Art attack: A beginner’s guide to Stendhal Syndrome

One of the more unusual psychological disorders that I have come across is the psychosomatic illness Stendhal Syndrome – also known as Florence Syndrome and hyperkulturemia. The trigger for the condition is works of art that are perceived by the individual to be beautiful and all housed in one place (e.g., an art gallery).

When exposed to the concentrated works of art, affected individuals experience a wide range of symptoms including physical and emotional anxiety (rapid heart rate and intense dizziness, that often results in panic attacks and/or fainting), feelings of confusion and disorientation, nausea, dissociative episodes, temporary amnesia, paranoia, and – in extreme cases – hallucinations and temporary ‘madness’. The syndrome has also been applied to other situations where individuals feel totally overwhelmed when in the presence of what they perceive to be immense beauty (such as something in the natural world like a beautiful sunset). The effects are relatively short-lived and do not seem to require medical intervention.

The condition was named after the 19th century French author Henri-Marie Beyle (1783–1842) – better known by his penname ‘Stendhal’ – who at the age of 34 years (in 1817) described in detail his negative experiences (in his book Naples and Florence: A Journey from Milan to Reggio) of viewing Florentine art of the Italian Renaissance (and hence it’s alternative name as Florence Syndrome). When Stendhal visited Florence’s Santa Croce Cathedral and first witnessed Giotto’s famous ceiling frescoes he became overly emotional about what he saw:

“I was in a sort of ecstasy, from the idea of being in Florence, close to the great men whose tombs I had seen. Absorbed in the contemplation of sublime beauty…I reached the point where one encounters celestial sensations … Everything spoke so vividly to my soul. Ah, if I could only forget. I had palpitations of the heart, what in Berlin they call ‘nerves.’ Life was drained from me. I walked with the fear of falling”.’

Since Stendhal’s published account, there have been hundreds of cases of people experiencing similar effects – particularly at the famous Uffizi Gallery in Florence, and had often been referred to as the ‘Tourist’s Disease’. (I also noted that in online self-confessions that some people call it ‘Art Disease’). However, it wasn’t until 1979 that the condition was given the name Stendhal Syndrome by the Italian psychiatrist Dr. Graziella Magherini (who at the time was the chief of psychiatry at Florence’s Santa Maria Nuova Hospital). She began to observe that many tourists visiting Florence appeared to be overcome with a range of symptoms including temporary panic attacks to seeming bouts madness lasting two or three days.

Based on her recollection of reading Stenhal’s account, she named the condition Stendhal’s syndrome. She later documented 106 similar cases admitted to the hospital in Florence between 1977 and 1986 in her 1989 book La Sindrome di Stendhahl. Her book described detailed accounts of people (including many Americans) who after viewing famous paintings or sculptures had severe emotional reactions leading to high anxiety and/or psychotic episodes. She believed the psychological disturbances were typically associated with “a latent mental or psychiatric disturbance that manifests itself as a reaction to paintings of battles or other masterpieces” The 106 cases were classed into three types:

• Type I: Patients (n=70) with predominantly psychotic symptoms (e.g., paranoid psychoses).
• Type II: Patients (n=31) with predominantly affective symptoms.
• Type III: Patients (n=5) whose predominant symptoms are somatic expressions of anxiety (e.g., panic attacks).

She also reported that 38% of Type 1 individuals had a prior psychiatric history, while over half (53%) of Type 2 individuals did. To date, there are relatively few cases published in the academic literature. The most recent case I came across was from 2009. Dr. Timothy Nicholson and his colleagues published a case report in the journal British Medical Journal Case Reports. Their case involved a 72-year old who developed a transient paranoid psychosis following a cultural tour of Florence. More specifically, they reported:

“While standing on the Ponte Vecchio bridge, the part of Florence he was most eager to visit, he experienced a panic attack and was also observed to have become disorientated in time. This lasted several minutes and was followed by florid persecutory ideation, involving him being monitored by international airlines, the bugging of his hotel room and multiple ideas of reference. These symptoms resolved gradually over the following 3 weeks”.

In 2005, Edson Amâncio, a Brazilian neurosurgeon published a paper arguing that there was evidence that Russian novelist Fyodor Dostoevsky suffered from Stendhal Syndrome, particularly when viewing Hans Holbein’s masterpiece, Dead Christ, during a visit to the museum in Basle. In a 2010 issue of the British Journal of General Practice, Dr. Iain Bamforth claimed that Marcel Proust also suffered from the condition and also suggested that psychologists Sigmund Freud and Carl Jung both wrote about experiences suggestive of Stendhal Syndrome. Despite hundreds of documented cases, the condition does not – as yet – appear in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders. According to an article in the Daily Telegraph, a team in Italy is currently examining the phenomenon more systematically by measuring tourist’s reactions (heart rate, blood pressure, respiration rate, etc.) as they view the artworks inside the Palazzo Medici Riccardi in Florence. As far as I am aware, they have yet to publish their findings, but when they do, I’ll update this blog.

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

Further reading

Amâncio, E.J. (2005). Dostoevsky and Stendhal’s Syndrome, Arq Neuropsiquiatr, 63, 1099-1103.

Bamforth, I. (2010). Stendhal’s Syndrome. British Journal of General Practice, December, 945-946.

Bogousslavskya, J. & Assal, G. (2010). Stendhal’s aphasic spells: The first report of transient ischemic attacks followed by stroke. In J. Bogousslavsky, M.G. Hennerici,  H. Bäzner & C. Bassetti (Eds), Neurological Disorders in Famous Artists – Part 3. (pp-130-143). Basel, Karger.

Fried, R.I. (1998). The Stendhal syndrome: Hyperkulturemia. Ohio Medicine, 84, 519–20.

Freud, S. (1936). A disturbance of memory on the Acropolis. Reprinted (1953-1974) in the Standard Edition of the Complete Psychological Works of Sigmund Freud (trans. and ed. J. Strachey), vol. 22, p. 239. London: Hogarth Press.

Guy, M.  (2003). The shock of the old. Frieze (Volume 72). Located at: http://www.frieze.com/issue/article/the_shock_of_the_old/

Magherini, G. (1989). La Sindrome di Stendhahl. Firenze: Ponte Alle Grazie.

Munsey, C. (2005). Bottles make me sick (Stendhal’s Syndrome). Bottles and Extras, Spring, 72-75.

Squires, N. (2010). Scientists investigate Stendhal Syndrome – fainting caused by great art. Daily Telegraph, July 28. Located at: http://www.telegraph.co.uk/news/worldnews/europe/italy/7914746/Scientists-investigate-Stendhal-Syndrome-fainting-caused-by-great-art.html#

The salivation army: A brief look at spit fetishes

In previous blogs I have examined many different bodily substances that have formed the basis of paraphilic and/or fetishistic behaviour including urine (urophilia), faeces (coprophilia), blood (menophilia and clinical vampirism), and breast milk (lactophilia). One bodily fluid that has not really been the subject of scientific research is saliva in relation to saliva fetishes and spit fetishes. In fact, the only purely academic reference I could find was from sociologist Eviatar Zerubavel who suggested in a 1991 book that many Americans seem to find sex “morally repugnant” and that it is because of the bodily fluids associated with sex (i.e., saliva and semen) are sticky, a liminal category between solid and liquid.

From my reading on this topic, there appears to be a difference between saliva fetishes and spit fetishes (which I will explain below). In researching this blog I came across two cases of saliva fetishes (one from New Zealand and one from Japan) that were both very similar.

• Case 1: Back in 2007 in Christchurch (New Zealand), a 28-year old male vineyard worker – Jared Simmonds – was jailed for 32 months because of his “deviant sexual arousal” towards saliva from young girls. He was arrested following an indecent sexual attack on an 11-year old girl. Simmonds had been previously convicted in 2005 for obtaining saliva from four pre-pubescent girls that he would use as a lubricant for masturbatory purposes. He had also been trying to do the same thing with the 11-year old girl. The court was told that Simmonds was incapable of relating to women of his own age and therefore targeted young girls to help maintain his sexual saliva fetish. The court was also told that Simmonds’ behaviour was premeditated as he approached the girls with plastic cups and chewing gum, and pretending to the girls that he was conducting a scientific survey and that their saliva would be analysed at Christchurch Polytechnic. He would give the girls gum to chew to stimulate salivation, and then get the girls to spit into the cup. As soon as the spittle was collected, he would rush back to his house to masturbate using the girls’ saliva as a lubricant.

• Case 2: More recently, at the end of 2011, there was a news report of a 55-year old Japanese man with an alleged saliva fetish. The man in question – Toshiko Mizuno – was arrested after approaching young women, and asking them to spit into a jar. While they spat into the jars, Mizuno filmed them and then kept their saliva to drink at a later point. To get them to spit in the jar, Mizuno used a cover story that he was doing research on saliva. After searching Mizuno’s house, they found over 200 video taped recordings of women spitting into jars, and dozens of empty jars that had once had women’s saliva in them. The police also found other videos of Mizuno masturbating and using the female saliva as a masturbatory lubricant. The man was charged with indecency as he had not actually caused any knowing harm to the women he had approached.

The online Urantia Book claims that (historically) saliva was a potent fetish. Apparently, “devils could be driven out by spitting on a person” and “for an elder or superior to spit on one was the highest compliment”. Furthermore, it could perhaps be argued that saliva plays a (direct or indirect) role in a lot sexual behaviour that raises the question of how “deviant” saliva fetishes actually are. However, in the case of Simmonds, the use of saliva from prepubescent girls suggests that the behaviour was a paedophilic precursor. There are also cultural variations that need to be taken into account. Few Westerners would disagree that kissing can be erotic and enjoyable. However, other cultures view kissing as simply the human exchange of saliva. For instance, the Amazonian Mehinaku tribe view kissing as disgusting and a sexual abnormality.

The saliva fetishists above don’t really appear to share much in common with spit fetishes that appear to be more a part of sadomasochistic sexual activity. For instance, at the ‘All Experts’ website, one of the female “experts” (“Hollie”) wrote speculatively about spit fetishes in response to one man’s question about what spit fetishes actually involved. Her perspective was clearly from those with an interest in sexual sadism and sexual masochism. She wrote:

“A spit fetish could manifest itself in a number of ways…either partner could have a fetish to be spat on, usually this is always closely linked to that individual seeking domination from the spitter, making the person being spat on submissive. it may also be part of sexual humiliation and other aspects of BDSM [Bondage, Discipline, Submission, Masochism]. Or, an individual could have the need to spit on someone, that would probably make them dominant and to want to control and/or humiliate their partner sexually. Or…both people could either enjoy to be spat on or to be the spitter…this could work both ways and simultaneously”.

In fact much of the online literature on spitting fetishes (as opposed to saliva fetishes) appears to be rooted in BDSM and is usually referred to as ‘spitting domination’. The dominant partner may spit into their submissive partner’s face and/or mouth. The submissive partner may also be forced to swallow the liquid spit if their mouth is spat into. Many of the online articles about spitting fetishes see parallels between the act of spitting and the act of ejaculation – particularly in relation to ‘facials’ (i.e., the act of men ejaculating onto someone’s face) and the practice of bukkake (i.e., the act of many men simultaneously ejaculating onto someone’s face and/or body).

In an online article on “Spit feeding [and] eating”, the [anonymous] writer examines spit fetishes, and asks whether spitting is an aggressive act of degradation, and if being spat on is always humiliating. The response was:

“Like any sex act, it all depends upon the attitudes of those involved. A slap can be aggressive or playful, hurtful or stimulating. Likewise, a wad of spit can be contemptuous or loving, depending on the intention. There’s nothing inherently demeaning about wanting to devour your lover’s liquid essences”.

In researching this blog I came across various people’s experiences of spit fetishism. The following quote was typical:

“I actually was in a relationship with a individual who had a spit fetish.  He longed for me, while we were having intercourse, to spit on him, his face all over him, he didn’t mind where but he especially liked it if I was dominant with him in doing so, maybe called him names at the same time, played a Dom to him. His fetish for spit also extended into dribbling, where he liked for me to dribble on myself, preferably across my chest, and for him to rub his face in it, in the spit. He loved the moistness physically, but it was more mental for him, the control aspect, the humiliation of it all, the dominance”.

Compared to all other paraphilic and fetishistic behaviours concerning sexual arousal to human bodily fluids, there is significantly less written about saliva and spitting fetishes. Whether academic and/or clinical research is needed is – at present – debatable.

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

Further reading

All Experts (2004). Fetishism/Spit fetish. January 14. Located at: http://en.allexperts.com/q/Fetishism-2835/spit-fetish.htm

Backdrop.net (2007). Spitting fetishism. Located at: http://www.backdrop.net/sm-201/index.php?title=Spitting_fetishism

Dahmer, J. (2011). The Guy with the Creepiest Fetish Ever! WDRG, December 14. Located at: http://wgrd.com/the-guy-with-the-creepiest-fetish-ever-yuk-bar-stool/

New Zealand Herald (2007). ‘Deviant saliva fetish’ led to attack, court told. July 30. Located at: http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=10454692

Pervscan (2007). Deviant saliva fetish led to attack. August 19. Located at: http://pervscan.com/2007/08/19/deviant-saliva-fetish-led-to-attack/

UB The News (undated). Fetishes, charms and magic. The Urantia Book (Paper 88). Located at: http://www.ubthenews.com/UrantiaBook/papers/p088.htm

World of Sexual Fetishes (2012). Swapping spit. March 5. Located at: http://worldofsexualfetishes.com/wordpress/?p=158

Zerubavel, E. (1991). The Fine Line: Making Distinctions in Everyday Life. Chicago, IL: University of Chicago Press.

For bidding, plan it: Can online auctions [like e-Bay] be addictive?

Back in 2007, a number of psychologists including Dr. Kimberly Young (Center for Internet Addiction Recovery, Pennsylvania, US), and myself were interviewed for a BBC news article about whether it was possible to become addicted to the online auction site eBay. In the article, Dr Young said she was seeing increasing numbers of people who were developing a problem concerning their eBay use. Dr Young claimed it was not the item bidded for on eBay itself that provided the “addictive buzz” but the excitement of bidding against others for it, and winning. She was quoted as saying that:

“eBay addicts will be there for the last few minutes of an online auction ready to outbid and bag the prize – ‘snipers’ as they are called in eBay circles. It gets more serious when eBay addicts feel a sense of accomplishment when they are the highest bidder and begin to bid on items they don’t need. Most people with eBay addiction] have financial and relationship problems. Some people come [for treatment] because they have been fired from work – doing eBay at work is not permitted, so they seek therapy after something like this happens. One woman was in debt by $400,000 and took a second mortgage out on her home and all the money from her retirement account. Her husband was furious when he found out. It does get pretty bad, with the lies to sustain the behaviour”

In an earlier 2004 paper on internet addiction published in American Behavioral Scientist, Dr. Young mentioned online auction [eBay] addiction in passing but presented no empirical evidence of its existence. The same observation was also made in a later 2009 paper by Dr. Tonino Cantelmi, and Dr. Massimo Talls in the Journal of CyberTherapy and Rehabilitation (but again in the absence empirical evidence).

So can eBay really be addictive? All addictions rely on being rewarded in some way. Sometimes the rewards are financial (you win money), social (you get praised for your behaviour), physical (you get a buzz when you do the activity) and/or psychological (the activity raises your self-esteem). As I noted in a previous blog on internet addiction, people can develop addictions to the Internet (such as chat room addictions) and have addictions on the Internet (such as online gambling addictions, online gaming addictions, online shopping addictions). In many cases, the Internet provides an easily accessible and convenient medium that people can engage in their favourite behaviour (such as looking for online pornography or playing online computer games). In a small number of cases this may become addictive.

So what about eBay addiction? Most of the cases I have come across are from press and/or non-peer reviewed reports. Dr. Kimberley Young wrote briefly about a female eBay addict (called ‘Chris’) in an unpublished paper entitled ‘Subtypes of internet addiction’ available from her website (although to be honest there was no real detail provided). In another case (reported in the popular press), a 25-year old female estate agent, Charlotte Mahoney was featured as an eBay addict in an article in The Sun. In a seven-month period she spent £5000. In her newspaper interview, Mahoney said:

“Everybody was talking about [eBay], so I logged on for a look and couldn’t believe it when I saw loads of brand new designer items up for sale. When my bid for a gorgeous Dior T-shirt was accepted I was over the moon. The second buzz came when the parcel arrived. I would bid obsessively until I got something. It was so easy but also exciting because you knew you were getting a bargain. My card details were already online so it didn’t even feel like I was really spending. In fact I avoided buying anything that required payment by cheque, because it made me feel guilty. Once I spent more than £800 in a single weekend. The fantastic feeling I got when the postman arrived with all those parcels made it worth it. Subconsciously, I must have known it was getting out of hand because I arranged for all my parcels to be sent to work just so I could smuggle them home past my boyfriend. When I finally worked out that I had spent £5,500 since last December, I felt sick. [eBay] can be dangerously addictive”.

On the face of it, there are certainly some things in this account that are suggestive of addiction but there is just not enough detail to make an informed judgment. Dr Richard Wood, one of my good friends and research colleagues was also interviewed for the BBC on eBay addiction and was reported as saying:

“The label ‘addiction’ is being over used and incorrectly applied. There is no such diagnosis as “eBay” addiction that has been incorporated into any respectable criteria. Instead people like Dr Young are adapting the criteria for substance abuse and/or pathological gambling. Of course, some people will do all kinds of activities too much if they are distracting enough to allow them to escape from their reality. I would argue that these are not bona-fide cases of addiction unless the activity itself has severe negative consequences, that the experience itself is the main driver of their behaviour, and that it affects enough people that it can be considered problematic in and of itself. eBay does not fit into that category. Furthermore, by over applying the addiction label we are in danger of both unduly scaring the public and trivializing the negative impacts of genuine addiction cases”

Empirical research into eBay addiction (and online auction addiction more generally) has begun to occur.  For instance, a 2007 paper by Dr. Cara Peters and Dr. Charles Bodkin in the Journal of Retailing and Consumer Services examined problematic behaviour among online auction users. They explored (i) which consumer behaviours could be construed as problematic and potentially addictive, (ii) which of these behaviours generally reflect the core components of addiction, and (iii) and what the implications are for online auction retailers, managers, and society. Using qualitative methods, the authors identified four key themes related to eBay addiction among their small number of participants: (i) psychological distress, (ii) habitual usage, (iii) negative consequences, and (iv) dependence, withdrawal and self-regulation.

A 2008 paper by Chih-Chien Wang in the Proceedings of the Asia-Pacific Services Computing Conference examined the influence of harmonious passion and obsessive passion on online auction behaviour and online auction addiction on 322 individuals. It also investigated whether people exhibiting compulsive buying behaviour had spent more time on online auction web sites. They found that people with obsessive passion were more addicted to online auctions than those with harmonious passion, and that people with higher compulsive buying behaviour spent more time on online auctions.

Finally, a 2011 study carried out by Dr. Ofir Turel and colleagues published in the MIS Quarerly also explored online auction addiction. They reported their findings from two empirical studies of 132 and 223 eBay users (using three different operationalizations of addiction). I have to admit that I found it hard to understand what their study actually showed. They carried out various factor analyses and showed that some key factors explained significant amounts of the variance but didn’t give any insight into what these main factors were tapping into. In their own words, their results indicated that:

“The level of online auction addiction distorts the way the IT artifact is perceived. Informing a range of cognition-modification processes, addiction to online auctions augments user perceptions of enjoyment, usefulness, and ease of use attributed to the technology, which in turn influence usage intentions. Overall, consistent with behavioral addiction models, the findings indicate that users’ levels of online auction addiction influence their reasoned IT usage decisions by altering users’ belief systems. The formation of maladaptive perceptions is driven by a combination of memory-, learning-, and bias-based cognition modification processes”.

The empirical evidence on eBay addiction to date is somewhat sketchy. In the article in The Sun newspaper (mentioned above), I was asked to provide an outline of possible ‘danger signs’ that point to an unhealthy interest in eBay. If eBay addiction existed, I wrote that I would expect to see the following:

• e-Bay becomes the most important thing in the person’s life and they are totally preoccupied thinking about being on e-Bay.
• The person has built up the amount of time they have spent on e-Bay to the point where it is significantly impacting on other important activities (and preferring to engage in eBay use over other activities).
• The person experiences withdrawal symptoms when they are not on e-Bay (e.g., moodiness and irritability, anxiety, difficulty in concentrating, sweaty palms etc.).
• The person uses e-Bay as a way of modifying their mood. They either use e-Bay to get aroused (to get a buzz or a high) or they use it to tranquilize themselves (to escape or de-stress)
• The person’s e-Bay use compromises everything else in their life and affects their job, outside hobbies/interests, and relationships with partner, children, and/or friends.

I was also asked to speculate on why e-Bay might be addictive. Based on the anecdotal press and unpublished academic reports, I wrote that e-Bay use would appear to take over a very tiny minority of people’s lives. These people appear to spend vast amounts of time online in the hope of getting bargains and/or making money. Because there is a financial consequence, it would appear that many of the addictive effects and/or consequences are similar to addictive gambling. Getting a great bargain is like winning – and people want to do it again as quickly as possible. Putting an item up for sale and hardly breaking even is like losing. To eliminate the negative feelings, a person goes back onto e-Bay in the hope of feeling good again. This for some individuals may become an addictive cycle and may be a hard habit to break.

It may take some time (if ever) before online auction addiction is accepted as a genuine addiction. However, I do believe it is theoretically possible to become addicted even if the evidence at present doesn’t stand up to in-depth scrutiny.

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

Further reading

Black, G.S. (2007). A comparison of the characteristics of eBay consumers and eBay nonconsumers. Journal of Direct, Data and Digital Marketing Practice, 9(1), 16-29.

Cantelmi, T & Talls, M. (2009). Trapped in the web: The psychopathology of cyberspace. Journal of CyberTherapy and Rehabilitation, 2, 337-350.

Griffiths, M.D. (1995). Technological addictions. Clinical Psychology Forum, 76, 14-19.

Griffiths, M.D. (1998). Internet addiction: Does it really exist? In J. Gackenbach (Ed.), Psychology and the Internet: Intrapersonal, Interpersonal and Transpersonal Applications. pp. 61-75. New York: Academic Press.

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

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

Peters, C.  & Bodkin, C.D. (2007). An exploratory investigation of problematic online auction behaviors: Experiences of eBay users. Journal of Retailing and Consumer Services, 14(1), 1-16.

Soteriou, H. (2007). Can you be addicted to eBay? BBC News, July 2. Located at: http://news.bbc.co.uk/1/hi/health/6519521.stm

Turel, O., Serenko, A. & Giles, P. (2011). Integrating technology addiction and use: An empirical investigation of online auction users. MIS Quarterly, 35, 1043-1061.

Wang, C-C. (2008). The influence of passion and compulsive buying on online auction addiction. Proceedings of the Asia-Pacific Services Computing Conference (pp. 1187 – 1192). IEEE.

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

Widyanto, L. & Griffiths, M.D. (2006). Internet addiction: Does it really exist? (Revisited). In J. Gackenbach (Ed.), Psychology and the Internet: Intrapersonal, Interpersonal and Transpersonal Applications (2^nd Edition), pp.141-163. New York: Academic Press.

Young, K. (undated). Subtypes of internet addiction. Unpublished manuscript (available at netaddiction.com)

Yong, K. (2006). What is eBay addiction, compulsive online gambling, and other types of Internet addiction? Located at: http://www.netaddiction.com/net_compulsions.htm

Young, K. S. (2004). Internet addiction: A new clinical phenomenon and its consequences. American Behavioral Scientist, 48, 402–415.

A not so stainless steal: A brief overview of kleptophilia

In a review of paraphilias not otherwise specified (P-NOS), Dr Joel Milner and colleagues defined kleptophilia – also known as kleptolagnia – as a sexual paraphilia in which individuals derive sexual arousal from illegally entering and stealing from someone’s house. For some kleptophiles, sexual arousal may occur when looking at, thinking about, or engaging in sexual play with the stolen object. If the things stolen (e.g., such as ladies’ knickers) are the sole sexual focus, then it would be classed as fetishism. may be the appropriate diagnosis. If the behaviour itself (e.g., the act of actually stealing something) is the sexual focus (rather than the stolen items), then it would be classed as kleptophilia (i.e., because the sexual arousal derives from either the act of stealing the items or the fact the items were stolen, the object itself is not considered sexual). Furthermore, this would be classed by the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, as a P-NOS. In extreme cases, kleptophilia is sometimes associated with sexual sadism. For example, a 1991 paper by Dr. Lauren Boglioli and colleagues in the American Journal of Forensic Medicine and Pathology reported that kleptophiles may sexually assault and/or rape the owner of the house that was burgled.

There has been relatively little research on kleptophilia and much of what is known comes from case studies (typically those who have been caught and arrested for the crime committed). The origin of the stolen item (i.e., whose item it is) may have some personal meaning for the kleptophile but for others it may be of no psychological consequence at all. The item may need to have belonged to someone personally significant for the act of stealing the item to be considered sexually pleasurable to the kleptophile. It has also been said that some kleptophiles may engage in their paraphilic behaviour legally by pre-arranging with a third party to have something stolen from their house. However, it is thought that most kleptophilic events are non-consensual and illegal, and thus result in criminal records for those kleptophiles that are caught.

Early writings by the psychoanalyst Otto Fenichel drew attention to the notion that stealing may have a sexual sense, and that doing a forbidden thing secretly may be a means of masturbation. Fenichel also asserted that for some people who steal, the sexual meaning is in the foreground and are therefore closer to being a paraphilia, and that the stolen object is the fetish itself.

In a 1999 issue of the Journal Of The American Academy of Psychiatry and Law, Dr. Louis Schlesinger and Dr. Eugene Revitch reported that:

“Burglary, the third most common crime after larceny-theft and motor vehicle theft, is rarely the focus of forensic psychiatric study. While most burglaries are motivated simply by material gain, there is a subgroup of burglaries fueled by sexual dynamics. [We] differentiate two types of sexual burglaries: (1) fetish burglaries with overt sexual dynamics; and (2) voyeuristic burglaries, in which the sexual element is often covert and far more subtle. Many forensic practitioners have informally noted the relationship of burglaries to sexual homicide, but this relationship has not otherwise been studied in any detail”

A more recent paper led by by Dr. Michael Vaughan (University of Pittsburgh, USA) examined a sample of 456 adult career criminals. Using a statistical technique called latent profile analysis, Vaughan and colleagues constructed a methodologically rigorous quantitative typology of career burglars. Their findings revealed four distinct types of burglars. These were (i) young versatile burglars, (ii) vagrant burglars, (iii) drug-oriented burglars, and (iv) sexual predator burglars. All four groups showed significant involvement in various criminal activities, but the “sexual predators” were the most violent and had the most serious criminal careers. However, the paper did not isolate the motivations for burglary and so it is not known to what extent any of the sample participants (and particularly the sexual predators) were kleptophiles.

In kleptomania (i.e., the recurrent failure to resist impulses to steal objects not needed for personal use or their monetary value), the underlying aim is not the stolen item itself but the act of stealing (in the same way that in kleptophilia, the act of stealing is the sexual focus, not the item stolen). In a 1983 issue of the British Journal of Psychiatry, Dr. Chalkley and Dr. Powell provided clinical descriptions of 48 of their patients with sexual fetishes, and noted that fetishism is not a criminal act unless accompanied by stealing fetish objects (i.e., kleptophilia). Interestingly, the authors reported that one of their 48 patients stole because he was attracted to stealing clothes, another stole to procure used and stained clothes, and a third stole to obtain something belonging to someone he had desired and followed home. In a review of kleptomania the American Journal of Psychiatry, Dr M.J. Goldman reported that many young people with kleptomania have stolen women’s underwear. He stressed that the ecstasy and urges felt while stealing a fetish object can contribute to sexual arousal and orgasm.

To my knowledge, only one case study in the psychological literature has specifically reported on the relationship between fetishism and kleptomania in a 2009 issue of the Archives of Neuropsychiatry. The paper was written by a group of Turkish psychiatrists led by Dr. Fatih Öncü and reported the case of a 32-year old married male patient suffering from both fetishism and kleptomania who was referred for psychiatric evaluation as a result of multiple stealing of the “fetish” items (mainly ladies’ underwear).

“At the age of 13-14 he had started to steal women’s garments (particularly scarves and skirts) at night. He used to take them to a secret place and masturbated with them while imagining having sex with the women he admired. After ejaculation, he threw the clothes away or burnt them. It was fifteen years ago when he first served a short jail sentence of about 45 days for stealing women’s garments…The same year he was arrested and jailed for 15 more days for the same reason, which was repeated 2-3 times in the next year, when he was jai- led for one month for each act, and four more times in the next ten years…Eight years ago, when he committed a crime similar to those mentioned above, a medical report with a diagnosis of ‘Psychosexual Disorder-Fetishism’ was issued by a state hospital. [He was] unable to control his impulses, repeatedly stole women’s garments (particularly while intoxicated) and had orgasm with these objects despite all social difficulties and punishments, and that he felt distressed, ashamed and regretful about his acts of stealing, he was diagnosed with the mental disease of “Fetishism and Kleptomania (involving only the fetish object)”.

According to the authors, the most important characteristics of this particular case are that (i) the individual stole items (in this case women’s underwear) that were not needed for personal use or their monetary value, and (ii) the act of stealing was recurrent and compulsive, but not preplanned. The authors note that while the intention in this case appears to be to possess the fetish item, the man was additionally gratified by the act of stealing itself. He did not need the items for their monetary value, and people close to him (such as his wife) already had such items.

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

Further reading

Boglioli, L. R., Taff, M. L., Stephens, P. J., & Money, J. (1991). A case of autoerotic asphyxia associ- ated with multiplex paraphilia. American Journal of Forensic Medicine and Pathology, 12, 64-73.

Chalkey, A.J. & Powell, G.E (1983). The clinical description of forty-eight cases of sexual fetishism. British Journal of Psychiatry, 142, 292-295.

Goldman, M.J. (1991). Kleptomania: Making sense of the nonsensical. American Journal of Psychiatry, 148, 986-996.

Milner, J.S. Dopke, C.A. & Crouch, J.L. (2008). Paraphilia not otherwise specified: Psychopathology and Theory In Laws, D.R. & O’Donohue, W.T. (Eds.), Sexual Deviance: Theory, Assessment and Treatment (pp. 384-418). New York: Guildford Press.

F Öncü, S Türkcan, Ö Canbek, D Yeşilbursa, N Uygur Fetişizm ve Kleptomani: Bir Adli Psikiyatri Olgu Bildirimi, Nöropsikiyatri Arşivi 2009;46(3):125-128

Revitch, E. (1983). Burglaries with sexual dynamics. In L. B. Schlesinger & E. Revitch (Eds.), Sexual dynamics of anti-social behavior (pp. 173–191). Springfield, IL: Thomas.

Schlesinger, L., & Revitch, E. (1999). Sexual burglaries and sexual homicide: clinical, forensic, and investigative considerations. Journal of the American Academy of Psychiatry and Law, 27, 227-238.

Zavitzianos, G. (1983). The kleptomanias and female criminality. In L. B. Schlesinger & E. Revitch (Eds.), Sexual dynamics of anti-social behavior (pp. 132-158). Springfield, IL: Thomas.

Region airs disease: A brief overview of culture bound syndromes

In a previous blog on coprophagia, I made a brief reference to Pibloktoq. Also known as Piblokto and Arctic Hysteria, the condition only manifests itself in winter among Inuhuit societies living (unsurprisingly) within the Arctic Circle. The condition is characterized by “an abrupt dissociative episode of intense hysteria, frequently followed by convulsive seizures and coma lasting up to 12 hours. Symptoms can include intense screaming, uncontrolled wild behaviour, depression, coprophagia, and insensitivity to extreme cold”.

Culture bound syndromes comprise a combination of psychiatric and/or somatic symptoms viewed as a recognizable disease within specific cultures or societies. They are often unknown outside of their own local regions. Even though the concept of culture-bound syndrome is highly controversial, the term was included in the American Psychiatric Association’s 1994 Diagnostic and Statistical Manual of Mental Disorders. Culture-specific syndromes are characterized by:

• Categorization as a disease in the culture (i.e., not a voluntary behaviour or false claim);
• Widespread familiarity in the culture;
• Complete lack of familiarity of the condition to people in other cultures;
• No objectively demonstrable biochemical or tissue abnormalities (symptoms);
• The condition is usually recognized and treated by the folk medicine of the culture.

Today’s blog is a brief look at some of the different culture bound syndromes that exist around the world. In later blogs I am going to look at some of these in much greater detail, but for this article, I am just going to take a brief look at a few of the ones that I find psychologically interesting.

• Beserkers is a culture-bound condition historically affecting Norsemen. The condition manifested itself among males only as an intense fury and rage (“berserkergang”) and mostly occurred in battle situations (but could also occur when they were engaged in labour-intensive work). When suffering the condition, it was alleged that the men affected were able to perform almost seemingly impossible super-human feats of strength. Those with beserkers were also said to experience a specific set of symptoms prior to the rage (i.e., beginning with shivering and chattering of their teeth, followed by a swelling and changing of colour in the face as they literally became ‘hot-headed’. The final stage was full-blown rage and fury accompanied by noisy grunts and howls. They would then just indiscriminately injure, maim and kill anything in their path. This would be followed by one or two days of feebleness, along with a dulling of the mind.

• Koro is found primarily in Asian regions (e.g., China, Singapore, Thailand, India) and has been documented for thousands of years in those particular cultures. In essence, Koro refers to a kind of “genital hysteria” with “terror stricken” males believing that that their genitals are shriveling, shrinking up, retracting into the abdomen and/or disappearing, and that this ultimately leads to death (a so-called ‘genital retraction syndrome). The word ‘Koro’ is of Malayan-Indonesian origin and means ‘tortoise’ (presumably used to highlight the similarity between the retracting head and wrinkled neck of a tortoise and the belief that the male penis is retracting inside the body). Some psychologists have also speculated that Koro may be psychologically related to body dysmorphic disorder.

• Wendigo is a psychotic mental disorder found primarily among Algonquian Native cultures in North America, but the frequency of Wendigo cases has declined rapidly in recent times because of Native American urbanization. It is also known by many variant names (including Windigo, Weendigo, Windago, Waindigo, Windiga, Witiko, and Wihtikow) and is part of a traditional belief system among the Oiibwe and Salteaux, the Cree, the Naskapi, and the Innu tribes. In essence, Individuals with Windigo believe that they are turning into cannibals and as a consequence have intense cravings for human flesh. Those with Wedigo were often executed as they typically threatened those they came into contact with. Although many have disputed whether the disorder exists, there are a significant number of substantiated eyewitness accounts (including Western anthrolopologists and ethnographers that demonstrate Wendigo is a factual phenomenon.

• Gururumba is a culture-bound disorder found only in New Guinea and sometimes referred to as ‘Wild Pig Syndrome’. Affected individuals are typically married men who become “wild men” (i.e., engage in involuntary anti-social behaviour) and engage in stealing items from houses in their neighbourhood. The items stolen are usually of little value but those with Gururumba believe the objects stolen have value. Once stolen, the person decamps to local forests, lives there for a number of days and then returns empty handed, slurring their speech, and suffering from amnesia, hyperactivity, and clumsiness. Those from Gururumba believe that the illness is transmitted through being bitten by ghosts of recently deceased tribe members. There are also a number of reports from Papua New Guinea that eating various parts of plants and/or fungi can initiate the syndrome.

• Saora Disorder is found only among the Saora tribe of Orissa State in India and is sometimes termed a ‘Shamanic initiatory illness’. Affected individuals can be male or female (and are typically teenagers or young adults) who display abnormal behaviour that Western health practitioners may define as a mental disorder. Those suffering often experience social stress from friends and relatives pressuring them to take on the life of a farmer against their wishes. Symptoms of Saora Disorder include inappropriate laughing and crying, amnesic episodes, fainting and passing out, and the experience of being constantly bitten by ants. Interestingly, the Saoran people blame the disorder on supernatural spirits who they claim want to marry the affected individual.

• Shenkui (sometimes translated as ‘kidney weakness’) is a Chinese culture-bound syndrome in which male men suffer acute anxiety and/or panic symptoms accompanied by a range of physical symptoms but have no discernible underlying physical complaint. Shenkui symptoms can include intense tiredness, bouts of dizziness, intense aching and body weakness  (e.g., backache), insomnia, and sexual dysfunction (e.g., impotence, premature ejaculation). Chinese men attribute the effects of Shenkui to excessive loss of semen (via too much masturbation, frequent sexual intercourse, and wet dreams). Chinese men believe the condition to be life threatening because excessive semen loss is thought to represent the loss of life’s vital essence (a result from a deficiency in yang). A similar condition exists in India and other South Asian cultures, where it is known as dhat.

• Ghost Sickness is a culture-bound psychotic disorder found among Navajo Native Americans. Members of these tribes think the disorder is highly associated with death. For instance, those afflicted are often mildly obsessed with a deceased person whom they believe to be the source of their problem. One of the major symptoms of the condition is an intense feeling of suffocation and terror because the affected person feels as though they are being buried alive with a friend or loved one. Other reported symptoms include general weakness and apathy, a loss of appetite, and recurring nightmares. The Navajo primarly attribute the condition to ‘chindi’ (ghosts), although sometimes it is attributed to witchcraft. Dr. Robert Putsch writing in a 2007 issue of the journal Drumlummon Views says that: “spirits or ‘ghosts’ may be viewed as being directly or indirectly linked to the cause of an event, accident, or illness”.

• Grisi Siknis (which roughly translates as “crazy sickness” and is also known as ‘grisi munaia’, ‘Chipil siknis’ and ‘Nil siknis’) is a culture-bound disorder that is primarily found among the Miskito People of eastern Central America. Most affected individuals are young women (typically 15 to 18 years of age) and the disorder is considered contagious. According to Dr. Phil Dennis in a 1981 issue of Medical Anthropology, grisi siknis is typically characterized by long periods of anxiety, nausea, dizziness, irrational anger and fear, interlaced with short periods of rapid frenzy. When a Gris Siknis sufferer has an attack they completely lose consciousness. They then fall to the floor and after regaining consciousness they become (like berserkers above) almost super-human. They feel no pain, feel invincible, may speak in tongues, and will attack anyone near them believing that they are ‘devils’. Alleged eyewitness accounts have claimed that some affected individuals will vomit up strange things (coins, hair, and even spiders). Once the attack is over, they have no memory of anything that has happened. According to Dr. Dennis, the Meskito people believe grisi siknis is caused by possession by evil spirits

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

Further reading

Bartholomew, R. (2008). Penis panics. In R. Heiner (Ed.), Deviance across cultures (pp. 79–85). New York: Oxford University Press.

Dennis, P.A. (1981). Part three: Grisi Siknis Among the Miskito. Medical Anthropology, 5, 445–505.

Garlipp, P. (2008). Koro – A culture-bound phenomenon intercultural psychiatric implications. German Journal of Psychiatry, 11, 21-28.

Newman, P. (1964). ‘Wild Man’ behavior in a New Guinea Highlands community. American Anthropologist, 66, 1-19.

Newman, Philip L. (1981). Sexual politics and witchcraft in two New Guinea societies. In G.D. Berremen (Ed.), Social Inequality: Comparative and Developmental Approaches, (pp.103-121). New York: Academic Press.

Phillips, K. (2004). Body dysmorphic disorder: recognizing and treating imagined ugliness. World Psychiatry, 3, 12-17.

Putsch, R.W. (2007). Ghost illness: A cross-cultural experience with the expression of a non-Western tradition in clinical practice. Drumlummon Views, Winter, 126-145.

Sumathipala, A., Siribaddana, S.H. & Bhugra, D. (2004). Culture-bound syndromes: The story of dhat syndrome. British Journal of Psychiatry, 184, 200-209.

Wikipedia (2012). Culture-bound syndrome. Located at: http://en.wikipedia.org/wiki/Culture-bound_syndrome

Wikipedia (2012). Ghost sickness. Located at: http://en.wikipedia.org/wiki/Ghost_sickness

Ch-ch-changes: The weird world of transformation fetishes

While researching some other articles on my blog – most notably those on the furries (sexual pleasure from dressing up as an animal and having sex with others dressed up as an animal), technofetishism (sexual pleasure and arousal arising from humanoid or non-humanoid robots), macrophilia (i.e., sexual arousal from a fascination with giants and/or a sexual fantasy involving giants), and agalmatophilia (sexual arousal from an attraction to statues, dolls, mannequins and/or other similar body shaped objects) – I constantly came across various references to ‘transformation fetish’ (TF). Basically, a transformation fetish is a form of sexual fetishism in which an individual derives sexual arousal from descriptions about (and depictions of) transformations (usually of people being transformed into other beings or objects).

The internet has a very active TF community, although some “TF fans” (as they seem to like being called) have no sexual interest as such but take an active interest in ‘transformation art’ and ‘transformation fiction’. After looking at the posts on such sites, there doesn’t seem to be any distinction between fetish and non-fetish fiction but some members of the online TF community are far more sexually orientated in their postings. For instance, one website I checked out was set up to house fetish inspired work comprising “stories, drawings, renderings, and photo-manipulations depicting many transformation fetishes. These fetishes include, but are not limited to: Transformation into toys, latex/rubber, spandex, balloon, zentai, clowns, toons, mannequins, robots, and statues”.

In his 2009 book Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices, Dr Anil Aggrawal (Maulana Azad Medical College, New Delhi, India) notes that TF can include:

“Examples are animal transformation, fantasies, and doll fetish. The former include fantasies in which human beings change to animals, or behave as animals (e.g., lycanthropy, vampires). Animal transformation fantasies are popular among those who participate in pony play. Doll fetish is a transformation fetish of being transformed into a doll or transforming someone else into a doll. It is often played out as role-play between two or more people. One partner – often the female – is dressed to look like a Barbie doll in shape with bold hair, enhanced breasts small waist, high heels, and a very revealing outfit made from rubber, latex or spandex”.

The posts I have read on various TF websites indicate that the transformations typically involve a human (that can be either gender, but seem to more often involve females) being transformed into some other form. For instance, check out the stories at the Experience Project  or the Fetish Transformation website.

I was interested in how the transformation takes place and there appears to be a lot of thought into how it happens. This might involve having fantasy sex in ritualistic ways with specific people, and/or certain creatures (in fact it is common for TF fans to report transforming into the creature they have had sex with). Other non-sexual ways that people can transform include magic spells, curses, viruses, and strange chemicals. In fact, one TF site provided an innovative list of how the transformation can manifest itself. This included:

• TFs caused by entering a cursed location
• TFs by injection
• TFs by bite or attack
• TFs from touch (whenever someone is touched by something the person start to turn into them – known as the “TF virus”)
• Inanimate TFs (e.g., transformations into statues)
• Second Skin TFs (e.g., where a person picks up a semi-sentient blob that soon covers their body, changing them into something else)
• Costume TFs (where the person gets trapped in a suit that soon begins to tighten and become their new body)
• Body alteration TFs (such as only growing fur, having only a face change)

I also read that the transformations are typically non-consensual, with “the transformer often becoming confused, scared, or angry as the changes take place, although some transformations are gladly accepted and even chosen by their victims”.

The most common form of TF appears to be transformation from humans into animals (but I’m only basing that on the number of websites that seem to cater for animal TF compared to other types of TF). As I mentioned in my previous blog on the furry fandom, the most common transformations are from humans to mammals (e.g., dogs, horses, cattle), and less common to other types of animal (e.g., birds, fish, amphibians and reptiles). The primary focus of role-play is often the “voluntary or involuntary reduction” (i.e., transformation) of humans to the status of an animal, and “focus on the altered mind-space created”. For instance, I came across this interesting quote from a TF fan:

“I don’t identify at all with the ‘furry’ thing. I mean, no offense to those of you that do. I think the main difference with my animal-TF interests is that I don’t really identify with any particular animal or animals. For me, it’s merely a curiosity about [a particular] form would physically feel like. And in some cases, there’s even a slight element of humiliation at no longer being ‘entirely human’ which is the only element of the TF that has a possibly erotic element. I’ll say ‘transformation fetish’ but in actuality, transformation alone is mostly just a fascination for me that’s non-sexual in nature. It’s when some element of control (whether being controlled, or just fighting against the changes to one’s body or impulses) and/or some slight humiliation that it becomes erotic. In fact, I’ve noticed one common theme in all the transformation scenes in various shows or movies that have caught my attention growing up. It’s that the scene typically focuses on the character’s reaction which is often a sense of ‘my own body is betraying me!’”

TF websites contain many examples of “conversion” across both animal type and developmental stages. Common conversions include felines (kittens, cats, lions, tigers), canines (puppies, dogs, foxes, wolves), and equines (foals, ponies, horses). However, many are depicted as half-human, half-animal hybrids, with the appealing characteristics of both highlighted. As one TF fansite asserted:

“Furries are usually bipedal and have the ability to speak, walk, talk, and think like a normal human. Many in the TF community, even those with an interest in TFs other than animal, adopt a made-up identity as a furry, known as a fursona. It should be noted that like the TF community not all Furries are involved with the fetish aspects of anthropomorphic media. There are some large differences between the communities”.

Another type of TF is common among ‘technosexuals’ (i.e., robot fetishists). A common fantasy among such people involves transformation into a robot. Some have argued this is most similar to agalmatophilia (i.e., attraction to or transformation into statues or mannequins) and in this sense could be viewed as a form of erotic anthropomorphism.

Looking at TF across the whole sexual fetish spectrum, some would argue that there are many different core types of transformation including transforming into inanimate everyday objects, transforming into other humanoid-looking forms (e.g., statues, dolls, robots), transforming into other living things (e.g., animals, animal hybrids, alien life forms), transforming into different and/or extend versions of the self in either fantasy (e.g., becoming a giant, the body aging years in just a few seconds) or reality (e.g., via body modification and/or gender reassignment sex changes).

Finally, in 1989, Dr. Ray Blanchard introduced the concept of autogynephilia, which refers to ‘‘a male’s propensity to be sexually aroused by the thought of himself as a female’’. This formed the basis of Blanchard’s hypothesis that there are two distinct manifestations of male-to-female transsexualism (i.e., homosexual and autogynephilic). It could also be argued that such thinking may be akin to transformation fetishes.

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

Further reading

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

Blanchard, R. (1989). The concept of autogynephilia and the typology of male gender dysphoria. Journal of Nervous and Mental Disease, 177, 616-623.

Holliday, K. (2011). Jimbo explains his transformation fetish. The Beautiful Kind, May 17. Located at: http://thebeautifulkind.com/jimbo-explains-his-transformation-fetish/

Pollack, N. (2004). Wonderlust: My transformation fetish. Nerve, April 21. Located at: http://www.nerve.com/personalessays/pollack/wonderlust

Private practices: A brief overview of male genital self-mutilation

One of the rarest behaviours in the world is the act of genital self-mutilation (GSM) in males. To date, approximately 125 cases have been recorded in the clinical literature dating back to the turn of the twentieth century. The first recorded case is thought to be a letter in the Journal of the American Medical Association by Dr D. Stroch in 1901.

GSM has been recorded in a variety of forms (e.g., simple lacerations, scrotal cutting, testicle removal, penile amputations, self-castration, and a combination of the above, so called ‘lock, stock and barrel mutilation’) across a variety of countries (USA, Middle East, India, Kenya, and Nigeria). There appears to be an increased incidence of GSM over the last decade although this may be due to increased reporting rather than increasing number of cases. GSM usually occurs in Caucasian men in the 20s and 30s (although there is a minority of cases from African and Indian descent and some case reports of individuals over the age of 70 years).

The range of instruments used to enable GSM include kitchen knifes, Stanley knives, scissors, blades, chain saw, and axe. In many cases, the genitals are disposed of immediately such as a recent case reported in the Saudi Medical Journal where a 37-year old male schizophrenic cut off both his penis and testicles and flushed them down the toilet.

A 1988 study by Tobias and colleagues in the South Medical Journal reported that self-mutilators (including all types of self-mutilation not just GSM) were most likely to suffer from schizophrenia (particularly command hallucinations), religious preoccupation, substance abuse, and/or social isolation. Genital self-mutilators are similar, and tend to fall into one of four types – schizophrenics, transsexuals (i.e., those with a gender identity crisis), those with complex cultural and religious beliefs, and a small number of severely depressed people who engage in GSM as part of a suicide attempt (around one-tenth of cases). A 1991 study in the journal Psychopathology also reported that GSM may also be triggered by a feeling of guilt for sexual offences. Similarly, Dr A.C. Waugh writing in the British Journal of Psychiatry concluded that GSM most commonly occurred in men with chronic paranoid schizophrenia and a history of delusions where only castration absolves them of guilt for sexual wrongdoing

A 2003 case report in the journal Urology, reported an attempt by an Indian man to become a ‘hijra’ (i.e., eunuch of the Indian subcontinent) due to his dissatisfaction with the wait for gender reassignment surgery. Reports indicate that transsexuals often resort to genital self-mutilation especially if they are unaware of the availability of professional (medical) help. Dr. D.B. Russell and colleagues in a 2005 issue of Sexual Health reported that genital mutilation that has a more ‘rational’ basis usually involves removal of the testicles (i.e., auto-castration) whereas those in a psychotic state are more likely to engage in penile amputation. An early study in 1993 by Aboseif and colleagues in the Journal of Urology reported that among a group of 14 genital self-mutilators, 61% of episodes involved the mutilation of one or both testicles. They also reported that among repeat mutilators, around one-third (31%) had a history of alcohol abuse and over a half (55%) had a history of drug abuse. The degree of injury didn’t differ between the psychotic and non-psychotic self-mutilators. Reporting on 52 cases in the Archives of General Psychiatry, Greilsheimer and Groves found 87% of genital self-mutilators to be psychotic and 13% to be non-psychotic. The psychotic individuals ranged from those with functional psychosis through to those with brain damage.

Those who engage in GSM as part of a religious belief are typically diagnosed as having Klingsor Syndrome. This was derived from the character Klingsor in Parsifol (a Wagner opera) who engaged in an act of self-castration to gain entry into the Brotherhood of the Knights of the Holy Grail. According to Samir Shirodkar and colleagues in the Saudi Medical Journal, group genital mutilation is a custom of a sect of Australian Aborigines where the blood is drunk by the infirm (who believe it restores their health).

In a fairly recent issue of the journal Mental Health and Substance Use, Dr Thomas Dunn and colleagues reported an unusual case of GSM. A 55-year-old non-psychotic homeless male turned up at hospital with penis and scrotal maggot infestation that was secondary to GSM. The man had gender identity issues and had performed GSM while he was drunk. However, he only sought medical help when he was barred from travelling on public transport because of the smell emanating from his maggot infection.

In a 2007 issue of the Jefferson Journal of Psychiatry, Dr. Craig Franke and Dr James Rush provided some risk factors that help in the identification of people at risk for GSM. These included: (i) psychotic patients with delusions of sexual guilt, (ii) psychotic patients with sexual conflict issues, (iii) prior self-destructive behaviour, (iv) depression, (v) severe childhood deprivation, and (vi) pre-morbid personality disorders. However, the condition is complex and as Dr Nagaraja Rao and colleagues highlighted in the Indian Journal of Psychiatry, “genital self mutilation like any other serious self injury is not a single clinical entity and it occurs in any psychiatric condition with corresponding psychopathology”.

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

Further reading

Aboseif, S., Gomez, R. & McAninch, J.W. (1993). Genital self-mutilation. Journal of Urology, 150, 1143-1146.

Ajape, A.A., Issa, B.A., Buhari, O.I.N., Adeoye, P.O., Babata, A.L. & Abiola, O.O. (2010). Genital self-mutilation. Annals of African Medicine, 9, 31-34.

Dunn, T.M., Collins, V., House, R.M. & Dunn, P.W. (2009). Male genital self-mutilation with maggot infestation in an intoxicated individual. Mental Health and Substance Use, 2, 235-238.

Eke N. (2000). Genital self-mutilation: there is no method in this madness. BJU International, 85, 295-298.

Franke, C.B. & Rush, J.A. (2007). Autocastration and autoamputation of the penis in a patient with delusions of sexual guilt. Jefferson Journal of Psychiatry, 21, Located at: jdc.jefferson.edu/jeffjpsychiatry

Greilsheimer, H. & Groves, J.E. (1979). Male genital self-mutilation. Archives of General Psychiatry, 36, 441.

Martin, T. & Gattaz, W.F. (1991). Psychiatric aspects of male genital mutilations. Psychopathology, 24, 170.

Master, V. & Santucci, R. (2003). An American hijra: A report of a case of genital self-mutilation to become India’s ‘‘third sex’’. Urology, 62, 1121.

Murota-Kawano, A, Tosaka, A. & Ando, M. (2001). Autohemicastration in a man without schizophrenia. International Journal of Urology, 8, 257-259.

Rao, K.N., Bharathi, G., & Chate S. (2002). Genital self-mutilation in depression: A case report. Indian Journal of Psychiatry. 44, 297-300.

Russell, D.B., McGovern, G. & Harte, F.B. (2005). Genital self-mutilation by radio frequency in a male-to-female transsexual. Sexual Health, 2, 203-204.

Shirodkar, S.S., Hammad, F.T. & Qureshi, N.A. (2007). Male genital self-amputation in the Middle East: A simple repair by anterior urethrostomy. Saudi Medical Journal, 28, 791-793.

Stroch, D. (1901). Self castration (Letter to the Editor). Journal of the American Medical Association, 36, 270.

Schweitzer, I. (1990). Genital self-amputation and the Klingsor syndrome. Australian and New Zealand Journal of Psychiatry, 24, 566-569.

Stunnell, H., Power, R.E., Floyd, M., & Quinlan, D.M. (2006). Genital self-mutilation. International Journal of Urology, 13, 1358-1360.

Tobias, C.R., Turns, D.M., Lippmann., S., Pary, R. & Oropilla, T.B. (1988) Evaluation and management of self-mutilation. South Medical Journal, 81(10), 1261-1263.

Waugh, A.C. (1986). Autocastration and biblical delusions in schizophrenia. British Journal of Psychiatry, 149, 656-658.

Wood you do it for me: A beginner’s guide to dendrophilia

Dendrophilia (also known as arborphilia) literally translates as a love of trees (in fact, I was originally going to try and get the words “pining for it” in the title of this blog but decided against it in the end). For me, human sexual contact with trees is not something that I think of as naturally going together. The only modern day “cultural” reference I can recall (an I use the word “cultural” in its loosest sense) was in the 1981 film The Evil Dead when the character Cheryl is attacked by trees possessed by the demons, that then come to life and brutally rape her (a scene that director Sam Raimi has since regretted including in the film).

However, the word ‘dendrophilia’ has now been adopted by some in the sexology field to refer to those who have a fetishistic or paraphilic interest in trees (i.e., individuals who derive sexual pleasure, sexual arousal and/or are sexually attracted to trees). This may involve actual sexual contact with trees and/or (as Raymond Corsini notes in his 1999 Dictionary of Psychology) veneration as phallic symbols. In his 2009 book Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices, Dr Anil Aggrawal (Maulana Azad Medical College, New Delhi, India) defines dendrophilia as arousal from trees or fertility worship of them” whereas Dr. G.R. Pranzarone in his online Dictionary of Sexology says it is the love of trees. But categorically states “it is not a paraphilia” (but doesn’t give any reason as to why).

Dr. Brenda Love in her Encyclopedia of Unusual Sex Practices writes about dendrophilia and notes that trees were ancient symbols of fertility and that on designated holy days, men had to go into the fields and ejaculate onto the trees. She also cites the work of anthropologist Thomas Gregor who studied the South American people of Mehinaku (a village of the Amazonian Xingu tribe) and described the following folk tale of a dendrophilic act in his 1985 book Anxious Pleasures; the Sexual Lives Of An Amazonian People:

“I have been able to find only two other stories of masturbation, and in both, men are the principal actors. In one tale we learn of a man who found a remarkably gratifying hole in a tree, which he began to use to the exclusion of his wife and girlfriends. In the second story, a man made an artificial vagina of leaves to which he became similarly attached. In both myths, the culprits were seen by other villagers who hacked away the hole with an axe and tore the leaf vagina to shreds. In both stories, the masturbators behaved as if their leafy companions had been real women. They wailed for the deceased plants, cut their hair short, and took off their belts as a symbol of mourning”.

Just to put these observations into context, Dr. Theodore Lidz in reviewing Gregor’s book for the Journal of the American Psychoanalytic Association, notes that the Xingu tribe are a small society that not only permits extramarital promiscuity (to an extent perhaps never before recorded), but the promiscuity promotes rather than disrupts the societal integration.

A fairly recent British case of dendrophilia came to light when 21-year old Scottish man William Shaw received a lifetime ban from Airdrie’s Central Park for attempting to have sex with one of the trees (with The Sun winning the best headline with “Fancy a treesome?”). He dropped his trousers and underpants and simulated sex with a tree while in the visitor attraction in September 2009. 
he was subsequently charged with an act of public indecency at the town’s sheriff court.
 The Sheriff (Frank Pieri) released Shaw on bail on the condition that he did not set foot in Central Park again. I also feel duty bound to point out that there was also a YouTube video posted in March 2012 showing a very intoxicated woman trying to have sex with a tree.

Willow Monrroe in her regular ‘Fetish of the Week’ column also briefly examined dendrophilia (although none of her claims were supported by any evidence). In relation to this fetish she claimed:

“I can see it. The metaphors are obvious and long over-drawn. And experience has proven that sex and the wild world of nature go together like cheese and wine, one being the natural complement of the other”…Dendrophilia is considered a pathology. There are documented cases of persons seeking and receiving treatment for what’s perceived as a psychological disorder. For example, one psychologist reported treating a man who had a long running affair with an oak tree”

The Deviant Minds website also featured an article on dendrophilia and speculated about the condition’s origins. The article asserted that dendrophiles “go beyond simply looking for new textures, for under their hands and other regions. It may involve deep emotional bond towards nature only a few might understand”. However, as with most online articles, there is absolutely no empirical evidence to back up a single claim made, and as far as I am aware, there is not a single academic or clinical study published – not even a case study.

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

Further reading

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

Corsini, Raymond J. (1999). The Dictionary of Psychology. London: Psychology Press.

Daily Telegraph (2010). Tree sex man ordered to leave park. Daily Telegraph, January 21. Located at: http://www.dailytelegraph.com.au/news/weird/tree-sex-man-ordered-to-leaf-park/story-e6frev20-1225821689910

Deviant Minds (undated). Dendrophilia. Located at: http://www.deviantminds-central.com/articles/fetisharchives/dendrophilia.php

Gregor, T. (1985). Anxious Pleasures; the Sexual Lives Of An Amazonian People. Chicago: University of Chicago Press.

Love, B. (2001). Encyclopedia of Unusual Sex Practices. London: Greenwich Editions.

Monroe, W. (2012). Fetish of the week: Dendrophilia. ZZ Insider, January 6. Located at: http://www.zzinsider.com/blogs/view/fetish_of_the_week_dendrophilia

Pranzarone, G.F. (2000). The Dictionary of Sexology. Located at: http://ebookee.org/Dictionary-of-Sexology-EN_997360.html

Design of the times: How does venue design influence gambling behaviour (revisited)?

In a previous blog I briefly examined how gaming venue design affects gambling behaviour, particularly in relation to casino atmospherics. Over the last century, the gaming industry has used various inducements and ploys to entice people to gamble. The psychology of marketing has become big business. Casinos – like any other business with a product to sell – has had to keep up with times and spend huge amounts of money in an effort to get even more of your money. As a psychologist, I have always been very interested in the design features of gambling venues. Put more simply, to what extent is psychology used in design features as a way of taking more money from you?

I have spent many years studying the situational characteristics of many gambling venues to examine this question. Situational characteristics are primarily features of the environment (such as the location of the casino, the number of casinos in a specified area, membership requirements, etc.) but can also include internal features of the casino itself (such as décor, heating, lighting). These features can be very important in both the initial decision to gamble and continued gambling once you are in the casino.

Most casinos around the world try to fill up as much floor space as they can with slot machines. This is because slots are the most profitable form of gambling for operators. The profitability of slot machines can depend on simple factors such as floor location, coin denomination and pay off schedules. Floor layout is also important in other areas. For instance, restaurants are often positioned in the centre or back of the casino so that customers have to pass the gaming areas before and after they have eaten. Another strategy is to use deliberate circuitous paths to keep customers in the casino longer, the psychology being that if the patrons are in the casino longer they will spend more money. In many US casinos the management will provide free alcoholic drinks – all in the hope that you may spend a little more while under the influence and being a little less rational!

Casino designers can also introduce environmental features to manipulate human senses. For instance, light and colour are two variables that can affect behaviour – and gambling is no exception. Psychological research has shown that colour can evoke affective states and influence behaviour. Some colours are associated with certain moods. Red is “exciting” and “stimulating”, blue is “comfortable”, “secure” and “soothing”, orange is “disturbing” and green is “leisurely”. Colour can affect physiological reactions such as blood pressure, breathing rate, mood and arousal. In gambling situations, research has shown that people will gamble and stake money more under red light than colours towards the blue end of the spectrum.

The use of sound can also be important. Constant noise and sound gives the impression of a noisy, fun and exciting environment. In addition, many slot machines play musical tunes or ring bells and buzzers if someone has won. As coins are paid out by dropping down onto a metal pay out tray (along with buzzers, bells and music), it gives the impression that winning is more common than losing – as you cannot hear the sound of losing! Music can also be used to manipulate how we feel. Two of the many effects music can have may be to heighten psychological arousal or to relax. Early studies showed that when customers in a supermarket were exposed to loud music, their shopping rate – how much they bought per minute spent in the store – was higher than when quiet music was played. Gamblers may also spend more under similar conditions although there have only been a handful of studies published to date. We have carried out a couple of experiments which have shown that gamblers play faster when there is music with a high beats per minute playing in the background.

Believe it or not – and as I pointed out in a previous blog – smell may also have an influence on gambling behaviour. Experiments carried out in Las Vegas casinos showed that a slot machine’s takings could be increased by spraying them with pleasant odours. Researchers found that the slot machines with pleasant aromas had significantly higher profits than the machines not sprayed with any odours. This is very similar to shops who pump the smell of chocolate in the run up to Valetine’s Day hoping it will increase sales.

Physical comfort is also an important factor. I call this the “seating, eating and heating” phenomenon. If a gambler is physically (as well as psychologically) comfortable, there is more chance they will stay in the casino. Comfort is therefore used by casino management to encourage and prolong gambling. For instance, taking a gambler off their feet enhances physical comfort considerably and reduces fatigue. Another obvious customer care tactic is the availability of refreshments and amenities (including toilets). Paradoxically, serious gamblers often gamble for long periods of time. Consequently, they are often reluctant to leave a slot machine or the roulette table to get a drink or food, or go to the toilet as they do not want to lose their “lucky seat” or favourite machine. Interestingly, in one research study, thirty bars with slot machines were compared with another thirty that didn’t. In the bars without slot machines, almost all of the clientele drank pints. However, in the bars with slot machines, only 8% of the clientele drank pints. The main reason for this was that slot machine players did not want to leave the machines to go to the toilet in case someone ‘stole’ their machine!

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

Further reading

Cole, T., Barrett, D.K.R., Griffiths, M.D. (2011). Social facilitation in online and offline gambling: A pilot study. International Journal of Mental Health and Addiction, 9, 240-247.

Dixon. L., Trigg, R. & Griffiths, M.D. (2007). An empirical investigation of music and gambling behaviour. International Gambling Studies, 7, 297-308.

Finlay, K., Kanetkar, V., Londerville, J. & Marmurek, H.C. (2006). The physical and psychological measurement of gambling environments. Environment and Behavior, 38, 570-581

Friedman, B. (2000). Designing Casinos to Dominate the Competition. Reno, NV: Institute for the Study of Gambling and Commercial Gaming, University of Nevada.

Griffiths, M.D. (2009). Casino design: Understanding gaming floor influences on player behaviour. Casino and Gaming International, 5(1), 21-26.

Griffiths, M.D. & Parke, J. (2003). The environmental psychology of gambling. In G. Reith (Ed.), Gambling: Who wins? Who Loses? pp. 277-292. New York: Prometheus Books.

Griffiths, M.D. & Parke, J. (2005). The psychology of music in gambling environments: An observational research note. Journal of Gambling Issues, 13. Located at: http://www.camh.net/egambling/issue13/jgi_13_griffiths_2.html.

Hirsch, A.R. (1995). Effects of ambient odors on slot-machine usage in a Las Vegas casino. Psychology and-Marketing, 12, 585-594.

Lam, L.W., Chan, K.W., Fong, D. & Lo, F. (2011). Does the look matter? The impact of casino servicescape on gaming customer satisfaction, intention to revisit, and desire to stay. International Journal of Hospitality Management, 30, 558-567.

Spenwyn, J., Barrett, D.K.R. & Griffiths, M.D. (2010). The role of lights and music in gambling behavior: An empirical pilot study. International Journal of Mental Health and Addiction, 8, 107-118.

Eye love to love: A brief look at oculophilia

In November 2011, various news reports were published claiming that Saudi Arabian women with “sexy eyes” were to be outlawed from displaying them in public. This was because Saudi Arabia’s Committee for the Promotion of Virtue and Prevention of Vice announced a proposal to make it law that women with “sexy eyes” must cover them up when out and about in public. This report got me wondering about the inter-relationship (if any) between ‘eyes’ and ‘sex’. There’s no doubt that someone’s eyes can be a source of sexual attraction. Furthermore, most people are aware that a person’s pupils enlarge when someone or something sexually attracts them. In fact, Brenda Love in her book the Encyclopedia of Unusual Sex Practices says that European women used to put chemicals in their eyes so that they would dilate as a way of making men thinking that the women in question were attractive to them.

Believe it or not, there are some people who have something of a fetish for eyes. This condition is called oculophilia and is a sexual paraphilia in which individuals derive sexual arousal and sexual pleasure from eyes. The fetish can manifest itself in a desire for actual physical contact and interaction with the eye. It can also take a number of different forms and might be very specific. For instance, it has been written that the 17th century philosopher and mathematician Rene Descartes (1595-1650) had a fetish for women with squinted eyes. He cited his attraction to cross-eyed women as originating from an infatuation with a childhood friend who had a squint. It appears there are modern day adherents too as I found this on an online confessional website:

“I am attracted to people that have lazy eyes. The more lazy their eye, the more attractive it is to me.
It’s a huge turn-on, especially eyes that turn outward (e.g., exotropia)”

One specific oculophilic activity involves the licking of eyes for sexual pleasure. This activity is called oculolinctus. According to Brenda Love in her book chapter in the 2005 book Everything You Know About Sex is Wrong, noted that oculolinctus appears “to be rare, but there are several cases, including one of a female who in order to orgasm would have to lick the eyeball of her obliging male lover”. She did add a note of caution that those engaging in the act should be aware that oral herpes (i.e., cold sores) can be transferred to the eye. There may also be other dangers. For instance, one website claimed that:

“Optometrists are calling for an immediate halt of eye licking by sexual fetishists due to the dangers involved. Particles, debris and plaque collected in the mouth can emerge at the tip of the tongue. During a tongue to eye licking session those particles can easily scrape the cornea causing significant damage to the eyeball. Optometrists are quick to point out that patients do not admit to eye licking as the source of such damage. Most attribute their scratches to sand, pine needles and rusty nails. Optometrists wish to inform the public that they know when their patients are lying about their sexual perversions when they involve the eyeball”

Another website claimed (in the complete absence of empirical evidence) that the oculophilic fetish is:

“A predominantly female one; that is, more women want to do it than men. In the rarest of cases, women have been documented that need to lick the eyeball of their lover in order to achieve orgasm”.

In modern literature, a detailed description of oculolinctus was described by novelist Jonathan Coe in his 1997 book The House of Sleep. However, a Wikipedia entry on this particular oculophilic act claimed: “The interest of the person in question is not always of an entirely sexual nature, but sometimes of an intellectual nature”. However, there is plenty of oculophilic fantasy fiction out there online in the form of short stories and blog musings.

Another variant of oculophilia is that of ‘eye-play’. This can only occur with those where the sexual recipient has glass eye and has the empty eye socket penetrated by a male penis or testicle. Again, Brenda Love writes about this practice in her book Encyclopedia of Unusual Sex Practices. More specifically, she cites the case of a prostitute in the Philippines who gained notoriety for soliciting men to penetrate her eye socket after removing her glass eye. Some of you reading this may have also come across the film Bed Scenes directed by François Ozon. The film features seven small vignettes depicting various moments around alternate styles of sexuality. In one of the vignettes, a man visits a prostitute to discover she uses the socket after her glass eye is removed to perform “oral” sex using her eye socket.

Eye socket sex – and more commonly eye socket rape – also appears in Japanese pornographic comics (i.e., Hentai Doujinshi and Hentai Manga). There are also occasional reports from the forensic crime literature indicating paraphilic interest in eyes. For instance, writing in a 2007 issue of the Journal of Forensic Sciences, Dr. John White examined evidence of primary, secondary, and collateral paraphilias left at serial murder and sex offender crime scenes. He reported that possible that serial killer Charles Albright may have “raped and killed three prostitutes (collateral paraphilia) for the purpose of carefully extracting their eyes (primary paraphilia of oculophilia)”.

In an online article by Dr. Ruth Neustifter on sexual eyeball licking she reports that:

“Eyeballs are covered in naturally salty water used to keep them lubricated and clean, which also gives them a distinctively smooth and salty flavour. While the eyeball doesn’t feel in the same way that our fingers and tongue do, it can sense pressure and temperature, making eyeball licking an optimal form of stimulation. Pretty much everyone recognizes the eye as a vulnerable area of the body, making it an intimate area for some people. Where there is vulnerability and intimacy, you might just find eroticism! Some folks enjoy doing the licking, both for the sensation and for the ability to enjoy their partner’s vulnerability in this way. And for those who like to be licked, they find the situation as well as the physical stimulation to be highly enjoyable. This isn’t a universal erogenous zone, so many folks won’t get the attraction even if they try it”.

This is yet another paraphilic and/or fetishistic behaviour on which there is no empirical research at all. We know next to nothing about the incidence, prevalence, etiology, or why people engage in the behaviour. This is definitely an area (if you excuse the poor pun) should definitely be looked at in more scientific detail.

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

Further reading

Didymus, J.T. (2011). Saudi women with ‘sexy eyes’ will have to cover them up in public. The Digital Journal, November 19. Located at: http://digitaljournal.com/article/314708

Love, B. (2001). Encyclopedia of Unusual Sex Practices. London: Greenwich Editions.

Love, B. (2005). Cat-fighting, eye-licking, head-sitting and statue-screwing. In R. Kick (Ed.), Everything You Know About Sex is Wrong (pp.122-129).  New York: The Disinformation Company.

Neustifter, R. (2008). Tuesday’s Twisted Fetish: Eye Licking (Oculingus). Exploring Intimacy, September 23. Located at: http://exploringintimacy.wordpress.com/2008/09/23/tuesdays-twisted-fetish-eye-licking-oculingus/

White, J.H. (2007). Evidence of primary, secondary, and collateral paraphilias left at serial murder and sex offender crime scenes. Journal of Forensic Sciences, 52, 1194-1201.

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