Crime and Folie À Deux: Review and Case History

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Abstract
The phenomenon to which Lasègue and Falret in 1873 applied the term “folie à deux”, had many times previously been recognized and described. William Harvey (1651) noted a case, and his contemporary, Sir Kenelm Digby (1658) not only recorded an excellent clinical description but suggested a psychopathology (Greenberget al., 1956). For Lasègue and Falret, folie à deux was a social rather than a psychiatric phenomenon: the second “passive” subject, they believed, was not truly psychotic but simply “absurdly credulous”. As they saw it, the more authoritative and intelligent “active” partner created the delusions and imposed them on the “passive” subject. This was more likely to occur in a setting of prolonged and isolated intimacy. The delusions were more likely to be accepted if they were plausible and played on the hopes and fears of the second subject. Heredity, they pointed out, offered no overall explanation, for this process frequently involved unrelated individuals. The second subject often accepted the first's delusions only after a fruitless and exhausting struggle to restore his sanity: “the indifferent escape both this useless travail and its consequences.” They held the prognosis for the “passive” subject to be invariably good, providing that the pair were separated. As early as 1563 Wier, writing on the cure of nuns afflicted en masse by demoniacal possession, had advised this course.
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