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Is Renfield's Syndrome real or as fictional as 'Renfield' himself?

Imagine what a single therapist could have prevented.

By Cassidy Ward
Renfield Trailer

In Bram Stoker’s classic vampire novel Dracula, the titular count is assisted by a mortal familiar named R.M. Renfield, the inspiration for the more modern-day "Renfield's Syndrome," a (maybe) real medical conundrum.

In Stoker's fictional world, Dracula’s devoted human servant helps him achieve his earthly goals in exchange for a steady diet of creepy crawlies and the promise of eternal life. See, Renfield is a patient in a mental institution, where he ostensibly receives treatment for his delusion that eating bugs allows him to consume their lifeforce to sustain his own life.

Using his ability to control animals, Dracula promises to facilitate Renfield’s immortality by supplying an all-you-can-eat buffet of mind-controlled insects and rats. Yum! Unfortunately for Renfield and Dracula (but totally rad for people and bugs everywhere), both of them are dead by the end of the book. Apologies for any century-old spoilers.


Recently, Dracula and his loyal servant were resurrected in Renfield, in theaters now! It tells its own version of Dracula and Renfield’s meeting in the early 20th Century. In a land deal gone horribly wrong, unassuming Englishman R.M. Renfield (Nicholas Hoult) becomes conscripted as Dracula’s (Nicolas Cage) familiar.

In the movie, Renfield isn’t suffering from any delusion, but actually lives inside one of those horrible “would you rather” questions. He has a choice. Through one door is every juicy bug on the planet, superhuman abilities, and eternal life. Through the other door is only death.


Between 1602 and 1604, rumors began to spread that Elizabeth Báthory, a Hungarian noble, had tortured and killed an untold number of young girls and women over the course of more than a decade. A formal investigation commenced, and testimony was gathered from more than 300 witnesses. According to testimony, Elizabeth began by luring young peasant girls with promises of well-paid maid work. Later, she moved onto the daughters of the lower gentry, telling them to come to the castle to learn etiquette.

By some accounts, more than 650 women and girls disappeared into the castle and never emerged. It’s said that Elizabeth tortured them, killed them, then drank and bathed in their blood in an effort to remain young and beautiful, earning her the moniker The Bloody Countess. She was convicted along with two of her servants. Elizabeth spent the rest of her life confined to the castle of Csejte and the servants were executed.

John Haigh was born in Stamford, Lincolnshire, England, in 1909 and reported recurring nightmares involving a forest of crucifixes and trees dripping with blood. Those dreams plagued him for his entire life and eventually led to him murdering several people and drinking their blood before disposing of their bodies in barrels of sulfuric acid. After his arrest, he is reported to have told a detective, “If I told you the truth, you would not believe me. It sounds too fantastic to believe.”

To the casual observer, it might appear as though our fictional man Renfield wasn’t all that unusual and was instead just an early example in a long history of vampiric behavior. In fact, clinical vampirism has shown up in psychological literature for decades (though not often with a direct reference to vampires) but, like the creatures it is named for, is going through something of a resurrection lately.

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While working on his book Bizarre Diseases of the Mind and Vampires, Werewolves, and Demons — which examines real cases of rare mental illnesses that resemble werewolves, demons, and other creatures of the night — author Richard Noll noticed that some patients behaved similarly to the fictional Renfield. Each of them adhered to some specific set of behaviors in the hope or belief that it would deliver some power. While writing, he jokingly spun together a new diagnosis based on the symptoms of the fictional Renfield as a way of lampooning what he saw as the failures of psychiatry in the 1980s. And he called his new illness "Renfield's Syndrome."

While it started as a joke, Renfield's Syndrome has been uttered in serious scientific circles since its invention — in part because it has gotten mixed up with clinical vampirism. Prior to Noll coining the term, clinical vampirism was associated with an often-erotic obsession with blood. Today, it’s more closely associated with an eating disorder involving the intentional consumption of blood or live animals, sometimes with an accompanied delusion of immortality or superhuman abilities. It’s worth noting that neither clinical vampirism nor Renfield's Syndrome are recognized diagnoses and few cases have been described.


(from left) Nicholas Hoult and Dracula in Renfield (2023)

It’s possible (perhaps even likely) that so few cases have been documented and so little information is available because vampirism isn’t real. We don’t mean that vampires aren’t real, that much is obvious, but even the delusion that a person is a vampire or familiar might be a fiction; the consequence of public fear, sensationalism, and outright lies. Allow us to tell you alternative versions of the above historical and contemporary vampires.

Of the 300 witnesses who testified against Elizabeth Báthory, nearly all of them said they had heard stories of Elizabeth’s activities but not personally witnessed them. No one inside the castle said word one about her until rumors began to spread around the kingdom. A woman in the seventeenth century, even a powerful one, had little defense against an accusation of that kind, and her conviction was probably assured from the moment she was accused. More to the point of her vampiric associations, the first mention of bathing in or drinking blood didn’t occur until 1729, more than a century after her death.

John Haigh may or may not have had bloody nightmares, but he was definitely a crook. One of his earliest jobs in insurance and advertising ended when he was fired for stealing from a cash box. He then started forging documents and was jailed for fraud. While in prison, his wife gave birth, gave the baby up for adoption, and left him. His family disowned him, as well. Haigh moved to London and became a Chauffer for the wealthy William McSwan. With his foot in the door of London’s elite, he began posing as a solicitor (lawyer) to sell fraudulent stocks from the recently deceased. He was convicted of fraud and imprisoned again. Deciding that his error was not in the fraud, but in leaving people alive to rat him out, he came up with a new plan.

Released in 1943, Haigh almost immediately started killing people, beginning with his old friend McSwan. He hit McSwan over the head with a lead pipe and dumped his body in a barrel of acid. Then he started living in McSwan’s house and collecting his rents. When his parents got suspicious, Haigh killed them too. When he was eventually caught, he pulled out the nightmares and claimed to have drunk the blood of his victims. Haigh wasn’t a vampire; he was a bad con man trying one last con to avoid the noose. It didn’t work.

While it might appear that Renfield's Syndrome or clinical vampirism gave a name to an already present human behavior, it’s more likely the opposite is true. There aren’t a bunch of vampires — psychological or otherwise — waiting out there to be recognized. Instead, we took the extremes of human behavior, exaggerated them, built a story around that behavior, and then gave it a name. And in naming the monsters, we made them real.

We prefer our vampires and familiars to remain fictional. Fortunately, Renfield is in theaters now. Get tickets here!

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