A patient, a colleague, or perhaps you have been stalked. The chances of a woman being stalked are an estimated 1 in 14; for men, it is 1 in 50.1 Fearful stalking victims may restrict their lives, change jobs, and curtail social activities to protect themselves from unwanted attention, physical assault, or even murder. They may develop anxiety, depression, or posttraumatic stress disorder (PTSD).2,3
Historical, clinical, and behavioral factors increase a stalker’s risk for committing violence (Table 1).2-7 As a psychiatrist, you may be asked to consult with local law enforcement and stalking victims to assess and manage victims’ risk. To best protect them, be aware of:
- 5 types of stalkers and their typical response to management strategies
- legal and safety issues to consider before taking actions that might endanger stalking victims
- strategies to help victims protect themselves
- interventions for victims and stalkers.
Factors that increase the risk of violence
|Criminal record (especially violent crimes)|
|Previous threats (especially specific or face-to-face)|
|Clinical||“Rejected” or “predatory” stalker type|
|Personality disorder with anger or behavioral instability|
|Depression with suicidal ideas|
|Behavioral||Access to weapons|
|Proximity to victim|
|Victim in a new relationship|
|Has already taken actions on plans/threats|
|Researching the victim|
|Unconcerned with negative consequences|
|Risk factors for homicide or serious physical harm:|
|Source: References 2-7|
Rejected stalkers—the most common and dangerous type—pursue the victim, often a former intimate partner, after a relationship ends. They often acknowledge a complex and volatile mix of desire for reconciliation and revenge. These stalkers likely have a history of criminal assault.
Rejected stalkers appear to respond best to a combination of coordinated legal sanctions and mental health intervention. Because they are most likely to be violent, rejected stalkers need intensive probation or parole supervision.5
Intimacy-seeking stalkers want an intimate relationship with a victim they believe is their “true love” and tend to imbue their victims with special desirability, excellence, and other qualities consistent with their belief of romanticized love. Most have erotomanic delusions, and the rest have morbid infatuations with the victim. Intimacy-seeking stalkers typically are unperturbed by legal sanctions, viewing them as the price to pay for “true love.” They often require court-mandated psychiatric treatment.
Incompetent stalkers know the victim is disinterested but forge ahead in hopes that their behavior will lead to a relationship. Their stalking can be viewed as crude or “incompetent” attempts to court the victim. Incompetent stalkers often are intellectually limited; they feel entitled to a partner but because of underdeveloped social skills are unable to build upon lesser forms of social interaction. Unlike intimacy-seekers, incompetent stalkers do not endow the victim with unique qualities.
In addition to needing legal sanctions and possible mental health treatment, incompetent stalkers often require social skills training. Otherwise, they are likely to continue their pattern of stalking with other victims.
Resentful stalkers who suffer from mental illness generally require court-ordered psychiatric treatment but are difficult to engage in therapy. Legal sanctions may inflame this type of stalker.
Predatory stalkers prepare for a sexual assault. They stalk to discover the victim’s vulnerabilities and seldom give warnings, so the victim is often unaware of the danger.
Predatory stalkers frequently suffer from paraphilias and have prior convictions for sexual offenses. They must be secured in a correctional or forensic setting to address their paraphilias and propensity for violence.
Identifying types of stalkers
|Type||Traits and behaviors|
|Rejected||Pursues former intimate partner|
|Desires reconciliation and/or revenge|
|Criminal assault history|
|Personality disorders predominate|
|Intimacy-seeking||Desires relationship with “true love”|
|Oblivious to victim response|
|Most have erotomanic delusions|
|Endows victim with unique qualities|
|Incompetent||Acknowledges victim’s disinterest|
|Hopes behavior leads to intimacy|
|Does not endow victim with unique qualities|
|Low IQ, socially inept, entitled|
|Resentful||Feels persecuted and desires retribution|
|Intends to frighten or distress|
|Specific or general grievance|
|Predatory||Preparing for sexual attack|
|Stalks to study and observe|
|Paraphilias, prior sexual offenses are common|
|No warnings before attack|
|Source: Reference 8|
Managing victims’ risk
Effectively managing a victim’s stalking risk is a dynamic process. It is critical to use professional judgment in a flexible manner and to work as a team with professionals from other agencies (Box).9-12