Giovanni Palumbo has been charged with three counts of failure to comply with a court order and criminal harassment. He has pleaded not guilty to the charges.
The former Ottawa doctor allegedly sent Twain a series of letters, made unwanted visits to her family cottage in Ontario and even attended her grandmother's funeral before being arrested at a Canadian awards ceremony this year.
Defense lawyer Gary Barnes said Friday during Twain's cross-examination that Palumbo simply didn't realize that Twain wasn't interested.
But Twain, appearing via video link from an undisclosed location in Europe, didn't see it that way.
"I'm torn emotionally because I have compassion for anybody who's reaching out in need - fans often do that.... I feel very sad ... and awkward having to go through these very personal matters with Mr. Palumbo because it's such an invasion of his privacy."
However, Twain said nothing she heard at the trial made her feel differently about Palumbo.
"I still have the fear and anxiety of being contacted in the future by Mr. Palumbo. And I do want it to stop."
For the second day in a row, the process seemed to become too much for Palumbo, who was clad in a rumpled black suit and navy slip-on sneakers Friday.
Twain was recounting the contents of numerous letters allegedly sent to her by Palumbo when the former doctor leapt to his feet and addressed the court loudly.
"But I didn't know you received any of them - you understand?" yelled Palumbo, alluding to why he persisted in corresponding with Twain.
"It is very emotional for everybody," Palumbo said, addressing the judge.
"Please understand I have emotions, very strong emotions."
Amid his outburst, he muttered that the letters were intended to be "lighthearted." But Twain had disagreed with that assessment.
"It was scary and haunting," she said of one correspondence.
On Thursday, Palumbo had a similar outburst declaring: "Eilleen, you can trust me, I'm going to plead guilty." Twain's real first name is Eilleen.
Palumbo has not yet changed his plea.