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Folie à deux

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Folie à deux (literally "a madness shared by two") is a rare psychiatric syndrome in which a symptom of psychosis (particularly a paranoid or delusional belief) is transmitted from one individual to another. (Related to the issue of shared delusions, there have also been occasional claims of shared visual hallucinations that are near-to-exact duplicates.) The same syndrome shared by more than one person may be called folie à trois, folie à quatre, folie à famille or even folie à plusieurs (madness of many). Recent psychiatric classifications refer to the syndrome as induced delusional disorder (DSM-IV) or shared psychotic disorder (ICD-10).

This case study is taken from Enoch and Ball's 'Uncommon Psychiatric Syndromes' (2001, p181):

Margaret and her husband Michael, both aged 34 years, were discovered to be suffering from folie à deux when they were both found to be sharing similar persecutory delusions. They believed that certain persons were entering their house, spreading dust and fluff and "wearing down their shoes". Both had, in addition, other symptoms supporting a diagnosis of paranoid psychosis, which could be made independently in either case.

This syndrome is most commonly diagnosed when the two or more individuals concerned live in close proximity and may be socially or physically isolated and have little interaction with other people.

Various sub-classification of folie à deux have been proposed to describe how the delusional belief comes to be held by more than one person.

• Folie imposée is where a dominant person (known as the 'primary', 'inducer' or 'principal') initially forms a delusional belief during a psychotic episode and imposes it on another person or persons (known as the 'secondary', 'acceptor' or 'associate') with the assumption that the secondary person might not have become deluded if left to their own devices. If the parties are admitted to hospital separately then the delusions in the person with the induced beliefs usually resolve without the need of medication.
• Folie simultanée describes the situation where two people, considered to independently suffer from psychosis, influence the content of each other's delusions so they become identical or strikingly similar.

Folie à deux and its more populous cousins are in many ways a psychiatric curiosity. The current Diagnostic and Statistical Manual of Mental Disorders states that a person cannot be diagnosed as being delusional if the belief in question is one "ordinarily accepted by other members of the person's culture or subculture" (see entry for delusion). It is not clear at what point a belief considered to be delusional escapes from the folie à... diagnostic category and becomes legitimate because of the number of people holding it. When a large number of people may come to believe obviously false and potentially distressing things based purely on hearsay, these beliefs are not considered to be clinical delusions by the psychiatric profession and are labelled instead as mass hysteria.

Being defined as a rare pathological manifestation, folie à deux is rarely found in general psychology or social psychology text books, and is relatively unknown outside abnormal psychology, psychiatry and psychopathology.

Your brain is smarter than you

Surfing the Web with nothing but brainwaves

Kiss your keyboard goodbye: Soon we'll jack our brains directly into the Net - and that's just the beginning.

By Chris Taylor, Business 2.0 Magazine senior editor

SAN FRANCISCO (Business 2.0 Magazine) - -- Two years ago, a quadriplegic man started playing video games using his brain as a controller. That may just sound like fun and games for the unfortunate, but really, it spells the beginning of a radical change in how we interact with computers - and business will never be the same.

Someday, keyboards and computer mice will be remembered only as medieval-style torture devices for the wrists. All work - emails, spreadsheets, and Google searches - will be performed by mind control.

If you think that's mind-blowing, try to wrap your head around the sensational research that's been done on the brain of one Matthew Nagle by scientists at Brown University and three other institutions, in collaboration with Foxborough, Mass.-based company Cyberkinetics Neurotechnology Systems. The research was published for the first time last week in the British science journal Nature.

Nagle, a 55-year-old quadriplegic, was hooked up to a computer via an implant smaller than an aspirin that sits on top of his brain and reads electrical patterns. Using that technology, he learned how to move a cursor around a screen, play simple games, control a robotic arm, and even - couch potatoes, prepare to gasp in awe - turn his brain into a TV remote control. All while chatting amiably with the researchers. He even learned how to perform these tasks in less time than the average PC owner spends installing Microsoft (Charts) Windows.

Decoding the brain

Nagle was able to accomplish all this because the brain has been greatly demystified in laboratories over the last decade or so. Researchers unlocked the brain patterns for thoughts that represent letters of the alphabet as early as 1999.

Now, Cyberkinetics and a host of other companies are working on turning those discoveries into real products. Neurodevices - medical devices that compensate for damage to the brain, nerves, and spinal column - are a $3.4 billion business that grew 21 percent last year, according to NeuroInsights, a research and advisory company. There are currently some 300 companies working in the field.

But Cyberkinetics is trying to do more than just repair neural damage: It's working on an implantable chip that Nagle and patients in two other cities are using to control electronic devices with their minds. (Check out this demonstration video).

Already, the Brown researchers say, this kind of technology can enable a hooked-up human to write at 15 words a minute - half as fast as the average person writes by hand. Remember, though, that silicon-based technology typically doubles in capacity every two years.

So if improved hardware is all it takes to speed up the device, Cyberkinetics' chip could be able to process thoughts as fast as speech - 110 to 170 words per minute - by 2012. Imagine issuing commands to a computer as quickly as you could talk.

But who would want to get a brain implant if they haven't been struck by a drastic case of paralysis? Leaving aside the fact that there is a lucrative market for providing such profoundly life-enhancing products for millions of paralyzed patients, it may soon not even be necessary to stick a chip inside your skull to take advantage of this technology.

What a tale your thoughts could tell

Brain-reading technology is improving rapidly. Last year, Sony (Charts) took out a patent on a game system that beams data directly into the mind without implants. It uses a pulsed ultrasonic signal that induces sensory experiences such as smells, sounds and images.

And Niels Birbaumer, a neuroscientist at the University of Tuebingen in Germany, has developed a device that enables disabled people to communicate by reading their brain waves through the skin, also without implants.

Stu Wolf, one of the top scientists at Darpa, the Pentagon's scientific research agency which gave birth to the Internet, seriously believes we'll all be wearing computers in headbands within 20 years.

By that time, we'll have superfast, supertiny computers that make today's machines look like typewriters. The desktop will be dead, says Wolf, and the headband will dominate.

"We already know we can trigger neurons mechanically," he says. "You can interact directly with the brain without implanted electrodes. Then the next step is being able to think something and have it happen: Flying a plane, driving a car, operating household machinery."

Controlling devices with the mind is just the beginning. Next, Wolf believes, is what he calls "network-enabled telepathy" - instant thought transfer. In other words, your thoughts will flow from your brain over the network right into someone else's brain. If you think instant messaging is addictive, just wait for instant thinking.

The only issue, Wolf says, is making sure it's consensual; that's a problem likely to tax the minds of security experts.

But just think of the advantages. In the office of the future, the conference call, too, will be remembered as a medieval form of torture.

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