Category Archives: Case Studies

Hooked on pain: Inside the world of the Corn Tryb Rituals

“Devotees at Kerala’s Aaryyankavu Bhagwathi Temple have devised a new way of performing the banned ancient Thookkam, or body-piercing ritual. In the original Thookam ritual, the back of the person willing to perform the ritual is pierced with sharp hooks and lifted up to a height of over 30 feet on a scaffold, before the bleeding victim is brought down and hooks taken out. However, the new method doesn’t require the devotee to be hung or lifted. ‘After a court put a ban on the ancient ritual of multiple body-piercing and hanging from rope, now only single piercing is done in the body and the person just stands still and does not hang. The devotees also fast for 41 days’ said Shiv Raman, a temple committee member. In 2004 – following a widespread protest by social activists and even Hindu priests – the practice was banned by a court. The legend behind the ritual goes back to the ancient days. Legend has it that even after slaying the demon Darika, the Goddess Kali remained bloodthirsty. Hindu god Lord Vishnu then sent his mount, the giant bird Garuda, to Kali. Garuda gave the goddess some drops of blood, which pacified her thirst. The ritual is performed based on this belief” (News Track India, March 31, 2010).

Last year I was the resident psychologist on a 12-episode series for the Discovery Channel called Forbidden (which is now airing in the UK). Each episode examined four cases of extreme human behaviour from around the world (in fact, when I started filming, the series was called Extreme Worlds and only changed names at the eleventh hour). One of the stories we covered featured people that hung and suspended themselves from hooks that were pierced into their flesh. Although some people appear to carry out the practice as part of sexually sadomasochistic practices, the opening story highlights that some people carry out such ritualistic behaviour for religious and/or spiritual reasons.

In Forbidden, the story concentrated on what were called the ‘Corn Tryb Rituals’ (CTRs). These originated in St. Louis (Missouri, USA) when a small group of friends formed a group that would meet to engage in bloodletting rituals and ‘flesh pulls’. These practices then evolved into regular ritualised ‘suspensions’ that strove to connect to ancient ways. As one CTR participant interviewed said: “We give back to the earth and universe parts of us. Usually blood, sometimes flesh…We burn sage and sing songs to the gods. We send out positive energies”.

In researching CTRs, the documentary makers found out that there were strong Mayan threads running through the group in St. Louis, the foremost theme being the myth of creation, i.e., the Mayans first created man out of mud, then wood, and then finally corn (and where the CTR name derives). All the St. Louis CTR members had a scarification or tattoo of day glyph, a symbol of the Mayan calendar. (A glyph is an element of writing – an individual mark on a written medium – that contributes to the meaning of what is written).

The CTR’s founder is Ricardo H. (a professional piercer by trade) who formed the group with 12 ‘core’ members comprising seven men and five women (although there are more individuals on the periphery). The members claimed that the female members had a higher pain threshold (although there was little evidence to back up this claim). The documentary’s production notes reported that:

“[The St. Louis CTR group] is one of few crews is the US that does suspension the tribal and ceremonial way. Other groups are more hardcore and punk, kind of like ‘F the World’, Ricardo says. CTR members say for them it’s about loving the world and forging a connection to Mother Earth. There are a few people in the Tryb that practice Druidism and several Wiccans, even a Catholic guy who believes that doing suspensions (especially things like the crucifixion suspensions) help him become closer to God. Then there are the atheists who just like to suspend because it gives them a high that tops any drug they’ve ever touched. Even for those who have never done drugs, it’s still a high for them. Being safe is their No. 1 priority. It took nearly three years before they had all the necessary equipment, especially considering mountain equipment is very expensive. In general, most suspension groups work with the same materials that are used by climbers and professional riggers. If people think they sloppily insert hooks and try dangerous procedures on a whim, they would be wrong. The procedures behind the suspensions are specific and everything is well planned out. The hooks are specialized for suspension and can cost from $15 to $75 each. And they are sanitized in a similar way as for piercing tools: cold sanitation scrub, soak, scrub, autoclave”.

During CTRs, the hooks are usually placed into parts of the body where the skin is soft and stretches easily (so called ‘sweet spots’). This includes hook placements in the upper to middle back, chest, hips, calves, forearms, and knees. Even for those that have participated in many suspensions, the initial piercing hurts (“the hooks sting”) like any other piercing but the pain lasts longer because the needles and hooks are longer and bigger than those involved in typical ‘everyday’ body piercings. As one of the female group members said:

“Getting pierced sucks…But once you’re off the ground it’s just a big endorphin rush like how marathoners get runner’s high. Once the pulling starts though it’s not so bad, just pressure. I can deal with pressure pain better than stingy pain. When it gets too intense, I just zone out, but I try not to because I like to be able to selectively ‘zone,’ which is something I’m working on with scarification”.

Each time the group carries out a ritual suspension there are between five and eight people present all with a specific job they have to do to make the process as safe as possible for the person undergoing the actual suspension. According to the show’s production notes, the different roles include:

  • The ‘rigger’ that installs and monitors all the suspension equipment such as cable and ropes.
  • The piercer (in charge of ‘hook placement’) who also monitors the person for flesh ripping.
  • The ‘bio’ (short for ‘biohazard’) who keeps an eye on the hooks throughout the suspension, and removes bubbles and/or patches up any holes that form. They also make sure that not a single drop of blood hits the ground.
  • The ‘rope director’ that hoists the suspended person up and controls the slackness of the rope. There are also one or two others that control the rope line going up and down (a ‘puller’ and/or ‘holder’).
  • The ‘anchor points’ that oversee where the cables and chains are stationed and anchored and oversee the pulley system.

The ceremonial aspect is fundamental to the whole process with spiritual and fasting components. One interviewee reported:

“When you are suspended you are in a state of meditation. You feel connected to everything, all the energy of nature, my Tryb, the love that’s there. We often fast, offer offerings, play drums and other things. It’s pretty amazing”.

At the time of filming, the CTR members were about to have their ‘End of the World’ party (December 21). The date is significant as this is when the ancient Mayans marked the end of an era that would reset the date to zero and signal the end of humanity. The CTR members don’t see this as the literal ‘end of time’ but as the end of the cycle, with the re-alignment of planets and the beginning of a new, exciting cycle. I’m sure most of you reading this can’t imagine being subjected to such a extreme bodily experience (I certainly can’t) but the CTR members stress that the experience for them is not abnormal. Ultimately, they claim the ritual is a way of coping and understanding pain. They also stress that no-one in the groups is a masochist. They do it because it’s a challenge and a way to test the boundaries of their bodies.

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

Further reading

News Track India (2010). Body-piercing ritual at Kochi Temple. March 31. Located at: http://newstrackindia.com/newsdetails/156577

Hook Life (2011). Corn Tryb Ritual. Suspension.org, September 28. Located at: http://www.suspension.org/hooklife/corn-tryb-ritual/

I love view: Can Google Glass be addictive?

Last week, The Guardian (and news media all over the world) reported the story of a man being treated for internet addiction disorder brought on by his excessive use of Google Glass. According to The Guardian’s report:

“The man had been using the technology for around 18 hours a day – removing it only to sleep and wash – and complained of feeling irritable and argumentative without the device. In the two months since he bought the device, he had also begun experiencing his dreams as if viewed through the device’s small grey window…[The patient] had checked into the Sarp [Substance Addiction Recovery Program] in September 2013 for alcoholism treatment. The facility requires patients to steer clear of addictive behaviours for 35 days – no alcohol, drugs, or cigarettes – but it also takes away all electronic devices. Doctors noticed the patient repeatedly tapped his right temple with his index finger. He said the movement was an involuntary mimic of the motion regularly used to switch on the heads-up display on his Google Glass”.

The story was based on a case study that has just been published in the journal Addictive Behaviors by Dr. Kathryn Yung and her colleagues from the Department of Mental Health, Naval Medical Center in San Diego (United States). The authors claim that the paper (i) reported the first ever case of internet addiction disorder involving the problematic use of Google Glass, (ii) showed that excessive and problematic uses of Google Glass can be associated with involuntary movements to the temple area and short-term memory problems, and (iii) highlighted that the man in their case study displayed frustration and irritability that were related to withdrawal symptoms from excessive use of Google Glass. For those reading this who have not yet come across what Google Glass is, the authors provided a brief description: 

Google Glass™ was named as one of the best inventions of the year by Time Magazine in 2012. The device is a wearable mobile computing device with Bluetooth connectivity to internet-ready devices. Google Glass™ has an optical head-mounted display, resembling eyeglasses; it displays information in a Smartphone-like, but hands-free format that is controlled via voice commands and touch”.

The man that came in for treatment was a 31-year old enlisted service member who had served seven months in Afghanistan. Although he did not suffer any kind of post-traumatic stress disorder (PTSD) he was reported by the authors as having a mood disorder, most consistent with a substance-induced hypomania overlaying a depressive disorder, anxiety disorder with characteristics of social phobia, obsessive–compulsive disorder, and severe alcohol and tobacco use disorders”. His referral to the substance use program was because he had resumed problematic alcohol drinking following a previous eight-week intensive outpatient treatment. It was only after re-entering the program that staff noticed other behaviours that were nothing to do with his alcohol problem. More specifically, they reported that:

“The patient had been wearing the Google Glass™ device each day for up to 18 h for two months prior to admission, removing the device during sleep and bathing. He was given permission by his superiors to use the device at work, as the device allowed him to function at a high level by accessing detailed and complicated information quickly. The patient shared that the Google Glass™ increased his confidence with social situations, as the device frequently became an initial topic of discussion. All electronic devices and mobile computing devices are customarily removed from patients during substance rehabilitation treatment. The patient noted significant frustration and irritability related to not being able to use the device during treatment. He stated, ‘The withdrawal from this is much worse than the withdrawal I went through from alcohol’, He noted that when he dreamed during his residential treatment, he envisioned the dream through the device. He would experience the dream through a small gray window, which was consistent with what he saw when wearing the device while awake. He reported that if he had been prevented from wearing the device while at work, he would become extremely irritable and argumentative. When asked questions by the examiner, the patient was noted on exam to reach his right hand up to his temple area and tap it with his forefinger. He explained that this felt almost involuntary, in that it was the familiar motion he would make in order to turn on the device in order to access information and answer questions. He found that he almost ‘craved’ using the device, especially when trying to recall information”.

Even though my primary area of research interest in behavioural addictions, the thing that caught my attention in the description above was the observation that his dreams were experienced in the way he viewed things through Google Glass while he was awake. On first reading this I thought this sounding very much like some research I have been doing with my colleague Angelica Ortiz de Gortari on Game Transfer Phenomena (GTP) in which gamers transfer aspects of their game playing into real life situations. Our work is an extension of the so-called Tetris Effect where Tetris players see falling blocks before their eyes even when they are not playing the game. It appears the authors of this case study has also made the same connection as they reported:

The patient’s experiences of viewing his dreams through the device appear to be best explained solely by his heavy use of the device and may be consistent with what is referred to as the ‘Tetris Effect’. When individuals play the game Tetris for long periods of time, they report seeing invasive imagery of the game in their sleep (Stickgold, Malia, Maguire, Roddenberry, & O’Connor, 2000). Interestingly, Stickgold et al. noted that patients with amnesia due to traumatic brain injury, who had trouble with short-term memory recall, reported invasive imagery of the game during sleep even though they did not recall playing the game (Stickgold et al., 2000). Technology-assisted learning devices and video gaming appear to be powerful methods to aid in the acquisition of new information. Further studies in the field of traumatic brain injury utilizing gaming and technology-assisted learning are needed”.

At the end of the 35-day inpatient stay, the outcome was reported as being good. The patient reported he felt less irritable, and he was making far fewer compulsive movements to his temple. However, no further follow-up was reported by Yung and her colleagues. There are, of course, wider questions about whether addiction to the internet even exists although the article in The Guardian did provide a link to a comprehensive and systematic review of internet addiction that I co-authored with Dr. Kuss and others in the journal Current Pharmaceutical Design. As regular readers of my blog will be aware, I believe that there is a fundamental difference between addictions on the internet and addictions to the internet. The vast majority of people appear to have addictions on the internet (such as gambling addiction, gaming addiction, sex addiction, shopping addiction, etc.) where the internet facilitates other addictive behaviours. However, there is growing evidence of internet-only addictive behaviour (with social networking addiction being the most common).

In relation to this case study, there have been some that have said that the study doesn’t have face validity because the battery life of Google Glass is so small that it is impossible to spend up to 18 hours a day wearing it. (For instance, check out an interesting article written by Taylor Hatmaker published by the Daily Dot). I ought to add that one of the study’s co-authors, Dr. Andrew Doan did say to various news outlets that:

“A wearable device is constantly there – so the neurological reward associated with using it is constantly accessible. There’s nothing inherently bad about Google Glass. It’s just that there is very little time between these rushes. So for an individual who’s looking to escape, for an individual who has underlying mental dysregulation, for people with a predisposition for addiction, technology provides a very convenient way to access these rushes. And the danger with wearable technology is that you’re allowed to be almost constantly in the closet, while appearing like you’re present in the moment”.

Based on the two-page paper that was published, I don’t think there was enough evidence presented to say whether the man in question was addicted to the internet via Google Glass. There were certainly elements associated with addiction but that doesn’t mean somebody is genuinely addicted. Furthermore, most addictive behaviours have to have been present for at least six months before being diagnosed as a genuine addiction. In this case, the man had only been using Google Glass for two months before entering the treatment program.

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

Further reading

Ghorayshi, A. (2014). Google glass user treated for internet addiction caused by device. The Guardian, October 14. Located at: http://www.theguardian.com/science/2014/oct/14/google-glass-user-treated-addiction-withdrawal-symptoms

Griffiths, M.D. (2000). Internet addiction – Time to be taken seriously? Addiction Research, 8, 413-418.

Griffiths, M.D. (2010). Internet abuse and internet addiction in the workplace. Journal of Worplace Learning, 7, 463-472.

Hatmaker, T. (2014). There is no such thing as Google Glass addiction. The Daily Dot, October 15. Located at: https://www.dailydot.com/technology/google-glass-internet-addiction/

Kuss, D.J., Griffiths, M.D. & Binder, J. (2013). Internet addiction in students: Prevalence and risk factors. Computers in Human Behavior, 29, 959-966.

Kuss, D.J., Griffiths, M.D., Karila, L. & Billieux, J. (2014).  Internet addiction: A systematic review of epidemiological research for the last decade. Current Pharmaceutical Design, 20, 4026-4052.

Kuss, D.J., Shorter, G.W., van Rooij, A.J., Griffiths, M.D., & Schoenmakers, T.M. (2014). Assessing Internet addiction using the parsimonious Internet addiction components model – A preliminary study. International Journal of Mental Health and Addiction, 12, 351-366.

Kuss, D.J., van Rooij, A.J., Shorter, G.W., Griffiths, M.D. & van de Mheen, D. (2013). Internet addiction in adolescents: Prevalence and risk factors. Computers in Human Behavior, 29, 1987-1996.

Ortiz de Gotari, A., Aronnson, K. & Griffiths, M.D. (2011). Game Transfer Phenomena in video game playing: A qualitative interview study. International Journal of Cyber Behavior, Psychology and Learning, 1(3), 15-33.

Ortiz de Gortari, A.B. & Griffiths, M.D. (2012). An introduction to Game Transfer Phenomena in video game playing. In J. Gackenbach (Ed.), Video Game Play and Consciousness (pp.223-250). Hauppauge, NY: Nova Science.

Ortiz de Gortari, A.B. & Griffiths, M.D. (2014). Altered visual perception in Game Transfer Phenomena: An empirical self-report study. International Journal of Human-Computer Interaction, 30, 95-105.

Ortiz de Gortari, A.B. & Griffiths, M.D. (2014). Auditory experiences in Game Transfer Phenomena: An empirical self-report study. International Journal of Cyber Behavior, Psychology and Learning, 4(1), 59-75.

Ortiz de Gortari, A.B. & Griffiths, M.D. (2014). Automatic mental processes, automatic actions and behaviours in Game Transfer Phenomena: An empirical self-report study using online forum data. International Journal of Mental Health and Addiction, 12, 432-452.

Stickgold, R., Malia, A., Maguire, D., Roddenberry, D., & O’Connor, M. (2000). Replaying the game: Hypnagogic images in normals and amnesics. Science, 290, 350–353.

Widyanto, L. & Griffiths, M.D. (2006). Internet addiction: A critical review. International Journal of Mental Health and Addiction, 4, 31-51.

Yung, K., Eickhoff, E., Davis, D. L., Klam, W. P., & Doan, A. P. (2014). Internet Addiction Disorder and problematic use of Google Glass™ in patient treated at a residential substance abuse treatment program. Addictive Behaviors, http://dx.doi.org/10.1016/j.addbeh.2014.09.024.

Palm minimization: An unusual case of Alien Hand Syndrome

In a previous blog I briefly overviewed Alien Hand Syndrome. Since writing that blog I came across an interesting case of alien hand syndrome published in a 2000 issue of the American Journal of Physical Medicine and Rehabilitation by Dr. B. Hai and Dr. I. Odderson. They reported an unusual case in which their patient had a right hemispheric stroke and subsequently experienced what the authors described as embarrassing manifestations of Alien Hand Syndrome in the form of involuntary masturbation. The case involved a 73-year old man who was brought into a hospital emergency ward by his wife because of a sudden loss of movement in the left-hand side of his body (including a slight droop on the left-hand side of his face), slurred speech and poor balance. Furthermore, he could stand if helped but was unable to walk unaided. The man had obviously had a stroke but four days later he started to experience involuntary movements of his left arm and claimed his left hand “has a mind of his own”. The paper reported that:

“He developed a tonic grasp reflex with inability to release. He also had a tendency to reach and grasp onto objects with the left hand, such as the telephone cord or the remote control for the television, and was unable to release despite verbal commands. He would persistently grab his comb or fix the collar of his shirt. He also demonstrated difficulty performing bimanual activities, such as eating

Most worryingly, the man’s wife expressed extreme concern when her husband’s left hand would expose his genitals and start to masturbate in public. The involuntary masturbation happened on numerous occasions when talking with the nurses and doctors in the hospital, and only ever occurred with his left hand (even though the man was right-handed). The man denied that he had any history of “excessive self-stimulation, sexual dysfunction, or exhibitionism. While in hospital, the man was dismayed and frustrated that he was unable to stop his left hand stimulating his genitals in front of other people. The authors reported that:

“A clinical impression of [Alien Hand Syndrome] was made, and magnetic resonance imaging of the brain showed an acute infarct [dead tissue] in the medial right frontal lobe [of his brain] in the anterior cerebral artery distribution involving the right anterior cingulate gyrus and the corpus callosum. After [three weeks] of acute inpatient rehabilitation, the patient was able to walk with a standard walker and negotiate stairs with rails with contact guard assist. He also began to use his left hand for bimanual activities. He was subsequently discharged to home with his family”.

After a month of treatment, the man was able to walk again unassisted but his left hand was still not under his own control (and telling the medical staff that his hand “still has a mind of his own and won’t turn things loose”). However, the good news was that the involuntary masturbation in public subsided and eventually ceased. The authors of the paper claim this is a very rare case because their patient displayed “an unusual and disturbing manifestation of uncontrolled involuntary genital fondling with the nondominant, apraxic hand and with mirroring hand movements during eating”. The authors also noted that the involuntary movements of the man’s left hand never occurred while they were carrying out medical tests and suggested that their findings indicate “the possibility of the presence of a dexterous ‘alien’ mode of control that can be distinguished from a more clumsy and slow ‘voluntary’ mode of control”. Although there is no known treatment for AHS, as I noted in my previous blog on the topic, the symptoms can be minimized and managed to some extent by keeping the affected hand occupied and involved in a task (e.g., by giving it an object to hold in its grasp). This would seem to explain why the man never masturbated while undergoing medical tests (i.e., his hands were being occupied). The authors also noted that:

“So far, at least two types of [Alien Hand Syndrome] have been described. The callosal type, as seen in our patient (lesion involving the corpus callosum with or without frontal damage), is characterized by frequent intermanual conflict and apraxia of the affected limb. The frontal type (lesion involving the left mediofrontal and callosal) is associated with dominant hand grasp reflex, compulsive movements (such as groping), restraining actions, and compulsive manipulation of tool [Feinberg, Schindler & Flanagan, 1992]”.

As I noted in my previous blog on AHS, research indicates that AHS sufferers often personify the alien hand and may believe the hand is ‘possessed’ by some other spirit or alien life form. Their hands may even appear to act in opposition to each other (such as when AHS sufferers who are also cigarette smokers put a cigarette in their mouth to set it alight, only for the alien hand to pull it out and throw the cigarette away). Such behaviour is an example of ‘intermanual conflict’ and has been given the name ‘diagnostic ideomotor apraxia’.

A number of published papers have reported that involuntary masturbation can be associated with other conditions. For instance, it has been associated with temporal lobe epilepsy. Dr. M. Cherian reported the case of excessive masturbation in a young girl in a 1997 issue of the European Journal of Pediatrics. However, until the publication of this case of AHS, it had not ever been associated with having a stroke. Dr. Hai and Dr. Odderson conclude:

Although [Alien Hand Syndrome] is a rare phenomenon, this condition should be considered in patients who present with a feeling of alienation of one or both upper limbs accompanied by complex purposeful involuntary movement. It must be differentiated from limb neglect and anosognosia, which present with dissociation from the limb as perceived object (i.e., where the limb is not perceived as a part of the “self”), but without involuntary movement and without dissociation from control over purposeful complex action of the affected limb (i.e., where the actions of the limb are perceived as self-generated). Further studies are required to elucidate a definite anatomical explanation that can lead to accurate diagnosis, specific treatment, and rehabilitation of these patients”

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

Further reading

Biran, I. & Chatterjee, A. (2004). Alien Hand Syndrome. Archives of Neurology, 61, 292-294.

Cherian, M.P. (1997). Excessive masturbation in a young girl: A rare presentation of temporal lobe epilepsy. European Journal of Pediatrics, 156, 249.

Doody, R.S. & Jankovic, J. (1992). The alien hand and related signs. Journal of Neurology, Neurosurgery and Psychiatry, 55, 806-810.

Feinberg, T.E., Schindler, R.J. & Flanagan, N.G. (1992). Two alien hand syndromes. Neurology, 42, 19-24.

Hai, B.G.O., & Odderson, I.R. (2000). Involuntary masturbation as a manifestation of stroke-related alien hand syndrome. American Journal of Physical Medicine & Rehabilitation, 79, 395-398.

Jacome, D.E. & Risko, M.S. (1983). Absence status manifested by compulsive masturbation. Archives of Neurology, 40, 523-524.

Scepkowski, L.A. & Cronin-Golomb, A. (2003). The alien hand: Cases, categorizations, and anatomical correlates. Behavioral and Cognitive Neuroscience Reviews, 2, 261-277.

Ginger rogerers: A very brief look at figging‬

While researching various other blogs (most notably one on urtication and sexual arousal from stinging nettles), I came across the sexual practice of figging. For the uninitiated, figging in the broadest sense refers the act of inserting something (typically ginger) into the body (typically a bodily orifice such as the anus, vagina and/or urethra) that subsequently causes a stinging and/or burning sensation for sexual pleasure and arousal. Figging would appear to be a relatively rare sexual activity, 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 figging in any academic article or book that I am aware of. According to an online article at the London Fetish Scene website:

“The word [figging] is likely to be a derivative of ‘feague’, the practice during Victorian times of putting a piece of peeled ginger into a horse’s anus to make it appear more sprightly and hold its tail up (for shows and selling). Mostly, figging is still used to mean putting a peeled, shaped piece of ginger root into an anus, but in a BDSM context the anus would be that of a [submissive]. Sometimes ‘figging’ is used to refer to a pervertable other than ginger (for example nettles) and also to cover the insertion into the vagina, athough it may be incorrect to consider these as figging…The ginger root is skinned and may also be carved into the shape of a butt plug. Inserting ginger into a healthy anus for even quite lengthy periods should cause no physical damage…Apart from, or together with, figging, ginger pieces or juice from crushed ginger can be inserted in the vagina or applied to the clitoris or male genitals. Care should be taken here, especially with juice, as the genitals are much more sensitive…Victorian texts on the proper treatment of recalcitrant wives included the instructions for figging as it was considered that a spanking should be received on relaxed buttocks and this was seen as one way to train them to receive the spanking properly. It may be from this practice that the phrase who gives a fig?’ originated”.

(By the way, I had never come across the word ‘pervertible’ but in another article on the London Fetish Scene website, pervertibles are defined as “ordinary non-sexual objects, especially everyday household objects, that can be used sexually, particularly in BDSM play”). The (very short) Wikipedia entry on figging also makes reference to the practice of inserting ginger into the anuses of horses (although they describe this practice as ‘gingering’ rather than figging).

As with other types of pain, sexual masochists can find the painful sensations of figging an erotic experience. In sadomasochistic sexual activity, the dominant partner may use figging as a punishment on their submissive partner. The London Fetish Scene article claims:

“If the sub is made to tighten his/her buttocks with a fig inside the anus, the sensation becomes more intense: thus they will usually try to relax those muscles. This provides a good target for caning or spanking, which will often cause the sub to clench his/her backside, which will immediately increase the feeling of heat and pain, thus causing them to want to un-clench”.

There is also the very similar practice called ‘rhapanidosis’ which refers to the insertion of horseradish into bodily orifices (usually the anus), and was allegedly a punishment given to adulterous wives in ancient Athens. According to Wikipedia:

“There is some doubt as to whether the punishment was ever enforced or whether the references to it in comic plays (such as the debate between Right and Wrong in The Clouds of Aritophanes) should be understood as signifying public humiliation in general. In order to be allowed to apply rhaphanidosis to an adulteror, one must catch the man in the act of adultery with one’s own wife, in one’s own house. Rhaphanidosis was not the only penalty available; sodomy by mulletfish was common as well, or the man could simply be killed on the spot. Following this, the adulterous wife would have to be divorced”.

In my research for this blog I came across more than a few websites that espouse the joys of figging. The Figging (Anal Discipline) website has a surprisingly diverse set of articles (such as one on ‘Why figging enhances sex’) and there are a number of websites that provide a ‘how to’ guide for figging. For instance, one detailed guide on the Live Journal by a BDSM practitioner provides the ‘theory and practice of ginger figging’ and asserts:

“Figging is a fairly rare practice that seems to have declined in popularity recently, which I think is a shame because it’s so easy and the effects are so interesting. It’s a lot of fun, and I encourage people to experiment with it”.

There’s also an interesting first person account by Elizabeth Black on the Sex is Social website who describes in detail the first time she tried it (and liked it). Other first hand accounts didn’t (such as those on A Kinkster’s Guide concluding “Stick to sex toys – don’t try this!”). Although there are many academic articles on sadomasochism and sadomasochistic practices, not one of them mentions figging. Therefore, we know absolutely nothing about the prevalence of the practice (but as I said earlier, it is likely to be very rare).

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

Further reading

Black, E. (2010). The fine art of figging Sex is Social, January 2. Located at: http://www.edenfantasys.com/sexis/sex/figging-0102101/

Figging: Anal Discipline (2005). Why figging enhances sex. November 19. Located at: http://www.figging.com/2005/11/19/why-figging-enhances-sex/

Live Journal (2007). BDSM: Theory and practice of figging. Located at: http://tacit.livejournal.com/225189.html

Wikipedia (2013). Figging. Located at: http://en.wikipedia.org/wiki/Figging

Wikipedia (2013). Rhaphanidosis. Located at: http://en.wikipedia.org/wiki/Rhaphanidosis

Wipi (2013). Figging. Located at: http://www.londonfetishscene.com/wipi/index.php/Figging

Wipi (2013). Pervertible. Located at: http://www.londonfetishscene.com/wipi/index.php/Pervertable

Blocked-in syndrome: Another look at Game Transfer Phenomena

Back in the early 1990s, I used to play the video game Tetris on my handheld Nintendo Game Boy. Although I say so myself, I was a really good player and I used to play for hours every day. When I went to bed I would see falling blocks as I closed my eyes. I often experienced the same thing when waking up. What I didn’t realise was that many other gamers experienced this too and that it had a name – ‘The Tetris Effect’. According to Wikipedia,the Tetris effect occurs when people devote so much time and attention to an activity that it begins to pattern their thoughts, mental images, and dreams.”

In the late 1980s I started researching into the area of video game addiction. One of the papers I cited a lot in my early research concerning the side effects of excessive playing was a 1993 case study published in the Irish Journal of Psychological Medicine by Dr. Sean Spence. Dr. Spence reported the case of a female video game player who was diagnosed as suffering from persecutory delusions, exhibiting violent behaviour, and experiencing constant imaginary auditory hallucinations triggered by the music of the Super Mario Brothers video game. This case study and the Tetris effect are both examples of what I and my research colleague Angelica Ortiz de Gortari call ‘game transfer phenomena’ (GTP).

These phenomena tend to occur when video game players become so immersed in their gaming that when they stop playing, they sometimes transfer some of their virtual gaming experiences to the real world. These phenomena can occur both visually and aurally as well is in the form of unconscious bodily movements.

We have been researching GTP for a number of years and our first published study in 2011 made worldwide news. Some of the press coverage was both sensationalist (“Gamers can’t tell real world from fantasy, say researchers) and misleading (“How video games blur real life boundaries and prompt thoughts of violent solutions to players’ problems) and angered some of the gaming community. Our first published study in the International Journal of Cyber Behavior, Psychology and Learning was an exploratory study in which 42 gamers were interviewed. Although the sample was small, we reported that all our participants had, at some point, experienced some type of involuntary sensations, thoughts, actions and/or reflexes in relation to videogames when not playing them. For instance, one gamer reported witnessing a mathematics equation appearing in a bubble above his teacher’s head while another reported health bars hovering over football players from a rival team. However, this didn’t stop some of the press coverage being derogatory (Unscientific survey of 42 gamers concludes video games interfere with perceptions of reality).

Since then we have published three more studies from a self-selected dataset of over 1,600 gamers’ experiences (all of who had experienced some form of GTP) in various academic journals (International Journal of Human Computer Interaction; International Journal of Mental Health and Addiction; International Journal of Cyber Behavior, Psychology and Learning). Our findings have shown that some gamers (i) are unable to stop thinking about the game, (ii) expect that something from the game will happen in real life, (iii) display confusion between video game events and real life events, (iv) have impulses to perform something as in the video game, (v) have verbal outbursts, and (vi) experience voluntary and involuntary behaviours.

While some gamers qualify their experiences as funny, amusing, or even normal, others said they got surprised, felt worried, embarrassed and their experiences were a reason to quit playing. Based on our research so far, Game Transfer Phenomena appear to be commonplace among excessive gamers but the good news is that most of these phenomena are short-lasting, temporary, and appear to resolve of their own accord.

Despite instances of GTP elsewhere in the psychological and medical literature, we argue that there are important reasons for not using the ‘Tetris effect’ concept when studying game transfer effects. Among the most important are that: (i) the Tetris effect definition is very broad and does not emphasize the importance of the association between real life stimulus and video game elements as a trigger of some of the transfer experiences, (ii) it does not make a clear distinction between sensorial modalities in the game transfer experiences or talk about players’ experiences across sensorial modalities (e.g., hearing a sound and visualizing a video game element), and (iii) the name itself is inspired by a one specific stereotypical puzzle game (i.e., Tetris). This simple name indicates that it is repetition that triggers the transfer effects but there are other factors involved in game transfer experiences. Furthermore, modern video games use more than abstract shapes and offer more flexible scenarios compared to Tetris and similar games.

Our latest study that surveyed over 2,500 gamers is currently being analysed but preliminary results indicate that game transfer phenomena appear to be common among players – especially those that play heavily. It could be that some gamers are more susceptible than others to experience GTP. Although for many gamers the effects of these experiences appear to be short lived, our research also shows that some gamers experience them recurrently. More research is needed to understand the cognitive and psychological implications of GTP. Our studies to date show there is a need to investigate neural adaptations and after-effects induced by video game playing as a way of encouraging healthy and safe video game playing.

Note: This blog is an extended version of an article first published in The Conversation

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

Further reading

Gackenbach, J.I (2008). Video game play and consciouness development: A transpersonal perspective. Journal of Transpersonal Psychology, 40(1), 60-87.

Griffiths, M. D., Kuss, D.J., & Ortiz de Gortari, A. (2013). Videogames as therapy: A review of the medical and psychological literature. In I. M. Miranda & M. M. Cruz-Cunha (Eds.), Handbook of research on ICTs for healthcare and social services: Developments and applications (pp.43-68). Pennsylvania: IGI Global.

Ortiz de Gotari, A., Aronnson, K. & Griffiths, M.D. (2011). Game Transfer Phenomena in video game playing: A qualitative interview study. International Journal of Cyber Behavior, Psychology and Learning, 1(3), 15-33.

Ortiz de Gortari, A.B. & Griffiths, M.D. (2012). An introduction to Game Transfer Phenomena in video game playing. In J. Gackenbach (Ed.), Video Game Play and Consciousness (pp.223-250). Nova Science

Ortiz de Gortari, A.B. & Griffiths, M.D. (2014). Altered visual perception in Game Transfer Phenomena: An empirical self-report study. International Journal of Human-Computer Interaction, 30, 95-105.

Ortiz de Gortari, A.B. & Griffiths, M.D. (2014). Auditory experiences in Game Transfer Phenomena: An empirical self-report study. International Journal of Cyber Behavior, Psychology and Learning, 4(1), 59-75.

Ortiz de Gortari, A.B. & Griffiths, M.D. (2014). Automatic mental processes, automatic actions and behaviours in Game Transfer Phenomena: An empirical self-report study using online forum data. International Journal of Mental Health and Addiction, 12, 432-452.

Parfitt, B. (2011). Metro “can’t tell real world from fantasy”. MCV. September 21. Located at: http://www.mcvuk.com/news/read/metro-can-t-tell-real-world-from-fantasy/085065

Purchase, R. (2011). Prof clarifies Game Transfer Phenomena. Eurogamer.net. September 21. Located at: http://www.eurogamer.net/articles/2011-09-21-game-transfer-phenomena-authors-defence

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

The Tetris Effect. Located at: http://en.wikipedia.org/wiki/Tetris_effect

Pet projects: A brief look at domestic animals with social media accounts

Earlier today, I was interviewed by BBC radio about people that have set up social media accounts for their pets. In all honesty I am not a pet person but I am also well aware of the many psychological studies showing that pets hold a special place in the lives of many families and that many people treat pets as if they are one of the family. Professor John Archer has written many papers on the psychology of pet ownership and in a 1997 review paper (‘Why do people love their pets?”) in the journal Evolution and Human Behavior noted:

“People form strong attachments with their pets…[The owning of pets] enable pets to elicit caregiving from humans…in some circumstances…pet owners derive more satisfaction from their pet relationship than those with humans, because they supply a type of unconditional relationship that is usually absent from those with other human beings”.

In August 2014, the Daily Telegraph published the results of a survey they had done and reported that almost one in four dogs and cats now has their own social feed or webpage. In fact, their survey of 2,000 pet owners claimed that 9% of dogs had their own Twitter account and 13% of cats had their own Facebook page. It was also reported that 2% of dogs even had their own blog. The article then went on to list pets that had high numbers of followers and admirers. This included ‘Boo the Dog’ (the ‘world’s cutest dog’ according to pop star Ke$ha with 15 million Facebook ‘Likes’), ‘Grumpy Cat’ (‘famous for his unimpressed face’ with 6 million Facebook ‘Likes’), Graham The Kitten (singer Ed Sheeran’s cat with 99,500 followers), ‘Maggie May’ (tennis player Andy Murray’s dog with 27,000 followers), and ‘Meredith Swift’ (singer Taylor Swift’s cat with 10,000 followers).

As there is no academic research on pets with social media account I went looking online for information and came across an article on the Social Times website entitled ‘Your dog may be more popular than you – 20% have over 50 Facebook friends’. The article began:

“How many pets are online?  How many pet owners are tweeting and Facebooking for their cats and dogs? How many pets have a YouTube page? A new infographic from eBay Classifieds reveals that Fido and Fluffy are hitting the social web a lot more often than you may think! The ‘Social Savvy Critters’ infographic reveals that 14% of dog owners maintain a Facebook page for their pet, 6% tweet for their dogs on Twitter, and a whopping 27% have their own YouTube page! In addition to providing stats about how many pets are online, the infographic also offers up some advice for pet owners looking to get their furry friends online. They provide 8 Twitter tips for dogs, tips on creating a blog from your pet’s perspective, and a list of pet-related social networks”.

The data were collected for a survey carried out by DoggyLoot.com. I have no details on how the data were collected or how many dog owners participated in the survey but in the absence of empirical research it’s the best I could find. The same survey also reported that among the 14% that had set up Facebook accounts for their dogs, 42% of the dogs (I’m not making this up, honestly) had 1-25 Facebook friends, and 20% had 50-100 Facebook friends. The article also made reference to a number of online communities where pets online can get together including petzume.com and petizens.com.

During my research for the radio interview I was surprised to find that Facebook founder had set up a Facebook account for his Hungarian sheepdog (‘Beast’) posting messages such as “I just took a dump and made Mark Zuckerberg pick it up. It was glorious”. The Guardian newspaper did a profile piece on Zuckerberg and his dog after the online social media account had been set up that turned into an article about pets being online. The (2012) article noted that: 

“Pets on social networking sites are huge – high-profile Beast is liked by more than 42,000 people so far – and more and more of us are creating online lives for our companion animals, despite Facebook rules that state you must be over 13 to use the site (at just two months, even in dog years, Beast is only 16 months old) and, more importantly, you cannot create a profile for anyone other than yourself”.

The Guardian reporter (Bim Adewumni) asked the obvious question of who befriends a dog on Facebook or follows a cat on Twitter? And (more importantly) why? To answer the questions, Adewumni interviewed people that had set up online accounts. She wrote:

“Yasmin Eshref set up a page for her cat Georgie Coalie, as a joke to cheer up a friend. ‘But then lots of friends started adding her and sending messages to her’ says Eshref. Georgie passed away last year, but lives on in Facebook. ‘I suppose I kept it up for sentimental reasons, like not wanting to throw away the possessions of a dead person. I know it sounds a bit naff, but it’s just hard to let go’ she says. One friend tells me she has befriended a dog belonging to a friend on Facebook. ‘He even posts updates. I love him’. But another follows a puppy she is less than enamoured with: ‘Truly, I think it is slightly ridiculous. I did it to avoid offending my friends. The dog is cute, but I’m not that into him’. Animals on social networking sites have enormous numbers of fans. Sockamillion, a grey-and-white cat belonging to computer administrator and historian Jason Scott, tweets under the alias Sockington and has more than 1.4 million followers on Twitter. His list of followers reveals hundreds of tweeting cats and dogs. There are also spoof accounts for Bo, the family dog of the Obamas, and, of course, Larry, the newly acquired Downing Street cat. Fictional animals are doing just as well. Scooby Doo, Gromit and even Aleksandr Orlov, the meerkat from the car insurance advertisements, have Facebook pages”.

As there is no research on why people set up social media accounts for their pets (or why people follow them on Twitter or ‘Like’ them on Facebook) we can only speculate about possible motivations for such actions. If pets are considered an equal member of some families or act as surrogate children for childless couples, it’s perhaps unsurprising if some set up online social media accounts in their name. As noted in the Guardian article, some may set the accounts up as a joke or for sentimental reasons. Others may find it harmless fun or do it simply because they can. As I have noted in much of my cyber-psychological research, many activities carried out online are usually done for similar reasons including amusement, boredom, and revenge.

Others may do things online to explore facets of their personality that they can’t do offline or as a way of feeling better about themselves. Is someone that writes online from the perspective of their pet psychologically any different from gamers who swap their gender or species within an online video game? Unlike some online activities connected with social media (online trolling, social media addiction, etc.), there appears to be little harm in posing as your pet. Given the unlikelihood of any problematic behaviour, I can’t see how such behaviour will ever become an area for serious scientific study.

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

Further reading

Adewunmi, B. (2011). Why has Mark Zuckerberg set up a Facebook page for his dog? The Guardian, March 9. http://www.theguardian.com/global/2011/mar/09/mark-zuckerberg-dog-facebook-page

Archer, J. (1997). Why do people love their pets? Evolution and Human Behavior, 18(4), 237-259.

Bryant, C. (2012). 7 ways to make your dog a social media superstar. Dogster, December 18. Located at: http://www.dogster.com/lifestyle/make-your-dog-social-media-superstar-7-tips

eBay Classifieds Blogs (2012). Social savvy critters. January 16. Located at: http://blog.ebayclassifieds.com/2012/01/16/social-savvy-critters/

Fuster, H., Oberst, U., Griffiths, M.D., Carbonell, X., Chamarro, A. & Talarn, A. (2012). Psychological motivation in online role-playing games: A study of Spanish World of Warcraft players. Anales de Psicologia, 28, 274-280.

Hussain, Z. & Griffiths, M.D. (2008). Gender swapping and socialising in cyberspace: An exploratory study. CyberPsychology and Behavior, 11, 47-53.

Kealey, H. (2014). The most popular pets on social media. The Daily Telegraph, August 26. Located at: http://www.telegraph.co.uk/lifestyle/pets/11056619/The-most-popular-pets-on-social-media.html

Lewis, A. & Griffiths, M.D. (2011). Confronting gender representation: A qualitative study of the experiences and motivations of female casual-gamers. Aloma: Revista de Psicologia, Ciències de l’Educació i de l’Esport, 28, 245-272.

McCormack. A. & Griffiths, M.D. (2012). Motivating and inhibiting factors in online gambling behaviour: A grounded theory study. International Journal of Mental Health and Addiction, 10, 39-53.

O’Neill, M. (2012). Your dog may be more popular than you – 20% have over 50 Facebook friends. Social Times, January 18Located at: http://socialtimes.com/social-media-pets-infographic_b88001

Thacker, S. & Griffiths, M.D. (2012). An exploratory study of trolling in online video gaming. International Journal of Cyber Behavior, Psychology and Learning, 2(4), 17-33.

Belch rare bit: A very brief look at burping fetishes

Over the last couple of years I’ve covered some pretty idiosyncratic fetishes in my blog. Today’s topic is up there with the strangest (and perhaps one of the least commonplace) – burping fetishism. My assertion that it is one of the least commonplace comes from the fact there is (perhaps unsurprisingly) absolutely nothing in the academic or clinical literature on burping fetishism. Furthermore, I was only able locate one online forum that appeared to be solely dedicated to the sexual side of burping – check out the Burp Fetish Forums website. (I ought to also mention that on YouTube there are dedicated collections of people burping on camera. Although these collected clips may be sexually arousing to a burp fetishist, I guess most people who watch them do so because they find them amusing).

However, it was while I was writing a previous blog on sneeze fetishes (in itself a strange and rare fetish) that I came across a few people also admitting that they were also sexually aroused by the thought and/or sight of someone burping and belching. (I’m not sure if there is really any difference between burping and belching although from what I’ve read in a fetishistic sense is that belching appears to be very loud burping whereas burping does not necessarily have to be loud).

Anecdotally, the ‘loudness’ aspect appears to be an important element to burp fetishists. In this sense, it is the noise made rather than the action itself that appears to be what is sexualized and/or interpreted by the fetishist as sexually pleasurable and arousing. In sexual behaviour more generally, hearing quite clearly influences sexual arousal and response. However, this is typically in the form of music that facilitates peoples’ mood in readiness for sex, and/or the sounds that people make while engaging in sexual activity (e.g., ‘talking dirty’ and/or moaning and groaning while making love). One 2002 book chapter I read on sexual response (in a book on human sexuality by Dr. Tina Miracle, Dr. Andrew Miracle and Roy Baumeister) reported some interesting studies on the role of sound in sexual arousal. More specifically it reported that:

“In one study, male college students were shown 60-second erotic videos both with and without the accompanying audio. There was a significant positive correlation between male sexual arousal and sound, as measured by penile plethysmograph and self-report (Gaither & Plaud, 1997). Another study found that a male partner’s silence during lovemaking inhibited the female partner’s sexual response (DeMartino, 1990). However, silence might be preferable to some other sounds, such as your partner burping during an embrace or the ringing of the phone. Many people find the sound of the words ‘I love you’ to be the most arousing of all”.

Interestingly, this extract makes a point of noting that burping during sex would be one of the worst sounds to hear in a sexual situation. However, judging by the extracts I collated below, this is not the case with everyone. I managed to find a small but sizable number of online admissions relating to burp fetishes. Obviously I cannot guarantee the veracity of the content but in the context of the pages that I found them on, they appear to be genuine and heartfelt:

  • Extract 1: “I’m a girl and I have a major fetish for guys that can burp loud. [I don’t know why] but I enjoy it a lot. It’s so sexy. I can also burp really loud so I wish I could find a guy with it so it’s mutual, but no luck so far. I can burp pretty good, and I also have a fetish for burping girls. The girl has to be attractive (not super ultra hot, but that would be nice), and I find it extremely erotic if they can out belch me. I don’t know why I was born with this ‘kink’, or why others are born with it”
  • Extract 2: “I for one love it when I hear a girl burp. In particular, I suppose it has to be a girl who I find attractive in the first place. If I don’t find her attractive then it’s only just as impressive as hearing another male burp. Don’t give up. Your burpin’ lovin’ man is out there somewhere. Fortunately, our mating call is loud and clear so you will eventually find him smiling back at you when you let one roar someday”.
  • Extract 3: Ever since I [can] remember, I’ve been turned on by other women burping! I cant go a day without watching a burping / farting / stuffing video”.
  • Extract 4: I’m a new guy here with some of what I would consider to be general turn ons (muscles, worship, lifting, etc.), but it’s my fetish for burping that I’m curious about. First off, I was wondering if there were other people in this forum who shared a similar fetish for belching and hearing other guys burp…I know in my case, the feeling of air trapped in the stomach tends to feed into another fetish of mine, inflation…YouTube provides a good library of belching guy videos, and I found one other site that deals with the fetish aspect (which I can’t list yet because of the post count limit), but the focus there is primarily for the heterosexual, burping girl enthusiast crowd”.
  • Extract 5: “Has anyone ever successfully gotten a boyfriend/girlfriend that can do/has features of their fetish? I would have no idea how to find a guy who can burp. It’s not something that usually comes up at the first date. But this goes for any fetish. Is it too much to ask to have a boyfriend to fulfill your fetish, and if not, how would you go about dropping the bomb to your boyfriend [or] girlfriend?”
  • Extract 6: “I really get turned on when I hear a men belch or burp. It’s burly and just wrong on so many levels, but it’s real and I love the thought of how much a person can consume to make them do that…Isn’t that so weird?”

There are also various online forums where burp fetishes are discussed (such as the Amber Cutie website). Although these online admissions surrounding the sexiness of burping are short, (if true) they lead to some immediate conclusions. Firstly, the online confessions came from both men and women. Secondly, the online confessions were made both heterosexuals and homosexuals. Thirdly, there appear to be psychological and/or behavioural overlaps with other sexual fetishes including inflation fetishes, feederism (i.e., stuffing) fetishes, and farting fetishes. All of these are arguably connected with the consumption of foodstuffs so perhaps the overlaps are not that surprising. The only other fetishes that I have come across where there is some overlap is sneeze fetishists that also have a burp fetish, and paraphilic infantilism (i.e., adult babies) where being burped by mother/matron figures is sometimes sexually arousing. However, all of these identified overlaps are anecdotal and not based on any scientific or clinical research.

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

Further reading

Miracle, T.S., Miracle, A. & Baumeister, R. (2002). Human Sexuality: Meeting Your Basic Needs. Upper Saddle River, NJ: Prentice-Hall/Pearson.

Plaud, J.L., Gaither, G.A., Hegstad, H.J., Rowan, L., & Devitt, M.K. (1999). Volunteer bias in human psychophysiological sexual arousal research: To whom do our research results apply? Journal of Sex Research, 36, 171-179.

Net gains: What are the benefits of online therapy for problem gamblers and clinicians?

“A 35-year old man comes home very late from a night out at the casino having lost all his savings at the roulette wheel. Unable to sleep, he logs onto the Internet and locates a self-help site for problem gambling and fills out a 20-item gambling checklist. Within a few hours he receives an E-mail which suggests he may have an undiagnosed gambling disorder. He is invited to revisit the site to learn more about his possible gambling disorder, seek further advice from an online gambling counsellor and join an online gambling self-help group” (from Griffiths and Cooper, 2003)

On initial examination, this fictitious scenario appears of little concern until a number of questions raise serious concerns. For instance, who scored the gambling test? Who will monitor the gambling self-help group? Who will give online counselling advice for the gambling problem? Does the counsellor have legitimate qualifications and experience regarding gambling problems? Who sponsors the gambling website? What influence do the sponsors have over content of the site? Do the sponsors have access to visitor data collected by the website? These are all questions that may not be raised by a problem gambler in crisis seeking help but they are important questions that require answers. Of course, these are also questions that should apply to any comparable face-to-face interventions.

The Internet could be viewed as just a further extension of technology being used to transmit and receive communications between the helper and the helped. If gambling practitioners shun the new technologies, others who might have questionable ethics will likely come in to fill the clinical vacuum. Online therapy is growing. Furthermore, its growth appears to outstrip any efforts to organize, limit and regulate it. It has been claimed that online therapy is a viable alternative source of help when traditional psychotherapy is not accessible. Proponents claim it is effective, private and conducted by skilled, qualified, ethical professionals. It is further claimed that for some people, it is the only way they either can or will get help (from professional therapists and/or self-help groups).

Psychological services provided on the Internet range from basic information sites about specific disorders, to self-help sites that assess a person’s problem, to comprehensive psychotherapy services offering assessment, diagnosis and intervention. Most experts agree that online therapy currently available is not traditional psychotherapy. For many, it appears to be an alternative for those who are either unable or reluctant to seek face-to-face treatment. There have been many reasons put forward as to why online assistance is advantageous. Here are the main ones:

  • Online therapy is convenient: Online therapy is convenient to deliver, and can provide a way to seek instant advice or get quick and discreet information. In the case of counselling by E-mail, one needs to keep in mind that therapy per se can occur either via professionally delivered formats or via peer-delivered self-help groups. In addition, the counselling might not necessarily be restricted to E-mail; some might augment face-to-face counselling with E-mail ‘booster’ sessions. In this way, correspondence happens at the convenience of both the client and the counsellor. Online therapy avoids the need for scheduling and the setting of appointments, although for those who want them, appointments can be scheduled over a potential 24-hour period. For problem gamblers who might have a sense of increased risk or vulnerability, they can take immediate action via online interventions, as these are available on demand and at any time. Crisis workers often report that personal crises occur beyond normal office hours, making it difficult for people to obtain help from mental health clinicians and the like. If a problem gambler has lost track of time at the casino only to depart depressed, broke, and suicidal at 4am in the morning, they can perhaps reach someone at that hour who will be understanding, empathic and knowledgeable. They likely have a better chance of finding someone at an online peer-support site like GamTalk (gamtalk.org) than they would at their local mental health centre.
  • Online therapy is cost-effective for clients: Compared with traditional face-to-face therapies, online therapy is cheaper. This is a big selling point often used by those selling their services online (for instance, some sites advertise their online services as ‘less than the customary cost of a private therapy session’ or ‘help and therapy at a reasonable fee’). This is obviously an advantage to those who may have low financial resources. It may also allow practitioners to provide services to more clients because less time is spent travelling to see them. Since there are financial consequences for a gambler, cheaper forms of therapy such as online therapy may be a preferred option out of necessity rather than choice. The cost factor is particularly important in countries where people are often forced to pay for health care (for example, in the United States). With the Internet, quality information and support (even if treatment is not yet freely available online) is available without cost. Arguably, one needs Internet access, but this too is becoming more freely available, and conceivably, even those who are homeless would be able to utilize such services through places like public libraries (although, literacy would continue to be an important requirement).
  • Online therapy overcomes barriers that otherwise may prevent people from seeking face-to-face help: There are many different groups of people who might benefit from online therapy. For example, those who are (i) physically disabled, (ii) agoraphobic, (iii) geographically isolated and/or do not have access to a nearby therapist (military personnel, prison inmates, housebound individuals etc.), (iv) linguistically isolated, and (v) embarrassed, anxious and/or too nervous to talk about their problems face-to-face with someone, and/or those who have never been to a therapist before might benefit from online therapy. Some like those with agoraphobia and/or the geographically isolated, might be more susceptible to activities like online gambling because they either tend not to leave home much or they do not have access to more traditional gambling facilities (like casinos, bingo halls, racetracks and so forth). It is clear that those that are most in need of help (whether it is for mental health problems, substance abuse or problem gambling often do not receive it).
  • Online therapy helps to overcome social stigma: The social stigma of seeing a therapist can be the source of profound anxiety for some people. However, online psychotherapists offer clients a degree of anonymity that reduces the potential stigma. Gambling may be particularly stigmatic for some because they may find it is a self-initiated problem. Others have found that the issue of stigma has caused some problem gamblers to avoid seeking treatment. Furthermore, in an exploratory study, my research colleague Dr. Gerry Cooper found that there was a correlation between higher levels of concerns about stigma and the absence of treatment utilization, and that lurking (i.e., visiting but not registering presence to other users) at a problem gambling support group website made it easier for many to seek help including face-to-face help. It should also be noted that there is strong emerging evidence for the power and effectiveness of narrative therapies. For example, there is some evidence to suggest that a person’s use of positive emotion words in their written articulations of difficult or problematic experiences lead to improved health changes.
  • Online therapy allows therapists to reach an exponential amount of people: Given the truly international cross-border nature of the Internet, therapists have a potential global clientele. Furthermore, gambling itself has been described as the ‘international language’ and has spread almost everywhere within international arenas.

From the brief outline presented here, it would appear that in some situations, online therapy can be helpful – at least to some specific sub-groups of society, some of which may include problem gamblers. Furthermore, online therapists will argue that there are responsible, competent, ethical mental health professionals forming effective helping relationships via the Internet, and that these relationships help and heal. However, online therapy is not appropriate for everyone. As with any new frontier, there are some issues to consider before trying it. In my next blog I will look at some of the downsides of online therapy.

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

Further reading

Bloom, W. J. (1998). The ethical practice of Web Counseling. British Journal of Guidance and Counselling, 26 (1), 53-59.

Connall, J. (2000). At your fingertips: Five online options. Psychology Today, May/June, 40.

Griffiths, M.D. (2001). Online therapy: A cause for concern? The Psychologist: Bulletin of the British Psychological Society, 14, 244-248.

Griffiths, M.D. (2005). Online therapy for addictive behaviors. CyberPsychology and Behavior, 8, 555-561.

Griffiths, M.D. (2010). Online advice, guidance and counseling for problem gamblers. In M. Manuela Cunha, António Tavares & Ricardo Simões (Eds.), Handbook of Research on Developments in e-Health and Telemedicine: Technological and Social Perspectives (pp. 1116-1132). Hershey, Pennsylvania: Idea Publishing.

Griffiths, M.D. & Cooper, G. (2003). Online therapy: Implications for problem gamblers and clinicians, British Journal of Guidance and Counselling, 13, 113-135.

Rabasca, L. (2000). Self-help sites: A blessing or a bane? APA Monitor on Psychology, 31(4), 28-30.

Segall, R. (2000). Online shrinks: The inside story. Psychology Today, May/June, 38-43.

Wood, R.T.A. & Griffiths, M.D. (2007). Online guidance, advice, and support for problem gamblers and concerned relatives and friends: An evaluation of the Gam-Aid pilot service. British Journal of Guidance and Counselling, 35, 373-389.

Wood, R. T., & Wood, S. A. (2009). An evaluation of two United Kingdom online support forums designed to help people with gambling issues. Journal of Gambling Issues, 23, 5-30.

Duty bound: A beginner’s guide to mummification fetishes

One thing that never ceases to amaze me is how specific some of the objects of erotic and sexual focus are when it comes to sexual fetishes and sexual paraphilias. A case in point is mummification (the wrapping the full body in a manner that prevents movement). In a previous blog on sexual masochism, I briefly mentioned the practice of mummification within a sadomasochistic context. According to Dr. Aggrawal’s 2009 book Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices, mummification is:

“An extreme form of bondage in which the person is wrapped from head to toe, much like a mummy, completely immobilizing him. Materials used may be clingfilm, cloth, bandages, rubber strips, duct tape, plaster bandages, bodybags, or straitjackets. The immobilized person may then be left bound in a state of effective sensory deprivation for a period of time or sensually stimulated in his state of bondage – before being released from his wrappings”.

The Wikipedia entry on mummification within a BDSM and bondage context includes verbatim text from Dr. Aggrawal’s definition (although doesn’t acknowledge the source of the material whatsoever). However, it does add that those who have undergone the process end up “looking like an Egyptian mummy” and that the act of mummification is typically used to enhance the feelings of total bodily helplessness, and is incorporated with sensation play (i.e., a group of erotic activities that facilitate particular physical sensations upon a sexual partner). Some mummification practitioners completely cover themselves with only one or two body orifices exposed (i.e., nose and/or mouth so that the person mummified can breathe without restriction). Sensation play typically differs from more mental forms of erotic play (e.g., sexual role playing). The Wikipedia entry on sensation play notes that:

“Sensation play can be sensual, where the sensations are generally pleasing and light. Many couples that would not consider themselves active in BDSM are familiar with this kind of play: the use of silk scarves, feathers, ice, massage oils, and other similar implements. Sensation play in BDSM can also involve sadomasochistic play, involving the application of carefully controlled stimuli to the human body so that it reacts as if it were actually hurt. While this can involve the infliction of actual pain, it is usually done in order to release pleasurable endorphins, creating a sensation somewhat like runner’s high or the afterglow of orgasm, sometimes called ‘flying’ or ‘body stress’”.

It’s probably stating the obvious to say that mummification can be risky for those who engage in the activity. Complications may arise if those encased (in materials such as clingfilm) are unable to signal to their sexual partner that they are having trouble breathing, sweating too much, and becoming severely dehydrated, or that their blood supply is being severely restricted. Straight after the ‘unwrapping’ process, body temperature may have significantly decreased so being in a warm environment and/or having warm blankets on hand is an absolute must. Sexual partners are also advised to have ‘panic shears’ (sometimes called ‘trauma shears’ by BDSM regulars) readily available at all times so that mummification binding can be cut through quickly and easily should things go awry. Mummification can also include more ‘innovatory’ techniques. For instance, in an article I read on ‘Shibari’ (Japanese bondage) by Hans Meijer in a 2000 issue of the Secret Magazine, he noted that wet sheets can be a particularly good material for sexual mummification of submissive sexual partners:

“A non-rope Japanese mummification is done with wet sheets. Wrap your sub in wet sheets and pull them tight. As the sheets dry they will shrink and the mummification will become even tighter. By using a hair dryer you can not only speed up the process, but also determine what areas you want to shrink first and by doing so will ass accents to your bondage”.

A 2004 article on the Forbidden Sexuality website claims that mummification bondage is “a new practice related with BDSM that is becoming more and more popular in the recent years”. Unsurprisingly, the article also states that mummification bondage is strongly associated with feelings of domination and submission. The article notes that:

“For some reason, people engaged to mummification bondage feel an intense sexual arousal and pleasure by being wrapped in bandages, and even being bound and encapsulated in a coffin after that…There has to be a strong connection of trust between the dominant part and the person who’s going to be mummified. It’s also a practice that also needs to be completely, 100% consensual, otherwise, it may be even faced as a crime of aggression. Mummification bondage also requires precaution and training to not suffocate the person who’s playing the submissive part. Some people who are engaged to mummification bondage also reports a connection with the feeling of being immortal which was associated with mummification in ancient Egypt, preserving the body youth to immemorial times”.

There would appear to be strong psychological and behavioural overlaps between mummification fetishism and ‘total enclosure’ fetishism (in fact I would argue that mummification fetishes are a sub-type of total enclosure fetishes). The Wikipedia entry on total enclosure fetishism highlights that such individuals find the claustrophobic and helplessness aspects sexually arousing (and would appear to be similar to claustrophilia that I covered in a previous blog). The Wikipedia entry notes that total enclosure sexual activities can include:

  • Rubber fetishism: This refers to fetishists who gain sexual pleasure and arousal from rubber suits, gas masks and similar garments and accessories.
  • Vacuum pack fetishism: This refers to fetishists who gain sexual pleasure and arousal from vacuum beds that rigidly enclose the entire human body inside a rubber sheet (apart from a small breathing tube).
  • Sleepsack/bodybag fetishism: This refers to fetishists who gain sexual pleasure and arousal from sleeping bags and bodybags (some of which increase pressure on the fetishist’s body).
  • Spandex fetishism: This refers to fetishists who gain sexual pleasure and arousal from such things as zentai suits that are used for total enclosure from head-to-toe in skintight fabric. Zentai suits have the advantage that the fetishist can breathe through the loose-woven fabric in a way that is impossible with PVC or rubber.

A few academic studies have examined mummification within the wider gamut of sadomasochistic activities. For instance, a Finnish study on BDSM activities led by Dr Laurence Alison and reported in the Archives of Sexual Behavior described the wide range of activities in which their 184 sadomasochistic participants engaged in (162 men and 22 women). This included flagellation, bondage, piercings, hypoxyphilia, fisting, knifeplay, electric shocks, and mummification. They reported that there were major differences in these activities depending upon sexual orientation (for instance, gay men were more likely to engage in activities such as “cock binding”). Most interestingly, the research team identified four sadomasochistic sub-groups based on the type of pain given and received. These were:

  • Typical pain administration: This involved practices such as spanking, caning, whipping, skin branding, electric shocks, etc.
  • Humiliation: This involved verbal humiliation, gagging, face slapping, flagellation, etc. Heterosexuals were more likely than gay men to engage in these types of activity.
  • Physical restriction: This included bondage, use of handcuffs, use of chains, wrestling, use of ice, wearing straight jackets, hypoxyphilia, and mummifying.
  • Hyper-masculine pain administration: This involved rimming, dildo use, cock binding, being urinated upon, being given an enema, fisting, being defecated upon, and catheter insertion. Gay men were more likely than heterosexuals to engage in these types of activity.

The same authors published a follow-up using the same dataset, and reported that within those who enjoyed physical restriction, 13.4% engaged in mummification activities. In another study published in a 2002 issue of Sexual and Relationship Therapy, the same authors combined the results from five previously published studies on sadomasochistic behaviour. They reported that 12.9% of all their sadomasochistic participants had engaged in mummification as a sexual practice.

These studies seemed to confirm and expand on a previous 1984 study published in the journal Social Problems by Dr. Martin Weinberg and colleagues. They interviewed sadomasochists over an eight-year period and reported that their behaviour comprised five distinct features: (i) dominance/submission, (ii) role-playing, (iii) consensuality, (iv) sexual context, and (v) mutual definition. Although not directly concerning mummification, it is clear that these features are critical in the extent to which those mummified experience the activity as sexually stimulating. A less than academic (but interesting) article on the What To See In Berlin website also observes:

“We must not lose sight that these mummies are used as foreplay, and should provoke pleasure in the submissive, allowing them to enjoy the feeling of subjugation and helplessness caused by having their motion restricted, all the while they resist the ‘evil’ that the dominant may want to practice with them. BDSM enthusiasts tend to fall into the temptation of taking a whip, a cane or tweezers to their mummy, because both participants find it stimulating! To maximize the game’s success, couples who seek to take the game to new erotic heights generally leave their favourite erogenous zones exposed following the sexual mummification (i.e. not covered by bandages, plastic or tape)… The most obvious and usual place of erotic stimulation, either by blows or strokes, are the nipples, genitals and buttocks, although the only limit is the imagination”.

It would appear from both anecdotal evidence and empirical research that mummification within a BDSM context comprises a significant minority interest and is probably nowhere near as rare as some other sexual behaviours that I have covered in previous blogs.

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

Further reading

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

Alison, L., Santtila, P., Sandnabba, N. K., & Nordling, N. (2001). Sadomasochistically oriented behavior: Diversity in practice and meaning. Archives of Sexual Behavior, 30, 1–12.

Forbidden Sexuality (2004). Mummification bondage. Located at: http://www.forbiddensexuality.com/mummification_bondage.htm

Meijer, H. (2000). Shibari: House of Japanese Bondage. Secret Magazine, 18, 23-46.

Sandnabba, N. K., Santtila, P., Alison, L., & Nordling, N. (2002). Demographics, sexual behaviour, family background and abuse experiences of practitioners of sadomasochistic sex: A review of recent research. Sexual and Relationship Therapy, 17, 39–55.

Sandnabba, N. K., Santtila, P., & Nordling, N. (1999). Sexual behavior and social adaptation among sadomasochistically oriented males. Journal of Sex Research, 36, 273–282.

Santilla, P., Sandnabba, N.K., Alison, L. & Nordling, G.N. (2002). Investigating the underlying structure in sadomasochistically-oriented behaviour: evidence for partially-ordered scales. Archives of Sexual Behavior, 31, 185-196.

Weinberg, M.S., Williams, C.J. & Moser, C. (1984). The social constituents of sadomasochism. Social Problems, 31, 379-389.

Wikipedia (2014). Sensation play (BDSM). Located at: http://en.wikipedia.org/wiki/Sensation_play_(BDSM)

Wikipedia (2014). Total enclosure fetishism. Located at: http://en.wikipedia.org/wiki/Total_enclosure_fetishism

Wikipedia (2014). Mummification (BDSM). Located at: http://en.wikipedia.org/wiki/Mummification_(BDSM)

Period pain: A brief look at ‘binge gambling’

Most of you reading this will have probably heard of ‘binge drinking’ and ‘binge eating’. These behaviours are well known in the psychological literature. However, there has been very little research into the phenomenon of binge gambling. Binge gambling shares many similarities with other binge behaviours including loss of control, salience, mood modification, conflict, withdrawal symptoms, denial, etc. However, there are also clear differences between some binge behaviours. For instance, amounts of alcohol and food can be quantified and measured in terms of physical factors (e.g., organ capacity, weight, metabolic rate), and are therefore subject to physical limitation. The amount of money spent gambling can be highly individual, related to the gambler’s income and access to money, and is limited by few external controls aside from time, fatigue, and lack of funds.

In 2003, Dr. Lia Nower and Dr. Alex Blaszczynski published a case study of a binge gambler in the journal International Gambling Studies. They hypothesized the existence of a unique typology of adult gamblers that are distinctly different from traditional pathological gamblers. They hypothesized that gambling binges are characterized by six factors including:

  • Sudden onset of irregular or intermittent periods of sustained gambling
  • Excessive expenditures relative to income
  • Rapidly spent money over a discrete interval of time
  • Sense of urgency and impaired control
  • Marked intra-and inter-personal distress
  • Absence between bouts of any rumination, preoccupation or cravings to resume gambling participation.

More recently I also published a case study of a binge gambler in the International Journal of Mental Health and Addiction – a male slot machine addict that I called ‘Trevor’ (and aged 31 years when I published my study). I met Trevor in my capacity as an expert witness in a court trial. Trevor was charged with criminal offences related to his gambling behaviour.

Trevor’s initial gambling involvement started in the summer of 1990 when he was 16 years of age. At the time, Trevor had just begun working on a Youth Training Scheme in a West Midland town in the UK. His place of work was situated right next to an amusement arcade that housed many slot machines. Trevor’s normal routine was to go to the arcade every Friday (on his ‘pay day’). At this stage, Trevor rarely spent more than £3 at any one time on the machines and they were clearly unproblematic at that point.

Over the following years (1993–1996), Trevor’s slot machine gambling became progressively worse (at least in the amount he was spending on them) although not necessarily problematic. From 1995 onwards, Trevor had a good job as a support worker for people with disabilities. He was 21-years old and “making good money” (£250 a week), but about half of his salary was used to fund his slot machine gambling. Trevor recalled very vividly one Friday evening at the end of 1995 when he lost £200 of his weekly wage playing a slot machine. This he said was “devastating” to him. It was after this single incident that Trevor admitted to himself that he may have a problem with his gambling. Trevor is what would best be described as a binge gambler and did not gamble daily. His typical pattern would be to gamble only once or twice a week (most Fridays and the occasional Sunday). However, these binges often resulted in the losing of substantial sums of money — at least substantial to Trevor.

The real “crunch” in Trevor’s life came in the latter half of 1997 (aged 23 years) when because of his excessive gambling he failed to pay any rent or bills and was evicted from the flat he was living in at the time. In February 1998, Trevor started attending Gamblers Anonymous (GA) even though there was not a local group to attend. This meant he had to travel to Birmingham, which was three-quarters of an hour away from where he lived. Trevor attended GA for just over a year and eventually left in March 1999. While drop out rates for GA tend to be high (over 90% in the first few weeks of attendance), Trevor gained immense benefit from this group by the fact he attended for a significant period of his life. The weekly GA meeting provided a supportive network that helped Trevor’s gambling problem subside. He also knew he wasn’t alone in experiencing these types of problem.

During the following five-year period (early 1999 to early 2004), Trevor didn’t gamble at all, took control of his own earnings, and appeared to have his slot machine gambling under control. During this period, his gambling problem almost totally subsided. He began a relationship in 2000, and in 2002, they had a baby son. Trevor gambled small amounts (approximately £2 to £3) very occasionally on slot machines and always in the company of his partner who would be “keeping an eye on him” to make sure he didn’t overspend. During this period of over three years, Trevor claimed he was in control of his gambling and that because his life had some stability.

In February 2004, Trevor and his partner split up and Trevor’s gambling once again “spiralled out of control”. Most of the time Trevor would be gambling on his favourite slot machine in his local pub because it served as an escape from the breakdown of his relationship. Trevor claimed that only a quarter of his wages at this point was spent on gambling because he needed to keep money back to buy things for when he got periodic access to his young son (such as nappies, food, etc.).

On the surface, this type of behaviour does not appear to be indicative of someone totally out of control with their gambling, as most problem gamblers do not think about the consequences of their actions before they gamble. It could be the case that Trevor was either lying about how much money he spent or — like many gamblers — was not accurately recalling how much money he was spending during this period. Alternatively, and perhaps more likely, he only gambled excessively when there was nothing else to focus on his life. If Trevor’s self-report is to be believed, his son appeared to act as a barrier to the worst excesses of his gambling as his son came first when he had access to him. On the occasions where Trevor was totally responsible for his son, it forced Trevor’s problem gambling into the background somewhat.

The research literature (including my own work) certainly shows that major life events often cause spontaneous remission in gambling addictions (e.g., getting married, birth of first child, getting a job etc.). During this period in 1994, Trevor didn’t feel he had enough to support his gambling from his wages as he resorted to criminal acts, (i.e., opening mail at the postal depot where he worked in an attempt to get money to gamble on slot machines). Being caught stealing money to feed his gambling habit clearly indicated to Trevor that he needed help with his gambling again. He once again attended GA in the latter half of 2004.

Trevor believed his gambling problems were related to low self-esteem coupled with feeling depressed and having nothing else to do. Such feelings are typically found in problem gamblers who use gambling as a way of modifying their mood. Trevor claimed that his excessive gambling was integrally linked with his mood state and that when he was feeling down and/or agitated he sought solace in gambling that made him (temporarily) feel better. However, when he lost money, he would feel even worse. Trevor’s gambling problems were usually linked to other underlying problems. When these were dealt with, his problem gambling all but disappeared. It became obvious that Trevor’s gambling binges were typically caused by very specific ‘trigger’ incidents and that Trevor used gambling as a way of making himself feel better. The break-up of his last relationship was such a clear trigger incident.

Compared to other problem gamblers I have known, Trevor’s gambling was much less problematic. The gambling was usually symptomatic of other problems in Trevor’s life. In short, problem gambling only occurred at two very specific periods in Trevor’s life (1997 and 2004) and that these binges were triggered by very specific incidents. It is also worth noting that Trevor’s gambling problem was very specific (i.e., slot machines) and that no other types of gambling caused him any problems. Trevor’s case appears to adhere to the six characteristics of binge gambling outlined above by Dr. Nower and Dr. Blaszczynski in that there was irregular or intermittent periods of sustained gambling, excessive expenditures relative to income, rapidly spent money over a discrete interval of time, a sense of urgency and impaired control (at least at the times of problem gambling), marked intra- and inter-personal distress, and absence between bouts of any rumination, preoccupation or cravings to resume gambling participation.

It is not uncommon for problem gamblers to gamble excessively on ‘pay days’, lose their money, and wait for the next cycle. What really distinguishes Trevor as a binge gambler is that there is clear evidence that Trevor has had long periods of trouble-free gambling in his life (e.g., 1990 to 1995; 2000 to 2004). When things were going well for Trevor, gambling was simply not an issue. When given access and responsibility for his son, Trevor clearly puts him before anything else. Being totally responsible for his son appears be a major protective barrier in preventing him gamble.

It is also interesting to note that between his two major binges of problem gambling (1997 and 2004), Trevor appeared to have phases of both abstinent and controlled gambling. This shares some similarities with the literature on controlled drinking (particularly the pioneering research of Dr. Linda Sobell and Dr. Mark Sobell) which suggests that alcoholics who had sustained periods of non-problematic social drinking may be more likely to be able return to controlled drinking. Trevor’s case also supports other case studies in the gambling literature showing that controlled gambling after periods of problem gambling is possible.

The concept of problem binge gambling is still a much overlooked area. It appears to be less serious than chronic problem gambling but can still cause significant problems in the lives of people it affects. More research should be carried out along the lines of the types of research that are currently being carried out into binge drinking.

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

Further reading

Dickerson, M. G., & Weeks, D. (1979). Controlled gambling as a therapeutic technique for compulsive gamblers. Journal of Behavioural Therapy and Experimental Psychiatry, 10, 139–141.

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

Griffiths, M.D. (1995). Adolescent gambling. London: Routledge.

Griffiths, M.D. (2002). Gambling and gaming addictions in adolescence. Leicester: British Psychological Society/Blackwells.

Griffiths, M.D. (2004). Betting your life on it: Problem gambling has clear health related consequences. British Medical Journal, 329, 1055–1056.

Griffiths, M.D. (2006). A case study of binge problem gambling. International Journal of Mental Health and Addiction, 4, 369-376.

Nower, L., & Blaszczynski, A. (2003). Binge gambling: A neglected concept. International Gambling Studies, 3, 23–35.

Rankin, H. (1982). Control rather than abstinence as a goal in the treatment of excessive gambling. Behavioural Research Therapy, 20, 185–187.

Sobell, L. C., Sobell, M. B., & Ward, E. (Eds.) (1980). Evaluating alcohol and drug abuse treatment effectiveness. Elmsford, New York: Pergamon.

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