Following his attempted assassination of Ronald Reagan, as part of his defence John Hinckley Jr explained that he had come up with the plot in order to impress the Jodie Foster, who he unfoundedly believed to be secretly in love with him.  Beliefs of this type are classed as erotomania.

Erotomania was first described by the French psychiatrist de Clérambault in 1921 and those affected hold the unfounded but unshakeable belief that another person is secretly in love with them.  The subject of the fixation is usually a stranger, normally of a higher status, and often a celebrity.  During episodes of erotomania the affected person will believe that the subject of the delusion is in love with them, and communicating with them through looks, gestures, signals, or messages in the media.

Whilst erotomania is most often seen during psychosis it can present itself without any other accompanying delusions or symptoms, and the person may in every other respect appear completely unaffected.  What they will attempt to do is to return the perceived affection through gifts and tempted contact with the subject of their delusion.  Unfortunately any denial or resistance on their part will normally only fuel the delusion that they want the relationship to remain secret.

Erotomania can be treated with anti-psychotic medication, but other delusions around loved ones may also have a physical cause in dementia or brain injury.   The Capgras delusion is the belief that a loved one has been replaced by an almost identical looking impostor, a fact which only they can recognise.

Research into people with the Capgras delusion suggests a link with prosopagnoasia, the inability to recognise faces.  In 1990 psychologists Hadyn Ellis and Andrew Young suggested that Capgras syndrome might be the “mirror-image” of prosopagnoasia.  They suggested that the conscious ability to recognise faces continued to work, but the system which governs emotional responses to familiar faces ceases to work.  This would explain the ability to recognise the individual with the inability to make the emotional connection creating the belief that there must have been a substitution.

Related to the Capgras delusion is the Fregoli delusion, in which the person believes that different individuals are in fact a single person who changes their appearance and disguises themselves.  Like Capgras syndrome the Fregoli delusion can have its basis in psychosis or brain injury, and has been linked to trauma in the fusiform gyrus, the area of the brain involved in facial recognition.

You can follow the link for some of the more common mental side effects of falling in love and infatuation.

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