Abstract
There is no single definition of stalking. Stalking is generally viewed as a ‘pattern of unwanted pursuit that the victim often perceives as harassing or threatening’ [1]. In New South Wales, anti-stalking legislation has been introduced and severe legal penalties can apply. The New South Wales Crimes Act 1900, section 562AB defines stalking as ‘intimidation with intent to cause fear for personal safety’.
In community surveys 1–2% of women report having been subjected to stalking in the previous year; the life-time risk for women is estimated to be in the region of 8% and that for men around 2% [2,3].
The authors describe an unusual presentation of serial same-gender stalking in which issues of adoption and twinship appear to have relevance.
Case description
This case is reported with the verbal and written permission of the patient and details have been excluded to protect her identity.
A is a clerical worker in her early twenties; she and her twin sister were adopted at birth. She was brought up in regional Australia in a middle-class family.
A asked her general practitioner to refer her to a psychiatrist so that she could better understand a long-standing behavioural pattern that was beginning to disturb her. She described following an older female colleague in a superior position within her organisation over a period of months. She had followed this person back to her home without her knowing but strongly denied any intent to harm the person or sexual motivation. She was aware that this person might be quite unwelcoming of this attention and might even seek legal recourse if she became aware of the following behaviour.
It was noted that between the ages of 12 and 16, A became obsessed with a female teacher and engaged in similar behaviours. Prior to her referral to a psychiatrist A acknowledged that she had briefly seen a female psychologist who had terminated therapy with her because she had begun to follow her. There was no significant history of drug or alcohol abuse. A had an unremarkable birth and apparently her mother had an uneventful pregnancy. Milestones were achieved normally and A had no difficulties with sporting or academic pursuits.
The relevant personal history revealed that her non-identical twin sister was a gregarious outgoing, high-achiever with whom she has limited contact. A spoke of her considerable rivalry with her sister and described her in terms of being ‘conformist and superficial’. A described a distant uninvolved father and an anxious mother who was rather tentative in her parenting style. A stated that her mother was totally unable to control her during a period of adolescence when she was drinking and partying.
She and her sister found out at school, at the age of 7, from a peer that they were adopted. Their mother confirmed this and the issue was apparently never spoken about again. A was unable to recall in any detail her feelings about this revelation at that time but did remember intuitively perceiving the need to protect her adoptive mother from any distress around this issue. A knows where her birth mother lives but has decided not to contact her, fearing this would ‘upset her (adoptive) mother’.
A moved from the small country town where she lived to a metropolitan centre. She immediately found work and has remained in this organisation ever since. She lives in shared accommodation, describes a supportive network of friends but no sexual experiences with either sex.
In terms of personality A described herself as shy and ‘not interesting or having anything special to offer’.
On examination she presented as a shy young woman, neatly attired, who made good eye contact and often laughed nervously. Her affect was reactive and she became extremely animated when talking about the woman concerned, stating that she felt ‘wonderful and excited to be near her’. She denied depressed mood. She had no neurovegetative features of depression or anxiety and was not suicidal or homicidal. No other indicators of obsessive–compulsive or ritualised behaviour were evident. No delusional material was evident in her references to the woman she was following nor in regards to her motivation. She denied perceptual disturbances. She presented as being intelligent, able to express herself articulately and had some insight into the inappropriateness of her behaviour. She felt that if she saw a male therapist there would be no risk of her engaging in stalking behaviour with him.
From a diagnostic viewpoint there was no clear-cut evidence of a depressive, anxiety or psychotic disorder. A did not fulfil DSM-IV diagnostic criteria for obsessive–compulsive disorder, delusional disorder (Erotomanic type) or paraphilia. She appeared to have avoidant personality traits and a low self-esteem but no clear markers of personality disorder. A did not appear to represent an overt danger to the person concerned.
After a period of further assessment the following themes appeared to be central: rivalry with her twin sister, the manner of discovery of her adoption and her relationships with her biological and adoptive mothers. A speculated that what she was looking for in the woman she followed was some kind of guiding figure and role model.
The legal ramifications of this behaviour were discussed in the assessment period with A and she agreed to stop these behaviours and accept a referral for ongoing psychotherapy.
Discussion with her male psychotherapist revealed that she has ceased her following behaviours, and therapeutic work has focused largely on the issues noted above.
Discussion
A's behaviour appeared to be an acting out of a desire to recapture some unfulfilled aspect of intimacy in her early relationship with either her adoptive or biological mother. Adoption has been noted to be a risk factor for stalking [4]. Adopted children may manifest attachment difficulties later in life [5–9]. The tasks of adopted children in the middle childhood years (ages 7–11) include, ‘searching for answers in regard to one's origin as well as the reasons for relinquishment' [8]. The inability of A and her adoptive mother to communicate about these matters would have made it difficult to achieve these tasks as well as to cope with ‘adoption related losses’ [10] such as realising other children are not adopted or how different life might have been.
The revelation of her adoption during the latency phase of her psychosexual development appears to have been what Mullen has termed a ‘provoking event’ [11] in regard to the evolution of her stalking behaviour.
Twins generally have greater problems in the separation–individuation phase of development. They not only need to individuate from their mothers but also from the symbiotic relationship with their twins [12]. Twins may also have difficulties in establishing satisfactory relationships with their mothers as the other twin is often interposed. Some primary care-givers may only be able to bond to one of the pairs of twins [12,13].
The early age of onset of this behaviour and serial stalking of older victims of the same gender is highly unusual [1,4].
A did not appear to represent an overt danger to her victim, however serious psychological damage can be inflicted even in the absence of physical attack. Some victims of stalkers have described the experiences as ‘psychological terrorism’ or ‘emotional rape’ [14].
Mullen [15] states that the bulk of stalkers will desist under the threat of prosecution but abstinence is often assisted by an appropriate supportive yet directive therapeutic relationship. Understandably, some therapists may be reluctant to take on for long-term therapy someone with a prior history of stalking fearing that they themselves might be stalked. Careful patient selection, clear boundaries (including willingness to involve police) and working as part of a team might reduce this risk [16].
Acknowledgment
The helpful comments by Paul Mullen are gratefully acknowledged.