Unfinished Portrait of General Bonaparte, Jacques-Louis David, c.1798.
CHAPTER VIII
10 June 1831. It’s nearly three years since Bedlam registered the death of one of its longest-term and most notorious patients, Margaret Nicholson. James Tilly Matthews has been in his grave in London for fifteen years. At Charenton asylum in Paris, a patient is admitted. A doctor makes notes about the man in the ‘Register of Medical Observations’:
The first day we found him dressed elegantly, head held high, with a proud, haughty air; his tone was that of command, and his least gestures indicated power and authority. He soon informed us that he was the Emperor of France, with millions in riches, that Louis Philippe was his chancellor, etc. Then he…pompously recited verses of his own commission, in which he allocated kingdoms, settled the affairs of Belgium and Poland, etc.1
There’s a stagey drama to his entrance, like a guest at a costume party and some of the same black comedy as with the glass king. To the staff at Charenton, though, this man means trouble. He’s not the first Napoleon to knock on the door of an asylum in Paris. And Napoleon has been dead for ten years.
We can picture this ‘Napoleon’ instantly, in his three-dimensional glory: the iconic bicorn hat, frock coat and proud gaze, short stature and puffed up, hands behind his back. His very name personified power and ambition and was a shorthand to the staff at Charenton, as it still is. The situation deteriorates into something much more desperate. According to the physician’s notes, this ‘Napoleon’ was violently disruptive:
During the day he smashed everything because people would not obey his every order. He was calmed by a shower and then shut up in a cell. The next day we found him naked, having torn up everything, shouting, threatening, etc.
We notice a pitiful disconnect between the proud icon ‘Napoleon’ and this raging unclothed man in an asylum cell.
The phenomenon of duplicate ‘Napoleons’ is spreading. The First Emperor of France continues to show up to other hospitals with orders. Nine years later, as the real Napoleon’s coffin is returned to the French capital, Dr Voisin, the head physician at the Bicêtre asylum, will note ‘fourteen or fifteen emperors’ in his hospital.2 As with glass delusion centuries before, here are multiple individuals experiencing a delusion with the same characteristics. Research in the city archives by the historian Laure Murat found that ‘delusions of grandeur’ accounted for more than a quarter of mental disorder diagnoses in the register for the Greater Paris area for 1840.3 And these delusional people are taking the shape of one grand figure above all the others: Napoleon Bonaparte.
The unshakeable belief that you are a person of great fame or power, when patently you are not, is a ‘delusion of grandeur’, another category in the World Health Organization’s taxonomy of delusions dating back to the sixties. It’s the second most common delusion type after paranoid, persecutory delusions, and it’s so fixed in the popular imagination that for many delusions of grandeur have come to represent the subject as a whole. This is probably in part owing to the splendid fancy-dress parade that accompanies the cases but also because grandiosity is often an attendant trait in people experiencing other primary delusions, as it was with ‘Madame M’ and James Tilly Matthews.4 Grandiosity is subtly different from a delusion of grandeur. The grandiose are related to Boudicca, or the king, or they have a fortune owed to them, or they are at the centre of diplomatic relations during the French Revolution. With a delusion of grandeur you are Napoleon.
Delusions of grandeur are the simplest expression of how delusions seem to function; a primer in the help and protection they offer a person. And Napoleon is the poster boy for the whole operation. The Charenton Napoleon of 1831, and the fourteen or fifteen other emperors after him at Bicêtre, jump out of the dusty ledgers of multiple nineteenth-century establishments. The message couldn’t be clearer. This is a declaration of importance. Here are the powerless asserting their authority. Like the Glass Men, they are telling the world how we should view them; how we should treat them, but they are shouting the instructions not whispering them. ‘Respect me!’ they cry. They are proactive, turning things around for themselves. It’s a basic mechanism transporting people who are knocking along on the bottom to positions of great wealth and power.
Laure Murat even found evidence of a woman who believed herself to be Napoleon: a seventy-one-year-old admitted in June 1852, though it’s not clear if she believed herself to be Napoleon I or III. ‘She says she’s Napoleon; she shouts, “Long Live Napoleon!”’5 Such was the power of Napoleon to trigger delusional illness in the mid-nineteenth century. It’s as disconcerting to count them all as it is to tally ‘Madame M’s substitute doubles. But these are not impersonations, they are not doppelgängers, they are Napoleon. Identities which feature in delusions of grandeur are unambiguous and unchanging like caricatures. Despite appearances, the individuals experiencing the delusion resist a simple interpretation, and we can lose them just as quickly as they arrived back into the throng or the gloomy backstreets.
Delusions of grandeur are perennial, but they have gone by different names over the millennia. The personas which crop up again and again to strut and fret on the stage are, predictably enough, the most powerful and influential figures of recorded history. No one is on record as being Louis Philippe – the so-called ‘Citizen King’ who took over in France a few years after Napoleon and was mocked for being utterly ineffectual. Delusional personas are from the landed nobility, or they own all of India, are Louis XIV, or Charlemagne; even Satan, and, not infrequently, Jesus.
This particular delusion goes back as far as the records. Robert Burton included a few choice examples of what we would now call delusions of grandeur in The Anatomy of Melancholy in 1621: a woman from Genoa, for example, who believed she was married to a king, thus making her queen. She conversed with this king, and when she saw bits of broken glass in the street, she said they were jewels that he had given her. A man from Cremona thought he was the pope and set to work appointing cardinals. Shakespeare is playful with grandiose delusions in The Taming of the Shrew. His drunk tinker, Christopher Sly, is found asleep, and on waking up he’s tricked into thinking he’s a nobleman.
By the time these nineteenth-century emperors were marching around, the belief that you were a world leader when you were not was already the quintessence of insanity. Thomas Hobbes wrote in 1651: ‘If some man in Bedlam should entertain you with sober discourse; and you desire in taking leave, to know what he were, that you might another time require his civility; and he should tell you he were God the Father, I think you need expect no extravagant action for argument of his madness.’6
Napoleon is an archetype of political power, Christ of spiritual power. In Western Europe, people who believe that they are the Messiah have made themselves known for centuries. They were spotted in the seventeenth century by Hobbes proselytising in their cells at Bedlam, and spotted again visiting the Holy Land itself. According to the Israeli psychiatric doctors who have to triage them, a few tourists to the biblical sites still present as the Messiah each year. These ‘Christs’ are connected to what’s become known as ‘Jerusalem syndrome’, a term coined in the 1930s by the Israeli psychiatrist Heinz Herman, where a person arriving in the city is overtaken by a state of high emotion and devotion, usually someone who is already an evangelical Christian.
Delusional ‘Messiahs’ arrived well before the formal description of the syndrome. A Frenchman, Simon Morin, is the most famous early case. He was burned at the stake in Paris in 1663 for his belief. The burning was in a public place, in the Paris of the ‘Sun King’, another absolute monarch whose confident vision was reflected in the new classical façades across the city. Morin’s burning exposed the tensions beneath these new façades. The Jansenist movement inside the Catholic Church was threatening the order of things with their emphasis on predestination and grace. Descartes was writing stirring rationalist critiques – about the contemptible nonsense of glass delusion, for example. It’s in this context that Simon Morin stands up and announces that he is the Messiah, and, according to his conviction about who he is, he makes the ultimate sacrifice. A ‘delusion of grandeur’ is often attached to a fearsome sense of responsibility, for saving the world in Simon’s case. The roar of power starts to sound more anxious. The message has more complexity and nuance.
Delusions of grandeur are as old as the hills. Nevertheless, the sheer number of people exhibiting them in Paris at the beginning of the nineteenth century was remarkable. Physicians and the general public alike puzzled over the phenomenon. You could be forgiven for thinking that delusions of grandeur (discussed side by side with a new concept of ‘monomania’ where a single fixation existed in an otherwise unaffected mind) were at epidemic levels in the city.
Why did so many people believe they were Napoleon, specifically, at this place and time, and not some other dignitary or royal from the past or present? Why did so many people identify, not just with him, but as him? Becoming this one man like Charles VI and the others became glass. Napoleon Bonaparte is long dead by 1840. His rule ended in 1815 and his last breath was taken in exile on St Helena in 1821. These Napoleons hold on to their personas with an iron grip.
Doctors at Charenton were continuing to refine the new discipline of psychiatry, along with their peers at the other great nineteenth-century establishments: Bicêtre, Salpêtrière, Sainte-Anne and Hôtel Dieu. Jean-Étienne Esquirol became chief physician at Charenton in 1826. He was a protégé of Philippe Pinel, who died that year, and he seized on the Napoleons as an opportunity to advance his mentor’s work. Under Esquirol’s leadership the physicians at Charenton continued to challenge the association of delusions with moral weakness and the idea that a person experiencing one was a vessel for the devil. There were still people who came to the hospital claiming to be Satan, but this was a psychological phenomenon, not demonic possession.
Under Esquirol, these ‘Napoleons’ would not be contained and punished like criminals. They would be listened, to with a view to curing them. Asylums like Charenton were still formidable places, no question, but Esquirol and his colleagues followed Pinel’s lead in a rigorous attention to note-taking and careful logging of symptoms. The startling numbers of Napoleons in the registers points to there being more of this kind of delusion per head of population in early nineteenth-century Paris than at any other point in history. At least part of the explanation for this, however, lies in the simple fact that they were keeping such extensive records.
By the time the fourteen or fifteen emperors turn up at Bicêtre in 1840, France is a country exhausted by decades of war, and the weak, charisma-free Louis Philippe is in charge.
The French had fallen a long way in a short time. A few years later, one of the contributors to the Bibliothèque du médecin-praticien went further by saying: ‘we have no fear of being taxed with exaggeration in saying that that the madness of the age is pride’ and that never before in history ‘have we seen so many men make themselves out to be saviours, to have first-rank talents and abilities’.7 The sin of pride had been identified as the culprit for mental instability for centuries. Wounded pride in a personal sense is something different, and it has also driven delusions under the radar and is thus harder to spot. Margaret Nicholson, James Tilly Matthews and Francis Spira were all influenced by it.
The people of France were looking for someone larger than life. Napoleon was a figure from a noble past. He was dead in the literal sense, but in another important sense he is even more alive, and necessary, than he had ever been. This is the archetypal self-made man. He came from the island of Corsica, not from Paris, and went on to command an empire. Napoleon represented the supreme triumph of perseverance over the accident of birth. The opposite to that lottery of primogeniture. His father was from a noble Italian family, but Napoleon spoke Spanish and was ridiculed for it in the mainland French military school he attended, as well as for his short stature. The battle for the new Republic brought him back from Corsica. He won promotion in 1793 after defeating the British at Toulon. Suspected of treason he was imprisoned for ten days, but unlike James Tilly Matthews he managed to negotiate himself back on side with the regime. When forces loyal to the king attempted to retain power in 1795 Napoleon was called in to stop the uprising. His prize was the badge of Commander of the Army of the Interior, then his Josephine, then Italy, Austria, Egypt. The rest is history (until the defeat at Waterloo) but the takeover was improbable. You wouldn’t have bet on it. Here was proof that magical thinking could work, and take anyone with enough grit to the world stage and then to its control room. He even managed to wrestle an accommodation with the Catholic Church in the Concordat with Pope Pius VII of 1801 by reaffirming its majority status among the other denominations. When the dust settled a few years after Waterloo the story that had survived about Napoleon was a simple one charting his domination of the Western world.
There’s a timeless draw to any story of an individual rising from a modest start to great success and power. Napoleon was a costume that felt good on, offering protection from a wretched existence, even a reversal of fortune – his had flipped in the right direction. The revolutions in printing and pamphleteering allowed the personality cult of Napoleon to be disseminated in a mass-media explosion.
Esquirol had a theory. He saw the ‘Napoleons’ and the other ‘grand figures’ walking the corridors at Charenton as a product of the frenetic empire-building overseen by the first Emperor of France. This was a time when territories were being fought over, boundaries drawn and encroached upon, fixed national identities and power bases destabilised:
At that epoch, when [Napoleon] peopled Europe with new kings, there were in France many monomaniacs who thought themselves emperors or kings, empresses or Queens. The Spanish war, conscriptions, and our conquests and reversals also produced their mental maladies. How many persons, stricken with terror at the two invasions, remained monomaniacs! Indeed, we now find in madhouses many people who consider themselves dauphins of France and destined to the throne!8
In this treatise from 1820 Esquirol looks back on recent history and makes a clear link between delusions of grandeur and their empirical context, especially an unstable – unreliable – political structure. He refers to ‘two invasions’, Austria in 1805, and Russia in 1812, as well as to the Peninsular War with Spain to the south-west in 1808. Allegiances broke up and reformed with England, Prussia, Russia, with tides of attack and retreat on both fronts.
In line with Esquirol’s analysis, the rise of the nation state across Europe coincided with a fair number of ‘Empress Eugénies’ and ‘Emperor Wilhelm Is’ and, during the geo-political creep of the Third Reich in the next century, it was not uncommon for women to claim Hitler was, for example, their brother. Margaret Nicholson was also an international sensation at this time. If Esquirol ever heard about her delusion in doctors’ despatches across the Channel from Bedlam he might well have put it down to the pride of the British Empire.
The dream of the Revolution had become an endless nightmare by the time the ‘Napoleons’ arrived. According to Esquirol, people had continued to respond to each successive trauma with delusions: ‘The influence of our political misfortunes has been so great, that I could give the history of our revolution from the taking of the Bastille to the last appearance of Bonaparte from that of certain insane persons whose insanity connects itself with the events which have [so marked] this long period of our history.’9 Esquirol’s take is that delusions are ground markers for the country.
Esquirol locates delusions in broad brush strokes of French history. There is one particular Napoleon delusion, a companion piece with a compelling twist on the original that is worth homing in on and considering in more detail. In the Analectic Magazine, an American digest of the best papers and articles of the day, there is an account of a European woman with a ‘delusion of grandeur’ who believed she was Napoleon’s wife. A letter of 12 June 1817 by an unnamed correspondent reports the author’s encounter with ‘Madame Bonaparte’.10 She is apparently experiencing her delusion while Napoleon is still alive in exile. The correspondent’s gloss on the situation is that she was from a ‘reputable family’, but ‘had an inordinate attachment to splendour and equipage; which the circumstances of her husband would not permit him to indulge… Her dress became highly expensive and fantastic: and she would take possession of any elegant carriage which she found drawn up at a neighbour’s house; giving the coachman directions to drive up to some spacious abode, which she deemed her own. In one of these excursions she was driven to the lunatic asylum; and, rather against her will, detained there. It was, however, “her palace”… At this time Napoleon Bonaparte enjoyed the wealth and dignity of a powerful emperor; and who should be the husband of our lady, but the potent monarch of France, and the temporary creator of the destinies of Europe!’ The eye-roll in the commentary makes fun of her claims. Her belief that she was empress was so strong that the commonly understood reality of the world and its property would adapt to fall in line with it. Then the story gets more complicated. She is not having a good time. She is in prison. ‘She was his spouse, but confined in a castle. He was testing her affection for her. She wouldn’t recognise her husband or daughters and dressed in a regal fashion even when confined.’ Here is another delusion of recognition. She won’t accept her children as her own. The author says they have in their possession a letter which the woman sent to Napoleon from ‘Spain’ on 26 March 1816. She actually wrote it in 1811. They transcribe ‘Madame Bonaparte’s words:
– what can I say to you? A volume could not contain it – and yet my pen is mute; nor can my hand, my tremulous hand, retrace the great, the vast, the awful ideas that nearly overpower my imagination; nor engage in that converse sweet that is comprised in objects more minute. I certainly have caught the contagion, or mania of objects that surround me. I am bewildered. The sublime, the profound, the infinite; the burlesque and trifling; the tender and endearing; the repulsive and forbidden; sham quarrels, and checked, reconciliations: – grandeur, magnificence in prospect; real sufferings, indignities and respect, the sway of the hearts and affections of millions in submissive subjection to a small single control, &c. &c. – are so blended and confounded, that I can give no intelligible expression to any of them.
Her letter goes on to address her imprisonment. She wants to be free, but she doesn’t understand why she isn’t. Who is supposed to make the next move? Is he waiting for her to do anything? This is a perverse version of true love where a mystery motive is keeping them apart. It’s moving to read a first-hand account of a ‘delusion of grandeur’ that doesn’t come filtered through a doctor. She is eloquent, existential, mysterious. How to treat something like this? What is going on?
At Charenton, Esquirol was interested in causes primarily as a means of improving treatments. One of the therapies tried at the hospital before his time was theatre. Charenton’s director at the time, Abbé de Coulmier, had been interested in psychotherapy through art and for several years prisoners performed alongside the guards. There was a packed bill of productions including works by Molière, with the playwright Pierre de Marivaux as master of ceremonies. The Marquis de Sade was in Charenton for two stints, once in 1789 and for a longer stretch in 1803 until his death in 1814, and he was allowed to write and direct plays as part of the theatre-as-therapy initiative. Audiences were invited in from outside to watch and Hippolyte de Colins, a former cavalry officer, got a seat for one particular performance in 1812. After the show de Colins witnessed one of the actors, a famous dancer called Trénitz, raging to the others at having to take off his costume. He was dressed up as a king for the play. Those in authority concluded the plays might in fact make delusions worse rather than better and in 1813 they were banned.11 So was there anything new that would help with a ‘delusion of grandeur’?
There were always the old tricks. Ruses were one of the only methods in the professional tool kit still reporting some success. When a captain of the dragoons experiencing the delusion that he was the Napoleon turned up at a home for the ‘mentally deranged’, Dr Leblond, who ran the place with his father, attempted a ‘pious fraud’. Leblond was in a standoff with the Emperor of France and entered just a few steps into the world of the delusion in the hope of negotiating a truce. He was met with outrage:
It is surely an indignity to treat Emperor Napoleon in this way!’ he declared to the doctor. ‘Those frightful valets bound me – I intend to have them shot.’ To which Leblond calmly replied: ‘Yes, you are indeed emperor Napoleon, but Napoleon on Saint Helena’. On hearing these words the madman fell silent, then began repeating ‘Saint Helena, Saint Helena.’ He then asked to be unbound and kept his promise to remain calm until he was freed.12
The resolution is suspiciously fast. But Leblond is respectful, and he was apparently successful in de-escalating the situation. Physicians have always understood that simply throwing logic or even conclusive evidence at a person experiencing a delusion does not loosen the grip of their belief. A willingness to engage with the alternative logic of the delusion, to meet it at least some of the way, can be effective.
There’s something about the pomposity and theatricality of a person with a delusion of grandeur that makes a ruse, which is like a parlour game, a particularly sympathetic match. There’s an elaborate ruse to cure a ‘delusion of grandeur’ in the 1921 Pirandello play Henry IV. An unnamed nobleman falls off his horse while playing Henry IV for an annual carnival. He wakes up believing that he is Henry, an eleventh-century emperor. He’s lives like this for twenty years, his family maintaining the charade in a villa made to operate like the court. Now a doctor arrives planning to shock ‘Henry’ out of his delusion. Hanging on the wall is a portrait of the nobleman wearing his carnival costume posing next to the woman he was in love with at the time. This woman has returned, with her grown-up daughter (a lookalike) and fiancé, to witness the ruse. The portrait is swapped for one of the daughter and her fiancé, and the rival is stabbed. The twist comes in Act II when the nobleman admits he has known the truth for eight years but would rather stay as Henry than live in the twentieth century. A king’s identity is a place of relative safety. On the other side of the coin is our glass king Charles VI who shatters under the weight of his crown. Either way, they’ve attained their power by accident of birth or strength of belief, rather than by divine right.
There’s an example of an American hospital hosting an old-fashioned ruse even later in the twentieth century, with serious ethical repercussions. In 1959 the psychologist Milton Rokeach brought together three men claiming to be Jesus in the Ypsilanti State Hospital in Michigan hoping to cure them of their delusion. In his 1964 book The Three Christs of Ypsilanti he wrote about the inspiration for this daring experiment.13 A commentary by Voltaire caught his attention first. By the by, in his notes Voltaire mentioned the most notorious case of a delusion of grandeur, and heresy, the ‘unfortunate madman Simon Morin’, who said that he was ‘incorporated with Jesus Christ’.14 Voltaire relays the story of Morin at an asylum meeting quite by chance someone else claiming to be ‘God the Father’ and being ‘so struck with the folly of his companion that he acknowledged his own, and appeared, for a time, to have recovered his senses’. It didn’t save Morin. The authorities found an apology to God tucked into one of his stockings, but he was nonetheless burned alive in 1663 for his heretical claims. But it planted the seed of an idea for Rokeach.
Rokeach then came across an article by the psychoanalyst Robert Lindler in Harper’s Magazine called ‘The Jet-Propelled Couch’ about a man who believed he was living half his life on another planet.15 Lindler’s line was that when a person enters – invades – another person’s delusion, the person with the delusion is forced to give way. He gives an example of the tactic: ‘imagining an encounter between two victims of, let us say, the Napoleonic delusion. The conviction that each is the real Napoleon must be called into question by the presence of the other, and it is not unusual for one to surrender, in whole or in part.’
Confront to cure is the theory. Lindler had more for Rokeach in the article: an extraordinary encounter that demonstrated the method. At a psychiatric sanitorium in Maryland, Lindler reports, were two middle-aged, paranoid women who both said they were Mary Mother of God. They were reportedly ‘mild mannered’, both Catholics, and of ‘similar socio-economic level’. The two deluded patients began talking:
Before long each revealed to the other her ‘secret’ identity. What followed was most instructive. The first, our ‘oldest’ patient, received the information with visible perturbation and an immediate reaction of startle. ‘Why you can’t be, my dear,’ she said, ‘you must be crazy. I am the Mother of God.’ The new patient regarded her companion sorrowfully, and, in a voice resonant with pity, said, ‘I’m afraid it’s you who are mixed up; I am Mary.’ There followed a brief but polite argument which I was restrained from interfering with by my older and more experienced colleague, who bade me merely to listen and observe. After a while, the argument ceased, and there followed a long silence during which the antagonists inspected each other warily. Finally, the older patient beckoned to the doctor standing with me. ‘Dr S.,’ she asked, ‘what was the name of our blessed Mary’s mother?’
‘I think it was Anne,’ he replied.
At once, this patient turned to the other, her face glowing and her eyes shining. ‘If you’re Mary,’ she declared, ‘I must be Anne, your mother.’ And the two women embraced.
According to Lindler, the woman who surrendered her Mother of God delusion ‘responded to treatment’ and was discharged.
Rokeach conceived an idea for another ruse, a formal experiment this time, to disrupt delusional belief systems. He brought the three men claiming to be Jesus together and made them interact while he observed. First, they engaged in spiritual debate over who was the holier, then there was a physical fight, and finally they each explained away the others’ delusions – they were mentally disabled, or dead, or it was the ‘machines’ inside them producing the fraudulent claims. Each said the others were ‘crazy’ or ‘duped’. Then Rokeach and his hospital team got more involved in the action, sending letters to the three men written in the guise of people who might influence their thinking. After two years Rokeach hadn’t seen any significant change.
In the afterword to the 1981 edition of his book about the experiment Rokeach expressed regret. He apologised for the manipulation without consent. ‘I really had no right, even in the name of science, to play God, and interfere round-the-clock with their daily lives.’ It had he said, cured him of his own ‘God-like delusion’ of manipulation and control.16
He had become ‘increasingly uncomfortable with the ethics of confronting people with delusions’. He could now see that something was going on in a delusion of grandeur that made a lot of sense: ‘Striving for morality and competence, are universal human motives.’ Napoleon wasn’t famous for his morality, unlike some of the most enduringly popular figures like Mary, but he knows what he’s doing and he knows why he’s doing it. He represents absolute confidence in his actions and an unblinking self-justification.
Rokeach’s work also made links between ‘baseless’ delusions and the rickety foundations so many of us use to construct our identities. My belief is my identity, say the ‘Christs’ the ‘Marys’ or the ‘Napoleons’. The world may not accept this; they are not literally the people they say they are, but what can a person do to prove their essential self anyway? What can anyone else do to disprove it? Stories about successful ruses in the past seem more and more dubious in the light of more recent experiments like Rokeach’s. Challenging a person with a delusion just made them freeze and put up the defences. They weren’t vulnerable to logical proof or hard physical evidence. Rokeach admitted that self-confrontation was much more effective but that relied on a person wanting to step out of a protective persona that was serving them well. Even Lindler’s story of the two ‘Marys’ who changed after meeting each other at the hospital was a subtle one. They didn’t snap out of it. They adapted their delusions to accommodate each other and they stayed in a delusional world. Aside from the ethical issue, the major one with the confront-to-cure ruse was that it didn’t work in the long term. Ruses fell firmly out of favour as a psychiatric treatment.
No ruse worked on Esquirol’s 1831 ‘Napoleon’, if they attempted one at all. Esquirol and colleagues had progressive ambitions, but treatments didn’t always get very far. The 1831 ‘Napoleon’ was discharged three months later, ‘not entirely cured’.17 The cause of this man’s delusion retreats away from us as he marches out of the records and back to the streets of Paris.
Alongside any psychological drivers, there may be an undetected biological dimension to delusions of grandeur from the past. Parallel roots in genetic predisposition or neurological damage. Scientists looking for consistent patterns of brain disease or damage with delusions are homing in on the right hemisphere of the brain.18 Lesions in patients with grandiose delusions are typically of the right frontal lobe. It’s the right hemisphere which deals with perception of self and other; the left hemisphere can be thought of as a creative narrator. The theory goes that right-lobe lesions stop a person regulating people, places or body parts in relation to self and so the left brain steps in with a false or excessive explanation to make sense of the confusion: you’re made of glass, your husband has been substituted for a double, you are Napoleon. The left side makes sense of the faulty perception on the right and invents a narrative. Delusions of persecution and guilt are typically associated with lesions on the left side in the temporal lobe.
Delusions of grandeur are also common as a secondary mania, in conjunction with diseases like Huntingdon’s, Parkinson’s and Wilson’s as well as with abuse of substances which disrupt neurotransmitter function, and with ‘bipolar’ depression. Religious practice can prepare the ground for them. Thomas Jefferson University in Philadelphia conducted brain imaging studies of people in a state of devotion. The limbic system, the centre of emotions, shows much higher activity when a person is in this state, and the frontal lobes, which play the key role in keeping it calm, shut down. This may go some way to explaining how people visiting the holy sites come to believe that they are the Messiah.
Do all the Napoleons have right-lobe lesions? Our interpretation of delusions adapts with each new insight into the organic brain, but the balance between biological and psychological is unclear.
We still don’t really know what to do with people presenting with a delusion of grandeur. There is an essential simplicity to a Napoleon delusion. Being Napoleon confers protection, influence and hope for the future. There is more than a little logic in the ‘madness’ of trying on the persona for size. It is a copycat power grab for anyone who feels at the mercy of the world. So far, so understandable.19
But then we remember ‘Madame Bonaparte’s letter to Napoleon and it’s not so simple. It’s worth replaying her words. They offer a rare inside story on a delusion of grandeur. ‘I am bewildered,’ she says. ‘The sublime, the profound, the infinite; the burlesque and trifling; the tender and endearing; the repulsive and forbidden; sham quarrels, and checked, reconciliations:– grandeur, magnificence in prospect; real sufferings, indignities and respect, the sway of the hearts and affections of millions in submissive subjection to a small single control, &c. &c.– are so blended and confounded, that I can give no intelligible expression to any of them.’ ‘Madame Bonaparte’ communicates the complexity and ambiguity that can underpin a ‘delusion of grandeur’. There’s a mystery to people, a melancholy to use the old word, that they don’t give up easily, even if they are presenting us with a caricature. Do we leave them in peace, as the three ‘Christs’ should have been left? Or do we listen more closely?