Capgras Syndrome

This would be very scary to have. You believe that people around you have been replaced with duplicates.

The disorder was first described in 1923 by the French psychiatrists Joseph Capgras and Jean Reboul-Lachaux. They treated a 53-year-old who believed that her husband, her children, her neighbors and even she had been replaced by exact “doubles” in a plot to steal her property.

In Capgras, there is an uncoupling of perception and recognition that leads many investigators to theorize that there may be a neurological, organic cause that remains unknown. Psychoanalysts have seen Capgras as an unusual form of displacement in which the patient rejects the loved one whenever negative features have to be attributed.

Yet guilt and ambivalence prevent the patient from becoming conscious of the rejection. The bad feelings are displaced to a double, who is an impostor and may safely be rejected. Anna Freud thought this delusion allowed patients to defend themselves against loss and distress about changes in close relationships.

After resuming her medicine, my patient quickly lost her belief that her husband, parents and psychiatrist were doubles. When she was healthy enough to return to outpatient treatment, I asked whether she had ever seen the movie “Invasion of the Body Snatchers.” She said no.

I thought I’d better not explain the plot to her.