# Monthly Archives: September 2013

## Problem thinking: Heuristics and cognitive bias in gambling

Once when I was playing roulette at my local casino, there was a run of seven reds in a row. I rarely bet by colour myself, but while I was laying my many 50 pence chips all over the roulette number grid, I told a friend standing next to me that many people would put a lot of their chips on black on the next spin of the wheel. And they did! I am no mind reader but what I do know about is the gambler’s fallacy. The gambler’s fallacy is a well-known psychological ‘rule of thumb’ where gamblers apply the law of averages to very small number sequences. Put very simply, I knew that most people would be thinking “by the law of averages the black is supposed to come up 50% of the time and hasn’t done so for the last seven spins”. While the 50% probability is true, the probability is based on very large sequences of numbers and not a few spins of the roulette wheel. What’s more, the roulette ball has no memory of where it landed before and every spin is independent of the last one. As it turned out, red came up again and there were some disgruntled and disbelieving gamblers. On the ninth spin, a black number finally came up.

The gambler’s fallacy is one of many psychological thinking patterns that are known as ‘heuristics’ (and sometimes called cognitive biases). The psychological effect of heuristics is to reduce uncertainty for the gambler. Open up any textbook on gambling and you will find that the gambler’s fallacy is referred to as the ‘representativeness bias’. This is because people expect to find a representative relationship between samples drawn from a small number of events (for example, eight spins on the roulette wheel), and the complete set of events (in this case, all the spins ever on all roulette wheels). When we gamble, we constantly process information (often unconsciously) in a consistently biased way. Humans tend to exhibit consistent biases when cognitively processing information in gambling situations. For instance, in psychological gambling experiments where people are asked to create a random sequence of imaginary coin tosses, they tend to produce sequences where the proportion of heads in a short segment is closer to 50% than chance would predict.

Over the last 35 years, psychologists have written about many different heuristics that gamblers use. One of the better known ones is the ‘availability bias’. This occurs when a person evaluating the probability of a chance event makes the judgement in terms of the ease with which relevant instances or associations come to mind. For instance, pools winners are highly publicised to invoke the idea that big wins are regular and commonplace when in fact they are rare. Availability biases can also be found when people actually gamble in lotteries. For instance, when selecting numbers, some people will pick (‘hot’) numbers that have come up more often and avoid the (‘cold’) numbers that by chance have not come up as often. For instance, during the week of the first ever triple rollover on the UK National Lottery it was noted by a number of newspapers that the number ‘13’ had come up much less than any other number in almost 10 years of lottery draws. Those gamblers prone to the ‘availability bias’ would be unlikely to pick this number. Of course, those prone to the ‘representativeness bias’ would be more likely to pick it! And that is one of the problems with ‘rules of thumb’ – it is almost impossible to know which heuristic will be applied in a given situation and it is quite possible for the same person to use a different heuristic in the same situation on different occasions.

Some of my favourite heuristics are those involving ‘illusory correlations’. These are superstitious behaviours where people believe two actions are related when in fact they are not. For instance, one seminal 1960s study of ‘craps’ players in US casinos (published by Dr. J. Henslin in the American Journal of Sociology) showed that players rolled the dice softly to get low numbers and rolled harder for higher ones. Other spurious examples are those people who have ritualised routines before they gamble, have ‘lucky chairs’ at the bingo hall, or those who carry lucky charms when they gamble. Most of these illusory correlations start by associative accident. For instance, a gambler might have three big wins at the roulette table and then notice that on all three of those occasions they wore the same pair of trousers. As a consequence, they might start to think that the trousers are somehow lucky and wear them on subsequent visits to the casino. When they win while wearing them, it bolsters the bias. The relationship between the winning and the trousers wearing is illusory but many gamblers display such irrational biases.

Psychological biases provide some insight into why some gamblers don’t learn from past losses and helps explain supposedly ‘irrational’ behaviour in the gambling process. Some psychologists claim that problem gambling is caused by defective reasoning, rather than personality traits, education or social environment.  They also claim that gamblers gamble, not because they have a bigger repertoire of heuristics, but because they select heuristics on the wrong occasions.

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Griffiths, M.D. (1994). The role of cognitive bias and skill in fruit machine gambling. British Journal of Psychology, 85, 351-369.

Griffiths, M.D. (1997). Selling hope: The psychology of the National Lottery. Psychology Review, 4, 26-30.

Griffiths, M.D. & Bingham, C. (2002). Bingo playing in the UK: The influence of demographic factors on play.  International Gambling Studies, 2, 51-60.

Griffiths, M.D. & Wood, R.T.A. (2001). The psychology of lottery gambling. International Gambling Studies, 1, 27-44.

Henslin, J. (1967) Craps and magic. American Journal of Sociology, 73, 316-330.

Kahneman, D. & Tversky, A. (1973). Availability: A heuristic for judging frequency and probability. Cognitive Psychology, 5, 207-233.

Langer, E.J. (1975). The illusion of control. Journal of Personality and Social Psychology, 32, 311-328.

Langer, E.J. & Roth, J. (1975). The effect of sequence outcome in a chance task on the illusion of control. Journal of Personality and Social Psychology, 32, 951-955.

Parke, J., Griffiths, M.D. & Parke, A. (2007). Positive thinking among slot machine gamblers: A case of maladaptive coping? International Journal of Mental Health and Addiction, 5, 39-52.

Tversky, A. & Kahneman, D. (1971). Belief in the law of small numbers. Psychological Bulletin, 76, 105-110.

Walker, M.B. (1992). The Psychology of Gambling. Pergamon, Oxford.

Wagenaar, W. (1988). Paradoxes of Gambling Behaviour. Erlbaum, London.

## Royal male: A brief look at queening fetishes

While researching a previous blog on squashing fetishes I came across an online account from a dominatrix talking about ‘queening’ fetishes. According to Dr. Anil Aggrawal’s 2009 book Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices, queening is a BDSM practice in where one sexual partner sits on or over another person’s face “typically to allow oral-genital or oral anal contact, or to practice ass worship or body worship”. In the book’s glossary of sexual terms, Dr. Aggrawal simply defines queening as “sitting on the side of a person’s face as a form of bondage”. A 2005 book chapter by Dr Brenda Love (in Russ Kick’s Everything You Know About Sex is Wrong) examined some of the strangest sexual behaviours from around the world and included a short section on queening. She wrote:

“The term queening refers to the European practice of a dominant female using a man’s head as her throne. The woman sits in one of several positions, either on the side of the man’s head or so that his nose is near her anus with his eyes covered by her genitals. The object of queening is bondage or breath control, not cunnilingus. The man may wear supplemental restraints on the wrists and ankles. A slightly comparable American sex scene is where a stripper completely disrobes and stands over a sitting male with his head titled back so that her genitals are only a couple of inches above his face. She stays in this position, moving her pelvis to the music for about five minutes. The male is not permitted to touch her in any manner during this exhibition”.

According to the Wikipedia entry on ‘facesitting’, within a sadomasochistic and dominance/submission context, the practice can be an “especially intense form of erotic humiliation”. The article also claims the practice is commonplace among sadomasochists. Although this would appear to have good face validity, I have yet to come across an empirical piece of research that either confirms or disconfirms this. The article differentiates facesitting from ‘smothering’ (i.e., the complete obstruction of the airways for sexual purposes) because the person being sat is not totally deprived of oxygen. The article also claims:

“The full-weight body-pressure, moisture, sex odors and darkness can be perceived as powerful sexual attractions or compulsions. The person sat upon may be in bondage, sexually submissive, or simply held down by the body-weight of the other person. Sometimes special furniture is used, such as a ‘queening stool’ or ‘smotherbox’. A queening stool is a low seat which fits over the submissive’s face and contains an opening to allow oral-genital and/or oral-anal stimulation of the domme while seated. In modern BDSM vernacular, the queening stool allows open access to the crotch while seated…The queening stool is also related to a ‘smotherbox’ which also allows the person under the seat to be locked in place, restrained by the neck as in a set of stocks”

This description also suggests there may be overlaps between queening and other sexual paraphilias and fetishes such as squashing fetishes, amaurophilia (where individuals derive sexual pleasure and arousal by a partner who is blind or unable to see due to artificial means such as being blindfolded or having sex in total darkness), and osmophilia (where individuals derive sexual pleasure and arousal caused by bodily odours such as sweat and urine).

An online article about queening on the Toilet Duck website (that ‘celebrates and questions watersports and toilet games’) begins by asserting that defining the act of queening is “difficult to say the least without leaving readers wondering why”.  Unlike the Wikipedia article, it does not differentiate between facesitting and smothering:

“[Queening is a] very erotic act in which a woman sits on a man’s face and is satisfied sexually while dominating her man and the man is incredibly turned on by the act as well…Also referred to as face sitting or smothering, queening is most often accomplished by a dominant woman sitting on her submissive man’s or slave’s face and deriving sexual pleasure by riding his face or forcing him to lick, suck, bite, or orally massage his domme’s vaginal and anal area until she climaxes. During a queening session a submissive experiences the sensation of his mistress’s weight on his face as she squats on top of his face. The smell of her, the moistness, and the slow erotic motion as she moves around on his face to gain pleasure from her submissive mixed with the urgency to breathe is what turns the sub on…Sometimes queening is accompanied by the infliction of pain, verbal humiliation, or water sports (the act of urinating on a sexual partner) depending on the couple and how deep into the BDSM scene they are into. Nipple twisting or flogging are also great additions to smothering as is a little cock and ball torture. However, Queening is most often used as a form of reward for submissives that have been very good”.

Although most of the claims made here are unsubstantiated empirically, the Toilet Duck article is at least written by proponents who actually engage in the practices they write about. This extract also suggests there are yet more overlaps with other sexual paraphilias including urophilia, masochism, and hypoxyphilia.

In my research for this blog I came across the Informed Consent website (“The UK’s BDSM website”) which highlighted queening as its ‘fetish of the week’ back in September 2010. As a consequence, it featured people writing about their queening experiences. I have collated a few extracts here to provide a flavour of what people enjoy about queening from a personal standpoint:

• Extract 1: “I practice [queening] and regard it more in [an orally erotic] way than as a means of breath play. Although I know for some the oral element doesn’t feature at all. For me, the breath play aspect is a fairly insignificant part of it”
• Extract 2: “I love all aspects of it. The sheer enjoyment of someone dominating me by pushing their body down on my face; the oral sex; the worshipping of an anus; the smells and tastes; the inability to control my breathing; being pushed right to the edge, gasping for the slightest bit of air. I love it when Mistress losses herself ‘in the moment’ so much that she forgets about me, and I literally have to protect my own breathing/life”
• Extract 3: “It’s one of my favourites, yet very rarely practiced…it encompasses so much…from total control to total intimacy”
• Extract 4: “Personally, I love [queening] and just can’t get enough of it. I seem to never get bored of it. The ultimate for me is for Mistress to sit on my face and conduct some nipple torture or candle wax on my chest. I think this is proper pain and pleasure mixed up perfectly”

The only other article of any length I have come across on queening is one on the Kinky Britain website. Their main take on queening is that it is a form of body worship but also sees the behaviour has having other sexual attractions including the darkness, the weight pressure, the smells, and the wetness (echoing some of the aspects outlined above). The article claims that it is not only engaged in by dominant women and submissive men, but also by “vanilla couples who use this highly-enjoyable position for woman-superior cunnilingus”. Like the Wikipedia article, smothering and queening are viewed as two different forms of sexual activity. The anonymous author notes:

“Smothering is NOT like regular cunnilingus. In fact, at times the guys can’t even lick because they’re just trying to inhale a breath of fresh air. Sure, that overpowering smell of [the vagina] is great, but oxygen is what they really want at times. Facesitting is very erotic in essence and may be practiced by non-BDSM (vanilla) couples for sexual pleasure. However, when applied in the context of female domination it symbolizes the Mistress superiority over the sub. There is a slight difference between facesitting to smothering or queening, which is associated with the deprivation of air, yet in the BDSM world these terms are often regarded as one”.

The other aspect to this article that is not mentioned in any others I have read concerns the type of submissive man (i.e., ‘the slave’) that engages in queening. The article claims it is the woman who chooses who the submissive male is, and it appears there is no commonality amongst the type of man who participate. The article claims (and I have no empirical evidence to counter them) that:

“She may wish to have a wimpish male twit under her. She may find more delight in subduing a macho strong male. She may have a cuckolded husband to humiliate, taunt and sit on. Some women like to have a mouth-dildo attached to their slave’s head, sticking up from his open mouth as a rideable accessory. This provides pleasant, full, vaginal passage orgasms, but prevents sucking and licking by the male victim. Other women blindfold their prone slaves, thus deleting any possible visual pleasure they might obtain. A few cruel ladies inevitably urinate on to his face after having orgasmed. Others enjoy demanding mouth service right after enjoying satisfactory adultery with a lover, thus making the victim more humiliated. Most queening ladies humiliate, taunt, torment, degrade and tease their victims before and after this enforced cunnilingus”.

The bottom line (no pun intended) about queening fetishes is that almost all the information we have appears to have been written by those who actually engage in the practice and that there is nothing written academically except passing references in academic books on unusual sexual practices. There is also the question of whether those who engage in the behaviour view it as fetishistic, and whether academics such as myself would class the behaviour as a fetish. Based on what I have read, queening appears to be an adjunct to other types of sexually paraphilic behaviour such as sexual masochism rather than a stand alone fetish although for some people, it may well be a genuine fetishistic sexual activity.

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Aggrawal A. (2009). Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices. Boca Raton: CRC Press.

Charland, V. (2010). Fetish furniture in art (queening chairs, bondage, facestting, etc.). Cuckold Journal, November 27. Located at: http://cuckold-journal-wet-options.blogspot.co.uk/2012/11/fetish-furniture-in-art-queening-chairs.html

Love, B. (2005). Cat-fighting, eye-licking, head-sitting and statue-screwing. In R. Kick (Ed.), Everything You Know About Sex is Wrong (pp.122-129).  New York: The Disinformation Company.

Love, B. (2001). Encyclopedia of Unusual Sex Practices. London: Greenwich Editions.

McGuire, C. (1989). Perfect Victim. New York: Dell.

Murray, T. (1989). The Language of Sadomasochism. Westport: Greenwood Press.

The Toilet Duck (2011). Queening – Can this be enjoyable for both parties? August 7. Located at: http://thetoiletduck.com/20/queening-can-this-be-enjoyable-for-both-parties/

Wikipedia (2012). Facesitting. Located at: http://en.wikipedia.org/wiki/Facesitting

## Becoming less of a drag: The Stoptober campaign (revisited)

(The following blog is based on an article I published last year in the Nottingham Post on why I was actively supporting the Stoptober smoking campaign to get people to stop smoking for 28 days during October. I also published a blog last year outlining my 10 top tips for giving up smoking. Since that blog, my ten tips have been slightly changed and adapted in co-operation with the Department of Health running the Stoptober campaign. I make no apologies for repetition between today’s blog and that published last year, as my only aim is to help people give up smoking).

Although most of my academic research is on behavioural addiction, I have published quite a few papers on more traditional addictions such as alcohol and nicotine addiction (see ‘Further reading’ below). Last year I had to watch my mother fight a losing battle with smoking-related lung cancer and chronic obstructive pulmonary disease. She died in September 2012 aged 66 years, and had chain-smoked most of her adult life. This followed the death of my father who also died of smoking-related heart disease, aged just 54.

This October, the Department of Health (DoH) are re-launching the ‘Stoptober’ campaign for the second time, urging as many nicotine smokers as possible to give up smoking for 28 days from October 1. The DoH website claims that “people who stop smoking for 28 days are five times more likely to stay smoke free” compared to those that don’t give up for such a long period. Like last year, those that decide to try and stop for the month will be given a lot of encouragement during the campaign including access to the Smokefree Facebook page and the downloadable Stoptober app. People will also be sent daily emails providing additional encouragement.

In the UK smoking accounts for approximately one in four cancer deaths, and as I said, it’s something I’ve witnessed first-hand. I’m sure most people reading this are aware of the addictive nature of nicotine. As soon as nicotine is ingested via cigarettes, it can pass from lungs to brain within ten seconds and stimulates the release of the neurotransmitter dopamine. The release of dopamine into the body provides reinforcing mood modifying effects. Despite nicotine being a stimulant, many people use cigarettes for both tranquillising and euphoric effects. Most authorities accept that nicotine is one of the most addictive drugs on the planet and that smokers can become hooked quickly. One of the reasons my own parents were never able to give up was because of the prolonged withdrawal effects they experienced whenever they went more than a few hours without smoking. This would lead to intense cravings for a cigarette. Watching both my parents’ die of smoking-related diseases is enough incentive for me to never smoke a cigarette. Hopefully, others can find the incentives they need to help them give up permanently. Here are my top ten tips to help you (or someone you know and love) stop smoking:

• (1) Develop the motivation to stop smoking: Many smokers say they would like to stop but don’t really want to. When you take stock, make sure you are clear as to why you want to give up. It may be to save money, to improve your health, to prevent yourself getting a smoking-related disease, or to protect your family from passive smoking. (It could of course be all of the above). Really wanting to give up is the best predictor of successful smoking cessation.
• (2) Get all the emotional support you can: Another good predictor of whether someone will overcome their addiction to nicotine is having a good support network. You need people around you that will support your efforts to quit. Tell as many people that you know that you are trying to quit. It could be the difference between stopping and starting again.
• (3) Avoid ‘cold turkey’: Although some people can stop through willpower alone, most people will need to reduce their nicotine intake slowly. The best way of doing this is to replace cigarettes with a safe form of nicotine such as those available from the pharmacy, or on prescription from the doctor.
• (4) Get support from a professional: Even if you are using a safe form of nicotine from your pharmacist or doctor, cutting out cigarettes completely can be hard. Getting support from a trained NHS stop smoking adviser can double your chances of stopping smoking. To find your nearest free NHS stop smoking service (in the UK call 0800-1690169) or visit the smokefree website and click on the ‘ways to quit’ tab.
• (5) Use non-nicotine cigarette shaped substitutes: Smoking is also a habitual behaviour where the feel of it in your hands may be as important as the nicotine it contains. The use of plastic cigarettes or e-cigarettes will help with the habitual behaviour associated with smoking but contain none of the addictive nicotine.
• (6) Use relaxation techniques: When cravings strike, use relaxation exercises to help overcome the negative feelings. At the very least take deep breaths. There are dozens of relaxation exercises online. Practice makes perfect.
• (7) Treat yourself: One of the immediate benefits of stopping smoking will be the amount of money you save. At the start of the cessation process, treat yourself to rewards with the money you save.
• (8) Focus on the positive: Giving up smoking is one of the hardest things that anyone can do. Write down lists of all the positive things that will be gained by stopping smoking. Constantly remind yourself of what the long-term advantages will be that will outweigh the short-term benefits of smoking a cigarette. In short, focus on the gains of stopping rather than what you will miss about cigarettes.
• (9) Know the triggers for your smoking: Knowing the situations in which you tend to smoke can help in overcoming the urges. Lighting up a cigarette can sometimes be the result of a classically-conditioned response (e.g. having a cigarette after every meal). These often occur unconsciously so you need to break the automatic response and de-condition the smoking. You need to replace the unhealthy activity with a more positive one and re-condition your behaviour.
• (10) Fill the void: One of the most difficult things when cigarette craving and withdrawal symptoms strike is not having an activity to fill the void. Some things (like engaging in physical activity) may help you in forgetting about the urge to smoke. Plan out alternative activities and distraction tasks to help fill the hole when the urge to smoke strikes (e.g. chew gum, eat something healthy like a carrot stick, call a friend, occupy your hands, do a word puzzle, etc.). However, avoid filling the void with other potentially addictive substances (e.g. alcohol) or activities (e.g. gambling).

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Griffiths, M.D. (1994). An exploratory study of gambling cross addictions. Journal of Gambling Studies, 10, 371-384.

Griffiths, M.D.  (2005). A ‘components’ model of addiction within a biopsychosocial framework. Journal of Substance Use, 10, 191-197.

Griffiths, M.D. (2012). First person: Highly-addictive drug killed both of my parents. Nottingham Post, October 1, p.13.

Griffiths, M.D., Parke, J. & Wood, R.T.A. (2002). Excessive gambling and substance abuse: Is there a relationship? Journal of Substance Use, 7, 187-190.

Griffiths, M.D., Wardle, J., Orford, J., Sproston, K. & Erens, B. (2010). Gambling, alcohol consumption, cigarette smoking and health: findings from the 2007 British Gambling Prevalence Survey. Addiction Research and Theory, 18, 208-223.

Griffiths, M.D., Wardle, J., Orford, J., Sproston, K. & Erens, B. (2011). Internet gambling, health. Smoking and alcohol use: Findings from the 2007 British Gambling Prevalence Survey. International Journal of Mental Health and Addiction, 9, 1-11.

Resnick, S. & Griffiths, M.D. (2010). Service quality in alcohol treatment: A qualitative study. International Journal of Mental Health and Addiction, 8, 453-470.

Resnick, S. & Griffiths, M.D. (2011). Service quality in alcohol treatment: A research note. International Journal of Health Care Quality Assurance, 24, 149-163.

Resnick, S. & Griffiths, M.D. (2012). Alcohol treatment: A qualitative comparison of public and private treatment centres. International Journal of Mental Health and Addiction, 10, 185-196.

Sussman, S., Lisha, N. & Griffiths, M.D. (2011). Prevalence of the addictions: A problem of the majority or the minority? Evaluation and the Health Professions, 34, 3-56.

Umeh, K. & Griffiths, M.D. (2001). Adolescent smoking: Behavioural risk factors and health beliefs. Education and Health, 19, 69-71.

## Not to be sniffed at: The weird and stupid world of ‘condom snorting’

In previous blogs I have examined some bizarre (and arguably extremely frivolous) human behaviours such as ‘used condom fetishism’ and ‘cremainlining’ (i.e., the snorting of human cremated remains). Today’s blog takes a brief look at ‘condom snorting’, something that I never would have believed existed but having seen dozens of YouTube clips of teenagers engaging in the behaviour, I have to admit that it is no myth. (There are also various newspapers who have compiled a selection of condom snorting videos such as the page on the Philadelphia Post website).

I often get asked where I get the ideas to write my blogs and on this occasion I was simply sent a press cutting by one of my PhD students who suggested that I might like to write about this bizarre practice. The article my student sent me was from a British tabloid newspaper (The Sun). The author of the article (Ian Garland) began by reporting that:

“A teenage girl unravels a condom on camera, pushes it up her nose and snorts it – before gagging as she pulls it out of her mouth. The pretty brunette is the latest teen to take part in a vile and deadly new internet craze called The Condom Challenge. Dozens of youngsters have posted similar videos on YouTube – including two giggling British girls who perform the sick stunt side-by-side on camera. The horrifying fad has been condemned by other internet users. One commenter wrote: ‘Why the hell would people do something so stupid?’ Another added: “Sheer stupidity. This is sick and disgusting’”

The girl snorting the condom was Amber-Lynn Strong, and the video she uploaded to YouTube went viral and got over 2.2 million views before being removed.  In addition to The Sun, the video (and the “condom snorting craze”) was discussed in many other media outlets including the Huffington Post, Metro, Massive, Gawker, and Buzzfeed. Kat Stoeffel writing for New York’s online magazine The Cut wrote:

“Teenagers are snorting condoms up their noses and pulling them out of their mouths, on camera and on the Internet, that raises more questions than it answers. A YouTube search for ‘condom challenge’ yields more than 200,000 results, most of them [not safe for work] due to gross noises. Is this the ‘gateway sexual activity’? Or is this what happens when there’s no sex [education]? Is it an elaborate ruse to buy and possess condoms? And is this better or worse than the condom’s intended purpose?”

Following the posting of many ‘condom snorting’ videos on YouTube, almost all newspaper articles reported that medical experts around the world were advising teenagers not to engage in the activity because it can cause infections, coughing fits, vomiting and, in extreme cases, death. An article in Massive magazine claimed that hospitals around the world had “seen the arrival of teens with condoms stuck in the back of their throat, leaving them helpless and needing assistance to remove the condoms”. The Sun’s resident medic Dr Carol Cooper reported in The Sun article that:

“[Condom snorting is] shocking and incredibly stupid. The nose is connected to the back of the mouth – it’s also connected to the airwaves. There’s every possibility something you push up your nose will end up in your windpipe, or in your lungs. With potentially fatal results.”

However, another article by Samantha Cheney in the US Metro newspaper interviewed a leading physician in Australia (Dr. Joe Kosterich) who provided an arguably more balanced view and was quoted as saying:

“Although it is highly unlikely to be fatal it could trigger a coughing fit in some. The nasal linings could get irritated but this would be annoying rather than serious. If it were to get stuck it would make for a pretty embarrassing trip to the E.R.”.

There was a lot of reader reaction to the article in The Sun some of which pointed out that although the practice might be stupid, (i) there was no evidence that the practice had caused any large-scale medical problems, and that (ii) the practice wasn’t new. Typical comments included the following:

• Extract 1: “Apparently, no-one has ever died or been injured from doing this. [People] have been doing it for over 20 years. It is not new. There were almost 280,000 videos of kids doing this before YouTube pulled all the [videos]. So, maybe a million+ kids have done this and not a one has suffered dire effects? I know it may be ‘shocking’, but until I see [legitimate statistics] of how many kids have been hurt/or have died from doing this, I am not going to lose any sleep over it” (Perlins).
• Extract 2: “This is so stupid but not new. People were doing this when I was younger [but] it’s just you see more of it now due to the internet, I’m only 30 so not too long ago really” (Weebird).

Almost all of the literature relating to medical condom emergencies concern either ‘lost’ condoms inside body cavities following sexual activity, or from drug-smuggling ‘body packers’ who get drug-filled condoms stuck after swallowing or rectally inserting the condom-filled package. For instance, I came across a case study by Dr. Shehnaz Somjee in a 1991 issue of the Journal of Laryngology and Otology who reported the case of a 28-year old man in prison who got a cannabis-filled condom stuck in his upper oesophagus.

Having read these reports I searched the medical literature to see if I could locate any medical reports on condom snorting that had gone wrong. I only found one report of ‘accidental condom inhalation’ and that concerned a woman who accidentally inhaled a condom during oral sex with her boyfriend (and reported in a 2004 issue of the Indian Journal of Chest Diseases and Allied Sciences by Dr. C.L. Arya and colleagues). A recent study led by Dr. Maarten Timmers and published in a 2012 issue of Pediatric Emergency Care examined all the cases of foreign body-related trauma in 8149 children and adolescents in their clinic over an 18-year period (1991-2009). They collected detailed data including age, sex, type of foreign body, injury severity, and anatomical location of the foreign body. They reported that the most predominant anatomical sites where foreign bodies got stuck were the respiratory tract/gastrointestinal tract (39.1%); ears (23.9%); nose (19.4%); and extremities (8.8%). The commonest objects were coins (20.8 %), (parts of) jewelry (9.5%), and food (8.7%). None of the foreign bodies removed were condoms (although the majority of the sample were aged below 10 years).

As there are no empirical studies on condom snorting, when it comes to why teenagers would engage in the behaviour, the wider question is why they would engage in risky behaviour in the first place? I have spent my whole career researching why adolescents engage in risky behaviours such as gambling and if you ask teenagers to explain their behaviour there are a consistent set of reasons given such as engaging in the activity because (i) it is fun, exciting, mood-enhancing, and/or dangerous, (ii) others around them do it (friends, relatives), (iii) they have a low boredom threshold, (iv) it is an act of rebellion against parents and other ‘authority’ adults, and (v) it may change others’ views on how they are perceived (with the person engaging in the act hoping they will be viewed more positively by their peers).

To me, the Condom Challenge is akin to other challenges usually taken on by teenagers in an attempt to impress their friends. For instance, there are thousands of YouTube videos with young people taking the ‘Cinnamon Challenge’ (where a tablespoon of cinnamon is put into someone’s mouth and the challenge is to swallow all of it within a 60-second period without drinking any water). It’s virtually impossible to do (it burns, it makes you cough, and you’ll most probably regret having tried in the first place) but it hasn’t stopped people trying.

Some recent research published in the Proceedings of the National Academy of Sciences by Dr. Agnieszka Tymula and colleagues at the New York University reported that adolescents were riskier in uncertain situations, and more willing than adults to accept ambiguity and take action even when they don’t fully understand the consequences. Interestingly the study found that adolescents were generally no more risky in their behaviour than adults but (in a gambling-related task) they went for the risky option more often when the outcome was not exactly known. In reports to the media, Dr. Tymula said that:

“Teenagers’ high tolerance to ambiguity is compounded by the fact that they often put themselves in situations where they might not even recognize the ambiguity of the full spectrum of consequences. The acceptance of the unknown makes teenagers engage in riskier behaviour”.

Unless condom snorting becomes an epidemic that leads to serious health risks, I can’t foresee there being any scientific research on the topic although I wouldn’t be surprised if a few extreme cases make it into the medical literature.

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Alvarez, A. (2013). What is the Condom Challenge and why are there videos? ABC News, April 17. Located at: http://abcnews.go.com/ABC_Univision/Entertainment/condom-challenge-videos-youtube-bad-idea/story?id=18977460#.UXfoULXvtqU

Arya, C.L., Gupta, R. & Arora, V.K. (2004). Accidental condom inhalation. Indian Journal of Chest Diseases and Allied Sciences, 46, 55-58.

Garland, I. (2013). Condom snorting: teens take part in vile and deadly new internet craze. The Sun, April 16. Located at: http://www.thesun.co.uk/sol/homepage/features/4890174/condom-snorting-the-vile-and-deadly-new-internet-trend.html

Huffington Post (2013). Condom Challenge: Teen condom snorting trend hits YouTube. April 15. Located at: http://www.huffingtonpost.com/2013/04/15/condom-challenge-snorting-condoms-videos_n_3085258.html

Somjee, S. (1991). A narcotic foreign body in the throat. Journal of Laryngology and Otology, 105, 774-775.

Stoeffel, K. (2013). Why are teenagers snorting their condoms? The Cut, April 17. Located at: http://nymag.com/thecut/2013/04/why-are-teenagers-snorting-their-condoms.html

Timmers, M., Snoek, K.G., Gregori, D., Felix, J.F., van Dijk, M. Sebastian A.B. (2012). Foreign bodies in a pediatric emergency department in South Africa. Pediatric Emergency Care, 28, 1348-1352.

Tymula, A., Belmaker, L. A. R., Roy, A. K., Ruderman, L., Manson, K., Glimcher, P. W., & Levy, I. (2012). Adolescents’ risk-taking behavior is driven by tolerance to ambiguity. Proceedings of the National Academy of Sciences, 109, 17135-17140.

Wheeler, T. (2013). Condom snorting, the latest craze. Massive (Volume 2, Issue 5), July 22. Located at: http://www.massivemagazine.org.nz/blog/9716/condom-snorting-the-latest-craze/

## Stock tales: Is financial trading a form of gambling?

One of the questions I am most asked by my students and the media alike is whether trading on the stock market is a genuine form of gambling. That might sound a simple question, but it all comes down to what definition of gambling you are using. My own view on gambling is that it boils down to the staking of money (or something of financial value) on a future event. When I first started my research into gambling back in the mid-1980s, there were four fundamental types of gambling:

• Gaming – Staking of money during a game (e.g. slot machines, roulette, blackjack, etc.)
• Betting – Staking money on a future event, typically sports events (e.g. horse race betting, greyhound betting, football betting, etc.)
• Lotteries – The distribution of money by lot (e.g. National Lottery)
• Speculation – Staking money on stock markets (e.g., investment in shares, day trading, etc.)

In a previous blog I briefly examined whether stock market speculation was a legitimate form of gambling. However, back in the 1980s, psychologists were only interested in studying the first three of these activities (i.e., gaming, betting and lotteries). Although a few academics accepted ‘speculation’ as a true form of gambling, the majority of researchers in the gambling studies field did not (including me). The prevailing view at the time was that ‘speculation’ was viewed as involving a fair amount of skill and/or relied on ‘insider information’ and therefore was not a legitimate form of gambling compared to other forms of gambling. Although there were clearly accepted forms of gambling that had skilful elements (e.g., poker, blackjack), academic psychologists still rejected speculation as a form of gambling worth investigating.

However, this all changed after the introduction of spread betting. I argued in a number of articles at the end of the 1990s that spread betting had taken the mechanics of stock market trading and applied it to sporting events. For me, this was a game changer in terms of studying the psychology of gambling. No longer could we say that speculation shouldn’t be studied because spread betting was clearly a form of speculation and it was something that appealed to a new type of gambler because it involved sporting events that many people think they know a lot about.

There was also one other key factor in changing psychologist’s perceptions of speculation as gambling – the ‘Nick Leeson effect’. In 1995, Leeson single-handedly brought down the UK’s oldest investment bank (Barings). Leeson was a derivatives broker whose fraudulent gambling caused the spectacular collapse of one of the UK’s most established financial institutions. From the early 1990s, Leeson made countless speculative (and unauthorised) gambles on the stock market that at first made large profits for his employers. However, as with most gamblers, his ‘beginner’s luck’ soon ran out and he started to lose huge amounts of money. Leeson’s losses eventually reached £827 million. Leeson’s psychology and behaviour was identical to that of a problem gambler (except he was gambling with much larger amounts of money and with someone else’s money).

There was perhaps another reason why speculation was seen as psychologically different from gaming, betting and lotteries. Unlike these other forms of gambling, speculation is a type of gambling where the gambler does not know how much they are going to win or lose on the gamble. If I put £1000 on a horse to win the Grand National or on black to come up on a roulette wheel, I know that losing will cost me £1000. On most stock market trades or spread bets, no-one knows beforehand what the losses could be. However, there are financial trades that could perhaps be argued to be more like betting than speculation. For instance, binary options look as though they are going to grow in popularity over the next year or two as the gambling payoff is more traditional than usual financial trading.

In binary option betting, a cash-or-nothing binary option will pay a fixed amount of money if the option traded on expires in-the-money (i.e., it is a simple ‘win-or-lose’ bet as the potential return it offers is certain and known before the purchase is made). One of the attractions of binary options is that they can be bought on virtually any financial product and can be bought in both up and down directions of trade. The simplicity is likely to attract more people especially if they feel they know something about the product being traded upon. This is the same reason why spread betting took off in such a big way because people feel they know about the market (e.g., football) that they are betting on, even if there is a huge element of chance (which there invariably is). My guess is that most people who work in the financial markets don’t see binary options as an investment opportunity – they see it for what it really is – a pure gamble.

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Griffiths, M.D. (1991). ‘Gambling and Speculation: A Theory, History, and a Future of some Human Decisions’ by R. Brenner and G.A. Brenner. Journal of Economic Psychology, 12, 197-201.

Griffiths, M.D. (1998). Gambling into the Millenium: Issues of concern and potential concern. GamCare News, 3, 4.

Griffiths, M.D. (2000). Day trading: Another possible gambling addiction? GamCare News, 8, 13-14.

Griffiths, M.D. (2006). An overview of pathological gambling. In T. Plante (Ed.), Mental Disorders of the New Millennium. Vol. I: Behavioral Issues. pp. 73-98. New York: Greenwood.

Griffiths, M.D. (2007). Gambling Addiction and its Treatment Within the NHS. London: British Medical Association (ISBN 1-905545-11-8).

Griffiths, M.D. & Auer, M. (2013). The irrelevancy of game-type in the acquisition, development and maintenance of problem gambling. Frontiers in Psychology, 3, 621. doi: 10.3389/fpsyg.2012.00621.

Griffiths, M.D. (2013). Financial trading as a form of gambling. i-Gaming Business Affiliate, April/May, 40.

## Snoozing personality: The strange case of ‘Sleeping Beauty’ paraphilia

Just recently (and quite by accident while I was doing some research into fingernail fetishes – the topic of an upcoming blog) I came across a case study of an allegedly unique sexual paraphilia called ‘Sleeping Beauty’ paraphilia. The paper was by Dr. Francesco Bianchi-Demicheli and three colleagues, and published in a 2010 issue of the journal Medical Science Monitor. The case involved a 34-year old married man who was admitted to a psychiatric unit in February 2007 following a violent physical attack on his wife. The marriage had been failing for a number of years because of the man’s paraphilic actions in which his wife was an unwilling participant.

The man’s sexual focus was arousal from seeing women sleeping. This as I have written about in a previous blog on somnophilia is not unheard of. (Somnophilia is a sexual paraphilia in which sexual arousal is derived from intruding on, caressing, and/or fondling someone – typically a stranger – while they are asleep without force or violence.) However, where the paraphilia differed from ‘classic’ somnophilia was that the man liked to look after the woman’s hands and nails while they were asleep (this helps explain why I came across the case while researching into fingernail fetishism). The man also had an idealized routine and would always start with the women’s right hand before moving on to the left. Over the years of the marriage, the urge to control his paraphilic interest worsened. At the start of his marriage he used to give his wife sleeping pills that she consented to take. However, the wife eventually refused to take the medication given by her husband. Consequently, the man began to surreptitiously administer sleeping pills (the benzodiazepine Bromaezepam) to his wife without her knowledge. In 2006, the man’s wife discovered what her husband had been doing and the relationship deteriorated even further. The authors wrote that:

“Because of the extremely powerful obsession with sleeping women and painting their nails, the patient disguised himself with a latex mask and attacked his wife, as she returned from work, with an Olerosin Capsicum (OC) spray, to anaesthetize her. During this episode, his wife succeeded in taking off his mask, escaped and called the police who brought him to the psychiatric emergencies”.

Following a psychiatric assessment that was deemed “normal” the man revealed that when he was 10 years old he had an incident of head trauma that resulted in a four-day long coma. He subsequently received various neurological evaluations, including neuroimaging brain scans. The authors reported that:

“The cerebral MRI showed a moderate atrophy in the fronto-parietal region with a diffuse and severe white matter injury compatible with his previous head trauma. On a functional viewpoint, this brain network is known to sustain among others, the sense of self, body-image, and attention mechanisms. His neuropsychological exam was in line with this assumption. The patient was diagnosed with a moderate dysexecutive syndrome and a very specific body image disorder characterized by an incomplete mental image of his hands, mostly the right (i.e., personal representational hemineglect), as ascertained by his graphical representation of his body parts. The clinical hypothesis was that the paraphilia might be related to his post-traumatic disturbed body image and more specifically to the incomplete hands representation”.

The authors made reference to a number of studies that suggest paraphilic behaviour can appear following brain damage (see ‘Further reading’ below) and concluded that their case study highlighted “the potential link between paraphilia, deviant and aggressive sexual behaviour, neurological disturbance and self-representation…Presumably, the occurrence of head trauma leading to catatonia in adolescents might have played a critical role on the development of his sexual self and body image”.

A good critique of this particular case study was by The Neurocritic who wrote that:

“One puzzling aspect of this case is why the ‘Sleeping beauty paraphilia’ became uncontrollable only in adulthood, showing a progressive escalation during his marriage. This might be suggestive of a neurodegenerative disorder, but that was not part of his diagnosis. And I’m not sure why an old traumatic brain injury would have lead to ‘moderate’ atrophy in the fronto-parietal region. I might have expected more involvement of the orbitofrintal cortex, given the nature of the patient’s behavioral changes. However, many other examples of impulsive sexual offenses are even less obviously related to neurological status (e.g., after head injuries when the damage might not be visible on an MRI scan, and of course the population of offenders who have never sustained a TBI [traumatic brain injury]). Since the lesions were distributed and not focal, a final mystery is why the body image disturbance was confined to the right hand (implying a left hemisphere origin). This type of personal representational hemineglect (neglect for a mental representation of one side of the body) is most often associated with lesions in the right hemisphere”.

The Neurocritic also makes a point that I have raised in other blogs that I’ve written on various paraphilias concerning the issue of whether something is problematic if there is a willing participant to share the sexual urges. The Neurocritic concludes:

“What is considered acceptable can vary widely across cultures and subcultures (Bhugra et al, 2010) and across individuals. If the patient of Bianchi-Demicheli et al. found a partner willing to have her fingernails done while sedated with sleeping pills, perhaps the classification would change from paraphilic disorder to something that might be considered strange and paraphilic to most people, but causing no distress to the two willing participants”

Personally, I feel this paraphilic behaviour is just a sub-type of somnophilia or somnophilia overlapping with hand fetishism. However. Given the complete lack of case studies ion the clinical literature on somnophilia, who is to say that this case study is not representative of somnophiles more generally?

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Bianchi-Demicheli F, Rollini C, Lovblad K, & Ortigue S (2010). “Sleeping Beauty paraphilia”: Deviant desire in the context of bodily self-image disturbance in a patient with a fronto-parietal traumatic brain injury. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research, 16(2), C15-C17.

Bhugra D, Popelyuk D, McMullen I. (2010). Paraphilias across cultures: Contexts and controversies. Journal of Sex Research, 47, 242-56.

Briken, P., Habermann, N., Berner, W. & Hill, A. (2005). The influence of brain abnormalities on psychosocial development, criminal history and paraphilias in sexual murders. Journal of Forensic Science, 50, 1204-1208.

Lehne G.K. (1994). Brain damage and paraphilia treated with medroxyprogesterone acetate. Sex and Disability, 10, 145–158.

Miller, B.L., Cummings, J.L,. McIntyre H et al (1986). Hypersexuality or altered sexual preference following brain injury. Journal of Neurology, Neurosurgery and Psychiatry, 49, 867–873

The Neurocritic (2010). “Sleeping Beauty Paraphilia” and Body Image Disturbance After Brain Injury. April 11. Located at: http://neurocritic.blogspot.co.uk/2010/04/sleeping-beauty-paraphilia-and-body.html

I have to admit that I know relatively little about the neuropsychology of hallucinations. The only time I have written about them in scientific journals is in the context of excessive video gaming where there are case studies of people who appear to display auditory and/or visual game-related hallucinations, and may be part of a wider repertoire of sensory consequences of video game playing that we have coined ‘game transfer phenomena’ (and which I outlined in a previous blog).

However, in a completely different context, I recently came across a really interesting 2011 case study by Dr. Amin Gadit who published a short paper in BMJ Case Reports entitled ‘Insightful hallucination: psychopathology or paranormal phenomenon?’ Dr. Gadit noted that hallucinations are usually indicative of a serious psychiatric problem (i.e., typically some kind of psychosis) and typically require treatment. However, Dr. Gadit described the case of a 26-year old successful Pakistani businessman who was suffering hallucinations but experienced a dilemma as to whether to treat him or not because his hallucinations appeared to be providing some therapeutic benefit to his patient.

The man was married to his first cousin (also from Pakistan) and was described as being “extremely close” to his mother. Dr. Gadit reported that his patient’s wife sometimes got extremely upset (which I interpreted as being jealous) about her husband’s attachment to his mother. Following the mother’s diagnosis of a terminal illness with only a few months left to live, the man (understandably given the relationship with his mother) experienced deep emotional turmoil and upset. Dr. Gadit wrote that according to his patient that:

“[His] mother told him before dying that she would remain in contact with him after death. The patient went through a complicated bereavement period when she died. However, 6 months later, he regained his cheerful mood and started taking an interest in business again. His wife noticed that he was talking to himself for at least an hour each day. When asked, he said that his mother visits him every day and he talks to her. This was his firm belief. There was no deterioration in his personality and no other features worthy of note”.

Following these episodes of speaking to his dead mother almost every night at different times in the evening, the man’s wife persuaded him to seek psychiatric help. Dr. Gadit claimed that his patient resented being in treatment and argued that the regular “contact” with his dead mother was a positive experience and made the man happy and helped bring normality to his day-to-day life. Following initial psychiatric assessment, Dr. Gadit noted that:

“There was no significant medical history or family history indicative of any mental disorder. A thorough clinical history revealed nothing except this hallucination. The patient had retained insight as he believed that this would not happen normally but in his case was a special occurrence. He attributed this to his Muslim belief of God’s blessing in sending his mother back to him in this way. His physical examination was unremarkable and all laboratory results were normal. MRI did not reveal any pathology. His mental state examination revealed normothymic mood, delusion, visual hallucination, psychosis (with no supporting evidence), intact cognitive function and reasonable insight into his problem”.

The man’s mother appeared most evenings wearing different dresses (ones that she used to wear when she was alive) but he said his mother would not allow him to touch her when she appeared. The man was adamant that his mother appeared before him in the real world and refused any medical treatment. Organ pathology (often associated with auditory hallucinations) was ruled out as a cause, and there was insufficient evidence for a diagnosis of schizophrenia (often associated with auditory hallucinations). Ultimately, Dr. Gadit did not reach a psychiatric diagnosis and he sought a second opinion (which also failed to produce a diagnosis). The lack of formal diagnosis posed a dilemma in terms managing the presenting condition. The man had monthly appointments for over half a year with Dr. Gadit but the condition remained constant. In discussing the case, Dr. Gadit wrote that:

The patient recognises the hallucination (perception without the presence of an external stimulus) as happening in the real world. It is important to differentiate true hallucination from ‘pseudo-hallucination’ and ‘imagery’. A pseudo-hallucination is an involuntary sensory experience vivid enough to be regarded as a hallucination but recognised by the patient as not the result of external stimuli; it would not be considered by the person to be ‘real’. Imagery is a collection of images used to create a sensory experience and is the element in a literary work used to evoke mental images and stimulate an emotional response. In the current case report, the patient believes that he can see and talk to his mother in the real world and that he is not imagining it”.

In discussing the case in relation to previous literature, Gadit made reference to a 2009 paper by H. Haween in the Dartmouth Undergraduate Journal of Science (DJUS) that reported hallucinations following bereavement typically resolve over time. Such hallucinations are most commonly in reported during the grieving process in males aged 25 to 30 years. Other similar non-psychiatric illnesses include Charles Bonnet’s Syndrome (typical sufferers being the elderly) that comprises clear hallucinations experienced among visually impaired individuals. A study dating back to 1971 by Dr. W.D. Rees and published in the British Medical Journal reported ‘widowhood hallucinations’ in 14% of Welsh widows and widowers (n=293). A more recent study in a 2002 issue of the British Journal of Psychiatry, a team led by Dr. L.C. Johns reported a 4% prevalence of hallucinations in white and ethnic minority populations and suggested that hallucinations are not always associated with psychotic disorders.

Gadit claimed that his male case study was “unique” as the persistent hallucinations resulted in no noticeable psychopathology, and appeared beneficial to his patient. He also speculated that the visions might be a paranormal experience or “a case of hallucinosis with a secondary delusional explanation”. Gadit claimed that paranormal phenomena are fairly common in both the developed and the developing world (and typically associated with rituals and myths).

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Gadit, A.A.M. (2011). Insightful hallucination: psychopathology or paranormal phenomenon? BMJ Case Reports 2011; doi:10.1136/bcr.10.2010.3456

Heewan K. (2009). Hallucination: a normal phenomenon? Dartmouth Journal of Undergraduate Science, November 21. Located at: http://dujs.dartmouth.edu/fall-2009/hallucination-a-normal-phenomenon

Johns, L.C., Nazroo, J.Y., Bebbington, P., et al. (2002). Occurrence of hallucinatory experiences in a community sample and ethnic variations. British Journal of Psychiatry, 180, 174-178.

Menon, G.J., Rahman, I. & Menon, SJ, et al. (2003) Complex visual hallucinations in the visually impaired: the Charles Bonnet Syndrome. Survey of Ophthalmology, 48, 58-72.

Ortiz de Gotari, A., Aronnson, K. & Griffiths, M.D. (2011). Game Transfer Phenomena in video game playing: A qualitative interview study. International Journal of Cyber Behavior, Psychology and Learning, 1(3), 15-33.
Rees, W.D. (1971). The hallucinations of widowhood. British Medical Journal, 4, 37-41.

Spence, S. A. (1993). Nintendo hallucinations: A new phenomenological entity. Irish Journal of Psychological Medicine, 10, 98–99.

## Better latex than never: A beginner’s guide to ‘rubberdolling’

In previous blogs I have looked at doll fetishism (i.e., individuals that derive sexual pleasure and arousal from dolls and doll-like objects) and the ‘reborn baby doll’ phenomenon (i.e., individuals who collect and look after liefelike baby dolls). Today’s blog examines the world of ‘rubberdolling’ – the practice of individuals dressing up head-to-toe as a rubber doll. As far as I am aware, there is no academic research on rubberdolling although there are clearly psychological and behavioural overlaps with other more academically researched areas including transvestic fetishism, rubber/latex fetishism, and sadomasochism. In fact, many people might view such activity as ‘extreme cross-dressing’ where men (but occasionally females) transform themselves into walking talking dolls, completely concealing their real identities. According to the Latex Wiki entry on rubberdolling:

“A doll (a.k.a. Rubber doll, rubberdoll, rubberdolly, v. dolling, v. rubberdolling) is a latex fetishist whose desire is to acquire the appearance of a doll, usually a female doll, through a mostly latex costume that completely covers the face and skin… A doll’s suit is often a catsuit, which might have been specifically designed to mimic a store mannequin or a blow-up doll. Common colours thus include approximations of skin tones, white and black (for a Heavy Rubber look)…For nude (a nude doll, that is) applications the suit may feature blow-up-doll-like openings with insertable pouches. Some manufacturers offer catsuits designed to look like a blow-up doll. These might include inflatable bosom, hips or other regions to enhance the visual effect of an artificial doll – or to give a male wearer the shape of a female”.

Rubberdolling is relatively new phenomenon that has come to the fetishistic fore over the last two decades. Most rubberdollers attribute the rise of rubberdolling to the work of German fetish photographer Peter Czernich who started the fetish magazines Marquis and Heavy Rubber. Rubberdollers are typically encased in latex rubber with exaggerated and accentuated Barbie-type female features (i.e., huge breasts, incredibly small waists, exaggerated thighs and hips, elongated fingernails, extra long eyelashes, bright and excessive make-up, etc.). Typically, the only areas of human flesh that remain uncovered are holes for the eyes, nose and mouth. According to an article on rubberdolling at the Rubber World Rendezvous website, there are four basic categories to which rubberdolling can apply:

• Submissive dolls: This is where individuals dress up as a rubber doll as part of a submissive role within a sadomasochistic relationship. Here the doll acts as a service submissive/slave and is utilized by others (usually the dominant partner) for their own sexual entertainment purposes. The dominant partner controls everything that the doll does and the costume often restricts the doll’s movements. The doll essentially becomes totally objectified and is at the total mercy of their dommes or mistresses. Here, rubberdolls may also be engaging in the behaviour as part of an encasement and/or rubber bondage fetish.
• Sissy dolls: This is where individuals dress up as a fetishistic ‘sissy’ rubber doll within the transgender and transvestite community. The activity may also be part of ‘cosplay’ (i.e., costume play). As the article at the Rubber World Rendezvous website claims, these people use “the rubber doll theme as a vehicle for play, disguise, sissification, cross dressing…This generally follows a common theme of Forced Femme or being turned into a female doll animate or inanimate. Again shape altering garments and female masks figure in this identity change. Many equate this to being turned into a Barbie Doll. Many [transvestites] who like shiny materials are now dressing in Latex and rubber as part of their look and while not wearing masks they are considered a rubber doll”.
• Show dolls: This is where individuals dress up as a rubber doll for exhibition purposes and may be part of either the BDSM and/or transvestite and transgender communities. In sadomasochistic relationships, show dolls are made to look as pretty as possible by their dommes or mistresses to show off to others in the rubberdolling scene (e.g., at fetish balls). Here, the dominant partner may actually play with the submissive as if it was a real doll. Show dolls are typically female in appearance, and the female form is accentuated and exaggerated.
• Art dolls: This is where individuals dress up as a rubber doll as an art form or art statement (i.e., a piece of ‘living art’ or ‘street theatre’) and may have nothing to do with sex or fetishistic sex (i.e., it is purely about seeing the doll from an aesthetic perspective). Such dolls may also be used to feature in fetish photography magazines (of which there seem to be a growing array based on what I came across while researching this article).

So how does someone actually transform another person into a doll? The Rubber World Rendezvous claims:

“This is done through dressing the subject in latex rubber garments and specialty items to change their form and look. Generally the basis for all of the forms of rubber doll is the female type cat suit which has a tight waist, bust cups for breast forms or attached inflatable breasts. The cut of the suit is usually female. Add to this the bra, breasts and padded hips along with a female mask and wig (if required) you have a basic naked doll. From here one dresses the doll however you desire to achieve the look you want”.

The Latex Wiki entry on rubberdolling claims that some people attempt to use (“and have variably succeeded”) the outer shells of blow-up sex dolls as full body suits. However, it then goes on to say that most inflatable dolls are too small to totally engulf someone, but that some varieties are reasonably life size. Blow-up dolls are usually made from materials such as PVC and latex, and therefore are not always sufficiently flexible for comfortable wear. The same article also claims that looners (i.e., balloon fetishists) may use heated air to stretch various plastic inflatables whilst retaining the proportions of the object close to original.

There is little in the way of an established literature on rubberdolling although there are quite a few rubberdollers that have their own webpage. One of the more interesting (and in-depth) ones is the Swedish Rubber Puppett site. The site’s owner is very open and reflective about his rubberdolling and I reproduce here what he has to say in his own words:

“I am a rubberdoll from the very south part of Sweden with a deep love for latex. I created this site to be able to reach out to other latex lovers and to make new friends all over the world. The rubber scene in Sweden is quite limited, especially if you are into dolling. I have been into latex and anything tight and shiny for as long as I can remember and some time ago I dressed up as a doll and I instantly felt this was my ‘thing’…Many people think of a rubberdoll as something passive and submissive, which is often the case. However, I am neither passive nor submissive and do this for entirely different reasons. For me it is all about dressing up and [transforming] myself into a different character. Perhaps this is similar to people who are into cosplay…Like an exhibitionist I love the way people turn their heads and look at me, some with fascination and some with fear in their eyes”.

Arguably the most interesting part of Rubber Puppett’s account is where he talks about where his love of dressing in rubber came from. He reported that:

I have been into rubber, latex and all shiny and tight things for as long as I can remember. As a young child I loved to dress up in rain clothes. I can remember the nice feeling I got the first time I tried a couple of waders. Now I am more focused towards latex, but I am still quite fond of those things, especially rubber boots. It wasn’t until I left home to study that I came into contact with latex…I did like the look of it and I decided to buy some simple garments for me and my girlfriend. I instantly fell in love with the tight feeling of the rubber clothes, the smell and the look of them. I soon ordered some more latex clothes such as hoods, stockings and dresses. When I first saw myself in the mirror wearing a hood I was instantly hooked. Since that day I have worked on my rubberdoll persona to create my fantasy woman”.

Based on what I have read elsewhere, I wouldn’t describe this account of rubberdolling as typical (and neither does he). Whether any academic research ever gets carried out on the topic remains to be seen, but it’s certainly an area that is of psychological interest.

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Latex Wiki (2011). Doll. Located at: http://www.latexwiki.com/index.php?title=Doll

Rubber World Rendezvous (2013). Frequently asked questions. Located at: http://www.rubberdollworldrendezvous.com/faq.php

## The loyal family: A brief look at brand image and gambling

Over the past decade, the psychology of gambling marketing has become big business. Despite the strict regulations concerning how gambling can be advertised, the psychology of ‘gambling advertising‘ is important in attracting potential clientele. Gambling imagery is designed to make a person spend money, and in almost all advertisements there is a lack of reference to the word ‘gambling’. Instead, guilt-reducing statements referring to leisure are used. Typical examples include “try your luck”, “test your skill” and “get into the holiday spirit”.

Image has become all important in the commercial arena and the gambling industry is no different. Having said that, the gaming industry has known that perception and image are important for well over a century. For instance, the first slot machine designed in 1895 was called ‘The Liberty Bell’ and typified patriotism as it was the symbol of American Independence!

The real shift that I have noticed in recent years has been the increased strategic use of ‘branding’ products. Brands are highly defined products that go beyond the packaging and the material they are made of. They can be anything from goods such as soap powder through to major corporations, service companies, political parties and even people. They appear everywhere and gambling products are no different. Research by psychologists has shown that children as young as three years old can recognize a brand. In fact, one study I read showed that more schoolchildren recognized the ‘crossed fingers’ Camelot logo than products such as Coca Cola and McDonalds!

So how are brands defined? The principal difference between an ordinary product and a brand is the intangibles beyond the product itself. A brand goes beyond functionality. In short it is how it is packaged, what it looks like, what its colour is, its personality. At the most basic level, product plus personality equals brand. My guess is that when you hear the words ‘Ladbrokes’, ‘William Hill’, or ‘Gala’ they invoke particular thoughts, moods, colours, and feelings.

Every great brand has an outstanding feature at its heart. A product also needs time and to be promoted and communicated consistently to become a brand. Repetition has appears to be one of the keys to establishing brand success. However, what really determines a brand – and this is especially important in the gambling arena – is trust. This is of paramount importance in getting individuals to gamble online. Players are more likely to gamble online with those companies that are well established than a little known company operating out of the Caribbean. Successful brands have a ‘trustmark’ rather than a trademark. It is the reason we prefer the product to other non-familiar ones. It says you have not been let down by the product or service and you can reduce anxiety by using the product or service again. Again, this is especially important in a business whose primary aim is to relieve you of your money!

Trust is an historical concept because we need repeated interactions coupled with good feelings to build it. Branding experts claim it takes at least three years to establish the feeling of goodwill among consumers. The good news for companies – including the gaming industry – is that we don’t even need to have experienced the product ourselves. We might engage in things because others have used or engaged in the product for years.

One of the most important things about brands for the gaming industry is that they help us define our self-image and who we are – at least on some psychological level. For some people, this ‘personal branding’ may be more important than their social identities within a community. For example, the car we drive or the newspaper we read, are particularly strong cultural indicators of what sort of person we are. Where you gamble and on what games can be an extension of this.

Brands appear to mean much more than they ever did probably because successful brands are worth millions of pounds. Nowadays, gambling brands are linked to ideas, hopes and dreams and match the player’s thinking and self-image. It is not enough that going to a casino will be a lot of fun. It has to say something as well. Gaming companies try to match their products and games to consumers through extensive market research by surveying potential clientele about their attitudes, habits and pleasures. The gaming industry spends a lot of resources (time and money) turning their products into brands. If the product is successful it will soon be open to competition from others who want to cash in on the market for the particular product. The gaming industry therefore has to find a way of showing that their brand of products gives something better than the competitors.

Over time, even the best brands can lose customer loyalty, which is why the gambling industry needs to stay fresh and innovative. Brands rely on image and are vulnerable to scandal. That is where the gaming industry walks a fine line. High profile stories about gambling addiction or gambling-related suicides will not bring in new players and is why there is now such a major investment in corporate social responsibility.

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Adams, P. (2004). Minimising the impact of gambling in the subtle degradation of democratic systems, Journal of Gambling Issues, 11. Available at: http://www.camh.net/egambling/issue11/jgi_11_adams.html.

Binde, P. (2007). Selling dreams – causing nightmares? On gambling advertising and problem gambling. Journal of Gambling Issues, 20, 167-191.

Griffiths, M.D. (2005).  Does advertising of gambling increase gambling addiction? International Journal of Mental Health and Addiction, 3(2), 15-25.

Griffiths, M.D. (2007). Brand psychology: Social acceptability and familiarity that breeds trust and loyalty. Casino and Gaming International, 3(3), 69-72.

Griffiths, M.D. (2010). Online ads and the promotion of responsible gambling. World Online Gambling Law Report, 9(6), 14.

Griffiths, M.D. & Wood, R.T.A. (2008). Responsible gaming and best practice: How can academics help? Casino and Gaming International, 4(1), 107-112.

Korn, D, Hurson, T. & Reynolds, J. (2004). Commercial Gambling Advertising: Possible Impact on Youth Knowledge, Attitudes, Beliefs and Behavioural Intentions. Report submitted to the Ontario Gambling Research Centre.

## Banned aid? A brief guide to compulsive helping

Back in the early 2000s, I (and one of my colleagues, Dr. Michael Larkin) carried out some research at the Promis addiction clinic down in Kent. We were researching people’s phenomenological experiences of addiction, and our interviews with the addicts receiving treatment were really helpful in the writing of what I personally thought were some really interesting papers (see ‘Further reading’ below). However, what interested me even more were the conversations I had with the clinic’s Director, Dr, Robert Lefever who told me of his interest and research into ‘compulsive helping’. Dr. Lefever has written a number of articles online about compulsive helping. In one of them he began by stating:

“Of all the addictive behaviours those surrounding relationships like sex and love addiction, relationship addiction or compulsive helping can be the most difficult to understand. This is further hindered by the confusing terminology used to describe it. Just as addiction means as many different things to as many people so do terms like co-dependency. We have tried to help clarify the situation by using different terms for different behaviours. Where people are addicted to someone they have a relationship with we call it relationship addiction, where people are addicted to helping others with their problems we call it compulsive helping”.

Dr. Lefever says that by giving these behaviours descriptive titles (like ‘compulsive helping’ and ‘relationship addiction’) help the affected person to identify the specific behaviour that they are actually addicted to. He also argues that such labels help the affected person relaise that the person responsible for the addictive behaviour is the individual and not someone or something else. However, Dr. Lefever is the first to admit that “the concept of compulsive helping can be particularly difficult to get one’s head around”.

Obviously not all helping is harmful but Lefever distinguishes between ‘caring’ (which he views as healthy) and caretaking (which he views as unhealthy). Compulsive helping occurs when the ‘caretaker’ (rather than a carer) continually takes on the responsibilities of someone else (very often a person who they love), and in essence runs that person’s life for them. Compulsive helpers often help other people that have an addiction (such as an alcoholic or a gambling addict) but Lefever claims that compulsive helpers can also end up compulsively helping people that doesn’t have problems themselves. (However, those without a problem are far more likely to notice compulsive helping behaviour in other people if they feel it is significantly and continually interfering in their day-to-day life and business). More specifically:

“Caring is lovely and healthy. I would never wish to change that characteristic in anyone. Caretaking however, is over-caring for someone, taking on the other person’s responsibilities for themselves and not allowing the other person to have the consequences of his or her behaviour…Helping is loving. Compulsive helping is destructive of both self and the other person. It is destructive of my own life and destructive of the person whom I am trying to compulsively help. That is not what I would call a loving action”.

Another short article on ‘compulsive helping’ by Rochelle Craig on her Piece By Piece Recovery website has a slightly different take and notes that:

“Compulsive Helping is when the individual finds it impossible to say no each and every time they are asked. A compulsive helper will always help regardless of what the situation is whether it is convenient for them or not. This can result in the compulsive helper building up resentment against the other person or persons and feeling like a doormat. When this happens the compulsive helper begins to resent being asked”

Like Dr. Lefever, Rochelle Craig believes that compulsive helpers take on too much responsibility, and therefore take away responsibility away from other people. Craig is adamant that people should examine their motivation for their helping behaviour to assess the extent to which it is helpful. If the act of helping others is a continual source of gaining self-worth, it may be indicative of compulsive helping. Other signs of compulsive helping is carrying on helping even if it is putting one’s own health, job, and/or other relationships at risk, Craig asserts that:

“It is important to remember that we are talking about addictive behaviour, we are talking about extremes, and we are talking about situations where the compulsive helper is so absorbed with helping others that they lose their own identity. Recovery is about self-discovery, self-improvement and building on self-esteem without relying on constantly helping others. It is about self-care first and everyone else second! Recovery is about recognising the difference between compulsive helping and genuine acts of kindness and most importantly it is learning to say no!”

In another (different) article on compulsive helping, Dr. Lefever refers to ‘compulsive helping’ as ‘co-dependency’ and claims that compulsive helping “is the most perverse, widespread and destructive of all addictive or compulsive behaviours” and the ‘need to be needed’. In fact Dr. Lefever claims that:

“Behind any addict of any kind will be a compulsive helper, or a bunch of them, taking responsibility for them. The compulsive helpers try to solve problems and ferret out information on causes and treatments. They give incessant advice and generally get in the way of addicts having any chance of learning or doing things for themselves – which, ultimately, are the only things that are going to help. Those of us who are afflicted by it go out of our way to give uninvited help. We want to feel useful and constructively helpful. These are admirable characteristics. But they can be very destructive when they are applied without thought to the consequences…When people have too much done for them, they fail to develop their own skills. They become part of the dependency culture”.

Dr. Lefever and psychologists at the University of Kent have published a number of empirical studies on addiction including compulsive helping. In a study led by Professor Geoffrey Stephenson and published in a 1995 issue of the journal Addiction Research, the researchers evaluated addiction in 16 behavioural areas on 471 patients (using 191 male addicts and 281 female admitted to Lefever’s Promis Recovery Centre). The addicted patients’ questionnaires were subjected to a factor analysis and results showed there to be two fundamentally different types of addiction labeled as ‘nurturance’ and ‘hedonism’. ‘Nurturance’ included caffeine, work, exploitative relationships (submissive), shopping, exercise, food bingeing, food starving and compulsive helping. ‘Hedonism’ included alcohol, nicotine, recreational drugs, gambling, exploitative relationships (dominant), sex, and prescription drugs.

A follow-up study published in 2004 by Stephenson and Lefever in the journal Addictive Behaviors, confirmed these earlier results but also suggested that ‘hedonism’ could further be divided into a ‘drug use’ factor and an ‘interpersonal dominance’ factor. The nurturance addictions comprised of both ‘self-regarding’ and ‘other-regarding’ factors. A more recent study in a 2010 issue of Addictive Behaviors by Dr. Vance MacLaren and Dr. Lisa Best confirmed the results among a student population (n=938). Despite this empirical research, it should be remembered that all of the data on compulsive helping has been done using the instrument that Lefever and his colleagues developed. There’s certainly a need for research to be carried out with instruments that weren’t developed and/or carried out by the people who have a vested interest in the ‘compulsive helping’ construct.

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Craig, R. (2012). Compulsive helping. Located at: http://www.piecebypiecerecovery.co.uk/index.php?pageid=8

Griffiths, M.D. & Larkin, M. (2004). Conceptualizing addiction: The case for a ‘complex systems’ account. Addiction Research and Theory, 12, 99-102.

Haylett, S., Stephenson, G.M. & Haylett, S. (2004). Covariation in addictive behaviours: A study of addictive orientations using the Shorter PROMIS Questionnaire. Addictive Behaviors, 29, 61-71.

Larkin, M. & Griffiths, M.D. (2002).  Experiences of addiction and recovery: The case for subjective accounts. Addiction Research and Theory, 10, 281-311.

Larkin, M. & Griffiths, M.D. (2004). Dangerous sports and recreational drug-use: Rationalising and contextualising risk. Journal of Community and Applied Social Psychology, 14, 215-232.

Larkin, M., Wood, R.T.A. & Griffiths, M.D. (2006). Towards addiction as relationship. Addiction Research and Theory, 14, 207-215.