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Capgras syndrome or Capgras delusion is a neuropsychological condition in which the affected person thinks that a close acquaintance or a family member has been replaced by a similar imposter. Capgras is usually classified as a delusional disorder and it is quite uncommon. Some psychologists have referred to the Capgras syndrome as the “imposter syndrome” (Hirstein and Ramachandran, 2007).
The syndrome is named after Joseph Capgras who was the first psychologist to describe this condition. Capgras syndrome is usually common in people who are suffering from other psychotic disorders such as Schizophrenia, dementia, and brain injuries. The complexity of this syndrome presents a challenge to both the patient and the people around him/her.
Around psychology circles, Capgras is considered to be a rare neuropsychological condition (Ellis and Lewis, 2001). This paper will present an analysis of Capgras syndrome including its history, manifestations, possible causes, effects, and possible treatment methods.
Joseph Capgras was a psychiatrist of French origin who lived between 1873 and 1950. Capgras first described elements of this disorder in 1923 through a case study he conducted on a woman who claimed that her husband had been replaced by an identical imposter. Capgras and the co-author of this study first referred to the syndrome as “the illusion of doubles” (Fischer, Keeler and Schweizer, 2009).
Initially, Capgras syndrome was considered a symptom of schizophrenia that was exclusively manifested within the female population. After Capgras’s initial study of the condition, the subsequent studies were more psychoanalytical in nature. A breakthrough in the study of Capgras syndrome was made in the 1980s. This is when the syndrome was categorized as a neurological disorder after a series of studies.
Capgras syndrome can be manifested without any warning taking both the patient and his/her caregivers by surprise. For instance, an old woman who is experiencing symptoms of Capgras syndrome might react with shock one morning after thinking that the person ‘claiming’ to be her husband is an imposter.
This is in spite of the fact that she can still recognize her husband’s appearance and mannerisms. Even after being reassured by other family members, the woman can still believe that the family members are a part of the impersonation scheme. Patients suffering from Capgras syndrome might also feel that multiple members of their family have been systematically replaced.
The suspicions against this replacement might also extend to pets and other household objects. There are various documented cases of Capgras’s manifestation. One of these manifestations was through a sixty-five year old woman who had previously been diagnosed with Alzheimer’s disease. The manifestation included instances of the woman’s husband trying to get her to recognize him.
The woman responds by telling her husband that he “looks like” her husband but she knows “that he is not him” (Fischer, Keeler and Schweizer, 2009). The woman goes on to tell her husband that he is one of the two imposters that come around pretending to be her husband. This case represents a real life manifestation of Capgras syndrome.
Although cases of Capgras syndrome are most common among women, they have also been witnessed among men. In a 2002 case study, an “89-year-old man who had earlier been diagnosed with Lewy Body Dementia was discovered by security guards while trying to locate his other apartment” (Silva and Leong, 2010). The man believed that he had ‘two’ apartments that were ‘exactly alike’ but he only slept in one at night.
It is not exactly known what causes Capgras syndrome but psychiatrists have forwarded various theories on possible causes. All these theories have a viable level of credibility. The first theory asserts that Capgras syndrome is caused by a malfunctioning of the brain’s visual cortex and the emotions of familiarity (Ramachandran, 2007). According to this theory, the patient’s eyes see the actual image but the emotional interpretation of familiarity is faulty.
This is why the patients identify characters as “exact” imposters. This theory is cemented by the fact that sometimes brain injury victims with Capgras are able to indentify characters over the phone only for them to claim they are imposters when they meet them face-to-face. This scenario may suggest that sounds are more connected to the familiarity process of the brain than sights. One of the most probable causes of Capgras syndrome is brain injuries.
The connection between familiarity and Capgras syndrome suggests that the disorder is caused by the part of the brain that controls familiarity. This diagnosis makes Capgras a biological disorder. This syndrome should not be confused with Prosopagnosia. Prosopagnosia is a disorder that refers to an individual’s inability to recognize familiar faces (Ellis and Lewis, 2001). Unlike Prosopagnosia, Capgras syndrome involves total facial recognition.
Some neuropsychological disorders can be accompanied by symptoms that pose a danger to patients and those around them. Some instances of Capgras symptoms have resulted in violent behaviors or even death. This usually happens when the patient becomes violent towards his/her perceived imposters.
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However, instances of violent behaviors are minimal. In addition, the existing research on the subject does not provide enough information to enable psychologists to predict the instances of violent behavior. The available literature on the subject indicates that there are very few studies that have focused on the issue of danger and Capgras syndrome.
Recent literature on Capgras does not address the dangers associated with patients suffering from Capgras syndrome. Moreover, all the recorded cases of violence in people suffering from Capgras have been connected to pre-existing conditions such as Schizophrenia and bipolar disorders. According to psychologists, various factors should be put into consideration when assessing the dangers associated with Capgras syndrome (Silva and Leong, 2010).
The first of these considerations is the co-existing forms of delusions in patients suffering from Capgras syndrome. The psychiatrist should also consider the accessibility of the people that the patient considers as imposters because close proximity to these “imposters” might increase the instances of violence. The pre-existing emotional dynamics that act as predisposing factors of violence should also be considered when assessing the dangers associated with Capgras syndrome.
Psychiatrists Dohn and Crews (2006) believe that Capgras syndrome is not as rare as it is currently believed. This is why treatment and management of this disorder should be prioritized. Moreover, some psychologists believe there should be more public and professional awareness on this neuropsychological disorder.
People who are experiencing Capgras syndrome can be highly perplexed and disturbed by this condition. This is also true for the caregivers of these people (Fischer, Keeler and Schweizer, 2009). There are various documented ways of managing Capgras syndrome. The complexity associated with the management of this syndrome has to do with the fact that effective management practices are very disturbing for caregivers of those affected by Capgras.
Most caregivers tend to turn to practices that aggravate the symptoms of this disorder. Treatment options for Capgras syndrome are based on an individual patient’s requirements. The management of this disorder aligns with the general management of other dementia related conditions.
Habilitation Therapy is one of the practices that are effective in the management of Capgras. This therapy specifies three concepts that are helpful to patients including choosing not to argue or correct the patient, “entering the reality of the person with dementia”, and creating positive experiences emotionally (Fischer, Keeler and Schweizer, 2009).
Seeing the world through an affected person’s eyes enables caregivers to understand the needs of these patients. The caregivers should also avoid arguing or correcting a person with Capgras syndrome. It is always advisable to avoid constant confrontation by avoiding arguments.
Constant arguing could lead to feelings of resentment in both the affected person and his/her caregivers. The other specification of Habilitation Therapy is to keep supplying positive reassurances to the affected person. Effective management of Capgras involves connecting emotionally with the affected person. In some cases, therapeutic and psychotic drugs are used in the treatment process. Other psychiatrists use cognitive therapy to help patients manage their daily lives.
Capgras syndrome is a disorder that is closely related to dementia (Oulis, Dimitrakopoulos and Konstantakopoulos, 2012). Although it is a rare condition, the public needs to be educated about its manifestations, causes, and treatment options. There is lack of enough literature that focuses on the disorder’s relationship with violent behavior. Those affected by Capgras syndrome should seek psychological help with the assistance of their caregivers.
Dohn, H., & Crews, E. (2006). Capgras syndrome: a literature review and case series. Hillside J. Clinic Psychiatry, 8(1): 56-74.
Ellis, H., & Lewis, M. (2001). Capgras delusion: a window on face recognition. Trends in Cognitive Sciences, 5(4). 13-20.
Fischer, C., Keeler, A., & Schweizer, T. (2009). A rare variant of Capgras syndrome in Alzheimer’s disease. The Canadian Journal of Neurological Sciences, 36(4), 509-511.
Hirstein, W., & Ramachandran, S. (2007). Capgras syndrome: A novel probe for understanding the neural representation of the identity and familiarity of persons. Biological Sciences, 264(13). 437-444.
Oulis, P., Dimitrakopoulos, S., & Konstantakopoulos, G. (2012).
Capgras delusion in paranoid schizophrenia complicated by vascular dementia. Journal of Neuropsychiatry and Clinical Neurosciences, 24(3), 100-128.
Silva, A., & Leong, B. (2010). The Capgras syndrome in paranoid schizophrenia. Psychopathology, 25(3), 147-153.