Psychiatry Notes - Autoscopy/Doppleganger

Many famous poets and writers have described autoscopy, sometimes based on their own experiences, like the German poet Goethe. While out in the woods, he thought he recognized himself in someone coming toward him. He perceived himself not through his real, physical eyes, but through the eyes of his soul. Goethe's account is probably the origin of descriptions of autoscopy as having some detached insight (Vondrýcek and Holub, 1968). This factor supports the idea that an extreme narcissism is a specific psychogenic factor here. Patients see themselves either in their contemporary aspect or sometimes older or younger.
Autoskopie, autoscopic hallucinations aussersichsein (to be outside oneself) and doppelsehen (seeing double) are the various terms which describe the experience of an individual seeing themselves.In the past, the term deuteroskopie was sometimes used. The phenomenon is more common in males (Arieti and Bemporad, 1974). Menninger-Lerchenthal, who coined the term heautoskopie, considered this phenomenon to exist primarily as a result of right parietal lobe impairment (Leischner, 1961). He observed one case in the right frontoparietal astrocytoma, and reported on several cases of autoscopy associated with right and left hemisphere damage due to shell injury

Causes: Autoscopic phenomena were described in cases of exhaustion, infection (especially Typhus exanthematicus), epilepsy, migraine, substance abuse or intoxication, and postpartum psychosis (Leischner, 1961).Deep prosopagnosia (impaired facial recognition) could also be a reason for autoscopy. Tranel wrote (1992).

German and Scottish superstitions maintain that seeing one's double is an omen that one will soon die.

Capgras had a female patient in 1923 with the delusion that she was of high noble origin but that, as an infant, she had been switched to another family. She believed that the members of her family had all been gradually replaced by doubles. All of her surroundings and all of her acquaintances were doubles. The patient believed her daughter had 2,000 doubles. The patient believed that in the Parisian underground, 28 million people were kept prisoner, while on the surface only their doubles existed. The patient feared that she herself could be considered to be her own double, and therefore she kept all of her documents on her body (Leischner, 1961).
(source)