The heautoscopic episode occurred shortly before admission. The patient stopped his phenytoin medication, drank several glasses of beer, stayed in bed the whole of the next day, and in the evening he was found mumbling and confused below an almost completely destroyed large bush just under the window of his room on the third floor. . . . The patient gave the following account of the episode: on the respective morning he got up with a dizzy feeling. Turning around, he saw himself still lying in bed. He became angry about “this guy who I knew was myself and who would not get up and thus risked being late at work.” He tried to wake the body in the bed first by shouting at it; then by trying to shake it and then repeatedly jumping on his alter ego in the bed. The lying body showed no reaction. Only then did the patient begin to be puzzled about his double existence and become more and more scared by the fact that he could no longer tell which of the two he really was. Several times his bodily awareness switched from the one standing upright to the one still lying in bed; when in lying in bed mode he felt quite awake but completely paralysed and scared by the figure of himself bending over and beating him. His only intention was to become one person again and, looking out of the window (from where he could still see his body lying in bed), he suddenly decided to jump out “in order to stop the intolerable feeling of being divided in two.” At the same time, he hoped that “this really desperate action would frighten the one in bed and thus urge him to merge with me again.” The next thing he remembers is waking up in pain in the hospital.
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
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).
