He's having a mental breakdown it seems, he's talking to you unpacking his truama over what happened with Strade it seems to be eating away at him, the survivors guilt.

"I should have helped him! He was looking at me when h-he bled out and I couldn't move...all I could think about while he was begging for help was...was everything he did to me..I didn't think he deserved my help...when he died, I ate his heart because I thought.. I deserved it after everything..all I thought is, I deserved this don't I? I-i was so selfish...and I needed him I love him but I hate him so much.."