Capgras Delusions: Living with an Imposter
By Samantha Giannelli
Imagine waking up one morning and not recognizing the person you are lying next to or going into the kitchen and not knowing the people who are gathered around the table. For some people, this situation is not merely something that would happen in far-fetched, fictional stories. It is their reality and something that they will experience firsthand. These are people who suffer from what is known as Capgras Delusions. These delusions consist of individuals suddenly believing their friends and family are strangers. One aspect of Capgras Delusions is that they do recognize the faces they are seeing; they just don’t believe that they are authentic. They think they are impostors!
It is awfully scary to think about this happening to you or someone you know. You may be wondering how on earth this could happen! There are a couple of things that can be the culprit of these delusions. Researcher Christiane Thiel suggests there are multiple causes of this syndrome that come together in a “perfect storm” causing these delusions. A large majority of people who have Capgras Delusions have abnormalities that include lesions within their right-sided frontal, temporal, or parietal regions of their brains, which can be found through the use of technologies that depict what is going on in the brain. PET (Positron Emissions Tomography) scans show the functioning of the brain, whereas CT (Computed Tomography) scans use images to look at the brain itself and the surrounding structures. The findings of these abnormalities may show similar characteristics to the brain of an individual with schizophrenia, which is why the actions of someone with this rare syndrome could be mistaken for similar neurological disorders. Thiel studied a middle-age mother named Mary who’s life literally is turned upside-down.
Mary experienced an episode of Capgras Delusions while picking her young daughter Sarah up from school one day. Mary was convinced that the little girl she was picking up was not, in fact, her daughter, but someone who looked exactly like her playing the role of her daughter. In other words, she believed this girl was an “imposter” of Sarah and that her “real” daughter had been taken and replaced!
Not only did Mary believe this delusion but she also experienced other episodes. Mary once believed her daughter, Sarah, had a twin whose birth was never recorded; leading her to believe once again that Sarah was not her true self. Mary’s delusions also included impossible situations with her daughter. For example, in the passenger seat of a car with an unknown driver. After experiencing such delusions of her own daughter being taken by strangers or having imposters of her, it is easy to assume she may become aggressive or violent. Although Mary has yet to become violent in these situations, many people who experience Capgras Delusions are quick to have their fears turn violent.
Individuals who experience this syndrome may become a danger to themselves and others. For example, one may attack the person involved in their delusions. Although in their mind, it comes across as self-defense in a fight or flight mindset, it becomes dangerous because their experiences are in fact only delusions. There are many ways of coping with these delusions which can include prescription medication and other therapeutic approaches. These are things that Mary has experimented with.
Mary has been prescribed medications to try and subside these delusions that she has about her daughter, but she has seen no success with this approach. Her daughter is now not allowed to be in her custody until her mom is no longer a danger. There is no standard for treating Capgras Syndrome. Different approaches may work from person to person because causes can be very different. Some other approaches to treat this have been with antipsychotics therapy and cognitive behavioral therapy. The approach of antipsychotic therapy is when the individual takes medications similar to what a schizophrenic patient may take in the hope to subdue these delusions. Cognitive-behavioral therapy involves the person with delisions to try to change their thinking and then their behavior. This is a rare and unusual thing to happen to people and we are only just beginning to know how to treat and go about dealing with this syndrome.
Resources
CT Scan. Mayo Clinic. Retrieved from: https://www.mayoclinic.org/tests-procedures/ct-scan/about/pac-20393675
Thiel, C. M., Studte, S., Hildebrandt, H., Huster, R. & Weerda R. (2014). When a loved one feels unfamiliar: A case study on the neural basis of Capgras delusion, Cortex, 52, 75-85, https://doi.org/10.1016/j.cortex.2013.11.011 .
What is Cognitive Behavioral Therapy? American Psychological Association. Retrieved from: https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral
What is a PET Scan? Healthline. Retrieved from: https://www.healthline.com/health/pet-scan