Hallucinations

The term “heautoscopy” (sometimes spelled héautoscopy), introduced in 1935, is not always regarded as a useful one. T. R. Dening and German Berrios, for example, write, “We see no advantage in this term; it is pedantic, almost unpronounceable, and not widely used in ordinary practice.” They see not a dichotomy but a continuum or spectrum of autoscopic phenomena, in which the sense of relationship to one’s autoscopic image may vary from minimal to intense, from indifferent to impassioned, and the sense of its “reality” may be equally variable and inconsistent. In a 1955 paper, Kenneth Dewhurst and John Pearson described a schoolteacher who, at the start of a subarachnoid hemorrhage, saw an autoscopic “double” for four days:

It appeared quite solid as if seen in a mirror, dressed exactly as he was. It accompanied him everywhere; at meal-times it stood behind his chair and did not reappear till he had finished eating. At night it would undress and lie down on the table or couch in the next room of his flat. The double never said anything to him or made any sign, but only repeated his actions: it had a constant sad expression. It was obvious to the patient that this was all a hallucination, but nevertheless it had become sufficiently a part of himself for the patient to draw a chair up for his double when he first visited his private doctor.

In 1844, a century before the term was coined, A. L. Wigan, a physician, described an extreme case of heautoscopy with tragic consequences:

I knew a very intelligent and amiable man, who had the power of thus placing before his eyes himself, and often laughed heartily at his double

, who always seemed to laugh in turn. This was long a subject of amusement and joke, but the ultimate result was lamentable. He became gradually convinced that he was haunted by [his other] self. This other self would argue with him pertinaciously, and to his great mortification sometimes refute him, which, as he was very proud of his logical powers, humiliated him exceedingly. He was eccentric, but was never placed in confinement or subjected to the slightest restraint. At length, worn out by the annoyance, he deliberately resolved not to enter on another year of existence — paid all his debts — wrapped up in separate papers the amount of the weekly demands — waited, pistol in hand, the night of the 31st of December, and as the clock struck twelve fired it into his mouth.

The theme of the double, the doppelgänger, a being who is partly one, partly Other, is irresistible to the literary mind, and is usually portrayed as a sinister portent of death or calamity. Sometimes, as in Edgar Allan Poe’s “William Wilson,” the double is the visible and tangible projection of a guilty conscience that grows more and more intolerable until, finally, the victim turns murderously on his double and finds that he has stabbed himself. Sometimes the double is invisible and intangible, as in Guy de Maupassant’s story “Le Horla,” but this double nonetheless leaves evidence of his existence (for instance, he drinks the water that the narrator sets out in his night bottle).

At the time he wrote this, de Maupassant often saw a double himself, an autoscopic image. As he remarked to a friend, “Almost every time when I return home I see my double. I open the door and see myself sitting in the armchair. I know it’s a hallucination the moment I see it. But isn’t it remarkable? If you had not a cool head, wouldn’t you be afraid?”

De Maupassant had neurosyphilis at this point, and when the disease grew more advanced, he became unable to recognize himself in a mirror and, it is reported, would greet his image in a mirror, bow, and try to shake hands with it.

The persecuting yet invisible Horla, while perhaps inspired by such autoscopic experiences, is a different thing altogether; it belongs, like William Wilson and Golyadkin’s double in Dostoevsky’s novella, to the essentially literary, Gothic genre of the doppelgänger, a genre which had its heyday from the late eighteenth century to the turn of the twentieth.

In real life — despite the extreme cases reported by Brugger and others — heautoscopic doubles may be less malign; they may even be good-natured or constructive moral figures. One of Orrin Devinsky’s patients, who had heautoscopy in association with his temporal lobe seizures, described this episode: “It was like a dream, but I was awake. Suddenly, I saw myself about five feet in front of me. My double was mowing the lawn, which is what I should have been doing.” This man subsequently had more than a dozen such episodes just before seizures, and many others that were apparently unrelated to seizure activity. In a 1989 paper, Devinsky et al. wrote: