This week the British paper, The Telegraph, published a well done article on malevolent stalking. Entitled “Rejected, obsessed and erotomanic: Inside the mind of a stalker,” it gives a well done examination of a current British case currently undergoing legal prosecution. It makes for informed reading and is still somewhat chilling. Among its relevant points are that a very substantial proportion of cases repeat their offenses and dangerous, terrorizing behaviors, even after being convicted and punished. They are not the ordinary ‘criminal recidivists, as they learn nothing from the punishment experiences but are largely NOT the psychopath who learns nothing from experience…These folks are different and still not well understood by my discipline. The psychotic ones are often fairly easy to discern in evaluations. The others are the products of family training by abusive parents, and the products of their unique personal developmental experiences which makes everything “imprecise,” and individualized.

Many celebrities can attest to the harrowing prolonged experiences with stalkers, and almost any celebrity of recent modern Western publicity has undergone this horrific, disruptive experience. My own favorite media example is that of David Letterman the beloved late night American tv comedian who for a number of years endured a woman who harassed him for bizarre motivations, making his life a porous hell. Innumerable other famous personages from all walks of life, politics, entertainment, news media, the sports world have all endured these modern day lunatics who almost defy modern psychiatric diagnosis and classification. We have long had in psychiatry the concept of “erotomanic transference,” referring to the patient in treatment who develops a psychotic level one sides delusion of love from the therapist and evolves into behaviors that intrude relentlessly into the lives of the treating professional. Often these result in orders of protection, prosecution and incarceration to put a stop to these unsettling behaviors and protection of the mental health practitioners and their families.

I myself have had such experiences. I have had occasion to evaluate malignant stalkers who committed crimes as a result of their extreme obsessions with their so called ‘love objects.’ Most of these were the love interest type for want of a better phrase. They were in my view, a more malignant extension of the now all too well known stalker type who stalks their separated spouse who has forcefully rejected them after a marital separation because of years of abuse, hyper-jealous delusional or pseudo-delusional unfounded convictions that their nearly imprisoned spouses have somehow been cheating on them. These stalkers will show the telltale behaviors of years of spying on the their long suffering, intimidated spouses, tracking their mileage when they drive cars, and nowadays in the age of GPS trackers, will surreptitiously monitor the comings and goings of their harassed spouses electronically in a hideous perversion of modern gadgetry. Before GPS these marital stalkers simply followed their spouses when the spouses were driving and out of sight. When the stalked spouses would return home they were subjected to terrifying interrogations as to where they had been even if there was no chance they had been out covertly meeting up with scads of other men.

But I have had a few patients who followed me and were ‘in love,; with me. In most instances, it was not known to me until too late. And then I had to forecefully fire the patients from my practices, and take out orders of protection to do everything I could to disabuse them of the notions that I was serious and had not a single iota of reciprocating interest in them; at least some of the more disturbed ones would cling to these notions of “he/she still wants me no matter what they do publicly.”

I only treated a few successfully whose ‘erotomanic” ( a goofy and antiquated term if there ever was one) attachment to me were based on real, understandable emotional needs and their histories. They were not ‘malignant’ my term for the nearly untreatable types. They had workable but severe forms of emotional neediness. They had more than a vestige of insight that their notions were wrong. They could tolerate the refusals and remain in treatment without fragmenting into violence and psychosis. They were able to psychologically to step back from their troublesome behaviors and work on them in therapy. They were able to reliably work on this issue without the use of legal restrictions which always automatically stopped treatment dead in its tracks. It took long term patient psychotherapy to work through these issues but it was successful. But they were the exceptions. The rest were not responsive to treatment and legal stainless steel limits had to be imposed quickly, swiftly, unambiguously and without hesitation, guilt or dilly-dallying, a mistake often made by dependent victims of such abuse and stalking.

The non-treatable, and fortunately rare cases I have had were altogether different. One of the worst was an unknown stalker whom I had seen so many years ago in another practice venue, that I never did recall him until his identify was uncovered by the dedicated law enforcement agencies and tireless investigators. He was the “grudge type” who blamed me for taking definite legal action against him, protecting his spouse as I was required to do under the now routinely accepted “Tarasoff Rule” where a mental health professional has to warn a potential victim of violence named by such a person. That was his spouse. She took appropriate heed, took charges out against him and as a result he was involuntarily committed to mandated treatment facility. He ended up being charged and prosecuted, serving several years for abuse and lost everything while his wife and family disappeared. Unbeknownst to me he spent a fair amount of time smouldering with hatred toward me and several years later he began to anonymously stalk me. It was then that I learned how vulnerable I was in the age of the Internet. He tracked me through three different practice venues, making inquiries at each that were so weird and off that each past practice site called and notified me of the strange inquiry they had received by this unusual person. He began travelling some distance from where he lived to where I then practiced and making telephone threats through the large facility’s switchboard that were immediately recognized as bogus and my identify and location were instantly protected. But he kept coming. He left frightening calling cards on the grounds of my hospital and practice sites as he trailed me. Fortunately he did not really recall what I looked like as I had aged and my appearance had changed from the passage of years.

But I had to take action notifying the facility police, who were not ‘rent-a-cops, were extremely professional and took my claims seriously in spite of much of any proof or corroborating data/evidence. But he kept coming. Then after many months of worrisome anonymous threatening calls, and little presents to alert us all as to the malevolent intent of his irregular cruising around my practice sites, he was caught quite a distance away from he lived. He was fortuitously apprehended by other localities’ law enforcement personnel for completely unrelated crimes. Inside his place of residence, a ‘shrine’ of hate was plastered on one wall with articles about me but fortunately no pictures since I am not a publicity hound at all. Just professional blurbs that one gathers over time from one’s professional activities. But he had tracked me through three practice relocations, though two in the same general area of my home state’s particular region, through the public listings of the state’s Board of Medical Examiners’ listing of physicians.

I did not know of his apprehension until one evening three law enforcement officials showed up at my home and interviewed me and informed me in controlled manner, not revealing all his circumstances or transgressions, how and why they had apprehended him. I was felled by the news and most grateful after I recovered from the shock. But his crimes that caused his apprehension had nothing to do with me and I realized that had he not been a legal habitual offender, he may never have been caught until it was too late for me…But since that experience, not uncommon to persons in my profession, I came to have more than an academic interest in stalkers.

And it has reinforced my long held opinion and professional conviction that his is one kind of pathology that is NOT entirely brain based aberrant chemistry like the major inexorable brain disordered psychoses, but a manifestation of the mysteries of malignant personalities that still have eluded us in our explanatory scientific efforts. I also consider that most NON psychotic spousal abusers are also not mentally ill per se and represent the other major poorly understood domain of aberrant human behavior. And we certainly have almost weekly national stories of these martial stalkers and murderers that cannot be found to be “Not Guilty by Reason of Insanity,” [read: major irresistible biological autonomous psychotic illness] and something altogether different.

As a result of these long time views, I have for years endeavored to give an educational talk to upper level high school girls wherever I have practiced, entitled “Dr. _____’s Quick and Dirty Guide to Abusive Young Men for Young Women” in girls’ only high school assemblies. I have done this for years in a number of locales to help high school girls become educationally ‘inoculated’ against the percentage of pre-abusive or already abusive young men in their midst, how to spot them and how to extricate themselves with help from these potentially dangerous relationships. Through the years, I must sadly report that it has been harder and harder to gain entre’ into high schools to do this. It seems that parents are more afraid of this topic, sweep it under the rug and pressure schools and school boards to not permit this kind of open discussion and preventive public health intervention. And it does not have to do with more rural, less sophisticated communities’ attitudes as one might snobbishly and pejoratively wrongly conclude. It appears to me to be a more pervasive and regrettable fear index and sign of our times.