Acute erotomania

A crime committed in an airplane?

1. I consider nude dancing an invitation to erotomanic delusion, particularly when the dancer will have direct eye contact with the male watcher and affectionally relate to him with pleasurable affect and even touching. The invitation to the male is to suspend disbelief and revel in the fantasy of an erotic-affectional relationship for the moment—and at an economical price. This illusory marriage of exhibitionism and voyeurism works well if the male's reality testing is adequate. If not, a delusional pursuit may occur. A small sampling of women who erotically dance indicates that delusional following is not unusual, and is directed toward the dancers with the largest breasts—perhaps a condensing of affectional-maternal neediness and unfulfilled sexual desire.

Studies concerning North African or Middle Eastern males and erotomania are also absent from the world psychiatric literature. El-Assra (1989) did report a case of erotomania in a Saudi Arabian woman. I have included two cases of delusional or borderline erotomania in males from these cultures to emphasize the importance of cultural factors in behavior. The most salient information to be gathered is the male's perception of female behavior in the culture of origin, and the meanings attached to it. In traditional Islamic countries, such as Libya, direct male observation of female behavior is usually limited to the mother and sisters, and heterosexual experimentation, whether "dating" or actual sexual activity, is prohibited prior to marriage. Strict containment of the erotic impulse in adolescence and young adulthood is possible if customs are rigid and pervasive but immigration to a more sexually open and permissive culture may lead to a gross misperception of female behavior. As noted in the case of Ahmed, the most prevalent psychiatric symptoms are ideas of reference, whereupon behaviors by the female are personalized and made heterosexually meaningful. The acculturation of the traditional Islamic male into American and Western European society appears to provide fertile ground for the pathogenesis of erotomania. Although we did not think that Ahmed posed a significant risk of physical violence toward the victim, we did suggest to the court that his approaches, and psychological intimidation, would continue. We recommended that Ahmed be sentenced to custody or deported from the country.

Although the general homicide rate in the United States has decreased slightly in the past five years, the enormity Of our intentional violence toward each other still shocks and then dulls, the senses. The Los Angeles Times conducted a computer-assisted study of homicides between 1990—1994 in the most populous Rnd heterogeneous county in the United States and found that, on average, someone was intentionally killed every five hours. This

vast urban killing field stretched across Los Angeles County, but deaths were concentrated in blighted and impoverished areas. Black males were twice as likely to be killed as Latino males, and fifteen times more likely to be killed than Caucasian or Asian males. In 26 percent of the 9,442 cases the perpetrator was a stranger to the victim; in all other cases, whether gang-related, familial, or spousal, there was an attachment. NO arrests were made in nearly half the cases (Los Angeles Times, Dec. 7, 1996). These data points mirror patterns throughout the and the U.S. continues to be one of the most violent nations in the world.

advanced a sequential psychodynamic model to explain the pursuit behavior. First, the obsessional follower develops a narcissistic linking fantasy in which the object is special, idealized, loved, admired, or destined to be with him. Second, the fantasy is a primary motivation for his actual approach, which is met with rejection. Third, this real-world rejection, contrary to his repeating fantasy (Person 1995), causes a deep narcissistic wound, felt as humiliation or shame. Fourth, the shame is defended against with narcissistic rage (Kohut 1972). Fifth, he now devalues and pursues the object to injure, dominate, or destroy her. And sixth, if the pursuit is successful, and the object is sufficiently derogated (this could range from a contentious post-separation pursuit fought primarily in a courtroom to homicide Of the once-idealized object), the narcissistic linking fantasy is restored in the perpetrator. Reality no longer intrudes upon his grandiose and entitled repeating fantasy,

This theoretical formulation, supported by some exciting empirical research that will appear next year in a book I am editing, The Psychology of Stalking, seems to be a parsimonious explanation that warrants attention. As the economist Milton Friedman once argued, the test of any scientific model is how much it explains with how little.