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De C14rambault On-Line: a Survey of Erotomania and Stalking from the Old World to the World Wide Web

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De C14rambault On-Line: a Survey of Erotomania and Stalking from the Old World to the World Wide Web l/ ............ .... , ~:."" ~i ..... " "'~.... ::~...... ~ ~"~~'~.:"'~"~" ' ~...... : ~'" ~ ~i ~-~ ~ ' ~--" U ~ ............ :'~ .......... .: l/ De C14rambault On-Line: A Survey of Erotomania and Stalking from the Old World to the World Wide Web Robert Lloyd-Goldstein, M.D., J.D. In recent years, there has been a burgeoning of interest in erotomania and its clinical variants, which had hitherto been relegated to the dubious status of "rare, unclassifiable, collective and exotic psychotic syndromes" (Arieti & Meth, 1959). Likewise, there has been a spectacular outpouring of media glare and attention from the law enforcement community and legislators over the phenome- non of stalking. Sensational headlines are an almost everyday occurrence, trumpet- ing the stalking of celebrities, as well as otherwise anonymous individuals. The relentless torments visited upon the victims, the psychological profiles of the stalkers, the grotesque dramas (including maimings and murders) that may ensue have become the subject of serious scholarly study (Meloy, 1996; Segal, 1989), as well as fodder for the popular culture (e.g., tabloids, television talk shows, and movies such as Play Misty For Me, The Story of Adele H., and the genre's magnum opus, Fatal Attraction). Unsurprisingly, the growth of new technologies, such as the proliferation of computers and the ubiquity of the World Wide Web, has been accompanied by the emergence of electronic surveillance, e-mail stalking, and Internet harassment, among other forms of on-fine crime. Quaint Old World clinical curiosities, where monarchs and members of the nobility were amorously pursued (usually from afar) by lovesick individuals (invariably women "of a certain age"), were described in the early literature by Kraepelin (1921), De C16rambault (1921/1942), Hart (1921), and others (Krafft- Ebing, 1879). It appeared to some to be so quintessentially a phenomenon of the Ancien 1L6gime, deeply rooted in continental culture, that one early psychiatrist described erotomania as a "syndrome essentiellement Fran~aise," (Reik, 1963). 193 The Psychology of Stalking: CHnical and Forensic Perspectives Copyright 9 1998 by Academic Press. All rights of reproduction in any form reserved. 194 Robert Lloyd-Goldstein One of the original cases described by De C14rambault in his classic work Les Psychoses Passionelles (1921/1942) was representative of this clinical entity: A 53-year-old Frenchwoman became absolutely convinced that King George V of England was in love with her. She was certain that English sailors and tourists in France were messengers sent by the King to proclaim his love for her .... During several trips to England, starting in 1918, she waited patiently outside the gates of Buckingham Palace; once when she saw a curtain moving in a window, she interpreted this as a signal from the King. She claimed that news of their love was known throughout London, but she also insisted that the King was disrupting her travel plans and that he had arranged for the loss of her luggage, which contained money and portraits of him. Despite these difficulties, which might have been interpreted as attempts to discourage her affections, she persisted in her belief that there was a special relationship between the King and herself, saying, "The King might hate me, but he can never forget. I could never be indifferent to him, nor he to me." (p. 343) Similar cases were reported by Kraepelin (1921), Hart (1921), and Spitzka (1889), utilizing the nosology, phenomenology, and scientific methodology of their time. Prior to the advent of psychiatry as we know it, this syndrome in one form or another was known to the ancients; described by Hippocrates, Galen, and Plutarch; reported by various physicians of the Middle Ages; and portrayed in classic works of literature, such as the Decameron of Boccaccio (Enoch, Tretho- wan, & Barker, 1967). In more recent years, we have witnessed the transplanting of this Old World syndrome to the soil of the New World, where it has taken root and flourished in ways that could not have been foreseen. Feder (1973) was one of the first to remark on this phenomenon: It is every clinician's experience to come across a case from time to time which hews closely to some classic description of disease. This is no less true in psychiatry, and it is all the more striking when one observes a clinical picture originally described in one cultural context making its appearance in another. Such a case tends to reaffirm that psychopathology--in fact, mental functioning in general--transcends its individual appearances in time and place and, indeed its very content. (p. 240) This transmogrification of erotomania has kept pace with many other trendy sociological vogues of our time, evoking the peculiarly American overtones of glitzy sensationalism, lurid "made for Hollywood" melodrama, overt violence and sadism, and pop commercialization (as a mega-cottage industry has sprung up, of concerned politicians, law enforcement entrepreneurs, and celebrity forensic psychiatrists, striving mightily to cash in on the bonanza). This Americanization of erotomania and stalking has taken us full cycle, from the clinical esoterica of a bygone era (with vignettes of genteel modistes and old maids, enmeshed in their romantic fantasies with Kings and clergymen), to the thoroughly hip modern celebrity stalkers of Madonna and David Letterman, to the startling instances of violence that have prompted anti-stalking legislation in all American jurisdictions, and most recently of all, to the vast new frontier of cyberstalking. The rekindling 10. De C16rambault On-Line 195 of an interest in the forensic aspects of erotomania, with its potential for stalking and serious violence (particularly in men, who often predominate in these forensic populations), was initiated by Goldstein (1978, 1986, 1987) and by Taylor, Mahen- dra, and Gunn, (1983) barely 20 years ago. During this brief span, erotomania and stalking have come of age, prompting a plethora of serious scientific inquiries that have added to our knowledge of the nosology, demographics, and clinical and forensic dimensions of this important entity. NOMENCLATURE AND DIAGNOSIS The nosological and diagnostic controversies over erotomania have appar- ently been resolved for the time being by DSM-IV (APA, 1994), which lists it as the erotomanic subtype of the diagnostic category delusional disorder (which represents a new diagnostic designation, first introduced by DSM-III-R [APA, 1987]). Prior to that, the appropriate DSM-III (APA, 1980) diagnosis for the condition was the nonspecific atypical psychosis. Before DSM conferred its authori- tative imprimatur, erotomania had languished for many years in "a kind of diagnos- tic limbo" (Segal, 1989), truly "a symptom in search of adequate conceptualiza- tion... [having] been incorporated into diagnostic systems in many different ways" (tLudden, Sweeney, & Frances, 1990, p. 625). Despite DSM's official fiat, individual cases may pose lingering questions that defy easy categorization. Mullen and Path~ (1994a) point out that DSM credits erotomania with being an occasional symptom of 22 categories of disorder, ranging from schizophrenia to multi-infarct dementia. These cases of "secondary" erotomania would necessarily exclude an Axis I diagnosis of delusional disorder. Thus, erotomanic symptoms in themselves do not dictate diagnosis. Patients with erotomania are a heterogeneous group, with diagnoses that may fall into two main categoriesmprimary erotomania (i.e., delusional disorder, erotomanic subtype) or secondary erotomania (i.e., the delusion is superimposed on another psychotic condition, e.g., schizophrenia, schizoaffective disorder, bipolar disorder) (tkudden et al., 1990). With an increased interest in erotomania and stalking, more cases are identified and reported in the literature than ever before. More precise diagnostic determinations will assist researchers to refine our ability to better predict clinical course, response to treatment, future dangerousness, and other variables (often in a forensic context). PRIMARY EROTOMANIA De C18rambault diagnosed primary (or "pure") erotomania as a monodelusio- nal disorder, in which there is a precise and explosive onset, with no significant psychiatric symptoms apart from the elaborate erotomanic features. The patient 196 Robert Lloyd-Goldstein (invariably a woman, according to De C16rambault) holds the delusional belief that a man, usualb older and of elevated social status, sometimes a public figure, is passionately in k,ve with her, despite paradoxical conduct by him, during which he may appear to deny his love for her vigorously, even to hate or harm her, when in fact he really does love her and is merely testing her love (or trying to throw others off the track) (De C16rambault, 1921/1942). As Segal (1989) emphasized, it was not De C16rambault, but Kraepelin who originally described erotomania in modern terms, as a subcategory in his schema of paranoia (Kraepelin, 1921). Kraepelin noted that erotomanic patients are usually mature women with persistent delusions of being loved, which serve as "a kind of psychological compensation for the disappointments of life" (Kraepelin, 1921, p. 259). He described a protoWpical case as follows: A female patient noticed that the reigning sovereign bowed with special respect to her in the theatre and made his children greet her .... Very soon the signs of the secret misunderstanding increased in number. Every chance occurrence, clothing, meetings,
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