Polyopic heautoscopy: Case report and review of the literature

Heautoscopy, i.e., the encounter with one's double, is a multimodal illusory reduplication of one's own body and self. In its polyopic form, more than one double is experienced. In the present article, we review fourteen published cases of polyopic heautoscopy and describe in detail the case of a 41-year-old man with polyopic heautoscopy resulting from a tumor in the insular region of the left temporal lobe. Our case is illustrative in several respects: (1) The patient's five doubles were all confined to the right hemispace. Laterality in this case is discussed with reference to previous cases of unilateral heautoscopy after focal brain damage, which generally do not show a hemispatial or hemispheric bias. (2) The patient's psychological affinity with his doubles, and also the extent of their echopraxia of his movements, decreased as a function of their perceived spatial distance from the patient's body, corroborating previous observations of associations between spatial and psychological phenomenologies during autoscopic phenomena. (3) While classical heautoscopy (the reduplication of a single body and self) is considered a breakdown in the integrative processes that enable us to identify our self with our body, the phenomenon of polyopic heautoscopy (a multiplication of body and self) points to the multiple mappings of the body, whose disintegration may give rise to the illusory experience of multiple selves.