Capgras\u27 Syndrome

Abstract

Capgras\u27 Syndrome, the delusion of doubles, is a rare delusional phenomenon in which a person believes that identical doubles have replaced significant people in his life and/or that there exist identical doubles of himself. These delusional doubles are almost always believed to be malevolent. The delusion occurs in a variety of psychotic states, usually schizophrenia. It occurs in both women and men in a wide age range. This dissertation reviews early French reports by Capgras and his associates as well as over 100 cases reported in English. Previous efforts to explain the Syndrome have stressed both organic and psychodynamic factors. The Syndrome has been observed with many organic conditions, but the allegation of doubles is selective, the problem is not misrecognition but belief, thus psychodynamic factors must be significant. Psychodynamic explanations have emphasized four major themes: Oedipal problems in women, feelings of strangeness, intolerble ambivalence, and pathological splitting. An approach to the delusion based on object relations theory seems most comprehensive, because it is the manner in which images of self and others are internalized that appears to underlie the delusion. For Capgras\u27 Syndrome to develop there must be paranoid characteristics, a psychotic state, and, I suggest, severe disturbances in early internalized object relations. The case presented here illustrates the application of an object relations approach to the history of a 32 year old woman who believed that her mother, uncle, and cousin (her only living relatives) had been replaced by doubles and that there were two doubles of herself. This woman experienced inadequate mothering in infancy, became an isolated and aloof adolescent, and suffered the onset of a schizophrenic illness in her mid-twenties, just after completion of medical school. Capgras\u27 Syndrome is a frightening yet uncannily familiar phenomenon. The idea of doubles has long had a place in human religion and literature, and to make the Syndrome more comprehensible and thus more treatable it is appropriate to examine the use of the idea of doubles in fiction. It is also useful to build a continuum from the psychotic delusion of doubles through the neurotic family romance toward a recognition of similar dynamics in normal life