Academic journal article The Journal of Mind and Behavior

Which Identification Is Disturbed in Misidentification Syndromes? A Structural Analysis of Fregoli and Capgras Syndromes

Academic journal article The Journal of Mind and Behavior

Which Identification Is Disturbed in Misidentification Syndromes? A Structural Analysis of Fregoli and Capgras Syndromes

Article excerpt

In current psychiatric literature, Fregoli and Capgras syndromes are seen as rare psychotic syndromes. Together with intermetamorphosis and the syndrome of subjective doubles, they are part of the group of Delusional Misidentification Syndromes (DMS) and are considered a disturbance in recognizing or identifying people, the two terms being employed as synonyms. We question the implicit assumption that has allowed, on the one hand, to characterize Capgras and Fregoli syndromes as recognition disorders and, on the other hand, to classify them as misidentification syndromes. From a psychoanalytic point of view, the assumption that identification and recognition are identical processes is in fact far from being self-evident. In claiming that the very same persecutor is disguised as many different people, or that persecutors have taken on the appearance of the patient's relatives, Fregoli and Capgras sufferers clearly show us that recognition and identification are two separate processes. Although the same analysis could easily be applied to intermetamorphosis and the delusion of subjective doubles, the present paper will focus on the Fregoli and Capgras delusions. The question of the significance of delusional misidentifications has been addressed by Cutting (1991) and Margariti and Kontaxakis (2006), who proposed that the common feature of DMSs (whether or not they involve recognition of people) was a disorder of identity or uniqueness. In the present paper, we show that the perception of the "uniqueness" of persons or objects depends on complex relations between recognition and identification.

Fregoli and Capgras syndromes were described by French psychiatrists in the 1920s under the generic term of false-recognition illusions of the insane ( illusions défaussé reconnaissance des aliénés).1 This terminology was used to differentiate the disorders from, on the one hand, ordinary false recognition - i.e., mistaking a person for somebody else due to an error or absent-mindedness - and, on the other hand, neurological deficits, for example, those affecting memory. While Capgras considered these disorders as manifestations of what he called "systematic misrecognition" (méconnaissances systématiques), the term "false recognition" (fausses reconnaissances) has mainly prevailed. Three syndromes became nosographie references: the syndrome d'illusion des sosies or syndrome of subjective doubles (Capgras and Reboul-Fachaux, 1923), the syndrome d'illusion de Fregoli or Fregoli syndrome (Courbon and Fail, 1927) and finally, the syndrome d'intermétamorphose or intermetamorphosis syndrome (Courbon and Tusques, 1932). The departure point for the work of these psychiatrists was Capgras's description of a symptom he found in one of his patients, Mrs. M., who suffered from persecution megalomania.

The patient maintained that her children had been stolen, hidden in the underground of Paris, and that her husband and her daughter had been replaced by multiple sosies. These sosies looked like her relatives but there were small differences. The case observation yielded other important elements. The patient gave herself a variety of proper names; she claimed that she was called Madame de Rio-Branco and was a descendant of numerous prestigious figures from a range of historical eras. With such a glorious ancestry, Mrs. M. also had an enormous fortune and throughout the centuries had given birth to an extraordinary number of children, all of whom had been stolen from her, replaced by doubles and hidden in mysterious places. In case that she herself might be replaced by a double, the patient wrote a description supposed to allow people to recognize her. This description involved a few anthropometric indices, but the patient mostly described her clothes with various details, her habits (for example, that she was normally accompanied by her daughter), and gave her address. To characterize Mrs. M.'s most striking symptom - her belief that her close relations had been replaced by sosies - Capgras coined a new term, agnosie d'identification (identification agnosia); the term was not used outside the context in which it was introduced. …

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