In a recent season 12 episode of Law & Order: SVU entitled “Bullseye”, we witness the portrayal of a mother who recognizes her daughter but believes that she is a replacement or a double, and even goes so far as to accuse the daughter of being an impostor. SVU psychiatrist Dr. Huang diagnoses this very disturbing yet real life condition as Capgras delusion, a symptom that can transpire in patients with a neurological disorder such as schizophrenia or in the case of the mother depicted in this episode, as a consequence of a brain injury. As the episode clearly demonstrates, the effects of Capgras delusion can be devastating to both the patient and to surrounding people including family and friends. Unlike other cognitive disorders that involve the inability to recognize a loved one, the belief that the person is a false representation of the actual being can invite strain and turmoil into relationships that may have flourished prior to the onset of this condition. In the SVU episode, the situation is made all the more tragic as it involves an affected mother and her young daughter who is recognized but unwanted by the sick mother. The fact that this neurological condition can fragment even the strongest familial bonds that people share is fascinating in the realm of functional brain research but frightening for those affected.
To temporarily circumvent the mother’s repulsion towards her own daughter due to the delusion, the SVU detectives set up a meeting between the mother and her daughter within separate rooms so that they could speak to each other but without the ability to see one another. In doing so, the mother acknowledges her daughter and expresses her love for her. This is in reference to a classical phenomenon in which a patient affected by the Capgras delusion can typically speak normally to a particular loved one without seeing his or her face, as would be the case when they communicate over the phone, but once the face is revealed the patient is unwilling to accept the loved one for who he or she really is. Research by Dr. Vilayanur Ramachandran and Dr. William Hirstein has suggested that the ability to recognize a loved one’s face is working because the face recognition center of the brain is fully functioning. However, the connection between face recognition and the emotional response center of the brain is severed, in effect rendering the patient unresponsive to the recognition of a loved one’s face.
The tragedy underlying Capgras delusion is the loss of what is thought to be the lasting foundation upon which relationships are built: memories and emotions. But then again, some may beg to ask the question: is love dependent on these things?