The Stalkers Amongst Us:

Historical, Clinical and Legal

Challenges

Roberto Sebastian, MD

Pamantasan ng Lungsod ng Maynila

College of Medicine
Ospital ng Maynila Medical Center
November 18, 2010
“Stalking is an old behavior but a
new crime.”
Meloy 1998
 Historical Perspective
 Genesis 39- Joseph
and Potiphar’s wife

 Galen and Plutarch

 works of literature
such as the
Decameron of
Boccacio.
Historical Perspective (Psychiatry)
 First described in 1838 by Esquirol in
Maladies Mentales.
 The erotomanic delusion
 first Kraepellin (1921)
 Hart (1921)
 Spitzka (1889)
 De Clerambault (1921/1942) with his classic
work, Les Psychoses Passionalle.
 Celebrity stalkers

Margaret Mary Ray David Letterman

 Definitions
 Webster dictionary
 to “pursue or approach a game, an enemy, etc.
stealthily as from cover.”
 Pathe and Purcell
 defined stalking as a course of conduct in which one
individual inflicts on another repeated unwanted
intrusions and communication, to such an extent that
the victim fears for his or her safety.
 Melloy
 “ the willful, malicious, and repeated following and
harassing of another person that threatens his or her
safety.”
 Prevalence of Stalking

 the National Institute of Justice and the

Center of Disease Control and Prevention
1997
 nationwide telephone survey involving 8,000
U.S. men and 8,000 U.S. women
 8 percent of women and 2 percent of men
have been stalked at some time in their lives;
 an estimated 1,000,970 women and 370,990
men are stalked annually.
 Prevalence
 Most stalking cases involved perpetrators and victims
who know each other; 23 percent of all female victims
and 36 percent of men are stalked by strangers.

 There is a strong link between stalking and other forms

of violence in intimate relationship: 81 percent of women
who were stalked by current or former partners were
physically assaulted and 31 percent were sexually
assaulted by sexual partners.

 50% reported to the police

 25% led to arrested
 12% prosecuted
Duration and Nature of Stalking
 The duration of stalking varied from 4 weeks to 20 years
(median=12 months).

 The most common method of communicating was by

telephone (78%, N=113)- Rejected stalkers

 62% Letters were sent by 94 (65%) –intimacy seekers

 Unsolicited gifts were sent by 69 stalkers (48%)

 Spurious legal actions=12 stalkers (8%)

 Threat and Violence
 More than half of stalkers threatened their
victims prior to their assault
 Resentful/Rejected stalkers more likely to
threaten their victims
 Previous convictions related to property
damage
 Past history of substance abuse
 Psychiatric Comorbidities
 Purcell, Pathe et al. 1999
 N: 145 Forensic Psych clinic in Victoria, Australia
 62 (46%) with Axis I diagnosis
 70% Delusional disorder
 19% Schizophrenia
 3% bipolar
 75 (51%) with Axis II Personality Disorders
 25% Substance related disorder
 Impact on Victims
 Mullen
 N:100 victims of stalking
 83% of the subjects developed increased anxiety,
37% fulfilled the criteria for Posttraumatic stress
disorder (PTSD) and 18% had PTSD like
symptoms.
 58% of subjects received threats,

 34 were physically assaulted

 All but six made (94%) major changes in their

social lives, with 53% changing employment and
39% emigrated.
 Impact on Victims
 Approximately 10% of victims
acknowledged recent suicidal ideation

 1 in 8 having strongly considered the

possibility of taking their own life in the
month prior to the survey.
 Impact on Victims
 Sheridan (2001)
 in United Kingdom, 95 self-defined victims of
stalking completed a 46-item questionnaire
relating to their experience.
 Nearly 44% said that they have altered their

behavior in such taking a different route to work,

stop going out alone in public, changed telephone
number and had moved out from their houses.
 22% said they moved either to another country or

overseas in an attempt to escape their stalkers.

 Cyberstalking
2001 Congress Report on Stalking and Domestic Violence
Report

- cyberstalking refers to the use of Internet, e-mail, and

other electronic communication devices to stalk another
person.

- e-mails, chat rooms, fax machines, cell phones, text

messaging and electronic bulletin boards (blogs).
 Cyberstalking
In an exploratory study of 339 students in
University of New Hampshire,
approximately 10-15% of students
reported receiving e-mail or instant
messages “that threatened, insulted or
harassed,” and more than 50% received
unwanted pornography.
 Why Cyberstalking?
The Internet has become a useful tool for stalkers as the
nature of anonymity allows the stalker to exercise
power and control over the victims.

 Some cyberstalkers obtain victims online, encouraging others

to contact the victim or even harm them.
 Cyberstalkers take ease in communication and able to gather
personal information of their victims which led to an increase
sense of control primarily through fear.
 Furthermore, as with physical stalking, online harassment and
threats may lead to a more serious behavior such a physical
violence.
David Caruso, CSI Miami
Victims among health providers
 Doctors and healthcare professionals are
at greater risk than the general population
of being stalked, particularly by their
patients (Pathe´ et al, 2002; Purcell et al,
2005b).

 6-10% of mental health providers were

stalked (sandberg, 2002; Galleazi, 2005)
Victims among health providers
 Health providers sympathy and attention
are easily reconstructed as romantic
interest.

 Lead to increasing stress, fear,

helplessness and disenchantment
(Sandberg et al, 2002).
 Psychodynamics

 Intense reaction to shame and rejection

 Defense against humiliation, loss and

sadness by setting up a narcissistic rage
towards the love object which thereby
maintain the fantasy love.
 Types of Stalkers
 Purcell et. al 1999  Zona 1993
 Rejected  Erotomanic
 Intimacy Seekers  Love obsessional
 Predatory’  Simple obsessional
 Resentful
 Incompetent
 Rejected Stalkers
 Rejection of a relationship,
 most frequently an ex partner. (N=41)
 estrangement from the mother (N=2)
 a broken friendship (N=6),
 disrupted work relationships (N=3)

 Rejected stalkers often shows a complex mixture of

desire for both reconciliation and revenge.

 The majority of the rejected stalkers had personality

disorders, although nine had delusional disorders, five
involving morbid jealousy.
 Intimacy Seeking Stalkers
 The central purpose of the intimacy-seeking stalkers was to establish a
relationship, but several were prey to jealousy, and a number became
enraged at their would-be partner’s indifference to their approaches.

 49 stalkers were seeking intimacy with the object of their unwanted

attention, whom they identified as their true love.

 Twenty-seven had erotomanic delusions and believed that their love was
reciprocated;
 20 of these had delusional disorder of the erotomanic type
 five had schizophrenia,
 two had mania.

 The remaining 22 intimacy-seeking stalkers

 “morbid infatuations” (15)
 personality disorder (7) who persisted in their pursuit without absolute
certainty of eventual success.
 Incompetent Stalkers
 incompetent stalkers acknowledged that the object of
their attention did not reciprocate their affection, but
they nevertheless hoped that their behavior would lead
to intimacy

 included intellectually limited and socially incompetent

individuals whose knowledge of courting rituals was
rudimentary

 a sense of entitlement to a partner but no capacity, or

willingness,
to start by establishing some lesser form of social
interaction.
 Resentful Stalkers
 Resentful stalkers stalked to frighten and distress the victim.

 Pursued a vendetta against a specific victim

 Example: man stalked a medical practitioner who he

believed
had failed to diagnose his wife’s cervical cancer.

 General sense of grievance and chose victims at random.

 Example: a stalker persistently pursued a young woman
because she appeared, when glimpsed in the street, to be
attractive, wealthy, and happy when the stalker had just
experienced a humiliating professional rejection.
 Predatory Stalkers
 Sexual attackers; Predatory stalkers predominantly had paraphilias
and were more likely than all other diagnostic groups to have
previous convictions for sexual offenses

 These men took pleasure in the sense of power produced by

stalking, and there were elements of getting to know their victim
and rehearsing, in fantasy, their intended attack.

 Such stalking could be prolonged before they either attacked or

were apprehended.

 One predatory stalker sought help after reaching the point of

equipping an isolated house, acquiring ether and ropes, and being
poised to abduct the victim.
 INTERVENTION
 CLINICAL

 LEGAL
 INTERVENTIONS
 Intimacy Seeking Stalkers
 Intensive Psychiatric management
 Psychotropic meds
 Counseling (assertive/communication skills
 Not responsive to judicial sanctions
 Rejected Stalkers
 Desists by imposing legal fines/sanctions
 Incompetent Stalkers
 Easily abandon their victims with ease
 Main challenge is to prevent revictimization
 INTERVENTIONS
 Resentful Stalkers
 Difficult to engage due to self righteousness
 Legal sanctions tend to enrage rather than
inhibit his behaviors
 Predatory Stalkers
 Primarily involves the justice systems
 In some cases, treat underlying paraphilias
 LEGAL INTERVENTION
 Involuntary commitment
 Restraining orders
 Trespassing orders
 Anti-stalking/harrassment/cyberstalking
laws
 Anti-cyberstalking laws

Rebecca Schaeffer
Robert Bardo
“My Sister Sam”
 Legal Definition
 Three Elements
 (1) pattern of behavioral intrusion upon
another person that is unwanted;
 (2) an implicit or explicit threat that is
evidenced in the pattern of behavioral
intrusion; and
 (3) as a result of the behavioral intrusion, the
person who is threatened experiences
reasonable fear.
 Legal Intervention
 State

 Federal

 Limitations
 Strategies for Physicians
 Maintain high levels of attention to the maintenance of
boundaries in working with patients

 Avoid confusion between personal and professional

involvement

 Take seriously prodromal features that possibly herald

the initiation of stalking such as requests for personal
details by patients

 Report stalking incidents in team meetings or in

supervision
 Summary
 Stalking behaviors has been in existence since the Early
Ages.
 Stalkers render a significant psychological impact to their
victims and in worst cases, potential physical violence.
 Both Legal and Clinical interventions needed
 Challenges remain in the horizon especially with the
rapid advancement of cybertechnology.
 Modifications of statutes through legislation should be
rendered in such a way that stalking laws is able to keep
pace with the advancing internet technology.
 Further research is needed to analyze the effectiveness
of cyberstalking statutes in prosecuting offenders.