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If You Did Not Care, You Would Not Notice: Recognition and Estrangement in Psychopathology

Young’s paper (2007) identifies fundamental differences in the use of the concept of familiarity in the description of the experience of patients affected by the Capgras delusion and by prosopagnosia. Moreover, he suggests a way of disambiguating “familiarity” and proposes that the experience of Capgras patients is accounted for in terms of estrangement. Although we share the concern that the concept of familiarity might be used too broadly, we find his proposed solution problematic with respect to the Capgras delusion. In this brief commentary, we address two interrelated issues. (1) Can estrangement from an object of experience be coherently distinguished from the failure of re-identification of that object? (2) Given that the delusional belief is what essentially characterizes the Capgras syndrome, can the experience of Capgras patients be accounted for independently of a reference to their delusional beliefs?