The Malta Independent 17 July 2024, Wednesday
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Stalking: The psychiatric truth behind ‘Baby Reindeer’ and the current realities of mental health

Andrea Caruana Sunday, 16 June 2024, 09:00 Last update: about 1 month ago

Following the success of the recent psychological thriller series Baby Reindeer and the controversies and debates following its release, The Malta Independent picked out one prominent theme, among others, of the whole media whirlwind it caused: stalking. To gain more insight into this abnormal behaviour, psychiatrist Prof. Anton Grech was consulted.

The mental illness, or the psychiatric grey area, behind the intense hounding of a person was explained by Grech, who, aside from giving his professional comment on the series, used it to showcase the direction stalking behaviour is taking with social media. He went on to give practical advice to all parties, including the loved ones of a “stalker” as well as giving an idea of the degree of stigma Malta has towards mental health and its treatment.

When asked to define stalking, Grech said that it is when someone shows an unreciprocated interest in another person. He said that the person showing the interest persists to the extent that the other person feels uncomfortable or threatened.

With regards to the “line in the sand” that must be crossed by a stalker to make a person be stalked, despite the victim possibly having doubts and paranoia of what is going on, is the simple test, “Do I feel uncomfortable or threatened?”, Grech believes.

He said that whoever is a “stalker” doesn’t do it “frivolously”, on the back of their severe mental illness or other psychological issues. Grech added that, though “difficult” to see it, the people who participate in stalking are “victims of their own condition” and while their actions cannot in any way be condoned, they cannot be demonised.

The exposure of the real-life character from the Baby Reindeer series illustrates Grech’s perception of the movement of stalking patterns in contemporary times. He stressed the prominent role of social media in current stalking cases.

Grech said that the main problem was with people having profiles on social media which can be followed and, in turn, can be contacted, for example through comments which can be repeated so intensely that it may reach the extent of stalking.

Stalking cannot be “put under one umbrella”, Grech said, when questioned if stalking behaviour is a “pathology” or illness. “Whatever causes suffering and discomfort is beyond the normal”. Grech went on to explain that for this reason it is not normal behaviour and in a number of cases severe mental illness is present.

He elaborated in saying that in about 10% of cases, pathology/severe mental illness is present. Grech gave one example using the condition of erotomania, which he explained is when someone becomes obsessed that someone else, generally a celebrity, is in love with them, and want to reciprocate his love interest despite the difficulty of forming a relationship with them.

He elaborated that this is an offshoot of psychosis, known as a delusional disorder, which he defined as a false belief that the patient firmly believes in and cannot be reasoned with. Grech said that this is why patients with erotomania cannot be convinced that the celebrity is not interested in them. In such cases, he said that patients “definitely” need treatment, typically medication.

Grech said that the remaining 90% of people with stalking behaviour “go beyond the norm” but do not necessarily have mental illness, or in other words, do not reach the extent of a mental illness. When questioned if this was a psychiatric grey area, he said that there is a grey area in everything since the behaviour of people cannot be “put into boxes”.

Grech prefers to see things in a “continuum” which has an inherent grey area and illustrated the point by saying that a patient may have severe depression while someone can be very sad though not classifies as being depressed, and so falls into the grey area. He added in these 90% of “grey area” cases, the best treatment would be psychotherapy.

Stalking behaviour is further complicated by local cultures. Grech said that psychiatry and mental illness, as a whole, must always be taken in the context of a particular culture. He gave an example with Malta by saying that if the majority of the people are Catholic and believe in the afterlife, that person would go about saying that there is life after death with no problems. However, Grech said that should that same person enter a different culture, with different beliefs, still saying he believes in an afterlife, he might be considered delusional.

Regarding the typical characteristics of stalking victims and perpetrators, there is a lack of research on the subject in Malta, Grech said. However, based on his practice and experience abroad, in the EU and the UK, he said that Malta appears to have a similar situation to other countries and evidence exists that the primary victims are women. Grech said that generally, the most common stalking behaviour is done by a man to a woman and, the second most common, is woman to woman but these typical patterns are not exclusive.

Generally, the damage a period of stalking can do to the person varies greatly, Grech said, going from damaging to discomfort. He said that it depends on a number of variables that affect the victim such as their psychological resilience, their current situation in life and what led to the stalking in the first place. He pointed out that stalking behaviour can be done to total strangers or ex-partners, and all this contributes to the damage.

Grech said that if someone feels threatened they must go to the police but he recommended ceasing all forms of contact with the person carrying out the stalking behaviour. Specifically, he tells those being stalked, “Don’t give mixed messages”, the reason being that he has seen cases where the victim feels pity for the perpetrator and may even accept gifts they offer them to avoid offending them. He added that this must be stopped, no matter how small, since the perpetrator may misinterpret the gestures and perpetuate the stalking. “No response, no contact at all, quite blunt but I think that's how it should be,” Grech said. 

He said that the “best” way to help the victim of a stalker is by helping the stalker get treatment and it is a win-win situation because in this way, the victim solves their problem “from the root cause” while the perpetrator, like any individual, deserves help.

Grech was then questioned about the ability of the Malta Police Force in dealing with cases of stalking to which he replied that they are generally effective and sensitive to psychiatric conditions that allows them to reach out to the experts when there is a doubt.

With the principles of mental health first aid in mind, Grech said that should one spot a loved one exhibiting tendencies of stalking behaviour, or any psychiatric condition in general, the best way you can help them is by convincing them to get help and treatment. He emphasised the importance of this, noting that a major issue in psychiatry is that people often don't seek help. He added that, compared to other types of illnesses, psychiatric conditions take the longest for patients to seek assistance after symptoms appear, sometimes for many years, primarily due to stigma. Grech gave the example of obsessive-compulsive disorder whose average time for patients to seek help is eight years following the onset.

On the flip-side, Grech said that should a person become self-aware that they may be carrying out stalking behaviour, they should seek help and “it's not a situation one can resolve on his own by good intentions and goodwill. You need help and support”. He added that should someone have concerns about their behaviour they should go for a check-up in the similar fashion that someone with ankle pain goes to the doctor to see what is wrong with their ankle.

Grech said that ultimately, he believes it should not be the role of the perpetrator to reduce the damage on the victim because there should be no contact between them at all, as he recommends. He added that if a person with stalking tendencies receives the necessary help that works there is no reason they should not be reintegrated in society.

Finally, when asked if the demonisation of mentally ill people is a common theme in psychiatry, in this case regarding stalkers, Grech said that misconceptions exist and cited research that shows that the “very vast majority” of violence is carried out by people who are well and a lot of stigma exists regarding the mentally ill, which must be fought. He said that mental illness is much more common than is thought and if one doesn’t suffer from it, chances are a first degree relative does, and went on to question if someone would demonise such close relatives.

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