In two previous blogs on the sexual paraphilias of salirophilia (i.e., deriving sexual arousal from soiling or disheveling the object of their desire) and urophilia (i.e., deriving sexual arousal from the sight or thought of either the act of urination or the urine itself) I briefly made reference to omorashi (i.e., deriving sexual pleasure from having a full bladder). Dr. Anil Aggrawal in his 2009 book Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices defines omorashi more specifically as being sexually aroused “from having a full bladder or a sexual attraction to someone else experiencing the discomfort of a full bladder” and also notes that it is “a fetish subculture predominantly seen in Japan”. Frances Twinn’s 2007 book, Miscellany of Sex also notes:
“[Omorashi is] mainly Japanese phenomenon, where a full bladder and wetting oneself in public causes arousal. Game shows and sex trade workers in Japan cater in large numbers to this fetish. Followers can also turn to Wet Set Magazine, an Australian-based publication aimed mainly at western practitioners”
In an online article at Listverse about the ‘top ten’ most bizarre fetishes, omorashi made an appearance in the number 10 spot and claimed (using information lifted from the Wikipedia entry on omorashi) that:
“For [omorashi] fetishists, climax usually coincides with the moment of relief and embarrassment experienced when the desperate individual loses bladder control. Though there is a small community devoted to such fetishism outside of Japan, it is usually overshadowed by the more hardcore fetishes, urolagnia and urophagia. Most omorashi videos are among the most softcore of erotica, featuring innocent young women, fully clothed, who have gotten themselves into an embarrassing bathroom situation. Commonly featured are schoolgirls, female working professionals, and other women attempting to look dignified before succumbing to the urge to childishly wet themselves”.
The Wikipedia entry is a little more detailed and claims that:
“Outside of Japan, it is not usually distinguished from urolagnia (urine fetish), though they are different things. Westerners who do make the distinction commonly use phrases such as ‘bladder desperation’ or ‘panty wetting’. The Japanese language term from which the subculture’s name is derived means ‘to wet oneself’ literally translated, ‘leaking’. The word is also occasionally romanized as ‘omorasi’ in the Kunrei-shiki romanization system”.
In researching this blog I came across a dedicated omorashi website (Omorashi.org) that describes itself as a softcore fetishist community that focuses on omorashi practices as well as other urophilic activities and claims to host over 525GB worth of videos and images. Another dedicated website is the ‘And The Worst Thing Is All That Juice I Drank’ run by a self-confessed omorashi fetishist, and features lots of omorashi fan fiction and fan art. The website owner says:
“My omorashi fetish is rather specific. I generally prefer desperation with accidental wetting (basically, just unintentional), clothed, male rather than female, nonsexual for the victim, and I really like seeing their mortification during and afterwards. So my posts will probably be biased toward that kind of thing. This is really just a place for me to indulge, but you are more than welcome to come along for the ride if you happen to enjoy it!”
The Wikipedia article also makes the point that:
“Most fetish activities concerning the use of bodily waste are considered by the general public as ‘hardcore’, taboo, or edgeplay. However, because the object of the fetish is clothed incontinence, omorashi videos do not feature direct sexual contact. The focus on clothed rather than overtly sexual images makes garment fetishism a prominent feature in most omorashi erotica: commonly featured outfits include those worn by schoolgirls, female working professionals, and other women attempting to look dignified before succumbing to the need to urinate”.
In Japanese subculture, there are a number of different ways by which the omorashi fetish can be practiced including ‘yagai’ and nappies (i.e., diapers). According to Wikipedia, ‘omorashi yagai’ translates as “to wet oneself outdoors (or publicly)”. Another variation of this is ‘yagai honyo’ that refers to outdoor (i.e., public) urination where the person removes their clothes in public to urinate. The Wikipedia article also claims that the practitioners of yagai honyo are similar to graffiti artists in that they engage in a public act without being caught. The practice of urinating in public while wearing a nappy (instead of underpants or knickers) is known as ‘oshime omorashi’ (as the literal translation is “to wet oneself in a diaper”). The article also claims that:
“Diapers may be favorable for public wetting because they render it more discreet and eliminate mess, and their use is not limited specifically to those with a diaper fetish. However, omorashi fetishists specifically interested in this aspect of the subculture could be considered a Japanese variation of the diaper lover community”.
An online article on omorashi at the Nation Master website also notes:
Depending on one’s role in an omorashi scenario (as the wetter or the watcher) these acts could be variously considered a form of sadism, masochism, sadomasochism, or erotic humiliation. It is worth noting that these scenarios almost invariably feature female wetters over males, and that the focus generally falls on the wetter’s tendency toward the irrepressible submissive qualities commonly associated with feminine weakness. In Japan, these attitudes are recognized as belonging to the wider archetyp of moe (pronounced “mo-eh”) fetishism. From this perspective, the incontinence serves as the essential, obvious sympathetic weakness that moe characters work hard to correct but never really succeed at getting rid of”.
To Excluding research on orgasm during urinary incontinence (see ‘further reading’ below for a couple of academic papers on the topic), I’ve come across very little that’s been written academically about omorashi. Dr. Christy Gibbs carried out her PhD on transgressing sexualities in Japanese animation and mentioned omorashi in passing but only as a type of Japanese sexual practice while talking about other Japanese-oriented animated pornography such as ‘tentacle rape’. Another academic paper that mentioned omorashi in passing was by Dr. Clarissa Smith in a 2009 issue of the journal Sexualities (in a paper exploring sexual cultures in the classroom), but again there was nothing of substance about omorashi itself. Maybe there’s more written in Japanese that I’ve been unable to access and/or understand. There’s certainly little written in English, even anecdotally.
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.
Gibbs, C. (2012). Transgressing sexualities in Japanese animation. University of Waikato, PhD. Located at: http://researchcommons.waikato.ac.nz/bitstream/handle/10289/6746/thesis.pdf?sequence=3
Hilton, P. (1988). Urinary incontinence during sexual intercourse: a common, but rarely volunteered, symptom. British Journal of Obstetrics and Gynecology 95, 377-381.
Khan, Z., Bhola A., & Starer P. (1988). Urinary incontinence during orgasm. Urology, 31, 279-282.
Listverse (2007). Top 10 bizarre fetishes. September 24. Located at: http://listverse.com/2007/09/24/top-10-bizarre-fetishes/
Nation Master (2013). Omorashi. Located at: http://www.statemaster.com/encyclopedia/Omorashi
Smith, C. (2009). Pleasure and distance: Exploring sexual cultures in the classroom. Sexualities, 12, 568-585.
Twinn, F. (2007). The Miscellany of Sex: Tantalizing Travels Through Love, Lust and Libido. London: Arcturus.
Wikipedia (2013). Omorashi. Located at: http://en.wikipedia.org/wiki/Omorashi
“Beards are like Marmite…you either love them or you hate them. Perhaps that’s why the gossip magazines go crazy when celebs like Brad Pitt and Johnny Depp take the natural approach to facial hair. For some beard afficianados, however, the love of beards goes one step further. Gay men and straight women alike with beard fetish, or pogonophilia, think there’s nothing more sexually attractive than a man with at least a five o’clock shadow” (Philia Phrenzy, May 2011).
In a previous blog, I looked at trichophilia, which according to Dr. Anil Aggrawal’s 2009 book Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices, is a sexual paraphilia (sometimes called trichopathophilia, hirsutophilia, and/or hair fetishism) in which individuals derive sexual pleasure and arousal from human hair (most commonly head hair). In that blog I also made reference to various sub-types of trichophilia including pogonophilia, a sexual paraphilia in which individuals derive sexual pleasure and arousal from beards. As with trichophilia more generally, the source of sexual arousal in pogonophilia may be derived from viewing, touching, or (in extreme cases) eating beard hair. A few online definitions of pogonophilia claim that it is “abnormal affection towards beards”. The online Urban Dictionary defines pogonophilia as:
“The admiration or promotion of people, usually males, who wear a facial beard. From pogon, Greek for beard”
Surprisingly, pogonophilia as an individual sexual paraphilia is not referred to anywhere in either Dr. Brenda Love’s Encyclopedia of Unusual Sex Practices or Dr. Anil Aggrawal’s Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices. Dr. Love notes that some hair fetishes are more favoured by particular genders. My own research into pogonophilia appears to indicate that sexual arousal for beards can be found among women and gay men. However, I have yet to come across a single piece of empirical research on the topic. Most of the evidence appears to be anecdotal. For instance, the cult novelist and multi-media artist Kris Saknussemm (who has written about various fetishes) recalled:
“Once, interviewing a woman with this fetish, I showed her four pictures of naked men: a well-endowed eighteen-year-old model, an extremely thin bearded man in his early thirties, a heavily muscled former professional athlete in his late forties, and Peter North, the porn star. Asked to choose the most ‘virile and masculine’ of the group, she selected the bearded man instantly. What I didn’t tell her was that the bearded man had terminal cancer and was quite seriously ill. Her selection directly defies the view that our choices of “attractiveness” are driven by an instinctual appraisal of health and reproductive capacity. When I presented a Photoshop-modified picture of the man without his beard, she no longer recognized him. In fact, she was repelled”.
To my knowledge, only one academic has written about beard fetishes at any length. Dr. Mark Johnston published a 2011 book entitled Beard Fetish in Early Modern England. I have to admit I didn’t read the book because from the various online summaries I read, I didn’t think there would be much in the way of psychological insight. For those interested, the book focuses on representations of beards in English Renaissance culture. More specifically:
“(The) study elucidates how fetish objects validate ideological systems of power by materializing complex value in multiple registers. Providing detailed discussions of not only bearded men but also beardless boys, bearded women, and half-bearded hermaphrodites, author Mark Albert Johnston argues that attending closely to early modern English culture’s treatment of the beard as a fetish object ultimately exposes the contingency of categories like sex, gender, age, race, and sexuality…Johnston’s reading of Marxist, Freudian, and anthropological theories of the fetish phenomenon acknowledges their divergent emphases—erotic, economic, racial and religious—while suggesting that the imbrication of diverse registers that fetish accomplishes facilitates its cultural and psychic naturalizing function”.
In my search for information about pogonophilia, I came across a few websites run by self-confessed pogonophiles. For instance, the Girls Who Love Beards Club website is dedicated to women’s love for the beard. The website’s homepage offers what is deemed to be the best advice the website’s owner had ever been given:
“A man who can grow a beard is the kind of man you want to be with because a man who has the patience to grow a beard, has the patience to deal with your shit”.
The Pogonologist website focuses on “more-or-less interesting, at-times humorous, and always sporadic musings on the Beard as a Medium of Communication”. The Men With Beards website was started by its owner “to nourish a fetish developed in 2011. It has photos of men, known and unknown, but all with beards”. Unfortunately, none of these dedicated pogonophilic websites provided any information on the psychology or etiology of the fetish. I came across dozens of self-confessed sexual love of beards on many different websites. Again, few of these gave any insight as to how and why they have beard fetishes but do add credence to the existence of the fetish.
- Extract 1: “I have a thing for beards. I think they are ridiculously sexy and mysterious. A boy can hide any imperfections behind it and it’s an instant invitation for a girl like me to touch a man’s face…I do believe that a beard makes a man ten times more attractive than without. Add some glasses and floppy hair, and I’m already imagining you naked”
- Extract 2: “I don’t know what it is, but I feel this fire burning almost, inside me when I see, or am around a male with a beard. I think it’s absolutely attractive. The sexiest part to a man…I get so excited. It’s odd, but I can’t help it. All my friends think I’m ‘messed up’ that I would be physically and sexually attracted to men with facial hair. I once thought Jesus Christ was sexy, because of his beard. It’s odd”
- Extract 3: “The fixation on bearded men. Guilty as charged. I dig facial hair on men. However I think this is more a preference rather than a fetish. I don’t eliminate men that I date based on their facial hair. Also maybe it’s only a fetish if you can’t sleep with a man or get aroused unless he has a beard”.
- Extract 4: “I have a thing for guys with beards (not the Santa kind of ones, but the not-shaved-for-some-days kind). Unfortunately in this country, the gay guys here have a strange perception ‘HAIR = BAD’…In fact, I am ONLY attracted to guys with le facial hair”
- Extract 5: “I’m a gay guy and for me a guy’s gotta have [a beard] for it to work. It can be a full beard, mustache, goatee, a soul patch or even 5 o’clock shadow, but there’s gotta be something for it to work for me! My partner of 10 years has a great, neatly trimmed full beard and mustache and he always laughs because he says that even after 10 years together he says that more often than not, when we chat I’m looking at his ‘stache or beard more than into his eyes. I dunno what it is; it’s really masculine and sexy to me, and when a guy with facial hair kisses you or nuzzles your neck – wow!”
- Extract 6: “I have a confession. I have a fetish….It’s a beard fetish. That’s right – beards excite me, and frankly I don’t think this particular fetish gets enough media attention. Maybe it’s because fetishes are, in general, associated with men, and a beard fetish [is] primarily a chick thing, although I’m sure there are a number of gay men who are familiar with beard power”.
- Extract 7: “I can’t get enough of [beards]. Some are just down right sexy. They do turn me on so much. MMMMM. They are just wonderful and tasty”
One of the more detailed insights I came across was written by E. Bealmear (a female) in an article simply entitled The Beard Fetish. Below is a small extract which suggests the origin of the fetish began in childhood and was most likely based on the fact that her father had a beard (and was obviously someone she loved):
“Now, I’m not talking about just any kind of facial hair. A mustache never put a bop in my hop…A goatee is a step in the right direction…If you’re interested in seeing a beard that knows how to work it, look no further than the actor Jason Lee…His perfectly shaped beard makes even a silly movie like Vanilla Sky worth watching…I can’t say for sure where or when my beard fetish began, but I have a fairly good idea, and I’m almost ashamed of myself because it’s such a Freudian cliché. My father had a beard while I was growing up, a dark-haired beard, my favorite kind, and much as I hate to admit it, I’m sure that’s the reason I find myself planet struck when I see one. My sister and our friend Holly, whose father also has a beard, have the same sort of peculiar attraction toward facial hair. We constantly badger our male friends and co-workers, telling them that they should grow one, and we spend way too much time imaging what they would look like if they actually indulged our fantasies. It is sort of bizarre; the power beards have over me. I’m such a sucker for facial hair that often my attraction level is completely based around whether a man picks up a razor that morning or not…Men with beards are what I think about when I’m not wearing underwear…I know a number of women who are turned off by beards…Frankly, I don’t really understand these beard hating women, given the fact that beards are part of our primal history”.
Sean Johnson has also produced a series of gay “Beard Love” videos because of his self-admitted fascination with facial hair on men and it’s connection to society. He wrote in an online article on ‘beard love’ that:
“The connection I make with facial hair is that it is usually worn by men of power: the father, the leader, and other iconic masculine figures throughout history, fantasy, and mythology. This idea of power in the wearer of the beard connects to many ideas I have about masculinity and manliness. Taking these ideas, I have looked at the way men and facial hair are both connected to masculinity, and how the beard has become fetishized by the bear community. I see the homosexual man with facial hair as a symbol for this masculinity that has been stripped from mainstream gay culture (especially American gay culture). The queer bearded man then becomes the icon of masculinity and representation of what I feel is somewhat lacking in gay culture. Aside from the social fetish connection to masculinity, I feel that the beard and the role of the father are connected with a form of dominance in the family…The beard is clearly a fetish for me as well. I love the way it feels on a man’s face, I love how it can grow, change shape, color, size, and make a man look older than he is. These differences are all dependent on the wearer (how he decides to manipulate his beard’s features), and the shaping and growth of it allows a person to change their look and ultimately their identity, making the way they are viewed by others changeable and fluid”.
As with many other sexual paraphilias and fetishes that I have examined in my blog, we know next to nothing about the incidence, prevalence, and etiology of pogonophilia, and in all honesty, we may never know. Although I am personally interested on the psychology of beards (for obvious reasons given my photos at the top of the page), I doubt pogonophilia will be a topic that ever gets priority in calls for research funding.
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.
The Atlantic (2009). Pogonophilia: Busted. July 12. Located at: http://www.theatlantic.com/daily-dish/archive/2009/07/pogonophilia-busted/198899/
Cotton, K. (2011). Who can resist a man with a beard? Philia Phrenzy, May 11. Located at: http://philia-phrenzy.blogspot.co.uk/2011/05/who-can-resist-man-with-beard.html
Johnston, M.A. (2011). Beard Fetish in Early Modern England. London: Ashgate.
Love, B. (2001). Encyclopedia of Unusual Sex Practices. London: Greenwich Editions.
One of the more unusual paraphilias I have come across in my reading is harmatophilia. Dr. Anil Aggrawal in his 2009 book Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices defines harmatophilia as individuals that derive sexual pleasure and arousal from sexual incompetence or mistakes, usually in female partner. Other definitions I have come across are similar such as the Sensual Swingers website that defines harmatophilia as sexual arousal “from a sexually inadequate partner” whereas the Inspire Jessamae website simply says it is a “penchant for partners who are useless in bed”. The Right Diagnosis online medical website describes harmatophilia more widely as referring to (i) sexual urges, arousal or fantasies involving breaking rules or making mistakes, and (ii) recurring intense sexual fantasies involving breaking rules or making mistakes. However, there is a general consensus amongst most harmatophilia definitions that the mistakes that are most sexually arousing are from sexual inadequacy and/or sexual incompetence. Dr. Brenda Love in her Encyclopedia of Unusual Sex Practices notes that:
“Harmatophilia refers to one who is aroused by mistakes or rules being broken…A great majority of men are aroused by their partner having less sexual knowledge or competence than themselves. This bolsters their self-esteem and makes them feel more secure in the relationship. Of course, this preference for sexually inept females can cause some women to either feign incompetence or prevent them from wanting to experiment or learn more about sex”.
As far as I am aware, there is absolutely no empirical evidence relating to harmatophilia – not even a single case study (although all mentions I have come across assume that it is predominantly male-based), so this appears to be yet another sexual paraphilia that has been created as a theoretical opposite to a legitimately known phobia (i.e., harmatophobia that refers to those people who have an abnormal fear surrounding sin, and making errors and mistakes). However, there is another sexual paraphilia that might be psychologically and conceptually similar to harmatophilia, and that is parthenophilia, which Dr. Aggrawal defines as individuals who are sexually attracted to (and aroused by) virgins.
Dr. Brenda Love in her Encyclopedia of Unusual Sex Practices noted that sex with a virgin is avoided by some people while other individuals “find it novel, feeling honored, enjoy the feeling of power in defiling a virgin, are relieved that they cannot be compared with anyone else, or have a religious ethic that would create prejudice against a partner who was not a virgin”. She also cites some evidence that some brothels and bordellos often catered to men who paid extra to have sex with a virgin female. A brief entry on parthenophilia at the London Fetish Scene website claims that In 18th and 19th century England “there was a somewhat sordid trade in the prostitution of girls or young women who were claimed to be virgins (often involving the attempted reconstruction of the hymen in order to obtain a high price for her deflowering more than once)”. There is an implicit assumption that such practices no longer exist but I have come across more contemporary anecdotal accounts that suggest that some men who regularly visit prostitutes prefer virgins and are willing to pay extra for such a service.
The historian and writer Hanne Blank made a few references to parthenophilia in her 2007 book Virgin: The Untouched History. She describes parthenophilia as “a pronounced sexual interest in virginity or virgins” and that it “is a genuine, observable sexual predilection”. Although she admits there are no studies on the topic, she then goes on to note that:
“The reason I propose we have for so long lacked a term for this particular erotic attraction is that unlike sexual interest in children, a sexual interest in virgins is something our culture considers normal, acceptable, and ideologically correct….We do not know how many people experience it. We do not know when the desire begins to be felt, whether those feel it perceive it as an innate or learned preference. We have no idea how many people have pursued specific sexual encounters on account of this desire, or what kind of sexual encounters they have pursued. No research into its possible role in motivating sexual assault or abuse has been conducted. We do not know to what extent it does or does not play a role in child sexual abuse or child prostitution. Even Sigmund Freud did little more than glance at it”.
There are a few online articles that write about the ‘virginity fetish’ (such as Tracy Clark-Forty’s article for Salon magazine, and Steve Mathonnet-VanderWell’s article in The Twelve) but none of these really concern virginity fetish as such as they are more concerned with the ‘purity’ movement (i.e., people not having sex until they get married) and the ‘fight against pornography’. There are also various online discussions on online sexual forums that discuss parthenophilia (although no-one actually calls it that). For instance, one man posted a question asking if anyone had a virgin fetish and it generated some interesting responses. Here are two extracts:
- Extract 1: “I have a virgin fetish, but with real virgins! (Born again virgins don’t count!) (Pretending is not the same either!). And not just any virgins, Asian girl virgins!” (Cy83rDra90n).
- Extract 2: “To tell the truth, this sounds at least very disrespectful, and kind of sick to me. It’s a stereotypical behavior that women have complained about and fought against for centuries. If you’re just looking to carve notches, I think your virgin partners should have a chance to carve a notch also – and I could suggest where they should carve it” (daletom)
According to the Right Diagnosis website, treatment for harmatophilia (and by default parthenophilia) is “generally not sought unless the condition becomes problematic for the person in some way and they feel compelled to address their condition”. If harmatophiles and/or parthenophiles exist, it would appear that they accept their fetish and manage to achieve gratification in an appropriate and non-problematic way.
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.
Blank, H. (2007). Virgin: The Untouched History. New York: Bloomsbury.
Clark-Forty, T. (2009). The virginity fettish. Salon, May 16. Located at: http://www.salon.com/2009/05/16/purity_myth/
Cotton, K. (2007). Harmatophilia heaven. Philia Phrenzy, March 2. Located at: http://philia-phrenzy.blogspot.co.uk/2007/03/harmatophilia-heaven.html
Love, B. (2001). Encyclopedia of Unusual Sex Practices. London: Greenwich Editions.
Mathonnet-VanderWell, S. (2012). Virgin fetish. The Twelve, April 24. Located at: http://the12.squarespace.com/steve-mathonnet-vanderwell/2012/4/24/virgin-fetish.html
Right Diagnosis (2012). What is harmatophilia? November 6. Located at: http://www.rightdiagnosis.com/h/harmatophilia/basics.htm
In previous blogs I have looked at anorexia nervosa in the context of addictive eating disorders, ‘tanorexia’ (excessive tanning) and ‘fanorexia’ (excessive following of a celebrity or sports team). Today’s blog takes a brief look at ‘sexual anorexia’ that according to Dr. Douglas Weiss in his 1998 book Sexual Anorexia, Beyond Sexual, Emotional and Spiritual Withholding, typically refers to “the active, almost compulsive withholding of emotional, spiritual and sexual intimacy from the primary partner”. The 12-Step group Sex and Love Addicts Anonymous offers this definition and analogy:
“As an eating disorder, anorexia is defined as the compulsive avoidance of food. In the area of sex and love, anorexia has a similar definition: Anorexia is the compulsive avoidance of giving or receiving social, sexual, or emotional nourishment”
A paper by Dr. Randy Hardman and Dr. David Gardner in a 1986 issue of the Journal of Sex Education and Therapy compared anorexia nervosa and sexual anorexia. They highlighted the four most significant characteristic similarities of these self-perpetuating disorders from both an intrapsychic and interpersonal level. These were (i) control (i.e., overt personal control and covert relationship power), (ii) fear (i.e., fear of losing control and fear of personal sexuality), (iii) anger (i.e., passive and active expressions of anger based on devaluation), and (iv) justification (i.e., an elaborate system of denial, delusion, and misperception).
Along with Dr. Weiss, most of the key writings on the topic have been written by Dr. Patrick Carnes (the author of many articles and books on sex addiction). Dr. Carnes defines sexual anorexia as: “an obsessive state in which the physical, mental and emotional task of avoiding sex dominates one’s life. Like self-starvation with food, deprivation with sex can make one feel powerful and defended against all hurts.” In a 1998 paper in the journal Sexual Addiction and Compulsivity, he also notes that: “the term “sexual anorexia” has been used to describe sexual aversion disorder [in the Diagnostic and Statistical Manual of Mental Disorders], a state in which the patient has a profound disgust and horror at anything sexual in themselves and others”.
According to the Wikipedia entry on sexual anorexia, the term ‘sexual anorexia’ has been around for over 35 years, and the first use it the term is generally attributed to psychologist Nathan Hare, a psychologist who coined the term in his 1975 PhD thesis. (However, I have failed to track this down, and none of the academic papers I have read on sexual anorexia ever mention Hare).
Dr. Carnes claims to have identified three causative factors in the formation of sexual anorexia. These are (i) a probable history of sexual exploitation or severely traumatic sexual rejection, (ii) family history of extremes in thought or behavior (often very repressive/religious or it’s polar opposite of “anything-goes” permissiveness), and (iii) cultural, social or religious influences that view sex negatively and supports sexual oppression and repression. Dr. Weiss adds that there are three key criteria in the formation of anorexia: (i) sexual abuse, (ii) attachment disorder with the opposite sex parent and (iii) sex addiction.
In his 1997 book Sexual Anorexia: Overcoming Sexual Self-Hatred, Dr. Carnes views the symptom cluster of the sexual anorexic as primarily sexual and includes: (i) a dread of sexual pleasure, (ii) a morbid and persistent fear of sexual contact, (iii) obsession and hyper-vigilance around sexual matters, (iv) avoidance of anything connected with sex, (v) preoccupation with others being sexual, (vi) distortions of body appearance, (vii) extreme loathing of body functions, (viii) obsessional self-doubt about sexual adequacy, (ix) rigid, judgmental attitudes about sexual behaviour, (x) excessive fear and preoccupation with sexually transmitted diseases, (xi) obsessive concern or worry about the sexual intentions of others, (xii) shame and self-loathing over sexual experiences, (xiii) depression about sexual adequacy and functioning, (xiv) intimacy avoidance because of sexual fear, and (xv) self-destructive behavior to limit, stop, or avoid sex.
The 1998 paper published in the journal Sexual Addiction and Compulsivity by Dr. Carnes is one of the very few in the literature to collect empirical data. The data were collected from 144 patients at his treatment clinic that were diagnosed with sexual anorexia. Of these, 41% were male and 59% female aged between 19 and 58 years (all of whom were Caucasian). The main findings were that:
- 67% reported a history of sexual abuse
- 41% reported a history of physical abuse
- 86% reported a history of emotional abuse
- 65% reported members of the immediate family as some type of addict
- 40% reported having a sex addict in the immediate family
- 60% described their family as “rigid”
- 67% described their family as “disengaged”
Carnes also reported that over two-thirds of the sexually anorexic population claimed to have other compulsive and/or addictive problems including alcoholism (33%), substance abuse (25%), compulsive eating (25%), caffeine abuse (26%), nicotine addiction (23%), compulsive spending (22%), and/or bulimia/anorexia with food (19%). Of most interest was the fact that Carnes compared his group of sexual anorexics with a group of sex addicts (also from his treatment centre). Carnes concluded that:
“By contrasting that profile with data from sex addicts who were in the same patient pool, some important contrasts can be made. The data for sex addicts and sexual anorexics were very parallel in terms of family system, abuse history, and related patterns of addiction, compulsion, and deprivation. Even the criteria for sex addiction and sexual anorexia have important parallels in terms of powerlessness, obsession, consequences, and distress…Such comparisons tend to confirm the proposition that extreme sexual disorders stem from many of the same factors and are variations of the same illness. Of equal importance is the possibility that extreme behaviors in various disorders (food, chemical, sexual, financial) whether in excess or in deprivation are for many patients interchangeable parts representing much deeper patterns of distress”
Finally, if you would like to know if you are sexually anorexic, you can take this simple test that I found at the Freedom In Grace website (and appears to be based on the world of Weiss and Carnes). If you endorse five or more of the following nine statements “you or your partner are currently struggling with sexual anorexia”.
- Withholding love from partner
- Withholding praise or appreciation from partner
- Controlling by silence or anger
- Ongoing or ungrounded criticism causing isolation
- Withholding sex from your partner
- Unwillingness or inability to discuss feelings with partner
- Staying so busy that they have no relational time for the partner
- Making the problems or issues about your partner instead of owning their own issues
- Controlling or shaming partner with money issues
Carnes, P. (1997). Sexual Anorexia: Overcoming Sexual Self-Hatred. Center City, MN: Hazelden.
Carnes, P. (1998). The case for sexual anorexia: An interim report on 144 patients with sexual disorders. Sexual Addiction and Compulsivity, 5, 293–309.
Hardman, R.K. & Gardner, D.J. (1986). Sexual anorexia: A look at inhibited sexual desire. Journal of Sex Education and Therapy, 12, 55-59.
Nelson, Laura (2003). Sexual addiction versus sexual anorexia and the church’s impact. Sexual Addiction and Compulsivity, 10, 179–191.
Sex and Love Addicts Anonymous (undated). Sexual anorexia. Located at: http://www.slaauk.org/files/anorexia.pdf
Weiss, D. (1998). Sexual Anorexia, Beyond Sexual, Emotional and Spiritual Withholding. Fort Worth, TX: Discovery
Weiss, D. (2005). Sexual anorexia: A new paradigm for hyposexual desire disorder. Located at: http://www.sexaddict.com/eBooks/SAeBk.pdf
Wikipedia (2012). Sexual anorexia. Located at: http://en.wikipedia.org/wiki/Sexual_anorexia
While researching a blog on Cotard Syndrome I came across a case study of Alice in Wonderland Syndrome published by Dr. Eric Bui and his colleagues published in the Journal of Neuropsychiatry and Clinical Neurosciences. They wrote:
“A 74-year-old retired French executive was admitted to hospital for major depressive disorder with psychotic features triggered by prostate surgery 3 months previously…The patient was described by his wife as usually sociable, jolly, scrupulous and a perfectionist. On admission, the patient presented with a depressed mood, loss of pleasure and interest, disordered sleeping, severe fatigue, loss of appetite, psychomotor retardation, and persecutory (being broken into and burgled) as well as somatic (his stools being contaminated) delusions…Ten days after admission, the patient exhibited new delusional symptoms: he believed his hands and feet were shorter than usual and was convinced that his clothes had shrunk. Organic causes (intracranial tumor and infection, thyroid disease, and nutritional deficiency) were ruled out by physiological, laboratory, neurological, and ophthalmological investigations…The patient continued to be delusional and severely depressed…He was discharged on day 45 of hospitalization with complete remission”.
As can be probably be surmised from this brief case study, Alice in Wonderland Syndrome (AIWS) is a non-contagious disorientation disorder and refers to when a person’s sense of body image, vision, hearing, touch, space, and/or time are distorted. AIWS sufferers typically experience micropsia (a neurological condition that affects human visual perception in which objects are perceived to be smaller than they actually are and make people feel bigger than they are) or macropsia (a neurological condition that affects human visual perception in which objects are perceived to be larger than they actually are and makes people feel smaller than they actually are). They may also experience feelings of paranoia.
AIWS has nothing to do with a malfunctioning of the eyes, but is a change in how the world is perceived with those suffering seeing objects the wrong shape or size. Arguably the most disturbing symptom for sufferers is the perceived alteration of their body image. AIWS sufferers become confused about the size and shape of their body (or specific body parts). Time perception may also be affected with many sufferers reporting that time seems to pass incredibly slowly as if they were on an LSD trip. Sufferers (most commonly thought to be children and migraine sufferers) often become very frightened, scared and panic-stricken, although it can often be treated successfully through complete rest and relaxation (and in most cases is a relatively temporary condition). Some research appears to indicate that AIWS can be due to abnormal amounts of electrical activity that causes blood to flow abnormally in the brain areas that process texture and visual perception.
AIWS was named after the 1865 book Alice’s Adventures in Wonderland by Lewis Carroll, but is also known as Todd Syndrome named after the psychiatrist who first wrote about the condition in a 1955 issue of the Canadian Medical Association Journal. (Interestingly, a short article by Dr. Klaus Podoll and Dr. Derek Robinson in The Lancet from 1999 highlighted that Carroll was a migraine sufferer and that his book may have been inspired by his own personal experiences!). Todd’s original paper reported five patients (of which four were female) all of who suffered from severe migraines. All of these patients described their body, body parts and/or objects around them changing in size (with two of them also having time disorientation too). On the basis of these five cases, Todd coined the term ‘Alice in Wonderland Syndrome’ (although such hallucinations had been noted three years prior to this by Dr. C.W. Lippman in a 1952 paper on “certain hallucinations peculiar to migraine”).
The condition has also been associated with other medical conditions besides migraines, including (mononucleosis) infections, and severe depression, and (in extreme cases) brain tumours. A paper by Dr. Nabil Kitchener in a 2004 issue of the International Journal of Child Neuropsychiatry also noted that AIWS can also be the presenting manifestations in some patients with epilepsy, hyperpyrexia (i.e., extremely elevated body temperatures), typhoid encephalopathy, and other psychiatric disorders. In a 2005 paper in the journal European Neurology, Dr. Valmantas Budrys also reported that AWS could occur in hypnagogic, delirious states, encephalitis, cerebral lesions, drug intoxication, and schizophrenia.
In a literature review on organic depersonalization in the Journal of Neuropsychiatry and Clinical Neuroscience, Dr. Michelle Lambert and her colleagues examined the literature on AIWS. The noted that since Todd’s case studies were published, the subsequent published case reports of body image distortion associated with AIWS, often included depersonalization and/or derealization. They suggested that such symptom were consistent with parietal lobe pathology. More specifically, they argued that the frequent accompanying symptoms of fear, anxiety, and panic implicate the role of the temporal lobe. Dr. Kitchener’s 2004 paper also concludes that AIWS manifestations are due to disturbed function of either medial temporal, hippocampal, tempro-occipital or tempro-parieto-occipital regions of the brain based on the research of Dr. Kuo and colleagues published in a 1998 study in the Pediatric Neurology journal.
However, the case study published by Dr. Bui and his colleagues that I began this blog suggested that AIWS may be similar to Cotard Syndrome (CS). As the authors noted, that:
“Cotard Syndrome comprises any one of a series of delusions ranging from the belief that one has lost organs to the conviction that one is dead. Since Cotard’s syndrome is also usually associated with severe depression and improves rapidly with ECT [electro-convulsive therapy], it is possible that the somatic delusions experienced by our [AIWS] patient were a variant of this syndrome. According to our observations, the psychotic features of major depressive disorder might present in the form of Alice in Wonderland syndrome although the relationship between this syndrome and Cotard’s syndrome remains to be determined”.
Depending upon co-morbid conditions, medical treatments include beta blockers, anti-depressants, and anti-convulsants, AIWS has also been reported in both the Pediatric Infectious Diseases Journal (1987) and British Journal of Ophthalmology (1992) as one of the early signs of the Epstein-Barr Virus, one of the most common human viruses and of the herpes family. Most commonly it causes glandular fever but is associated with various forms of cancer including Hodgkin’s lymphoma. Chronic AIWS is untreatable and time is the only healer. Sharing experiences with other sufferers is also thought to be therapeutically beneficial (although I know of no clinical support for the claim).
Budrys, V. (2005). Neurological eponyms derived from literature and visual art. European Neurology, 53, 171-178.
Bui, E., Chatagner, A. & Schmitt, L. (2010). Alice in Wonderland Syndrome in major depressive disorder. Journal of Neuropsychiatry and Clinical Neurosciences, 22, 352.e16-352.e16.
Cinbis, M. & Aysun, S. (1992). Alice in Wonderland syndrome as an initial manifestation of Epstein-Barr virus infection (case report). British Journal of Ophthalmology, 76, 316.
Eshel, G.M., Eyov, A., & Lahat, E., et al (1987). Alice in Wonderland syndrome, a manifestation of acute Epstein-Barr virus infection (brief report). Pediatric Infectious Diseases Journal, 6, 68.
Kew, J., Wright, A., & Halligan, P.W. (1998). Somesthetic aura: The experience of “Alice in Wonderland”. The Lancet, 351, 1934.
Kitchener, N. (2004). Alice in Wonderland Syndrome. International Journal of Child Neuropsychiatry, 1, 107-112.
Kuo, Y, Chiu, N.C., Shen, E.Y., Ho, C.S., Wu, M.C. (1998). Cerebral perfusion in children with “Alice in Wonderland” syndrome. Pediatric Neurology, 19, 105-108.
Lahat, E., Eshel, G., & Arlazoroff A (1990). “Alice in Wonderland” syndrome and infectious mononucleosis in children (letter). Journal of Neurology, Neurosurgery and Psychiatry, 53, 1104.
Lambert, M.V., Sierra, M., Phillips, M.L. & David, A.S. The spectrum of organic depersonalization: A review plus four new cases. Journal of Neuropsychiatry and Clinical Neuroscience, 14, 141-154.
Lippman, C.W. (1952). Certain hallucinations peculiar to migraine. Journal of Nervous and Mental Diseases, 116, 346-351.
Podoll, K., Ebel, H., Robinson, D., & Nicola, U. (2002). Obligatory and facultative symptoms of the Alice in wonderland syndrome. Minerva Medicine, 93, 287-293.
Podoll, K. & Robinson, D. (1999). Lewis Carroll’s migraine experiences. The Lancet, 353, 1366.
Rolak, L.A. (1991). Literary neurologic syndromes. Alice in Wonderland. Archives of Neurology, 48, 649–651.
Todd, J. (1955). The syndrome of Alice in Wonderland. Canadian Medical Association Journal, 73, 701–704.
From the university of perversity (Part 2): An A to Z of non-researched sexual paraphilias and strange sexual behaviours
In a previous blog I did an A-Z of sexual paraphilias about which we know almost nothing. Today’s blog takes a brief A to Z look at another 26 unusual and/or strange sexual behaviours where (as far as I am aware) there is absolutely no empirical or clinical research on the topic. The majority of the paraphilias below can be found in either Dr. Anil Aggrawal’s book Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices and/or Dr. Brenda Love’s Encyclopedia of Unusual Sex Practices (although a few were also taken from such sources as the Write World’s dedicated webpage on ‘philias’ and the online Urban Dictionary).
- Autodermatophagia: This behaviour involves eating one’s own flesh as a form of erotic auto-masochism. The only place I’ve seen this mentioned is in Dr. Aggrawal’s book and appears to be a sub-variant of autosarcophogy (i.e., self-cannibalism) that I covered in a previous blog.
- Brontophilia: This behaviour involves people who derive sexual arousal from thunderstorms. It was also the inspiration for the song Brontophilia (Satanic Anal Thunder) by the group Spasm (Google it if you don’t believe me!)
- Cryptoscopophilia: This is the desire to see behaviour of others in privacy of their home (although some sources claim it is not necessarily sexual). The One Look website lists three different websites that have definitions including the online Urban Dictionary that defines it as “the urge to look through the windows of homes upon walking past them. Usually done for sexual satisfaction/curiosity reasons”. This appears to be a sub-type of voyeurism.
- Dermaphilia: This is a behaviour in which the sexual stimulus for arousal comes from skin. The Sex Lexis definition website is a little more specific and claims that it is common among leather fetishists who becomes sexually aroused “when coming in direct contact with the skin or leather from animals or humans, from wearing leather clothing”.
- Ederacinism: This is possibly one of the most unbelievable behaviours on this list and refers to the tearing out of sexual organs by the roots as in a frenzied way to punish oneself for sexual cravings. This would appear to be a sub-variant of genital self-mutilation and/or Klingsor Syndrome (that I covered in previous blogs).
- Furtling: According to Dr. Aggrawal’s book, this behaviour involves the use of a person’s fingers underneath cut-outs in genital areas of photos as a way of gaining sexual arousal. It is also listed in a Spanish article on sexual paraphilias by Dr. Ruben Serrano in the Revista Venezolana de Urologia.
- Gynotikolobomassophilia: This apparently refers to sexual pleasure from nibbling on a woman’s earlobe (aural sex?). At least four websites list this as a bona fide sexual activity according to the One Look webpage.
- Hodophilia: This behaviour refers to individuals that derive sexual arousal from travelling (at least according to Dr. Aggrawal’s book). It is unclear whether this refers to modes of travelling (such as those who derive sexual pleasure from riding in cars or trains) or whether it refers to deriving sexual pleasure from being a tourist.
- Icolagnia: Again found in Dr. Aggrawal’s book and is defined as those individuals who derive sexual arousal from contemplation of, or contact with, sculptures or pictures. This would seem to overlap with more specific sexual paraphilias such as agalmatophilia (sexual arousal from statues and/or manquins) that I covered in a previous blog.
- Judeophilia: According to the Write World website, this behaviour involves “abnormal” sexual affection towards Jewish people. I have never come across this in any reputable sexual text.
- Kokigami: According to the online Urban Dictionary, this involves the wrapping of the penis in a paper costume. The roots of Kokigami apparently lie in the eighth-century Japanese aristocrats who practiced the art of Tsutsumi (i.e., a man wrapped his penis with silk and ribbons in elaborate designs as a gift to lovers. He would then enjoy the physical sensations as his lover carefully unwrapped her prize.
- Lygerastia: This is mentioned in Dr. Brenda Love’s sex encyclopedia and refers to tendency to being sexually aroused by being in darkness. This would appear to share psychological and behavioural overlaps with amaurophilia (sexual arousal from blindness) that I covered in a previous blog.
- Melolagnia: This behaviour refers to those individuals who derive sexual arousal from music (and listed as a sexual paraphilia by both Dr. Love and Dr. Aggrawal).
- Nanophilia: This refers to sexual arousal from having a short or small sexual partner. This is one of the few behaviours on this list that has been mentioned in an empirical research paper (as it was mentioned in the research on fetishes by Dr. C. Scorolli and colleagues in the International Journal of Impotence Research
- Oenosugia: According to Dr. Aggrawal, this behaviour refers to the pouring wine over female breasts and licking it off. If you type ‘oenosugia’ into Google you get only two hits (one of which is Dr. Aggrawal’s book).
- Phygephilia: I’m not sure how many people this could possibly refer to but Dr. Aggrawal defines this behaviour as sexual arousal from being a fugitive. The Inovun website defines it as “arousal from flight” (i.e., running away).
- Queening: According to Dr. Anil Aggrawal, 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”.
- Rupophilia: According to the online Kinkopedia this behaviour refers to a sexual attraction towards dirt (and presumably derives from the word ‘rupophobia’ that is a phobia towards dirt). This sexual paraphilia would seem to share similarities with mysophilia (i.e., sexual arousal from filth and unclean items) that I covered in a previous blog.
- Savantophilia: According to Dr. Aggrawal, this behaviour refers to those who are sexually aroused by mentally challenged individuals. The only case that I am aware of that could potentially fit such a description is Jimmy Saville (see my previous blog for details).
- Tripsophilia: According to the Sex Lexis website, this behaviour refers to being sexually arousal by being “messaged or otherwise manipulated”. Dr. Aggrawal describes the same behaviour as tripsolagnophilia.
- Undinism: Dr. Aggrawal simply describes this behaviour as individuals who derive sexual arousal from water. This appears to be another name for aquaphilia (that I covered in a previous blog).
- Vernalagnia: This is a seasonal behaviour and according to Dr. Aggrawal refers to an increase in sexual desire in the spring. Another online website simply defines it less sexually as “a romantic mood brought on by spring”.
- Wakamezake: This appears to be similar to oenosugia (above), and is a sexual term originating in Japan involving the drinking alcohol (such as sake) from a woman’s body. The Wikipedia entry on ‘food play’ provides a description: “The woman closes her legs tight enough that the triangle between the thighs and mons pubis form a cup, and then pours sake down her chest into this triangle. Her partner then drinks the sake from there. The name comes from the idea that the woman’s pubic hair in the sake resembles soft seaweed (wakame) floating in the sea”.
- Xenoglossophilia: I have yet to find this sexual act in any academic text but a few online websites define this as a sexual affection for foreign languages. I briefly mentioned this behaviour in a previous blog on xenophilia (sexual arousal from strangers) but asserted that such behaviour could hardly be classed as a sexual paraphilia.
- Yoni worship: This refers to the worship of the female genitals (yoni is the Sanskrit word for the vagina). There are some interesting articles on Yoni worship at both the Basically Blah and Tantric Serenity websites.
- Zeusophilia: I have yet to come across this behaviour in any reputable academic text, but a number of online websites (such as the Write World website) all claim that this behaviour refers to a sexual love of God or gods.
Gates, K. (2000). Deviant Desires: Incredibly Strange Sex. New York: RE/Search Publications.
Love, B. (2001). Encyclopedia of Unusual Sex Practices. London: Greenwich Editions.
Scorolli, C., Ghirlanda, S., Enquist, M., Zattoni, S. & Jannini, E.A. (2007). Relative prevalence of different fetishes. International Journal of Impotence Research, 19, 432-437.
Serrano, R.H. (2004). Parafilias. Revista Venezolana de Urologia, 50, 64-69
Write World (2013). Philias. Located at: http://writeworld.tumblr.com/philiaquirks
Gaming addiction has become a topic of increasing research interest. Over the last decade there has been a significant increase in the number of scientific studies examining various aspects of video game addiction. This has resulted in a wide-ranging selection of review papers focusing on different aspects of the topic. These include general literature reviews of video game addiction, reviews of online (as opposed to offline) gaming addiction, reviews of the main methodological issues in studying video game addiction, reviews of structural characteristics and their relationship with video game addiction, reviews of video game addiction treatment, reviews of video game addiction and co-morbidity/convergence with other addictions such as gambling addiction and Internet addiction, and miscellaneous review papers on very specific aspects of video game addictions such as social responsibility, screening instruments, or reviews refuting that video game addiction even exists.
Furthermore, the amount and the quality of research in the gaming addiction field has progressed much over the last decade but is still in its infancy compared to other more established behavioural addictions, such as pathological gambling. Today’s blog briefly provides a considered (and somewhat speculative) examination of what might happen in the gaming addiction field from a number of different standpoints (e.g., methodological, conceptual, technological). These are taken from a paper I recently published in Current Psychiatry Reviews with Dr. Daniel King (University of Adelaide, Australia) and Daria Kuss (Nottingham Trent University, UK). These trends were loosely modeled on a 2011 paper I wrote on the technological trends in gambling and published in Casino and Gaming International.
- There is likely to be an even bigger increase in empirical research into problematic video game playing and video game addiction. This will of course be dependent on both appropriate funding streams and/or whether gaming addiction ends up being included in future psychiatric disorder classifications (e.g., Diagnostic and Statistical Manual, International Classification of Diseases, etc.). Future research is likely to include more epidemiological and/or general population data on media use, leading to better insights into the onset and course of problematic video game play and addiction.
- Given the many different screening instruments that have been developed over the last decade, there is likely to be a refinement of video game addiction measures and greater consensus on its conceptualization, either as a single disorder and/or incorporated into other known disorders (e.g., impulse control disorder). This is also likely to lead to improved assessment tools based on such conceptualization(s).
- Measures of gaming use and subsequent behaviour are likely to diversify in terms of media use, including social networking sites (SNS) and associated Internet resources. Already, games such as Call of Duty and Battlefield 3 are being released with their own SNS (e.g., COD Elite) that track player behaviour and provide feedback to players as to how to improve their game (thus functionally reinforcing video game play and thus have implications for excessive and/or potentially addictive play).
- Given the pressure on media enterprises to ‘monetize’ their business and look for different revenue streams, there is likely to be even greater media convergence between gaming and other more profit-making activities such as gambling. Given the well established addictive potential of gambling, this may also have implications for the incidence of video game addiction.
- Gaming on the move is likely to be a big growth area that may have implications for excessive gaming via ‘convenience’ hardware such as handheld gaming consoles, PDA devices, mobile phones, tablet computers, and MP3 players.
- Given the fact that the Internet is gender-neutral, there is likely to be increasing feminization of gaming where increasing numbers of females not only engage in the playing of online games, but also develop problems as a result. Casual gaming online is already popular among females. However, the biggest difference between male and female gaming is likely to be content-based (e.g., males may prefer competitive type gaming experiences whereas females may prefer co-operative type gaming experiences).
- Given the increasing number of research teams in the gambling field being given direct access to gambling companies behavioural tracking data, there is likely to be an increasing number of such collaborations in the gaming studies field.
- Given the increased importance of additional research into the structural and situational characteristics of consumptive behaviours (e.g., smoking nicotine, drinking alcohol, gambling, etc.), it is likely that research on design features within games and their psychological impact (including potential addiction) will increase as well. Such research has already begun (including quite a few studies by our gaming research unit).
- As the diagnosis of video game addiction becomes more legitimate in psychiatric and medical circles, it will lead to better randomized control trials on interventions for problematic video game play than the ones already carried out. There is also likely to be an increase in the online medium itself being used as a treatment channel. The reasons that people like to engage in some online leisure activities (i.e., the fact that the online environment is non-face-to-face, convenient, accessible, affordable, anonymous, non-threatening, non-alienating, non-stigmatizing, etc.) may also be the very same reasons why people would want to seek advice, help and treatment online rather than in face-to-face situations.
Based on our review paper there are several noticeable trends that can be drawn from our recent reviews of problematic video game play and video game addiction.
- There has been a significant increase in empirical research decade by decade since the early 1980s.
- There has been a noticeable (and arguably strategic) shift in researching the mode of video game play. In the 1980s, research mainly concerned ‘pay-to-play’ arcade video games. In the 1990s, research mainly concerned stand alone (offline) video games played at home on consoles, PCs or handheld devices. In the 2000s, research mainly concerned online massively multiplayer video games.
- There has been a noticeable shift in how data are collected. Up until the early 2000s, data about video game behaviour was typically collected face-to-face, whereas contemporary studies collect data online, strategically targeting online forums where gamers are known to (virtually) congregate. These samples are typically self-selecting and (by default) unrepresentative of the general population. Therefore, generalization is almost always one of the methodological shortcomings of this data collection approach.
- Survey study sample sizes have generally increased. In the 1980s and 1990s, sample sizes were typically in the low hundreds. In the 2000s, sample sizes in their thousands – even if unrepresentative – are not uncommon.
- There has been a diversification in the way data are collected including experiments, physiological investigations, secondary analysis of existing data (such as that collected from online forums), and behavioural tracking studies.
- There has been increased research on adult (i.e., non-child and non-adolescent) samples reflecting the fact that the demographics of gaming have changed.
- There has been increasing sophistication in relation to issues concerning assessment and measurement of problematic video game play and video game addiction. In the last few years, instruments have been developed that have more robust psychometric properties in terms of reliability and validity. However, there are still some concerns as many of the most widely used screening instruments were adapted from adult screens and much of the video game literature has examined children and adolescents. In other papers I have co-written with Dr. King, we have asserted that to enable future advances in the development and testing of interventions for video game-related problems, there must be some consensus among clinicians and researchers as to the precise classification of these problems. (In fact, we’ve just had a major review paper accepted on assessing video game addiction in Clinical Psychology Review which I examined in a previous blog).
Clearly, there exist a number of gaps in current understanding of problematic video game play and video game addiction. There is a need for epidemiological research to determine the incidence and prevalence of clinically significant problems associated with video game play in the broader population. There are too few clinical studies that describe the unique features and symptoms of problematic video game play and/or video game addiction. While the current empirical base is relatively small, gaming addiction has become a more mainstream area for psychological and psychiatric research and is likely to become an area of significant importance given the widespread popularity of gaming.
Additional input: Daria Kuss and Daniel King
Griffiths, M.D. (2010). Online video gaming: What should educational psychologists know? Educational Psychology in Practice, 26(1), 35-40.
Griffiths, M.D. (2011). Technological trends and the psychosocial impact on gambling. Casino and Gaming International, 7(1), 77-80.
Griffiths, M.D., Kuss, D.J. & King, D.L. (2012). Video game addiction: Past, present and future. Current Psychiatry Reviews, 8, 308-318.
King, D.L., Delfabbro, P.H. & Griffiths, M.D. (2009). The psychological study of video game players: Methodological challenges and practical advice. International Journal of Mental Health and Addiction, 7, 555-562.
King, D.L., Delfabbro, P.H. & Griffiths, M.D. (2010). Video game structural characteristics: A new psychological taxonomy. International Journal of Mental Health and Addiction, 8, 90-106.
King, D.L., Delfabbro, P.H. & Griffiths, M.D. (2010). The role of structural characteristics in problem video game playing: A review. Cyberpsychology: Journal of Psychosocial Research on Cyberspace. Located at: http://www.cyberpsychology.eu/view.php?cisloclanku=2010041401&article=6.
King, D.L., Delfabbro, P.H. & Griffiths, M.D. (2010). The convergence of gambling and digital media: Implications for gambling in young people. Journal of Gambling Studies, 26, 175-187.
King, D.L., Delfabbro, P.H. & Griffiths, M.D. (2010). Cognitive behavioural therapy for problematic video game players: Conceptual considerations and practice issues. Journal of CyberTherapy and Rehabilitstion, 3, 261-273.
King, D.L., Delfabbro, P.H., Griffiths, M.D. & Gradisar, M. (2011). Assessing clinical trials of Internet addiction treatment: A systematic review and CONSORT evaluation. Clinical Psychology Review, 31, 1110-1116.
King, D.L., Delfabbro, P.H. & Griffiths, M.D. (2012). Clinical interventions for technology-based problems: Excessive Internet and video game use. Journal of Cognitive Psychotherapy: An International Quarterly, 26, 43-56.
King, D.L., Delfabbro, P.H., Griffiths, M.D. & Gradisar, M. (2012). Cognitive-behavioural approaches to outpatient treatment of Internet addiction in children and adolescents. Journal of Clinical Psychology: In Session, 68, 1185-1195.
King, D.L., Haagsma, M.C., Delfabbro, P.H.,Gradisar, M.S. &, Griffiths, M.D. (2013). Psychometric assessment of pathological video-gaming: A systematic review. Clinical Psychology Review, 33, 331-342.
Over the last year I have examined a number of culture-bound syndromes that comprise a combination of psychiatric and/or somatic symptoms viewed as a recognizable disease within specific cultures or societies. One of the more interesting types is Brain Fag Syndrome (BFS). The first cases of BFS were described in 1960 by Dr. Raymond Prince in the British Journal of Psychiatry. He reported on a “very common psychoneurotic syndrome occurring among the students of southern Nigeria” that is typically initiated after intensive periods of intellectual activity. More specifically he wrote that:
“The symptoms are such as to prevent the student from carrying on with his work and include various unpleasant head symptoms accompanied by inability to grasp what he reads or what he hears in a lecture, memory loss, visual difficulties, inability to concentrate, inability to write, etc.”
Other researchers (such as a team led by Dr. Bolanie Ola – writing in a 2009 issue of the African Journal of Psychiatry) have noted that BFS comprises a wide range of somatic complaints (as noted by Dr. Prince) but can also include cognitive and sleep-related impairments, as well as localized pain in the head and neck. BFS is seen as an interesting phenomenon in the field of transcultural psychiatry. For some researchers, BFS was controversially included (for the first time) in the fourth edition of American Psychiatric Association’s 1994 Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), and included as a culture bound syndrome such as the Koro (the genital retraction syndrome that I reviewed in two previous blogs examining male Koro and female Koro).
Since the publication of Prince’s seminal paper over 50 years ago, BFS has been documented among non-Caucasians in various African countries (Ethiopia, Liberia, Ivory Coast, South Africa, and Uganda), and a few countries outside of Africa (Brazil, India, Malaysia, China). However, the number of cases from those countries outside of Africa are exceedingly rare. There also appear to be similar syndromes such as the Trinidadian illness ‘studiation madness’ that has similar symptoms to BFS.
The term ‘brain fag’ was the name of the disorder that the students themselves called it (and appears to be a shortened version of ‘brain fatigue’). Based in his early research, Dr. Prince believed that BFS was not caused and/or associated to genetic predisposition, general intelligence, parental literacy, study habits or family responsibilities. He believed that BFS was related to:
“The imposition of European learning techniques upon the Nigerian personality [and that] European learning techniques emphasize isolated endeavour, individual responsibility and orderliness – activities and traits which are foreign to the Nigerian by reason of the collectivistic society from which he derives, with its heightened ‘orality’ and permissiveness”.
Dr. Ola and his colleagues questioned the extent to which BFS is an objective or subjective phenomenon. They asked a number of pertinent questions: Is BFS one phenomenon or a variant of other known disorders? Is BFS a mental illness? Ola and colleagues described the case of a young male student from Yoruba.
“When studying for an exam [he] began to have sharp pains in his head and could not grasp what he was reading. He slept more than usual, and had difficulty forcing himself to go to school in the morning. When writing the examinations, he felt he knew the answers, but was unable to recall them; his mind was blank. His right hand was weak and shook so that he couldn’t write. Because of these symptoms, he was forced to postpone the writing examinations for several years. His symptoms improved greatly with Largactil (an antipsychotic medication) and reassurance”.
Much like the early findings of Prince, Ola and his colleagues suggest that BFS may in sufferers be “the somatic manifestation of the rather sudden Westernization of African education”. The authors also claimed that between 6% and 54% of Nigerian university students may experience brain fag symptoms although those with the “full-blown syndrome” appear to be significantly lower. However, a more recent paper in the ASEAN Journal of Psychology claimed that among secondary school students, BFS is prevalent in 20-40% of students.
A more recent paper by Bolanie Ola and David Igbokwe in a 2011 issue of Africa Health Sciences, cites some work carried out on the etiology of BFS by Guinness in 1992 (although no reference is provided for the study itself). Guinness reported five independent factors associated with the syndrome: (a) the financial implications of education which represented the change from subsistence to cash economy; (b) fear of envy and bewitchment which represented the intense cultural response to education; (c) parenting in the pre-school years which was the independent family variable; (d) academic ability; (e) attributes of the school.
In a paper examining the factorial validation and reliability analysis of the Brain Fag Syndrome Scale (BFSS) by Ola and Igbokwe, it was argued by the authors that there was a lack of consistent findings relating to the etiology, pathophysiology and risk factors of BFS. This, they argued, reflected the “lack of standardized reproducible diagnostic criteria” for the syndrome. In short, they asserted that different studies had used different instruments to assess BFS and that only a few followed the description first formulated by Prince. They claimed that 60% of the BFS studies they reviewed simply reported the rates of BF symptoms rather than BFS. Following psychometric evaluation on 234 participants (aged 11- to 20-years), Ola and Igbokwe claimed that the BFSS is a valid and reliable two-dimensional instrument to assess BFS and can therefore be used in future studies. At least there is now an instrument that can be used to carry out empirical research more systematically.
Fatoye, F.O. (2004). Brain fag syndrome among Nigerian undergraduates: present status and association with personality and psychosocial factors. Ife Psychologia, 12, 74-85.
Fatoye, F.O. & Morakinyo, O. (2003). Study difficulty and the ‘Brain Fag’ syndrome in south western Nigeria. Journal of Psychology in Africa, 13, 70-80.
Igbokwe, D.O. & Ola, B.A. (2011). Development and validation of the Brain Fag Propensity Scale. ASEAN Journal of Psychiatry, 12, 1-13.
Morakinyo, O. (1980). Psychophysiological theory of a psychiatric illness (the Brain Fag syndrome) associated with study among Africans. Journal of Nervous and Mental Disease, 168, 84-89.
Morakinyo, O. & Peltzer, K. (2002). Brain Fag symptoms in apprentices in Nigeria. Psychopathology, 35, 362-366.
Ola, B.A. & Igbokwe, D.O. (2011). Factorial validation and reliability analysis of the brain fag syndrome scale. African Health Sciences, 11, 334-339.
Ola, B.A., Morakinyo, O. & Adewuya, O. (2009). Brain Fag Syndrome – a myth or a reality. African Journal of Psychiatry, 12,135-43.
Peltzer, K. & Woldu, S. (1990). The brain fag syndrome in female Nigerian students: intercultural analysis and intervention of gender change. Curare, 13, 141-146.
Prince, Raymond (1960). The “Brain Fag” Syndrome in Nigerian students. British Journal of Psychiatry, 106, 559-570.
Wikipedia (2012). Brain fag. Located at: http://en.wikipedia.org/wiki/Brain_fag
“For years I have had a real fetish for witches – I believe its called wiccaphillia – or something like that! My wife indulges my interest and she has sixteen sexy witch outfits!” (from the Sexy Witch website)
There are various websites that list hundreds of different types of sexual paraphilias. Many of these paraphilias are simply the names of specific phobias with the suffix ‘-phobia’ replaced by the suffix ‘-philia’. Examples of this include: agoraphobia and agoraphilia (fear of the outdoors; sexual arousal from the outdoors), cremnophobia and cremnophilia (fear of steep cliffs and precipices; sexual arousal from steep cliffs and precipices), and kynophobia and kynophilia (fear of getting rabies; sexual arousal from getting rabies). Another sexual paraphilia that often appears in these lists (such as the one at the Sensual Swingers website) is wiccaphilia (sexual arousal from witches and witchcraft) that I assumed was just based on the opposite phobia (wiccaphobia – fear of withes) and didn’t really exist (especially as it doesn’t appear in either Dr. Anil Aggrawal’s Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices or Dr. Brenda Love’s Encyclopedia of Unusual Sex Practices. Furthermore, there is not a single reference to wiccaphilia in any academic article or book that I am aware of.
I obviously tried to look up wiccaphilia on (…ahem) Wikipedia but there was surprisingly nothing. The Wikipedia entry on ‘wicca’ noted that wicca is a modern pagan religion (developed here in England in the first half of the twentieth century) concerning witchcraft, drawing on a diverse set of ancient pagan rituals. In relation to sexual behaviour, the article noted:
“A central aspect of Wicca…often sensationalised by the media is the traditional practice of working in the nude, also known as skyclad. This practice seemingly derives from a line in Aradia, Charles Leland’s supposed record of Italian witchcraft. Other traditions wear robes with cords tied around the waist or even normal street clothes. In certain traditions, ritualized sex magic is performed in the form of the Great Rite, whereby a High Priest and High Priestess invoke the God and Goddess to possess them before performing sexual intercourse to raise magical energy for use in spellwork. In nearly all cases it is instead performed ‘in token’, thereby merely symbolically, using the athame to symbolise the penis and the chalice to symbolise the womb”
In the course of my research for this article, I came across lots of references to witches’ sexuality but these were light-hearted and non-academic including photographic sites of the 25 sexiest witches, artistic sites of the sexiest witch pin-ups (i.e., drawings and paintings rather than photographs), the sexiest witches seen in the movies, articles on having sex with witches and ‘wiccan sex’, and articles on the application of make-up for sexy witches. There is also the ‘Sex. Fetish, Witch, Art’ photograph website run by a woman who claims: “I’m a 50+ year old average everyday woman who still likes ‘Sex’, is a ‘Fetishist’, identifies strongly with my natural ‘Witch’ instincts and gets off on ‘Art’. I see myself as a type of Carnal Muse”. All of these sites make the assumption that witches are female but one thing that surprised me when researching this blog was an article in The Frisky online magazine that noted male witches are not called warlocks but are also witches. The article claims that the term ‘warlock’ actually refers to an oath breaker, or someone who was banished from a witches’ coven.
Professor Walter Stephens published a 2002 book entitled Demon Lovers: Witchcraft, Sex, and the Crisis of Belief where he describes alleged sex between witches and demons, and the mechanics of their lovemaking (and also confirmed that some witches were male). Dale Keiger interviewed Stephens for the John Hopkins Magazine where it was noted that:
“Before 1400, tales of sex with demons existed but were almost always accounts of rape; in the 15th century, the sex becomes consensual, and more. Accused witches speak not just of sex, but of good sex, the kind that brought them back for more and seduced them into forswearing God and agreeing to do the Devil’s bidding. Not only women were seduced by demons; men, too, were lured into sex with beings who turned out to be something other than just willing village girls. (Scholars estimate that 20 percent of the people accused of witchcraft during this time were male.)”
In another article in The Frisky, one article claimed that medieval witches inserted magic potions or ‘flying ointment’ into their vaginas with a special dildo or ‘broomstick’ (i.e., ”getting high and pleasuring themselves”) that may explain the origins of the flying broomstick. In response to this claim, one person under the pseudonym ‘Snagglez’ wrote:
“I wrote my Masters’ thesis on the appearance of demonic creatures and witches in 16th century wood block prints in Germany and I can completely verify this theory. One of the reasons female witches were seen as so scary was because of their rampant sexuality which was a threat to society – basically sex for pleasure rather than procreation. They would subvert the natural order of life and become the sexual aggressor instead of the man. They were often attended by male witches but women were in charge. Part of the satanic ritual involved the unholy mass which culminated in group sex with the devil on an altar. But, witches were believed to be unable to bear children because of the polluted nature of their bodies. That is why there were often depicted as crones – mainly because post-menopausal women could also not bear children. In fact it was believed that some of their spells required the blood of small children (completely perverting their gender’s purpose) so witches were often blamed if babies died for unexplained reasons. I really suggest reading ‘The Witch as Muse’ by [Linda] Hults”
Most reference to witches’ sex is usually made in relation to ‘sex magic’ (or ‘sex magick’ as it is often spelled, and which I will look at in a future blog). A 2010 online article by “herbalist, writer and artist” Sarah Lawless examined sex magic in traditional witchcraft (but wiccaphilia was not mentioned). She made some interesting observations:
“Our animistic ancestors believed that the earth was a fertile woman and the sky god her lover. When it rained, it was the god’s semen fertilizing the earth goddess. Worship of the phallus is found the world over, as is worship of the Sacred Whore…In etymology the proto-Germanic root word for Witchcraft – weik – from which wicce, wicca, wiccaecrafte and related sorcerous words stem from literally translates as ‘cunning and guile’. This possibly explains the use of sexual initiation for certain traditions, especially within Medieval and modern traditional witchcraft. Sex is a way to connect with the Gods of both the Upper and Lower Worlds. There are accounts from the witch trials of women having sex with the devil himself to be initiated into a coven and into the mysteries…Sex magic has multiple uses within Witchcraft. It can be used as an offering for deity worship, for acting out the mysteries of the gods, to attain knowledge/ awareness /inspiration, to be initiated into a tradition or mystery, to raise energy for workings, to empower sexual fluids for magical uses, to conceive, to act as Sacred Whore, to empower a working or sigil, for healing, or for flying”.
Arguably one of the best websites discussing witches’ sexuality is the Sexy Witch blog. The website is one of the very few that go beyond an informational definition of wiccaphilia and attempts (in an admittedly speculative way) to provide an insight into different types of wiccaphilia from a witch’s perspective. The female author notes:
“Curiously, Wiccaphilia seems to be a lot less common than Wiccaphobia. At least, if you Google the two terms the ratio is 3:18,500 (or about 1:6000). But I am sceptical: everyone loves witches, don’t they?…Someone suffering from mild Wiccaphilia might, for example, take particular pleasure in accidently finding pictures or descriptions of witches or Wiccans on the internet. Someone with moderate Wiccaphilia might search the web for images witches and take particular pleasure in locating a blog dealing with Sexy Witches. Severe Wiccaphilia might result in the victim spending a small fortune on books and objects featuring witches and then shamelessly parade their affliction by starting a blog about Sexy Witches. Sad, but true”.
Given the complete lack of academic and/or clinical research on wiccaphilia, I am not in a position to either conform or dispute such claims. I came across a book written by LaSara Firefox (simply called Sexy Witch) but from the summaries on various bookseller sites (e.g., “Employing a unique blend of feminism and magick, this refreshing guide to female self-empowerment helps women acknowledge the beauty, strength, and sexiness within themselves…LaSara FireFox banishes the damaging misconceptions and shame often associated with female sexuality and sheds light on what it truly means to be a Sexy Witch”) is not an academic tome (but appeared to get lots of positive feedback from those who had read the book). Given the lack of empirical data, there is nothing known about whether the paraphilia really exists, and if it does what the incidence, prevalence or etiology of wiccaphilia is. If it does exist, there could perhaps be some psychological crossover with those who have specific uniform fetishes (that I covered in a previous blog).
Farsaci, L. (2009). I’ll get you, my pretty: Sexy women and witchcraft. Carnal Nation, October 20. Located at: http://carnalnation.com/content/35869/615/ill-get-you-my-pretty-sexy-women-and-witchcraft
The Frisky (2012). 5 things you probably didn’t know about witches. October 5. Located at: http://www.thefrisky.com/2012-10-05/5-things-you-probably-didnt-know-about-witches/
Keiger, D. (2002). Sexy devils. John Hopkins Magazine, 53(4). Located at: http://www.jhu.edu/jhumag/0602web/stephens.html
Lawless, S. (2010). Sex magic in traditional witchcraft, July 30. Located at: http://witchofforestgrove.com/2010/07/30/sex-magic-in-traditional-witchcraft/
Stephens, W. (2002). Demon Lovers: Witchcraft, Sex, and the Crisis of Belief. Chicago, IL: University of Chicago Press.
Wikipedia (2013). Sex magic. Located at: http://en.wikipedia.org/wiki/Sex_magic
Wikipedia (2013). Wicca. Located at: http://en.wikipedia.org/wiki/Wicca