The Doppelgänger phenomenon and death: a peculiar case of homicide by a subject with first-episode psychosis

Abstract

The Doppelgänger phenomenon refers to the experience of a direct encounter with one’s self, characteriswed by: (i) the perception of a figure with one’s own identical physical features; or (ii) the apprehension that the perceived figure shares the same personality and identity. The Doppelgänger does not only look like the same person, it is his/her double. The perceptual element is usually a hallucination, although occasionally a false perception of an actual figure may be involved. This phenomenon has been described in individuals suffering from overwhelming fear, severe anxiety or intoxication, epilepsy, as well as in the sleep-wakefulness transition. It has also been reported in major psychoses. The fear of imminent death often precedes the Doppelgänger experience. This report presents the case of a 30-year-old man, Mr. Y, who was stabbed to death by Mr. X, his “double”. The aggressor and his victim, although not related, were truly doubles; remarkably, they shared the same name and surname, age, professional activity and place of work. Moreover, they attended the same sports center but barely knew each other. The forensic psychiatric evaluations in Mr. X, subsequent to the crime committed, were suggestive of a psychotic condition. This case is unique in the scientific literature. In the most serious psychotic forms, the issue of the “double” calls into question not only the dissociative processes involved in the etiopathogenesis of the disorder, but also bio-psycho-social elements, as well as personal data in this case, which made the victim and the aggressor “identical”. In the context of psychopathological functioning, the delusional mood (Wahnstimmung) that precedes the development of delirium is a sort of gateway to an impending psychotic illness, involving delusional awareness or mood (atmosphere). In psychosis, splitting is the main issue and this influence is seen as an evil, foreign, apocalyptic and unknown side no longer recognised as belonging to the self even in a physical sense. In such a situation, it is felt that the only way to survive is by suppressing one’s double as a defense against disorganisation of the self.

Key points

• People suffering from Delusional Misidentification Syndromes constitute a sub-category of psychiatric patients who may become verbally threatening and violent towards others.

• “Autoscopy” is a term used for the hallucination of “seeing one’s own body at a distance” which can occur as a symptom of major psychoses such as in schizophrenia, but also in migraine and epilepsy.

• Understanding the role of the “Doppelgänger phenomenon” in the progression to severely violent acts may help to elucidate factors with a potential significance in the causation of dangerous behaviours.

Keywords:

• Forensic sciences
• forensic psychiatry
• homicide
• first-episode psychosis
• Doppelgänger
• delusional disorder
• criminal responsibility

Authors’ contributions

Cristiano Barbieri and Gabriele Rocca conceived the study. Caterina Bosco, Lucia Tattoli and Ignazio Grattagliano participated in its coordination and helped to draft the manuscript. Giancarlo Di Vella revised the manuscript. All authors contributed to the final text and approved it.

Compliance with ethical standards

The patient gave permission to the processing, collecting and handling of his personal data, also for purpose if anonymized at the first forensic assessment. A patient consent form could not be obtained because the patient was then not easily accessible in a forensic psychiatric facility far away from the university where he was assessed. Ethical approval was exempted by the committee (CNB of University of Turin, Italy) to this non-interventional study.

Disclosure statement

No potential conflicts of interest were reported by the authors.

Funding

The authors received no specific funding for this work.