Affective Prosopagnosia and “Hoccleve’s Complaint”

To the Editor: The poet and scribe, Thomas Hoccleve (1368–1426), a contemporary of Chaucer, evidently suffered from a severe form of affective psychosis. Some of the symptoms of his recurrent mood disorder are described in his poem, known as “Hoccleve’s Complaint.” Though formal diagnosis based on such self-disclosed, historical data cannot be made with confidence, some of Hoccleve’s descriptions suggest either a bipolar disorder with psychotic features or some form of schizoaffective disorder. For example, during what sound like depressive phases, Hoccleve describes feeling “sick and beaten/deserted by fortune,” so that “you practically swim in misery/And lose all delight in living.” 1 In contrast, during what appear to be manic periods or agitated catatonic states, Hoccleve describes himself (based on reports of contemporary observers) as

Whatever the nature of the underlying disorder, Hoccleve describes a peculiar experience upon looking at his reflection in the mirror:

Harrington et al. 2 described several neuropsychiatric syndromes characterized by disordered recognition and perception of human faces, including acute schizophrenia and mescaline-induced psychosis. They include so-called “affective prosopagnosia” or “stress-related dysfunctional face recognition” among these. They also describe the “mirror phenomenon,” which they define as

Recently, fMRI studies have found evidence that “…a unique network involving frontoparietal structures” in the right hemisphere underlies self-face recognition 3 and that altered functional connectivity between frontoparietal networks and visual cortices is associated with major depression. 4

While retrospective inferences regarding Hoccleve’s diagnosis are fraught with risk, it is tempting to see his unusual “mirror experience” as related to such frontoparietal abnormalities, perhaps in the context of psychotic affective symptoms. Further research on abnormal self-face recognition and affective psychosis seems warranted.