Reduplication phenomena: body, mind and archetype.

Abstract

The many biological and few psychodynamic explanations of reduplicative syndromes tend to have paralleled the dualism of the phenomenon with organic theories concentrating on form and dynamic theories emphasising content. This paper extends the contribution of psychoanalytic thinking to an elucidation of the form of the delusion. Literature on clinical and aetiological aspects of reduplicative phenomena is reviewed alongside a brief examination of psychoanalytic models not overtly related to these phenomena. The human experience of doubles as universal archetype is considered. There is an obvious aetiological role for brain lesions in delusional misidentifications, but psychological symptoms in an individual can rarely be reduced to an organic disorder. The splitting and doubling which occurs in the phenomena have resonances in cultural mythology and in theories from different schools of psychodynamic thought. For the individual patient and doctor, it is a diverting but potentially empty debate to endeavour to draw strict divisions between what is physical and what is psychological although both need to be investigated. Nevertheless, in patients in whom there is clear evidence of an organic contribution to aetiology a psychodynamic understanding may serve to illuminate the patient's experience. Organic brain disease or serious functional illness predispose to regression to earlier modes of archetypical and primitive thinking with concretization of the metaphorical and mythological world. Psychoanalytic models have a contribution in describing the form as well as the content of reduplicative phenomena.