I think it depends. Part of it is definitely your “social predictor” turning on without being around others. But I often wonder if part of it is just thoughts - they’re things made up of cells (neurons) so they are organisms in their own right (and some theories suggest they compete with one another for your attention)

Most people are desensitized to this, some psychosis is the desensity breaking. Perceiving your thoughts as beings independent of yourself.