When reading fiction, the reader prepares to experience a product of the author's imagination, including characters, encounters and locations that do no exist. When reading fantasy and science fiction, we expect to be hood winked on a greater scale, suspending our disbelief in the face of worlds that operate under different rules, often with altered physics, chemistry and biology. We assume other works of fiction don't require quite the same suspension of disbelief, that the author wouldn't lie to us about the basic rules of their story's setting. In fiction that doesn't claim to be fantasy, we wouldn't expect to discover that an included case study report, and the purportedly respected journal it is taken from, are really works of fiction.

Published 1997, Ian McEwan's novel Enduring Love tells the story of a science journalist, Joe Rose, who is stalked by a religious loner, Jed Parry. Rose becomes determined to diagnose Parry's behaviour, and concludes that he suffers from a homoerotic manifestation of De Clérambault's Syndrome. The tale is a disturbing one and made all the more harrowing by its two appendices: a psychiatric case study from the British Review of Psychiatry and another letter from Parry. Apparently separate from the fiction of the novel, it seems the appendices to provide the connection to reality, evidence that what we thought to be fiction is in fact the dramatisation of someone's real experience.

De Clérambault's Syndrome is an classified disorder, described as a paranoid delusion with an amorous element. The sufferer, usually a single woman, has the belief that a stranger, or person of high social status or public figure, is in love with them. It is referred to as erotomania in contemporary classification systems. The disorder is named after the French psychiatrist, Gaëtan Gatian de Clérambault, who published a comprehensive review paper, titled Les Psychoses Passionelles in 1921.

McEwan's case study, though thorough and authentic in its grasp of the psychiatric lexicon, is entirely fake. The British Review of Psychiatry does not exist and the last names of the paper's authors, Dr Robert Wenn and Dr Antonio Camia, are an anagram of Ian McEwan. He received many letters from reading asking whether he'd written the case study, but many reviewers and even some psychiatrists accepted the case report without question. Spurred on by the success of his deceit, McEwan even submitted the appendix to the British Journal of Psychiatry, under the name of one of his invented authors. The case study wasn't published, but was authentic in tone and content to fool experts in the field.

Speaking to The Guardian in 1999, McEwan admitted his deceit:

"I can confirm that Appendix I of Enduring Love is fictional, based on the novel that precedes it rather than the other way around," he admits, adding wistfully: "If the monograph had been published, it would have seemed that my novel was based on a genuine case, my characters would have acquired an extra sheen of plausibility and the division between the real and the invented world would have become seamless. The authority of the anagramatic Drs Wenn and Camia would have been enhanced as their names dissolved among the authentic citations in the bibliography."

McEwan enjoys blurring the lines between fact and fiction. He seems disappointed that his hoax wasn't assimilated into scientific literature, as if in doing so, it would've made the story more 'real'.

"Psychiatric case studies are like small novels," he muses. "To base a psychiatric theory on what one person says she or he discovered of another person is fantastically unscientific and owes much to a certain kind of literary interpolation. So why not go the whole way? Why not subject the characters in your novel to psychiatric study?"

Could McEwan be suggesting that his characters act as fully formed experiments on which he can conduct psychiatric study? This does suggest a brash confidence in the consistency of his character construction. However, humans can be very inconsistent, so the same could be said of basing a psychiatric theory on a single case study. At least an author may undergo a conscious effort to retain a character's consistency.

If we read Enduring Love with this in mind, it becomes a piece of speculative fiction, imposing a novum (De Clérambault’s syndrome) on a character and observing how the situation progresses and what impact it has on other people in the novel.

Not only did the appendix prove authentic enough to fool experts in the field, but Parry exhibits clear symptoms of De Clérambault's throughout the novel. De Clérambault’s most famous patient was a French woman who believed that King George V of England was in love with her, a case that is documented in the report in the end of Enduring Love. Since De Clérambault, other research has revealed that sufferers can be male, and that males are likely to be more intrusive and more dangerous. In choosing to invent a male case study, McEwan was perhaps aiming to invent a rare homosexual case, as if he believed this example would be of greater contribution to research into the condition.

Sufferers of de Clérambault’s syndrome often read signals that aren't there. The sufferer is under a delusion, in which they perceive actions, such as arrangement of objects, changes in routine, physical movements, as signals of affection, even when they have received no apparent encouragement. In a letter to Rose, Parry expresses his love and refers back to their first meeting, at a hot air ballooning accident in the opening chapter of the novel. Parry speaks of the beauty of nature surrounding him and shares his joy at discovering a 'message' Rose has left for him. In reality, Rose had brushed the hedge while rushing out of the house, but Parry believes that the leaves Rose had touched felt different than the others, signalling an intentional 'message'. Parry misinterprets Rose's throwaway actions as signals, such as the gentle touch that Rose makes on Parry’s shoulder when they both discover the body at the start of the film. He also finds meaningful patterns in Rose's routine, such as in the opening and closing of bedroom curtains.

The obsession can develop with little or no contact between the sufferer and the object of their affection, though this progresses with phone calls and letters, and the subject is usually understandably embarrassed by these advances. In the novel, Parry makes contact with Rose and announces his feelings, convinced that Rose will reciprocate. Rose, happily married and taken aback by the determination behind Parry's advances, turns him down and dismisses the situation as ridiculous. Rose is perplexed by Parry's irrational behaviour, though Parry is undeterred. Sufferers of De Clérambault's typically are unwavered by their subjects embarrassment and denial, as they believe it's a sign of them trying to hide their feelings.

However, Rose goes on to develop equally obsessive behaviour as a reaction to Parry's advances, behaviour that his wife finds disturbing. He begins research to find a scientific diagnosis to the problem. Joe is thrilled when he identifies Parry as a sufferer of De Clérambault’s syndrome, because he is no longer a mystery, a confusing emotional force. With the diagnosis, Parry can now be explained by a scientific narrative.

De Clérambault’s syndrome. The name was like a fanfare, a clear trumpet sound recalling me to my own obsessions. There was research to follow through now and I knew exactly where to start. A syndrome was a framework of prediction and it offered a kind of comfort.
-- Enduring Love, pg. 124

However, the mirror is turned on Rose's obsessive behaviour, and we wonder perhaps if the novel is really a case study of his character. With a knowledge of De Clérambault’s syndrome, we can predict Parry's behaviour, the amorous letters and phone calls, down to his later more drastic behaviours. Yet we get a greater insight into Rose's mind and his tribulations: how the situation affects his sense of self and impacts on his marriage. Rose's determination to define Parry's 'love' as a clinical disorder could be seen as distasteful, as an character flaw, or even a psychiatric problem. His wife is certainly repelled by his behaviour, as he cynically reduces romantic love to a biological process.

Parry's inventive case study, presented as though it were genuine, may have caused great uproar. However, the novel itself is a deeper and more interesting case study into the mind of an equally troubled character, that of protagonist Joe Rose.

References & Further Reading

  • De Clérambault, 'Les Psychoses Passionelles', Oeuvre Psychiatrique (1921).
  • McEwan, Enduring Love, Jonathan Cape (1997).
  • 'Fooled You', The Guardian (1999).
  • Enduring Love, Pathe Pictures (2004).

Listing image: Pathe Pictures