Loved Ones Near and Far: Feinberg’s Personal Significance Theory

Abstract

Commentary by William Hirstein (Elmhurst, IL)Todd Feinberg's personal significance theory offers a coherent and unified explanation for the misidentification syndromes, such as Capgras syndrome, as well as certain body-image disorders, such as asomatognosia and somatoparaphrenia. This reply offers several criticisms directed toward sharpening the theory. First, personal significance is still a broad and indistinct concept, and most of the representations in our brains are of people and things of personal significance to us. Second, the idea that the Capgras patient has lost his sense of personal significance for, for example, his parents, does not explain why he believes they are impostors. A more specific hypothesis directed toward explaining this is that Capgras syndrome involves a type of mindreading disorder, in which the patient's representation of his parents' minds and personalities is damaged or inaccessible to his cognition. If we assume that our representations of peoples' external features can become disconnected from our representations of their internal, mental features, this is exactly the sort of thing that would produce the appearance of an impostor. Third, the two-factor account of delusions offers a plausible competitor to Feinberg's approach. According to it, Capgras syndrome is caused by two sites of damage in the brain, one that affects the way the person appears to the patient, and a second, frontal site of damage that affects the patient's rationality in such a way that he does not notice the gross implausibility of the impostor claim.