manic behaviour

by Sarah Myers

egomania | pyromania | erotomania | help and info

When irresistible impulses and delusional thoughts take over people's minds, their behaviour can be dangerous and destructive – to themselves and those around them.

Sarah Myers looks at three psychological disorders and the manic behaviours each can bring: egomania, pyromania and erotomania.

egomania

© Channel 4

Everyone thinks they know an egomaniac, don't they? You might pin the label on an unbelievably arrogant friend or a tyrannical boss. But to be a true egomaniac – that is, to be diagnosed with what psychiatrists call Narcissistic Personality Disorder (NPD) – you must show at least five of the following characteristics:

• A grandiose sense of self-importance – Egomaniacs exaggerate their achievements and talents, and want other people to recognise them as superior.
• Preoccupation with success and power – They're obsessed with fantasies involving their own brilliance or beauty.
• Arrogance – Their behaviour is haughty, their attitude conceited and they show rage when frustrated, contradicted, or confronted.
• Need for excessive admiration – Egomaniacs need attention, they want to be adored or, failing that, feared.
• A sense of entitlement – They have unreasonable expectations and believe they deserve favourable treatment.
• Exploitative – Happy to take advantage of others, they use people to get what they want.
• Lack of empathy – Egomaniacs can't or won't acknowledge other people's feelings.
• A belief of being unique – They believe that they're special and can only be understood by and associate with people of high status.
• Feel envy towards others – And believe others feel envious of them.

Where might you find an egomaniac? Well it won't be doing charity work... They have no regard for other people and resent any weakness or vulnerability in others. They feel no need to take responsibility for their actions and won't accept being challenged or criticised. The ultimate egomaniac is the cult leader. They get to be at the centre of a group of adoring followers, giving them the god-like status they think they deserve.

It's thought there are around six million people across the world with NPD. There could be many more, but it's difficult to diagnose. Most people affected won't present their symptoms to the doctor; they simply don't believe there's anything wrong with them, rather that other people are the cause of any problems.

Someone's personality is part of their psychological make up and impossible to change, making personality disorders like NPD difficult to treat. What therapists can do is help to control the traits of NPD and concentrate on changing behaviour. It can take years of therapy to make a difference.

pyromania

© Channel 4

An estimated four million people suffer from Pyromania – the uncontrollable urge to start fires. Pyromaniacs experience tension and excitement before starting a fire, then pleasure and relief once it's alight. They are fascinated by the flames, smoke and smell, and enjoy watching the destruction a fire can cause. Most pyromaniacs stay around to watch as their fire takes hold, getting pleasure from observing what has to be done to distinguish their handiwork.

True pyromania is diagnosed by ruling out other motivations for starting fires. Pyromaniacs don't start fires because of anger, revenge or for a potential insurance claim. Serial arsonists aren't necessarily pyromaniacs. If any other mental health issues are identified, such as delusional states or impaired judgement, pyromania may be ruled out. For pyromaniacs there are no external factors, it's a compulsion based on pure enjoyment. Their work is deliberate, and they find the results satisfying.

Like compulsive gambling or kleptomania (impulsive stealing), pyromania is an 'impulse control disorder'. It involves the person responding to an immediate desire or impulse and having no regard for the consequences. Pyromania involves a lot more planning that other impulse control disorders; it's more compulsive.

Most common in under 18s, pyromania often goes hand in hand with other emotional problems and attention disorders. Pyromaniacs get a sense of control from starting a fire, and are often responding to a feeling that they lack control in other areas of their lives.

Pyromania is often treated with behaviour therapy, which focuses on how the person acts now rather than concentrating too heavily on their past. It works to change the patterns of behaviour by directing the person's interest away from fires and finding other outlets for their feelings.

erotomania

© Channel 4

Erotomania, or de Clerambault's syndrome, is a 'delusional romantic preoccupation with a stranger'. It's more commonly recognised as stalking. Someone suffering from the condition believes, quite wrongly, that another person is in love with them. They may have never even spoken to that person.

Erotomaniacs usually focus their attention on those with high social status, quite often celebrities or public figures. They also go for people who have shown them kindness or helped them in some way – for example, a doctor. And they do more than innocently daydream about the object of their desire. They fabricate a whole relationship with that person, going in to great detail. They believe that they will be with that person one day and won't accept rejection. Simply unable to recognise that the person doesn't share their feelings, they assume that someone else must be manipulating the person they love or doing something to prevent them being together. (For example, they might think 'His wife made him get that restraining disorder, he really wants to be with me.')

More women than men have erotomania, and those affected tend to be lonely and have social difficulties. They've usually grown up with a poor sense of self, and sometimes come from an abusive background. Erotomaniacs tend to have difficulty with intimacy. They can't attain it in reality, so seek it in fantasy. Often having experienced loss, they feel safer attaching themselves to people who are unattainable, preventing any further loss.

Most erotomaniacs won't seek treatment or even ask for help. They don't think they're doing anything wrong. The condition is not easy to spot; they may seem a bit depressed or like they're having a rough time but nothing too concerning – unless you're on the receiving end of their behaviours. When they are encouraged to seek help (or they could be forced to if the criminal justice system gets involved) a therapist might recognise signs of schizophrenia or borderline personality disorder. A therapist or psychiatrist will treat the psychological disorders causing the behaviour, often with a combination of antipsychotic drugs and behaviour therapy.

(February 2007)

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