The stranger in my bed

From Thursday's Globe and Mail

One morning, Katherine Waxman looked at her husband, Sheldon, and asked him who he was.

She had been battling mental illness for almost a decade, but this was new.

He told her his name, and she eyed him incredulously.

"No, Sheldon's a good guy," she told him. "You're hateful. You're a terrible person."

Ms. Waxman, 55, suffers from Capgras delusion, which can accompany schizophrenia and causes individuals to believe their loved ones have been replaced by imposters.

In Canada, doctors see only about 50 to 100 cases a year, but the disorder has entered the public consciousness of late with the trial of Tony Rosato, a former SCTV cast member who is facing charges of criminal harassment against his wife. According to his lawyers, Mr. Rosato suffers from Capgras and believes his wife and daughter have been substituted by mysterious twins.

It is the stuff of science fiction, a bizarre affliction that has formed the plot of CSI episodes and the 2006 novel The Echo Maker. It is even referenced in the new film The Invasion, a remake of Invasion of the Body Snatchers that will be released tomorrow.

But for the family members of those who suffer from Capgras, the strange delusion is all too real.

They must struggle to deal with wives, husbands and children who suddenly look at them as strangers, and often perceive them as a threat.

"It's hard on the families," said Joel Jeffries, a psychiatrist at the Centre for Addiction and Mental Health in Toronto who has seen several cases of Capgras. "You explain that it's part of the illness and not to take it too personally, but it is personal because they're seen as the imposters."

Mr. Waxman said it has been torture to slowly lose his wife of 31 years, but he has grown immune to her accusations."I'm numb to it now," said the 66-year-old lawyer who lives in Grand Rapids, Mich. "I've developed a thick skin."

He met Ms. Waxman when she was working as an intensive care nurse. She was so full of energy that he used to call her "the butterfly" because she was constantly flitting from one place to the next.

"I left my first wife to marry her," he recalled this week. "She was the woman of my dreams."

But 15 years into their marriage, she began to change.

She became despondent and suffered what doctors classified as a "psychotic break," usually the first episode of a decline into schizophrenia. She was given tranquillizers, hospitalized repeatedly and eventually diagnosed with schizoaffective disorder, which combines the psychotic symptoms of a thought disorder with the manic components of a mood disorder.

She heard voices, carried on conversations with invisible characters and paced the yard of their home screaming to the sky.

"It was horrible," her husband said.

The Capgras delusion came later, he added, and was always directed solely at him.

Some sufferers, perhaps including Mr. Rosato, believe that several people in their lives have been replaced by strangers. Others suffer "mirror self-misidentification" in which they believe their own reflection is an imposter.

In his book Phantoms in the Brain, California psychiatrist V.S. Ramachandran describes a Capgras patient who thought his poodle had been replaced, and another who woke up each morning believing his shoes had been switched in the night.

Ms. Waxman recognizes her children, who are 30 and 26, but is constantly suspicious of her husband.

"If I'm not Sheldon, how come your children accept me as being Sheldon?" Mr. Waxman used to ask his wife. "She would tell me I had them brainwashed."

Capgras delusion was named in 1923 for a French psychiatrist who described the case of Madam M, a woman who insisted her family had been switched with doubles. According to a 2005 article about the affliction in Scientific American Mind, she believed the imposters were rapidly replaced and claimed to have had more than 80 strangers in the role of her husband.

Dr. Jeffries says most Capgras suffers regard their doubles as benign, and are treated with anti-psychotic medication. Mr. Rosato's case has raised alarms within the mental health community because he has been held in custody for two years without receiving treatment.

But Mr. Waxman's wife stopped taking anti-psychotic medication years ago after developing painful side effects, and refuses to begin again.

The couple's son wanted to have her committed, so she would be cared for professionally, but Mr. Waxman, who works as a criminal lawyer, could not bring himself to see her liberties restrained.

"The idea of incarceration doesn't sit well with me," he said.

Now, Mr. Waxman lives in one end of his ranch house with his wife in the other.

He has given her a cellphone in case she gets lost or confused in public, and often receives calls from store clerks asking him to pick her up. Once, he had to bail her out of jail.

"She has a life," he said. "I don't think it's one that you or I would like to have, but she's functional in a lot of ways."

While he doesn't spend much time analyzing her delusions now, he does still wonder what triggered this change in his wife.

When she was young, she was hit in the left side of the head with a baseball bat, he said.

Some studies of the Capgras phenomenon have linked the delusion to head injuries, suggesting a neurological malfunction, but no definitive cause is known.

It cannot be a simple case of the brain misreading visual cues, because blind people have been known to have Capgras.

In some rare cases, Capgras patients become violent.

A psychiatrist at a Veterans Affairs medical centre in California compiled 80 cases in which Capgras patients attacked a presumed double either verbally or physically, two of which involved fatalities.

In 2005, Andrew Crago of Mississauga was found not criminally responsible for killing his parents, Robert and Cecella. The 29-year-old suffered from Capgras and during his trial the court heard that he believed his real parents had been killed or were being held against their will.

Mr. Rosato's wife, Leah, is reportedly so afraid of her husband that she has agreed to testify only from behind a screen in the courtroom, so that he can't see her.

Mr. Waxman said his wife has never been violent toward him, but her illness has taken other tolls.

He takes occasional comfort in her describing the good qualities of the real Sheldon, but says he has come to see Ms. Waxman as just as much of a stranger as she regards him.

"Do I still love her? I love who she used to be, but she's not that any more," he said. "So, no, I guess not."


Our commentary in the Globe and Mail

August 15, 2007

Ottawa Mens, from Ottawa, Canada wrote: Shsss dont you know schizophrenia is a taboo word? Just go to family court and watch some well known judges in action and any reasonable person, read, experienced lawyer will tell you that several Ottawa Family Court judges make "aberrant" decisions that makes jaws drop wide open and shake their heads in disbelief. That taboo is also correctly identified as a "code of silence". I call it a delinquent failure of fiduciary duty" not to mention a flagrant abuse of judicial discretion. Equally taboo is to mention that a woman in a family court matter is or was mentally ill. One day my ex wife called me "my hormones, they were talking to me", "they were telling me to get off the plane (in flight)". Then she complained of smelling vomit in the pristine clean bedroom. Shortly afterwards I was in the kitchen washing dishes and boom, she king hit me in the right ear without any conversation or provocation of any kind. Then proceeded more "aberrant behaviour" king hits to the solar plexus and screaming incoherent abuse while holding in her outstretched arm a long kitchen knife with its tip embedded in my face. AT the time, I correctly summed it up that if I called the police, I was the one who would be arrested. At the time I knew nothing about mental illness. The cause? chronic childhood sexual abuse, apparently a very common denominator in schizophrenia according to US expert Dr. McKenzie. Women like this leave a trail of destruction that results in endless litigation that the Family Court Judiciary simply regard as a taboo allegation and issue almighty costs orders with orders that any further motion is prevented unless paid and of course its permanent in effect. Children grow up without fathers and live with mentally ill mothers until someone someday sees something wrong that may not ever happen until the child becomes an adult. Thanks to extreme feminist lawyers who are prepared to personally fabricated evidence. 613-797-3237


More comments later posted.

Ottawa Mens, from Ottawa, Canada wrote: Tony Rosato really needs help. I find it offensive that his wife has been programmed by "those folks". She was living with his nightmare; she is probably one of the best witnesses to his madness. Rosato sounds harmless; his major problem is that he fails to understand that he is suffering delusions. In plain language, he has gone mad. In more accurate terms, he has yet to receive professional help that accurately addresses his difficulties to the point that medication can assist him in seeing reality more clearly or understand his constant never ending delusions. Its a very sad fact that most criminal and family cases involve mental illness and or combinations of mental health problems and severe personality disorders. His wife is getting lots of protection; Tony is locked up good and proper. This trial is a farce, he is obviously incapable of understanding his thinking is wrong, he cannot possibly be convicted by a reasonable unbiased judge. The big problem is that this now is a "Political Trial", the prosecutor has jumped over the ropes with an unprofessional missionary zeal that rivals that of executive directors of Canadian Man Hating Associations known for unwanted sexual advances upon their employees. This prosecution is so far fetched itís a sick joke in the legal profession. It begs the question, why are they spending so many tens of thousands of dollars on a criminal prosecution that has next to zero probability of a conviction when the same money could be used to gain "appropriate treatment" for an obviously very sick man. The Attorney General of Ontario needs to kick some buts and tell this crown to take some leave and seek some professional help. 613-797-3237