De Clerambault’s Syndrome: The Delusion of Love

Contemporary syndrome

De Clerambault's Syndrome, also called erotomania, is a psychological condition in which the sufferer is under the delusion that a certain person is in love with him or her. Typically, the object of this delusion is of a higher social class than the sufferer and is merely an acquaintance - at the most - in reality. To the person with de Clerambault's syndrome, everything that the object of affection does takes on a special significance that it does not really have.

De Clerambault's syndrome is named after Gaetan Gatian de Clerambault, a French psychiatrist who wrote a comprehensive paper on the condition in 1921. De Clerambault's syndrome has been recognized in some form since long before Gaetan Gatian de Clerambault published his paper, although there was no standard term for it. Ancient authors, including Hippocrates and Plutarch, describe cases that today would probably be diagnosed as de Clerambault's syndrome. Psychiatrist Jacques Ferrand is credited with the first mention of the syndrome in psychiatric literature, in 1623.

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The concept of the condition has changed throughout the centuries, as it was originally likened to illness caused by unrequited love, and only relatively recently came to be understood as a delusional belief that another person is making romantic advances. There have been many famous cases of de Clerambault's syndrome, most of which manifested themselves through stalking behavior. The object of many of these cases was a celebrity of some sort, either in the realm of politics or entertainment.

One of the most well-known cases affected John Hinckley, Jr. , who shot President Ronald Reagan in 1981 in an attempt to impress actress Jodie Foster, who he believed wanted a sign of his devotion. De Clerambault's syndrome has also often been the subject of fiction. Nikolai Gogol's classic story, "Diary of a Madman" (1835), describes a descent into insanity that begins with a case of de Clerambault's syndrome. Ian McEwan's novel Enduring Love (1997), adapted to film in 2004, tells the story of a homosexual case of the condition.

The illness often occurs during psychosis, especially in patients with schizophrenia or bipolar mania. In one case, erotomania was reported in a patient who had undergone surgery for a ruptured cerebral aneurysm. During an erotomanic psychosis, 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. 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 Clerambault's syndrome, after the French psychiatrist Gaetan Gatian de Clerambault (1872–1934), who published a comprehensive review paper on the subject (Les Psychoses Passionelles) in 1921.

Berrios and N. Kennedy outlined in 'Erotomania: a conceptual history' (2002) 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"

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 antipsychotics.

The assassination attempt of Ronald Reagan by John Hinckley, Jr. was reported to have been driven by an erotomanic delusion that the death of the president would cause actress Jodie Foster to become infatuated with him. Late night TV entertainer David Letterman and retired astronaut Story Musgrave were both stalked by Margaret Mary Ray. In popular culture Examples of de Clerambault's syndrome (erotomania) in fiction include Ian McEwan's novel Enduring Love, and the French films Anna M. (2007) and Laetitia Colombani's A la folie... as du tout (2002), starring Audrey Tautou. The band Dream Theater has a song titled "Erotomania", which is the first of a three part suite titled A Mind Beside Itself. The condition of erotomania formed the basis of the plot for the episodes "Somebody's Watching" and "Broken Mirror" of the television series Criminal Minds. Erotomania also formed the basis of the plot of the 2006 film Borat. Throughout the film, Borat travels from Khazakstan in an attempt to find his "love" Pahmeela Anderson. At the end of the film, when Borat finds Pahmeela, he attempts to kidnap her in large burlap bag.

Erotomania can be defined as a psychological disorder in which the afflicted relentlessly pursues the notion that the object of his/her affection reciprocates his/her romantic feelings and/or fantasies. This obsession with the desired individual continues long after that individual has asserted that he/she is not interested in pursuing a romantic relationship with the afflicted. Consequently, erotomaniacs tend to stalk their victims. It has been postulated that those who stalk suffer from a basic fault in their capacity to have relationships with others. (Lipson et al. , 1998). Though brought to light with the Tarasoff case, Erotomania continues to be considerably new in the literature and consequently little research has been done to suggest any consistent hypothesis as to causality.

Characteristic of the erotomaniac

Characteristic of the erotomaniac (generally across the board) are the following:

1. irrationality,
2. a tendancy toward impulsive actions,
3. obsessiveness,
4. paranoia,
5. psychotic tendancies.

Typically the erotomaniac shares certain behavioral characteristics consistent with that of a Borderline. The erotomaniac tends to begin with simple, subtle expressions of affection to reach the object of his/her desire which later spirals out of control and can lead to expressions of anger, rage, frustration and violence when such gestures go ignored and the victims continues to assert lack of interest.

Strangely the erotomaniac fails altogether to see the victim's lack of interest. The erotomaniac attributes lack of positive response to a litany of things. In the case of my stalker, Louise attributed her ex-husband (my boyfriend) taking a restraining order out against her to a belief that somehow I was behind the scenes manipulating him to do so in order to keep him from "recognizing his love for her" and "going back to her". Louise also wrote constant letters saying she knew I "had to be pregnant" because she didn't know why else he wouldn't be returning her calls and answering her threatening letters.

Finally, the erotomaniac is psychotic and no longer in reality. Any reaction from the victim can be construed as a signal of approval. Returning to the case of my stalker, Louise believed the act of my boyfriend taking a restraining order out against her was somehow indicative of encouragement to continue to call and visit him and so she did continue, persisting even after countless arraignments, community service and jail time. Erotomania is a rare disorder in which a person holds a delusional belief that another person, usually of a higher social status, is in love with them.

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