Evidence-Based Reviews

Stalking intervention: Know the 5 stalker types, safety strategies for victims

Current Psychiatry. 2007 May;6(5):31-38

References

1. Basile KC, Swahn MH, Chen J, Saltzman LE. Stalking in the United States: recent national prevalence estimates. Am J Prev Med 2006;31(2):172-5.

2. McEwan T, Mullen PE, Purcell R. Identifying risk factors in stalking: a review of current research. Int J Law Psychiatry 2007;30:1-9.

3. Spitzberg BH, Cupach WR. The state of the art of stalking: taking stock of the emerging literature. Aggression and Violent Behavior 2007;12:64-86.

4. Mullen P, Mackenzie R, Ogloff JR, et al. Assessing and managing the risks in the stalking situation. J Am Acad Psychiatry Law 2006;34:439-50.

5. Mohandie K, Meloy JR, McGowan MG, Williams J. The RECON typology of stalking: reliability and validity based upon a large sample of North American stalkers. J Forensic Sci 2006;51(1):147-55.

6. James DV, Farnham FR. Stalking and serious violence. J Am Acad Psychiatry Law 2003;31(4):432-9.

7. McFarlane J, Campbell JC, Watson K. Intimate partner stalking and femicide: urgent implications for women’s safety. Behav Sci Law 2002;20(1-2):51-68.

8. Mullen PE, Pathé M, Purcell R. Stalkers and their victims. Cambridge, UK: Cambridge University Press; 2000.

9. Binder RL. Commentary: the importance of professional judgment in evaluation of stalking and threatening situations. J Am Acad Psychiatry Law 2006;34(4):451-4.

10. White S, Cawood J. Threat management of stalking cases. In: Meloy JR, ed. The psychology of stalking: clinical and forensic perspectives. San Diego, CA: Academic Press; 1998:295-314.

11. Orion D. I know you really love me: a psychiatrist’s journal of erotomania, stalking, and obsessive love. New York: Macmillan; 1997.

12. Maxey W. The San Diego stalking strike force: a multi-disciplinary approach to assessing and managing stalking and threat cases. Journal of Threat Assessment 2002;2(1):43-53.

13. McFarlane J, Malecha A, Gist J, et al. Protection orders and intimate partner violence: an 18-month study of 150 black, Hispanic, and white women. Am J Public Health 2004;94(4):613-8.

14. Melton HC. Predicting the occurrence of stalking in relationships characterized by domestic violence. J Interpers Violence 2007;22(1):3-25.

15. Meloy JR. The clinical risk management of stalking: “someone is watching over me….” Am J Psychother 1997;51(2):174-84.

16. Purcell R, Pathé M, Mullen PE. When do repeated intrusions become stalking? J Forensic Psychiatry Psychol 2004;15(4):571-3.

17. Pathé M. Surviving stalking. Cambridge, UK: Cambridge University Press; 2002.

18. Kamphuis JH, Emmelkamp PMG. Traumatic distress among support-seeking female victims of stalking. Am J Psychiatry 2001;158:795-8.

19. Pathé M, Mullen PE. The impact of stalkers on their victims. Br J Psychiatry 1997;170:12-7.

20. Turmanis SA, Brown RI. The stalking and harassment behavior scale: measuring the incidence, nature, and severity of stalking and relational harassment and their psychological effects. Psychol Psychother 2006;79(Pt 2):183-98.

21. Ashmore R, Jones J, Jackson A, Smoyak S. A survey of mental health nurses’ experiences of stalking. J Psychiatr Ment Health Nurs 2006;13:562-9.

22. De Becker G. The gift of fear: survival signals that protect us from violence. New York: Dell Publishing; 1997.

Improving victims’ safety

Coach a victim to take responsibility for his or her safety by becoming familiar with local stalking laws, resources, and law enforcement policies.^13,22 Emphasize that a victim must be assertive to ensure that safety measures are in place (Table 3).^3,8,10,15,18

As soon as unwanted pursuit is apparent, the victim should unequivocally tell the stalker that no relationship is wanted.⁸ This message must be firm, reasonable, and as clear as possible. The victim should not attempt to deliver the message gently or let the stalker “down easy.” Otherwise, the stalker may believe the victim is ambivalent about the decision and will continue or redouble his or her efforts.

After delivering this message, the victim should not engage in any further discussion or initiate contact with the stalker. The victim must avoid all contact to minimize the effects of “intermittent positive reinforcement.”¹⁵

The victim should document and preserve evidence by recording the dates and times of each unwanted contact, including vandalism, in an “incident log” or journal. Encourage him or her to photograph and note the date of any property damage. This documentation will help establish a clear course of illegal conduct and can prove invaluable to police and prosecution efforts.

The victim should preserve any evidence—including gifts, mementos, and other materials—by placing it in a plastic bag labeled with the date, time, and place it was received. Encourage the victim to:

resist the urge to discard evidence that may evoke feelings of fear, shame, or disgust
avoid handling evidence, and store it in a secure location.

Teach a victim to protect his or her address, phone numbers, email address, and other personal information by disclosing it only to trusted persons. He or she could:

establish a post office box to prevent someone from stealing mail containing personal information
shred personal mail instead of placing it in the trash.

Encourage the victim to have a frank discussion with law enforcement personnel about how much assistance can be expected. Hiring a private investigator who is familiar with personal protection and stalking might be worthwhile after law enforcement officials document the stalking behavior.

Clinical Point

Know your state’s duty-to-protect statutes and stalking case law so you can discuss legal obligations before treating a stalker

It is essential for the victim to form a network of trusted social contacts who will provide a “safety net.” Informing family, friends, co-workers, and neighbors about stalking and its potentially serious consequences may reduce the risk that they might inadvertently disclose a victim’s personal information to the stalker.⁸ The victim can distribute a photo of the stalker to members of the safety network, as well as co-workers, with instructions to call the victim if the stalker is spotted.

Security experts often advise victims not to adhere to their usual, predictable routines by, for example, taking different daily travel routes or being prepared to go out of town at short notice.² Victims should also make contingency plans in case their social supports are unavailable in an emergency. Victim advocacy agents can give information about services and locations of local “safe houses” or domestic violence shelters.

Table 3

Victim safety strategies

Give stalker 1 clear “stay away” message Avoid all subsequent contact Document and record incidents Protect personal information Stay in contact with law enforcement Build a safety network Vary daily routines Make contingency plans for emergencies Seek counseling
Source: References 3,8,10,15,18

Treating stalkers

Failing to treat a mentally ill stalker may result in continued risk to the victim. For example, an intimacy-seeking stalker with erotomanic delusions who is confined without treatment likely will be released with no significant reduction in risk. No reliable outcome data exist on treatment for stalkers, however, so you must rely on empirically derived clinical data.

Clinical Point

Expect a stalker to present with denial, present with denial, rationalization, and minimization and minimization

Specialized training is recommended for clinicians who treat stalkers. At the very least, nonforensically trained therapists require education on stalker psychology.

If you work with stalkers, you must be familiar with your state’s duty-to-protect statutes and relevant case law related to stalking so you can discuss legal obligations with the stalker before beginning treatment.

Most stalkers will be difficult to engage in treatment because they have been compelled by a court order to seek therapy. Initially you are likely to encounter the stalker’s striking lack of insight into the nature and consequences of this behavior. The stalker may seek validation for his or her actions while demonstrating little interest in ending the obsessional behavior. Expect well-entrenched defenses of denial, rationalization, and minimization.