Over the last eight decades a plethora of psychodynamic explanations h
ave been invoked to account for the Capgras delusion. While often ill-
founded and convoluted, these formulations have, until recently, domin
ated many theoretical approaches to the phenomenon. Generally post hoc
and teleological in nature, they postulate motives that are not intro
spectable and defence mechanisms that cannot be observed, measured or
refuted. While psychosocial factors can and often do play a part in th
e development, content and course of the Capgras delusion in individua
l patients it remains to be proven that such factors are necessary and
sufficient to account for delusional misidentification in general and
the Capgras delusion in particular.