The Vampire: A Casebook

Clinical Vampirism: Blending Myth and Reality

PHILIP D. JAFFE AND FRANK DICATALDO Clinical Vampirism: Blending Myth and Reality More orless independent ofthe mainstream scholarship devoted to the vampire, we find a steady stream ofessays reflecting a psychiatric interest in the subject. Disturbed patients who exhibited a penchant for drinking blood, either their ownthatactivity termedautovampirism-orthat oftheirvictims-sometimesreferred to as clinical vampirism-presented a problem for psychiatrists. What was the meaning ofsuch behavior? How couldit be explained?Andwhat, ifany, treatment might be effectivefor such individuals? In marked contrast with Barber's "literal" explanation ofthe vampire, wefind Dr. Philip D. Jaffe, apsychiatrist andfaculty memberofpsychologyandeducationsciencesatthe University ofGeneva in Switzerland , and Frank DiCataldo, an expert onjuvenile delinquency, affiliated with the BridgewaterState Hospitalin Bridgewater, Massachusetts, who offerquiteadifferentpicture ofreputed vampires thatfigure prominently in a numberofdocumented clinical and legal cases. It may be legitimately asked whether or not "clinical" vampires have much to do with the vampire oftradition. One could argue, for instance, that the label "vampire " is only a convenient metaphorfor aform ofmentalpathology which includes the ingestion ofblood. On the other hand, it might also be contended that whatever the underlyingcauses ofthe mentalpathology might be, they couldinfact be related to the underlying ultimate origins ofthefolkloristic vampire. Whatever the actual relationship between clinicalvampirism and thefolkloristic vampire mightbe, there can be no question that thepsychiatricapproach to the vampire is well establishedand is likely to continuefor decades to come. Thosefavorably disposed towardssuch an approach may wish to read DonaldR. Morse, "The Stressful Kiss: A Biopsychosocial Evaluation ofthe Origins, Evolution, and Societal Significance ofVampirism, "Stress Medicine 9 (1993): 181-199; and RichardM. Gottlieb, "The Legendofthe European Vampire: ObjectLossandCorporealPreservation , " Psychoanalytic Study of the Child 49 (1994): 465-480. Reprinted from the Bulletin ofthe AmericanAcademy ofPsychiatry and the Law 22 (1994): 533544 . Copyright © 1994 American Academy of Psychiatry and the Law. Reprinted with permission. 143 Philip D. Jaffe and Frank DiCataldo In the modern age, vampires have become media stars. Published in 1897, Dracula by Bram Stoker! made the word vampire a household term. More recently, the vampire trilogy by Anne Rice2 became a bestseller. On the silver screen, W. Murnau's Nosferatu (Prana Films, Berlin, 1992) remains a classic, and a new Dracula movie is periodically released to please today's audiences. This enduring fascination with vampires evolved from beliefs and superstitions dating back to medieval Europe and to humankind's most archaic myths. Curiously, while providing inspiration for the arts, their legacy is also found in the rare clinical condition of vampirism, which groups some of the most shocking pathologic behaviors observed in humanity. In this article, we review the clinical aspects of overt vampiristic behavior and its various definitions and describe its relationship to more established psychiatric disorders. The original case study ofa "modern vampire" will help illustrate how myth and reality can blend and solidify in dramatic fashion. But first, by way of introduction, we review the vampire myth to which clinical vampirism owes its existence. Mythological Precursors to the Modem Vampire Records ofvampirelike figures exist in several ancient religions. Commonly mentioned are the Vajra deities ofTibet represented as blood drinkers, the Atharva Veda and the Baital-Pachisi in ancient Indian literature, and Mexico 's Ciuateteo, who was associated with women in Mexico having died during their first labor. Summers3 describes what is perhaps the first pictorial evidence ofthe vampire, an Assyrian bowl showing a man copulating with a female vampire whose head has been severed. He also reports on Babylonian , Semite, and Egyptian beliefs involving a dead person that continues to live in its original body and feeds off the living. Similar ancient beliefs are traced to ancient European, Chinese, Polynesian, and African cultures, and most refer to demonic female figures and fused relationships between the living and the dead, expressed through blood rituals as well as sexualized and aggressive exchanges. Current manifestations of these ancient beliefs still are found in voodooism and associated practices in the Caribbean and in Latin America. In Catholicism, wine continues to symbolize Christ's blood and is consumed by priests during mass.4 The modern vampire media myth probablyoriginated in Scandinavia and the British Isles, but it most firmly took hold in medieval central and eastern Europe. It owes as etymology to Slavic languages (e.g., upir in Bulgarian, vopyr in Russian, vapir in Serbian, vampir in Hungarian). Periodic vampire 144 Clinical Vampirism scares agitated these regions and their superstitious inhabitants late into the nineteenth century. A prevalent beliefinvolved a person who had died leaving...