Baudrillard’s jeremiads. Ultimately the paper moves in the direction of icosis as the somatic group plausibilization of normative opinion.