Erotomania

For the sexual condition, see Hypersexuality. For the song by Dream Theater, see A Mind Beside Itself.

Erotomania is a type of delusion in which the affected person believes that another person, usually a stranger or famous person, is in love with him or her. The illness often occurs during psychosis, especially in patients with schizophrenia or bipolar mania.^[1] During an erotomanic episode, the patient believes that a "secret admirer" is declaring his or her affection to the patient, often by special glances, signals, telepathy, or messages through the media. Usually the patient then returns the perceived affection by means of letters, phone calls, gifts, and visits to the unwitting recipient. Even though these advances are unexpected and unwanted, any denial of affection by the object of this delusional love is dismissed by the patient as a ploy to conceal the forbidden love from the rest of the world.^[2]

The term erotomania is often confused with "obsessive love", obsession with unrequited love, or hypersexuality (see nymphomania). Obsessive love is not erotomania by definition.

Erotomania is also called de Clérambault's syndrome, after the French psychiatrist Gaëtan Gatian de Clérambault (1872–1934), who published a comprehensive review paper on the subject (Les Psychoses Passionelles) in 1921.

History

Early references to the condition can be found in the work of Hippocrates, Erasistratus, Plutarch and Galen^{[citation needed]}. In the psychiatric literature it was first referred to in 1623 in a treatise by Jacques Ferrand (Maladie d'amour ou Mélancolie érotique) and has been variously called, "erotic paranoia" and "erotic self-referent delusions" until the common usage of the terms erotomania and de Clérambault's syndrome.

G.E. Berrios and N. Kennedy outlined in 'Erotomania: a conceptual history' (2002)^[3] several periods of history through which the concept of erotomania has changed considerably:

• Classical times – early eighteenth century: General disease caused by unrequited love
• Early eighteenth – beginning nineteenth century: Practice of excess physical love (akin to nymphomania or satyriasis)
• 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.^[2]

Presentation

The core symptom of the disorder is that the sufferer holds an unshakable belief that another person is secretly in love with him or her. In some cases, the sufferer may believe several people at once are "secret admirers." The sufferer may also experience other types of delusions concurrently with erotomania, such as delusions of reference, wherein the perceived admirer secretly communicates his or her love by subtle methods such as body posture, arrangement of household objects, and other seemingly innocuous acts (or, if the person is a public figure, through clues in the media). Erotomanic delusions are typically found as the primary symptom of a delusional disorder or in the context of schizophrenia and may be treated with atypical anti-psychotics.

Historical examples

• The assassination attempt of Ronald Reagan by John Hinckley, Jr. was reported to have been driven by an erotomanic delusion to Jodie Foster.^[4]

• Late night TV entertainer David Letterman and former astronaut Story Musgrave were both stalked by Margaret Mary Ray.^[5][6]

In popular culture

Examples of de Clerambault's syndrome (erotomania) in fiction include Ian McEwan's novel Enduring Love, which was later turned into a film also called Enduring Love; the American movies Fatal Attraction and The Bodyguard, the Portuguese film O Fantasma (2001) and the French films Anna M. (2007) and Laetitia Colombani's À la folie... pas du tout (2002), starring Audrey Tautou. A psychiatrist Dr. Falkowski, in real life, and in the film U Be Dead, was stalked by a woman who suffered from this condition.

The band Dream Theater has a song titled "Erotomania", which is the first of a three part suite titled A Mind Beside Itself.

The television series Criminal Minds featured the condition of erotomania as the basis of the plot for the episodes "Broken Mirror", "Somebody's Watching" and "The Crossing". The episode "Nothing But The Night" in the series Wire in the Blood [season3, episode3] , also features a female stalker suffering from de Clerambault's, and is diagnosed by the series' main character who is also the person being stalked, psychologist Dr. Tony Hill.

It is also seen in Law and Order: Special Victims Unit season 3 episode 17 - "Surveillance".

In the manga series One Piece, the villain of the Fishman Island Arc Vander Decken IX shows erotomania towards the Mermaid Princess Shirahoshi. Fully believing she is in love with him, and her father locked her up and wants to use her marriage for political reasons. Where in reality she is utterly terrified of him and her father locked her up to protect her from Decken as he regularly attempts to kill her.

In the film Swimfan Madison is shown to be obsessed with the main character Ben, to the point she tries to ruin everything in his life from his swim team, to his girlfriend, and even framing him for murder in a delusional attempt to get him to be with her. It is also revealed this has happened more than once, as she did similar to a boy named Jake, suggesting she caused a car crash which left him in a coma and she got out without a scratch.

The ITV television crime drama Lewis explicitly references de Clerambault's syndrome in the season five episode "The Mind Has Mountains."

See also

• Delusion
• Delusional disorder
• Love addiction
• Monomania
• Psychosis
• Schizophrenia
• Stalking
• Limerence
• Play Misty For Me
• Fatal Attraction

Notes

1. ^ Remington GJ, Jeffries JJ (July 1994). "Erotomanic delusions and electroconvulsive therapy: a case series". J Clin Psychiatry 55 (7): 306–8. PMID 8071292. 
2. ^ ^{a b} Anderson CA, Camp J, Filley CM (1998). "Erotomania after aneurysmal subarachnoid hemorrhage: case report and literature review". J Neuropsychiatry Clin Neurosci 10 (3): 330–7. PMID 9706541. http://neuro.psychiatryonline.org/cgi/reprint/10/3/330.pdf. 
3. ^ Berrios GE, Kennedy N. (2002). Erotomania: a conceptual history. History of Psychiatry. Dec;13(52 Pt 4):381-400. pmid=12638595
4. ^ Letter written to Jodie Foster by John Hinckley, Jr. March 30, 1981. Retrieved February 26, 2007.
5. ^ 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
6. ^ Foster, David & Levinson, Arlene. Suicide on a railroad track ends a celebrity-stalker's inner agony, Associated Press, October 11, 1998

References

• Berrios GE, Kennedy N (December 2002). "Erotomania: a conceptual history". History of Psychiatry 13 (52 Pt 4): 381–400. doi:10.1177/0957154X0201305202. PMID 12638595. 
• Fitzgerald P., Seeman M.V. (2002). "Erotomania in women". In Sheridan, Lorraine; Boon, Julian. Stalking and psychosexual obsession: Psychological perspectives for prevention, policing, and treatment. New York: Wiley. ISBN 0-471-49459-3. 
• Giannini AJ, Slaby AE, Robb TO (February 1991). "De Clérambault's syndrome in sexually experienced women". The Journal of clinical psychiatry 52 (2): 84–6. PMID 1993641. 
• Kennedy N, McDonough M, Kelly B, Berrios GE (2002). "Erotomania revisited: clinical course and treatment". Compr Psychiatry 43 (1): 1–6. doi:10.1053/comp.2002.29856. PMID 11788912. http://linkinghub.elsevier.com/retrieve/pii/S0010440X02207580. 
• Munro, Alistair (1999). Delusional disorder: Paranoia and related illnesses. Cambridge, UK: Cambridge University Press. ISBN 0-521-58180-X.