Erotomaniac
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Erotomania, also known as de Clérambault's syndrome, is a relatively uncommon
paranoid Paranoia is an instinct or thought process that is believed to be heavily influenced by anxiety, suspicion, or fear, often to the point of delusion and irrationality. Paranoid thinking typically includes persecutory beliefs, or beliefs of con ...
condition that is characterized by an individual's delusions of another person being
infatuated Infatuation, also known as being smitten, is the personal state of being overly driven by an uninformed or otherwise unreasonable passion, usually towards another person for whom one has developed strong Romantic love, romantic or sexual feelin ...
with them. It is listed in the
DSM-5 The ''Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition'' (DSM-5), is the 2013 update to the '' Diagnostic and Statistical Manual of Mental Disorders'', the taxonomic and diagnostic tool published by the American Psychiat ...
as a subtype of a
delusional disorder Delusional disorder, traditionally synonymous with paranoia, is a mental illness in which a person has delusions, but with no accompanying prominent hallucinations, thought disorder, mood disorder, or significant flattening of affect. Ameri ...
. Commonly, the onset of erotomania is sudden, and the course is chronic. This disorder is most often seen (though not exclusively) in female patients who are shy, dependent, and sexually inexperienced. The object of the delusion is typically a male who is unattainable due to high social or financial status, marriage, or lack of interest. The object of obsession may also be imaginary, deceased, or someone the patient has never met.
Delusions of reference Ideas of reference and delusions of reference describe the phenomenon of an individual experiencing innocuous events or mere coincidences and believing they have strong personal significance. It is "the notion that everything one perceives in the ...
are common, as the erotomanic individual often perceives that they are being sent messages from the secret admirer through innocuous events such as seeing license plates from specific regions.


Symptoms

The core symptom of erotomania is that the individual holds an unshakable belief that another person is secretly in love with them. In some cases, the person with the condition may believe several people at once are "secret admirers". Most commonly, the individual has delusions of being loved by an unattainable person who is usually an acquaintance or someone the person has never met. They may also experience other types of delusions concurrently with erotomania, such as delusions of reference, wherein the perceived admirer secretly communicates their love by subtle methods such as body posture, arrangement of household objects, colors, numbers, license plates on cars from specific states and other seemingly innocuous or, if the person is a public figure, through clues in the media such as coded social media posts and meaningful clothing choices. Some delusions may be extreme such as the conception, birth, and kidnapping of children that never existed or the belief that the individual was predestined or chosen by God to be with the object of their obsession. The delusional objects may be replaced by others over time, and some may be chronic in fixed forms.
Denial Denial, in colloquial English usage, has at least three meanings: * the assertion that any particular statement or allegation, whose truth is uncertain, is not true; * the refusal of a request; and * the assertion that a true statement is fal ...
is characteristic with this disorder as the patients do not accept the fact that their object of delusion may be married, unavailable, or uninterested. The phantom lover may also be imaginary or deceased. Erotomania has two forms: primary and secondary. Primary erotomania is also commonly referred to as de Clérambault's syndrome and old maid's insanity and it exists alone without
comorbidities In medicine, comorbidity refers to the simultaneous presence of two or more medical conditions in a patient; often co-occurring (that is, concomitant or concurrent) with a primary condition. It originates from the Latin term (meaning "sickness" ...
, has a sudden onset and a chronic outcome. The secondary form is found along with mental disorders like paranoid schizophrenia, often includes
persecutory delusions A persecutory delusion is a type of delusional condition in which the affected person believes that harm is going to occur to oneself by a persecutor, despite a clear lack of evidence. The person may believe that they are being targeted by an i ...
,
hallucination A hallucination is a perception in the absence of an external stimulus that has the compelling sense of reality. They are distinguishable from several related phenomena, such as dreaming ( REM sleep), which does not involve wakefulness; pse ...
s, and grandiose ideas, and has a more gradual onset. Patients with a "fixed" condition are more seriously ill with constant delusions and are less responsive to treatment. These individuals are usually timid, dependent women that are often sexually or socially inexperienced. In those with a more mild, recurrent condition, delusions are shorter-lived and the disorder can exist undetected by others for years. Problematic behaviors include actions like calling and texting, sending letters and unwanted gifts, persistent internet harassment via social media and email, making unannounced house visits, contacting or attempting to contact the individual's friends, family or co-workers and other persistent stalking behaviors.


Cause

Erotomania may present as a primary mental disorder, or as a symptom of another psychiatric illness. With secondary erotomania, the erotomanic delusions are due to other mental disorders such as
bipolar I disorder Bipolar I disorder (BD-I; pronounced "type one bipolar disorder") is a type of bipolar spectrum disorder characterized by the occurrence of at least one manic episode, with or without mixed or psychotic features. Most people also, at other ti ...
or
schizophrenia Schizophrenia () is a mental disorder characterized variously by hallucinations (typically, Auditory hallucination#Schizophrenia, hearing voices), delusions, thought disorder, disorganized thinking and behavior, and Reduced affect display, f ...
. Symptoms may also be precipitated by
alcoholism Alcoholism is the continued drinking of alcohol despite it causing problems. Some definitions require evidence of dependence and withdrawal. Problematic use of alcohol has been mentioned in the earliest historical records. The World He ...
, substance abuse (including cannabis use) and the use of antidepressants. There may be a potential genetic component involved as family histories of first degree relatives (parents, siblings) with histories of psychiatric disorders and/or
dementia Dementia is a syndrome associated with many neurodegenerative diseases, characterized by a general decline in cognitive abilities that affects a person's ability to perform activities of daily living, everyday activities. This typically invo ...
are common. The disorder also has behavioral similarities to
early onset Alzheimer's disease Early-onset Alzheimer's disease (EOAD), also called younger-onset Alzheimer's disease (YOAD), is Alzheimer's disease diagnosed before the age of 65. It is an uncommon form of Alzheimer's, accounting for only 5–10% of all Alzheimer's cases. Ab ...
(
mood swings A mood swing is an extreme or sudden change of mood. Such changes can play a positive or a disruptive part in promoting problem solving and in producing flexible forward planning. When mood swings are severe, they may be categorized as part ...
, poor
judgement Judgement (or judgment) is the evaluation of given circumstances to make a decision. Judgement is also the ability to make considered decisions. In an informal context, a judgement is opinion expressed as fact. In the context of a legal tria ...
,
confusion In psychology, confusion is the quality or emotional state of being bewildered or unclear. The term "acute mental confusion"
,
hallucinations A hallucination is a perception in the absence of an external stimulus that has the compelling sense of reality. They are distinguishable from several related phenomena, such as dreaming ( REM sleep), which does not involve wakefulness; pse ...
).
Sigmund Freud Sigmund Freud ( ; ; born Sigismund Schlomo Freud; 6 May 1856 – 23 September 1939) was an Austrian neurologist and the founder of psychoanalysis, a clinical method for evaluating and treating psychopathology, pathologies seen as originating fro ...
explained erotomania as a defense mechanism to ward off homosexual impulses which can lead to strong feelings of paranoia, denial, displacement and projection. Similarly, it has been explained as a way to cope with severe loneliness or ego deficit following a major loss. Erotomania may also be linked to unsatiated urges dealing with homosexuality or
narcissism Narcissism is a self-centered personality style characterized as having an excessive preoccupation with oneself and one's own needs, often at the expense of others. Narcissism, named after the Greek mythological figure ''Narcissus'', has evolv ...
. Some research shows brain abnormalities occurring in patients with erotomania such as heightened temporal lobe asymmetry and greater volumes of lateral ventricles than those with no mental disorders.


Treatment

Prognosis differs from person to person, and the ideal treatment is not completely understood. Treatment for this disorder gains the best results when tailored specifically for each individual. To date, the mainline pharmacological treatments have been
pimozide Pimozide (sold under the brand name Orap) is a neuroleptic medication, drug of the diphenylbutylpiperidine class. It was discovered at Janssen Pharmaceutica in 1963. It has a high potency compared to chlorpromazine (ratio 50-70:1). On a weigh ...
(a typical antipsychotic which was also approved for treating Tourette's syndrome), and atypical antipsychotics like
risperidone Risperidone, sold under the brand name Risperdal among others, is an atypical antipsychotic used to treat schizophrenia and bipolar disorder, as well as aggressive and self-injurious behaviors associated with autism spectrum disorder. It is t ...
and
clozapine Clozapine, sold under the brand name Clozaril among others, is a psychiatric medication and was the first atypical antipsychotic to be discovered. It is used primarily to treat people with schizophrenia and schizoaffective disorder who have ...
. Non-pharmacologic treatments that have shown some degree of efficacy are electroconvulsive therapy (ECT), supportive psychotherapy, family and environment therapy, rehousing, risk management and treating underlying disorders in cases of secondary erotomania. ECT may provide temporary remission of delusional beliefs; antipsychotics help attenuate delusions and reduce agitation or associated dangerous behaviors, and SSRIs may be used to treat secondary depression. In delusional disorder there is some evidence that pimozide has superior efficacy compared with other antipsychotics. Psychosocial psychiatric interventions can enhance the quality of life through allowing some social functioning, and treating comorbid disorders is a priority for secondary erotomania. Family therapy, adjustment of socio-environmental factors, and replacing delusions with something positive may be beneficial to all. In most cases, harsh confrontation should be avoided. Structured risk assessment helps to manage risky behaviors in those individuals more likely to engage in actions that include violence, stalking, and crime. For particularly troublesome cases, neuroleptics and enforced separation may be moderately effective.


History

Early references to the condition can be found in the work of
Hippocrates Hippocrates of Kos (; ; ), also known as Hippocrates II, was a Greek physician and philosopher of the Classical Greece, classical period who is considered one of the most outstanding figures in the history of medicine. He is traditionally referr ...
, Freud (1911),
French French may refer to: * Something of, from, or related to France ** French language, which originated in France ** French people, a nation and ethnic group ** French cuisine, cooking traditions and practices Arts and media * The French (band), ...
psychiatrist A psychiatrist is a physician who specializes in psychiatry. Psychiatrists are physicians who evaluate patients to determine whether their symptoms are the result of a physical illness, a combination of physical and mental ailments or strictly ...
Gaëtan Gatian de Clérambault Gaëtan Henri Alfred Edouard Léon Marie Gatian de Clérambault (; 2 July 1872 – 17 November 1934) was a French psychiatrist. Apart from his psychiatric studies, he was an acclaimed painter and wrote on the costumes of various native trib ...
(1942),
Erasistratus Erasistratus (; ; c. 304 – c. 250 BC) was a Greek anatomist and royal physician under Seleucus I Nicator of Syria. Along with fellow physician Herophilus, he founded a school of anatomy in Alexandria, where they carried out anatomical research ...
,
Plutarch Plutarch (; , ''Ploútarchos'', ; – 120s) was a Greek Middle Platonist philosopher, historian, biographer, essayist, and priest at the Temple of Apollo (Delphi), Temple of Apollo in Delphi. He is known primarily for his ''Parallel Lives'', ...
and
Galen Aelius Galenus or Claudius Galenus (; September 129 – AD), often Anglicization, anglicized as Galen () or Galen of Pergamon, was a Ancient Rome, Roman and Greeks, Greek physician, surgeon, and Philosophy, philosopher. Considered to be one o ...
. Parisian physician, Bartholomy Pardoux (1545-1611) covered the topics of nymphomania and erotomania. In 1623, erotomania was referred to in a treatise by Jacques Ferrand (Maladie d'amour ou Mélancolie érotique) and has been called "erotic paranoia" and "erotic self-referent delusion" until the common usage of the terms erotomania and de Clérambault's syndrome. In 1971 and 1977, M.V. Seeman referred to the disorder as "phantom lover syndrome" and "psychotic erotic transference reaction and delusional loving". Emil Kraepelin and Bernard also wrote of erotomania and more recently, Winokur, Kendler, and Munro have contributed to knowledge on the disorder. G. E. Berrios and N. Kennedy outlined in "Erotomania: a conceptual history" (2002) several periods of history through which the definition of erotomania has changed considerably: *Classical times – early eighteenth century: General disease caused by unrequited love *Early eighteenth-beginning of nineteenth century: Practise of excess physical love (akin to
nymphomania Hypersexuality is a proposed medical condition said to cause unwanted or excessive sexual arousal, causing people to engage in or think about sexual activity to a point of distress or impairment., according to the website of '' Psychology T ...
or
satyriasis Hypersexuality is a proposed medical condition said to cause unwanted or excessive sexual arousal, causing people to engage in or think about sexual activity to a point of distress or impairment., according to the website of ''Psychology Toda ...
) *Early nineteenth century – beginning twentieth century: Unrequited love as a form of mental disease *Early twentieth century – present: Delusional belief of "being loved by someone else" In one case, erotomania was reported in a patient who had undergone surgery for a ruptured
cerebral aneurysm An intracranial aneurysm, also known as a cerebral aneurysm, is a Cerebrovascular disease, cerebrovascular disorder characterized by a localized dilation or ballooning of a blood vessel in the brain due to a weakness in the vessel wall. These a ...
.


Well-known cases

In his paper that described the syndrome, de Clérambault referenced a patient he had counselled who was obsessed with British monarch
George V George V (George Frederick Ernest Albert; 3 June 1865 – 20 January 1936) was King of the United Kingdom and the British Dominions, and Emperor of India, from 6 May 1910 until Death and state funeral of George V, his death in 1936. George w ...
. She had stood outside
Buckingham Palace Buckingham Palace () is a royal official residence, residence in London, and the administrative headquarters of the monarch of the United Kingdom. Located in the City of Westminster, the palace is often at the centre of state occasions and r ...
for hours at a time, believing that the king was communicating his desire for her by moving the curtains. Parallels were drawn between this and a 2011 case where the body of a homeless American man was found on a secluded island in
St James Park St James Park and variants may refer to: Football stadiums * St James' Park, Newcastle upon Tyne, England, ground of Newcastle United F.C. * St James Park (Exeter), England, ground of Exeter City F.C. * St James Park, ground of Brackley Town F.C., ...
, within sight of Buckingham Palace. The man had sent hundreds of "strange and offensive" packages to
Queen Elizabeth II Elizabeth II (Elizabeth Alexandra Mary; 21 April 19268 September 2022) was Queen of the United Kingdom and other Commonwealth realms from 6 February 1952 until Death and state funeral of Elizabeth II, her death in 2022. ...
over the previous fifteen years. The
attempted assassination This is a list of survivors of assassination attempts. For successful assassination attempts, see List of assassinations. Non-heads of state Heads of state and government Gallery File:Arrestation Gregori.jpg, Arrest of Louis Gregori, th ...
of United States president
Ronald Reagan Ronald Wilson Reagan (February 6, 1911 – June 5, 2004) was an American politician and actor who served as the 40th president of the United States from 1981 to 1989. He was a member of the Republican Party (United States), Republican Party a ...
by
John Hinckley Jr. John Warnock Hinckley Jr. (born May 29, 1955) is an American man who attempted to assassinate U.S. president Ronald Reagan as he left the Hilton Hotel in Washington, D.C., on March 30, 1981, two months after Reagan's first inauguration. Using ...
has been reported to have been driven by an erotomaniac fixation on actress
Jodie Foster Alicia Christian "Jodie" Foster (born November 19, 1962) is an American actress and filmmaker. Foster started her career as a child actor before establishing herself as leading actress in film. She has received List of awards and nominations re ...
, whom Hinckley was attempting to impress. Late-night TV entertainer
David Letterman David Michael Letterman (born April 12, 1947) is an American television host, comedian, writer, producer, and auto racing team owner. He hosted late-night television talk shows for 33 years, beginning with the February 1, 1982, debut of ''Late N ...
and former astronaut
Story Musgrave Franklin Story Musgrave (born August 19, 1935) is an American physician and a retired NASA astronaut. He is a public speaker and consultant to both Disney's Imagineering group and Applied Minds in California. In 1996, he became only the second a ...
were both stalked by
Margaret Mary Ray Margaret Mary "Peggy" Ray (1952 – October 5, 1998) was an American woman who had schizophrenia and erotomania. She received much media attention for stalking talk show host David Letterman and retired astronaut Story Musgrave. Early life R ...
, who had erotomania. Michael David Barrett allegedly had erotomania, stalking ESPN correspondent
Erin Andrews Erin Jill Andrews (born May 4, 1978) is an American sportscaster and television personality. She rose to prominence as a correspondent on the American cable sports channel ESPN after joining the network in 2004. She later joined Fox Sports in 2 ...
across the country, trying to see her and taking lewd videos. Many cases of obsession or stalking can be linked to erotomania but do not always necessarily go hand in hand.


In media

* In ''
Black Narcissus ''Black Narcissus'' is a 1947 British psychological drama film jointly written, directed and produced by Michael Powell and Emeric Pressburger, based on the 1939 novel by Rumer Godden. It stars Deborah Kerr, Sabu, David Farrar, and Flora R ...
'' (1947) Sister Ruth exhibits erotomania towards Mr Dean * '' Girls Town'' (1959) * ''
Play Misty for Me ''Play Misty for Me'' is a 1971 American psychological thriller film directed by and starring Clint Eastwood, his directorial debut. Jessica Walter and Donna Mills co-star. The screenplay, written by regular Eastwood collaborators Jo Heims and ...
'' (1971) * ''
Fatal Attraction ''Fatal Attraction'' is a 1987 American psychological thriller film directed by Adrian Lyne and written by James Dearden, based on his 1980 short film '' Diversion''. It follows Dan Gallagher ( Michael Douglas), an attorney who cheats on his ...
'' (1987) * ''
Nurse Betty ''Nurse Betty'' is a 2000 American black comedy film directed by Neil LaBute and starring Renée Zellweger as the title character, a small town, Kansas waitress who suffers a nervous breakdown after witnessing her husband's torture murder, and s ...
'' (2000) * A main character in the American TV series ''
Orange Is the New Black ''Orange Is the New Black'' (sometimes abbreviated to ''OITNB'') is an American comedy-drama television series created by Jenji Kohan for Netflix. The series is based on Piper Kerman's memoir '' Orange Is the New Black: My Year in a Women's Pr ...
'',
Lorna Morello Lorna Morello is a fictional character from the Netflix dramedy series ''Orange Is the New Black'', played by Yael Stone. Stone was initially contracted for one episode, but was quickly promoted to series regular. Morello is based on two real-life ...
, exhibits erotomanic behavior towards a man to whom she deludedly believes herself to be engaged * '' He Loves Me... He Loves Me Not'' (2002) * A 2011 episode (season 5, episode 3) of the British TV series ''Lewis'' features a character with erotomania, referred to in the show as de Clérambault's syndrome * ''
Enduring Love ''Enduring Love'' is a 1997 novel by British writer Ian McEwan. The plot concerns two strangers who become perilously entangled after witnessing a deadly accident. Summary On a beautiful and cloudless day, a middle-aged couple celebrate their ...
'' (1997) * ''
Criminal Minds ''Criminal Minds'' is an American police procedural crime drama television series created by Jeff Davis that premiered on CBS on September 22, 2005. It follows a group of criminal profilers who work for the FBI as members of its Behavioral ...
'' – season 1, episode 5: "Broken Mirror" * ''
Criminal Minds ''Criminal Minds'' is an American police procedural crime drama television series created by Jeff Davis that premiered on CBS on September 22, 2005. It follows a group of criminal profilers who work for the FBI as members of its Behavioral ...
'' – season 1, episode 18: "Somebody's Watching" * ''
Doc Martin ''Doc Martin'' is a British medical comedy-drama television series starring Martin Clunes as Doctor Martin Ellingham. It was created by Dominic Minghella developing the character of Dr Martin Bamford from the Nigel Cole comedy film '' Saving ...
'' – season 6, episode 3: "The Tameness of a Wolf" * ''
Law & Order ''Law & Order'' is an American police procedural and legal drama television series created by Dick Wolf and produced by Wolf Entertainment and Universal Television, launching the ''Law & Order'' franchise. ''Law & Order'' aired its entire ...
'' – season 3, episode 18: "Animal Instinct" * ''
Wire in the Blood ''Wire in the Blood'' is a British crime drama television series, created and produced by Coastal Productions with Tyne Tees Television and broadcast on ITV from 14 November 2002 to 31 October 2008. The series is based on the Tony Hill and Ca ...
'' - season 3, episode 3: "Nothing But the Night" * A 2019 episode (season 1, episode 2) of the British-Austrian series ''Vienna Blood'' features a character who displays symptoms of de Clérambault's syndrome (although correctly not described as such, since the programme is set in 1907, 14 years before de Clérambault himself described the syndrome) * ''
You In Modern English, the word "''you''" is the second-person pronoun. It is grammatically plural, and was historically used only for the dative case, but in most modern dialects is used for all cases and numbers. History ''You'' comes from ...
'' (2018) Joe Goldberg experiences erotomania in most of his interactions with women he's meeting for the first time * In Chapter VIII of ''
The Great Gatsby ''The Great Gatsby'' () is a 1925 novel by American writer F. Scott Fitzgerald. Set in the Jazz Age on Long Island, near New York City, the novel depicts first-person narrator Nick Carraway's interactions with Jay Gatsby, a mysterious mi ...
'', the title character expresses the view that Daisy, his obsession, might, at most, have loved her husband "just for a minute, when they were first married" but that she loved him, Gatsby, "more even then". * ''Erotomaniac'' (2022) an animated horror film about erotomania * ''
The Brokenwood Mysteries ''The Brokenwood Mysteries'' is a New Zealand television detective drama series that premiered on Prime (now Sky Open) in 2014. Each of the first six series comprises four episodes. From Series 7, seasons were extended to six episodes. The progr ...
'' – series 10, episode 4: "Love You to Death"


See also


Further reading

* * * Frank Bruni, Behind the Jokes, a Life Of Pain and Delusion; For Letterman Stalker, Mental Illness Was Family Curse and Scarring Legacy, New York Times, November 22, 1998 * Foster, David & Levinson, Arlene. Suicide on a railroad track ends a celebrity-stalker's inner agony Archived 2011-06-14 at the Wayback Machine., Associated Press, October 11, 1998 * * Helen K. Gediman (14 December 2016). ''Stalker, Hacker, Voyeur, Spy: A Psychoanalytic Study of Erotomania, Voyeurism, Surveillance, and Invasions of Privacy''. Karnac Books. pp. 21–34. .


References


Notes


Bibliography

* * *Helen K. Gediman (14 December 2016). ''Stalker, Hacker, Voyeur, Spy: A Psychoanalytic Study of Erotomania, Voyeurism, Surveillance, and Invasions of Privacy''. Karnac Books. pp. 21–34. . * * *McDonnell, Margaux, and Mike McPadden. "9 Stalkers That Make Us Glad We're Not Famous". CrimeFeed, 12 Nov. 2013, crimefeed.com/2013/10/9-stalkers-that-make-us-glad-were-not-famous/. * * * {{Authority control Psychosis Delusional disorders Love Stalking Psychopathological syndromes Delusions