Clinical vampirism

Clinical vampirism, more commonly called Renfield's syndrome or Renfield syndrome, is an obsession with drinking blood. The earliest formal presentation of clinical vampirism to appear in the psychiatric literature, with the psychoanalytic interpretation of two cases, was contributed by Richard L. Vanden Bergh and John F. Kelley in 1964. As the authors point out, brief and sporadic reports of blood-drinking behaviors associated with sexual pleasure have appeared in the psychiatric literature at least since 1892 with the work of Austrian forensic psychiatrist Richard von Krafft-Ebing. Many medical publications concerning clinical vampirism can be found in the literature of forensic psychiatry, with the unusual behavior reported as one of many aspect of extraordinary violent crimes. The behavior has never gained official recognition by the psychiatric profession and is not found in any edition of the International Classification of Diseases or the Diagnostic and Statistical Manual of Mental Disorders. However, in the more colorful era in the history of psychiatry that predated the 1980s rise of the bureaucratic hegemony of coded categories of (supposedly) theory-neutral mental disorders in DSM and ICD, the psychiatric literature was fertile ground for the flourishing of case history reports of "uncommon psychiatric syndromes" or "extraordinary disorders of human behavior" that included not only clinical vampirism, but also lycanthropy, possession, stigmata and other unusual phenomena.

Renfield's Syndrome
The alternate label "Renfield syndrome" is named after Dracula's human zoophagous patient, R. M.Renfield, in the 1897 novel by Bram Stoker. According to an interview conducted by psychology professor Katherine Ramsland with clinical psychologist Richard Noll, who coined the eponymous term in a 1992 book, he invented the term and its purported diagnostic criteria as a whimsical pastiche of the "new DSM-speak" of the psychiatry of the 1980s. After Noll's book appeared in 1992 clinical vampirism has usually been referred to as Renfield's syndrome. In an NBC pre-Halloween special hosted by actor Peter Graves entitled "The Unexplained: Witches, Werewolves and Vampires" that aired on 23 October 1994 (and is available on YouTube, with the 34:11 mark beginning the segment), pages from Noll's book were shown on camera as Canadian psychologist Leonard George summarized Renfield's syndrome for a wide television audience.

The twenty-year evolution of a "fang-in-cheek" 3-page book section that shot through the mass media and then—uncritically—into the pages of a peer-reviewed scholarly journal should serve as a cautionary tale about the purported validity of other "mental disorders." Philosopher of science Ian Hacking refers to this process as "making up people" and critiques medical and psychiatric elites for the untoward effects of their "dynamic nominalism" on individual lives. Such arbitrary categories create new natural "kinds" of people (e.g., perverts, multiple personalities and so on) that serve larger political, cultural and moral purposes and change with historical contingencies.

According to the case history reports in the older psychiatric literature that formed the basis of Noll's pastiche, the condition starts with a key event in childhood that causes the experience of blood injury or the ingestion of blood to be exciting. After puberty, the excitement is experienced as sexual arousal. Throughout adolescence and adulthood, blood, its presence, and its consumption can also stimulate a sense of power and control. Noll speculated that Renfield's syndrome begins with autovampirism and then progresses to the consumption of the blood of other creatures.

The usefulness of this diagnostic label remains in question. Very few cases of the syndrome have been described, and the published reports that do exist refer to what has been proposed as Renfield's syndrome through the use of official psychiatric diagnostic categories such as schizophrenia or as a variety of paraphilia. A number of murderers have performed seemingly vampiric rituals upon their victims. Serial killers Peter Kürten and Richard Trenton Chase were both called "vampires" in the tabloids after they were discovered drinking the blood of the people they murdered. Similarly, in 1932, an unsolved murder case in Stockholm, Sweden was nicknamed the "Vampire murder", due to the circumstances of the victim’s death.

In addition to references to Renfield's syndrome in the psychiatric literature and mass media, the horror writer Chelsea Quinn Yarbro published a story entitled "Renfield's Syndrome" in July 2002, which was then reprinted in an anthology that appeared the following year.

Sufferers of Renfield's Syndrome are overwhelmingly male. The disorder is typically sparked by an event in childhood in which the sufferer associates the sight or taste of blood with excitement. During puberty, the feelings of attraction to blood become sexual in nature.

Renfield's Syndrome typically follows three stages. In the first, autovampirism or autohemophagia, the sufferer drinks his own blood, often cutting himself in order to do so. The second stage is zoophagia, which consists of eating live animals or drinking their blood. Obtaining animal blood from a butcher or slaughterhouse for consumption also falls into this stage.

In the third stage, true vampirism, the sufferer's attention is turned to other human beings. He may steal blood from hospitals or blood banks, or drink blood directly from a living person. Some people with Renfield's Syndrome commit violent crimes, including murder, after entering this stage.

Though Renfield's Syndrome is newly named and has not yet been accepted into the DSM, it is not a new disorder. Noll noted apparent references to the disorder in German psychiatrist Richard van Krafft-Ebing's 1886 text Psychopathia Sexualis and speculated that Stoker may have been familiar with Krafft-Ebing's work.

History and famous figures
Clinical vampirism is named after the mythical vampire, and is a recognizable, although rare, clinical entity characterized by periodic compulsive blood-drinking, affinity with the dead and uncertain identity. It is hypothetically the expression of an inherited archaic myth, the act of taking blood being a ritual that gives temporary relief. From ancient times vampirists have given substance to belief in the existence of supernatural vampires. Four vampirists, including Haigh, the 'acid-bath murderer', are described. From childhood they cut themselves, drank their own, exogenous human or animal blood to relieve a craving, dreamed of blood-shed, associated with the dead, and had a changing identity. They were intelligent, with no family mental or social pathology. Some self-cutters are auto-vampirists; females are not likely to assault others for blood, but males are potentially dangerous. Vampirism may be a cause of unpredictable repeated assault and murder, and should be looked for in violent criminals who are self-mutilators. No specific treatment is known.

Because of the disease not generally being recognized and no current treatment is known, there are debates about the dangers of not being able to treat this disorder, as patients are potentially dangerous to society.

Psychiatric and Forensic Contexts
The usefulness of this pseudo-diagnostic label remains in question. Very few cases of the syndrome have been described, and the published reports that do exist describe clinical vampirism as behaviors that are subsumed under more conventional psychiatric diagnostic categories such as schizophrenia or paraphilia. A case of vampirism in Turkey reported in 2012 was discussed as an unusual feature of a patient diagnosed with dissociative identity disorder and post-traumatic stress disorder. While not referencing the literature on Renfield's syndrome, two Irish psychiatrists surveyed the psychiatric literature on vampirism as evidence of a changing discourse in psychiatry from the narrative of case studies to the depersonalized discourse of checklist diagnostic criteria.

A number of murderers have performed seemingly vampiric rituals upon their victims. Serial killers Peter Kürten and Richard Trenton Chase were both called "vampires" in the tabloids after they were discovered drinking the blood of the people they murdered. Similarly, in 1932, an unsolved murder case in Stockholm, Sweden was nicknamed the "Vampire murder", due to the circumstances of the victim’s death. Clinical vampirism in the context of criminal acts of violence, as well as "consensual" vampirism as a social ritual, have been extensively documented in the many works of Katharine Ramsland. Others have commented upon the psychiatric implications of "vampire cults" among adolescents.