Category Archives: Obsessive-Compulsive Disorder

List watch: A brief look at glazomania

“Real happiness consists in not what we actually accomplish, but what we think we accomplish” (Charles Green Shaw, American abstract artist)

Ever since I can remember I have always been someone that compiled lists. Back in my youth it was lists of my favourite pop groups, film stars, sports stars, etc. I still make loads of lists but these days they are more likely to be long ‘to do’ lists (in fact, I’ve even written articles on getting the most out of ‘to do’ lists and being organized – see ‘Further reading’ below) or writing articles in the form of lists (in fact, I used to write what I called ‘psychol-lists’ for the British Psychological Society’s in-house magazine The Psychologist). When I make lists I feel more productive, and they are often the spurs to get things done (as long as I actually do the things on the list).

Obviously, list making can be an important activity in the organizational skills of many working individuals. Based on my own observations, most people make lists so they (i) don’t forget things, (ii) don’t procrastinate, (iii) feel in control and focused in what they are doing, (iv) can relieve stress, and (v) can cross things off the list and feel a sense of accomplishment. However, for a minority of people, making lists appears to be obsessive and a mental health issue. In short, there may be a fine line between being organized and being neurotic. From my own personal experience, I know that writing lists can be related to perfectionism. But life isn’t perfect and not completing activities on ‘to do’ lists can raise stress and worry levels. Ironically, the only way some people can deal with this is to make even more lists of things to do.

Obsessive list making is sometimes referred to as glazomania (check out the ‘Manias’ page at The Scorpio Tales website). Online dictionaries tend to define glazomania as either a passion for list makingor an unusual fascination with making lists”. However, the term ‘glazomania’ doesn’t appear to be used much academically. I did come across one recent paper in Distinktion: Scandinavian Journal of Social Theory, by Dr. Urs Staeheli that mentioned it:

“Recently, quite a number of coffee-table books have been published that collect different sorts of everyday lists. Some authors even speak of a ‘glazomania‘ (Cagen 2007) – that is, an uncontrolled urge to produce lists and a fascination with list-making”

However, there was no other information provided. I managed to track down the 2007 reference to Sasha Cagen’s book (To-Do List: From Buying Milk to Finding a Soul Mate, What Our Lists Reveal About Us). The book includes creative list-making exercises with the aim of helping individuals to “get in touch with their passion for life, inside and out of work, and refocus them on what brings them alive”. Cagen now makes a living on writing and giving workshops on the benefits of list making (one of her major clients being Google)

Although the term ‘glazomania’ is seldom used academically or clinically, obsessive list making is often mentioned as one of the symptoms of obsessive-compulsive disorder. As one online admission I came across noted:

“I have OCD, and recently my OCD flares up in the form of compulsive list making. This behavior totally affects my ability to be productive because I am constantly afraid of forgetting something and of spending time doing the wrong thing. Does anyone have any tips on how to break the cycle?”

The Wikipedia entry on obsessive-compulsive personality disorder notes that the main symptoms are “preoccupation with remembering and paying attention to minute details and facts, following rules and regulations, compulsion to make lists and schedules, as well as rigidity/inflexibility of beliefs or showing perfectionism that interferes with task-completion. Symptoms may cause extreme distress and interfere with a person’s occupational and social functioning” (my emphasis)

Psychologically, an argument could be made that obsessive list makers are simply trying to create an illusion of control in otherwise chaotic lives. The reason whyindividuals with OCD make lists compulsively is that they often afraid (in some cases, to the point of being phobic) that they will forget something important (even though research shows they do not have memory problems). These (arguably unnecessary) lists provide a reminder to carry out daily activities (i.e. brushing teeth, making breakfast, etc.). As with other OCD-type behaviours, the action of making a list helps the individual to feel psychologically better (albeit temporarily). The etiological roots may lie in the fact that the sufferer may at some point in their past history have been reprimanded severely, or repeatedly, by others for innocently forgetting things that were important. The OCD Types website adds:

“They never learn that they do not need the list to remember things. People with OCD may also make lists to remember things that may be contaminated to later wash or avoid, which also contributes to the OCD process. List-making can be in writing or verbalized aloud”.

In 2010, the BBC reported an exhibition at the Archives of American Art in Washington featuring lists made by eminent artists (everything from “scribbled on scraps of paper” to the “elaborately illustrated” including lists by Pablo Picasso, Alfred Konrad, Oscar Bluemner, Eerp Saarinen and Harry Bertoia). Bluemner even kept lists of lists. The curator of the exhibition (Liza Kirwin) told the BBC that:

“In trying to give order to his life, [Bluemner] obscures the clarity of the inventory of his work. He’s completely obsessed with this type of record keeping…This very mundane and ubiquitous form of documentation can tell you a great deal about somebody’s personal biography, where they’ve been and where they’re going. People can relate to this form of documentation because so many people are list keepers and organise their lives this way”.

In the same article, the BBC interviewed the US psychoanalyst Dr. Michael Maccoby who claimed that there are various types of list makers. However, there was little detail and the only quote in relation to types of list makers claimed: “The extreme is the obsessive who has to make lists of everything. These are people who have an unconscious fear that everything is going to be out of control if they don’t make a list”. As far as I am aware, there is no published empirical research on personality types and list making although there is some psychological literature showing that list making – as part of time management practices – appears to have some beneficial effects on both student grade point averages and workplace productivity.

Finally, a few months ago, an online article by Dr. Carrie Barron at the Psychology Today website provided a brief summary of why making lists is psychologically good for people. I’m not sure about the empirical basis of her claims but they seem to have reasonable face validity. I’ll leave you with her reasons (her verbatim list of “six great benefits”!). In summary, Barron believes that lists:

  • “Provide a positive psychological process whereby questions and confusions can be worked through.
  • Foster a capacity to select and prioritize. This is useful for an information-overload situation.
  • Separate minutia from what matters, which is good for identity as well as achievement.
  • Help determine the steps needed. That which resonates informs direction and plan.
  • Combat avoidance. Taking abstract to concrete sets the stage for commitment and action. Especially if you add self-imposed deadlines.
  • Organize and contain a sense of inner chaos, which can make your load feel more manageable”.

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

 

Further reading

 

Barron, C. (2014). How making lists can quell anxiety and breed creativity. Psychology Today, March 9. Located at: http://www.psychologytoday.com/blog/the-creativity-cure/201403/how-making-lists-can-quell-anxiety-and-breed-creativity

 

Cagen, S. (2007). To-Do List: From Buying Milk to Finding a Soul Mate, What Our Lists Reveal About Us. Chicago: Touchstone.

 

Griffiths, M.D. (1995). Psycholo-lists. The Psychologist: Bulletin of the British Psychological Society, 8, 240.

 

Griffiths, M.D. (1996). More psycholo-lists. The Psychologist: Bulletin of the British Psychological Society, 9, 384.

 

Griffiths, M.D. (2006). Tips on…To do lists. British Medical Journal Careers, 332, 215.

 

Griffiths, M.D. (2008). Tips on…’To do’ lists. Psy-PAG Quarterly, 68, 27-28.

 

O’Brien, J. (2010). The art of list-making. BBC News, March 3. Located at: http://news.bbc.co.uk/1/hi/8537856.stm

 

OCD Types (2014). About obsessive-compulsive disorder. Located at: http://www.ocdtypes.com/unusual-compulsions.php

 

Staeheli, U. (2012). Listing the global: Dis/connectivity beyond representation? Distinktion: Scandinavian Journal of Social Theory, 13(3), 233-246.

 

Wikipedia (2014). Obsessive-compulsive personality disorder. Located at: http://en.wikipedia.org/wiki/Obsessive–compulsive_personality_disorder

 

Chewing it over: Luis Suárez and the psychology of biting

Last week I was one of the millions of football fans that watched the Uruguayan footballer Luis Suárez sink his teeth into the shoulder of Giorgio Chiellini during the Uruguay versus Italy World Cup match. Straight after the match I jokingly tweeted a link to one of my previous blogs on the psychology of sexual biting (known as odaxelagnia). My tweet simply said “Maybe Luis Suárez has an undiagnosed odaxelagnia disorder” followed by a link to my article. The next day, I got a call from a journalist from Daily Telegraph newspaper (Harry Wallop) who was writing an article on why we find the act of biting so shocking.

I’m admittedly no expert on biting but I spent 15 minutes talking to the Telegraph about some of the possible psychological reasons and explanations for human biting in adults. The journalist specifically wanted to know why the act of biting was so shocking. Very little of what I said made it into the published Telegraph article. In fact, the only quotes attributed to me were embedded within a section involving Freudian explanations for biting:

“Suárez may not be found to have committed an offence. But it is clear that an adult biting another in public is much more disturbing than throwing a punch, even if both might be criminal assault. Dr Mark Griffiths, a psychologist at Nottingham Trent University, says: ‘How many times in football have we seen fisticuffs, elbowing, even headbutting? All these things are awful, but they have become almost part and parcel of the game. But biting is so rare, that is one of the reasons why it is so shocking’. Also, psychologists explain, biting shocks us because it involves using an intimate and soft body part that one normally associates with pleasure. And here we touch on a basic tenet of Freudianism. According to the founding father of psychoanalysis, all sexual pleasure and anxieties are rooted in different periods of childhood, the first of which is the oral stage, when babies explore the world through their mouths. Toddlers often then go on to bite to attract attention and will continue doing so until a parent teaches them otherwise. Behaviour learnt in the oral stage of development is the explanation, Freudians believe, for everything from a predilection for chewing pencils all the way to full-blown vampirism. It is no coincidence that Freud wrote his seminal work on psychosexual theories within a decade of the publication of Bram Stoker’s Dracula. The vampire, spreading fear in a sexually repressed society, is a powerful metaphor”.

Anyone that knows me knows that I am no fan of Freudian theory. I find him interesting to read but many of his theories can’t be falsified using the scientific method. If his theories can’t be empirically tested then I have little time to take his theories seriously. (For instance, in my main field of gambling addiction, Signund Freud speculated that gambling was unconscious substitute for masturbation and an act of psychic masochism). However, I do believe that many people have unconscious thoughts and desires and that sometimes people simply do not know why they did what they did. Maybe Suárez’ most recent biting incident was no different. Maybe there was no premeditation and that his bite into Chiellini’s shoulder was simply instinctive. Maybe it was a classically conditioned response going back to his childhood.

One of the most surprising aspects in the aftermath of the whole incident is how Suárez’ teammates, his manager, and even the Uruguayan President Jose Mujica, defended his actions. If an England player had done the same thing, I can’t imagine David Cameron welcoming him back to the country. My partner (who is also a psychologist) and I were talking with our children about Suárez’ actions after the game as they both kept asking about why Suárez would bite someone during a game. We speculated that because Suárez has been great footballer all his life, biting incidents that occurred during his childhood may not have been treated and acted upon in the same way in someone not quite so talented. In short, maybe his biting behaviour was tolerated rather than being punished because he was always told what a gifted individual he was.

While being interviewed by the Telegraph, I also speculated that Suárez’ biting may have been some kind of a stress-based reaction. At the time of the bite in the match, Uruguay were heading out of the tournament (as Italy only needed a draw to progress and the score was 0-0). Maybe Suárez’ felt Uruguay were being pushed into a psychological corner by Italy and the biting was symptomatic of feeling under stress. Although rare, Suárez is not the first sportsman to bite an opponent. Many people will recall Mike Tyson biting a piece out of Evander Holyfield’s ear. Less high profile cases include the rugby union players Johan Le Roux (of South Africa) and Dylan Hartley (England). These other cases somehow seem less shocking than that of Suárez. In the Telegraph article, other psychologists were interviewed. Professor David Wilson (Birmingham City University) was quoted as saying:

“To bite someone, you have to get very close, you have to put your head – the place you want to protect the most in a conflict – right up against them…Think about what this does. It literally marks your partner as belonging to you. In evolutionary terms, there are many animals who bite their mates as a way of controlling them before engaging with them sexually. Try as we might, it is hard to escape the sexual nature of biting. It is sometimes even used as a method of attack during sexual crimes…It is nearly always a form of sadism. Often I’d be looking at children who had been bitten by a paedophile or women who had been bitten on their sexual organs. I really don’t want to over-egg it, but Suárez has a mild psychological issue”.

Dr. Saima Latif wrote an article for the Daily Telegraph and asserted that Suárez needs psychological help (i.e., anger management therapy). He (like I) speculated as to why Suárez had bitten Giorgio Chiellini although Latif’s angle was more Freudian and psychodynamic. He wrote:

“Biting is an act borne of frustration, stress and loss of control. Luis Suárez is likely to have felt humiliated and put down in some way that he wanted to get one over on his opponent…Research shows that the most violent period of our lives is when we are between three and four years old. That is the most aggressive stage of development, because if we don’t get what we want, we fight and lash out. It’s also the stage when the Id takes over; a basic instinct when we can’t control our temperament. It’s a possibility that Suárez thought his provocation would lead to his opponent retaliating and then being sent off. However, given that he may also be sent off for biting, this reasoning is slightly more remote.Perhaps his biting started in childhood and was triggered by something, perhaps he was bitten in turn. To get to the root of the problem and address it effectively he does require psychological therapy which looks at the more deep-seated issues that might be of concern”.

Watching Suárez being interviewed after the game, I’m still amazed how trivial he thought the incident to be (“these things happen in football”). He believed he had done nothing wrong and like a child that has been caught doing something wrong he tried to deflect the blame elsewhere. As Dr. Latif noted:

“Most children, when they are confronted with something they have done, will immediately take recourse in lying. The fact that this is a repeated action shows that it is habitual, rather than pathological. It is his particular technique, which makes you wonder how many time’s he’s done it off the pitch”.

Maybe we’ll never know why biting an opponent is part of Suárez’ non-footballing behavioural repertoire on the field. However, that doesn’t mean we should stop hypothesizing about what caused the behaviour in the first place.

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

Further reading

Latif, S. (2014). Luis Suarez needs therapy to overcome urge to bite. Daily Telegraph, June 25. http://www.telegraph.co.uk/sport/football/players/luis-suarez/10925060/Luis-Suarez-needs-therapy-to-overcome-urge-to-bite.html

Wallop, H. (2014). Luis Suárez and the Bite. Daily Telegraph, June 26. Located at: http://www.telegraph.co.uk/sport/football/players/luis-suarez/10925858/Luis-Suarez-and-the-Bite.html

Men of steal: A brief look at the psychology of shoplifting

In previous blogs I have examined activities like shopping as an addiction. One similar such behaviour is shoplifting. I have to admit that from a personal perspective I came from a family where at least two of my siblings were regular shoplifters and were both regularly caught by shop staff members and reported to the police. As a teenager, my brother was a habitual shoplifter. His behaviour was economically motivated at the start (i.e., we came from a very poor and impoverished family and he stole things because he couldn’t afford to buy things that his friends had) but was later carried out to help feed his addiction to slot machines (i.e., he would steal shop items, sell them, and use the money to gamble). This latter behaviour is common among adolescent gamblers and I have written about this in both of my published books on adolescent slot machine addiction as well as in a number of my published papers.

Last week, one of my regular blog readers, forensic psychologist Dr. John C. Brady, sent me a copy of his latest book Why Rich Women Shoplift – When They Have It All. It’s an engrossing and fascinating read (I sat an read it all in one sitting) and there are many references throughout to seeing some forms of shoplifting as an addiction. I will return to this topic in a future blog (along with a look at the related behaviour of kleptomania) but I thought I would use today’s blog to talk about something very specific in Dr. Brady’s book.

One of the many interesting things I read was Brady’s classification of 16 different types of shoplifters with seven underlying psychological dimensions. The classification included those that are (i) impulse driven (The Externalizer; The Compulsive; The Atypical Shoplifter), (ii) psychologically motivated (The Kleptomaniac; The Thrill Seeker; The Trophy Shoplifter; The Binge-Spree Shoplifter; The Equalizer; The Situational Shoplifter), (iii) economically influenced (The Professional; The Impoverished [Economically Disadvantaged] Shoplifter), (iv) age determined (The Provisional/Delinquent Shoplifter), (v) alcohol and substance connected (The Drug or Alcohol Addict), (vi) mentally/medically impaired (The Alzheimer’s Sufferer/Amnesiac; The Chemically/Alcohol Driven Shoplifter), and (vii) no identifiable psychosocial drivers (The Inadvertent/Amateur Shoplifter). Brady acknowledges that the typology is purely descriptive, not exhaustive and was not developed to be mutually exclusive. Here is a brief description of the 16 types:

  • The Externalizer: These are people who feel that they are not in control of their lives (“controlled by outside forces that serve as negative psychological drivers, lowering their moral threshold”) and have an external locus of control. Brady argues that shoplifting simply channels to express anger or help legitimize their personal aggression. All of Brady’s rich women that shoplift fit this particular profile.
  • The Compulsive: From the descriptor, it is self-evident that this type of shoplifts as a compulsive behaviour and may also engage in other types of addictive behaviour such as gambling addiction and shopping/buying addiction. According to Brady they are generous individuals but do not care about themselves. When they are caught shoplifting they are full of remorse (and only feel good during or just after the shoplifting incident) but simply cannot resist the urge to shoplift.
  • The Atypical Shoplifter: This type of shoplifter is based on the work of Dr. Will Cupchik and described in his 2011 book Why Honest People Shoplift or Commit Other Acts of Theft: Assessment and Treatment of ‘Atypical Theft Offenders. Brady describes such people as not shoplifting for any kind of personal economic gains. Such people claim they had no idea why they engaged in shoplifting except to say that it wasn’t economically motivated.
  • The Kleptomaniac: Like atypical shoplifters, kleptomaniacs also steal and shoplift for no apparent reason (and do so impulsively). Many people may have the impression that most shoplifters are kleptomaniacs but as Brady is keen to point out, only 5% of shoplifters are kleptomaniacs. Brady claims this category is the most controversial although the classification in the Diagnostic and Statistical Manual of Mental Disorders (correctly) classes kleptomania as an impulse-control disorder and the behaviour is not carried out as an expression of anger or vengeance. (Dr. Brady spends a whole chapter in his book explaining why the DSM classification of kleptomania is poor).
  • The Thrill Seeker: Brady describes this group of people (typically adolescents) as a “higher risk shoplifter” who shoplift for the intrinsic excitement of carrying out an illegal behaviour. They may also shoplift as part of a dare simultaneously with other shoplifters. Brady claims that shoplifting for thrill seekers gives them a sense of autonomy (and that the goal is “psychological overcompensation” for individuals that may have a history of failure in the lives).
  • The Trophy Shoplifter: Brady claims there have been an increasing number of cases of trophy shoplifters reported in the media. Citing Terence Shulman (who also wrote the Foreword for Brady’s book), Brady quotes from Cluttered Lives, Empty Souls – Compulsive Stealing, Spending and Hoarding (Shulman’s 2011 book) and says trophy shoppers “tend to need to have the best of everything: they seek out that perfect object, be it fashion, art, car, etc. – the more special, unique, or rare, the better”. To me, this behaviour appears to be a by-product of being an ardent collector, and Brady does go on to say there is a “direct connection” between a collector and a trophy shoplifter.
  • The Binge-Spree Shoplifter: According to Brady, binge-spree shoplifters are typically adolescents (but may carry on as an adult) where the person shoplifts in a short bout of thefts arising from a combination of weak impulses and doing it to impress their peers (i.e., or as Brady terms it “subcultural recognition”). Like binge drinking and binge gambling, the behaviour occurs in short specific bouts followed by appreciable periods of abstinence.
  • The Equalizer: This category of shoplifter arose from some of Brady’s own case studies. Some of the shoplifters he interviewed felt that over the course of their lives, many things (both real and perceived) had been taken from them and that shoplifting was “retaliatory justification” for such past events. Brady also described such individuals as going through their lives with “a good-size chip on their shoulders” and who are agitated, edgy and resistant to treatment.
  • The Situational Shoplifter: Brady describes the situational shoplifter as an opportunist that steals on the spur of the moment after seeing an item that has some kind of appeal to them. The process itself was described by Brady as “almost unconscious”. In many ways, the motivation is similar to the compulsive shoplifter but the activity is much more likely to be done on a very occasional basis.
  • The Professional: Professional shoplifters are very simply those that steal (often expensive “high-end”) items for profit. A number of television shows in the UK have profiled such people and as Brady points out, this type of shoplifter shows no remorse if caught and will often try to resist arrest.
  • The Impoverished [Economically Disadvantaged] Shoplifter: Like the professional shoplifter, the motivation to steal is economically motivated but is done out of necessity rather than for profit and/or greed. Items stolen may be basic necessities (food, toiletries, nappies, etc.) and when caught such people may show remorse (however, according to Brady they are hostile towards the “system” that has led to them being economically disadvantaged).
  • The Provisional/Delinquent Shoplifter: This type of shoplifter is usually an adolescent delinquent that shoplifts as part of a wider group of antisocial behaviours in their “troubled teens”. There appears to be some crossover with thrill seeking shoplifters and binge-spree shoplifters as there are elements of both hedonism and peer pressure associated with the criminal act. The good news is that many teens appear to mature out of such behaviour.
  • The Drug or Alcohol Addict: This type of shoplifter engages in shoplifting behaviour to support their addictive habit (and as such – and as Brady acknowledges – could technically be in the ‘economically influenced’ category of shoplifters. Brady claims they often take high risks and will try to steal as many items as quickly as possible and then run out of the shop. According to Brady, pre-planning is almost non-existent.
  • The Alzheimer’s Sufferer/Amnesiac: This group of shoplifters includes those with severe memory problems and who simply walk out of shops without paying simply because they forgot and/or didn’t realize they hadn’t paid. Brady claims that this group of shoplifters is arguably the fastest growing group as we live in a society where the average age of dying is increasing all the time.
  • The Chemically/Alcohol Driven Shoplifter: Brady claims that this group of shoplifters is distinct from drug and alcohol addicts because the shoplifting is not economically motivated and occurs because they are in an altered state of awareness (due to the psychoactive effects of the substances ingested). As Brady notes, their “mental state typically involves such symptoms as confusion, psychomotor agitation, memory lapse, disorientation, nervousness, and perceptual disturbance” (especially those high on cocaine or meth). From a public safety perspective, the police claim that it is these individuals that pose the biggest threat.
  • The Inadvertent/Amateur Shoplifter: This final category refers to those without any kind of psychological or physiological disorder who simply “forget to pay” for an item. People may not even realize for some considerable time after that they didn’t pay for the item(s) and it is then up to the person’s conscience as to whether they return the “stolen” items.

I think this typology is intuitive and covers almost all the types of shoplifter that I can think of. I say ‘almost’ as my own brother’s late teenage shoplifting behaviour would not be included in any of the 16 types listed here. However, the ‘drug/alcohol addict’ category could be widened to ‘chemical or behavioural addict’ and then he would be able to be included.

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

Further reading

Brady, J.C. (2013). Why Rich Women Shoplift – When They Have It All. San Jose, CA: Western Psych Press.

Cupchick, W. (1997). Why Honest People Shoplift or Commit Other Acts of Theft: Assessment and Treatment of ‘Atypical Theft Offenders. Toronto: Tagami Communication.

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. (2011). Adolescent gambling. In B. Bradford Brown & Mitch Prinstein(Eds.), Encyclopedia of Adolescence (Volume 3) (pp.11-20). San Diego: Academic Press.

Griffiths, M.D. (in press). Gambling and crime. In W.G. Jennings (Ed.), The Encyclopedia of Crime and Punishment. London: Sage.

Griffiths, M.D. & Sparrow, P. (1996). Funding fruit machine addiction: The hidden crime. Probation Journal, 43, 211-213.

Shulman, T.D. (2011). Cluttered Lives, Empty Souls – Compulsive Stealing, Spending and Hoarding. West Conshohocken, PA: Infinity Publishing.

Yeoman, T. & Griffiths, M.D. (1996). Adolescent machine gambling and crime. Journal of Adolescence, 19, 99-104.

That’ll do icily: A brief look at pagophagia

In a previous blog on five ‘weird addictions’ I briefly mentioned pagophagia, a craving and compulsion for chewing ice. Pagophagia is a type of pica (which I also covered in a previous blog). Pica is defined as the persistent eating of non-nutritive substances for a period of at least one month, without an association with an aversion to food. Although the incidence of pagophagia appears to have increased over the last 30 years in westernized cultures, Dr. B. Parry-Jones (in a 1992 issue of Psychological Medicine) carried out some historical research and pointed out that both Hippocrates and Aristotle wrote about the dangers of excessive intake of iced water. Parry-Jones also noted that references to disordered eating of ice and snow were also recorded in medical textbooks from the sixteenth century. However, the first contemporary reference to pagophagia appears to have been a 1969 paper by Dr. Charles Coltman in the Journal of the American Medical Association entitled ‘Pagophagia and iron lack’.

Pagophagia is closely associated with iron deficiency anemia but can also be caused by other factors (biochemical, developmental, psychological, and/or cultural disorders). If pagophagia is due to iron deficiency (such as case studies of those with sickle cell anemia), it may sometimes be accompanied by fatigue (e.g., being tired even when performing normally easy tasks). Dr. Youssef Osman and his colleagues published a number of case reports of pagophagia in a 2005 issue of the journal Pediatric Haematology and Oncology including the case of a child with sickle cell anemia and rectal polyps (that caused a lot of bleeding and made the anemia worse):

“An 8-year-old Omani boy, a known case of sickle cell anemia…presented with history of craving for ice. The child was noticed over the last 4 months to like drinking very cold water and to open the deep freezer and scratch the ice and eat it. The parents tried to stop him from doing so, but they failed…The child was started on oral iron therapy…and his craving for ice was completely stopped. Meanwhile, the rectal polyp was removed surgically”.

Other potential health side effects include constant headaches (a ‘brain freeze’ similar to ‘ice cream headache’) and teeth damage although this is thought to be relatively rare. However, a recent paper by Dr. Yasir Khan and Dr. Glen Tisman in the Journal of Medical Case Reports highlighted the case of a 62-year-old Caucasian man who presented with bleeding from colonic polyps associated with drinking partially frozen bottled water.

Khan and Tisman also suggested that some people who are deficient in iron experience tongue pain and glossal inflammation (glossitis). Others claim that chewing ice may help those with stomatitis (i.e., inflammation of the mucous lining inside the mouth). A recent 2009 case study published by Dr. Tsuyoshi Hata and his colleagues in the Kawasaki Medical Journal, reported the case of a 37-year old Japanese women who ate copious amounts of ice to relieve the pain of temporomandibular joint disorder (i.e., chronic pain in the joint that connects the jaw to the skull). Khan and Tisman also claim that the classical symptoms of pagophagia have changed in the last 40 years since Dr. Coltman’s initial paper in the Journal of the American Medical Association.

“This may probably be the result of advances in technology and changes in culture. When initially described [by Coltman], pagophagia was defined as the excessive ingestion of ice cubes from ice trays and the ingestion of ice scraped from the wall of the freezer. With the advent of ice cube makers and auto defrosters, the presentation of pagophagia has changed in a subtle manner as described in…our patients. Now we observe a subtler ingestion and/or sucking of ice cubes from large super-sized McDonalds-like cups and from the use of popular bottled water containers that have been frozen”.

There have been few epidemiological studies examining the prevalence of pagophagia. Such estimates vary widely within particular populations but (according to Dr. Youssef Osman and his colleagues) have been shown to be more common in low socioeconomic and underdeveloped areas. Pagophagia is thought to be relatively harmless in itself or to one’s health, although there are some claims in the literature that pagophagia can be addictive. However, empirical reviews suggest that pagophagia (and pica more generally) is part of the obsessive-compulsive disorder spectrum of diseases. As a consequence, some case studies even suggest that ice chewing compromises their ability to maintain jobs or personal relationships.

Treatment for pagophagia can often be overcome with iron therapy and Vitamin C supplements (to supplement iron deficiency if that is the cause). For instance, Dr. Mark Marinella in a 2008 issue of the Mayo Clinic Proceedings successfully treated a 33-year old woman with pagophagia following complications with gastric bypass surgery:

“The patient received red blood cells, iron sucrose, and levofloxacin. On further questioning, the patient denied taking vitamin, mineral, or iron supplements since surgery and reported prolonged, heavy menstrual cycles. She consumed large amounts of ice daily for several months. The patient’s husband frequently observed her in the middle of the night with her head in the freezer eating the frost off the icemaker. The patient admitted to awakening several times nightly for months with an uncontrollable compulsion to eat the frost on the icemaker. This craving resolved after transfusion and iron administration”

However, if the condition is psychologically or culturally based, iron and vitamin supplements are unlikely to work, and other psychological treatments (such as cognitive-behavioural therapy) are likely to be employed.

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

Further reading

Coltman, C.A. (1969). Pagophagia and iron lack. Journal of the American Medical Association, 207, 513-516.

de Los Angeles, L., de Tournemire, R. & Alvin, P. (2005). Pagophagia: pica caused by iron deficiency in an adolescent. Archives of Pediatrics, 12, 215-217.

Edwards, C.H., Johnson, A.A., Knight, E.M., Oyemadej, U.J., Cole, O.J., Westney, O.E., Jones, S. Laryea, H. & Westney, L.S. (1994). Pica in an urban environment. Journal of Nutrition (Supplement), 124, 954-962.

Hata, T., Mandai, T., Ishida, K., Ito, S., Deguchi, H. & Hosoda, M. (2009). A rapid recovery from pagophagia following treatment for iron deficiency anemia and TMJ disorder accompanied by masked depression. Kawasaki Medical Journal, 35, 329-332.

Khan, Y. & Tisman, G. (2010). Pica in iron deficiency: A case series. Journal of Medical Case Reports, 4, 86. Located: http://www.jmedicalcasereports.com/content/4/1/86

Kirchner, J.T (2001). Management of pica: A medical enigma. American Family Physician, 63, 1177-1178.

Marinella, M. (2008). Nocturnal pagophagia complicating gastric bypass. Mayo Clinic Proceedings, 83, 961

Osman, Y.M., Wali, Y.A. & Osman, O.M. (2005). craving for ice and iron-deficiency anemia: a case series. Pediatric Hematology and Oncology, 22, 127-131.

Parry-Jones, B. (1992). Pagophagia, or compulsive ice consumption: A historical perspective. Psychological Medicine, 22, 561-571.

A world of disc-overy: Record collecting as an addiction

Regular readers of my blog will know that (a) some of my friends describe me as a music obsessive and (b) that I have written blogs on both compulsive hoarding and ‘collecting’ as an addiction‘ (including a separate blog on murderabilia). Today’s blog briefly looks at a really interesting 2008 paper I came across on ‘record collecting’ as an addiction written by Professor Kevin Moist in the journal Studies in Popular Culture. (Moist also has a new co-edited book – Contemporary Collecting: Objects, Practices, and the Fate of Things – that has just been published by Scarecrow Press).

According to research papers and books by Dr. Russell Belk, around one in three people in the United States collects something – yet one of the observations that Moist makes is that collectors (in general and not just relating to record collectors) are often portrayed negatively as obsessive, socially maladjusted oddballs in thrall to acquisitive drives”. I have to admit that those closest to me certainly see my passionate interest in collecting music by certain recording artists as “obsessive” (although arguably not “socially maladjusted”). I’ve also been described as “no different to a trainspotter” (but said in such a way that it obviously relates to something negative).

Research by Dr. Susan Pearce (published in her 1998 book Contemporary Collecting in Britain) shows that collectors as a group are “quite average, socially speaking”. Additionally, Dr. Belk claims that the image of a ‘collector’ acts as “an unwitting metaphor for our own fears of unbridled materialism in the marketplace”. Belk then goes on to say that his research has led him to the conclusion that collectors cherish things about objects “that few others appreciate” and are not necessarily materialistic in their motivations for collecting. Belk also talks about collecting behaviour being on a continuum of the ‘heroic passionate’ collector at one end of the spectrum and the ‘obsessive-compulsive type’ at the other with most collectors falling somewhere between the two. I briefly dealt with the motivations to collect things in my previous blog but in her book Museums, Objects, and Collections, Dr. Pearce argues collecting falls into three distinct (but sometimes overlapping) types. As Moist summarizes:

“One of these she calls ‘souvenirs’, items or objects that have significance primarily as reminders of an individual’s or group’s experiences. The second mode is what she calls ‘fetish objects’ (conflating the anthropological and psychological senses of the term), relating primarily to the personality of the collector; the collector’s own desires lead to the accumulation of objects that feed back into those desires, with the collection playing a central role in defining the personality of the collector, memorializing the development of a personal interest or passion. The third mode, ‘systematics’, has the broader goal of creating a set of objects that expresses some larger meaning. Systematic collecting involves a stronger element of consciously presenting an idea, seen from a particular point of view and expressed via the cultural world of objects”.

When it comes to record collecting, I appear to most fit the second (i.e., fetish) type. The artists that I collect are an extension of my own personality and say something about me. My tastes are diverse and eclectic (to say the least) and range from the obvious ‘classic’ artists (Beatles, David Bowie, Rolling Stones, Led Zeppelin, Lou Reed), the not so obvious (Adam Ant, The Smiths, Bauhaus, Heaven 17, Depeche Mode, Gary Numan, Divine Comedy), the arguably obscure (Art of Noise, John Foxx, Propaganda, David Sylvian, Nico) and the downright extreme (Throbbing Gristle, Velvet Underground). Arguably, most people’s conceptions of record collecting (if they are not collectors themselves) are likely to be based on media and cultural representations of such individuals (such as John Cusack and Jack Black in High Fidelity, or Steve Buscemi in Ghost World). I agree with Professor Moist who asserts:

“Most record collectors fit well within Belk’s definition, passionately acquiring sets of records both as objects and cultural experiences. As with most types of collecting, the ‘thrill of the chase’ is a major part of the experience…[However] today, with eBay and other online resources, the amount of time required for the hunt has been reduced, and collecting is also less of a face-to-face social activity since one can search in private rather than actually traveling to find records…Music writer Simon Reynolds notes that record collecting also ‘involves the accumulation of data as well as artifacts’, a factor that can be seen in magazines devoted to record collecting such as Goldmine and Record Collector, and that has only increased as collecting has gone online”.

The above paragraph could have been written about me. I am one of those record collectors that collect as much for the cultural experience as for the object itself. I have loads of mint condition singles and LPs that I haven’t even played (but listen to the music on my i-Pod). I have bought Record Collector magazine every month for over 30 years and have never missed an issue. Every month I buy a wide range of other music magazines including Mojo, Q, Uncut, Vive Le Rock, Classic Rock and Classic Pop (as well as the occasional issue of Rolling Stone, NME, The Wire, Future Music and Shindig). In short, almost a lot of my disposable income goes on buying music or reading music. My records, CDs and music magazines can be found in almost every room in my house. To me, my collection is priceless (and I mean that in an emotional sense rather than a financial one). I am an archivist of the artists I collect as much as a collector. Professor Moist comments that: “While such fanatical and obsessed collectors do exist…they are clearly outliers on the scale of collecting passion…For such people collecting is a real problem”. However, I am a true fanatic of music but don’t believe I am addicted (based on my own criteria). My love of music and collecting it adds to my life rather than takes away from it. As Moist also notes (and which I again wholeheartedly agree:

“Most record collectors collect as much for the content as for the object: one is far less likely to find a collector whose collecting criteria is ‘records with yellow labels’ than to find one whose focus is ‘west coast jazz’ or ‘pre-war blues’. Collectors might follow particular artists (Charlie Parker, the Sex Pistols), musical genres (reggae, soul, classical), records from certain cultural/geographic areas (New Orleans, South Africa), records from specific labels (Sun, Stax, Rough Trade), records for special types of use (sound effects, ‘library’ music), records from a historical era (the 1960s), records with covers by particular graphic artists, special editions of records (first/original pressings are again popular), particular types of records (45s, LPs), records that embody memory on a more personal scale (those played by a favorite local DJ, or listened to in one’s youth, etc.), and many more besides. For many collectors, records’ status as bearers of personal and/or collective meaning is most significant”.

Moist’s chapter also features a number of case studies of people that appear to be addicted to record collecting – an activity that completely takes over (and conflicts with) almost every area of their lives. Moist concludes:

“Is there something about recorded music that lends itself to this sort of collecting? It could be that records’ dual levels of significance – objects themselves, and materializations of sound – make such types of activity more likely, that the status and possibilities of the object itself provide for certain approaches to collecting it…more research is needed on other types of collecting before such conclusions can be reached, though certainly the era of mass production has seen popular collecting expand greatly, and the digital era should see even further changes”.

I (for one) would love to carry out research in the area of record collecting but I guess I would get little research funding to carry out such studies. To me, the psychology of record collecting is fascinating but I know only too well that most others I know simply cannot fathom what it is I love about music and collecting music.

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

Further reading

Belk, R.W. (1995). Collecting as luxury consumption: Effects on individuals and households. Journal of Economic Psychology, 16(3), 477-490.

Belk, R.W. (2001). Collecting in a Consumer Society. New York: Routledge.

Moist, K. (2008). “To renew the Old World”: Record collecting as cultural production. Studies in Popular Culture, 31(1), 99-122.

Pearce, S. (1993). Museums, Objects, and Collections. Washington, D.C.: Smithsonian Institution Press.

Pearce, S. (1998). Contemporary Collecting in Britain. London: Sage.

Reynolds, S. (2004). Lost in music: Obsessive music collecting. In E. Weisbard (Ed.), This Is Pop: In Search of the Elusive at Experience Music Project (pp.289-307). Cambridge, MA: Harvard University Press.

Within you, without you: Where does addiction reside?

In 1984, Dr. Milton Burglass and Dr. Howard Shaffer published a paper in the journal Addictive Behaviors and claimed that arguably the important questions in the addiction field are ‘why do people become addicted to some things and not others?’ and ‘why some people become addicted and not others?’ Answers to these questions have been hindered by two common misconceptions about addiction, which to some extent have underpinned the ‘hard core’ disease concept of addiction. These are that addiction somehow resides within: (i) particular types of people or (ii) particular substances, and/or particular kinds of activity. That is, either some people are already ‘diseased,’ or else some substances/ activities cause this disease, or both.

There is a belief that some people are destined to become addicted. Typically this is explained in one (or both) of two ways. That some people (i.e., ‘addicts’) have an addictive personality, and that there is a genetic basis for addiction. The evidence for ‘addictive personality’ rests to a certain extent upon one’s faith in the validity of psychometric testing. Setting aside this major hurdle, the evidence in this area (as I argued with my colleagues Dr. Michael Larkin and Dr. Richard Wood in a 2006 issue of Addiction Research and Theory [ART]) is still inconclusive and contradictory.

First, psychologists have yet to determine which particular personality traits are linked to addiction. Studies have claimed that ‘the addictive personality’ may be characterized by a wide range of factors (e.g., sensation-seeking, novelty-seeking, extroversion, locus-of-control preferences, major traumatic life events, learned behaviours, etc.). The extent of this range stretches not only the notion of an ‘addictive personality’ but also the concept of ‘personality’ itself. Inevitably, much of this work relies on correlation analysis, and so the interpretation of results is not easily framed in terms of cause and effect. The approach is overly simplistic and is underpinned by a simple proposition that if we can divide people up into the right groups, then the explanation will emerge. However, addiction is far more complex than this. Of course, the relationship between individual bodies, minds, contexts, and life histories is complex and important – but it requires that we approach the matter from a more sophisticated and integrative position.

The search for a genetic basis for addiction rests upon the notion that some types of individuals are somehow ‘biologically wired’ to become addicts. In our 2006 ART paper, we argued that we must set aside any doubts about the limited conceptualization of ‘the environment’ that often typifies this kind of research, and its combination with epidemiological designs that are largely descriptive. Meta-analytic reviews have concluded that the heritability of addictive behaviour is likely to be controlled by many genes each contributing a small fraction of the overall risk. Furthermore, some of these same genes appear to be risk factors for other problems, some of them conceptually unrelated to addiction. We argued that the main point here is that while these findings do contribute something to our understanding of ‘why some people and not others,’ they do not adequately or independently explain the range of variation. Therefore the most we can say is that some people are more likely to develop problems under certain conditions, and that given the right conditions most people could probably develop an addiction. Emphasis needs to be placed on identifying those ‘conditions,’ rather than on searching for the narrowest of reductionist explanations.

We also argued in our 2006 ART paper that substances and activities cannot be described as intrinsically addictive in themselves (unless one chooses to define ‘addictive’ in terms of a substance or behaviour’s ability to produce tolerance and/or withdrawal, and to ignore the range of human experience that is excluded by this). Biologists may be able to tell us very valuable things about the psychopharmacological nature of the rewards that particular substances and behaviours provide, and the different kinds of neuroadaptation that they may or may not produce in order to effect tolerance and/or withdrawal. But we argue that this on its own, is not an adequate explanation for addiction. In 1975, Dr. Lee Robins’ classic study (in the Archives of General Psychiatry) of heroin-users returning from the Vietnam war is one example of the evidence that refutes this oversimplification. This study clearly highlighted the importance of context (i.e., that in a war zone environment individuals were addicted to heroin but on return to civilian life the addiction ceased to exist), and the framework provided by such contexts for making sense of addiction. In a hostile and threatening environment, opiates clearly provided something not usually required by most people; and given a cultural environment in which opiate use is a commonplace, and opiates are available, then opiate use ‘makes sense’. This study provides support for the assertion that some people are more likely to become addicted under some conditions, and that given the right conditions perhaps many people could understand what it means to be an addict.

So, with regard to the question, ‘why some individuals/addictions and not others?’ the rewards associated with various activities may be qualitatively very different, and may not necessarily be inherent or unique to a particular activity or substance, either. Many rewarding activities are rewarding because they present individuals with opportunities to ‘shift’ their own subjective experience of themselves (for example, see the research on Ecstasy use and bungee jumping that I published with Dr. Michael Larkin in a 2004 issue of the Journal of Community and Applied Social Psychology).

Frequently, a range of such opportunities is offered to the experienced user. Dr. Howard Shaffer (in a 1996 paper in the Journal of Gambling Studies) has pointed out that those activities that can be most relied upon to shift self-experience in a robust manner are likely to be the most popular – and (as a consequence) to be the most frequent basis of problems. So, obviously, our understanding of the available resources for mood modification must play a major part in understanding addiction. However, we must make a careful distinction between describing some substances as being more ‘robust shifters of experience’ than others (as we advocated in our 2006 ART paper) and describing some substances as ‘more addictive’ than others (which we argued against).

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

Further reading

Burglass, M.E. & Shaffer, H.J. (1984). Diagnosis in the addictions I: Conceptual problems. Addictive Behaviors, 3, 19-34.

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

Griffiths, M.D. (2011). Behavioural addiction: The case for a biopsychosocial approach. Transgressive Culture, 1(1), 7-28.

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

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

Orford, J. (2001). Excessive Appetites: A Psychological View of the Addictions (Second Edition). Chichester: Wiley.

Robins, L.N, Helzer, J.E, & Davis, D.H (1975) Narcotic use in Southeast Asia and afterward. Archives of General Psychiatry, 32, 955-961.

Shaffer, H. J. (1996). Understanding the means and objects of addiction: Technology, the Internet, and gambling. Journal of Gambling Studies, 12, 461–469.

Tyndale, R.F. (2003). Genetics of alcohol use and tobacco use in humans. Annals of Medicine, 35(2), 94–121.

Walters, G. D. (2002). The heritability of alcohol use and dependence: A meta-analysis of behavior genetic research. American Journal of Drug and Alcohol Abuse, 28, 557–584.

Stats entertainment (Part 2): A 2013 review of my personal blog

My last blog of 2013 was not written by me but was prepared by the WordPress.com stats helper. I thought a few of you might be interested in the kind of person that reads my blogs. I also wanted to wish all my readers a happy new year and thank you for taking the time to read my posts.

Here’s an excerpt:

The Louvre Museum has 8.5 million visitors per year. This blog was viewed about 860,000 times in 2013. If it were an exhibit at the Louvre Museum, it would take about 37 days for that many people to see it.

Click here to see the complete report.

Duly noted: A brief overview on compulsive singing

In a number of previous blogs I have made reference to the fact that I am a music obsessive. One of the consequences of my insatiable desire for music is that I often find myself unconsciously singing (either along with the music itself or just spontaneously as the mood takes me). Although I do not believe I have a compulsion to break into song, I was surprised to find that there are a number of case studies in the psychological literature on compulsive singing and other music related compulsions such as compulsive humming and whistling (although these all appear to be consequences of other underlying conditions). As noted in a previous blog, compulsive behaviour typically involves a repetitive and irresistible urge to perform a particular action (or set of actions) where the person feels they have no control to inhibit or stop the habitual behaviour. Compulsivity is part of obsessive-compulsive disorder (OCD), but may occasionally occur as stand-alone symptom following the onset of various physiological disorders.

One of the earliest papers I came across on the phenomenon was by Dr. Daniel Jacome in a 1984 issue of the Journal of Neurology, Neurosurgery and Psychiatry. Dr. Jacome described the case of a musically naive patient with dominant fronto-temporal and anterior parietal infarct developed transcortical mixed aphasia. From early convalescence, he exhibited elated mood with hyperprosody and repetitive, spontaneous whistling and whistling in response to questions”. In addition to the whistling, Jacome also reported that the individual spontaneously sang without any error in melody, lyrics, pitch, and rhythm. The man also developed the desire to spend long periods of time listening to music.

Compulsive whistling was also reported in a 2012 issue of BMC Psychiatry by Dr. Rosaura Polak and her colleagues. Their paper reported the case of a 65-year-old man who started whistling compulsively following a heart attack. The heart attack had caused some brain damage due to a lack of oxygen to the brain. Prior to the cardiac arrest, the man had never displayed any obsessive-compulsive symptoms or psychiatric complaints. He was treated with clomipramine (a seretonin reuptake inhibitor) and this decreased time spent compulsively whistling. The authors concluded that:

“This case shows that the whistling can be explained in the context of compulsivity with its repetitive character. It illustrates that the compulsive behavior can be present as an independent symptom of cortico-striatal dysfunction, and may not always belong to frontal syndrome, punding or OCD. Finally, this case illustrates that pharmacological treatment with clomipramine is effective and suggests that similar cases of compulsivity may benefit from this treatment”

A paper published in a 2000 issue of the Journal of the Korean Neurological Association examining 25 patients with fronto-temporal dementia (20 women and five men with an average age of 56 years) noted that compulsive behaviour is one of the commonest early manifestations of the condition. The researchers analyzed their symptoms and compulsive behaviours and 22 of the patients (88%) showed various compulsive behaviours including “reading signboards, stereotypy of speech, ordering, hoarding, washing, checking, counting, singing, and wandering a fixed route”. However, no real detail was provided in relation to the compulsive singing. Other papers – such as one in a 2002 issue of European Psychiatry by Dr. F. Muratori and colleagues – have reported compulsive singing in people that have Kleine-Levin syndrome (i.e., recurrent primary hypersomnia where individualscan lapse into a deep sleep at any time without warning, sometimes lasting as long as 16 hours).

One of the most interesting and detailed papers on compulsive singing is a 2007 paper by Dr. Christophe Bonvin and colleagues in the Annals of Neurology. They reported two case studies of individuals with advanced Parkinson’s disease who exhibited “a peculiar and stereotyped behavior characterized by an irrepressible need to sing compulsively when under high-dose dopamine replacement therapy”. They argued that the compulsive singing behaviour shared many features with punding (i.e., repetitive behaviour that is a side effect of some drugs). Here is a brief summary of the two cases:

Patient 1: “A 70-year-old female university professor and amateur piano player while being treated with 1,268 L-dopa equivalent units (LEU)…exhibited a repetitive, compulsive behavior characterized by singing endlessly…It started with an irrepressible urge to hum the rhythm and then the main melody of Francesca di Foix, a jocular opera written in 1831 by Gaetano Donizetti. She had heard this rarely produced piece in Milan years ago, and although she did not particularly like it, she had an obsessive need to repeat this song again and again for hours. Even though it was disruptive, preventing sleep and social interactions, singing was reported as pleasant and associated with a feeling of calmness and relief. If interrupted, she became irritated…All symptoms improved minimally after quetiapine (25mg twice daily) had been introduced”.

Patient 2: “A 71-year-old male painter…[that] grew up in a family of musicians and used to spend time listening to classical music and singing willingly…While being treated with 634 LEU, he started to hum repeatedly the same melody, initially once a week, then several times daily, mostly in the evening…Although he asserted singing exclusively Mozart’s 7th Serenade (‘Haffner’ KV 250), his wife reported also about 10 different poorly elaborated songs. This stereotyped behavior was reported as irrepressible and gave him a sensation of relief and ‘peace of mind’. On demand, he could stop singing for short periods but felt somewhat frustrated, demonstrating some aggressive behavior toward his spouse. There were no concomitant auditory or visual hallucinations. This phenomenon exacerbated dramatically when LD/benserazide was increased to 1,000/250mg daily (1134 LEU)…[This resulted in] the patient losing control over the compulsion and singing almost unendingly all day…Eventually, compulsive singing improved, but did not disappear, when LD/benserazide was reduced to the minimal daily doses (500/125mg)”.

The authors noted that in both of these patients developed a peculiar, stereotyped, and compulsive behaviour characterized by an urge to sing repeatedly the same song. They also concluded that in both cases:

“[The] compulsive singing developed as an isolated, elaborate, and selective feature, unrelated to mania or psychosis…Although the singing behavior was fully recognized by both patients as inadequate and socially disruptive, they were unable to stop singing for more than a few seconds to minutes, partly because the singing-induced sensation of pleasure felt was overwhelming. To the best of our knowledge, this phenomenon has not been consistently identified in [Parkinson’s disease] thus far…Moreover, PET and functional magnetic resonance imaging studies conducted in humans have correlated pleasure and reward from music listening with a significant activation of the ventral tegmental area and accumbens nucleus, as well as of the hypothalamus, insula, and orbitofrontal cortex. These findings suggest that music listening may recruit similar neural circuitry of reward and emotions as other pleasure inducing stimuli like food and sex, and this may also be the case for singing”.

In 2010, Dr. Hiroshi Kataoka and Dr. Satoshi Ueno described the case of an 82-year old woman (also with Parkinson disease) who started to sing compulsively (in the absence of any other types of pathologic behaviour) following treatment with pergolide. In the journal Cognitive and Behavioral Neurology, the authors reported that she would hum the same melody and sing songs repeatedly. When she stopped taking her ergolide medication, the compulsive singing and humming considerably subsided. Drs. Kataoka and Ueno suggested that a dopamine agonist in the patient’s medication may have contributed to her compulsive singing. The same phenomenon was also reported in three Parkinson’s patients treated with dopamine agonists by a Dr. C. Borrue-Fernandez at a Spanish conference on treating Parkinson’s disease in 2011.

It would appear from the few papers that have been published on compulsive singing that it almost always occurs alongside or as a consequence of other primary medical conditions and that some excessive or sensitized dopaminergic stimulation is a necessary prerequisite for such musical stereotypies to occur.

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

Further reading

Bonvin, C., Horvath, J., Christe, B., Landis, T., & Burkhard, P. R. (2007). Compulsive singing: another aspect of punding in Parkinson’s disease. Annals of Neurology, 62, 525-528.

Borrue-Fernandez, C. (2011). Compulsive singing as an Impulse Control Disorder in dopamine agonist treated patients: Review of three cases. The 15th Congress of the European Federation of Neurological Societies.

Jacome, D. E. (1984). Aphasia with elation, hypermusia, musicophilia and compulsive whistling. Journal of Neurology, Neurosurgery and Psychiatry, 47, 308-310.

Kataoka, H., & Ueno, S. (2010). Compulsive singing associated with a dopamine agonist in Parkinson disease. Cognitive and Behavioral Neurology, 23(2), 140-141.

Muratori, F., Bertini, N., & Masi, G. (2002). Efficacy of lithium treatment in Kleine–Levin syndrome. European Psychiatry, 17, 232–3.

Polak, A. R., van der Paardt, J. W., Figee, M., Vulink, N., de Koning, P., Olff, M., & Denys, D. (2012). Compulsive carnival song whistling following cardiac arrest: a case study. BMC Psychiatry, 12(1), 75.

Yoon, S. J., Jeong, J. H., Kang, S. J., & Na, D. L. (2000). Compulsive behaviors and presenting symptoms of frontotemporal dementia. Journal of the Korean Neurological Association, 18, 681-686

Excess in success: Are celebrities more prone to addiction?

One of the recurring questions I am often asked to comment on by the media is whether celebrities are more prone to addiction than other groups of people. One of the problems in trying to answer what looks like an easy question is that the definition of ‘celebrity’ is different to different people. Most people would argue that celebrities are famous people, but are all famous people celebrities? Are well-known sportspeople and politicians ‘celebrities’? Are high profile criminals celebrities? While all of us would say that Hollywood A-Listers such as Tom Cruise, Johnny Depp, Angelina Jolie, Brad Pitt and Julia Roberts are ‘celebrities’, many of the people that end up on ‘celebrity’ reality shows are far from what I would call a celebrity. Being the girlfriend or relative of someone famous does not necessarily famous.

Another problem in trying to answer this question is what kinds of addiction are the media actually referring to? Implicitly, the question might be referring to alcohol and/or illicit drug addictions but why should other addictions such as nicotine addiction or addiction to prescription drugs not be included? In addition to this, I have often been asked to comment on celebrities that are addicted to sex or gambling. However, if we include behavioural addictions in this definition of addiction, then why not include addictions to shopping, eating, or exercise? If we take this to an extreme, how many celebrities are addicted to work?

Now that I’ve aired these problematic definitional issues (without necessarily trying to answer them), I will return to the question of whether celebrities are more prone to addiction. To me, when I think about what a celebrity is, I think of someone who is widely known by most people, is usually in the world of entertainment (actor, singer, musician, television presenter), and may have more financial income than most other people I know. When I think about these types of people, I’ve always said to the media that it doesn’t surprise me when such people develop addictions. Given these situations, I would argue that high profile celebrities may have greater access to some kinds of addictive substances.

Given that there is a general relationship between accessibility and addiction, it shouldn’t be a surprise if a higher proportion of celebrities succumbs to addictive behaviours compared with a member of the general public. The ‘availability hypothesis’ may also hold true for various behavioural addictions that celebrities have admitted having – most notably addictions to gambling and/or sex. It could perhaps be argued that high profile celebrities are richer than most of us (and could therefore afford to gamble more than you or I) or they have greater access to sexual partners because they are seen as more desirable (because of their perceived wealth and/or notoriety).

Firstly, when I think about celebrities that have ‘gone off the rails’ and admitted to having addiction problems (Charlie Sheen, Robert Downey Jr, Alec Baldwin) and those that have died from their addiction (Whitney Houston, Jim Morrison, Amy Winehouse) I would argue that these types of high profile celebrity have the financial means to afford a drug habit like cocaine or heroin. For many in the entertainment business such as being the lead singer in a famous rock band, taking drugs may also be viewed as one of the defining behaviours of the stereotypical ‘rock ‘n’ roll’ lifestyle. In short, it’s almost expected. In an interview with an online magazine The Fix, Dr. Scott Teitelbaum, an American psychiatrist based at the University of Florida:

“Some people who become famous and get put on a pedestal begin to think of themselves differently and lose their sense of humility. And this is something you can see with addicts, too. Famous or not, people in the midst of their addiction will behave in a narcissistic, selfish way: they’ll be anti-social and have a disregard for rules and regulations. But that is part of who they as an addict – not necessarily who they would be as a sober person. Then there are some people who are narcissists outside of their disease, who don’t need a drug or alcohol addiction to make them feel like the rules don’t apply to them – and yes, I have seen in this in many athletes and actors. Of course, you also have non-famous people who struggle with both…People with addiction and people with narcissism share a similar emptiness inside. Those who are famous might fill it with achievement or with drugs and alcohol. That’s certainly not the case for everyone. But when you see people who are both famous and narcisstic – people who struggle with staying right-sized or they don’t have a real sense of who they are without the fame – you know that they’re in trouble… People with addiction and people with narcissism both seek outside sources for inside happiness. And ultimately neither the fame nor the drugs nor the drinking will work”.

The same article also pointed out that there is an increase in the number of people who (usually through reality television) are becoming (in)famous but have no discernable talent whatsoever. In my own writings on the psychology of fame, I have made the point that (historically) fame was a by-product of a particular role (e.g., country president, news anchorman) or talent (e.g., captain of the national sports team, a great actor). While the Andy Warhol maxim that everyone will be famous for 15 minutes will never be truly fulfilled, the large increase in the number of media outlets and number of reality television shows suggests that more people than ever are getting their 15 minutes of fame. In short, the intersection between fame and addiction is on the increase. US psychiatrist Dr. Dale Archer was also interviewed for The Fix article and was quoted as saying:

“Fame and addiction are definitely related. Those who are prone to addiction get a much higher high from things – whether it’s food, shopping, gambling or fame – which means it  [the behavior or situation] will trigger cravings. When we get an addictive rush, we are getting a dopamine spike. If you talk to anyone who performs at all, they will talk about the ‘high’ of performing. And many people who experience that high report that when they’re not performing, they don’t feel as well. All of which is a good setup for addiction. People also get high from all the trappings that come with fame. The special treatment, the publicity, the ego. Fame has the potential to be incredibly addicting”.

I argued some of these same points in a previous blog on whether fame can be addictive in and of itself. Another related factor I am asked about is the effect of having fame from an early age and whether this can be a pre-cursor or risk factor for later addiction. Dr. Archer was also asked about this and claimed:

 “The younger you are when you get famous, the greater the likelihood that you’re going to suffer consequences down the road. If you grow up as a child star, you realize that you can get away with things other people can’t. There is a loss of self and a loss of emotional growth and a loss of thinking that you need to work in relationship with other people”.

I’m broadly in agreement with this although my guess is that this only applies to a minority of child stars rather than being a general truism. However, trying to carry out scientific research examining early childhood experiences of fame amongst people that are now adult is difficult (to say the least). There also seems to be a lot of children and teenagers who’s only desire when young is “to be famous” when they are older. As most who have this aim will ultimately fail, there is always the concern that to cope with this failure, they will turn to addictive substances and/or behaviours.

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

Further reading

Griffiths, M.D. & Joinson, A. (1998). Max-imum impact: The psychology of fame. Psychology Post, 6, 8-9.

Halpern, J. (2007). Fame Junkies. New York: Houghton Mifflin Harcourt

McGuinness, K. (2012). Are Celebrities More Prone to Addiction? The Fix, January, 18. Located at: http://www.thefix.com/content/fame-and-drug-addiction-celebrity-addicts100001

Rockwell, D. & Giles, D.C. (2009). Being a celebrity: A phenomenology of fame. Journal of Phenomenological Psychology, 40, 178-210.

Net benefits: A brief look of excessive egosurfing

“I was reminded of a scene in the second series of The Thick Of It, where Peter Mannion, an old-school Tory MP, is told by his Steve Hilton-style spin doctor that he needs to start embracing the internet. ‘Have you ever tried Googling your own name?’ he asks. ‘It’s like opening the door to a room where everyone tells you how shit you are.’ I think this nicely encapsulates the relative merits of Googling yourself: namely, that there are none” (from an article by journalist Bryony Gordon, Daily Telegraph, February 29, 2012).

Last year, the actor Dominic West let it be known to the mass media that he regularly Googles himself and was reported as saying: “I like to have chats about myself with people – mainly putting forward the case for the defence. I use my own name but nobody ever believes me”. I have never worked out why it is such a social faux pas to Google yourself and why it is so derided. I’m quite happy to admit that I regularly Google myself, and that I probably do it more than most other people. In my defence, I am regularly interviewed by the print media and I like to check on what gets reported (particularly as it’s not unknown for me to get misquoted or for my words to be taken out of context. In an article published in the Online Journalism Review, Patrick Dent writes in defence of egosurfing:

“If you are a Web professional – whether an online instructor or journalist, Web developer or marketer – you should be aware of your presence on the Web. And perhaps more importantly, the existence of Web namesakes. And if you are active in the job market, being aware of your nom-de-plume’s cyberexistence is crucial. You should be aware of any nefarious deeds or ill impressions Internet namesakes may be performing… This all goes to illustrate that searching for your name on the Internet is more than the self-serving, vanity endeavor that the label ‘ego-surfing’ implies. Beyond being an interesting exercise, and yes in some cases stroking your ego, it is a prudent – if not downright necessary – activity in today’s Web-aware professional world”.

As an academic, being cited by others is something that is seen positively. As of this morning, I had 14,564 citations on Google Scholar (which for the non-academics reading this means that my papers, articles and books have been cited 14,564 times in other papers, articles, and books). Googling myself is just another variation of seeing how I’ve been cited and I do not think there is anything wrong with it. I suppose I just like knowing about the digital footprint I am leaving online. According to the entry on Wikipedia:

“Egosurfing (also referred to as Googling yourself and less frequently called vanity searching, egosearching, egogoogling, autogoogling, self-googling, master-googling, google-bating) is the practice of searching for one’s own given name, surname, full name, pseudonym, or screen name on a popular search engine in order to review the results. Similarly, an egosurfer is one who surfs the Internet for his or her own name to see what information appears. It has become increasingly popular with the rise of internet search engines, as well as free blogging and web-hosting services”.

So, there you have it. According to Wikipedia’s definition I am officially an egosurfer. The same article also claims that the word ‘egosurfing’ was first coined in 1995 by Sean Carton (who’s written many books about online technology) and then featured in a March 1995 issue of Wired magazine (although the Wired definition of egosurfing is more encompassing and  says it is “scanning the Net, databases, print media, or research papers looking for mentions of your own name”).

According to a short 1999 article in the British Medical Journal by Professor James Drife, looking yourself up online is “arguably the naffest way of coping with boredom”. Professor Drife’s whole article was a simple account of what he had found by Googling his own name. By doing so, he claimed to have expanded his horizons, and “strengthened [his] belief that the world is not quite ready to do without paper. Nevertheless, universities could be making plans to judge academics on their internet hits and the response rate”. (Something that I believe is already happening and is one of the reason I like to egosurf). Exactly the same thing was carried out by JoAnne Lehman, one of the editors of Feminist Collections: A Quarterly of Women’s Studies Resources and published in 2004. She also listed all the things she had discovered egosurfing and concluded:

“If there’s a point to my telling of this story here – beyond the desire to promote a woman writer’s work – perhaps it’s about the satisfaction of connecting with kindred spirits, and how those connections can be made in surprising ways. Oh, and maybe that Internet surfing, even the ego kind, isn’t necessarily a waste of time”.

Writing about ego-surfing appears to be a popular way of writing an article not just in academic journals but also in non-academic publications such as the national press. Bryony Gordon (the journalist I cited at the beginning of this blog) wrote that:

“Now, I am not Dominic West (Hollywood star; 5,030,000 Google results in just 0.18 seconds). I am Bryony Gordon (newspaper journalist; 431,000 Google results in a glacial 0.21 seconds). But I don’t think it matters whether you are a world famous actor or Joe Bloggs; the fact remains that Googling yourself is a dangerous and egoistical exercise that will never end well. The best case scenario for Joe Bloggs is that he finds nothing, thus making him feel like a nobody; the worst that he finds a group of his mates bitching about him on a social networking site. Ditto, on a good day the likes of Dominic West will come away from a self-Googling session with an even bigger sense of self-importance, on a bad one with a miserable neediness that their agents and lackeys will have to pull them out of. As Reese Witherspoon says, ‘it’s an affirmation of every horrible feeling you have about yourself’”.

Articles in Tech Crunch (by Duncan Riley), and Tech News World (by Katherine Noyes) reported that 47% of Americans had Googled themselves based on a study carried out by the Pew Internet and American Life Project (up from the previous study in 2002). Using a telephone survey, the study sampled 2,373 adults (of which 1,623 were internet users). Only a very small minority (3%) Googled themselves regularly (and there was nothing on excessive self-Googling). The main reasons given for egosurfing were (i) for entertainment purposes, (ii) as a means of online reputation management (which is probably the category that I would fall under), and (iii) self-promotion and maintenance of a positive online reputation (e.g., locating online inaccuracies and ‘data spills’ and correcting them).

This is certainly an area worthy of further empirical investigation – even if it’s just to examine stereotypes around the kind of person who ego-surfs.

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

Further reading

Dent, P. (2000). ‘Ego-Surfing’ derides valid, prudent activity. Online Journalism Review. Located at: http://www.ojr.org/ojr/ethics/1017964102.php

Drife, J.O. (1999). Egosurfing. British Medical Journal, 318, 203.

Gordon, B. (2012). Google and be damned. Daily Telegraph, February 29. Located at: http://www.telegraph.co.uk/technology/google/9111193/Google-and-be-damned.html

Lehman, J. (2004). From the editors. Feminist Collections: A Quarterly of Women’s Studies Resources, 26, ii.

Nicolai, T. Kirchhoff, L., Bruns, A., Wilson, J. & Barry Saunders, B. (2008). Google Yourself! Measuring the performance of personalized information resources. Proceedings Association of Internet Researchers 2008: Internet Research 9.0: Rethinking Community, Rethinking Place, Copenhagen, Denmark. Located at: http://en.scientificcommons.org/31968134

Noyes, K. (2007). Pew study: Self-Googling on the rise. Tech News World, December 17. Located at: http://www.technewsworld.com/story/Pew-Study-Self-Googling-on-the-Rise-60810.html

Riley, D. (2007). Do you use Google for vanity searching? You’re not alone. Tech Crunch, December 16. Located at: http://www.pewinternet.org/Media-Mentions/2007/Do-You-Use-Google-For-Vanity-Searching-Youre-Not-Alone.aspx

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

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