What should I do? My wife thinks I’m an imposter!

What would you do if one day your spouse accuses you of being an imposter who has replaced his/her beloved partner and you perceived that this was not a joke? While this may sound farfetched, this is potentially a real situation which has happened to a relatively few persons.{{more}}

A case scenario

Consider the situation of Mr AI who wrote: “I woke up one morning three months ago and my wife called me an imposter. Since then she has consistently asked, ‘Who are you and what have you done with my husband?’

“I constantly reassure her that I am the same man that she married 45 years ago (when she was age 25) and with whom she has been happy, but this has not helped. Her response has been, “I want my husband back. What have you done with him?” I thought maybe she was upset with me for some reason and that this would blow over, but, no! Instead things seem to be getting worse; now she is saying that someone swapped the dog and replaced him with an imposter too, and the home in which we have lived for so long belongs to someone else and she wants to go back to her own home.”

This is truly a worrying situation that would cause any spouse to be alarmed, confused, and distressed. What could possibly be causing this kind of behaviour and what could possibly be done to help?

The Capgras Delusion (or Syndrome)

The condition outlined above is known as the Capgras Delusion (Syndrome) and is a very rare neuropsychological disorder, which may occur after a traumatic brain injury, Alzheimer’s Disease, a stroke, drug overdose, paranoid schizophrenia, and other conditions in which the individual believes that the self or other familiar persons, such as a first degree relative or spouse (or even a pet) has been replaced by an imposter, although they act and appear to be the same person in every other way. This feeling of having an imposter around may start with the closest person to the individual, then extend to relatives, friends, the person’s pet, home, and others who are significant in his or her life.

What is a delusion or syndrome?

Since this disorder is considered to be a delusion, it means that in this case, the wife’s experiences of her husband as a ‘double’ (he is not her real husband, but a counterfeit who looks and behaves like him) in her life are not real; they are false beliefs that appear to be real to her and which she holds on to very strongly, although she has evidence to the contrary – as everything remains the same as it was before. Capgras Delusion is a mental illness that consists of a ‘world filled with imposters,’ which is also frightening to her and a distress to her husband and other loved ones. A syndrome refers to a number of related conditions that are component parts of a disorder in that the individual is susceptible to them as part of the illness, for example, anxiety and delusions.

What are the causes of Capgras Delusion?

Capgras Delusion is caused by a disconnection between the visual face recognition areas and the emotional response centres of the brain so that when a familiar face is seen, it does not evoke the expected warm response, so the individual rationalizes that this could not be my husband (or wife), or my mother, or my pet (and so on) and therefore he, she, it, must be an imposter. While being unable to recognize their loved ones visually, the individual with Capgras Delusion may still be able to recognize their loved ones audibly (in the absence of visual stimulation), for example, by communicating via telephone. So, the person who is being rejected as an imposter in person may be accepted as who he or she really is via telephone, because there are no visual images involved.

What to do:

Seek treatment

Treatment for Capgras Delusion (Syndrome) involves individual psychotherapy, using a cognitive approach which includes reframing techniques and the testing of reality, while at the same time ensuring that the client’s delusions are not directly confronted or validated. Antipsychotic medication may also be prescribed.

Give support and comfort

This condition requires an enormous amount of patience, loving care, and understanding from family members, especially spouses, so continue to provide constant reassurances that family members, friends, home, and pet(s) remain the same, although they may appear to be different. In this case the wife will need constant supervision or monitoring, and spouse and other family members may need to take turns in so doing, or employing the help of a professional home-care aid.

Understand mental illness

Caregivers will do well to bear in mind that a mental illness is an illness like others, such as diabetes, in that they are often biologically-based and as such our loved ones should be given the same high quality of care as if the disorder were only purely physical. There should also be no shame in illness and so our communities likewise should lend support to those who are mentally ill.

Need help with relationship and other problems? Ask DYNACII’s Life Coach, Dr Adams, a licensed clinical psychologist. Please note that all correspondence to the Life Coach is confidential and the cases presented are modified in order to maintain the anonymity of each writer. Dynamic Action Centre International Inc (DYNACII) is a non-governmental organization, committed to social and spiritual empowerment. For more information on DYNACII please visit: http://www.dynacii.com