29

Capgras et al.

Bruce looked embarrassed. Dr Livingstone had implied that he might like the post-lightning-strike syndrome named after him. It was true that that possibility had crossed his mind – and indeed would have appealed greatly to the old Bruce, but not to the new person he felt himself to be. So he replied, “I wasn’t thinking of myself, you know.”

Dr Livingstone was tactful. “Of course not.” He thought for a moment. “Of course, it’s more often the discoverer of the syndrome who gets the credit, as it were. Capgras Syndrome was first described by a French psychiatrist called Joseph Capgras. And then there’s de Clérambault’s Syndrome, and Cotard’s Syndrome too. There are quite a lot of these, I suppose, that immortalise the doctor who first identifies them. Not that I would want there to be a Livingstone’s Syndrome, frankly. That’s not my motive in any of this.”

Bruce was interested. “This Capgras Syndrome – I’ve never heard of it – nor of any of the others. What do you do if you’ve got Capgras?”

“It’s an unusual one, that,” said Dr Livingstone. “In fact, all of them are pretty rare. Most of the time, we deal with much more mundane complaints. But Capgras is certainly interesting.”

Bruce waited.

“Capgras Syndrome,” Dr Livingstone explained, “is present when the patient believes that a person he knows – often a close relative or friend – has been replaced by a double. The patient says, ‘Yes, that certainly looks like my wife, but it isn’t, you know – it’s somebody who looks exactly like her.’ ”

Bruce looked incredulous. “They actually believe that?”

Dr Livingstone nodded. “There’s a very good account of it in a book called Uncommon Psychiatric Syndromes by two psychiatrists, Enoch and Trethowan. It’s an illuminating read – if you’re interested in the wilder shores of human behaviour. They have a whole chapter on Capgras Syndrome – and some its variants. Capgras-type conditions can get quite complicated. There’s the delusion of intermetamorphosis, for instance, where the patient thinks that people are exchanging their identities. So, you think that John has taken on Harry’s identity and Harry has taken on Frank’s – and Frank has taken John’s. Not simple.”

“No, not simple at all.”

“And then,” Dr Livingstone continued, “there is often some delusion of persecution going on in the background. The patient believes that his persecutor has replaced the person close to him in order to be able to carry to out whatever persecution is being practised more effectively.”

“And what do you do?” asked Bruce.

“There are drug treatments,” said Dr Livingstone. “They may or may not help. If the background delusion is treated, then they may stop imagining that there is a double. It doesn’t always work, but it may.”

“And the other syndromes you mentioned?”

“De Clérambault’s is rather worrying,” said Dr Livingstone. “I’ve never encountered it, but it’s not all that uncommon. It can have tragic consequences. It’s where the patient believes that somebody is in love with him or her – somebody who may have absolutely nothing to do with the patient, who probably doesn’t even know him – or her: women are prone to this too. It’s often a public figure or somebody whom the patient sees somewhere and latches on to. Thomas Clouston, who was a very distinguished Scottish psychiatrist in the nineteenth century, described a case of this nature in a one-legged dressmaker who conceived of the idea that a random member of her church congregation wanted to marry her. There was, of course, no basis for this belief, but it was certainly held by the woman in question. These people really believe that the objects of their affections feel something for them.”

“And the other one?”

“Cotard? That’s even stranger. You have Cotard if you end up denying your own existence and the existence of the external world. The French call it the délire de négation, which is a good description of it. It leads to utter nihilism.”

Bruce shook his head. “It’s difficult to imagine what it’s like to believe any of the things these people believe. It’s bizarre.”

Dr Livingstone laughed. “What’s the Yorkshire saying? There’s nowt so queer as folk? That’s true, you know. But listen, there’s an even more bizarre delusion. This one is exceptionally rare – probably non-existent today – but there was a time when it was quite common. Sometimes an odd belief can be socially transmitted – as in mass hysteria. You know how groups of people can suddenly get an odd idea in their heads all at the same time. It used to happen a bit in boarding schools, where you could get hysterical behaviour.

“This delusion is very colourful. It’s called the glass delusion, and effectively what it means is that you believe you’re made of glass.”

Bruce looked incredulous. “You actually think that? That you’re made entirely of glass?”

Dr Livingstone nodded. “Yes. It was quite well-known in the seventeenth century, although there were references to it before then. It’s mentioned by Cervantes and Descartes, and there was a French monarch who suffered from it, Charles VI. He was very careful about not being bumped into in case he shattered.”

“No!” exclaimed Bruce. “Your actual king of France? He thought he was made of glass?”

“And then there might have been something similar going on in the mind of Tchaikovsky, who was very worried that when he was conducting an orchestra, his head would fall off. He may have been suffering from something very similar to the glass delusion.”

“Seriously strange,” said Bruce. He stared at Dr Livingstone. “You don’t think I’ve got anything like that, do you?”

Dr Livingstone laughed. “Oh, my goodness, no. I do think, though, that when one gets struck by lightning there is a chance there will be some lasting effects. These could be the result of disturbance in the brain pathways. That’s one hypothesis. That’s why I was keen to talk to you about how you feel you’ve changed as a result of your unfortunate experience on…”

“Dundas Street,” said Bruce.

“Yes, Dundas Street.”

Dr Livingstone took a sip of his coffee. “Tell me, then, how you think you’ve changed.”

“Utterly,” said Bruce. “I know it sounds corny, but I’ve changed utterly.”

“Would you say that you’re a nicer person?” asked Dr Livingstone. “Or have you changed for the worse?”

“Oh, for the better,” said Bruce. “I used to be…” He hesitated.

Dr Livingstone gave him an encouraging look. “You need not be embarrassed with me,” he said. “I’ve seen and heard just about everything. And there’s nothing to be ashamed of.” Then, seeing Bruce hesitate, he added, “I’m unshockable.”

Bruce lowered his voice. “I used to be really hot. I used to admire myself in the mirror – sometimes for fifteen, twenty minutes at a stretch. I used to put this clove-scented gel in my hair. I used to think I was God’s gift to women. I really did.”

“And now?”

“Now, I want to lead a simple, chaste life. I want to grow things. I want to work with my hands. I want to unclutter.”

“Interesting,” said Dr Livingstone. “And you think you’ll find all this in a monastery?”

“I know I shall,” said Bruce. “And that’s not a delusion on my part.”

“Hah!” said Dr Livingstone.

“Don’t you believe me?” asked Bruce.

“Oh, I do,” said Dr Livingstone. “My hah was not a hah of incredulity. It was a hah of recognition – perhaps even of sympathy.”

“I hate myself,” Bruce muttered.

“You mustn’t,” said Dr Livingstone.

“Okay, I disgust myself.”

Dr Livingstone nodded. “That’s better,” he said, adding, “There is a distinction, you know.”