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[REVIEW]

THESE BOOTS ARE MADE FOR STALKING:


Characteristics of Female Stalkers
by SARA G. WEST, MD, and SUSAN HATTERS FRIEDMAN, MD
Dr. West is from the Department of Psychiatry, University Hospitals/ Case Western Reserve University School of Medicine in Cleveland, Ohio;
Dr. Friedman is from the Department of Psychiatry, University Hospitals/ Case Western Reserve University School of Medicine in Cleveland,
Ohio, and from Forensic Psychiatry, Northcoast Behavioral Healthcare in Northfield, Ohio.

Psychiatry (Edgemont) 2008;5(8):37–42

ABSTRACT
When one is asked to picture a
stalker, images of men with dark
sunglasses, trench coats, and
surreptitious behavior may come to
mind. Contrary to popular belief, it is
premature for mental health
professionals to discount the actions
of female stalkers. This article
reviews how stalking is defined and
classified in a broad sense and why it
is important for mental health
professionals to be aware of stalking
behavior. The article narrows the
focus to what the research has
shown about women who stalk.
Finally, there is a brief discussion of
women who stalk celebrities and of
Hollywood’s portrayal of the female
stalker.

AN INTRODUCTION TO STALKING
Stalking has likely existed since
the dawn of mankind, but it is only in
the past several decades that the
ADDRESS CORRESPONDENCE TO: Sara G. West, MD, Department of Psychiatry, University
subject has appeared regularly in the
Hospitals, Case Medical Center, 11100 Euclid Ave., Cleveland, OH 44106; Phone: (216) 844-
psychiatric literature.1 It was not 8985; Fax: (216) 844-1703; E-mail: sara.west@uhhospitals.org
until 1989, when the actress Rebecca
Schaeffer was murdered by a stalker, KEY WORDS: stalker, female, criminal behavior, mental health professional
that the movement to create
antistalking laws was initiated.2
However, it is important to recognize somewhat, this behavior is illegal in population of 145 stalkers referred to
that “stalking is not only a crime for all 50 states.5 Large community a forensic psychiatric clinic. The
celebrities.”3 surveys indicate that the lifetime risk sample consisted of 115 men and 30
According to Meloy, stalking is for becoming the victim of stalking women. Researchers examined the
“the willful, malicious, and repeated for a man is two percent and for a duration and methods associated
following or harassing of another woman is eight percent.6,7 with the stalking, the occurrence of
person that threatens his or her In 1999, Mullen, et al.,8 published threats and violence, the relationship
safety.”4 Though state laws differ a landmark study based on a of the stalker to the victims, and the

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psychiatric status and criminal they were entitled to a relationship.


histories of the stalker. From their This group had often stalked other TABLE 1. Mullen’s stalker typology8
data, the authors derived the victims before.
following typology for classifying The resentful stalker. This
stalkers, which aids in understanding category (n=16) included those The Rejected Stalker—stalking follows
the range of motivations for the stalkers whose behaviors were meant the end of a relationship
behavior (Table 1): to distress and frighten their victims.
The rejected stalker. This was Half acted on grievances against The Intimacy Seeking Stalker—
the largest group (n=52), and their specific people, while the others stalking based on a desire for intimacy
behavior was brought about by the were generally disgruntled and chose
termination of a relationship, most targets at random. In addition to the The Incompetent Stalker—stalking
commonly with a romantic partner, rejected group, these stalkers were with lack of social skills; stalker feels
but also with estranged mothers, most likely to threaten their victims. entitled to a relationship
broken friendships, or strained work The predatory stalker. While
relationships. Often, these stalkers most notorious, this was the smallest The Resentful Stalker—stalking meant
to frighten victims
experienced ambivalent feelings group (n=6) and contained only
about reconciliation and revenge men. These stalkers acted in
regarding their targets. The majority preparation for a sexual attack. They The Predatory Stalker—stalking in
suffered from personality disorders, enjoyed the power inherent in their preparation for a sexual attack
although about one-fifth had stalking behavior. They were
delusional disorders. This group had predominantly diagnosed with
the widest range of methods paraphilias and were the most likely TABLE 2. Common characteristics of
stalkers who target mental health
associated with stalking but was to have prior convictions for sexual
professionals
significantly associated with offenses.
telephone harassment. Male
The intimacy seeking stalker. RELEVANCE TO MENTAL HEALTH
This group was also large (n=49). PROFESSIONALS Axis I and/ or Axis II diagnosis
Classification was based on the In addition to being called upon to
desire for intimacy with someone treat both stalkers and their victims,
Prior history of stalking
that the stalkers had identified as there is another important reason
their true love. Half believed that that mental health professionals
their love was requited, qualifying should be familiar with the Often under the clinician’s direct care
for the Diagnositc and Statistical characteristics of stalking: mental
Manual of Mental Disorders, health professionals may themselves Motivated by a desire for greater intimacy
Fourth Edition (DSM-IV) diagnosis become victims of stalkers. Research
of delusional disorder, erotomanic demonstrates that, in a variety of
type.9 The other half were termed to samples, 11 percent of mental health with the practitioner.11 Clinicians
have morbid infatuations, in which professionals have been the victims who are stalked must be wary not to
they recognized that their love was of stalking (a weighted mean with a minimize their patients’ behavior and
not returned but “insist(ed), with range of 3–29%).11–15 Stalkers who to also recognize that the stalkers
delusional intensity, on both the targeted mental health professionals may pose a serious threat (Table
legitimacy and the eventual success (Table 2) were typically male with a 3).16 Certain prodromal behaviors,
of their quest.”10 Along with the major mental disorder diagnosed on such as requests for personal
rejected stalkers, this group tended Axis I and a comorbid personality information or chance meetings
to be the most persistent over time. disorder on Axis II. They may also outside the office setting, should be
The incompetent stalker. have had a prior history of stalking noted. It is useful to systematically
These stalkers (n=22) lacked behavior.16 The stalker was document this and other suspicious
appropriate social skills and frequently under the direct care of activities, such as gifts or unusual
knowledge of courtship rituals but the victim, and the motive was often phone messages, in a separate file
hoped that, regardless of these a desire for greater intimacy.11 along with the dates and times at
deficits, their behavior would lead to Of all the mental health which they occurred.17,18 All of this
intimacy. These stalkers targeted professionals, psychiatrists and information should also be reported
people that they believed would be psychologists were the most likely to in team meetings or supervision.11
good romantic partners but were not be stalked; this may be related to a In order to discourage potential
infatuated with them to the same patient’s potential to misconstrue stalkers, clinicians should carefully
degree as the intimacy seekers. They boundaries and assign an protect their private information
too did not believe that their feelings inappropriate amount of intimacy to (e.g., home address, cell phone
were reciprocated, but rather that his or her therapeutic relationship numbers). If stalking is suspected,

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TABLE 3. Tips for mental health and a solid minority having achieved their victims for an average of 22
professionals who may become the target a college or graduate degree. Their months.
of a stalker intelligence may have allowed them Australian forensic clinic
to be more successful in pursuing study. In 2001, Purcell, et al.,20
Guard personal information carefully their victims. published a study that compared
Reports of substance abuse were female stalkers (n=40) to their male
Be aware of patients’ boundary violations, not common, but about one-third of counterparts (n=150). The data was
such as the following: women used substances while collected based on referrals to a
• Requests for personal information stalking. Available data suggested the community forensic mental health
• Unusual phone calls or messages presence of Axis I and II disorders. clinic that specializes in the
• Frequent and inappropriate gifts
Twenty percent of those with Axis I assessment of stalkers. One of the
• Contact outside of work setting
disorders were diagnosed with limitations of this study is that it
Record all unusual activity delusional disorder. The most involved a retrospective analysis of
common Axis II diagnosis was data collected from evaluations
borderline personality disorder performed over a period of eight
Report unusual activity to supervisors
(n=10 of 22). Antisocial personality years.
disorder was not diagnosed in any of Similar to the men, the women,
Consult with specialists the women. Despite incomplete data, on average, were 35 years old,
there appeared to be a high rate of single, and employed. Women were
Alert one’s family to the threat sexual (n=18 of 40) and physical less likely to have a history of
(n=12 of 40) abuse in the personal criminal behavior. Almost half of the
Consider a restraining order against the histories of the female stalkers, women (n=18 of 40) had an Axis I
perpetrator
which may have predisposed these diagnosis, most commonly (10 of 18)
women to the development of delusional disorder. Half (n=20 of
consultation with forensic specialists, borderline personality characteristics 40) were diagnosed with an Axis II
the police, or lawyers may be or posttraumatic stress disorder. disorder, including borderline,
necessary. It may also be necessary A great majority of the victims of dependent, and narcissistic
to alert one’s own family to the female stalkers were known to them, personality disorders. The diagnostic
threat, given that their safety may be either as acquaintances, former profiles of these women did not
in jeopardy. A restraining order may lovers, or family members. However, differ from their male counterparts,
be another alternative, though they one-fifth of the victims were except women had lower rates of
are not always effective. completely unknown to their substance use.
stalkers. Frequent reasons for With only two exceptions, female
THE RESEARCH ON FEMALE stalking included anger, obsession, stalkers knew their victims. Forty
STALKERS feelings of abandonment, loneliness, percent of the victims were
International survey study. and dependency. Usual stalking professional contacts, frequently
Meloy and Boyd19 collected data on behaviors included telephone calls mental health professionals. Men
82 adult women who had engaged in and messages, giving letters and were comparatively more likely to
stalking behavior via a survey sent to gifts, driving by the victim’s location, pursue strangers. Same gender
mental health and law enforcement trespassing, and following the victim. stalking was more frequent among
professionals in the United States, More than half of the women women than men. Based on Mullen’s
Canada, and Australia. Though this threatened their victims, and a typology,8 women’s primary motive
study has some limitations, including quarter were physically violent, with for stalking behavior in almost half
a dependence on the observations of three victims losing their lives to of the cases was to seek intimacy. In
a variety of clinicians who were not their stalkers. Most episodes of the female group, there were no
using a standardized instrument to violence, however, did not involve cases of sexually motivated
evaluate the female subjects, it the use of a weapon and did not predatory stalking, which differed
assesses one of the large groups of result in injuries. Violence was more from the male stalkers. Women and
female stalkers found in the likely if the stalker and the victim men appeared to stalk their victims
literature. had been previously sexually for a similar duration of time.
Typically, the perpetrators were intimate. In more than half of the Women were more likely to harass
Caucasian, heterosexual, single cases, the behavior increased in their victims via telephone call but
women with a mean age of 35 frequency and intensity. The victims less likely to physically pursue them
(ranging from 18–58 years old). were usually Caucasian, heterosexual when compared to men. Strikingly,
Often, these women did not have males with a mean age of 41 women had the same propensity to
children. They appeared to be (ranging from 16–68 years). Female make threats and become violent,
educated, with a large majority victims were targeted one third of including property damage and
having graduated from high school the time. The perpetrators pursued assault, as the male stalkers.

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Battered women who stalk. A more likely to be suspects in the discovered the existence of her twin
study focusing on stalking and intimate stalking cases (n=114 of at age seven, at which point it was
unwanted pursuit behavior 174 or 65.5%). confirmed by her adoptive mother
perpetrated by 55 women residing in Case reports. There have been a and never mentioned again. The
a battered women’s shelter was number of interesting case reports patient chose not to contact her
published in 2006.21 A limitation of published on female stalkers. The biological mother for fear that it
this study, as described by the first case highlights a potential would distress her adoptive mother.
authors, involved an inability to ask etiology for stalking behavior. On examination, the patient did not
the subjects, due to the concerns of Soliman, et al.,23 described a woman fulfill DSM diagnostic criteria for
the shelter employees, about their diagnosed with Huntington’s disease obsessive compulsive disorder, a
motivations for perpetrating the exhibiting escalating stalking delusional disorder, or a personality
stalking behavior. behavior directed toward her female disorder. Psychodynamically, it was
The women, on average, were in therapist. This was accompanied by postulated that she was looking for a
their early 30s, were unemployed, amorous feelings toward and maternal figure and role model in the
and had children. The specific acts obsessive thoughts about this women that she followed. After she
perpetrated by this group of women therapist. Her behaviors included agreed to cease this behavior, she
included begging the abuser not to frequent phone calls, unwanted gifts, was referred to a male therapist for
leave, seeking information from threats, and physical assault. The ongoing psychotherapy around these
others about the abuser, giving the stalking behavior in this patient may issues.
abuser unwanted gifts, visiting the have been linked to caudate In 2006, Reisner26 published a case
abuser unexpectedly, following the dysfunction caused by the report on a female stalker with
abuser, making a threat toward the Huntington’s disease. Basal ganglia multiple psychiatric diagnoses,
abuser, or threatening suicide or self- lesions may have accounted for the including Munchausen syndrome by
harm. It was noted that, if these obsessive thoughts and amorous proxy (MSBP) and borderline
women had themselves previously feelings. Her thoughts and behavior personality disorder. The patient lost
been a victim of these behaviors, resolved following treatment with a custody of her two young children
they were more likely to become a selective serotonin reuptake inhibitor after it became evident that she
perpetrator of similar behavior. (SSRI) and an antipsychotic. This harmed her older child in a manner
These women were more likely to case supports the theory that consistent with MSBP. She later
form insecure attachments, suffer stalking behavior may be caused by admitted to overdosing him on
from depression, blame themselves an increase in subcortical diphenylhydantoin and injecting him
for the abuse, and leave the shelter dopaminergic function and a with soda or saliva. While she was
quickly compared to other women in decrease in serotonergic activity.24 being investigated for this behavior,
the shelter who did not participate in According to another case report, she began stalking the child
stalking or unwanted pursuit therapy addressing psychodynamic protective service worker who was
behavior. issues may be an effective treatment assigned to her case. She allegedly
LAPD study. In an effort to for stalkers. A 34-year-old woman harassed the case worker through
determine the degree of intimacy in requested to see a psychiatrist after the internet and threatened to kill
the stalker-victim relationship, disclosing to her primary care her; for this, she was charged with
Palarea, et al.,22 compared 135 physician her long-standing history aggravated menacing. She received
intimate and 88 nonintimate stalkers of stalking behavior.25 She had been intense psychiatric treatment and
investigated by the Los Angeles following an older female colleague responded well to clozapine and,
Police Department’s Threat who held a superior position at her later, quetiapine.
Management Unit. Women accounted place of employment. The patient As indicated earlier, clinicians not
for 22 percent of the sample. followed this woman to her home but only treat stalkers and their victims,
Unfortunately, despite a large denied any violent or sexual fantasies but they may also find themselves
amount of data collected on this about her. The patient described she the targets of stalking behavior.
group, not much of it was analyzed had a similar obsession concerning a Another report described a female
specifically by gender. Intimate female teacher from the ages of 12 to patient who presented to a family
stalkers were married to, engaged to, 16. Additionally, she had previously practice group complaining of
cohabited with, dated, or had a been terminated by a female depression and was prescribed a
casual sexual relationship with the therapist who was the target of one-week supply of an
victim. The authors determined that similar thoughts and behaviors. The antidepressant. She took the pills all
women were somewhat more likely patient’s history revealed that she at once and went to the emergency
to participate in nonintimate stalking was adopted and had a twin whose room, where a computed
(n=28 of 49 or 57.1%) when personality was described as tomography (CT) scan revealed
compared to intimate stalking. This outgoing and exuberant and with brain atrophy. She erroneously
differed from the men, who were whom she had little contact. She believed that this was caused by her

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TABLE 4. Common characteristics of Female stalkers are no exception to behavior. Finally, mental health
female stalkers this. David Letterman, long-time host professionals should be aware of the
of late night television, was plagued possibility of female stalkers in both
Caucasian by the stalking behavior of Margaret their clinical practice and their
Ray, a mentally ill woman who personal life, as stalkers may target
Heterosexual ultimately committed suicide in their care providers.
1998.29 Brad Pitt30 and John Cusack31
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42 Psychiatry 2008 [ A U G U S T ]

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