Erotomania (Clerambault’s Syndrome)

What is Erotomania?

Erotomania, also known as de Clérambault’s syndrome is a form of paranoid delusion combined with amorousness.

It is a delusional disorder centered on the subject believing that someone else is in love with him or her when they truly are not. Typical manifestations of this disorder involve people who have a higher status than the person, like celebrities or another famous person. However, this disorder can also be applied to a complete stranger.

Erotomania has an extensive history.

Even current celebrities still deal with obsessed fans (short for fanatics) who believe that because they support their form of entertainment, that they are entitled to something, in this case love. Some viewers of film believe that the actor or actress is talking directly to them when they are performing and this further entrenches them in their delusion.

Early depictions of this disorder are discovered in the work of Galen, Plutarch, Erasistratus and Hippocrates.

The very first reference occurred in psychiatric literature in the year 1623. The treatise, written by Jacques Ferrand called Maladie d’amour ou Mélancolie érotique went into detail about this disorder. Erotomania has also been referred to as, “erotic self-referent delusions” and “erotic paranoia”.

Two prominent professors, G.E. Berrios and N. Kennedy documented the change in description of Erotomania through the years:

  1. During the classical era (Early eighteenth century) – Referred to as a general disease precipitated by unrequited love
  2. During the early eighteenth century (Beginning of the nineteenth century) – Referred to as a practice of excess physical love (similar to nymphomania or satyriasis)
  3. During the early nineteenth century (Beginning of the twentieth century) – Referred to as unrequited love as a type of mental defect
  4. During the early twentieth century (Present) – Referred to as a delusional belief of being loved by someone else

In a particular case, erotomania was diagnosed in a patient who was recovering from surgery for a ruptured cerebral aneurysm.

Symptoms of Erotomania

The symptoms of Erotomania are of a wide variety, but the most common are:

  • Delusions
  • Harassing behavior
  • Stalking
  • Mania
  • Psychosis
  • Schizophrenia
  • Jealousy
  • Catatonic behavior
  • Sometimes speech disorders can occur
  • Diminished emotional expressions
  • Constantly changing their diet plan
  • Moon overs
  • Possessiveness
  • Romance that does not exist

The descent into erotomania can be sudden or subtly occur over time. More commonly, it starts off as a simple crush and maybe there are photos in the person’s room of who they are thinking about. Progression of the disorder is evidenced by increasingly disturbing behavior. They will begin to believe that they are in on a secret between the person they are obsessed with and himself or herself. When the celebrity says they love their fans, they will believe that is a coded message to them directly, serving as an open profession of their love. They will perceive things such as the object of their erotomania wearing a certain color that happens to be their favorite, as a telepathic message indicating that they want them.

The mental issue advances further when the person alters their diet believing that the lack of affection might have something to do with their appearance. Shrines to the target are often erected along with engraved items serving as a testament to their loving relationship, albeit imagined. Friends of the person afflicted or even strangers might also have an attraction to the target and anger will rise up in the person. They believe that the same unrealistic attraction that they have is actually a threat to their “real” relationship with the target. They will begin reaching out to the target to let them know that the message was received and they are ready to enter into this imagined life together.

Acting on this delusion, the person afflicted, will begin to pursue the target wanting to let them know that they received their message and they are ready to take the next step in their “relationship”. However, here is where they learn that their delusion is not real and rather than face that reality, they set out to either force realization onto the focus of their mania, or punish them for playing with their emotions.

D. Erotomania in Popular Culture

While erotomania is not reserved only for celebrities, they are the most commonly affected by it. Given the way they are elevated and lauded for their acting, singing, creativity or other vein they operate in, this causes an intense need to watch what they do and to be around them. Being a “fan” of someone really means being fanatical about them. Fanaticism is a belief that entails zeal without objectivity to the point of obsession.

“Regular” people are constantly inundated with news stories, updates and breaking news about things ranging from the most major to minute events in celebrities’ lives. Coupling with this, is the personal connection generated by investing your money into them. In many people’s minds, they begin to believe that they are owed something from these celebrities because they have supported them.

A person who is able to think rationally, will not get to this point. Reason being, they understand that their financial support is something they chose to do and not something the celebrity forced upon them. Movies are successful because people choose to go view them and they are flops when not enough people take an interest.

A few famous celebrities who have been affected by the symptoms of Erotomania:

  • Michael Douglas and Catherine Zeta-Jones – A woman claimed she was having an affair with Douglas and said that she would cut up Zeta-Jones and feed her to dogs.
  • David Letterman and Story Musgrave were stalked by a woman who was suspected of suffering from erotomania.

There are several major films whose central theme is erotomania:

  • Single White Female
  • The Fan
  • Play Misty For Me
  • Obsessed
  • The Crush
  • Fatal Attraction

Erotomania Causes

The causation of Erotomania is still a mystery to many.

It has been known to start during mid to late adulthood and the length of time is lasts varies. Although there have been many cases, there really is no clear marker for what causes its inception. The most common accepted thought as to why it occurs is that erotomania begins during childhood. The latching on to people the subject does not know and claiming that they love them, is an indication that love was absent somewhere in their life from someone who was of significant importance to them.

Because of this absence, they look to fill this void with someone larger than life who they believe would be big enough to provide them ease from their pain of being unloved. In female patients, the belief is the lack of attention or affection from their fathers could be the reason for the onset of erotomania. Females are also the most common gender associated with erotomania, while males are the ones that are the focus of women with this issue. Because of this, it has been surmised that lack of affection from the mother instead of the father is the main reason this develops.

Treatments for Erotomania

The treatments for Erotomania vary, but the typical way doctors attack this illness is with medication blended with psychotherapy. Antipsychotic drugs have performed well, but family has to be a strong support system also. Erotomania is something that should not be taken lightly because the afflicted person would surely be a threat to people who are the object of their affections.

In addition, people who are erotomanic believe that what they are thinking is true, so it is quite difficult to make them understand that what they have in mind is exactly right.

Erotomania treatments include:

  • Build a helpful alliance and work out satisfactory symptomatic treatment objectives. Meeting patients “where they are”, offering compassion, concern and enthusiasm for their healing is the ideal way to begin.
  • After getting permission from the patient, it is vital to include their family in the treatment process. Their support is key to improving their well being.
  • Consider the impact of culture for treatment planning.
  • Avoid direct confrontation of the delusional symptoms to enhance the possibility of treatment compliance and response.
  • Use medication judiciously to target core symptoms and associated problems (e.g. anger).
  • Use outpatient treatment unless there is potential for harm or violence.
  • Tailor treatment strategies to the individual needs of the patient and focus on maintaining social function and improving quality of life.
  • Recognize and ease coexisting psychiatric disorders.
  • Inpatient hospitalization should be discussed and considered if a patient’s delusions cause them to be a threat to themselves, others, or if he/she is presumed to be seriously disabled.

Antipsychotics have been used since the 1970s when the first report was published on the use of pimozide for the medical care of monosymptomatic hypochondriacal psychosis (now known as a delusional disorder, somatic type by DSM-5). Of approximately 1,000 treated cases of delusional disorder from 1965-1985, a subanalysis of 257 best-described cases revealed that delusional disorder has a relatively good prognosis when adequately treated — 52.6% of the patients recovered, 19.2% did not improve and 28.2% achieved partial recovery. Treatment response was positive regardless of the specific delusional content. The data concluded that pimozide (68.5% recovery rate and 22.4% partial recovery rate) may be better than other typical anti-psychotics (22.6% recovery and 45.3% partial recovery).

Another treatment of Erotomania that is not as common is the encouragement of marriage. By entering into a committed relationship where the person suffering from this illness and their partner are mutually focused on the other, the troubling fantasies should subside.

Erotomania Prevention

It has not yet been discovered how to prevent delusional disorder. But, early diagnosis and psychiatric treatment can aid in lowering the disruption to the person’s life, family, and friendships.

Erotomania is difficult to prevent because after it has been identified in the patient, you have to go back through their life to find out what could have made them predisposed to this sort of behavior. Then you will likely find the absence of love in their life and grow to a greater level of understanding as to why they grafted themselves onto a stranger to fill a loveless void. A solid home life with both parents affirming and supporting the child is the greatest way to avoid the inception of erotomania later in life.

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Last Reviewed:
September 22, 2017
Last Updated:
December 20, 2017
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