Category Archives: Compulsion

The weighting game: Gambling with the nation’s health (revisited)

A couple of weeks ago I wrote a blog on why problem gambling should be considered a health issue. Earlier this week, I came across an interesting study carried out by jackpot.co.uk who surveyed 2,131 online gamblers (58% males and 42% female) about their health. After the self-reported data had been collected, the gamblers were classed into one of nine categories based on the casino game type that the gambler played most often (i.e., slot machines, video poker, blackjack, roulette, dice/craps, baccarat, poker, pai gow, and ‘other’). The data were then tabulated so that all the health variables (including obesity) corresponded to the gambler’s preferred casino game.

I was interested in the findings not only because I am a Professor of Gambling Studies, but also because I was a member of the Department of Health’s Expert Working Group on Sedentary Behaviour, Screen Time and Obesity’ (a reference to our final report to the British government can be found in the ‘Further Reading’ section below). The study took an objective measurement of physical condition by asking each gambler their height (centimetres) and their weight (kilograms) to calculate each person’s Body Mass Index (BMI) by dividing the gamblers’ weight by height (metres) and dividing by height again (for example, someone who weighs 80kg and is 180cm tall, the BMI is 24.1 as this is 80/1.80)/1.80). The survey then asked s few general health and lifestyle questions (similar to ones that we have used in the last few British Gambling Prevalence Surveys:

  • Do you normally drink more than the recommended limit for weekly alcohol consumption (21 units of alcohol for men and 14 for women)? (Yes/No)
  • Do you smoke regularly? (Yes/No)
  • Do you normally engage in at least 30 minutes of physical activity, 5 times per week? (Yes/No)

Overall, the survey found that British casino gamblers as a group were no less healthy than the rest of the British population, with an average Body Mass index (BMI) of 27 (which is the same as the UK national average). However, the survey also reported that the average BMIs, health, and lifestyle choices (such as smoking cigarettes, engaging in exercise, and drinking alcohol varied considerably depending on the casino games that the respondents played. Here are some of the main findings:

  • Slots players were the least healthy. They took less exercise and had an average BMI of 31, pushing them into the category of obese (which is linked to increased chance of developing illnesses such as Type 2 diabetes and reduced life expectancy)
  • Roulette, blackjack, video poker and craps/dice players were not far behind slots players, each having BMI levels higher than the national average.
  • Those that played poker, baccarat and Pai Gow had an average BMI of 25 or under (well within the normal range recommended by the World Health Organisation.
  • Whilst drinking levels might be reasonably high among poker players, they were very exercise conscious, with 58% engaging in physical activity for at least 30 minutes, five times a week. For slots players the figure was 27% meeting this government recommended target.
  • Overall slots players drink the most, with 24.1% drinking over the recommended weekly limit. Poker players are not far behind on 23%. Female slots players were the biggest drinking subgroup, closely followed by male poker players.
  • Slots players also smoked more, with 24% being regular smokers (compared to the UK national average of 20%). Blackjack and roulette players smoked slightly more than average, on 21% and 22% respectively, while poker players smoked slightly less than average, on 19.5%.

None of these results is overly surprising as there are many studies (including my own) showing comorbidity between gambling and other potentially addictive behaviours. However, very few academic studies have ever looked at these health variables by game type. Although this was not an academic study, the results will likely be of interest to those in the gambling studies field.

The survey also examined the most common platform on which the gamblers played casino games. The most common was the desktop computer (65%), followed by mobiles and tablets (20%) and land-based casinos (14%). This is not surprising given the survey was completed by online gamblers. Interestingly, desktop use was linked to higher levels of obesity, drinking and smoking. This is something that I would expect given that online gambling is the most sedentary of these activities.

There are (of course) some limitations with the data collected particularly as it comprised a self-selected sample of online gamblers that played via jackpot.co.uk websites. We have no idea as to whether the sample is representative of all online gamblers but as I noted above, it is no surprise that online gamblers preferred playing casino games online compared to offline (i.e., land-based casinos). The data were also self-report and are therefore open to any number of individual biases including recall biases and social desirability biases. Also, we have no geographical breakdown of the sample as the internet (by definition) is global. However, the sample size is good in comparison to many published studies on gambling and the sample included individuals that were actually gamblers (as opposed to university undergraduates or members of the general public). According to Sam Marsden (editor of jackpot.co.uk and author of the report):

“There’s an undeniable link connecting passive games like slots and video poker to unhealthy, sedentary lifestyles. On the other hand, games that require concentration, strategy and some physical stamina like poker and blackjack seem to fare much better in the health stakes. It seems it’s less a case of ‘you are what you eat’ and more ‘you are what you play’.”  

Although such a conclusion could be argued to be PR spin on the findings, the results suggest that more rigorous studies could be carried out in the area including secondary analyses of the robust datasets that already exist including the British Gambling Prevalence Surveys, the English Health Surveys, and the Scottish health Surveys.

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

Further reading

Biddle, S., Cavill, N., Ekelund, U., Gorely, T., Griffiths, M.D., Jago, R., et al. (2010). Sedentary Behaviour and Obesity: Review of the Current Scientific Evidence. London: Department of Health/Department For Children, Schools and Families (126pp).

Griffiths, M.D. (2001). Gambling – An emerging area of concern for health psychologists. Journal of Health Psychology, 6, 477-479.

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

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

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

Marsden, S. (2014). Booze, bets, and BMI. Jackpot.co.uk, October 6. Located at: http://www.jackpot.co.uk/online-casino-articles/booze-bets-bmi

Rigbye, J. & Griffiths, M.D. (2011). Problem gambling treatment within the British National Health Service. International Journal of Mental Health and Addiction, 9, 276-281.

Wardle, H., Griffiths, M.D., Orford, J., Moody, A. & Volberg, R. (2012). Gambling in Britain: A time of change? Health implications from the British Gambling Prevalence Survey 2010. International Journal of Mental Health and Addiction, 10, 273-277.

Wardle, H., Moody. A., Spence, S., Orford, J., Volberg, R., Jotangia, D., Griffiths, M.D., Hussey, D. & Dobbie, F. (2011). British Gambling Prevalence Survey 2010. London: The Stationery Office.

Wardle, H., Seabury, C., Ahmed, H., Payne, C., Byron, C., Corbett, J. & Sutton, R. (2014). Gambling behaviour in England and Scotland: Findings from the Health Survey for England 2012 and Scottish Health Survey 2012. London: NatCen.

Wardle, H., Sproston, K., Orford, J., Erens, B., Griffiths, M. D., Constantine, R., & Pigott, S. (2007). The British Gambling Prevalence Survey 2007. London: National Centre for Social Research.

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 losses: What are the downsides of online therapy for problem gamblers and clinicians?

In my last blog, I briefly looked at the advantages of online therapy. However, the growth of online therapy is not without its critics. I may have given the impression in my previous blog that online therapy has nothing but positive implications. However, this blog briefly examines some of the main criticisms that have been levelled against online therapy. This loist is not exhaustive but hopefully covers the key concerns:

  • Legal and ethical considerations: As Internet counselling services grow, attention will have to be focused on the specialist construction of a legal and ethical code for this type of work. Cyberspace transcends state and international borders, therefore, there are many legal and regulatory concerns. For example, client/doctor confidentiality regulations differ from one jurisdiction to another. It may not be legal for a clinician to provide chat-room services to problem gamblers who are in a jurisdiction in which the clinician is not licensed. Furthermore, some problem gamblers may be excluded from telehealth services because they lack the financial resources to access the Internet. One potential ethical and legal dilemma is the extent to which service quality can be ensured. It is possible that individuals who register to provide counselling services online do not have the qualifications and skills they advertise. They may not even be licensed to practice. There are also issues regarding the conduct of practitioners engaged in all forms of telecommunication therapy. For example: issues of informed consent, the security of electronic medical records, electronic claims submissions and so forth. Therapy provided over the Internet holds promise but there is a need to check that it works and see to it that, if it is done then it is done well. Underlying guidelines that are applicable to all forms of counselling are that: (i) the therapist must be trained, supervised and accountable with qualifications that can be checked against a list held by a mainstream organisation, and (ii) the nature of the contract between client and practitioner must be spelled out so clients understand the boundaries of what they are receiving for what they are paying.
  • Effectiveness of online therapy: There are a growing number of evaluation studies that have examined whether online therapy is an effective treatment approach. With specific regard to problem gambling, my research colleague Dr. Gerry Cooper reported that about 70% spoke of how they benefited from their exposure to and involvement with GAweb, an online peer support group. An evaluation that I carried out with Dr. Richard Wood of Gam-Aid also showed that participants derived great benefit from using the online service and was particularly attractive for problem online gamblers (that are already comfortable with interacting online).
  • Confidentiality: Online therapy may compromise privacy and confidentiality, particularly if a skilled computer ‘hacker’ is determined to locate information about a particular individual. There is also some evidence that as more personal information is required of counselling sites online, the attractiveness of these sites is reduced. On the other hand, one of the things that the Internet is especially helpful with is its ability to afford the consumer the control over self-disclosure. In this way, individuals may overestimate the degree to which their information is safe and secure from computer hackers.
  • Encryption: No online therapist can confidently promise a problem gamblers confidentiality given the limitations of the medium. That being said, there are some sites that now offer secure messaging systems that offer the same level of protection as banking institutions. To protect confidentiality, care will have to be taken to prevent inappropriate and deliberate hacking into counselling sessions on the Internet. There will need to be a continuous upgrading of technology to stay ahead of hackers’ ability to breach security.
  • Complicated payment structures: Given the cross-national nature of the Internet, there may be complicated pay structures for problem gamblers to overcome when selecting a therapist. While universally-accepted credit cards might actually make payment easier (since one can use their credit card online and the credit card company will automatically calculate the currency exchange for the transaction), one may not immediately understand how much the online counselling has cost in their own currency. They may not know this until their credit card invoice arrives at a later date.
  • Cost-effectiveness to the therapist: For the therapist, there is the problem that online counselling may be as time consuming as face-to-face therapy with substantially less financial remuneration.
  • Identity problems: One of the major potential problems is that online problem gamblers may not be who they say they are, i.e., counsellors may not always know the true identity of their online clients (although identity is an issue only applicable to those services that are not anonymous). This is clearly a major issue since some assumptions (rightly or wrongly) are made by the clinician depending on what the problem gambler presents (including age and other demographics). However, to some extent, these issues also apply to telephone and face-to-face counselling as the therapist has to accept what is said at face value. Additionally, some might argue that merely responding to the words that a problem gambler chooses to use necessitates more focus on the part of the therapist. As a result, this may lead to a more democratic counselling environment. In other words, the role of therapist and problem gambler becomes more equal in this situation. Some therapists may have difficulty adapting to these new roles.
  • Severity of client problems: Some clients’ problems may be just too severe to be dealt with over the Internet. To some extent, there can always be contingencies, but because people can come from anywhere in the world and have a multitude of circumstances, online clinicians may be hard-pressed to meet everyone’s needs. It is important to acknowledge that this is not a panacea; that online help will not solve everybody’s problems (to be sure, those who are illiterate will likely have a difficult time of it without some additional support nearby). On the other hand, it is likely to go a long way in helping a great many more people than otherwise would have been the case.
  • Client referral problems: One obvious difficulty for the counsellor is how to go about making a referral for someone in a faraway town or another country. Once again, one would need to establish basic contingencies. Over time, it could be expected there would be many more international-regional clearinghouses regarding where to get immediate assistance, but to date it is very difficult to know what services are available for many parts of the world.
  • Establishing client rapport: It could perhaps be argued that there might be difficulty in establishing rapport with someone that the therapist has never seen. This is an interesting area where clearly more information is needed. One might also argue that because the problem gambler is in a more equal relationship with the therapist, they will feel more comfort. That is, since the problem gambler controls all of the personal disclosure levers, rapport might be established much more easily.
  • No face-to-face contact: Online therapy leads to a loss of non-verbal communication cues such as particular body language, voice volume and tone of voice. Furthermore, the lack of face-to-face interaction between problem gambler and therapist could result in a wrong referral or diagnosis. What is known about online communication where cues are filtered out, is that it typically takes more work to accomplish a task where more than one person is involved. It may be the case that with time and experience, therapists who work online will develop skills that will help them compensate for the absence of visual cues. For example, they might become much more skilled and precise with the words they choose to use.
  • Incomplete information: The written information provided in online therapy may be incomplete. Online therapy (via e-mail) may not allow the opportunity for immediate follow-up questions. Making a provisional recommendation or diagnosis is fraught with potential problems. For instance, a problem gambler may describe problems that are symptomatic of other more serious underlying disorders. However, diagnostic processes are quite heterogeneous practices even in face-to-face settings. Diagnoses are often provisional and therapists usually require more information to validate initial observations. In fact, clinicians might have better access to their clients through e-mail than trying to track them down face-to-face or exchanging telephone answer messages, should they need further information. Still, the information derived from problem gamblers in online formats may be unverifiable, more so than in face-to-face contexts.
  • Loss of therapist contact: Although perhaps more of a possibility than a reality, therapists can just ‘disappear’ only to re-emerge weeks later saying that their server failed and/or leave a problem gambler mid-therapy with little that the problem gambler can do about it. The same problem could occur with some clinicians in face-to-face settings although being online may be more of a problem in finding out what has happened.
  • Commercial exploitation: Consumers theoretically are not always as anonymous as they might think when they visit health sites because some sites share visitors’ personal health information with advertisers and business partners without consumers’ knowledge or permission. Some sites allow third-party advertisers to collect visitors’ personal information without disclosing this practice. As a result, visitors may get e-mails from advertisers about their products and services. Information can be collected during a variety of tasks including the visiting of chat rooms and bulletin boards, searching for information, subscribing to electronic newsletters, e-mailing articles to friends or filling out health-assessment forms. This allows third parties to build detailed, personally identified profiles of individuals’ health conditions and patterns of Internet use. In relation to gamblers, this is a real issue. By virtue of posting to places where problem gamblers talk to each other online with an accurate e-mail address shown, online gambling operators have the potential to collect such information in order to later send junk e-mail promoting their gambling websites. Other questionable and fraudulent marketing practices by online operators have also been outlined in my previous blogs.
  • Emergency situations: Being online and geographically distant has the potential to cause problems in an acute situation. For instance, if a clinician does not know where a problem gambler lives or can be located, they cannot call for help in the case of an emergency such as a suicidal threat.
  • Convenience: Although convenience was outlined as an advantage in the previous section, it can also have a downside. For instance, it may mean that the problem gambler is less likely to draw on their own existing coping strategies and use the online therapist as a convenient crutch (something which is actively discouraged in face-to-face therapy).

Hopefully this blog has redressed the balance of my previous blog on the positive benefits of online therapy. Anyone that seeks online advice, help, and/or treatment needs to carefully do their own cost-benefit analysis as to whether such an online service will be of direct benefit to them after taking into account some of the disadvantages outlined here.

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.

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.

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.

Token gestures: A brief look at ‘sexual trophy collecting’

Back in 2002, I had a little piece published on excessive collecting behaviour in the Guardian newspaper (‘Addicted to hoarding’). In it I wrote:

“I have always been interested in why we have what seems like an innate ability to collect. I would almost go as far as to say that we are ‘natural born hoarders’. Furthermore, there has been surprisingly little research in this area and Freud’s theories on the topic are unfortunately almost empirically untestable. I would also add that for some people, collecting is at the pathological end of the behavioural continuum. There are some that are (for want of a better word) ‘addicted’ to collecting and there are some with obsessive-compulsive disorders who simply cannot throw away anything”.

Since then I’ve published a few articles on the psychology of collecting in this blog and is probably one of the reasons that I have had a few approaches over the last couple months from journalists asking me about the psychology behind various forms of collecting. (In fact, I’ve also been approached to write an academic chapter on the phenomenon too). Two of the most recent media requests included journalists writing articles on why people collect retro video games (which I hope to write about in a future blog) and another on why people collect ‘sexual trophies’.

I have to admit that I am no expert on sexual trophies so I did a little reading on the topic. According to one definition I came across, a sexual trophy is “any item or piece of clothing gained from a sexual encounter as proof of a successful sexual conquest”. To tie in with the release of US comedy I Just Want My Pants Back, MTV conducted a [non-academic] survey and reported that one in three young British people (aged between 18 and 34 years) admitted to owning some sort of sex trophy with one in six of them (16%) claiming they had two or more sex-based trophies (a group that MTV termed ‘Sexual Magpies’).

However, when it comes to the collecting ‘sexual trophies’, I would argue that most academic research that I have come across on the topic relates to more criminal sexual deviance rather than day-to-day sexual encounters. For instance, in the 2010 book Serial Murderers and Their Victims, Dr. Eric Hickey described the case of man – who was a voyeur – from Georgia (US) that used to break into houses and steal women’s underwear. On his eventual arrest they found over 400 pairs of knickers that he had stolen. More disturbing are cases such as this excerpt from a story in the Daily Telegraph. This is arguably more typical of what I perceive to be sexual trophy hunters:

“A company manager and ‘pillar of the community’ has been exposed after 20 years as a serial sex attacker known as the Shoe Rapist. James Lloyd, 49, a long-standing Freemason who took the footwear of his victims as trophies, was finally caught through advances in DNA techniques. Police later found more than 100 pairs of stiletto shoes hidden behind a trap door at the printing works where he was employed… As well as taking their shoes, he often stole jewellery from the women, mainly in their teens and early 20s, between 1983 and 1986” (Daily Telegraph, July 18, 2006).

However, Dr. Hickey’s book describes even worse acts of sexual trophy collecting. He noted that many serial killers are “known for their habits of collecting trophies or souvenirs. Others have collected lingerie, shoes, hats, and other apparel”. A sizeable section of the book concentrates on the types of serial killers that are popular in the media (such as those that commit ‘lust murders‘) and are the subject of many Hollywood films such as the series of films with (my favourite fictional psychopath) Hannibal Lecter. As Hickey notes:

“These are the rapists who enjoy killing and, often, indulging in acts of sadism and perversion. These are the men who have engaged in necrophilia, cannibalism, and the drinking of victims’ blood. Some like to bite their victims; others enjoy trophy collecting – shoes, underwear, and body parts, such as hair clippings, feet, heads, fingers, breasts, and sexual organs…[and] evoke our disgust, horror, and fascination”.

One of the cases discussed is 1950s US serial killer Harvey Glatman (known in the media as ‘The Lonely Hearts Killer’) who used to take photographs of the women he murdered. Citing the work of Dr. Robert Keppel (another expert in serial murder cases and author of Serial Murder: Future Implications for Police Investigations), Dr. Hickey wrote:

“His photos were more than souvenirs, because in Glatman’s mind, they actually carried the power of his need for bondage and control. They showed the women in various poses: sitting up or lying down, hands always bound behind their backs, innocent looks on their faces, but with eyes wide with terror because they had guessed what was to come”.

Other murderers described by Dr. Hickey included a man that liked to surgically remove (and keep) the eyeballs from his sexual victims (most probably 1990s’ serial killer Charles Allbright) and another that skinned his victims and made lampshades, eating utensils, and clothing. In his overview of necrophilic homicide (i.e., those individuals that kill others in order to engage in sexual activity), Hickey also mentions that such necrosadistic murderers often engage in other paraphilias related to necrophilia “including partialism or the desire to collect specific body parts that the offenders finds sexually arousing. This may include feet, hands, hair, and heads, among others”. Hickey also noted that:

“Another important characteristic of these lust killers was the ‘perversion factor’. This subgroup was often prone to carry out bizarre sexual acts. These acts most commonly included necrophilia and trophy collection. Jerry Brudos severed the breasts of some of his victims and made epoxy molds. Brudos, like others, also photographed his victims in various poses, dressed and disrobed. The photos served as trophies and a stimulus to act out again”.

Later in the book, Dr. Hickey examines the case of Jerry Brudos in more detail (please be warned that some of the things written here may offend those of a sensitive nature):

“At an early age, Jerry Brudos developed a particular interest in women’s shoes, especially black, spike-heeled shoes. As he matured, his shoe fetish increasingly provided sexual arousal. At 17, he used a knife to assault a girl and force her to disrobe while he took pictures of her. For his crime he was incarcerated in a mental hospital for 9 months. His therapy uncovered his sexual fantasy for revenge against women, fantasies that included placing kidnapped girls into freezers so he could later arrange their stiff bodies in sexually explicit poses. He was evaluated as possessing a personality disorder but was not considered to be psychotic…He continued to collect women’s undergarments and shoes. Prior to his first murder, he had already assaulted four women and raped one of them. At age 28, Jerry was ready to start killing…He took [his first victim] to his garage, where he smashed her skull with a two-by-four. Before disposing of the body in a nearby river, he severed her left foot and placed it in his freezer. He often would amuse himself by dressing the foot in a spiked-heel shoe. His fantasy for greater sexual pleasure led him…to strangle [another victim] with a postal strap. After killing her, he had sexual intercourse with the corpse, then cut off the right breast and made an epoxy mold of the organ. Before dumping her body in the river, he took pictures of the corpse. Unable to satisfy his sexual fantasies and still in the grasp of violent urges, he found his third victim…After sexually assaulting her, he strangled her in his garage, amputated both breasts, again took pictures, and tossed her body into the river”.

Arguably the most infamous ‘sexual trophy collector’ was 1980s US serial killer Jeffrey Dahmer, the so-called ‘Milwaukee Cannibal’. In Dr. Hickey’s account he noted that:

“Restraining Dahmer, the officers looked around the apartment and counted at least 11 skulls (7 of them carefully boiled and cleaned) and a collection of bones, decomposed hands, and genitals. Three of the cleaned skulls had been spray-painted black and silver. These were to be part of the shrine fantasized by Dahmer. A complete skeleton suspended from a shower spigot and three skulls with holes drilled into them were found throughout the apartment…Chemicals, including muriatic acid, ethyl alcohol, chloroform, and formaldehyde, were also discovered, along with several Polaroid photographs of recently dismembered young men. A complete human head sat in the refrigerator”.

Another infamous case from the early 1970s (that I admit I had never heard of until I read Dr. Hickey’s book) was Ed Kemper, a cannibalistic killer who also collected human trophies and keepsakes of his victims. Citing the book Hunting Humans by Dr. Elliot Leyton, it was reported that:

“At the age of 23, Ed started killing again, a task that would last nearly a year and entail eight more victims. He shot, stabbed, and strangled them. All were strangers to him, and all were hitchhikers. He cannibalized at least two of his victims, slicing off parts of their legs and cooking the flesh in a macaroni casserole. He decapitated all of his victims and dissected most of them, saving body parts for sexual pleasure, sometimes storing heads in the refrigerator. Ed collected ‘keepsakes’ including teeth, skin, and hair from the victims. After killing a victim, he often engaged in sex with the corpse, even after it had been decapitated. In his confession Kemper stated five different reasons for his crimes. His themes centered on sexual urges, wanting to possess his victims, trophy hunting, a hatred for his mother, and revenge against an unjust society (Leyton, 1986)”.

The most obvious question related to these depraved acts is why such people do it in the first place. Writing in the Encyclopedia of Murder and Violent Crime, Nicole Mott provides an answer:

“A trophy is in essence a souvenir. In the context of violent behavior or murder, keeping a part of the victim as a trophy represents power over that individual. When the offender keeps this kind of souvenir, it serves as a way to preserve the memory of the victim and the experience of his or her death. The most common trophies for violent offenders are body parts but also include photographs of the crime scene and jewelry or clothing from the victim. Offenders use the trophies as memorabilia, but also to reenact their fantasies. They often masturbate or use the trophies as props in sexual acts. Their exaggerated fear of rejection is quelled in front of inanimate trophies. Ritualistic trophy taking, as is found with serial offenders, acts as a signature. A signature is similar to a modus operandi (a similar act ritualistically performed in virtually all crimes of one offender), yet it is an act that is not necessary to complete the crime”

In one of my previous blogs on the psychology of collecting more generally, I referred to a paper by Dr. Ruth Formanek in the Journal of Social Behavior and Personality. She suggested five common motivations for collecting: (i) extension of the self (e.g., acquiring knowledge, or in controlling one’s collection); (ii) social (finding, relating to, and sharing with, like-minded others); (iii) preserving history and creating a sense of continuity; (iv) financial investment; and (v), an addiction or compulsion. She also claimed that the commonality to all motivations to collect was a passion for the particular things collected. Personally, I think that the acquisition of sexual trophies – even in the most deranged individuals – can be placed within this motivational typology in that such individuals clearly have a passion for what they do and I would argue that the behaviour is an extension of the self that to some individuals may be a compulsion or addiction.

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

Further reading

Branagh, N. (2012). Third of UK owns sex trophy. March 26. Located at: http://www.studentbeans.com/mag/en/sex-relationships/third-of-uk-owns-sex-trophy

Du Clos, B. (1993). Fair Game. New York: St. Martin’s Paperbacks.

Griffiths, M.D. (2002). Addicted to hoarding. The Guardian (Review Section), August 10, p.19.

Formanek, R. (1991). Why they collect: Collectors reveal their motivations. Journal of Social Behavior and Personality, 6(6), 275-286.

Hickey, E. W. (Ed.). (2003). Encyclopedia of Murder and Violent Crime. London: Sage Publications

Hickey, E. W. (2010). Serial Murderers and Their Victims (Fifth Edition). Pacific Grove, CA: Brooks/Cole.

Keppel, R. D. (1989). Serial Murder: Future Implications for Police Investigations. Cincinnati, OH: Anderson.

Leyton, E. (1986a). Hunting Humans. Toronto: McClelland and Stewart.

Leyton, E. (1986b). Compulsive Killers: The Story of Modern Multiple Murder. New York: New York University Press.

Campaign killer? Gambling with people’s reputations (revisited)

On Twitter last week, Adrian Parkinson of the Campaign for Fairer Gambling (and the associated Stop The FOBTs campaign) posted a number of tweets about me (and my research). In the tweets, Parkinson said that (a) I am a “supposed academic”, (b) I am the “industry ‘funded’ defender of FOBTs” (fixed odds betting terminals), (c) I am “doing more dirty work” for the Association of British Bookmakers, and (d) I do “what the industry tells [me] to do”.

Parkinson Libel Tweets 2014

All of these assertions are untrue and potentially libellous. According to legal dictionaries, the official definition of libel is “to publish in print (including pictures), writing or broadcast through radio, television or film, an untruth about another which will do harm to that person or his/her reputation, by tending to bring the target into ridicule, hatred, scorn or contempt of others”. Based on this defintion, Parkinson’s tweets are potentially libellous and are definitely an attack on my professional integrity. This cannot go unchallenged so here are the facts of the matter in relation to the claims made.

  • “Supposed academic”: Obviously the assertion by Parkinson that I am a “supposed academic” is both false and deliberately malicious. An academic by most dictionary definitions is a teacher or scholar in a university or other institute of higher education”. As a professor employed at an English university, there is nothing “supposed” about my occupation or status. To add to this, I would point out that on the basis of my academic research and reputation I became of one of the UK’s youngest ever professors (aged 34 years). So far in my career, I have been awarded 14 national and/or international awards and prizes for my gambling research and research dissemination including three Fellowship awards (British Psychological Society, Royal Society of Arts, and the Academy of Social Sciences) and two Lifetime Achievement awards. I am also one of the most highly cited psychologists in the world (currently 17,500 citations on Google Scholar that you can check here).
  • “Industry funded’ defender of FOBTs”: Parkinson claimed that I am “funded defender” of FOBTs and the gambling industry. In my career to date, I have published approximately 460 academic peer reviewed journal papers (which most academics would describe as ‘prolific’ – and not bad for a “supposed academic”) and another 1000+ academic articles (in professional/practitioner journals, gambling trade press, newspapers, magazines, etc.). Of these 1500 or so papers and articles, none were funded by a research grant from the gaming industry. Two of the papers I have published – both concerning social responsibility in gambling initiatives – did arise out of gaming industry consultancy (one study was about gamblers’ attitudes toward the social responsibility tool PlayScan funded by Svenska Spel, and the other was the development of a new social responsibility tool for the gaming industry to use to protect vulnerable player funded by the Nova Scotia Gaming Corporation). Also, none of my published academic papers has ever been specifically about FOBTS. I have published a handful academic journal papers that have mentioned FOBTs in passing but all of those were papers based on data collected in the British Gambling Prevalence Surveys (of which I was one of the co-authors) and were funded by the Gambling Commission not the gambling industry. In 2008, I also wrote a report for the Department of Culture, Media and Sport (again funded by the Gambling Commission) on high stake-high prize machines that included references to FOBTs. However, the only article I have ever published specifically on FOBTs was one of my previous blogs (which looked at FOBTS in relation to the BGPS findings). In short, the assertion that I am an “industry ‘funded’ defender of FOBTs” simply has no basis in truth whatsoever.
  • “Dirty work” for the Association of British Association of Bookmakers: Parkinson claimed I carry out “dirty work” for the ABB. In my academic career I have been a consultant in the area of responsible gambling for approximately 15 years and have written in the region of 150 consultancy reports. Of these reports, three have been for the Association of British Bookmakers. The first report (in June 2013) was evaluation and input into the new code of conduct concerning responsible gambling and player protection (and which I wrote about in a previous blog). I was invited to carry out this piece of work by Neil Goulden (Chairman of the UK’s Responsible Gambling Trust) specifically because of my reputation of being both totally independent and as someone that has been critical of the gambling industry on previous occasions in relation to social responsibility and player protection. More recently (July 2014), I was commissioned to carry out two further pieces of consultancy for the ABB. The first was a review of problem gambling in Great Britain and the second was a preliminary evaluation of the responsible gambling initiatives relating to the introduction of the ABB’s new Code of Conduct (both of which are being published today). All three pieces of consultancy that I have carried out for the ABB concerned player protection and responsible gambling. Far from being “dirty work” they are the very areas areas that are at the heart of almost all the research that I carry out into problem gambling.
  • “Doing what the industry tells me to do”: Of all the potentially libellous claims made about me by Parkinson, this is the one that is the most ludicrous. The main reason I was asked for my expertise in the first place by the ABB was because I have never been afraid to criticize the gaming industry when they have done something I believe to be wrong and/or socially irresponsible. Anyone who actually knows me and has followed my research career over the last three decades will tell you that the one common denominator is my absolute independence in anything that I do. For the best part of 15 years I was vilified and criticized by some members of the gaming industry because of my belief that vulnerable and susceptible people should be protected from the potential harms of gambling. When ‘social responsibility’ and ‘responsible gambling’ became important issues in gaining operating licenses, gaming companies soon started approaching me to help them develop their codes of conduct and player protection programs. In short, I have spent years telling the gambling industry what I think they should do to minimize problem gambling (not the other way around).

There are of course bigger issues here concerning research funding, and this is an issue on which I have published my own views (see ‘Further reading’ below). Parkinson’s incorrect and misguided comments about me appear to be based on the view that academics shouldn’t have any association whatsoever with the gambling industry. Unfortunately, this (in my opinion) is a blinkered view that will not help those that need it (i.e., vulnerable populations). Almost all of the ‘big name’ researchers in the gambling studies field have carried out research and/or consultancy funded by the gambling industry. When this happens it may call into question academic ‘independence’. However, industry funded research appears to be an increasing economic reality in many countries across the world. In the UK, the governmental philosophy of research funding relating to gambling is now ‘polluter pays’ (i.e., the UK government has said it will not fund research on gambling and that the industry will have to pay for such work itself). Although my own research is not industry funded, the current funding model is pushing researchers in the gambling field down such a route.

One researcher that I have published with (now retired from day-to-day university life) refuses to carry out research or consultancy if it is sponsored or funded by the gambling industry (even indirectly via the Responsible Gambling Trust because the money is accrued from voluntary donations by the gambling industry). Furthermore, he will not attend conferences that have gaming industry sponsorship and declines invitations to speak if they are held on gaming premises. Although laudable and highly principled, researchers who now want to pursue a research career in the gambling studies field will are likely to find that taking such principled actions will become a barrier to career enhancement.

Having been in the gambling studies field for nearly 30 years now, I feel very proud that over the last decade, some sectors of the gaming industry have now started to take the issue of social responsibility in gambling seriously. All the personal vitriol that I received for years from certain individuals working in the gaming industry appears (in retrospect) to have been worth it. My own view is that if those in the gambling industry are really serious about social responsibility, they need to sometimes work in partnership with researchers in the gambling studies field if the end goal is the same (i.e., protection of vulnerable individuals and minimization of problem gambling).

From my research, I have gotten to know people that have had gambling problems and that would like to ban slot machines (including FOBTs). This is highly unlikely to reduce gambling problems. We know that banning alcohol does not cure alcoholism. Similarly, banning gambling products will not solve the issue of problem gambling. It would only drive the activity underground. Most people that gamble (including myself) do not have a problem. The underlying principle of social responsibility is to maximize fun for those that enjoy gambling and minimize harm for those that may be vulnerable. Mr. Parkinson and his campaign have every right to express their views but what they say should have a basis in fact (rather than prejudice) and they definitely shouldn’t resort to questioning my reputation or research in the absence of the full facts.

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

Further reading

Adams P. J., Raeburn J., De Silva K. (2009). A question of balance: prioritizing public health responses to harm from gambling. Addiction, 104: 688–91.

Griffiths, M.D. (2009). Minimising harm from gambling: What is the gambling industry’s role? Addiction, 104, 696-697.

Griffiths, M.D. (2008). Impact of high stake, high prize gaming machines on problem gaming. Birmingham: Gambling Commission.

Griffiths, M.D. (2009). Gambling research and the search for a sustainable funding infrastructure. Gambling Research, 21(1), 28-32.

Griffiths, M.D., Wood, R.T.A. & Parke, J. (2009). Social responsibility tools in online gambling: A survey of attitudes and behaviour among Internet gamblers. CyberPsychology and Behavior, 12, 413-421.

Morrison, P. (2009). A new national framework for Australian gambling research: A discussion paper on the potential challenges and processes involved. Gambling Research, 21(1), 8-24.

Wood, R.T.A., Shorter, G.W. & Griffiths, M.D. (2014). Rating the suitability of responsible gambling features for specific game types: A resource for optimizing responsible gambling strategy. International Journal of Mental Health and Addiction, 12, 94–112.

Blog-nitive psychology: 500 articles and counting

It’s hard for me to believe that this is the 500th article that I have published on my personal blog. It’s also the shortest. I apologise that it is not about any particular topic but a brief look back at what my readers access when they come across my site. (Regular readers might recall I did the same thing back in October 2012 in an article I wrote called ‘Google surf: What does the search for sex online say about someone?’). As of August 26 (2014), my blog had 1,788,932 visitors and is something I am very proud of (as I am now averaging around 3,500 visitors a day). As I write this blog, my most looked at page is my blog’s home page (256,262 visitors) but as that changes every few days this doesn’t really tell me anything about people like to access on my site.

Below is a list of all the blogs that I have written that have had over 10,000 visitors (and just happens to be 25 articles exactly).

The first thing that struck me about my most read about articles is that they all concern sexual fetishes and paraphilias (in fact the top 30 all concern sexual fetishes and paraphilias – the 31st most read article is one on coprophagia [7,250 views] with my article on excessive nose picking being the 33rd most read [6,745 views]). This obviously reflects either (a) what people want to read about, and/or (b) reflect issues that people have in their own lives.

I’ve had at least five emails from readers who have written me saying (words to the effect of) “Why can’t you write what you are supposed to write about (i.e., gambling)?” to which I reply that although I am a Professor of Gambling Studies, I widely research in other areas of addictive behaviour. I simply write about the extremes of human behaviour and things that I find of interest. (In fact, only one article on gambling that I have written is in the top 100 most read articles and that was on gambling personality [3,050 views]). If other people find them of interest, that’s even better. However, I am sometimes guided by my readers, and a small but significant minority of the blogs I have written have actually been suggested by emails I have received (my blogs on extreme couponing, IVF addiction, loom bandsornithophilia, condom snorting, and haircut fetishes come to mind).

Given this is my 500th article in my personal blog, it won’t come as any surprise to know that I take my blogging seriously (in fact I have written academic articles on the benefits of blogging and using blogs to collect research data [see ‘Further reading’ below] and also written an article on ‘addictive blogging’!). Additionally (if you didn’t already know), I also have a regular blog column on the Psychology Today website (‘In Excess’), as well as regular blogging for The Independent newspaper, The Conversation, GamaSutra, and Rehabs.com. If there was a 12-step ‘Blogaholics Anonymous’ I might even be the first member.

“My name is Mark and I am a compulsive blogger”

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

Further reading

Griffiths, M.D. (2012). Blog eat blog: Can blogging be addictive? April 23. Located at: http://drmarkgriffiths.wordpress.com/2012/04/20/blog-eat-blog-can-blogging-be-addictive/

Griffiths, M.D. (2012). Stats entertainment: A review of my 2012 blogs. December 31. Located at: http://drmarkgriffiths.wordpress.com/2012/12/31/stats-entertainment-a-review-of-my-2012-blogs/

Griffiths, M.D. (2013). How writing blogs can help your academic career. Psy-PAG Quarterly, 87, 39-40.

Griffiths, M.D. (2013). Stats entertainment (Part 2): A 2013 review of my personal blog. December 31. Located at: http://drmarkgriffiths.wordpress.com/2013/12/31/stats-entertainment-part-2-a-2013-review-of-my-personal-blog/

Griffiths, M.D. (2014). Top tips on…Writing blogs. Psy-PAG Quarterly, 90, 13-14.

Griffiths, M.D. (2014). Blogging the limelight: A personal account of the benefit of excessive blogging. May 8. Located at: http://drmarkgriffiths.wordpress.com/2014/05/08/blogging-the-limelight-a-personal-account-of-the-benefits-of-excessive-blogging/

Griffiths, M.D., Lewis, A., Ortiz de Gortari, A.B. & Kuss, D.J. (2014). Online forums and blogs: A new and innovative methodology for data collection. Studia Psychologica, in press.

Arcade fire: A brief look at pinball addiction

“I guess what started my pinball addiction was how it has become the perfect distraction. I like to drink beer. And go out. And recreate. Pinball is often found in bars here in the San Francisco Bay Area, so grabbing a beer and dropping a few quarters and playing a game with a friend is a great way to kick it. That’s kind of how it started, as something I might do here and there, but it’s grown into a full blown addiction as I’ve discovered more about pinball. It’s a hobby, a sport, and a pastime, but for me, it’s all consuming” (Gene X, December 18, 2013).

PinballJunky.com is a periodic hobby-blog operated by one guy with over 20 years of unbridled collector’s obsession over anything having to do with the Art, Science, History and Culture of Pinball. Armed with an arsenal of over 30 Pins, our Moderator has built, rebuilt, repaired, restored, demolished and labored with an OCD level of passion over 100’s of pinball machines from the 70’s, 80’s and 90’s era. While he has experimented with various EM pins over the years, The Junky is particularly passionate about the SS games of the 90s and present” (from the Pinball Junky website).

As far as I am aware, only one academic paper has ever been published on pinball addiction, and that was a case study that I published in 1992 issue of Psychological Reports. My paper featured the case of a young man (aged 25 years) that I interviewed as part of another study on slot machine gambling (that I published in a 1994 issue of the British Journal of Psychology about the role of cognitive bias and skill in slot machine gambling). During the post-experimental interview, I asked all my participants to complete a questionnaire that included the (1987 revised third edition) Diagnostic and Statistical Manual of Mental Disorders criteria for pathological gambling. None of the nine items was endorsed but after completing my questionnaire, my participant spontaneously added that if he’d been asked the same questions about his pinball playing and videogame playing he would have answered ‘yes’ to a majority of the questions. On the spur of the moment I changed the word ‘gamble’ in the DSM-III-R criteria to the word ‘play’ and asked him to take that part of the survey again. In short, I asked him if he endorsed any of the following

  • Frequent preoccupation with playing or obtaining money to play
  • Often plays with larger amounts of money or over a longer period than intended
  • Need to play more to achieve the desired excitement
  • Restlessness or irritability if unable to play
  • Repeatedly returns to win back losses
  • Repeated efforts to cut down or stop playing
  • Often plays when expected to fulfill social, educational or occupational obligations.
  • Has given up some important social, occupational or recreational activity in order to play
  • Continues to play despite inability to pay mounting debts, or despite other significant social, occupational, or legal problems that the individual knows to be exacerbated by playing

If a person answers ‘yes’ to four of the above questions, the person was deemed to be an amusement machine ‘addict’. This time, my participant answered ‘yes’ to six out the nine questions, that I interpreted as showing signs of pinball pathology. It was at this point he was interviewed further.

The participant began playing pinball machines (and arcade videogame machines) at school when he was around 14 or 15 years of age. This he did with many of his male peers at the start of the ‘videogame explosion’ (as he put it) in around 1979 to 1980. He became “very good” at pinball playing and felt particularly good when lots of people, both male and female, were watching him and he was playing well. This implied he played mainly for social reasons. However, he also enjoyed playing on his own and, at the time of my study, he predominantly played alone. While playing, he reported that he experienced a ‘high’ – a continuous high (as opposed to an immediate high or ‘rush’ reported by some addicted slot machine gamblers (that I had reported throughout my published studies on adolescent slot machine players in 1990 and 1991) which was especially notable when he “started off with a good ball”, got free replay”, or experienced something intrinsically motivating to him (e.g., someone watching him play).

Back in 1983, Dr. Sidney Kaplan and Dr. Shirley Kaplan reported in the Journal of Popular Culture, that male pinball players may be attracted by the machine’s sexual graphics. However, my participant reported that he was more attracted by the features within the game and liked the idea that he could master a game, something that attracted him to videogames as well. He went on to say that both pinball machines and videogame machines were very similar because they both (i) score through points, (ii) have no financial reward – unlike a fruit machine, (iii) give the players pleasure from gaining a high score, i.e., an intrinsic reward, (iv) have the chance to gain free replays, and (v) require skill to play well. The reasons he didn’t play slot machines were because (i) its financial rewards were too infrequent, (ii) they are mostly chance-oriented, (iii) there are no points to score, and (iv) there is no free replay feature (except of course if the player won and decided to play again).

At the time I published the paper, it had been argued at various gambling conferences that I attended that “videogames are not as bad as slot machines because the better the player gets, the less money the player spends”. At face value this was correct as some adolescents could make 10 pence last over an hour on a videogame. However, the participant explained to me that he (and others) used to spend “hundreds of pounds” learning to play videogames and pinball machines, and then, when they were proficient at them, they would get bored with the game and spend their money learning how to play a new game on another machine. For this participant, pinball machines were different from videogame playing. Although he had played many different pinball machines, he had a personal favourite which he always returned to because it was the one on which he had his first “major success” (i.e., a very high score).

Back in 1992 I argued that it would be beneficial to adapt the criteria for pathological gambling for use in the monitoring of gaming machine addictions. By using such checklists (which can be administered quickly and easily), I argued it would be possible to record objective measures of incidence of probable amusement-machine addicts (including pinball addiction) and possibly show whether these types of addictions are implicated or act as precursors to more established addictions (e.g., pathological gambling). In 2013, criteria for Internet Gaming Disorder were included in Section 3 of the latest DSM-5 (using many of the criteria outlined above). However, given the complete lack of any other academic paper on pinball addiction, it doesn’t look as though pinball addiction will be appearing in any psychiatric diagnostic manual anytime soon. However, this case and other papers that I wrote on slot machine and video game addiction at the time led to my 1995 paper on technological addictions (that has now become one of my most highly cited papers).

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

American Psychiatric Association (1987). Diagnostic and Statistical Manual of Mental Disorders (3rd Edition -Revised). Washington D.C. : Author

Griffiths, M.D. (1990). Addiction to fruit machines: A preliminary study among males. Journal of Gambling Studies, 6, 113-126.

Griffiths, M.D. (1991). Fruit machine addiction: Two brief case studies. British Journal of Addiction, 85, 465.

Griffiths, M.D. (1991). Amusement machine playing in childhood and adolescence: A comparative analysis of video games and fruit machines. Journal of Adolescence, 14, 53-73.

Griffiths, M.D. (1991). The psychobiology of the near miss in fruit machine gambling. Journal of Psychology, 125, 347-357.

Griffiths, M.D. (1991). The observational study of adolescent gambling in UK amusement arcades. Journal of Community and Applied Social Psychology, 1, 309-320.

Griffiths, M.D. (1992). Pinball wizard: A case study of a pinball addict. Psychological Reports, 71, 160-162.

Griffiths, M.D. (1993). Tolerance in gambling: An objective measure using the psychophysiological analysis of male fruit machine gamblers. Addictive Behaviors, 18, 365-372.

Griffiths, M.D. (1993). Fruit machine addiction in adolescence: A case study. Journal of Gambling Studies, 9, 387-399.

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). Technological addictions. Clinical Psychology Forum, 76, 14-19.

Kaplan, S. J. (1983). The image of amusement arcades and differences in male and female video game playing. Journal of Popular Culture, 17(1), 93-98.

Kaplan, S., & Kaplan, S. (1981). A research note: Video games, sex, and sex differences. Social Science, 208-212

Kaplan, S., & Kaplan, S. (1983). Video games, sex and sex differences. The Journal of Popular Culture, 17(2), 61-66.

Trance-sexuality: A brief look at sex and stage hypnosis

Regular readers of my blog may remember that my first academically published papers were on hypnosis (as I recounted in a previous blog I did on hypnofetishism). Consequently, I’ve always had a passing interest in stage hypnotism although some of those that I’ve seen sail close to the wind in terms of their ethics. In fact the following online query raised some of the sort of questions I have often asked myself when watching such shows:

“My in-laws recently attended an ‘adults only’ hypnotist show in Las Vegas. The hypnotist selected audience members to be hypnotized. I’m sure you all know the drill here. The selected individuals did all sorts of sexual (or inferred sexual acts) from masturbating a teddy bear to having an orgasm when another sneezes…Is it ethical? Is it a form of abuse if these people were not in full control of their capacities? I would think in this day of lawsuit happy lawyers a participant could easily sue a hypnotist for ‘suggesting’ this type of behavior”

Over the last few years there have been a number of high profile stories about ‘X-rated’ stage hypnotists. For instance, in 2012, Colin Adamson’s “raunchy hypnosis show” was banned for being “too rude” by the University of Kent’s student union after the hypnotist got his participants to simulate sex acts and lap dances on stage. Some of those on stage were made to believe they were having orgasms while others simulated masturbation. One of the women that was hypnotized into believing she had been touched indecently by someone watching the show and was left ”too upset to speak”. Sadaeva president of the University of Kent Feminist Society was “disgusted” and was quoted as saying: “[Adamson] shows a lack of empathy towards rape victims and all women, and a lack of basic human decency – he has no place at a student union”.

One infamous case of problems with someone that participated in stage hypnotism was recounted by Dr. Michael Heap in a 2000 issue of the journal Contemporary Hypnosis (as well as on his own website). Heap was an expert witness for the defendant in a case he calls ‘Norman versus Byrnes’ (Mr. Byrnes was the defendant, the stage hypnotist; Mr. Norman, the plaintiff was the person on stage under hypnosis). Dr. Heap began by briefly reviewing the main issues:

“Mr. Norman’s story is that on Wednesday June 30th 1993, he took part in Mr. Byrnes’s stage hypnosis show at a hotel.  At some point in the show Mr. Byrnes offered to help Mr. Norman give up smoking.  Amongst other things, he gave him a post-hypnotic suggestion that from now on cigarettes would taste foul.  Towards the end of the performance Mr. Byrnes suggested to his volunteers that as they were sitting in their chairs they would feel more and more sexy.  He then hit his microphone repeatedly calling out ’10 times more sexy’, ’20 times more sexy’…..and so on.  Mr. Norman seemed to become carried away; he stood up and made thrusting movements at the chair.  Mr. Byrnes then suggested to the participants that when they went to bed that night they would feel even 50 times more sexy than they did then. Mr. and Mrs. Norman both confirmed that when they went to bed that night, as soon as Mr. Norman laid down on the mattress he started shaking violently and bouncing up and down.  Mr. Norman claimed that he was having sexual intercourse with the mattress and that indeed he did find the mattress sexually attractive.  Thus he continued simulating intercourse with the mattress and the other contents of his bed, with the exception of his wife”.

Mr. Norman had sex with his hotel bedroom furniture for about four hours (1am to 5am). When Mr. Norman stopped at one point to smoke a cigarette he became violently sick. On resuming his furniture sex, Mrs. Norman managed to stop the activity by blowing cigarette smoke into her husband’s face. Over the following days, Mr. Norman’s sexual urges diminished during the day but the uncontrollable urge to have sex with the furniture and other domestic appliances came back each night in the hotel room. Mr. Norman and his wife reported that the objects that became sexually attractive included all the bed’s contents, the hotel ceiling, a variety of ornaments in the hotel room, the room’s armchair, the hotel bath, and a tumble dryer. Dr. Heap then reported:

“On Monday, five days after her husband’s stage hypnosis experience, Mrs. Norman went to see a lawyer; on Wednesday Mr. Norman went to see his doctor.  He was prescribed antidepressants and several days later his doctor ‘performed hypnotherapy on him to remove the post-hypnotic suggestion’ and this appeared to be successful.  However, about three weeks later he was referred to a psychiatrist, Dr. Thomas, with ‘depression and delusions’ and violent behaviour. Dr. Thomas saw Mr. Norman on October 18th…Dr. Thomas ascribed Mr. Norman’s problems to Mr. Byrnes’s failure to take him ‘out of the hypnotic trance’…Things appeared to go quiet, and Mr. Norman did not receive any medication or treatment for these problems until four months later…Mr. Norman continued to present with a bewildering array of mental symptoms variously diagnosed as dissociative state, hypomania, hysteria, Ganser’s syndrome, major depression, post-traumatic stress disorder, paranoid psychosis and schizo-affective disorder”.

Mr. Norman’s legal team then secured the services of a consultant psychiatrist Dr. James, who was former official of the British Society of Medical and Dental Hypnosis. Dr. James then made a number of allegations of negligence against Byrnes (e.g., Byrnes didn’t establish what the exact counter-suggestion should have been to dispel the post-hypnotic suggestion). Dr. Heap then claimed:

“When I consider these serious allegations against Mr. Byrnes, I cannot help hearing in my mind the music ‘The Sorcerer’s Apprentice’.  Dr. James casts Mr. Byrnes in the role of an inept would-be wizard whose task, under the stern eye of a properly qualified master wizard, is to discover the best counter-spell or incantation that would lift the evil curse with which he had previously inadvertently bewitched Mr. Norman…This case came to trial in September 1997.  I sat in Court every day…but on the fifth day, long before the defence had opened its case, the trial collapsed.  Mr. Norman’s financial backer withdrew, his legal aid having already been rescinded.  The reason for the latter was as follows: had Mr. Norman won his case, the compensation that he would have received would have been claimed back by the state to offset the considerable welfare and sickness benefits he had received while indisposed.  Thus he would have been financially no better off and legal aid is not granted when such is the case”.

Dr. Heap was under the view that Mr. Norman was “clearly malingering in his claims to have been afflicted with his unusual sexual compulsions”. Heap claimed that there were grounds for considering Norman’s symptoms as a factitious disorder (like Munchausen’s Syndrome).

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

Further reading

Heap, M. (2000). A legal case of a man complaining of an extraordinary sexual disorder following stage hypnosis. Contemporary Hypnosis, 17(3), 143-149.

Heap, M. (2001). Some stories about hypnosis. The Skeptical Intelligencer, 3(4), 29-35

Heap, M. (2014). Some stories about hypnosis. Located at: http://www.mheap.com/hypnosis.html

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