A Conceptual History of Erotomania
A Conceptual History of Erotomania
A Conceptual History of Erotomania
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381
Erotomania:
conceptual history
According
382
historiographical
Good historiographical practice enjoins that the history of the word erotomania
be distinguished from the history of its concepts and target behaviours (Berrios,
1994). The moment at which all three converge is usually reported as that in
which the particular clinical phenomenon was first discovered. Things are
more complicated than that, but the historical analysis of such convergences
often provides an explanation of how and why the symptom in question was
constructed in the first place (Berrios, 1996). Hence a complete account of
erotomania should include the three histories mentioned above, in addition
to attending to concepts and mores, such as ongoing views on love (Casas,
1930), pudor (Bonilla, 1964) and sexuality (Foucault, 1976).
The word erotomania
One of the earliest usages of 8pMTO)J.avta (raving love) has been traced to
Plutarch (Jones, 1994) although excellent descriptions of the consequences
of excessive love can [also] be found in Plaute, Paul Aegineta, Galen, Valerio
Maximus, Amatus Lusitanus, Valleriola, Sennert, etc. [later] Tulpius reported
the case of someone whose love precipitated a cataleptic attack; and Manget
of another who developed a high fever (Diderot and DAlambert, 1754).
This primigenial sense of erotomania is still present in the work of Jerome
Gaub (Rather, 1965) who reported that Perdiccas:
inflamed by love of Phila, the concubine of the king his father, had
abandoned all hope of ever possessing her, and having restrained his
ardour within, is said to have fallen seriously ill. Nor did he recover until
Hippocrates shrewdly observed that as often as Phila came by the pulse
beat of the invalid altered ...
(There have been at least three kings called Perdiccas; the one referred to
by Gaub was a contemporary of Hippocrates and can be assumed to be
383
Perdiccas
II, the
(Smith, 1869).)
son
of and
successor to
Alexander
I, King of Macedonia
Stage
l:
But I think that he was originally in love, and that he was dejected and
spiritless from being unsuccessful with the girl, and appeared to the
common people to be melancholic. He then did not know that he was in
love; but when he imparted the love to the girl, he ceased from his
dejection ...
is
rapid pulse
was
Although accepting
relationship
384
problem should
physicians
came
321)
the lovers pulse is variable and irregular, especially when he sees the
object of his affections, or hears her name, or gets tidings of her. In this
way one can discover, in the case of the one who conceals his love and the
name of his beloved, who is the object of his passion.
This view survived untouched until the middle of the seventeenth century:
it is a vulgar and most common observation, that if any one once being
taken with the aspect and conversation of a woman, begins inwardly to be
love sick for her, and to desire her earnestly, and for his most devoted
affection gets nothing but denials and contempt, unless he be upheld by a
very strong reason, or being seized by other affections, be turned another
way, as it were, there is great danger lest he fall into a love-melancholy;
with which passion if he happen to be affected presently he seems
transformed from himself into a living statue, as it were, he thinks or
speaks of nothing but his mistress; he seeks to put himself upon any of the
great dangers of life and fortune for her sake; mean while he does not only
neglect the care of domestick [sic] or publick [sic] concerns, or even of his
own salvation but, being frustrated of his desire, often layes [sic] violent
hands on himself ... (Willis, 1685: 475-6).
quelque chose.... Ce
(Furetiere, 1690).
pour
was
gar~on
erotomania
began
to mean
385
that form of madness caused by an excess of sexual appetite that leads to the
belief that sex is the supreme objective enslaving the person to its practice. It
is a form of melancholia, a true disease; it is what Willis called erotomania and
Sennert ainor insanus. (Diderot & DAlambert, 1754; original italics).
Those a~iicted by erotomania are no longer in platonic love with a
specific other; all they want is to indulge in indiscriminate physical sex.
Platonic love has been variously defined, the most common being love or
affection for one of the opposite sex, of a purely spiritual character, and free
from sensual desire. (OED, 1992; for a description of the concept itself, see
Gould, 1963.) By the second half of the eighteenth century nymphomania or
satyriasis had become the prototype of erotomania and they were listed in all
the great eighteenth century nosologies. For example, Boissier de Sauvages
and Sagar classified the two conditions under Morositates (cupiditates aut
aversationes depravatae); and Linn6 under Pathetici (satyriasis = deside?ium
Veneris enorme; erotomania = desideriwn Amantium pudicum) (Cullen, 1803).
and
satyriasis should be
preternatural affections
pyrexia,
as
386
...
De Bienville (1771: 44-5) was astonished to notice that all of the great
Moschio,
physicians of antiquity [had] kept silent about uterine furor.
Greek physician, called the disorder satyriasis, others metromania and
erotomania (which means the mania of love). All these terms are arbitrary
and I shall continue calling it nymphomania for its central feature is uterine
...
furor.
Nymphomania as a neurosis
Not all agreed with the hypothesis that nymphomania was a specific disorder
of the genital organs; for example, one of the French translators of Cullen,
classified it as a neurosis of generation (Pinel, 1813) . It would be anachronistic,
however, to interpret Cullens concept of neurosis as entailing an organic
or neurobiological view of mental disease in the current sense of the term.
This is because the concept of nervous system it is based on (see definition
above) has little relation with current views on the central nervous system
(L6pez Pinero, 1983). This is one of the reasons why, by the end of the
nineteenth century, the concept of neurosis was so easily converted into a
psychological one.
Together with masturbation or onanism (Tissot, 1781; Stengers & Van
Neck, 1984; Duch6, 1994), nymphomania became an object of moral panic
in Western Europe, and its medicalization was rushed through. Here moral
panic means an attitude of exaggerated revulsion and fear towards a
disease (often related to sexual behaviour) shown by certain sectors of the
population. Scientifically unwarranted and stridently driven by the popular
media, a moral panic finds its ideologists in religious and pressure groups
who seize the opportunity to try to impose their own beliefs. On occasions,
this agitation may cause retrograde legislation to be enacted. Examples of
moral panics are the fear of neurosyphilis during the nineteenth century and,
currently, HIV. Although court scientists often provide quick justifications,
the real engine for moral panics must be sought in deep-seated fears and
387
prejudices (usually about sex) and in bids by social cliques to gain moral
control upon society. The concept of moral panic helps to understand earlier
European attitudes towards masturbation, satyriasis and nymphomania, and
the terrible treatments that were meted out to women believed to be suffering
from the latter.
Exaggerated claims are characteristic of moral panic. In the case of selfabuse and nymphomania it was claimed that it was only a matter of time
before total social disintegration took place. The level of exaggeration can be
gauged by the observation that the most vociferous among the nineteenthcentury alienists had not many examples to report! This is so for Krafft-Ebing
(1931: 486) who could only admonish: chronic conditions of nymphomania
are apt to weaken public morality and lead to offences against decency. Woe
uiito the man who falls into the meshes of such an insatiable Messalina, whose
sexual appetite is never appeased ... (our italics). Benedict Morel was more
honest when he admitted that in his long professional life had seen only three
cases of nymphomania (Bouchereau, 1878: 823). This may explain why
nineteenth-century textbook writers had to borrow each others cases. It is
interesting to note that there is little difference between the Messalina
invective used by Krafft Ebing and current rhetoric against pornographic
material (see the thoughtful analysis by Stoller, 1991 ) .
The nineteenth century was particularly fertile in the coining of generic
medical categories for the erotomanias, homosexuality and other practices.
These included perversion (Lanteri-Laura, 1979; Huertas, 1990), 1amour
morbide (Laurent, 1891), lrotisme (Legrand du Saulle, 1864) and
psychopathia sexualis (1-,rafft-Ebing, 1931). As Wettley (1959) showed, these
medical categories provided the pabulum for the science of sexuality that
was to develop in later years. (On the so-called Scientia sexualis, see Foucault,
1976: 71-98).
The scientific claims made in regard to these new diseases contrast sharply
with the coy, moralizing and (often) hypocritical tone of the medical
literature of the day. For example, Laurent (1891: 107) wrote: Le lecteur
me pardonnera la crudite des faits que je vais rapporter. Jai voulu peindre un
triste milieu et fletrir linfme proxnte qui livre au vieillard lascif la jeune
fille naive et sans defense. Le savant ne doit reculer devant aucun document
... (our italics). And Legrand du Saulle (1864: 486): Nous aurons
inevitablement loccasion dexposer des faits et de reproduire des observations
capables dalarmer certaines susceptibilites; mais il na dependu de nous de
la science est comme le feu, elle purifi tout
rendre le sujet moins scabreux
Yet
others alienists like Krafft-Ebing (1931)
ce quelle touche. (our italics)
felt oblige to break into macaronic Latin when the topic became scabreux. Ey
(1950: 233) was right in losing patience with this attitude:
...
388
moralistes et psychiatres ont parfois tendance a placer de tels ecarts du
comportement moral et social hors de la nature, soit en les considerant
comme un pche contre nature soit en y voyant 1effet dun processus
morbide cr6ateur de tendances heterogenes a la nature humaine.
Nymphomania
and
degeneration theory
first
act
consequences in Genesis 3
...
389
carnal desire. Nymphomania thus became the nosological flagship of erotomania and this remained so well into nineteenth century in spite of the fact
that the 1820s a new view, namely, that erotomania was unrequited love
leading to mental disorder made its appearance. Thus, throughout the
nineteenth century, nymphomania was still considered as an object of moral
fear and was made the target of extraordinary treatments.
To render easier the coexistence of the two views, writers took pains to
differentiate between erotomania and primary nymphomania: the former
was defined as a mental disorder (i.e., monomania) and the latter as a
localized pathology of the genitals. In the event, nymphomania was redefined
as a mere symptom (to be found in a multitude of mental disorders) and by
the First World War was no longer used as a diagnostic category.
case
of
man
Then, he started
1912).
Erotomania
as a
monomania
erotomania
form of monomania:
Monomania was the first workable clinical counterpart of the older forensic
notion of partial insanity (Kageyama, 1984). Although it contributed to the
shaping of the current concept of psychosis (Berrios, 198?a), it turned out
to be, in the event, a transitional concept. The latter is defined as a clinical
category that helps to carry clinical phenomena from one (usually older)
390
which tends to last for only a relatively short time.
thus carried by monomania from the old eighteenth-century
nosology to the view that it was a form of partial mental disorder, as Esquirol
poetically put it, a disease of the imagination.
Thus, by the middle of the nineteenth century, when Falret (1864) and
others challenged the usefulness of monomania, the position and meaning of
erotomania were threatened; and when, by the 1880s, monomania had all
but disappeared (Linas, 1874), it was time for erotomania to change its
status: this it did (as many of its sister monomanias had to) and became a
plain delusion.
From the start, Esquirols proposal that erotomania was a monomania and
that it should be separated from nymphomania (on the grounds that the
latter was a localized disorder of the genital organs) was not received
favourably by clinicians, who on account of their religious convictions did
not want the boundaries between bad and mad to be blurred. For example,
in an early work, Morel (1853) argued that the two behaviours differed only in
terms of degree and opposed the medicalization of erotomania: Erotomania
must not be separated from nymphomania. In saying that the former is just a
disorder of imagination one confuses crime with madness. To differentiate
badness from madness, Morel (1853: 256) advised that three questions
should be asked: Has there been an amorous passion before the onset of the
disease? Are the depraved tendencies shown by the patient related to her
character rather than to any disease? Are the erotic ideas just a transformation of early signs of dementia? (By dementia Morel did not mean
organic dementia in the current sense of the term but a chronic state of
madness; see Berrios, 1987b). Renaudin (1854) expressed a similar
sentiment: in spite of all efforts to spintuali*ze this delusion [erotomania], and
however separated it might seem at first sight from all the physical components
[nymphomania], we cannot ignore the general interdependence of these two
aspects of our existence.
The view that, like monomania (Saussure, 1946), erotomania could lead
to crime stretches from Marc to Portemer. In his famous forensic textbook,
Marc (1840) included a chapter on Erotic monomania or erotomania &
aidoimania (laidoiomanie ou fureur genitale). Esquirols definition, Marc
believed, provided no criteria to differentiate excessive love from erotic
monomania, or erotomania from aidiomania (ai8ov = pudenda). (The latter
was a euphemism coined by Marc for nymphomania.) In the female, erotomania became complicated by hysteria and in the male by hypochondriasis.
nosology
to a new one
Erotomania
was
Because erotomania affected the emotions and the will (not the intellect),
it could be feigned. In practice, all these conditions could be confused and it
was difficult for the courts to decide on what was what (Marc, 1840: 182-
221).
391
insanity
Lorry;
our
italics)
italics)
392
who after discovering a new star cannot stop seeing it with his minds eye,
the erotomaniac cannot stop seeing his beloved ... the disease of the
erotomaniac resides in his brain; otherwise he experiences a chaste love
without any carnal desire. (pp. 131-2)
Erotomania
as a
delusion
By the early twentieth century, the view that erotomania was a delusion as
opposed to a form of partial madness had developed fast, and the need
arose to identify the type of delusion that it might be. S6rieux and Capgras
(1909), authors of one of the great books on delusion at the beginning of the
twentieth century, classified it as a dlire dinte~pretatiosi:
associated with ideas of jealousy, amorous delusions may persist for a long
time in some cases of delusions of interpretation: whether the love is
platonic or physical, it will depend upon the personality of the subject....
But the delusion may have as its object a person that the patient has never
seen but about whom he knows a great deal on account of mysterious
clues to which only he has the key ... (p. 115)
393
In his medical
...
The clinical observation that erotomaniac patients may suffer from pararnnesias
(pseudomemories) has also been neglected. In all probability this is due to
the fact that during the twentieth century the concept of delusion of
memory fell by the conceptual wayside. Indeed, it is little known that
Kraepelin was one of its creators (Markovd & Berrios, 2000).
At the beginning of the twentieth century, Portemer (1902: 175-6) wrote
an important book on erotomania:
Erotomania is
by
an
essentially
394
idealized and psychical form of it. There is no carnal appetite. It is a
sexual anomaly by default. It belongs to the group of monomanias
(Esquirol) and is characterized by a primitive disorder of the intellect
(Baillarger). Only the centre of ideation, situated in the frontal area, is
involved (Magnan). Like other sexual anomalies, erotomania must be
considered, according to Morel (1857) as a form of degeneration. In fact
it is not difficult to find in erotomaniacs some of the psychological and
physical stigmata of degeneration. Like all delusional ideas supervening
upon a background of degeneration, that of the erotomaniac is essentially
obsessional and impulsive.... An ideal is first formed in the mind and
when the patient believes to have found someone near it he is struck and
the obsession becomes implanted. Because all erotomaniacs are also
megalomaniacs, the ideal is always of a person of higher rank (queen,
unfavourable,
as
This shift from the delusion of being in love to the delusion of being loved
culminated in Ferdi~res (1937) classic book Lroromanie: illusion delira~ate
dtre aim. From now on, the feelings and behaviour of the object of love
became the focus of the patients delusion. What led to this final shift? It has
been mentioned already that both Ball and Leroy had suggested a
mechanism for this change. During the early twentieth century, other
alienists took up this view, some developing it in interesting and almost
precious ways. De Clerambault was one of them.
De C16rambault
395
The earliest documented intervention on erotomania by de Clrambault
dates back to 1913 when he is found commenting upon a paper by
Briand and Vinchon (1913) read at the Societe Clinique de Medicine
Mentale. It concerned two cases of what, at the time, was called women in
love with priests. De C16rambault knew the second case well and expressed
doubts as to whether she had a pure erotomaniac delusion, suggesting
instead that she entertained a wider vindicatory delusional system against the
(1942)
Clerambault,
1942:
318)
After World War I, de Clerambault continued his interest in the topic and
in 1920 (together with Brousseau) he reported the case of a French woman
who believed that George V, the English king, was in love with her. This
paper contains a summary of his theoretical views: at the basis of erotomania
there is an lme1lt gnrateur, a delusional postulate that, in addition to the
belief of being loved, contains supporting perceptions, attitudes, emotions
and interpretations. In erotomania, pride is more important than love and
gives rise to the delusional postulate. Platonic love has little to do with
erotomania (de Clerambault, 1942: 325).
In 1921 de Clerambault delivered a short paper on the subject, and the
rapporteur of the Society intimated that a longer version was to appear in
A1lllales Mdico-Psychologiques (de Clrambault, 1942: 337). (The authors of
the present paper have been unable to find any such publication.)
Erotomaniac delusions, our author claimed, were not of the interpretative
type (one of the three types recognized in French psychiatry at the time) but
(together with vindicative delusions and morbid jealousy), belonged to a new
category called morbid delusions of passion (dlires passi01l11els 11l0rbides). It
could appear alone (autonome et pur) or be associated with other delusions
and developed in three stages: hope, vexation and grudge (stade despoir, stade
de depit, stade de rancU11e). To identify it properly, asking questions was not
enough but patients had to be encouraged to act out their delusion (en
interrogeant de tels maladesJ il ne suffit pas de les questionner, il faut encore les
1942:
338).
In another paper de Clerambault discussed two cases and dealt with the
issue of differential diagnosis and with transitional states between benign and
morbid forms of delusions of passion. On occasions benign forms may
become morbid, in which case the patient needed hospital admission (de
396
1942: 346). (Nothing will be said here on de Clerambaults
process of differential diagnosis as the subtle, occasionally precious clinical
devices he used to this end would not make a great deal of sense to those not
au fait with the complex classification of delusional disorders reigning in
France during this period.) In the same year he reported yet another detailed
case of pure erotomania going through the stage of vexation. A new feature
was that it included an interview with the women who were the object of the
patients love! (In 1923 he reported this case as unimproved; de C16rambault,
Clerambault,
1942: 373.)
In 1923 de C16rambault published a final cluster of papers on erotomania
1942: 372) and gracefully accepted the proposal by Truelle
and Reboul-Lachaux that secondary erotomania was a better designation
than associated erotomania (de C16rambault, 1942: 370). He also reported
the case of a woman aged 55 whose pure erotomania had lasted for 37 years
(p. 406). There is, in addition, an important theoretical paper responding to
criticisms by Joseph Capgras which illustrates well the cultural specificity of de
Clerambaults ideas (p. 414). Lastly, there are two papers setting out the
boundaries of his concept of delusion or madness of passion (p. 423 and
p. 426, respectively). His plan of publishing a book on the subject never
materialized.
As mentioned above, de C16rambaults views on erotomania are locked
within French psychiatric culture, and to understand them a good command
is needed of a system of psychiatric ideas that even the current generation of
French psychiatrists find difficult to master. It is also clear that current
Anglo-Saxon views on erotomania (also dominant in France via translation
of DSM-IV; APA, 1994) take their cue not from the work of de Clerambault
but from earlier clinical descriptions, some going back to the nineteenth
century. If so, the eponym de Clerambaults syndrome poses something of a
paradox, for its current definition has little to do with his actual views.
Putting this right, however, would require rescuing and honouring old
French views on delusion, psychosis and indeed psychiatry that would clash
with those entertained in DSM-IV and ICD-10.
(de Clerambault,
Conclusions
This paper has presented a new historical hypothesis to account for the
construction of the clinical state currently called erotomania. The following
historiographical rules were adhered to: the history of the word erotomania
and that of the concepts and behaviours to which it referred in successive
historical periods were kept separate; and the locus of analysis were the
convergences, i.e., the historical moments when the three historical strands
came
together.
There have been four historical convergences. The period during which
each has been predominant has been called a stage. The boundaries
397
between stages
not
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