“My 30-year-old son thinks that I am not his father, that I am an impostor. He says the same thing about his mother, that we are not his real parents. We just don’t know what to do or where to go for help.” (Ramachandran)
Such was the bleak despair in the tone of Arthur’s father, who, on one fine afternoon had decided to ring up the laboratory of Dr. V. S. Ramachandran, hapless as he was about his son’s condition. His son Arthur was a thirty-year-old survivor of a car crash, an incident which had left him with a peculiar delusion – he thought his parents were imposters, who were trying to dupe him by presenting themselves as his mother and father.
Dr. Ramachandran’s interest was piqued. He agreed to meet them at his laboratory, and after breaking the ice through the initial conversation, he asked him simply – “Arthur, who brought you to the hospital?”
“That guy in the waiting room,” Arthur replied. “He’s the old gentleman who’s been taking care of me.”
“You mean your father?”
“No, no, doctor. That guy isn’t my father. He just looks like him. But I don’t think he means any harm.”
Such was the case of Arthur – one of those rarest holders of the Capgras Delusion. Named after French psychiatrist Joseph Capgras, the first documented case of the syndrome dates back to 1923, when a quinquagenarian woman presented to Joseph Capgras and Jean Reboul-Lachaux with a particular dilemma. She was under the impression that a conspiracy to steal her inheritance was brewing under her nose, and a few imposters who had replaced her husband, children, and a lot of other people in her life, were the perpetrators of it.
Capgras is a bizarre delusion – one would expect such a condition to arise from a diseased mind, but funnily enough, a huge chunk of the patients present with a history of trauma or some other organic pathology in the brain. The initial Freudian explanation that was used to dismantle and understand the syndrome, has been replaced by a more scientifically sound, albeit less colorful explanation. The limbic system of the brain is concerned with the perception of emotions – it is wired through neural circuitry to receive a signal from the visual regions of the temporal lobe, which reach it after passing through its ‘gateway’ or the amygdala. The limbic system, after thorough analysis, interprets this visual input that it gets. The hypothesis proposed by Ramachandran and Hirstein, says that the dilemma in Capgras arises out of a disconnection between the face-recognition area of the temporal lobe and the limbic system; and thus, despite being able to recognize the person’s face, the patient is unable to fathom the depth of the emotional attachment that he shares with him.
If viewed through the Freudian lens, Capgras could be described by taking cues from the Oedipus complex, which suggests that male children feel a strong sexual attraction to their mothers in the earlier parts of their life, and a strong sense of jealousy towards their fathers, who is considered to be a sexual rival in this equation. These desires which mostly become latent, are unhinged when the patient injures his head. The shame and repulsion that he feels from such thoughts, thus lead him to claim that since he is harbouring such thoughts for his mother, she definitely has to be someone else (or, an imposter!). As intriguing as this might sound, the Freudian perspective has been contradicted by more scientifically sounder ones.
Unfortunately, except for treating the underlying causes of the delusion, specific treatment options for Capgras are limited. As it stands today, validation therapy and reality orientation techniques are used to calm the patient. In case of the former, the patient is made to believe that the illusion is actually true – this alleviates the constant anxiety that is accompanied along with it. The latter, as the name suggests, focusses on spatially and temporally rehabilitating the person to his surroundings. In the absence of more definitive treatment options, therapy helps.
Family is the foundation – it is from where our emotional needs are satiated. When that foundation becomes tremulous, the anguish accompanied with it is overbearing. For a person afflicted with Capgras, the sense of unfulfilment is immense. Arthur, once asked his mother – “Mum, if the real Arthur ever returns, do you promise that you will still treat me as a friend and love me?” The question lingers.
- Ramachandran, V S. “The Unbearable Likeness of Being.” The Independent, Independent Digital News and Media, 22 Nov. 1998, www.independent.co.uk/arts-entertainment/the-unbearable-likeness-of-being-1186663.html.
- Ramachandran, V. S. “Consciousness and Body Image: Lessons from Phantom Limbs, Capgras Syndrome and Pain Asymbolia.” Philosophical Transactions of the Royal Society B: Biological Sciences, vol. 353, no. 1377, 1998, pp. 1851–1859., doi:10.1098/rstb.1998.0337.
- “Capgras Syndrome: Causes, Treatment, and Caregiving.” Healthline, Healthline Media, www.healthline.com/health/capgras-syndrome#coping.