Clinical Vampirism: Blending Myth and Reality*

Philip D. Jaffe and Frank DiCataldo

Vampires arouse strong popular interest and attract large print and film audiences. Their influence is also notable in clinical vampirism, a rare condition described in the forensic literature covering some of humanity's most shocking behaviors. Defi- nitions of vampirism involve aspects of necrophilia, sadism, cannibalism, and a fascination with blood. Its relationships with established diagnostic categories, particularly and psychopathy, are also examined and illustrated by the presentation of a "modern" . As myth and reality are disentangled, clinical vampirism reveals the complex mother- dyad's blood ties running amok.

In the modern age, have be- manity. In this article, we review the come media stars. Published in 1897, clinical aspects of overt vampiristic be- Dracula by Bram Stoker' made the word havior and its various definitions and "vampire" a household term. More re- describe its relationship to more estab- cently, the vampire trilogy by Anne lished psychiatric disorders. The original Ri~e~-~became a bestseller. On the silver case study of a "modern vampire" will screen, W. Murnau's Nosferatu (Prana help illustrate how myth and reality can Films, Berlin, 1992) remains a classic blend and solidify in dramatic fashion. and a new Dracula movie is periodically But first, by way of introduction, we released to please today's audiences. review the vampire myth to which clin- This enduring fascination with vampires ical vampirism owes its existence. evolved from beliefs and superstitions Mythological Precursors to the dating back to medieval Europe and to Modern Vampire humankind's most archaic myths. Cur- Records of vampirelike figures exist in iously, while providing inspiration for several ancient religions. Commonly the arts, their legacy is also found in the mentioned are the Vajra deities of Tibet rare clinical condition of vampirism, represented as blood drinkers, the which groups some of the most shocking Atharva Veda and the Baital-Pachisi in pathologic behaviors observed in hu- ancient Indian literature, and Mexico's Ciuateteo, who was associated with Philip D. Jaffi is a faculty member of Psychology and women in Mexico having died during Education Sciences, University of Geneva, Switzerland. Frank DiCataldo is affiliated with Bridgewater State their first labor. Summers5 describes Hospital, Bridgewater, MA. Address all correspondence to Dr. Philip D. Jaffk, University of Gcncva, FPSE, 9 what is perhaps the first pictorial evi- route de Drize, 1227 Carouge, Switzerland. dence of the vampire, an Assyrian bowl

Bull Am Acad Law, Vol. 22, No. 4, 1994 533 Jaffe and DiCataldo showing a man copulating with a female vapor and mist. In addition, because the vampire whose head has been severed. vampire is "dead" and soulless, it has no He also reports on Babylonian, Semite, reflection. Those who the vampire at- and Egyptian beliefs involving a dead tacks are generally in a trance and are person that continues to live in its orig- almost sensually embraced while their inal body and feeds off the living. Similar blood is sucked. Summers5 also relates ancient beliefs are traced to ancient Eu- more cannibalistic practices, whereby ropean, Chinese, Polynesian, and Afri- the vampire bites the victim's abdomen can cultures, and most refer to demonic and sometimes extracts and eats the female figures and fused relationships heart. The victim eventually dies and, between the living and the dead, ex- unless proper measures are taken, will pressed through blood rituals as well as in turn become a vampire. Other ways sexualized and aggressive exchanges. to join the "undead," depending on local Current manifestations of these ancient tradition, are to commit suicide, practice beliefs still are found in voodooism and black magic, be cursed by parents or the associated practices in the Caribbean church, be a werewolf, or even be an and in Latin America. In Catholicism, unlucky corpse in Greece on the way to wine continues to symbolize Christ's the cemetery and have a bird or cat cross blood and is consumed by priests during in front of the procession. Jones6 reports mass.+ that in Dalmatia vampires were divided The modern vampire media myth in two categories: innocent and guilty, probably originated in Scandinavia and respectively called Denac and Orko. the British Isles, but it most firmly took Some of the prerequisites to becoming hold in medieval Central and Eastern an Orko vampire were working on Sun- Europe. It owes its etymology to Slavic day, smoking on a religious holiday, and languages (e.g., upir in Bulgarian, vopyr incestuous relations with a female as- in Russian, vapir in Serbian, vampir in cendant, in particular, a grandmother. Hungarian). Periodic vampire scares To counter vampires, schemes rang- agitated these regions and their supersti- ing from the crude to the elaborate were tious inhabitants late into the 19th cen- designed to identify potential vampires tury. A prevalent belief involved a per- and to eliminate them from the world son who had died leaving his tomb at of the living. Garlic and the crucifix were night to attack his victims, often friends considered effective apotropaics (i.e., and relatives, to suck their blood to re- protective measures against evil). Iden- tain his own immortality. The vampire tifying vampires in many ways paral- then returned to his coffin before sunrise leled witch-hunting techniques. Tell-tale or risked paralysis and total helplessness. signs indicating a possible vampire were Some superstitions give the vampire unusual birthmarks, infants born with the power of metamorphosis, the ability teeth, red-haired and sometimes blue- to transform into animal form (most eyed children, tall and gaunt people, and frequently a butterfly or a bat)$ or into epilepsy. Tombs often were opened to

534 Bull Am Acad Psychiatry Law, Vol. 22, No. 4, 1994 Clinical Vampirism see if the cadaver had moved, if it had people were perhaps mistakenly buried fresh cheeks, open eyes, and if the hair alive while suffering from catatonic stu- and nails were still growing. Similar rit- por and hysterical state^.^ Barberlo offers uals were performed in Connecticut in elements of forensic pathology to under- the 18th and 19th centuries.' stand the combined effects of premature Suspected vampires or suspicious burials and human tissue decomposition corpses faced a variety of measures. (e.g., cadavers may change position and These ranged from symbolic exorcism hair and nails may continue to grow). to brutal mutilation. In Bulgaria a sor- There is also an explanation based on cerer armed with a saint's picture would the porphyrias, genetic disorders that drive the vampire into a bottle, which produce reddening of the eyes, skin, and was then thrown into a fire.8 Elsewhere, teeth; receding of the upper lip, craclung the suspected vampire would be put to of the skin; and bleeding in ~unlight.~~'I death, and some of its blood or flesh These reality-based speculations can- consumed. If already buried, the cadaver not fully account for the vampire myth, was unearthed and the head severed and which is too psychologically complex placed between the feet. If necessary the and deeply embedded in ancient pow- heart was also boiled in oil and dissolved erful beliefs and symbols. Indeed, in vinegar. The most popular response Wilgowicz12 points out that Dracula is was to impale the vampire on a wooden only the "typical figure of a large family stake with a single blow through the with entangled branches." In a sense, the heart. Sometimes a priest was called on more modern and media-inspiring im- to shoot the vampire with silver bullets. age of the vampire masks fundamental The image of the vampire also owes aspects of the underlying myths and ar- much of its notoriety to reality. A com- chetypes, the very ones that may allow panion in arms of Joan of Arc, Gilles de for a more significant understanding of Rais, in the 15th century and the Hun- the rare clinical condition of vampirism. garian Countess, Erzsebet Bathory, two Indeed, today's human beings who are centuries later, are famous for having described as vampires owe this label pri- murdered up to 600 children to obtain marily to overt behavior. Yet, closer ex- their blood. Dracula, Bram Stoker's lit- amination reveals the power of the more erary creation, was probably inspired by ancient vampire myths and the process Vlad, a Walachian nobleman in the 15th by which they are transposed into mod- century whose cruelty earned him two ern manifestations. epithets "Tepes" (i-e., "the Impaler") and Count "Dracul" (i.e., "dragon" or Clinical Vampirism: Overview "devil"). and Definitions Several authors suggest that the "un- Both clinical and forensic psycholo- dead" quality of vampires may have re- gists and psychiatrists have described sulted from inadequate or premature cases that involve acts that are strongly burial during times of plague.%any reminiscent of some aspect of the myth-

Bull Am Acad Psychiatry Law, Vol. 22, No. 4, 1994 535 Jaffe and DiCataldo ical vampire's behavior. Clinical defini- object (usually a love object) and receiv- tions of vampirism reviewed in the lit- ing resultant sexual excitement and erature place the emphasis on overt pleasure." In this view, the sucking or vampiristic behavior. drinking of blood from the wound is In the broadest definition, Bour- often an important part of the act but guignon13 proposes to call "vampirisms not an essential one. They report on a [. . .] all sexual or aggressive acts- case of a young man serving a prison whether or not there is blood suction- sentence who came to the attention of committed on a deceased or a dying prison authorities after several inmates person." This view tends to cover a va- were caught stealing iron tablets and riety of behaviors that the author himself expressed a fear of developing anemia. identifies: necrophilia, necrosadism, The investigation showed that the young necrophagia, sadonecrophilia, and vam- man had been trading sexual favors with pirism. The case of Antoine Liger who these inmates in return for the oppor- in 1824 drank his victim's blood but also tunity to suck their blood. raped, murdered, mutilated, and par- Hemphill and Zabow18 attempt to de- tially devoured a young girl is summa- fine vampirism closely to the Dracula rized by Bourguignon to illustrate an myth as a recognizable, although rare, instance of polyvampirism. clinical entity characterized by periodic A more recent case fitting this broad compulsive blood-drinking, affinity with definition of vampirism is described in the dead, and uncertain identity. Rely- detail in the psychiatric literature.I4-l6In ing on the modern vampire myth, they 1978, during a two-day rampage in the reject associated features such as dese- Mayenne region of France, a 39-year- crating graves, violating corpses, eating old man attempted to rape a preadoles- human flesh, or having sexual inter- cent girl, also biting her deeply in the course with the living. Their clinical neck, murdered an elderly man whose sample expressed no interest in sex, and blood he drank and whose leg he par- blood ingestion represented a compul- tially devoured, killed a cow by bleeding sive behavior that brought mental relief it to death, murdered a married couple to the participant without any ability to of farmers, and almost succeeded in psychologically comprehend the experi- doing the same with their farm hand. ence or ascribe it any meaning. Arrested on the third day, he also ad- A fourth definition involves autovam- mitted to strangling his wife almost a piristic behavior. This condition is dis- year before and disguising her death as tinguished from self-mutilating behav- a drowning. iors, intentional suicide attempts, dra- Vandenbergh and Kelly" propose a matic gestures in the context of definition that excludes overt necro- treatment of borderline patients, and philic activity and emphasizes a libidinal manipulative self-harm that may take component. They see clinical vampirism place for secondary gain in prisons. "as the act of drawing blood from an Vandenbergh and Kelly" discuss the

536 Bull Am Acad Psychiatry Law, Vol. 22, No. 4, 1994 Clinical Vampirism case of a 28-year-old man who at pu- patients, often paramedical staff, who berty began masturbating and taking bleed themselves surreptitiously and erotic satisfaction at the sight of his own wrap themselves in a web of nontruths. blood flowing. With practice he was able In addition to hiding their instrumental to direct blood spurts from his neck involvement in the condition, they also artery to his mouth. McCully19 describes make up stories regarding important as- autovampiristic behavior in a young pects of their lives. man that strikingly resembles the pre- Regardless of which definition is vious case. Although there is no conclu- adopted or for that matter, if they are all sive evidence, we believe that the same adopted, overt vampiristic and auto- patient is described in both publications. vampiristic behavior are rare phenom- Bourguignon" introduces an impor- ena. Relying on figures of a thesis by tant distinction within autovampiristic Desr~sieres,~~~ourguignonl~ tallies 53 behaviors by relating the case of a young cases, all but one men having acted out woman hospitalized during her fourth almost exclusively on deceased women pregnancy following repeated vomiting various blends of necrophilic vampir- of considerable amounts of blood. She ism. Prins9, 23 conducted an informal apparently enjoyed these hemorrhages inquiry into the incidence of vampirism and the sight of her blood. She also in Great Britain by contacting mainly voluntarily disconnected transfusion forensic mental health specialists. Seven equipment, let her blood drip, and stated cases were reported, one of which was a she would prefer to drink it. At first no third-hand account. Hemphill and investigation was able to determine the Zabow18 report on four cases of vampir- source of the bleeding. Finally a mouth ism, which they view as an all-male phe- examination by a specialist revealed sev- nomenon as opposed to autovampirism, eral bleeding wounds at the base of the which is a gender-blind but predomi- tongue. Treating staff inferred that she nantly female behavior. sucked these wounds, swallowed the Cases of clinical vampirism are sufi- blood, and then vomited. Apparently ciently rare to warrant a full description sometimes she just would keep the blood of a "modern vampire" with whom both in her mouth before rejecting it, because authors were directly involved at a max- subsequent analyses revealed that gastric imum-security forensic hospital in the juices were not always present. She even- U.S. The case of Jeremy also illustrates tually developed severe anemia and died many of the nosological difficulties as- two years later. An autopsy revealed a sociated with this pathologic behavior. stomach bloated with blood. A psycho- This aspect will be discussed in the last logical feature of critical diagnostic im- section of this paper. portance was the patient's mythomania. It is likely that this patient suffered from The Case of a "Modern Vampire" the rare syndrome of Lasthihie de In addition to the authors' personal Ferj01,~described exclusively in female knowledge of the case, biographic infor-

Bull Am Acad Psychiatry Law, Vol. 22, No. 4, 1994 537 Jaffe and DiCataldo mation also was drawn from hospital from gunshot wounds. To this day, he records. Other sources include a jour- paints vampires ravaging helpless fe- nalist's report of an interview with the males. He also became an avid reader of patient24and a review of portions of the witchcraft literature and horror novels, trial transcript in which the patient's including most of the classics. mother was a principal witness. His mother testified that when he was Jeremy, currently 35-years old, was 13 years old he started killing small an- raised in a seemingly ordinary middle- imals, such as cats, squirrels, fish and class family. His father worked as an birds, and ate them. He also became electrical engineer, and his mother was nocturnal and wandered the streets of a mathematics teacher. He has a brother, his hometown. two years younger, whom he felt his By adolescence he was using illicit mother favored over him. He harbors drugs on a daily basis and was arrested an intense hatred toward her and be- for shoplifting and vandalism. At 15 lieves that her testimony at the trial years of age, he was caught stealing a sealed his conviction for the murder of case of tear gas from the local police his paternal grandmother. He often has station. This led to the first of several alleged that his mother was physically court-ordered hospitalizations. After his abusive during his childhood. Descrip- discharge, he began showing signs of psy- tions of the abuse vary over time and chosis. He developed the delusion that a are colored by delusional thinking. For transmitter in his head was controlled instance, he believes that she belonged by someone in outer space. He felt some- to a witchcraft club, when in fact she thing was wrong with his head and built taught astrology on the side. During the and wore a cardboard pyramid in the club's occult siances, Jeremy claims that hope it would somehow protect and heal blood was drawn from him. He has him. He was in and out of treatment openly expressed his wish to kill his until age 17 when he disclosed to a ther- mother and fantasizes about her death. apist that he was thinking of killing his He has written her letters seething with father. hatred from prison and the maximum After a two-week hospitalization, he security hospital where he now serves his returned home. However, his family was sentence. alarmed when he began keeping an ax Jeremy first demonstrated his fasci- at his bedside. They installed locks for nation with blood at age five when he their bedrooms. They even slept in shifts was hospitalized with pneumonia. While so that one family member would be convalescing, he drew pictures of hypo- awake at all times. Eventually Jeremy's dermic needles dripping blood and but- mother obtained a court order to re- tocks with open wounds oozing blood. move him from the home. He moved In school, his preoccupation expanded into his own apartment and then trav- to include drawings of goblins, bats, eled to Florida. witches, and scenes of violent deaths He called his parents from Florida

538 Bull Am Acad Psychiatry Law, Vol. 22, No. 4, 1994 Clinical Vampirism telling them that vampires were trying not shake him from his belief. He also to kill him. A year later, at age 19, he believed that she was trying to poison returned home and lived with his family him. A few days later, he murdered her. again. His mental condition deteriorated Jeremy's verbatim account of the rapidly. He was unable to sleep, became murder, documented in the court-or- withdrawn, and neglected his hygiene. dered forensic mental health evaluation, He reported hearing voices for the first reveals his psychotic state of mind: time. These voices warned him to be- So it was raining one day, and I washed out of ware of his family and friends, because this job interview so then I took out a gun and they were vampires. His interest in con- painted the bullets gold. I asked my grand- suming animal and human flesh was mother if she wanted anything done and she said she wanted me to do the laundry. I did rekindled. He killed several cats and re- the laundry and asked her if she wanted any- moved their brains to see if he could thing else done. She said 'no.' So I put on my learn how to correct his own brain, suit and shot her. 1 thought she wanted to die. which he believed was dysfunctional. He When I pulled the gun on her I was surprised. She said 'no, no, don't do that.' But it was too also reportedly drank horse blood. late. Once I pulled the gun on her, 1 had to do His obsession with the ingestion of it. I shot her in the heart, and she was wiggling blood, especially human blood, seems to and screaming at me. Then I shot her three more times real fast. Then I started saying a come from his belief that he could be- bunch of weird things to her real fast. I whis- come a vampire and escape the torment pered in her ear something about the devil, of voices in his head and be granted something I had read in a witchcraft book eternal life. Initially he obtained human once. I gave her the last rites and said a small short prayer. blood through accidental circumstances. Later, in psychiatric hospitals, he cut The coroner's report indicates the vic- elderly and infirm patients with small tim also was stabbed, but Jeremy has staples and also traded sex for blood. He always denied this. Currently he denies also bought a hand gun with the inten- drinking her blood, but at one point he tion of shooting someone to draw blood. admitted trying to suck her wounds but After another court-ordered hospital- gave up because she was "too old." ization for killing, dissecting, and eating He dragged the corpse off the sofa and a cat, he was released into the custody into a bedroom where he poured dry gas of his now-divorced father. Auditory on it. He ignited the corpse, which even- hallucinations kept warning him that tually led to the whole house catching some people were vampires. They ridi- fire. He then disposed of the gun in a culed him because he had never killed nearby river, picked up his father, and anyone and told him that to become a drove him to his house. He was with his vampire he must kill and drink some- father when the police called to report one's blood. Furthermore, he believed the tragedy. Jeremy and his father drove that his grandmother used an ice pick to to what remained of the torched house. steal his blood while he slept. That she He tried to enter it to retrieve a box, was an invalid and in a wheelchair did telling the police it contained tax re-

Bull Am Acad Psychiatry Law, Vol. 22, No. 4, 1994 539 Jaffe and DiCataldo turns. The box already had been confis- for the past three years. Considerable cated by the police and contained among therapeutic effort has brought behav- other things gold-painted bullets. The ioral stability. However, he still remains next day he went to the police station invested in a portion of his delusion of and forcibly tried to recover the box. A being a vampire needing to consume struggle ensued, and he was arrested and human blood and flesh. There are no charged with assault and battery on a plans to discharge him from this hospital police officer. He confessed to the mur- in the near future. der the following day. Jeremy underwent a complete psy- His trial showcased a battle of mental chological assessment in 1992, and rec- health experts. Jeremy's lawyer pleaded ords of test results dating back to 1978, not guilty by reason of insanity and in- before the killing of his grandmother, troduced four expert witnesses who tes- also are available. Overall, Jeremy's in- tified that he suffered from paranoid tellectual functioning falls in the average schizophrenia. The prosecution, in an range according to Wechsler's classifi- attempt to get a murder conviction, in- cation, with verbal IQ slightly superior troduced their own expert who testified to performance IQ. The analysis of pro- that Jeremy suffered from a borderline jective records reveals a subtle transfor- personality disorder and was criminally mation between the two assessment^.^^ responsible. The jury convicted Jeremy From the 1978 records, a clinical picture of second degree murder, which carries of psychotic dimensions emerges with a life sentence, and returned a concur- some salient psychopathic traits in the rent lengthy sentence for arson. background. However, 14 years later, his He was sentenced to a maximum-se- presentation is rather psychopathic with curity prison and managed rather well some elements attesting to an underly- for three years on antipsychotic medi- ing psychosis. This apparent contradic- cation. After stopping medication, he tion will in part orient the discussion in developed the delusion that a prison of- the following section. ficer was stealing his spinal fluid. He also believed that the left side of his body The Relationship to was dying, and that by consuming hu- Psychopathology man flesh or spinal fluid he could reverse The relationship of vampirism to psy- the process. He bought a shank from the chopathology is complicated by the low prison underground for protection and incidence of this behavior. Some au- shortly after almost killed the prison of- thors, such as Benezech and associates, ficer he feared. citing the psychological complexity of Jeremy was charged with attempted their cases, describe associated symp- murder but this time was found not tomatology and refrain from any further guilty by reason of insanity. He was spec~lation.'~Others, including Mc- committed to a maximum-security fo- Cully, theorize from the perspective of rensic hospital and has remained there individual depth psych~logy,'~but their

540 Bull Am Acad Psychiatry Law, Vol. 22, No. 4, 1994 Clinical Vampirism analysis offers little possibility of gener- for the schizophrenic to literally replen- alizing to other cases. Yet, as descrip- ish himself. This feature may also be a tions of vampirism cases have accumu- more regressed manifestation of peculiar lated, inferences about psychopathology dietary habits sometimes exhibited by may be drawn. The reader will recognize some schizophrenics. Another consid- Jeremy's symptoms in several of the fol- eration is the lack of any stable sense of lowing categories. self. Some schizophrenics may well suc- Kayton8 considers that the vampire cumb to extremely concrete forms of myth gives "a unique phenomenological testing their very existence such as cut- view of schizophrenia" and indeed overt ting through the skin to determine that vampiristic delusions have been associ- blood flows and merging with and living ated most notably with this disorder. off dead or dying victims. According to The connection is particularly salient in Kayt~n,~other aspects often observed in the more gruesome cases involving can- schizophrenic patients and related more nibalistic and necrosadistic behavior directly to the vampire myth are a preoc- that resemble the content of schizo- cupation with mirrors (another sign of phrenic delusional material acted out. profound identity disturbance) and re- These cases generally present massive versal of the day-night cycle. disorganized oral sadistic regressions, The psychodynamics of vampirism depersonalization, confused sexuality, are quite different for the cases featuring multiple concurrent delusions, and psychopathic and perverse personality thought disorder in content and form. traits. As defined by Cleckley2' and later Psychodynamic explanations draw at- by Hare,29,30 psychopathy is a personal- tention to Karl Abraham's biting oral ity disorder characterized by grandiosity, stage during which the infant uses his egocentricity, manipulativeness, domi- teeth with a vengeance to Melanie nance, shallow affect, poor interpersonal Klein's description of children's aggres- bonding, and lack of empathy, anxiety, sive fantasies"and to W.R.D. Fairbairn's and guilt. Among the most contrasting notion of intense oral sadistic libidinal elements with schizophrenics displaying needs formed in response to actual ma- overt vampirism are that psychopathic ternal depri~ation.~' and perverse personalities carry out Despite the speculative nature of this more integrated and organized behavior theoretic approach and regardless of and reality testing appears mostly intact. whether early psychological and/or Bourguignon, l3 emphasizing the physical abuse actually took place, it is strong libidinal component in vampir- interesting to note that schizophrenics istic behavior, labels it a perversion. The often manifest persecutory delusions of perverse aspects can be observed in few incorporation, introjection, devouring, cases of vampirism, specifically when and destruction. Lacking the capacity the subject apparently draws sexual sat- for symbolic thought, the ingestion of isfaction from drinking a live victim's blood and/or body parts may be a way blood. Here, the subject's history may

Bull Am Acad Psychiatry Law, Vol. 22, No. 4, 1994 54 1 Jaffe and DiCataldo be the key to understanding the fixation tendency to violate limits and rules. on blood and its idiosyncratic meaning. More often than not, a history of animal Within the psychopathic clinical abuse including mutilations is elicited. cases, depending on the actual circum- These features tend to persist into adult- stances of the vampirism, the strong de- hood: lack of empathy towards others sire to control the victim may be the becomes glaring, and criminalization most important feature. This aspect may can occur. The acquisition of physical account for the popularity of sadoma- force and the propensity to act out on sochistic scenarios involving aspects of innocent victims without the capacity to vampirism. In mainstream sexuality, foresee and without concern for unpleas- love bites between amorous partners ant consequences create the conditions may be highly symbolic remnants of for lethal behavior. vampire sensuality. However, in the case Whereas clinical vampirism would of necrophilic and necrosadistic vampir- seem to maintain strong nosological ties to schizophrenia, Jeremy's case indicates ism, even when, for example, cadavers connections with various diagnostic cat- are sexually violated, the link between egories. Indeed, a striking feature of un- vampirism and perversion is not clearly usual forensic cases involving extreme established. In this we disagree with behavior is that they are almost literally Bo~rguignon,'~and our review of pub- situated at what Prins9 calls the "bound- lished cases of clinical vampirism sug- aries of psychiatric disorder." As such, gests that as far as vampirism is con- clinical vampirism is one of the few cerned sexual behavior appears almost pathologic manifestations that blends completely subordinated to a destructive myth and reality in dramatic fashion and sadistic drive barely more elaborate and contains a hodgepodge of nosologi- than what is observed in the more grue- cal elements, including schizophrenic, some schizophrenic vampirism. The psychopathic, and perverse features. Un- cases of Jeffrey Dahmer, the Wisconsin fortunately, there has been scant litera- multiple murderer of the early 1990s, ture on the question of violence in psy- and Sergeant Bertrand in the mid- 1850s chopaths who also suffer from psychosis. in France illustrate this predominance In fact, there is considerable historical despite sexual acting out.' resistance within most diagnostic sys- When vampirism is embedded in a tems to juxtapose psychosis and psycho- psychopathic personality disorder, the pathy. A notable exception has been the potential for extremely dangerous be- contributions of Meloy3' and Meloy and havior seems compounded. The cases Ga~ono.~*The association of schizo- presented by Hemphill and Zabow18 fall phrenic and psychopathic features seems in this category. In cases of vampirism particularly relevant with regard to clin- ical vampirism. within psychopathy, subjects frequently present the common salient childhood Conclusions impulse control difficulties, are under- One of the inherent aspects of all socialized, and demonstrate an early myths is that new versions succeed one

542 Bull Am Acad Psychiatry Law, Vol. 22, No. 4, 1994 Clinical Vampirism another with the most recent reflecting Vampiristic behavior thus no longer transpositions of the earlier ones. By represents the outwardly expression of virtue of its universality, the vampire vitiated intrapsychic drives, but acquires myth does not escape this evolution. a strong dyadic and relational quality, Earliest mythology has associated albeit irremediably disturbed. Vampir- vampires with female figures represent- ism and vampirization are the two poles ing potential destruction and children in of this extremely close, literally blood- a state of dependency and helplessness. tied relationship. Clinical vampirism Wilgo~icz'~points to affinities between represents the most dramatic manifes- the Dracula inspired vampire myth, on tation of perhaps the most archaic rela- the one hand, and childbirth, on the tionship running amok. Vampiristic be- other. Birth implies opening the eyes and haviors that very frequently involve a sunlight entering. Symbolically, birth fascination with the dead or actually kill- also buries the umbilical and blood-shar- ing represent in our view a hopeless at- ing relationship between mother and fe- tempt to extricate from an archaic rela- tus. The modern, Dracula-based, vam- tionship with parental figures even pire myth insists on blood ties in a though the victims are rarely the parents macabre sense, i.e., suction of the vic- themselves. tim's blood, but also in a relational and Appendix familial as well as sexual sense, i.e., vic- * This article is an expanded version of a presenta- tion madc at the XIXth International Congress of thc tims were generally family members. International Academy of Law and Mental Health, We believe contemporary psychoa- Lisbon, Portugal, June 1993. t In 785, King Charlemagne of France was com- nalysis and psychology have generated pelled to legislate against the literal interpretation of new versions of the vampire myth. transubstantiation. $ The association with bats seems to have been most Jones6 relies on traditional psychoanal- popularized in movies. However, in 1762, the French naturalist Buffon named a bat variety vampynis san- ytic theory to analyze the vampire myth guisangus. from the living's perspective. Love, hate, 6 The LasthCnie de Feriol svndrome. named after the'heroine of Barbey d'~u>evili~'snovel, Une histoire guilt, libidinal urges, sadistic drives, and sans norn, was first described by Bernard, Najean, Alby, incestuous feelings towards important and Rain." Burguin and Feillard2' present a more recent case. figures who died form the psychological 11 Discussing the primitive use of the body to express web that contributed to the creation and aggressive fantasies, RivikreZ6graphically lists the child's physical armamentarium: "Limbs shall trample, kick, fear of vampires. However, when the and hit; lips, fingers and hands shall suck, twist, pinch; myth blends with reality, as in Jeremy's teeth shall bite, gnaw, mangle and cut; mouth shall devour, swallow and kill (annihilate); eyes kill by a look, case, complementary explanations are pierce and penetrate; breath and mouth hurt by noise [. . -1." p. 50. needed. In this view, maternal figures 11 In his own written rebuttal to views expressed at provide affective nourishment essential his trial by a famous forensic psychiatrist, Sergeant Bertrand exclaims: "Oui! Destructive monomania has for the child's successful development, always been stronger in me than erotic monomania, it but under unfavorable circumstances, is undeniable, and I believe that I would never have taken any chances to rape a cadaver had I not been able children also can experience depletion to destroy it afterwards. Therefore destruction wins over and a form of psychological vampiriza- sexuality, whatever is said, and nobody is able to prove the contrary; I know better than anyone what was going ti~n.~~ on in me."13

Bull Am Acad Psychiatry Law, Vol. 22, No. 4, 1994 543 Jaffe and DiCataldo References of Haigh, the 'acid-bath murderer'. S Afr Med J 63:278-8 1, 1983 1. Stoker B: Dracula. Oxford: Oxford Univer- 19. McCully RS: Vampirism: historical perspec- sity Press, 1897 tive, and underlying process in relation to a 2. Rice A: The Vampire Lestat. New York: case of auto-vampirism. J Nerv Ment Dis Ballantine, 1986 139(5):440-52, 1964 3. Rice A: The Queen of the Damned. New 20. Bernard J, Najean Y, Alby N. Rain JD: Les York: Ballantine, 1989 animies hypochromes dues a des himorra- 4. Rice A: Interview with a Vampire. New gies volontairement provoquies. Syndrome York: Ballantine, 199 1 de Lasthinie de Ferjol. Presse Med 75:2087- 5. Summers M: The Vampire. New York: Uni- 90, 1967 versity Books, 1960 2 1. Burguin C, Feillard J: "Histoi~esans nom": 6. Jones E: On the Nightmare. London: Ho- A propos de la mythomanie. Evolution Psy- garth Press, 193 1 chiatrique 5 1 : 187-204, 1986 7. New Englanders "killed" corpses, experts say. 22. Desrosikres P (1974): A propos d'un Cas de NY Times, Oct 31, 1993, at 36 Nkcrophilie. Place du Corps duns les Perver- 8. Kayton L: The relationship of the vampire sions: Nficrophilie, Nkcrosadisme ez Vampir- legend to schizophrenia. J Youth Adoles- isme. Doctoral dissertation (#37). University cence 1(4):303-14, 1972 of Paris-Criteil, France 9. Prins H: Bizarre Behaviours: Boundaries of 23. Prins H: Vampirism-Legendary or clinical Psychiatric Disorder. London: Routledge, phenomenon? Med Sci Law 24(4):283-93, 1990 1984 10. Barber P: Vampires, Burial and Death: Folk- 24. Page C: Blood Lust: Conversations with Real lore and Reality. London: Yale University Vampires. New York: Harper Collins, 199 1 Books, 1988 25. Jaffi PD. DiCataldo F, Tschopp C: A late 11. Prins H: Vampirism: A clinical condition. Br night story: Rorschach records of a vampire. J Psychiatry 146:666-8. 1985 Presented at the XIVth International Ror- 12. Wilgowicz P: Le Vampirisme. De la Dame schach Congress and Projective Methods, Blanche au Golem. Meyzieu. France: Cisura, Lisbon, Portugal, July 1993 1991. p. 8 26. RiviZre J: On the genesis of physical conflict 13. Bourguignon A: Situation du vampirisme et in early infancy. Int J Psychoanal 55:397- de I'autovampirisme. Ann Med Psychol 404, 1936 (Paris) l(2): 18 1-96, 1977 27. Fairbairn WRD: An Object-Relations The- 14. Fellion G, Duflot JP, Anglade P, Fraillon J: ory of the Personality. New York: Basic i Books. 1952 Du fantasme la rialiti: A propos d'un 28. Cleckley H: The Mask of Sanity (ed 5). St. passage i I'acte criminel et cannibalique. Ann Louis, MO: Mosby, 1976 Med Psychol (Paris) 138(5):596-602, 1980 29. Hare R: Psychopathy: Theory and Research. 15. Benezech M, Bourgeois M, Villeger J, Etch- New York: Wiley, 1970 egaray B: Cannibalisme et vampirisme chez 30. Hare R: 20 years experience with the Cleck- un schizophrene multimeurtrier. Bordeaux ley psychopath, in Unmasking the Psycho- Midical 13: 126 1-5, 1980 path. Edited by Reid W. Dorr D. Walker J, 16. Benezech M, Bourgeois M, Boukhabza D, Bonner J. New York: Norton. 1986 Yesavage J: Cannibalism and vampirism in 3 1. Meloy JR: The Psychopathic Mind: Origins, paranoid schizophrenia. J Clin Psychiatry Dynamics, and Treatment. Northvale, NJ: 42(7):290. I98 1 Aronson, 1988 17. Vandenbergh RL, Kelly JF: Vampirism: a 32. Meloy JR. Gacono C: A psychotic (sexual) review with new observations. Arch Gen Psy- psychopath: ''I just had a violent thought. . ." chiatry 2:543-7, 1964 J Pers Assess 58:480-93, 1992 18. Hemphill RE, Zabow T: Clinical vampirism: 33. Yvonneau M: Matricide et vampirisme. a presentation of 3 cases and a reevaluation Evolution Psychiatrique 55:567-77, 1990

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