Clones, psychics and the Antichrist
MARK GReeneR asks what light delusional misidentification syndromes might shed on fortean phenomena
The clones, operating under the influence of the psychics, wanted to chase him from his apartment. The psychics had even replaced the three people who ran the building with clones. So, he stabbed them to death. Another man was admitted to a psychiatric unit upset because other people couldn’t accept that he was the Antichrist – but the government knew. Then there’s the case of the 44-yearold man who, following a brain injury, became convinced that substitutes had replaced his wife and five children.
All these are manifestations of the so-called ‘delusional misidentification syndromes’ (DMS), a psychiatric classification that might help explain some possessions, doppelgängers and even alien abductions. And these dramatic, poorly understood and enigmatic conditions are more common than you might expect. Fregoli and Capgras syndromes are the best studied DMS. Fregoli is, essentially, a delusion of over-familiarity. People with Fregoli syndrome typically believe that someone else changes his or her appearance or is in disguise. The syndrome’s name commemorates Leopoldo Fregoli, a famous quick-change artist who performed around the turn of the 20th century. Fregoli could switch costumes and characters so rapidly that people claimed that there were several ‘Fregolis’.
In 1927, two clinicians, Courbon and Fail, reported that a 27-year-old woman believed that the actresses Sarah Bernhardt and Robine, whom she often saw at the theatre, “pursued her closely”. Bernhardt and Robine used numerous disguises and took the appearance of “people she knows or meets”. She believed, for example, that Robine regularly pretended to be her neighbour. The woman was admitted to hospital after attacking a person in the street. But she believed that Bernhardt and Robine, disguised as nurses, forced her to masturbate.
Capgras syndrome (see FT123:14, 133:16 and this month’s Necrolog, p24) is the converse: a delusion of under- familiarity. In June 1918, a woman who insisted on being called ‘Mathilde de Rio-Branco’ (not her real name) was admitted to a shelter for the mentally disturbed in Paris. She claimed that bandits had kidnapped several children, which they were holding prisoner in her cellar, where she could hear them whimpering. The following year, she told her psychiatrist Joseph Capgras that doppelgängers had replaced her husband and daughter. She filed for divorce, although ‘de Rio-Branco’ also claimed her marriage documents were forged. ‘Madam de Rio-Branco’ had a long history of delusions. For example, she said her mother was a descendent of Henri IV. She also said that her father had told her on his deathbed that he had stolen her from a wealthy family when she was 15 months old. She was the heir to mines in Argentina, all of Rio de Janeiro, and 75 houses in France. But these had been stolen from her. She saw doppelgängers all around her – nurses, patients, doctors – but only of people she already knew, never strangers. In other words, she recognised, but could not identify, the people and assumed they were doppelgängers.
Capgras and his assistant ReboulLachaux described the condition in 1923 as l’illusion des sosies (the illusion of doubles). People with Capgras syndrome believe that an imposter has replaced a close friend or relative. Even blind people can suffer from Capgras: a woman believed her ‘real’ husband was heavier and smelt different. Similarly, a German woman believed her daughter, who had emigrated to the USA, had been replaced, based on telephone calls alone. Although his book reflects the rampant paranoia that gripped the USA during the 1950s, Jack Finney evokes Capgras syndrome perfectly in his Invasion of the Body Snatchers: “She was perfectly sure her husband wasn’t her husband at all… he looked, talked, and acted exactly the way her husband always had” but “it simply wasn’t him”.
Psychiatrists now recognise numerous other DMS, some of which seem to overlap and might evolve into each other. Indeed, one in 10 patients have Capgras and Fregoli simultaneously and about a third experience delusions about a person and a place. For example, people experiencing a type of DMS called “environmental reduplication” insist that an unfamiliar environment (such as a hospital room) is really in or near a place that is important to them, often their home. In other cases, a person with DMS can feel the house has been replaced. An elderly woman who survived a stroke clung to a delusion that her house was not her ‘real’ home. Sometimes she packed her belongings to set off for her ‘real’ house.
DMS seem to be relatively common, at least among some patients. One
study estimated that about one person in every 1,000 experiences Capgras syndrome, for example. The rate is especially high in patients with certain psychiatric and neurological conditions including schizophrenia, where 15 per cent seem to experience a DMS, Alzheimer’s disease (20-30 per cent) and Lewy body dementia (17 per cent).
DMS also go some way to accounting for fortean phenomena – although they are not the only explanation, of course – including certain cases of lycanthropy and possession. In 1978, a 56-year-old woman “behaved like a wild dog” and later developed Capgras syndrome. A 49-year-old man was admitted to a US psychiatric hospital “feeling despondent” because others did not acknowledge that he was the Antichrist. At 36 years old, “he ‘realised’ that he was the Antichrist and began to recall his previously forgotten psychological identity”. The man also “believed that the government feared his power as the Antichrist” and implanted an electronic monitoring device in his head. His doctors felt that the delusion was “consistent with a DMS.”
Closer to home, doctors from Northern Ireland reported a 44-yearold man who presented with Fregoli syndrome and believed that he and a female friend shared the same body – a type of DMS called delusional hermaphroditism. DMS patients who develop a condition called ‘asomatognosia’ lose their recognition or awareness of parts of their body. So, they might believe that the doctor owns one of their limbs or speak of ‘‘my dead husband’s hand’’.
An outsider, without the benefit of modern psychiatric insights, could easily conclude that a person who believes that they are the Antichrist, shares a body or has a replaced body part, is possessed. A person with Capgras believes ‘something’ has replaced a loved one, which again could be interpreted as possession. Indeed, Capgras patients often regard the misidentified person with suspicion, which might evolve into paranoia and aggression. In one study, three in five (61 per cent) DMS patients had attacked someone else.
Although there are numerous examples in the medical literature, DMS has proved difficult to explain. Some delusions seem to be defensive: the person projects negative aspects of themselves onto an external ‘other’. (I wonder if the original case of Fregoli syndrome was projecting her frustrated and repressed sexuality.) In other cases, a person may replace a stressful environment – a hospital, for example – with a safe place, such as their place of work or home.
Arguably, this aspect of DMS could help account for some alien abductions. Perhaps some abductees project something they dislike – their frustration and anxieties, for example – onto an external environment, creating the delusion of the UFO. Interestingly, ‘Madam de Rio-Branco’ believed that people in a network of underground operating theatres under Paris were mutilating the city’s inhabitants: replace cellars with UFOs and mutilation for implants, and this sounds familiar. Indeed, in some cases of Capgras the person is under the delusion that a robot or an alien has replaced the loved one. One person in Missouri believed an alien had replaced his stepfather, so he beheaded him to search for batteries and microfilm.
Another suggestion proposed that a person with DMS might not be able to integrate memories and experiences. So, they don’t recognise when something is familiar and, in response, generate delusional doubles. Yet another explanation held that the parts of the brain that process and store memory become disconnected, so new information is not linked to previous memories. This, in turn, leads to duplication. Several researchers linked DMS to brain damage that generates ‘faulty information’. Other parts of the brain attempt to interpret this faulty information. The discordance between the two leads to DMS. For example, when an injured area cannot produce the appropriate emotional response to a patient’s spouse, the other part concludes there is an imposter. Essentially, the damage allows an abnormal perception to go unchallenged by another brain area.
Until recently, many researchers believed that damage to two parts of the brain was needed to account for DMS: one to generate the error and one to allow the delusion to pass unchallenged. But each part of the brain connects to many others. A recent study found that a single hit in an area that is linked to regions involved in familiarity is enough to generate DMS. This study found that pattern of connectivity was consistent across cases of Fregoli and Capgras, as well as misidentifications involving different categories of objects (e.g. people versus places). This might explain why the same person can develop different forms of DMS.
Finally, the findings can help understand human behaviour – including how we interpret reality. Fregoli and Capgras are devastating and dramatic diseases. But what happens when one part of the brain generates a less dramatic error that passes unchallenged? Would we even notice? Someone who can really feel that their home isn’t their home or that their loved ones have been replaced is, perhaps, at one end of a spectrum. What if this happens in more subtle ways with less marked damage? DMS show, too, that memory isn’t as infallible as we like to think. What does this say about the relationship between our internal mental state and the outside world? DMS show just how fragile our grip on reality really is.