Anil Aggrawal MBBS, MD (Professor of Forensic Medicine) * Maulana Azad Medical College, S-299, Greater Kailash-1, New Delhi 110 048, India a r t i c l e i n f o Article history: Received 16 July 2008 Received in revised form 25 September 2008 Accepted 9 December 2008 Keywords: Necrophilia Necrophilism Necrolagnia Thanatophilia Pseudonecrophilia a b s t r a c t Necrophilia is a paraphilia whereby the perpetrator gets sexual pleasure in having sex with the dead. Most jurisdictions and nations have laws against this practice. Necrophilia exists in many variations, and some authors have attempted to classify necrophilia. However many related terms such as pseudo- necrophilia continue being used differently by different authors, necessitating the introduction of a new classication system. The classication system suggested by the author attempts to put all different shades of necrophilia under 10 classes. 2008 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved. 1. Introduction Necrophilia, sexual gratication by having sex with the dead, is one of the most weird, bizarre and revolting practices of abnormal and perverse sensuality. Also known as necrophilism, necrolagnia, necrocoitus, necrochlesis and thanatophilia, it may be seen alone or in association with a number of other paraphilias, namely sad- ism, cannibalism, vampirism (the practice of drinking blood from a person or animal), necrophagia (eating the esh of the dead), nec- ropedophilia (sexual attraction to the corpses of children) and nec- rozoophilia (sexual attraction to the corpses of or killings of animals also known as necrobestiality). DSM-IV-TR 1 does not assign any specic or unique code to nec- rophilia. Instead along with several other uncommon paraphilias (seven of which are specically named), necrophilia is grouped un- der the code 302.9 (paraphilias not otherwise specied). 1.1. Necrophilia in gravediggers and mortuary attendants Gravediggers and mortuary attendants, who are most often found practicing necrophilia, engage in this activity perhaps be- cause of their loneliness, coupled with easy access to corpses. 2 It is also possible, that they chose this profession in the rst place be- cause they were necrophiles. It is known that necrophiles often chose a profession which allows them free and unhindered access to dead bodies. In ancient times, when dead bodies were transported across na- tions by sea for last funeral rites (as in cases of deaths of people occurring in foreign countries), sailors were often accused of necro- philia. Long transportation periods along with loneliness and lack of witnesses allowed, and even encouraged sailors to commit acts of necrophilia with dead bodies. In his seminal work, Psychopathia Sexualis, Richard von Krafft- Ebing called it a horrible manifestation of sadism. 3 Abraham A. Brill, who published one of the earliest detailed studies of necro- philia in 1941, characterized necrophiles as mentally decient, psychotic, and incapable of obtaining a consenting partner. Necro- philia has frequently been associated with cannibalism (necropha- gia) and vampirism (drinking blood of humans) as all are considered perversions. Necrophilia may be explained in some cases at least by the simple fact that the dead can not refuse, reject or resist; they also do not tell tales or talk back. Necrophagia may represent a hang- over from our evolutionary past, where carrion-eating was common. 2. Variations of necrophilia Some variations on the theme of necrophilia are autonecrophilia (imagining oneself as a corpse or becoming sexually aroused by simulated corpses) and pseudonecrophilia. The term pseudonecro- philia has been used differently by different authors. Some authors take it to mean arousal from having sex with someone pretending to be dead 4 , while others use the term to describe erotic fantasies of a person to have sexual relations with a dead body, and mastur- bation (but not actual contact). 57 Still others use it to refer to a 1752-928X/$ - see front matter 2008 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved. doi:10.1016/j.jm.2008.12.023 * Tel.: +91 11 29235460, +91 11 41731893; fax: +91 11 23235574. E-mail addresses: [email protected], [email protected], anil.aggrawal@ gmail.com. Journal of Forensic and Legal Medicine 16 (2009) 316320 Contents lists available at ScienceDirect Journal of Forensic and Legal Medicine j our nal homepage: www. el sevi er . com/ j m person who has a transient attraction to a corpse, but corpses are not the main object of his sexual fantasies. 8 According to the latter denition, the preferable sexual contact in pseudonecrophiles re- mains a living person. Because of the multitude of meanings the term pseudonecrophilia has come to acquire, it is preferable to do away with this term entirely and follow the classication sys- tem suggested below. 3. Proposed classication of necrophilia Some classications of necrophilia already exist. Rosman and Resnick 8 classify all necrophiles in three groups with an additional category of pseudonecrophilia. However with more literature pouring in since their suggestion, a newer classication is more appropriate. A new classication is also desirable, because it tends to put an end of an enormous confusion currently centering around the term pseudonecrophilia. According to some authors it refers to an arousal from having sex with someone pretending to be dead, 4 according to others 57 it refers to people who nd sexual stimula- tion in the presence of the dead, and according to yet others, 8 it re- fers to those persons who are normally content with having sex with the living, but given an opportunity, would have sex with the dead too. Quite obviously such a situation may generate con- siderable confusion among scientists trying to communicate among one another. Some general classications of diseases, especially DSM-IV-TR 1 and ICD-10 9 have been devised precisely to prevent such kind of confusion occurring among scientists. This is achieved by assigning mathematical codes to diseases, instead of subjective names. Mathematical codes also enable easy computerization and com- munication. But neither DSM-IV-TR nor ICD-10 assign any specic or unique code to necrophilia, let alone its subclasses. DSM-IV-TR assigns code 302.9 (paraphilias not otherwise specied) to necro- philia along with several other uncommon paraphilias. ICD-10 too classies necrophilia under the code F65.8 (other disorders of sexual preference) along with several other paraphilias such as telephone scatologia and frotteurism. A classication system is therefore urgently needed preferably mathematical for easy computerization and communication for all subclasses of necrophilia. A ten tier classication from class I till class X is proposed in this paper in order to address this issue. As can be seen, the three different denitions of pseudonecrophilia mentioned earlier would now fall in three different classes according to the new proposed system classes I, III and VII. Thus there is no scope for any confu- sion over terminologies. Instead of talking about subjective terms as pseudonecrophilia, one would refer to objective mathematical classes. The proposed classication is based on severity of psychosexual disorder present among the necrophiles. This classication, besides being simple and elegant, appears to have an intuitive appeal. From the least innocuous to the most, all necrophiles may be categorized in following ten categories: 3.1. Class I necrophiliacs: role players These people are only mildly pathological, since they seem to enjoy a kind of role playing. They do not have sex with a dead body, but get intense arousal from having sex with a living person pre- tending to be dead. It is a kind of sexual role play. Some authors have called this practice pseudonecrophilia. 4 Some others have used the terms simulated necrophilia, and symbolic necrophilia. 10 A more appropriate term appears to be necrobiophilia (from Greek nekros, dead, and bios, living). Certain Parisian brothels cater to this perversion; the prostitute is made up like a corpse with a pallid appearance, dressed in a shroud, and lies in a cofn (often known as casket sex). 11 A person may want his sexual partner to cover her body with a whitish cosmetic to simulate blood-drained skin of a corpse, cover her in a plastic sheet and even add a toe tag before starting sexual intercourse. Some may utilize a resurrection fan- tasy where the lover brings the dead partner to life through sex- ual activity. The lover who pretends to be brought back to life may turn the tables on the other, dominating him, and even acting out a zombie fantasy. Sometimes a vampire fantasy is involved where the lover sim- ulates a killing by biting the neck. A case is recorded of a woman, who imagined herself to be a vampire. She would ask her husband to pretend he was dead and then stimulate his organ with her mouth. She would then pretend that the resulting erection was rig- or mortis, and this would give her erotic pleasure. 3.2. Class II necrophiliacs: romantic necrophiles These people show only very mild necrophilic tendencies. These are the normal bereaved people, who cannot bear separation from their loved ones. They do not seem to agree that their loved ones have died. They mummify their loved ones dead body (or parts of them) and continue relate sexually to them much as they did in life. Their psychopathology is only transient in nature, and they would normally recover as time passes. From a legal standpoint, classes I and II necrophiliacs are quite innocuous. There are no cases on record, where they have been prosecuted; class II necro- philes may be in need of psychiatric help though. 3.3. Class III necrophiliacs: People having a necrophilic fantasy necrophilic fantasizers Class III necrophiliacs are somewhat less innocuous from a legal standpoint. Psychosocially, they do show an aberrant behavior and are thus abnormal. These necrophiles do not engage in sexual intercourse with the dead. They are content simply with fantasiz- ing sexual intercourse with the dead. They may visit cemeteries and funeral parlors often for this purpose, and merely the sight of dead bodies may give them erotic pleasure. 12 Some would like to have a sexual intercourse in the presence of a cofn, because it increases their orgasmic intensity. Some may be seen masturbating during funeral sermons or dirges as they sit in a crowd of mourners. These kinds of incidents have occurred at the Paris morgue several years ago, whereby a certain number of indi- viduals were discovered, on different occasions, in the act of mas- turbating in front of the glass case where the cadavers were exposed. These incidents ultimately necessitated a well-directed surveillance system to prevent repetitions. 13 Most paraphiliacs in the rst three classes never get to touch a dead body. Those who never touch the dead but nd sexual grati- cation merely from looking at them have been labeled platonic necrophilisists, or platonic necrophiles. 13 All these cases may be termed as cases of latent necrophilia or fantasy necrophilia, with the perverts known as latent necrophiles or fantasy necrophiles. As seen earlier, many authors have called this pseudonecrophil- ia. 57 Taphophilia is the name given to people who get arousal from funerals. 3.4. Class IV necrophiliacs: tactile necrophiles These necrophiles go one step ahead of class III necrophiles and need to touch a dead body in some erotic way in order to get an orgasm. They enjoy touching, stroking parts of the dead body, such as genitalia or breasts or perhaps licking them. Some may even take up jobs as mortuary attendants, or some other job dealing with the dead, because they want to be near dead bodies. They A. Aggrawal / Journal of Forensic and Legal Medicine 16 (2009) 316320 317 insist that attendance at funeral homes (during visiting hours, of course) should be encouraged as an outlet for them. Medical students who get an erection while dissecting cadavers also fall in this group. Indeed Stekel mentions the case of a student who when dissecting a corpse during anatomy classes would have a sudden erection. 14 Legally, in most jurisdictions, these necrophiles may be sued for disturbing the dead. 3.5. Class V necrophiliacs: people having a fetishistic necrophilia fetishistic necrophiles These necrophiliacs are a shade more abnormal than classes III and IV necrophiliacs, but they still do not engage in any copulatory activity with the dead. Instead, if they come across a dead body and if chance arose, they would cut up some portion of the body per- haps a breast for later fetishistic activities. They may even keep some portion of the dead body pubic hair or a nger perhaps in the pocket for continuous erotic stimulation, or sometimes may wear it as an amulet for similar pleasure. Some remove clothes, especially panties or even tampons from corpses to keep as fetish objects. These perverts are necrofetishists, and their par- aphilia is known as necrofetishism. At rst glance, they may appear to be similar to class II necrophiles, as the latter also engage in sim- ilar activities. However class II necrophiles preserve parts of their recently dead loved ones in order to ll up a psychosexual vacuum that their death has caused. They would not do so with the dead body of a stranger as do necrophiles of class V. Martin Schurig (16561733) in his Spermatologia, describes the case of a Belgian lady, who secretly cut off the penis of her husband when he died and treasured it as a sacred relic in a silver casket. 15 She eventually powdered it and found it an efcacious medicine for herself and others. Havelock Ellis 16 , cites an earlier example, of an- other lady at the French court who embalmed and perfumed the genital organs of her dead husband, always preserving them in a gold casket. 3.6. Class VI necrophiliacs: people having a necromutilomania necromutilomaniacs These are more severe cases than earlier classes. Rosman and Resnick 8 described this category under the title necrophilic fan- tasy. Wulffen 17 describes this class under type necrophagy. These individuals also do not engage in sexual intercourse with the dead. However their erotic pleasure comes from mutilating the dead body and masturbating simultaneously. In some cases, the offen- der may eat parts of corpse as part of sexual gratication. Rajs and colleagues 18 have described mainly four types of mutilations, of which necromanic mutilation is one. Rosman and Resnick 8 describe the case of a 40-year-old single white male, who fantasized killing a woman, cutting her up, removing her organs and then masturbating while immersing his hands in the blood of the corpse. His erotic pleasure came mainly from the mutilation of warm bodies. In his late 20s, he obtained a job in a morgue for the sole purpose of being near dead bodies, and being able to cut them up. His case represents a typical class VI necrophile. Many mortuary attendants and technicians belong to this category. 3.7. Class VII necrophiliacs: opportunistic necrophiles Rosman and Resnick 8 describe this category under the term pseudonecrophilia. Normally they are quite content having inter- course with the living and would not think of engaging in sexual intercourse with the dead. However if an opportunity arose, they would. Rosman and Resnick describe an interesting case under this category in which a 37-year-old single white male, who was dating a 49-year-old woman, and was having normal sexual relations with her. One day he accidentally shot her under the inuence of alcohol. He panicked and tried to hide the dead body. When he was hiding her body, he became sexually excited and had anal intercourse with the corpse, and then disposed it of. He was aware of necrophilia and necrophiliacs as he had earlier read about them in pornography magazines. Mortuary attendants, funeral workers and sailors who resort to sexual intercourse with the dead, because they have an easy access to them fall under this category. Sometimes, a person may murder his consort for other reasons (say jealousy) and then have sexual intercourse with the dead body. Setia and Tabin 19 describe a rare case where the accused killed his wife and then had sexual intercourse with her. The rea- son he gave in his testimony was that she had not consented to intercourse with him for last few years, as she was having an extra- marital affair with someone else. Sometimes, she would have physical relations with her boy friend even in the presence of her husband, which frustrated him very much. There was no previous history of any psychiatric illness in the accused. The authors see the behavior of the accused as being a result of both jealousy resulting from his wife having extramarital affair, as well as frus- tration for not getting sexual gratication. 3.8. Class VIII necrophiliacs: regular necrophiles These are the classical necrophiliacs, as one normally under- stands. Wulffen 17 describes this class under type necrostuprum, and Rosman and Resnick 8 under their sub-class regular necro- philia. They would not enjoy sexual intercourse with the living, even if this choice were available to them. Instead they would seek out a dead body to have sexual intercourse with, because they get more pleasure in having sex with a dead body. They would resort to stealing dead bodies from mortuaries or graveyards for this pur- pose. As seen above, a mortuary attendant who has an intercourse with the dead only because a dead body was easily available to him would not fall under this category. However if he preferred a dead body for sexual intercourse to living partners, he would come un- der this category. Regular necrophiles may have sexual intercourse with the living from time to time, but their preference remains sex with the dead. Necrophiliacs in all categories are mostly males, but Rosman and Resnick 8 describe the case of a female under this category. A 21-year-old, separated white woman was employed as an appren- tice embalmer for 4 months. She had been sexually molested at the age of eight, and raped by a teacher at the age of 14. At the age of 20 perhaps as a result of repeated childhood trauma she came to regard herself as having died in spirit, started drinking heavily, avoided living beings and enjoyed company of the dead only. She had a very low self-esteem. During the short period she was em- ployed as apprentice embalmer, she had sexual intercourse with as many as 2040 male corpses. Her case is typical of class VII necrophilia. 3.9. Class IX necrophiliacs: homicidal necrophiles This is the most dangerous category of necrophiliacs. They need to have sex with a dead body to the extent, that they resort to kill- ing. They are also known as violent necrophiles or lagnonectors (persons who kill in order to have sex with the corpse), and the practice is often known as homicidophilia. The term warm necro- philia may be applied to these cases, since intercourse is at- tempted on fresh bodies, which are recently dead. This is the class to which Wulffens 17 lust murderers or necros- adists belong. Many cases of lust murder belong to this category. Rosman and Resnick 8 include this in their sub-class necrophilic 318 A. Aggrawal / Journal of Forensic and Legal Medicine 16 (2009) 316320 homicide. They describe the case of a 25-year-old, single white male, who had a very high sex drive. He masturbated at least seven times a day, had a large collection of pornography and had com- mitted acts of bestiality, urophilia, coprophilia, necrophilia with animals (necrozoophilia) and dead bodies in the morgue of the hospital where he worked as an orderly. He murdered an eight- year-old neighborhood girl in order to carry out his sexual fantasy. Many murders of the American serial killer Jeffrey Dahmer (19601994) are believed to be of this category. He was believed to be aroused by just pieces of the bodies of his victims (he was also aroused by dead animals). Another offender who could be listed among this category is Gary Leon Ridgway (1949 ), also known as the Green River Killer. He claimed an addiction to prostitutes and most of his victims were either prostitutes and female teenage runaways. He would return to places where he had dumped his victims bodies and have sexual intercourse with their corpses. It has been suggested that on one instance he left his son in vehicle while he went into the woods and undertook sexual activities with the dead body of one of his victims. 3.10. Class X necrophiliacs: exclusive necrophiles This group, which is perhaps the rarest of all, is not necessarily the most dangerous. However this is still listed in the last, because these offenders need only dead bodies for intercourse. They are un- able to perform intercourse with the living. Since dead bodies is an absolute necessity for them for sex, they may go to any length to acquire them. In as much as this, they may be more dangerous than the rest. If a given necrophile is able to perform sex with a living person of either sex or of any age, he would not be listed among this class. In Rosman and Resnicks 8 series of 122 cases, the authors could nd only 6 cases which could be listed among this class. 4. Discussion Necrophilia is a little studied subject, mainly because clinical material concerning this paraphilia is very sparse (a pubmed search with the term necrophilia reveals only 37 publications). Whatever little research is available, has been done by few researchers, who have tended to remain fairly insulated from one anothers works. This has resulted in different classications and different usages of related terminologies. The best example of this confusion is the use of the term pseudonecrophilia, which has been used in at least three different senses by different authors. The cur- rent classication system attempts to do away with subjective terms like these, and introduces a more scientic mathematically graded system, whereby necrophiliac tendencies are rated from the most innocuous to the most heinous. This classication appears to have an instinctive appeal, rang- ing all necrophilics from minimal to maximum severity. The low- est rung in the proposed classication class I belongs to role players people who merely act out their fantasy. This kind of behavior is seen not only with necrophilics, but with many other paraphilics. For instance, many zoophilics are merely role players, i.e. they want to have sexual intercourse with their partners, only when they act out or position themselves as animals. These per- sons are fantasizers, i.e. they merely fantasize about a particular paraphilia, without actually carrying out their activity. People with exhibitionistic and voyeuristic tendencies are known, who merely fantasize about their paraphilia, without actually carrying it out in reality. 20 From a legal standpoint, these people have no criminal liability. The highest rungs classes IX and X belong to those people who are almost exclusive necrophilics. Class IX people need to kill people in order to acquire a corpse for sexual intercourse. Class X people are exclusive necrophiles, in the sense, that they are so dependent upon a dead body for expression of their sexuality, that even if a willing living partner was available to them, they would be unable to form a romantic relationship with him or her. Table 1 summarizes the major characteristics of each class of necrophilia. This classication would hopefully be useful for other purposes too, most notably for uniform statistical compilation of data from around the world, epidemiological surveys, calculation of inci- dence and prevalence of this phenomena, and treatment. Table 1 Major characteristics of each of the ten classes of necrophiles. Class Tentative name Major characteristics I Role players Do not want to have sex with a dead person. Enjoy sex with a living person pretending to be dead II Romantic necrophiles Bereaved people, who would mummify a part of the body of their recently departed loved ones, and keep it with them in order to get a psychosexual stimulation. Would not show a similar interest in any other dead body, i.e. body of a person with whom they were not romantically involved in life III Necrophilic fantasizers Fantasize intercourse with the dead. May visit cemeteries and funeral parlors and may masturbate in the presence of the dead IV Tactile necrophiles Interest in dead bodies increases to the level of touching them. Like to stroke erotic parts of a dead body, such as breasts. May manipulate sexual organs of the dead in order to get an orgasm V Fetishistic necrophiles Cut up parts of a dead body say a breast mummify it, and keep it in their possession to use it as a fetish for their necrophilic activities. Differ from class II necrophiles in the sense that they (class V) do it with the bodies of strangers with whom they held no romantic relationship in life. Thus they do not do it merely to ll a psychosexual vacuum left by the death of their loved ones VI Necromutilomaniacs Interest in dead bodies is more than merely touching them. Necrophilic pleasure comes from mutilating a dead body VII Opportunistic necrophiles Actual sexual activity with the dead starts from this class. Normally these necrophiles would be content to have sexual intercourse with the living, but if an opportunity arose, would not refrain from having sexual intercourse with the dead. Necrophilic mortuary attendants belong to this class VIII Regular necrophiles The so-called classic necrophiles. They do not enjoy sexual intercourse with the living and prefer dead bodies for intercourse. They can however have sex with both living and dead persons. In this sense they differ from class X necrophiles, who can have sex only with dead persons IX Homicidal necrophiles This penultimate category is the most dangerous of all, in the sense that they would kill a person in order to have intercourse with him or her. They are however capable of having sexual intercourse with the living, but the need for sexual intercourse with the dead is so great that they must kill human beings in order to have sexual intercourse with their dead bodies X Exclusive necrophiles Sexual intercourse is possible only with the dead, with the complete exclusion of living partners A. Aggrawal / Journal of Forensic and Legal Medicine 16 (2009) 316320 319 5. Conclusions The paper aims to introduce a new classication system of nec- rophilia, taking into consideration all available literature on necro- philia. It is hoped that the new proposed system of classication would put an end to confusion centering around some necrophilia related terms currently. Conict of interest statement None declared. Funding No funding. Ethical approval No ethical approval is needed. References 1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Text rev. 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