Skip to main content
SpringerLink
Log in

Beliefs, experiences and misplaced being: an interactionist account of delusional misidentification

  • Published:
Phenomenology and the Cognitive Sciences Aims and scope Submit manuscript

    We’re sorry, something doesn't seem to be working properly.

    Please try refreshing the page. If that doesn't work, please contact support so we can address the problem.

Abstract

This paper contrasts an interactionist account of delusional misidentification with more traditional one- and two-stage models. Unlike the unidirectional nature of these more traditional models, in which the aetiology of the disorder is said to “progress” from a neurological disruption via an anomalous experience to a delusional belief, the interactionist account posits the interaction of top-down and bottom-up processes to better explain the maintenance of the delusional belief. In addition, it places a greater emphasis on the patient’s underlying phenomenal experience in accounting for the specificity of the delusional content. The role played by patient phenomenology is examined in light of Ratcliffe’s recent phenomenological account. Similarities and differences are discussed. The paper concludes that a purely phenomenological account is unable to differentiate between non-delusional patient groups, who have what appear to be equivalent phenomenal experiences to patients suffering from delusional misidentification but without the delusional belief, and delusional groups, something the interactionist model is able to do.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Notes

  1. I acknowledge that, with regard to the DSM-IVR classification, the Cotard delusion is not classified as a form of delusional misidentification; nevertheless, I include it under the umbrella term used here for two reasons. First, it is often discussed in relation to other disorders that are classified as forms of delusional misidentification (such as the Capgras and Frégoli delusions): discussion often centring on the varying degrees of similarity the Cotard delusion shares with these other disorders in terms of aetiology, phenomenology and applicability of explanatory models (see Devinsky 2009; Ellis et al. 1994; Marková and Berrios 1994; Weinstein 1994; Young et al. 1994). Second, and more importantly, it is my contention that misplaced being is a form of misidentification that results from a conflict in recognition. When misplaced being occurs in conjunction with delusional beliefs, then the patient undergoes a form of delusional misidentification (of self, in the case of the Cotard delusion), irrespective of any lack of established clinical classification to that effect.

  2. The Capgras delusion was first reported by Capgras and Reboul-Lachaux (1923), Frégoli delusion by Courbon and Fail (1927) and Cotard delusion by Cotard (1882).

  3. Cognitive models of delusional misidentification are typically concerned with the nature of the cognitive deficit/bias that produces the delusional belief. Such models have little to say about disruption that occurs at the neurological level; consequently, this disruption is not a feature of the model itself but, rather, is presumed to occur (I thank the anonymous reviewer for drawing my attention to this point). Nevertheless, even if not a feature of the model itself, some form of neurological disturbance must be acknowledged implicitly by the aforementioned presumption, leaving the original elements (1–3) valid.

  4. The problem of specificity would also have to be overcome if conjecturing that the delusional belief is the result of a disruption in subpersonal processes that cause directly the delusional belief, thereby by-passing the need for any anomalous experience (I thank the anonymous reviewer for this suggestion). It is not clear how the specificity of the delusional content can stem from a disruption in one’s subpersonal processing, however. What specific area of the brain could be damaged, or what level of neurochemical imbalance could produce subpersonal processing anomalies that target one’s wife or loved ones, specifically, to the effect that they are believed to be impostors (for example)? Surely, this would be on par with positing that damage to Broca’s areas (or somewhere similar) could lead to one not being able to use language effectively when directed towards one’s family but which, nevertheless functioned perfectly well on all other occasions

  5. Although this is a testable hypothesis, to the best of my knowledge, no studies have been carried out to measure the SCR of Frégoli patients.

  6. Young (1999) notes that there have been reports of Capgras patients who claim to perceive differences in the impostor. However, when pressed on what exactly these differences are, they have difficulty pointing them out.

  7. This would help explain why some Cotard patients claim not to be dead but to be immortal or to have been resurrected. These claims are also compatible with a state of being one has never encountered before and is therefore unfamiliar with (Young, under review).

  8. Here, absence of physical recognition should not be understood as necessarily meaning failure of physical recognition. When in the presence of strangers, one would not expect to physically recognise them, and in fact, one may even recognise that they are physically unfamiliar.

  9. Adapted from Young (2010).

  10. The word “tartling”, we are told by Cleary and Specker, has its roots in the Scottish language.

  11. JR presented with damage to the left hemisphere (the lateral temporo-occipital junction).

  12. However, Rapcsak et al. (1999) did report that their patient might claim not to have available further information about the (misrecognised) individual, or extrapolate further and compound the mistake.

  13. Staton et al. (1982) in a not too dissimilar way implicate disruption in the memory process—between stored representations and new perceptions—in their explanation of delusional misidentification.

  14. Estrangement is defined by the Oxford pocket dictionary as a turning away, in terms of feeling or affection, of one person from another (a definition compatible with a loss of appropriate emotional orienting evident in the Capgras patient, I suggest).

  15. Based on Bayes’ theorem: Incoming information is interpreted in light of prior expectation (taken from Corlett et al. 2009, p. 516).

  16. Or it may be extended to incorporate other delusional states—see Startup et al. (2009) for a discussion on delusions of reference.

References

  • Bauer, R. M. (1984). Autonomic recognition of names and faces in prosopagnosia: a neuropsychological application of the guilty knowledge test. Neuropsychologia, 22, 457–469.

    Article  Google Scholar 

  • Bermúdez, J. L. (2001). Normativity and rationality in delusional psychiatric disorder. Mind and Language, 16(5), 457–493.

    Article  Google Scholar 

  • Breen, N., Caine, D., & Coltheart, M. (2000). Models of face recognition and delusional misidentification: A critical review. Cognitive Neuropsychology, 17(1/2/3), 55–71.

    Article  Google Scholar 

  • Brighetti, G., Bonifacci, P., Borlimi, R., & Ottaviani, C. (2007). Far from the heart far from the eye: Evidence from the Capgras delusion. Cognitive Neuropsychiatry, 12(3), 189–197.

    Article  Google Scholar 

  • Campbell, J. (2001). Rationality. Meaning and the analysis of delusion. Philosophy, Psychiatry, and Psychology, 8(2/3), 89–100.

    Article  Google Scholar 

  • Capgras, J., & Reboul-Lachaux, J. (1923). L’illusion des ‘soises’ dans un délire systématisé chronique. Bulletin de la Société Clinique de Médicine Mentale, 11, 6–16.

    Google Scholar 

  • Cleary, A. M., & Specker, L. E. (2007). Recognition without face identification. Memory & Cognition, 35(7), 1610–1619.

    Article  Google Scholar 

  • Coltheart, M. (2007). The 33rd Sir Fredrick Bartlett Lecture. Cognitive neuropsychiatry and delusional belief. The Quarterly Journal of Experimental Psychology, 60(8), 1041–1062.

    Article  Google Scholar 

  • Corlett, P. R., Frith, C. D., & Fletcher, P. C. (2009). From drugs to deprivation: A Bayesian framework for understanding models of psychosis. Psychopharmacology, 206(4), 515–530.

    Article  Google Scholar 

  • Cotard, J. (1882). Du de´lire des négations. Archives de Neurologie, 4, 152–170.

    Google Scholar 

  • Courbon, P., & Fail, G. (1927). Syndrome “d’illusion de Frégoli” et schizophrenie. Annales Médico-Psychologiques, 85, 289–290.

    Google Scholar 

  • Davies, M., & Coltheart, M. (2000). Introduction to pathologies of belief. Mind and Language, 15(1), 1–46.

    Article  Google Scholar 

  • Davies, M., Coltheart, M., Langdon, R., & Breen, N. (2001). Monothematic delusions: Towards a two factor account. Philosophy, Psychiatry, and Psychology, 8(2/3), 133–158.

    Article  Google Scholar 

  • Devinsky, O. (2009). Delusional misidentifications and duplications: Right brain lesions, left brain delusions. Neurology, 72, 80–87.

    Article  Google Scholar 

  • Ellis, H. D., & Young, A. W. (1990). Accounting for delusional misidentification. The British Journal of Psychiatry, 157, 239–248.

    Article  Google Scholar 

  • Ellis, H. D., Luauté, N. P., & Rettersøl, N. (1994). Delusional misidentification syndromes. Psychopathology, 27, 117–120.

    Article  Google Scholar 

  • Ellis, H. D., Young, A. W., Quayle, A. H., & de Pauw, K. W. (1997). Reduced autonomic responses to faces in Capgras delusion. Proceedings of the Royal Society: Biological Science, B264, 1085–1092.

    Article  Google Scholar 

  • Fine, C., Craigie, J., & Gold, I. (2005). Damned if you do; damned if you don’t: The impasse in cognitive accounts of Capgras delusion. Philosophy, Psychiatry, and Psychology, 12(2), 143–151.

    Google Scholar 

  • Gerrans, P. (2000). Refining the explanation of Cotard’s Delusion. Mind and Language, 15(1), 111–122.

    Article  Google Scholar 

  • Gerrans, P. (2002). A one-stage explanation of the Cotard delusion. Philosophy, Psychiatry, and Psychology, 9(1), 47–53.

    Article  Google Scholar 

  • Greve, K. W., & Bauer, R. M. (1990). Implicit learning of new faces in prosopagnosia: An application of the mere exposure paradigm. Neuropsychologia, 28, 1035–1041.

    Article  Google Scholar 

  • Heims, H. C., Critchley, H. D., Dolan, R., Mathias, C. J., & Cipolotti, I. (2004). Social and motivational functioning is not critically dependent on the feedback of autonomic responses: Neuropsychological evidence from patients with pure autonomic failure. Neuropsychologia, 42, 1979–1988.

    Article  Google Scholar 

  • Hirstein, W., & Ramachandran, V. S. (1997). Capgras’ syndrome: A novel probe for understanding the neural representation of the identity of familiarity of persons. Proceedings of the Royal Society: Biological Sciences, B246, 437–444.

    Article  Google Scholar 

  • Hohwy, J. (2004). Top-down and bottom-up in delusion formation. Philosophy, Psychiatry, and Psychology, 11(1), 65–70.

    Article  Google Scholar 

  • Hohwy, J., & Rosenberg, R. (2005). Unusual experiences, reality testing, and delusions of alien control. Mind and Language, 20(2), 141–162.

    Article  Google Scholar 

  • Klee, R. (2004). Why some delusions are necessarily inexplicable beliefs. Philosophy, Psychiatry, and Psychology, 11(1), 25–34.

    Article  Google Scholar 

  • Leeper, R. (1935). A study of a neglected portion of the field of learning—The development of sensory organization. The Journal of Genetic Psychology, 46, 41–75.

    Google Scholar 

  • Mabuchi, N., Hirayama, M., Koike, Y., Watanabe, H., Ito, H., Kobayashi, R., et al. (2010). Progression and prognosis in pure autonomic failure (PAF): Comparison with multiple system atrophy. Journal of Neurology, Neurosurgery and Psychiatry, 76, 947–952.

    Article  Google Scholar 

  • Magnifico, F., Misra, V. P., Murray, N. M. F., & Mathias, C. J. (1998). The sympathetic skin response in peripheral autonomic failure—Evaluation in pure autonomic failure, pure cholinergic dysautonomia and dopamine-beta-hydroxylase deficiency. Clinical Autonomic Research, 8, 133–138.

    Article  Google Scholar 

  • Maher, B. A. (1974). Delusional thinking and perceptual disorder. Journal of Individual Psychology, 30, 98–113.

    Google Scholar 

  • Maher, B. A. (1988). Anomalous experience and delusional thinking: The logic of explanations. In T. F. Oltmanns & B. A. Maher (Eds.), Delusional beliefs (pp. 15–33). New York: Wiley.

    Google Scholar 

  • Maher, B. A. (1999). Anomalous experience in everyday life: Its significance for psychopathology. Monist, 82(4), 547–570.

    Google Scholar 

  • Mandler, G. (1980). Recognizing: The judgement of previous occurrence. Psychological Review, 87, 252–271.

    Article  Google Scholar 

  • Marková, I. S., & Berrios, G. E. (1994). Delusional misidentification: Facts and fancies. Psychopathology, 27, 136–143.

    Article  Google Scholar 

  • McLaughlin, B. P. (2009). Monothetic delusions and existential feelings. In T. Bayne & J. Fernández (Eds.), Delusion and self-deception: Affective and motivational influences on belief formation (pp. 139–164). New York: Psychology.

    Google Scholar 

  • Pacherie, E. (2009). Perception, emotion, and delusions: The case of the Capgras delusion. In T. Bayne & J. Fernández (Eds.), Delusion and self-deception: Affective and motivational influences on belief formation (pp. 107–125). New York: Psychology.

    Google Scholar 

  • Ramachandran, V. S., & Blakeslee, S. (1998). Phantoms in the brain: Human nature and the architecture of the mind. New York: William Morrow.

    Google Scholar 

  • Rapcsak, S. Z., Polster, M. R., Comer, J. F., & Rubens, A. B. (1994). False recognition and misidentification of faces following right hemisphere damage. Cortex, 30, 565–583.

    Google Scholar 

  • Rapcsak, S. Z., Reminger, S. L., Glisky, E. L., Kaszniak, A. W., & Comer, J. F. (1999). Neuropsychological mechanisms of false facial recognition following frontal lobe damage. Cognitive Neuropsychology, 16(3/4/5), 267–292.

    Article  Google Scholar 

  • Ratcliffe, M. (2008). Feelings of being: Phenomenology, psychiatry and the sense of reality. Oxford: Oxford University Press.

    Google Scholar 

  • Startup, M., Bucci, S., & Langdon, R. (2009). Delusions of reference: A new theoretical model. Cognitive Neuropsychiatry, 14(2), 110–126.

    Article  Google Scholar 

  • Staton, R. D., Brumback, R. A., & Wilson, H. (1982). Reduplicative paramnesia: A disconnection syndrome of memory. Cortex, 18, 23–36.

    Google Scholar 

  • Stone, A., & Valentine, T. (2003). Perspectives on prosopagnosia and models of face recognition. Cortex, 39, 31–40.

    Article  Google Scholar 

  • Stone, T., & Young, A. W. (1997). Delusions and brain injury: The philosophy and psychology of belief. Mind and Language, 12(3/4), 327–364.

    Article  Google Scholar 

  • Tranel, D., & Damasio, A. R. (1985). Knowledge without awareness: An automatic index of facial recognition by prosopagnosics. Science, 228, 1453–1454.

    Article  Google Scholar 

  • Tranel, D., Damasio, H., & Damasio, A. R. (1995). Double dissociation between overt and covert face recognition. Journal of Cognitive Neuroscience, 7(4), 425–432.

    Article  Google Scholar 

  • Vörös, V., Tényi, T., Simon, M., & Trixler, M. (2003). ‘Clonal Pluralization of the Self’: A new form of delusional misidentification syndrome. Psychopathology, 36, 46–48.

    Article  Google Scholar 

  • Vuilleumier, P., Mohr, C., Valenza, N., Wetzel, C. A., & Landis, T. (2003). Hyperfamiliarity for unknown faces after left lateral temporo-occipital venous infarction: A double dissociation with prosopagnosia. Brain, 126, 889–907.

    Article  Google Scholar 

  • Weinstein, E. A. (1994). The classification of delusional misidentification syndromes. Psychopathology, 27, 130–135.

    Article  Google Scholar 

  • Young, A. W. (1999). Delusions. Monist, 82(4), 571–589.

    Google Scholar 

  • Young, A. W. (2000). Wondrous strange: The neuropsychology of abnormal beliefs. Mind and Language, 15(1), 47–73.

    Article  Google Scholar 

  • Young, G. (2007a). Clarifying ‘familiarity’: Examining differences in the phenomenal experiences of patients suffering from prosopagnosia and Capgras delusion. Philosophy, Psychiatry, and Psychology, 14(1), 29–37.

    Google Scholar 

  • Young, G. (2007b). In defense of estrangement. Philosophy, Psychiatry, and Psychology, 14(1), 51–56.

    Google Scholar 

  • Young, G. (2008a). Capgras delusion: An interactionist model. Consciousness and Cognition, 17(3), 863–876.

    Article  Google Scholar 

  • Young, G. (2008b). Restating the role of phenomenal experience in the formation and maintenance of the Capgras delusion. Phenomenology and the Cognitive Sciences, 7(2), 177–189.

    Article  Google Scholar 

  • Young, G. (2009). In what sense ‘familiar’? Examining experiential differences within pathologies of facial recognition. Consciousness and Cognition, 18(3), 628–638.

    Article  Google Scholar 

  • Young, G. (2010). Delusional misidentification. New York: Nova Science.

    Google Scholar 

  • Young, A. W., & de Pauw, K. W. (2002). One stage is not enough. Philosophy, Psychiatry, and Psychology, 9(1), 55–59.

    Article  Google Scholar 

  • Young, A. W., Leafhead, K. M., & Szulecka, T. (1994). Capgras and Cotard delusions. Psychopathology, 27, 226–231.

    Article  Google Scholar 

  • Zajonc, R. B. (2001). Mere exposure: A gateway to the subliminal. Current Directions in Psychological Science, 10(6), 224–228.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Psychology, School of Social Sciences, Nottingham Trent University, Nottingham, NG1 4BU, UK

    Garry Young

Authors
  1. Garry Young
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Garry Young.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Young, G. Beliefs, experiences and misplaced being: an interactionist account of delusional misidentification. Phenom Cogn Sci 10, 195–215 (2011). https://doi.org/10.1007/s11097-010-9168-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11097-010-9168-9

Keywords

Search

Navigation