Category Archives: Case Studies
While researching a previous blog on condom snorting, I came across an interesting case study of ‘accidental condom inhalation’ (and no, I promise I am not making this up). The case dates back to 2004 and was published by Dr. C.L. Arya and colleagues in the Indian Journal of Chest Diseases and Allied Sciences (IJCDAS).
Anyone who has kids will know that (just out of curiosity) they commonly put things in their mouths. The IJCDAS paper made reference to a number of medical studies that have shown inhaled items include things that can be from the edible (nuts, seeds, beans, etc) to the non-edible (plastic objects, screws, needles, pins, etc). They also note that when inhaling such objects, it doesn’t always lead to immediate medical symptoms or complications (such as choking, wheezing, coughing, etc.). However, the case that Dr. Arya and colleagues reported on was a little out of the ordinary.
The case involved a 27-year-old woman who was a schoolteacher. For a six-month period she had been suffering from a persistent cough where she was coughing up mucus along with some pneumonia symptoms. Initial examination showed nothing of consequence. Further tests took place and the paper reported that:
“The chest radiographs carried out subsequently showed development of a non-homogeneous right upper lobe lesion, not resolving either with antibiotics or a four-month trial of an empirical anti-tuberculosis treatment instituted by various practitioners. No symptomatic relief was obtained with either therapy. [A later] chest radiograph demonstrated a right upper lobe collapse-consolidation of lung. The opacity led us to promptly carry out a video-bronchoscopy, which gave impression of a white membranous object protruding from the collapsed right upper lobe bronchus. On probing further, it was noticed to be an inverted bag-like structure ‘sitting’ in the bronchus and having a flap-like action. A rigid bronchoscopy was then performed and the object was easily removed with biopsy forceps, though, it tore into pieces during procedure”.
As you will have noted from the title of this blog, the pieces were identified as being from a condom. The woman and her husband eventually recalled to the medics (after much probing by the medics) that there was an incident that occurred where a condom had become loosened while the wife was performing oral sex on her husband. During this particular sexual act, the woman had experienced a bout of coughing and sneezing and without her knowing she had accidentally inhaled her husband’s condom.
One of the reasons that the accidental inhalation went unnoticed for so long was because the inhaled object was of “soft, elastic and rubbery consistency that [was] unlikely to cause a direct lung injury”. The authors noted that:
“The airway obstruction of the right upper lobe segments produced by [the condom], could have resulted in the retention of secretions and the infection of corresponding lung segments, which may have become radiologically visible as a non-homogeneous right upper lobe collapse-consolidation. Despite mechanical obstruction, the flap-like action of condom (as noticeable on video-bronchoscopy) probably continued to clear secretions from right upper lobe, contributing to the delay in radiologic presentation of case”.
The medics were unsure whether the woman had genuinely accidentally swallowed the condom or whether she was just too embarrassed to report the incident and/or didn’t relate the incident to her subsequent symptoms. The authors also claimed that the original physicians who examined the woman were responsible for the condition being prolonged as they had failed to suspect that a foreign object (i.e., a condom) was the cause of the non-resolved pneumonia. They then noted that:
“Perhaps, views of physicians were guided by the age of patient (that was less suited for a suspicion of an inhaled foreign body), and also the fact, that a disease like tuberculosis was so highly prevalent in this part of world that a preference for the institution of [anti-tuberculosis treatment] was quite natural”.
Together, all of these reasons are likely to have resulted in a delayed diagnosis. The authors also noted that:
“Even following the condom retrieval [both husband and wife] were understandably hesitant in disclosing it owing to the nature of affair concerned (involving one’s privacy), the unusual nature of coitus performed (via an oral route) and the inhalation of a discrete object (like condom). The possibility of seminal aspiration also taking place simultaneously may not be ruled out…The case has certain atypical features, of which, the foremost relates to the type of inhaled object, i.e., a condom, which has not been reported in the literature to the best of our knowledge…[Another] atypical feature was adult-age of patient, that by any means, would be least expected to be associated with any foreign body inhalation”.
The authors speculated as to whether this incident was a one-off or whether such incidents were more widespread and were being under-reported because the Indian sub-continent has “a traditional conservative culture” where “people tend to have religious attitudes and sex is largely considered to be a subject limited to a person’s private life”. The authors concluded that:
“Perhaps, the young lady in our case was also quite apprehensive about fellatio, a fact that could have played a part in the condom inhalation. It is much desirable that sex taboos prevalent on the sub-continent are curbed and greater sexual awareness created in the people’s minds”.
Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
Agarwal, R.K., Banerjee, G., Shembish, N., & Jamal, B.A., Kareemullah, C. & Swaleh, A. (1988). Foreign bodies in the tracheobronchial tree: A review of 102 cases in Benghazi, Libya. Annals of Tropical Paediatrics, 8, 213-16.
Arya, C.L., Gupta, R. & Arora, V.K. (2004). Accidental condom inhalation. Indian Journal of Chest Diseases and Allied Sciences, 46, 55-58.
Ben-Dov, I. & Aelony, Y. (1989). Foreign body aspiration in the adult: An occult cause of chronic pulmonary symptoms. Postgraduate Medical Journal, 65, 299-301.
Causey, A.L., Talton, D.S., Miller, R.C., Warren, E.T. (1997). Aspirated safety pin requiring thoracotomy: Report of a case and review. Pediatric Emergency Care, 13, 397-400.
Lyons, D.J., McClod, D., Prichard, J., Dowd, D., & Clancy L. (1993). Very long retention of bronchial foreign bodies: Two new cases and a review of the literature. Irish Medical Journal, 86, 74-75.
Murthy, P.S., Ingle, V.S., George, E., Ramakrishna S. & Shah, F.A. (2001). Sharp foreign bodies in the tracheobronchial tree. American Journal of Otolaryngology, 22, 154-56.
It was while I was researching a previous blog on nun fetishism that I came across a number of academic papers that had written about and/or carried out research into the sex lives of nuns. Given that nuns are meant to be celibate I couldn’t help but be interested in a topic that on the face of it seemed a non-research topic. Having said that, I am aware that there are lots of stereotypes surrounding nuns’ sexuality, and there are certainly lots of sexual jokes at the expense of nuns. For instance, in researching this article I came across a joke that I found in an academic paper by Dr. Christian Hempelmann in a 2003 issue of the journal (appropriately titled) Humor:
“100 nuns live together in a convent. One morning the head nun gets up to make an announcement. ‘Sisters,’ she says, ‘I have terrible news: There has been a man in the convent.’ 99 nuns gasp, 1 nun giggles. ‘Still more,’ says the head nun, ‘we have found a condom.’ 99 nuns gasp, 1 nun giggles. ‘The worst news is,’ says the head nun, ‘we have found a hole in the condom.’ 99 nuns giggle, 1 nun gasps”.
OK, a little frivolous I know, but the joke at least suggests that not all nuns are celibate. One of the most enduring stereotypes of nuns is that they are lesbian. There are certainly examples in the academic literature relating to lesbianism among nuns dating back many centuries. For instance, Dr. Judith Brown published a book in 1984 on the life of seventeenth century Italian nun Benedetta Carlini entitled Immodest Acts: The Life of a Lesbian Nun in Renaissance Italy. Carlini’s lesbianism was exposed by her companion Bartolemea Crivelli. According to Crivelli’s account, over a period of two years, Benedetta forced Crivelli to regularly engage in lesbian acts (and gave rise to the ‘immodest acts’ in the title of Brown’s book). Jacqueline Murray reviewed Brown’s book for the journal Renaissance and Reformation, and noted the wider importance and implications of the book:
“[Brown’s book] is a study of unparallelled detail of a lesbian mystic in pre-modern Europe. Benedetta Carlini is the only lesbian from this period for whom any detailed information survives. Recent studies of the history of homosexuality either make fleeting references to lesbians or, despairing of information, define them as outside the parameters of study. Thus Brown’s work is important as the first in-depth study of female homosexuality in the pre-modern period”.
In my previous blog on nun fetishism I made reference to a 2005 book chapter by Richard Zacks (in Russ Kick’s Everything You Know About Sex is Wrong). Zacks described what he claimed was “unquestionably the longest and kinkiest list of medieval sexual practices still in existence”. Zacks managed to uncover a medieval text that refers to having sex with nuns. He wrote that in 1012, a German bishop called Burchard of Worms wrote a 21-volume text including a long section on sexual sins. In Chapter 5 of Volume 19, Burchard lists 194 different sexual sins. In this list there is a section entitled ‘Questions for Men’ relating to the penance for having sex with a nun. More specifically, the entry reads:
“Have you committed fornication with a nun, that is to say, a bride of Christ? If you have done this, you shall do penance for forty days on bread and water, which they call a ‘carina’, and [repeat it] for the next seven years; and as long as you live, you shall observe all six holy days on bread and water”
There are other papers that make passing references to nuns’ sexuality. For instance, a 2009 paper by in the journal Culture, Health and Sexuality Professor Marjorie Muecke examined female sexuality in Thai discourses about ‘lay nuns’ (known as ‘maechii’) by interviewing monks, maechii, and lay persons. The paper noted that although maechii vow to be celibate, the social constructions of their role are grounded in sexuality. More specifically, Professor Muecke reported:
“[My] findings suggest that maechii comprise an ambiguous category linguistically, Buddhistically, and in terms of their sexuality. Case studies of the founders of nunneries conducted in ChiangMai indicate that maechii leaders have been resisting the prevalent views that most maechii are social misfits, yet also are capable of undermining monks’ celibacy and, by extension, the larger social order”.
However, the most interesting academic paper I have come across on the topic of nun’s sexuality was published in a 1978 issue of the Journal of Sex and Marital Therapy by Margaret Halstead and Lauro Halstead entitled ‘A Sexual Intimacy Survey of Former Nuns and Priests’. Halstead and Halstead’s study reported:
“Men and women who have lived in a celibate religious community experience a unique set of sexual, social, and psychological problems upon resuming a secular life style. In many instances the personality factors and circumstances which led both to a decision to enter and then to leave a celibate religious community are not easily appreciated by the nonreligious professional counselor and do not readily lend themselves to extrapolation from other population groups. [We report] the findings of a preliminary study to identify the sexual experiences and problems of persons who have left religious communities”
The data collected and reported were from the responses to a mailed, anonymous questionnaire. The survey was sent to 223 former nuns and priests living across the United States, and was completed by 126 of them (76 ex-nuns and 50 ex-priests). The survey examined (i) sexual behaviour and enjoyment prior to, while living in, and after leaving a religious community; (ii) current sexual behaviour, satisfaction and problems; (iii) sexual counselling experience; and (iv) general problems and concerns with integrating sexual intimacy into present life styles. The survey asked the participants if they had engaged in various sexual activities before, during, and/or after they had been a nun or priest. It was reported that:
- In relation to masturbation, the figures were 47% before, 57% during, and 85% after their time as a nun or priest
- In relation to sexual intercourse, the figures were 11% before, 15% during, and 82% after their time as a nun or priest
- In relation to oral sex, the figures were 9% before, 5% during, and 75% after their time as a nun or priest
- In relation to homosexual activity, the figures were 11% before, 21% during, and 16% after their time as a nun or priest
- In relation to being celibate, the figures were 46% before, 32% during, and 10% after their time as a nun or priest
The results also showed 50% of the ex-nuns (compared to 53% of the ex-priests) reported being less satisfied sexually after relinquishing their religious orders than they would have liked. The reasons most frequently cited for decreased sexual satisfaction were lack of sexual partners (57%), religious and/or moral reasons (44%), feelings of not being desirable (35%), and/or communication problems (20%). One in five of the nuns also admitted that orgasmic dysfunction was a reason. Despite the relatively small sample, the paper dispels the idea that all nuns are completely celibate. At the very least, a replication study would be a really interesting piece of research to carry out
Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
Brown, J. C. (1984). Lesbian sexuality in Renaissance Italy: The case of sister Benedetta Carlini. Signs, 751-758.
Murray, J. (1988). Immodest Acts. The Life of a Lesbian Nun in Renaissance Italy [Book review]. Renaissance and Reformation/Renaissance et Réforme, 24(2), 132-135.
Gerber, A. (2005). Sex by numbers: Excerpts from The Book of Sex Lists. In R. Kick (Ed.), Everything You Know About Sex is Wrong (pp.340-344). New York: The Disinformation Company.
Halstead, M. & Halstead, L. (1978). A sexual intimacy survey of former nuns and priests. Journal of Sex and Marital Therapy, 4, 83-90.
Hempelmann, C. F. (2003). “99 nuns giggle, 1 nun gasps:” The not-all-that-Christian natural class of Christian jokes. Humor, 16(1), 1-32.
Muecke, M. (2004). Female sexuality in Thai discourses about maechii (‘lay nuns’). Culture, Health and Sexuality, 6(3), 221-238.
Murray, J. (1988). Immodest Acts. The Life of a Lesbian Nun in Renaissance Italy. Renaissance and Reformation/Renaissance et Réforme, 24(2), 132-135.
Visser, R. O. D., Smith, A. M., Richters, J., & Rissel, C. E. (2007). Associations between religiosity and sexuality in a representative sample of Australian adults. Archives of sexual behavior, 36(1), 33-46.
Zacks, R. (2005). Burchard’s Medieval sexual menu. In R. Kick (Ed.), Everything You Know About Sex is Wrong (pp.327-329). New York: The Disinformation Company.
I apologize in advance that today’s blog spills into ‘pop psychology’ but I thought I would share it with you anyway. A number of years ago, I helped a leading Internet poker company do some research on different types of poker player and developed a typology. With the help of US poker tournament director Jack McClelland, the typology was based on a survey of 2000 poker players and produced seven different types of player. These were subsequently called ‘The General’, ‘The Joker’, ‘The Wallflower’, ‘The Calculator’, ‘The Hunter’, ‘The Artisan’, and ‘The Politician’. The study found that 39% of players were Wallflowers or Calculators (40% male and 38% female), 17% were Jokers (16% male and 17% female), 15% were Generals (17% male and 13% female) and 4% were Hunters (5% male and 3% female). The ‘Politician’ and ‘Artisan’ sub-types constituted only a very small minority of players. So which type of player are you? Here is a quick psycho-portrait of each type.
The General: Instantly recognisable for their guts, Generals won’t shirk in the face of risk and are comfortable in their ability to fight back from a short stack. In everyday life, The General’s supreme self-belief can be overbearing, but Generals tend to reap the rewards and are often very successful in their careers. At the green baize, the high risk-high gain strategy employed tends to see them bust out first or win the lot.
The Joker: A natural born entertainer, a jester at the table who ensures everyone will have fun. Well liked, Jokers command other’s allegiances and will use this to their advantage. But beware, they are more than happy to talk you off a pot should they choose to. Unfortunately, Jokers are as easily distracted, and can be distracting at the poker table. This can be dangerous. A lack of discipline and patience can make you question whether the Jokers are equipped with the will to win. What’s more, their need to be liked can often stand in their way of closing in on the kill.
The Wallflower: The Wallflower is happy to sit on the sidelines and wait for others to fight it out before they get involved. In everyday life the Wallflower will rarely throw in their lot with anyone and will take their time to make allegiances. Wallflowers are equipped with the most important of all poker virtues – patience. Their tendency to avoid the quagmire of the group dynamic gives them an extra edge – their relationships come with no baggage. While the others fight it out the Wallflower will sit back, observe and learn. According to journalist and female poker player Victoria Coren, while Wallflowers can survive quite a while in a game, they can’t necessarily change gear later and nail money finishes.
The Calculator: Cool, composed and naturally conservative, Calculators will only go into a hand with the best of it. In everyday life, Calculators were often the cleverest kids in their class – if not the ones with the biggest circle of friends. Instinctively risk-averse, their strengths as a poker player include a methodical approach and the ability to separate emotion from decisions. Skilful as they may be, there is no easier player to read than a Calculator. What’s more, Calculators can be quite passive and are unwilling to chase the action if it doesn’t come their way.
The Hunter: At first glance, the Hunter can easily be mistaken for a General. Both exude the same forcefulness and strength of character, but where The General is all about thought through risks, The Hunter is all about naked aggression. Off the poker table, Hunters aren’t always the best communicators, but are hugely loyal and very determined. On the poker table, a Hunter is a formidable opponent and loves the thrill of trying to beat the odds. A loose player, they’ll play a lot of hands and will feed off the weaker players by bullying them off pots.
The Politician: An arch manipulator, you can spot Politicians because they’re your best friends. Trouble is, they’re also your next-door neighbour’s best friend and even your enemy’s best friend. Their good qualities are highly tuned instincts and a whole deck of charisma. Both will serve them well at the poker table, but both can also lead to trouble. A tendency to play the people rather than the cards can spell disaster, and the Politician is one of the most likely players to bluff.
The Artisan: At first glance, the Artisan may not appear to be a natural born poker player. Led by the creative left side of their brain rather than the more mathematical right hand side, Artisans are more usually found engaged in less competitive activities. However, Artisans have very finely honed intuitive skills and always love to rise to a challenge. An Artisan will take a very lateral approach to the game and won’t be scared to make a move if their instincts tell them to.
I’m not pretending that the work I did was particularly scientific but it was certainly interesting. Obviously the whole problem with formulating sub-types like this is that they are usually based on a particular way of looking at the activity. For instance, I have a typology based on the types of playing mistakes players make – but I’ll leave that for a future blog.
Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
Griffiths, M.D., Parke, J., Wood, R.T.A. & Rigbye, J. (2010). Online poker gambling in university students: Further findings from an online survey. International Journal of Mental Health and Addiction, 8, 82-89.
McCormack. A. & Griffiths, M.D. (2012). What differentiates professional poker players from recreational poker players? A qualitative interview study. International Journal of Mental Health and Addiction, 10, 243-257.
Parke, A. & Griffiths, M.D. (2011). Poker gambling virtual communities: The use of Computer-Mediated Communication to develop cognitive poker gambling skills. International Journal of Cyber Behavior, Psychology and Learning, 1(2), 31-44.
Parke, A., Griffiths, M., & Parke, J. (2005) Can playing poker be good for you? Poker as a transferable skill. Journal of Gambling Issues, 14.
Recher, J. & Griffiths, M.D. (2012). An exploratory qualitative study of online poker professional players. Social Psychological Review, 14(2), 13-25.
Wood, R.T.A., Griffiths, M.D. & Parke, J. (2007). The acquisition, development, and maintenance of online poker playing in a student sample. CyberPsychology and Behavior, 10, 354-361.
Wood, R.T.A. & Griffiths. M.D. (2008). Why Swedish people play online poker and factors that can increase or decrease trust in poker websites: A qualitative investigation. Journal of Gambling Issues, 21, 80-97.
While researching previous blogs on harmatophilia (i.e., individuals who derive sexual arousal from those who are sexually incompetent), parthenophilia (i.e., individuals who derive sexual arousal from virgins), cuckold fetish (i.e., individuals – usually men – that derive sexual arousal from the knowledge that their wife is having sex with another man), and veil fetishism (i.e., individuals who derive sexual arousal from those who wear veils), I came across various references for bride fetishism. This fetish does not appear in either Dr. Anil Aggrawal’s book Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices or Dr. Brenda Love’s Encyclopedia of Unusual Sex Practices. However, a short article on the London Fetish Scene (Wipipedia) website claims that:
“A bride fetish is a sexual fetish in which either a woman (or possibly a man) enjoys dressing in the typical outfit worn by a bride, or someone derives sexual pleasure from viewing women (or possibly men) dressed in this manner. A bride may be regarded as the archetype of a virgin ready and waiting to have sexual intercourse. A bridal outfit can be considered to be full of fetishistic imagery. Brides often wear lingerie such as basques or corsets, stockings and thongs; they also wear stileto shoes. Generally, a bridal dress and lingerie are white or nearly white, denoting purity. For a transvestite, bridal wear may be the ultimate female apparel”.
Similarly, a short piece on bride fetishes at a telephone sex site (Fone Fetish) claims that:
“Bride Fetish is sometimes known as a virgin fetish, where the ideal woman is pure and uninitiated, making her a safe partner in many ways. The bridal fetish extends to the image of an innocent appearing virginal bride being your own total whore, willing and anxious to do anything to please you sexually”.
As far as I am aware there is no academic research on bride fetishism but there is plenty of anecdotal evidence to suggest that (a) it exists, and (b) that there are specific sub-varieties. For instance, there are dozens of bespoke webpages devoted to bride fetishism including the Deviant Art website page on ‘Bridal Fetish’, the Behance website page on ‘Fetish Bride’, the Goddess Narcissa webpage on ‘Black Fetish Bride’, the Hot Wife Allie website (with a myriad of bride fetish postings such as ‘The Great Wedding Porn Gallery’ and ‘Wedding Night Cuckold’), and the Jim Roe webpage on ‘Nude Bride Fetish’. I also came across dedicated webpages on ‘fetish vampire brides’, ‘mature bride fetish’, ‘bondaged brides’, and ‘bride face sitting fetish’ (please be warned that most of these sites contain very sexually material). In addition to this there are also dedicated websites that make fetish bridal wear (such as the Adixxtion website) and provide online dating services to match up fetish bride and grooms. I’m the first to admit that none of this is in any way academic, but it does at least point to the fact that there appears to be a niche (sexual) market for bride fetishism.
The online articles that I have managed to locate are short and speculative and provide absolutely no facts on the incidence of prevalence of the behaviour or its etiology. For instance, a 2010 entry on the Venus O’Hara website (where the website author dressed herself as a fetish bride) claims that:
“Plenty of men are into the bridal fetish. Traditionally, a bride, dressed in white silks and satins, is a visual metaphor for virginity and exclusivity. Her imminent sexual unavailability isn’t the end of the story…To some, her new status becomes highly attractive and doesn’t put them off of the hunt at all, quite the opposite in fact. In this set [of photos] I wanted to portray myself as a kind of bride who permits those men to lust after me and gives license to their desires because I, and they, are aware that there is no groom to watch over me. Although I felt like a princess when I was dressed-up I understood, quite quickly, that I couldn’t walk very fast while wearing the dress, neither could I sit down easily; my freedom of seductive movement was restricted. Perhaps, I thought, that was the whole point. I don’t like wearing anything that prevents me from flaunting my charms so I began to subvert the dress and its meaning. I didn’t need to clutch a bouquet to pose in it. I found out that I’m more comfortable being provocative and available when I wear white. Modern bridal wear is much more revealing and adaptable these days. Each new pastel-coloured design emphasises the curve of exposed shoulder and the slimness of bare neck instead of hiding them. I approve totally”
In my research for this blog, I have to admit that I didn’t come across a single dedicated online bride fetish forum group, although I did come across discussions on fetish sites where some individuals claimed they had bride fetishes (although not very many). For instance:
- Extract 1: “Any out there with a bridal fetish? Get turned on by a lovely young woman in a bridal outfit? Would you like to watch a bride and her groom make love? Would you like to JOIN in, making it a threesome? Would [you] like to cuckold the poor bridegroom, making love to the bride on the ‘happiest day of her life’? Making love to the bride in front of the groom and all the guests? Too ridiculous? I’ve seen stranger happenings! Has this ever been discussed? Please discuss!”
- Extract 2: “Hell yeah, [brides] drives me crazy! Have you got any photos, or do you know how to get any? Brides are so sexy!”
- Extract 3: “I have a total fetish over Brides! I love it when there all done up and have their wedding dress on, it’s so sexy. There isn’t a single Bride that doesn’t turn me on! Is anyone out there with me or is it just me? Also if any of you out there have got any Wedding day/night photos that you could upload for me then that would blow my mind, naughty or not. What do you think?”
- Extract 4: “I used to belong to a yahoo group that specialized in brides but it seems to have dissipated”.
These few extracts again appear to give credence to the idea that bride fetishism exists but there may (for some people) be an overlap with cuckold fetishes. More recently, there have been a number of online articles that have talked about ‘foreign bride fetishes’. Almost all of the articles I came across (such as one in the New York Times by Mike Hale entitled ‘Foreign Bride as Fetish and a Person’) relate to the television documentary ‘Seeking Asian Women’ directed by Debbie Lum.
“Steven is a 60-year-old parking-garage attendant who lives in a small apartment above a store in the Northern California suburbs. He’s white, which is significant because he has what is politely known as an Asian fetish and popularly known as yellow fever. ‘They’re all so beautiful,’ he says, looking at a display of thumbnail images of prospective Asian brides…Steven manages to persuade Sandy, a 30-year-old office worker from Shenzen, China, to come to the United States to marry him. [The program] profile[s] a man obsessed with Asian women in order to understand a phenomenon…The nature of Asian fetishism remains as mysterious, or perhaps as obvious, as ever. As Steven and Sandy make wedding plans — her K-1 visa gives them four months to marry — fights erupt over money (he doesn’t have much) and whether he’s still infatuated with an earlier Chinese pen pal…The dramatic arc of Steven and Sandy’s relationship is mildly suspenseful but also pretty familiar”.
Personally, this is another instance of using the word ‘fetish’ as meaning ‘intense like for’ rather than its’ meaning within sexology. My own (online) research (relying on non-academic and anecdotal sources) suggests that bride fetishism is a niche sexual market that appears to have at least a handful of genuine adherents. I can’t really see this subject ever being the topic of serious academic research but I’d be happy to be proved wrong.
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.
Hale, M. (2013). Foreign bride as a fetish and a person. New York Times, May 5. Located at: http://tv.nytimes.com/2013/05/06/arts/television/seeking-asian-female-on-pbs-shows-an-internet-order-bride.html?_r=2&
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
Venus O’Hara (2010). Bridal fetish, July 1. Located at: http://venusohara.org/montjuic-bride.html
Wipipedia (2011). Bride fetish. London fetish Scene, September 6. Located at: http://www.londonfetishscene.com/wipi/index.php/Bride_fetish
One of the recurring questions I am often asked to comment on by the media is whether celebrities are more prone to addiction than other groups of people. One of the problems in trying to answer what looks like an easy question is that the definition of ‘celebrity’ is different to different people. Most people would argue that celebrities are famous people, but are all famous people celebrities? Are well-known sportspeople and politicians ‘celebrities’? Are high profile criminals celebrities? While all of us would say that Hollywood A-Listers such as Tom Cruise, Johnny Depp, Angelina Jolie, Brad Pitt and Julia Roberts are ‘celebrities’, many of the people that end up on ‘celebrity’ reality shows are far from what I would call a celebrity. Being the girlfriend or relative of someone famous does not necessarily famous.
Another problem in trying to answer this question is what kinds of addiction are the media actually referring to? Implicitly, the question might be referring to alcohol and/or illicit drug addictions but why should other addictions such as nicotine addiction or addiction to prescription drugs not be included? In addition to this, I have often been asked to comment on celebrities that are addicted to sex or gambling. However, if we include behavioural addictions in this definition of addiction, then why not include addictions to shopping, eating, or exercise? If we take this to an extreme, how many celebrities are addicted to work?
Now that I’ve aired these problematic definitional issues (without necessarily trying to answer them), I will return to the question of whether celebrities are more prone to addiction. To me, when I think about what a celebrity is, I think of someone who is widely known by most people, is usually in the world of entertainment (actor, singer, musician, television presenter), and may have more financial income than most other people I know. When I think about these types of people, I’ve always said to the media that it doesn’t surprise me when such people develop addictions. Given these situations, I would argue that high profile celebrities may have greater access to some kinds of addictive substances.
Given that there is a general relationship between accessibility and addiction, it shouldn’t be a surprise if a higher proportion of celebrities succumbs to addictive behaviours compared with a member of the general public. The ‘availability hypothesis’ may also hold true for various behavioural addictions that celebrities have admitted having – most notably addictions to gambling and/or sex. It could perhaps be argued that high profile celebrities are richer than most of us (and could therefore afford to gamble more than you or I) or they have greater access to sexual partners because they are seen as more desirable (because of their perceived wealth and/or notoriety).
Firstly, when I think about celebrities that have ‘gone off the rails’ and admitted to having addiction problems (Charlie Sheen, Robert Downey Jr, Alec Baldwin) and those that have died from their addiction (Whitney Houston, Jim Morrison, Amy Winehouse) I would argue that these types of high profile celebrity have the financial means to afford a drug habit like cocaine or heroin. For many in the entertainment business such as being the lead singer in a famous rock band, taking drugs may also be viewed as one of the defining behaviours of the stereotypical ‘rock ‘n’ roll’ lifestyle. In short, it’s almost expected. In an interview with an online magazine The Fix, Dr. Scott Teitelbaum, an American psychiatrist based at the University of Florida:
“Some people who become famous and get put on a pedestal begin to think of themselves differently and lose their sense of humility. And this is something you can see with addicts, too. Famous or not, people in the midst of their addiction will behave in a narcissistic, selfish way: they’ll be anti-social and have a disregard for rules and regulations. But that is part of who they as an addict – not necessarily who they would be as a sober person. Then there are some people who are narcissists outside of their disease, who don’t need a drug or alcohol addiction to make them feel like the rules don’t apply to them – and yes, I have seen in this in many athletes and actors. Of course, you also have non-famous people who struggle with both…People with addiction and people with narcissism share a similar emptiness inside. Those who are famous might fill it with achievement or with drugs and alcohol. That’s certainly not the case for everyone. But when you see people who are both famous and narcisstic – people who struggle with staying right-sized or they don’t have a real sense of who they are without the fame – you know that they’re in trouble… People with addiction and people with narcissism both seek outside sources for inside happiness. And ultimately neither the fame nor the drugs nor the drinking will work”.
The same article also pointed out that there is an increase in the number of people who (usually through reality television) are becoming (in)famous but have no discernable talent whatsoever. In my own writings on the psychology of fame, I have made the point that (historically) fame was a by-product of a particular role (e.g., country president, news anchorman) or talent (e.g., captain of the national sports team, a great actor). While the Andy Warhol maxim that everyone will be famous for 15 minutes will never be truly fulfilled, the large increase in the number of media outlets and number of reality television shows suggests that more people than ever are getting their 15 minutes of fame. In short, the intersection between fame and addiction is on the increase. US psychiatrist Dr. Dale Archer was also interviewed for The Fix article and was quoted as saying:
“Fame and addiction are definitely related. Those who are prone to addiction get a much higher high from things – whether it’s food, shopping, gambling or fame – which means it [the behavior or situation] will trigger cravings. When we get an addictive rush, we are getting a dopamine spike. If you talk to anyone who performs at all, they will talk about the ‘high’ of performing. And many people who experience that high report that when they’re not performing, they don’t feel as well. All of which is a good setup for addiction. People also get high from all the trappings that come with fame. The special treatment, the publicity, the ego. Fame has the potential to be incredibly addicting”.
I argued some of these same points in a previous blog on whether fame can be addictive in and of itself. Another related factor I am asked about is the effect of having fame from an early age and whether this can be a pre-cursor or risk factor for later addiction. Dr. Archer was also asked about this and claimed:
“The younger you are when you get famous, the greater the likelihood that you’re going to suffer consequences down the road. If you grow up as a child star, you realize that you can get away with things other people can’t. There is a loss of self and a loss of emotional growth and a loss of thinking that you need to work in relationship with other people”.
I’m broadly in agreement with this although my guess is that this only applies to a minority of child stars rather than being a general truism. However, trying to carry out scientific research examining early childhood experiences of fame amongst people that are now adult is difficult (to say the least). There also seems to be a lot of children and teenagers who’s only desire when young is “to be famous” when they are older. As most who have this aim will ultimately fail, there is always the concern that to cope with this failure, they will turn to addictive substances and/or behaviours.
Griffiths, M.D. & Joinson, A. (1998). Max-imum impact: The psychology of fame. Psychology Post, 6, 8-9.
Halpern, J. (2007). Fame Junkies. New York: Houghton Mifflin Harcourt
McGuinness, K. (2012). Are Celebrities More Prone to Addiction? The Fix, January, 18. Located at: http://www.thefix.com/content/fame-and-drug-addiction-celebrity-addicts100001
Rockwell, D. & Giles, D.C. (2009). Being a celebrity: A phenomenology of fame. Journal of Phenomenological Psychology, 40, 178-210.
“I was reminded of a scene in the second series of The Thick Of It, where Peter Mannion, an old-school Tory MP, is told by his Steve Hilton-style spin doctor that he needs to start embracing the internet. ‘Have you ever tried Googling your own name?’ he asks. ‘It’s like opening the door to a room where everyone tells you how shit you are.’ I think this nicely encapsulates the relative merits of Googling yourself: namely, that there are none” (from an article by journalist Bryony Gordon, Daily Telegraph, February 29, 2012).
Last year, the actor Dominic West let it be known to the mass media that he regularly Googles himself and was reported as saying: “I like to have chats about myself with people – mainly putting forward the case for the defence. I use my own name but nobody ever believes me”. I have never worked out why it is such a social faux pas to Google yourself and why it is so derided. I’m quite happy to admit that I regularly Google myself, and that I probably do it more than most other people. In my defence, I am regularly interviewed by the print media and I like to check on what gets reported (particularly as it’s not unknown for me to get misquoted or for my words to be taken out of context. In an article published in the Online Journalism Review, Patrick Dent writes in defence of egosurfing:
“If you are a Web professional – whether an online instructor or journalist, Web developer or marketer – you should be aware of your presence on the Web. And perhaps more importantly, the existence of Web namesakes. And if you are active in the job market, being aware of your nom-de-plume’s cyberexistence is crucial. You should be aware of any nefarious deeds or ill impressions Internet namesakes may be performing… This all goes to illustrate that searching for your name on the Internet is more than the self-serving, vanity endeavor that the label ‘ego-surfing’ implies. Beyond being an interesting exercise, and yes in some cases stroking your ego, it is a prudent – if not downright necessary – activity in today’s Web-aware professional world”.
As an academic, being cited by others is something that is seen positively. As of this morning, I had 14,564 citations on Google Scholar (which for the non-academics reading this means that my papers, articles and books have been cited 14,564 times in other papers, articles, and books). Googling myself is just another variation of seeing how I’ve been cited and I do not think there is anything wrong with it. I suppose I just like knowing about the digital footprint I am leaving online. According to the entry on Wikipedia:
“Egosurfing (also referred to as Googling yourself and less frequently called vanity searching, egosearching, egogoogling, autogoogling, self-googling, master-googling, google-bating) is the practice of searching for one’s own given name, surname, full name, pseudonym, or screen name on a popular search engine in order to review the results. Similarly, an egosurfer is one who surfs the Internet for his or her own name to see what information appears. It has become increasingly popular with the rise of internet search engines, as well as free blogging and web-hosting services”.
So, there you have it. According to Wikipedia’s definition I am officially an egosurfer. The same article also claims that the word ‘egosurfing’ was first coined in 1995 by Sean Carton (who’s written many books about online technology) and then featured in a March 1995 issue of Wired magazine (although the Wired definition of egosurfing is more encompassing and says it is “scanning the Net, databases, print media, or research papers looking for mentions of your own name”).
According to a short 1999 article in the British Medical Journal by Professor James Drife, looking yourself up online is “arguably the naffest way of coping with boredom”. Professor Drife’s whole article was a simple account of what he had found by Googling his own name. By doing so, he claimed to have expanded his horizons, and “strengthened [his] belief that the world is not quite ready to do without paper. Nevertheless, universities could be making plans to judge academics on their internet hits and the response rate”. (Something that I believe is already happening and is one of the reason I like to egosurf). Exactly the same thing was carried out by JoAnne Lehman, one of the editors of Feminist Collections: A Quarterly of Women’s Studies Resources and published in 2004. She also listed all the things she had discovered egosurfing and concluded:
“If there’s a point to my telling of this story here – beyond the desire to promote a woman writer’s work – perhaps it’s about the satisfaction of connecting with kindred spirits, and how those connections can be made in surprising ways. Oh, and maybe that Internet surfing, even the ego kind, isn’t necessarily a waste of time”.
Writing about ego-surfing appears to be a popular way of writing an article not just in academic journals but also in non-academic publications such as the national press. Bryony Gordon (the journalist I cited at the beginning of this blog) wrote that:
“Now, I am not Dominic West (Hollywood star; 5,030,000 Google results in just 0.18 seconds). I am Bryony Gordon (newspaper journalist; 431,000 Google results in a glacial 0.21 seconds). But I don’t think it matters whether you are a world famous actor or Joe Bloggs; the fact remains that Googling yourself is a dangerous and egoistical exercise that will never end well. The best case scenario for Joe Bloggs is that he finds nothing, thus making him feel like a nobody; the worst that he finds a group of his mates bitching about him on a social networking site. Ditto, on a good day the likes of Dominic West will come away from a self-Googling session with an even bigger sense of self-importance, on a bad one with a miserable neediness that their agents and lackeys will have to pull them out of. As Reese Witherspoon says, ‘it’s an affirmation of every horrible feeling you have about yourself’”.
Articles in Tech Crunch (by Duncan Riley), and Tech News World (by Katherine Noyes) reported that 47% of Americans had Googled themselves based on a study carried out by the Pew Internet and American Life Project (up from the previous study in 2002). Using a telephone survey, the study sampled 2,373 adults (of which 1,623 were internet users). Only a very small minority (3%) Googled themselves regularly (and there was nothing on excessive self-Googling). The main reasons given for egosurfing were (i) for entertainment purposes, (ii) as a means of online reputation management (which is probably the category that I would fall under), and (iii) self-promotion and maintenance of a positive online reputation (e.g., locating online inaccuracies and ‘data spills’ and correcting them).
This is certainly an area worthy of further empirical investigation – even if it’s just to examine stereotypes around the kind of person who ego-surfs.
Dent, P. (2000). ‘Ego-Surfing’ derides valid, prudent activity. Online Journalism Review. Located at: http://www.ojr.org/ojr/ethics/1017964102.php
Drife, J.O. (1999). Egosurfing. British Medical Journal, 318, 203.
Gordon, B. (2012). Google and be damned. Daily Telegraph, February 29. Located at: http://www.telegraph.co.uk/technology/google/9111193/Google-and-be-damned.html
Lehman, J. (2004). From the editors. Feminist Collections: A Quarterly of Women’s Studies Resources, 26, ii.
Nicolai, T. Kirchhoff, L., Bruns, A., Wilson, J. & Barry Saunders, B. (2008). Google Yourself! Measuring the performance of personalized information resources. Proceedings Association of Internet Researchers 2008: Internet Research 9.0: Rethinking Community, Rethinking Place, Copenhagen, Denmark. Located at: http://en.scientificcommons.org/31968134
Noyes, K. (2007). Pew study: Self-Googling on the rise. Tech News World, December 17. Located at: http://www.technewsworld.com/story/Pew-Study-Self-Googling-on-the-Rise-60810.html
Riley, D. (2007). Do you use Google for vanity searching? You’re not alone. Tech Crunch, December 16. Located at: http://www.pewinternet.org/Media-Mentions/2007/Do-You-Use-Google-For-Vanity-Searching-Youre-Not-Alone.aspx
Wikipedia (2012). Egosurfing. Located at: http://en.wikipedia.org/wiki/Egosurfing
In a previous blog I examined clothes fetishism and in doing that research, I soon realized that some people’s fetishistic desires are very specific when it comes to clothing (e.g., particular types of uniform or particular types of footwear). One of the more unusual clothing fetishes is ‘veil fetishism’. From the online articles that I have come across, veil fetishism appears to be an almost exclusively male fetish in which the individuals have a fetishistic sexual desire for women wearing veils over their faces (although paradoxically, most women who wear veils for religious reasons do so to stop others lusting after them). A few online articles claim this has lead to tension among online communities where Muslims and veil fetishists share the same virtual space (although I’ve not come across this myself – and I did go looking for it!).
A number of online articles claim that one of the main reasons that veils have permeated into Western consciousness is the increase in the number of media images of veiled women in the news following the 9/11 attacks in 2001 and the US ‘War on terrorism’. However, as far as I am aware, there is no academic research on veil fetishism although there is much speculation as to the motivational roots including an article on Wipipedia that says it may be a result of “mystery, bondage and the preservation of virginity” and that such fetishists “may be interested in niqabs, burkas and harem-style veils” while “some are attracted to women who wear all-covering Muslim-style veils, while others are attracted to women wearing translucent veils”. A Nation Master online article develops some of these ideas and claims that:
“Control may be behind veil fetishism…Arab and other Muslim women are often seen in the Western world as being veiled against their will; they are only doing it for religious or social reasons (though many contend otherwise). Such control issues may be seen in other fetishes and paraphilias, such as bondage fetishism”.
This is partly confirmed by Professor Mohja Kahf in his 1999 book Western Representations of the Muslim Woman that noted:
“Veiled, secluded, submissive, oppressed – the ‘odalisque’ image has held sway over Western representations of Muslim women since the Enlightenment of the eighteenth century. Yet during medieval and Renaissance times, European writers portrayed Muslim women in exactly the opposite way, as forceful queens of wanton and intimidating sexuality”
A short online article on the Venus O’Hara website about veil fetishes also makes some bold claims:
“Veil fetishists understand and enjoy the significance of veils and the women who wear them, the effect that this piece of material can have on them is phenomenal. By covering, disguising and obscuring the female face, a sense of importance, power and the thrill of an ancient taboo is brought into focus for them. If the features of the woman can only be guessed at through the veil, the psychological need of a spectators mind to discover them becomes overwhelming. The fantasy of unveiling then becomes the idealised intimate act-not unlike the imagined removal of the clothes of someone desired but out of reach. If the veil remains in place then that understanding is postponed and the pleasure of erotic anticipation is preserved…Women may become sexually aroused by veiling themselves as well. They may feel protected, or experience an enjoyment that is similar to women with more explicit bondage fantasies”.
Despite all this pop psychology insight, I couldn’t find a single piece of evidence (empirical or otherwise) to support any of the speculations made by academics or non-academics. It was also claimed in a couple of the articles that I read that veil fetishists are not from a particular religion and can comprise both Muslims and non-Muslims. In a Wikiquote article on the ‘Hijab’, the British writer Shabbir Akhtar was quoted as saying that the Hijab is creating “a truly erotic culture in which one dispenses with the need for the artificial excitement that pornography provides”.
Of course, veiled woman and sexual lust have been a staple of films and television shows for decades but the situations in which women typically wore veils were often sexually provocative (such as the Dance of the Seven Veils, or the heroines in the Italian films of director Tinto Brass who often wear veils and showcase them as fetishistic objects). An article in Seven Oaks (“a magazine of politics, culture and resistance”) by Rebecca Manski interviewed Middle Eastern Studies scholar Elizabeth Warnock Fernea who was quoted as saying:
“Because ‘western’ men had no access to the female sphere in Middle Eastern society, they were inclined to exoticize or devalue it. Generally the perception of the Middle Eastern woman involved a secluded odalisque – a lazy, sexy lady in a harem veiled from all men but her husband”.
An online essay on the Venus O’Hara website makes some further interesting observations:
“Most people imagine that veils are a way of hiding erotic potentials and alluring features but I know, after making this set, that veils can be ultimate fetish…Sometimes veils would have been used, as an alternative to a mask, as a simple method of hiding the identity of a woman who was traveling to meet a lover, or doing anything she didn’t want other people to find out about…In Judaism, Christianity and Islam the concept of covering the head is or was associated with propriety…An occasion on which a Western woman is likely to wear a veil is on her wedding day, if she follows the traditions of a white wedding. Brides used to wear their hair flowing down their back at their wedding to symbolise their virginity, now the white diaphanous veil is often said to represent this. The lifting of the veil was often a part of ancient wedding ritual, symbolising the groom taking possession of the wife, either as lover or as property, or the revelation of the bride by her parents to the groom for his approval. In ancient Judaism the lifting of the veil took place just prior to the consummation of the marriage in sexual union. The uncovering or unveiling that takes place in the marriage ceremony is a symbol of what will take place in the marriage bed. Just as the two become one through their words spoken in wedding vows, so these words are a sign of the physical oneness that they will consummate later on. The lifting of the veil is a symbol and an anticipation of this”
Additionally, a 2003 book by Faegheh Shirazi (The Veil Unveiled: The Hijab in Modern Culture) highlights that:
“The veil, the garment known in Islamic cultures as the hijab, holds within its folds a semantic versatility that goes far beyond current clichés and homogenous representations. Whether seen as erotic or romantic, a symbol of oppression or a sign of piety, modesty, or purity, the veil carries thousands of years of religious, sexual, social, and political significance”.
Shirazi uses examples from both the East and West (including American erotica) and argues that the veil has become a ubiquitous titillating marketing tool for diverse enterprises, from pornographic magazines like Penthouse and Playboy to advertising companies. She argued that the perceptions of the veil change both with the cultural context of its use as well as over time. Obviously ‘veil fetishism’ has been little studied scientifically (and maybe it never will). However, the phenomenon clearly exists although the prevalence of such behaviour may be very rare (although the incidence may well be on the increase given the number of dedicated websites to such practices are growing).
Kahf, M. (1999). Western Representations of the Muslim Woman: From Termagant to Odalisque. Texas: University of Texas Press.
Manski, R. (2005). Lifting the veil between women East and West. Seven Oaks, September 20. Located at: http://www.sevenoaksmag.com/features/79_feat1.html
Nation Master (2008). Veil fetishism. Located at: http://www.nationmaster.com/encyclopedia/Veil-fetishism
Shirazi, F. (2003). The Veil Unveiled: The Hijab in Modern Culture. Florida: University of Florida Press
Steele, V, (1996), Fetish, Fashion, Sex and Power. Oxford: Oxford University Press.
Tales Of The Veils (2012). The lure of the veil: A History and Examination of the practice and pleasures of veiling. September 30. Located at: http://www.talesoftheveils.info/lure/lure.html
Venus O’Hara (2010). Veil fetish. November 20. Located at: http://venusohara.org/veil-fetish.html
Venus O’Hara (2012). Veil fetish. Located at: http://venusohara.org/c/fetish-glossary/veil-fetish-fetish-glossary
Wipipedia (2012). Veil fetishism. Located at: http://www.londonfetishscene.com/wipi/index.php/Veil_fetishism
While researching a previous blog on Stendhal Syndrome, I came across various references to a number of “city syndromes”. According to an interesting book chapter by Nadia Halim, city syndromes are “acute, (usually) short-lived disorders that have in common a similar set of symptoms and pattern of onset and recovery”. Each of the city syndromes that have been identified in the psychological literature is associated with a specific tourist destination (e.g., Jerusalem, Paris, Florence) and identified by medical practitioners (usually psychiatrists) when sufferers access mental health services. In essence, the condition is a type of ‘culture shock’ where an individual becomes psychologically disorientated when they experience new environments that feel alien to them.
One such city syndromes is ‘Paris Syndrome’, a psychological condition that appears to affect Japanese tourists only, suggesting that it is some kind of culture bound syndrome. According to an article in the BBC News, Paris Syndrome was first identified in 1986 by Professor Hiroaki Ota (a Japanese psychiatrist who was working in France at the time). The condition is said to cause mental breakdown when visiting the city. The incidence of the disorder is very small as reports estimate that only 10-20 people a year suffer out of millions of tourists. However, the only ‘cure’ is for the affected individuals to return back to Japan.
As far as I am aware, there are only a couple of academic papers that have been published on Paris Syndrome. The first one was a case study published in a 1998 issue of the Journal of the Nissei Hospital by Dr. Katada Tamami. This was a report of a male manic-depressive who shortly after visiting Paris presented with symptoms of insomnia, fluctuation of mood, aggression, irritation and increase in sex drive. Tamami noted that being separated from his family, and living alone in Paris, the man had an identity crisis as in Paris he was no longer a father or professor. His fantasy and idealization of Paris played a large part in his abnormal behaviour.
The second paper was by a group of French psychiatrists in a 2004 issue in the French psychiatry journal Nervure. The authors reported that between 1988 and 2003, a total of 63 Japanese patients had been hospitalized because of the condition (with a slight bias towards females in their 30s). Although the number of affected patients was relatively low, the Japanese Embassy arranged for a Japanese psychiatrist to work in the authors’ hospital (i.e., St. Anne’s Hospital). In fact, the Japanese Embassy has a 24-hour telephone hotline for Japanese tourists suffering from severe culture shock. The paper claimed that for affected individuals, the city of Paris held a “quasi-magical” attraction and that it was characteristically “symbolic of all the aspects of European culture that are admired in Japan”. A Wikipedia article on Paris Syndrome claims that: “the susceptibility of Japanese people may be linked to the popularity of Paris in Japanese culture”. The same article also noted that:
“Mario Renoux, the president of the Franco-Japanese Medical Association, states in Liberation’s article ‘Des Japonais entre mal du pays et mal de Paris” (December 13, 2004) that Japanese magazines are primarily responsible for creating this syndrome. Renoux indicates that Japanese media, magazines in particular, often depict Paris as a place where most people on the street look like fashion models and most women dress in high-fashion brands”.
The symptoms of Paris Syndrome are typically transient and include anxiety attacks, violent and aggressive outbursts, feelings of persecution, acute psychotic delusions (of paranoia, megalomania, erotomania and/or mysticism), dissociative and/or disoriented feelings, depersonalization, derealization, psychomotor abnormalities (e.g., dizziness, sweating, tachycardia), and – in some cases – thoughts of suicide. Interviews with the affected individuals revealed that the Japanese arrive in the city with highly romanticized expectations and that many had spent years dreaming of coming to Paris before doing it in actuality.
The authors of the paper published in Nervure identified two fundamentally different types of the syndrome based on previous psychiatric problems and when the symptoms occurred:
- Type 1 [Classic]: These individuals typically have a problematic psychiatric history and may travel to Paris for idiosyncratic “strange” or delusional reasons. However, the onset of the symptoms is immediate upon arrival in Paris (and may even begin in the airport).
- Type 2 [Delayed Expression]: These individuals do not usually have a personal and/or familial psychiatric history. The reasons for visiting Paris are typically for ‘normal’ travelling reasons but the onset of the symptoms is much later than the ‘classic’ type (i.e., three months or longer after arriving in Paris).
As an example of the first type of sufferer, the paper described the case of a 39-year-old Japanese woman with a history of schizophrenia that was hospitalized following a psychotic breakdown on her immediate arrival in Paris. She had come to Paris following an advertizing campaign that had the tagline: “France is waiting for you”. She took it to mean it was her personal destiny to go there and claimed she was going to become the queen of one of the Scandinavian countries (“Sweden, Finland or Denmark”). As an example of the second type of sufferer, the paper described the case of a 30-year-old Japanese man with no previous psychiatric history who came to France for educational reasons. The onset of the symptoms was five months after arriving in France and started when he moved into a Paris hotel (after initially studying in Reims). He was hospitalized after experiencing severe anxiety, insomnia, anorexia, and auditory hallucinations (i.e., voices threatening to kill him and his family).
One of the factors that appear to be common among sufferers is that they appear to be highly unprepared for the reality of day-to-day life in the city (e.g., the marked cultural differences, the great difference in language, the difference in public manners and behaviours, etc.). It is these differences that appear to act as a trigger for the onset of the behaviour. The most salient trigger for Paris Syndrome is thought to be the language barrier. Another factor appears to be intense exhaustion caused by trying to cram in as much as possible in the short time available for sightseeing alongside the effects of jetlag. Such factors are said to contribute to the psychological destabilization of some Japanese visitors. Another French physician (Youcef Mahmoudia) working at the hospital Hotel-Dieu de Paris claimed that Paris Syndrome was “a manifestation of psychopathology related to the voyage, rather than a syndrome of the traveller” and hypothesized that it was the excitement resulting from visiting Paris that caused the psychosomatic symptoms (e.g., increased heart rates, dizziness, etc.).
Angelique, C. (2006). Paris syndrome hits Japanese. The Guardian, October 25. Located: http://www.guardian.co.uk/world/2006/oct/25/japan.france
Fastovsky N, Teitelbaum A, Zislin J, et al (2000). The Jerusalem syndrome. Psychiatric Services, 5, 1052.
Halim, N. (2009). Mad tourists: The “vectors” and meanings of city-syndromes. In K. White (Ed.), Configuring Madness. Oxford: Inter-Disciplinary Press.
Monden, C. (2005). Development of psychopathology in international tourists. In van Tilburg, M. & Vingerhoets, A. (Eds.), Psychological Aspects of Geographical Moves: Homesickness and Acculturation Stress (pp. 213-226). Amsterdam: Amsterdam Academic Archive.
Tamami, K. (1998). Reflexions on a case of Paris syndrome. Journal of the Nissei Hospital, 26, 127-132.
Viala, A., Ota, H., Vacheron, M.N., Martin, P., & Caroli, F. (2004). Les Japonais en voyage pathologique à Paris: Un modèle original de prise en charge transculturelle. Nervure (supplement), 17(5), 31-34.
Wikipedia (2012). Paris Syndrome. Located at: http://en.wikipedia.org/wiki/Paris_syndrome
Wyatt, C. (December 20, 2006). Paris Syndrome strikes Japanese. BBC News, December 20/ Located at: http://news.bbc.co.uk/1/hi/6197921.stm
In previous blogs I have looked at pica and some of the pica sub-variants including pagophagia (the eating of ice) and coprophagia (the eating of faeces). Pica is defined as the persistent eating of non-nutritive substances for a period of at least one month, without an association with an aversion to food. Today’s blog takes a look at geophagia (the eating of earth, soil and/or clay). In a literature review published in the Journal of the Royal Society of Medicine by Dr Alexander Woywodt and Dr. Akos Kiss that geophagia has been regarded as a psychiatric disease, a culturally sanctioned practice and/or a sequel to poverty and famine. Geophagia is also a culturally sanctioned practice in some parts of the world. Woywodt and Kiss also stated that:
“[Geophagia] is not uncommon in southern parts of the United States5 as well as urban Africa. Fine red clay is often preferred. In particular, geophagia is observed during pregnancy or as a feature of iron-deficiency anaemia. Where poverty and famine are implicated, earth may serve as an appetite suppressant and filler; similarly, geophagia has been observed in anorexia nervosa. However, geophagia is often observed in the absence of hunger, and environmental and cultural contexts of the habit have been emphasized. Finally, geophagia is encountered in people with learning disability, particularly in the context of long-term institutionalization”.
The relationship between anaemia and pica (including geophagia) has been well documented. However, Woywodt and Kiss assert that it is still unclear whether anaemia prompts geophagia to compensate for iron deficiency or whether geophagia is the cause of anaemia. Prevalence rates of pica have range anywhere between 0.02% and 74% depending on the study and population studied although there are few reliable prevalence estimates of geophagia. One study of pregnant Tanzanian women found a prevalence rate of 26.5% (but this is – of course – a totally unrepresentative sample).
A recent review on pica led by Dr Sera Young (University of California, USA) noted that geophagia is the most common type of pica described in the psychological and medical literature although it did also report that geophagics frequently eat other non-food stuffs (particularly if the desired soil is unavailable or socially unacceptable). For many people, pica is not dangerous but for geophagia there may be complications including parasitic infections (from eating soil). Although eating soil and clay may be regarded as unappetizing (and perhaps bizarre) by most people, some authors have argued that eating soil can be nutritionally beneficial (which if that was the case, it wouldn’t technically be a form of pica).
While not being considered a social norm in Western society, eating soil or clay is said to be quite common among primitive or economically depressed peoples a way of augmenting a scanty and/or mineral-deficient diet. Having said that, the geophagia is most often confined to people suffering from chronic mental illness. Clay (as opposed to soil) consumption has been reported in India, Haiti, various parts of Africa (Cameroon, Gabon, Guinea), and even rural areas of the USA. Like soil consumption, clay consumption has also been associated with pregnant women and some women claim they eat it to eliminate nausea. The Wikipedia entry on geophagia noted:
“In Haiti, the poorest economy in the Western Hemisphere, geophagy is widespread. The clay mud is worked into what looks like pancakes or cookies, called ‘bon bons de terres’…The cookies have little or no nutritional value and are associated with various health problems”.
A study led by Dr. L.T. Glickman and colleagues, and published in a 1999 issue of the International Journal of Epidemiology, provided some data on geophagia by carrying out a study examining intestinal parasitism among children from three rural villages in Guinea (Africa). More specifically they examined the faecal stools of 266 randomly selected children (aged 1-18 years). The researchers found that 53% of children were infected by at least one type of soil-transmitted parasite. They also surveyed parents and reported that geophagia was reported by parents to occur in 57% of children aged 1-5 years, 53% of children aged 6-10 years, and 43%, of children aged 11-18 years. It was concluded that geophagia is an important risk factor for orally acquired parasitic infections in African children.
A small study carried out by Turkish researchers and published in a 1978 issue of Acta Haematologica carried out oral iron and zinc tolerance tests on 12 patients from Turkey and Iran aged between 8 and 21 years with iron deficiency anemia and geophagia. The research team reported decreased iron and zinc absorption in patients compared to control patients. They concluded that iron and zinc malabsorption may be an additional feature of the syndrome characterized by geophagia among those from Turkey and Iran. Finally, in their literature review on geophagia, Dr Woywodt and Dr Kiss concluded that:
“The causation is certainly multifactorial; and clearly the practice of earth-eating has existed since the first medical texts were written. The descriptions do not allow simple categorization as a psychiatric disease. Finally, geophagia is not confined to a particular cultural environment and is observed in the absence of hunger”
Arcasoy, A., Cavdar, A.O. & Babacan, E. (1978). Decreased iron and zinc absorption in Turkish children with iron deficiency and geophagia. Acta Haematologica, 60, 76-84.
Ashworth, M., Hirdes, J.P. & Martin, L. (2008). The social and recreational characteristics of adults with intellectual disability and pica living in institutions. Research in Developmental Disabilities, 30, 512-520.
Danford, D.E. & Huber, A.M. (1982). Pica among mentally retarded adults. American Journal of Mental Deficiency, 87, 141-146.
Glickman, L.T., Camara, A.O., Glickman, N.W. & McCabe, G.P. (1999). Nematode intestinal parasites of children in rural Guinea, Africa: Prevalence and relationship to geophagia. International Journal of Epidemiology, 28, 169-174.
Kettaneh, A., Eclache, V., Fain, O., Sontag, C., Uzan, M. Carbillon, Stirnemann, J. & Thomas, M. (2005). Pica and food craving in patients with iron-deficiency anemia: A case-control study in France. American Journal of Medicine, 118, 185-188
Lacey, E. (1990). Broadening the perspective of pica: Literature review. Public Health Reports, 105, 29-35.
López, L.B., Ortega Soler, C.R. & de Portela, M.L. (2004). Pica during pregnancy: A frequently underestimated problem. Archivos latinoamericanos de nutricion, 54, 17-24.
Nyaruhucha, C.N. (2009). Food cravings, aversions and pica among pregnant women in Dar es Salaam, Tanzania. Tanzania Journal of Health Research, 11(1), 29–34.
Rose, E.A., Porcerelli, J.H, & Anne Neale, A.V. (2000). Pica: Common but commonly missed. Journal of the American Board of Family Practice, 13, 353-358.
Stein, D.J., Bouwer, C. & van Heerden, B. (1996). Pica and the obsessive- compulsive spectrum disorders. South African Medical Journal, 86, 1586-1592.
Woywodt, A. & Kiss, A. (2002). Geophagia: the history of earth-eating. Journal of the Royal Society of Medicine, 95:143-146.
Young, S.L., Wilson, M.J., Miller, D., & Hillier, S. (2008). Toward a comprehensive approach to the collection and analysis of pica substances, with emphasis on geophagic materials. PLoS One, 3(9), e3147.
Wikipedia (2012). Geophagy. Located at: http://en.wikipedia.org/wiki/Geophagy
In previous blogs I have examined various culture bound syndromes (CBSs) such as koro and berserkers. CBSs comprise a combination of psychiatric and/or somatic symptoms viewed as a recognizable disease within specific cultures or societies and are often unknown outside of their own local regions. One of the more unusual CBSs is dhat syndrome, typically located in the Indian sub-continent (India, Sri Lanka, Bangladash). Dhat is one of the CBSs listed in the World Health Organization’s International Classification of Diseases.
The term ‘Dhat syndrome’ was first described by Dr. N.N. Wig in a 1960 issue of the (Indian) Journal of Clinical and Social Psychiatry, and then by Dr. J.S. Neki in the British Journal of Psychiatry (1973). A 1975 paper by Dr. H.K. Malhotra and Dr. N.N. Wig in the Archives of Sexual Behavior called dhat “the exotic neurosis of the Orient”. According to a short paper by Dr. Om Prakash in the Indian Journal of Psychiatry, dhat syndrome comprises various psychological, somatic and sexual symptoms attributed by the patient to the passing of whitish fluid, believed to be semen in urine (i.e., psychological distress and anxiety related to semen-loss). Prakash says that the word ‘dhat’ is derived from the Sanskrit word ‘dhatu’ (which has multiple meanings including ‘metal’, ‘elixir’ and ‘constituent part of the body’). He also noted that:
“This notion of seminal loss frightens the individual into developing a sense of doom if a single drop of semen is lost, thereby producing a series of somatic symptoms…fear of semen loss and resulting problems [in India] is so strong that cures are advertised by vaids and hakims everywhere – on walls, on television, in newspapers and on roadside hoardings”.
The anxiety surrounding the semen loss can also relate to the releasing of semen via nocturnal emissions (i.e., ‘wet dreams’) and masturbation. The symptoms include fatigue, listlessness, appetite loss, lack of physical strength, poor concentration, forgetfulness, guilt, and (in some cases) sexual dysfunction. Given the syndrome relates to psychological anxiety surrounding semen loss, the disorder is (necessarily) found among men, but interestingly, the dhat syndrome has also been applied to women who experience similar symptoms relating to white vaginal discharge). According to an online article on CBSs, it claims that:
“The anxiety related to semen loss can be traced back thousands of years to Ayurvedic texts, where the loss of a single drop of semen, the most precious body fluid, could destabilize the entire body”
A 2004 literature review on dhat syndrome by Dr. A. Sumathipala and colleagues in the British Journal of Psychiatry speculated that the disorder was a “hypochondriacal preoccupation”. This may have some validity as a 1990 paper by Dr. R.K. Chadha and Dr. N. Ahuja (also in the British Journal of Psychiatry) reported a study of 52 dhat patients. Three-quarters of their sample were reported as having hypochondriacal symptoms.
Another study in the British Journal of Psychiatry a year later by Dr. M.S. Bhatia and Dr. S.C. Malik reported that 93 (out of 144) consecutive patients attending a sexual dysfunction clinic had dhat syndrome. A number of papers published on the dhat syndrome in the 1980s and 1990s all report that depressive, anxiety and/or somatoform disorders are prevalent in the majority of dhat sufferers. A small 1989 Sri Lankan study by Dr. P. De Silva and Dr. S. Dissanayake in the Sexual and Marital Therapy journal on 38 men with sexual dysfunction, reported that ‘semen loss’ was seen by most of the men as the main reason for their sexual dysfunction. The same study reported that 40% of the sample had hypochondriasis. Similar findings have been reported among Bangladeshi men. (It should also be noted that there are various reports of similar syndromes in other countries. For instance, Prakash’s paper also mentions ‘shen-k’uei’ in Taiwan and China which from the symptoms listed appear almost identical to dhat)
Based on papers published in the British Journal of Psychiatry and Indian Journal of Psychiatry (mainly from the 1980s and 1990s), Prakash presents a profile of those affected with dhat and claims that most are young males, recently married, from rural areas, low to average socioeconomic status (farmers, labourers, farmers), and from families with conservative attitudes towards sex. He also claims (seemingly based on a 2001 book chapter by by Dr. A. Avasthi and Dr. R. Nehra) that there are three types of dhat patients:
- Dhat alone (where their symptoms are attributed to semen loss, and with presenting symptoms that are hypochondriacal, depressive or anxiety-related in nature)
- Dhat with comorbid depression and anxiety (where dhat is seen as a symptom accompanying another disorder)
- Dhat with sexual dysfunction
The duration of the symptoms can be relatively short-lived (e.g., 3-12 months) but some papers report people suffering for up to 20 years. Prakash lists the most common co-morbid disorders and sexual dysfunctions associated with dhat. This included depressive neurosis (40%-42%), anxiety neurosis (21%-38%), somatoform and hypochondriasis (32%-40%), erectile dysfunction (22%-62%), and premature ejaculation (22%-44%). Prakash also reports that the majority (i.e., two-thirds) of dhat sufferers recover (66%), with the remainder either improved (22%) or unchanged (12%). Finally, the most recently published paper on dhat syndrome by Dr. Neena Sanjiv Sawant and Dr. Anand Nath in a 2012 issue of the Sri Lankan Journal of Psychiatry noted that dhat beliefs are often based on misconception and myths:
“These myths and misconceptions which are deeply rooted in Indian culture are passed from generation to generation. Due to the lack of proper information and lack of open communication between parents and children, the only source of knowledge for many remain their peers, who are equally ignorant about the subject, and this leads to widespread misconceptions. Many people consult unqualified practitioners who reinforce their ignorance”
Avasthi, A. & Nehra, R. (2001). Sexual disorders: A review of Indian Research. In: Murthy, R.S. (Ed.), Mental Health in India (1995-2000) (pp.42-53). Bangalore: People’s Action for Mental Health.
Behere, P.B., Natraj, G.S. (1984). Dhat syndrome: The phenomenology of a culture-bound sex neurosis of the orient. Indian Journal of Psychiatry, 26, 76-78.
Bhatia, M.S. & Malik, S.C. (1991). Dhat Syndrome – A useful diagnosis entity in Indian Culture. British Journal of Psychiatry, 159, 69-75.
Chadda, R.K. & Ahuja, N. (1990). Dhat syndrome: A sex neurosis of the Indian subcontinent. British Journal of Psychiatry, 156, 577-579.
De Silva, P. & Dissanayake, S.A.W. (1989) The loss of semen syndrome in Sri Lanka. A clinical study. Sexual and Marital Therapy, 4, 195-204.
Malhotra, H.K. & Wig, N.N. (1975). A culture bound sex neurosis in the Orient. Archives of Sexual Behaviour, 4, 519-528.
Neki, J.S. (1973). Psychiatry in South East Asia. British Journal of Psychiatry, 123, 257-269.
Prakash, O. (2007). Lessons for postgraduate trainees about Dhat syndrome. Indian Journal of Psychiatry, 49, 208–210.
Sawant, N.S. & Nath, A. (2012). Cultural misconceptions and associated depression in Dhat syndrome. Sri Lankan Journal of Psychiatry, 3, 17-20.
Sumathipala, A. Siribaddana, S.H. & Bhugra, D. (2004). Culture-bound syndromes: The story of dhat syndrome. British Journal of Psychiatry, 184, 200-209.
Wig, N.N. (1960). Problems of mental health in India. Journal of Clinical and Social Psychiatry (India), 17, 48-53.