Monthly Archives: September 2012

Aural sex? A brief overview of ecouteurism and acousticophilia

On a wet Sunday afternoon, I recently found myself reading through a list of strange paraphilias in Dr. Anil Aggrawal’s book Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices. I came across a sexual paraphilia called ecouteurism which according to Dr. Aggrawal refers to individuals who derive sexual pleasure and arousal “by listening to stories of sexual encounters of others or to sounds of others produced during intercourse either live or recorded”. Other slightly different definitions of the behaviour have been noted. For instance, the Right Diagnosis website says that ecouteurism refers to “intentionally listening to other people having sex without them being aware of it or consenting to it” whereas the Dictionary of Psychology and Allied Sciences notes that it refers to the sexual pleasure obtained from sounds or listening to sexual or toilet activities of others”.

The Intimate Medicine website claims there is no scientific literature on ecouteurism but that is not quite true. The one and only paper the academic literature was written back in 1968 by Australian psychiatrist Dr. F.M. Mai and published in the Australian and New Zealand Journal of Psychiatry. Dr. Mai’s paper concerned the case of 32-year old single man who derived his sexual satisfaction from covertly tape-recording and then playing back the sounds from female toilets. Over a one-year period he amassed 13 hours of females’ toilet recordings, all of which were made at nights and only when he was feeling lonely and depressed. Dr. Mai argued that this was phenomenologically and psychopathologically similar to voyeurism (i.e., the deriving of sexual pleasure from watching other people typically engaged in sexual behaviour). The Intimate Medicine website concurs with this as they assert that ecouteurism is the same for the ear as voyeurism is for the eye”.

It was in fact Dr. Mai who termed this condition ‘ecouteurism’. Over a 12-month period, the man in question had regularly frequented female toilets and placed microphones through the windows to record all the sound activity inside the cubicles. The man would then go home and listen to the recordings he had made but strenuously denied that he masturbated while the sound recordings were being played. The furthest that the man would go was to say he “got something out of it”. Dr. Mai noted that despite no admission of using the recordings as masturbatory material, there seemed little doubt in his mind “that this man derived sexual gratification from recording and later listening to the sounds emanating from female toilets”.

Dr. Mai claimed that the roots of the behaviour were due to the man’s sexual inadequacy that was – at least in part – caused by the man’s dysfunctional relationship with his overtly aggressive father. His father had high hopes for his son’s future but his son could not live up to his father’s ambitious plans because of his relatively low intellectual ability. Ultimately, this had led to the man seeking alternative forms of sexual expression manifested in his desire to listen to women going to the toilet. As to more specific causes, Dr. Mai could only speculate. He said that:

“[The man’s] long-standing auditory symptoms may have played some part in localising the symptoms to the organ of hearing rather than any other sense organ. His relative social isolation and passive personality could be a further contributory factor. The passive-aggressive quality of his behaviour is clear, and is in keeping with the personality features he presented on clinical examination. A compulsive aspect is also suggested by his reference to unsuccessful efforts to control his symptom”

In his paper, Dr. Mai also spent some time discussing two other cases of “sexual gratification from auditory stimuli” that were observed by his colleague (Dr. Millar) but not published.

“The first was an “impotent man with a complex history of oddities of behaviour, poor heterosexual adjustment complicated by alcoholism. He remembered as a young child being aroused and stimulated by seeing and hearing his mother urinating”. As an adult he admitted that ‘the sound ofconstant drumming of female urine in a lavatory pan fills me with the greatest excitement’. The other was a criminal trans-sexualist, who when very young witnessed and heard his mother having intercourse with men she picked up in the street. Millar considered that ‘critical imprinting’ may have played an important part in the psychopathogenesis of both these psychosexual disorders”.

Taking all three cases together, it could perhaps be argued that two of the cases perhaps involved some type of urophilia and/or coprophilia (as the sexual excitement was gained from the hearing of female toilet activity. Ecouteurism would appear to be related to other auditory paraphilias listed in both Dr. Aggrawal’s Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices and Dr. Brenda Love’s Encyclopedia of Unusual Sex Practices This would appear to include both acousticophilia (i.e., sexual arousal from certain sounds), and melolagnia (i.e., sexual arousal from music). According to the Right Diagnosis website, acousticophilia signs and symptoms included: (i) sexual interest in certain sounds, (ii) abnormal amount of time spent thinking about certain sounds, (iii) recurring intense sexual fantasies involving certain sounds, (iv) recurring intense sexual urges involving certain sounds, and/or (v) sexual preference for certain sounds.

According to the Encyclopedia of Unusual Sex Practices (as well as the online Sex Dictionary and Fetish Freedom websites), acousticophilia is defined as being sexually aroused by any auditory stimulus (including music, songs, poetry, verbal abuse, speaking in a particular foreign language, screaming, panting, moaning, groaning, and heavy breathing). The key to defining it as acousticophilia appears to be that the stimulus itself is not necessarily sexualized. Many websites I have come across claim that the character Wanda Gershwitz (in the film A Fish Called Wanda) has acousticophilia as she is sexually turned on whenever she hears a male speaking in Italian. Similarly, in The Addams Family film, Gomez Addams becomes sexually aroused when his wife Morticia speaks in French. Another film character that appears to have acousticophilia is Séverine in Belle De Jour who has several sexual fantasies involving the noise of carriage bells and cats’ mewing.

The Intimate Medicine website cite a book called Sex Variants (by Paul J. Gillette) who wrote about an acousticophile. The

“Gillette came across a young man who confided in him that he gets very much aroused when he can listen to others’, including his girlfriend’s real sex stories. He demanded from the girl to be very clear, use juicy expressions, and tell everything she did. The young man admitted the narration led him to the climax, and he experienced it by accident. He asked one of his friends if anything new was going on in her private life. When she told him that she had two lovers, he got a little curious about it, and then he realised that he had a strong erection and everything drove him wild. Gillette concluded that it was a sort of foreplay, and ecouteurism cannot be considered a disorder, meaning that it is in fact less “dangerous” than voyeurism”.

To me, this account is not acousticiphilia but narratophilia (which I examined in a previous blog – or maybe narratophilia is just a subtype of acousticophilia). Gillette also noted that very few women that he had come across in his research were ecouteurists and that the vast majority of them were men. The lack of empirical research in the area may be more down to the fact that auditory aspects of sex have become so commonplace within traditional sexual practice that they are not considered in any way ‘abnormal’ unless the person engages in such activity without the consent of the other individual(s).

Finally, I will leave you with a snippet that I came across on the Foot Fetish Photography website that seems to suggest there could be an overlap between acousticophilia and some aspects of foot fetishism. The author of the article (Johnny Jaan) is a foot fetishist and made the following observation based on an experience in a hospital waiting room:

“Arousal from sounds. So, could it be a cocktail of three fetishes? Foot fetish, retifism (shoe fetish) and sound fetish all in one…I once recall sitting in a hospital waiting room waiting for someone. It was rather “quiet” as waiting rooms are and no one was in conversation. I remember hearing someone walking through a side corridor approaching the waiting area. From the type of the sound, the heels, I could tell that it was a woman walking towards where we were sitting. It was a slow walk. The sound was getting louder and louder as she approached. She eventually came into the waiting room and walked right by me into another room…what was most striking was the “sticky” slapping sound that the soles of her feet made with the arch of the shoes every time she took a step, rather like the sound that flip-flops make only a bit more “sticky” as if her soles were a little moist with sweat”.

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.

Bhatia, M.S. (2009). Dictionary of Psychology and Allied Sciences. Delhi: New Age International.

Fetish Freedom (2012). Acousticophilia: Sound fetish. Located at:

Intimate Medicine (2010). Do you like to listen to others having sex? May 10. Located at:

Jaan, J. (2006). Foot fetish and acousticophilia. Foot Fetish Photography, February 23. Located at:

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

Mai, F.M.M. (1968). A new psychosexual syndrome – “Ecouteurism” Australian and New Zealand Journal of Psychiatry, 2, 261-263.

Right Diagnosis (2012). Ecouteurism. February 1. Located at:

Sex Dictionary (2012). Acousticophilia. Located at:

Aural wrecks: A brief look at self-mutilation of the ear

If I was playing a word association game and said the words ‘self-inflicted ear mutilation’, I would hazard an educated guess that the first thing that popped into most people’s minds would be the Dutch artist Vincent Van Gogh. On the evening of December 23, 1888, in Aries (France) Van Gogh (in a state of deep depression) cut off the lower part his own right ear with a razor (and later immortalized in his famous painting Self Portrait With Bandaged Ear). Earlier in the day he had threatened his long-time friend and artist Paul Gaugin with a razor and was not in a good state of mind (both that day and in life more generally). Van Gogh had become a heavy smoker and heavy drinker and had taken a liking to the alcoholic drink absinthe. After cutting off his ear, he took it over to a local brothel and gave it to a prostitute called Rachel (telling her to take good care of it). He would have died of blood loss but the local police took him to the hospital.

This incident has given rise to what has been called the Van Gogh Syndrome which has now become a catch-all term for self-mutilation, particularly in relation to amputation of a bodily extremity (such as the cutting off of one’s own penis, or the removal of one’s own eye). Such actions may be due to a wide range of conditions including psychoses, mood disorders (e.g., clinical depression), body dysmorphic disorder, or as a component of Lesch-Nyhan syndrome (a genetic disorder that affects how the human body builds and breaks down purines).

Van Gogh would have been classed as a ‘psychotic self-mutilator’ in psychiatrist Karl Menninger’s self-mutilation typology developed in the 1930s. He proposed that self-mutilators fall into one of six categories:

  • Neurotic self-mutilators: These individuals comprise nail biters and pickers, extreme hair removal and those seeking unnecessary cosmetic surgery.
  • Religious self-mutilators: These individuals comprise self-flagellators and/or genital self-mutilators.
  • Puberty rite self-mutilators: These individuals comprise those who engage in hymen removal, circumcision or clitoral alteration.
  • Psychotic self-mutilators: These individuals engage in eye or ear removal, genital self-mutilation and extreme amputation.
  • Organic disease self-mutilators: These individuals comprise those who engage in repetitive head banging or hand biting, intentionally fracturing fingers and eye removal, due to diseases such as encephalitis or disorders such as severe mental retardation.
  • Conventional self-mutilators: These individuals comprise normal people that engage in customary or conventional forms of self-mutilation (that most would argue is not self-mutilation at all, e.g., nail clipping, hair trimming, and beard shaving).

More recent typologies tend to talk about self-harm rather than self-mutilation and class such behaviour into one of three types (i.e., psychotic, organic or typical). Again, Van Gogh would be classed as a psychotic self-harmer:

  • Psychotic self-harmers: These individuals comprise those who remove or amputate body parts (e.g., eyes, limbs, ears, genitals, digits). In these cases, body part removal is carried out in response to hallucinations bought on by psychosis. Unsurprisingly, this is the most severe type of self-harming.
  • Organic self-harmers: These individuals comprise those who self-harm in the form of behaviours such as head-banging and lip-biting because of conditions such as Autistic Spectrum Disorders, developmental disabilities, and other similar disorders. Here the self-harm is a consequence of physical or chemical issues in the body.
  • Typical self-harmers: These individuals comprise those who self-harm in the form of self-cutting, burning, hair-pulling (trichotillomania), skin-picking (dermotillomania), biting, hitting, interference with wound healing, scratching or bone-breaking. Here, the self-harm is initiated by emotional or psychological trauma that is unrelated to psychotic or organic conditions. This is the most common type of self-harming.

In a 2006 issue of the Journal of Deaf Studies and Deaf Education, Dr. David Veale reported that major self-injurious behaviours tend to “be very isolated events and consists of severe or life-threatening tissue damage, such as self-castration, eye nucleation, or less commonly self-amputation of a limb or ear. They mainly occur in young psychotic men or older males with psychotic depression usually in the context of command auditory hallucinations or delusions of guilt”.

Despite the fact that self-inflicted ear mutilation is well documented, there are surprisingly few published case studies. In 1989, Dr. J. Silver and colleagues published a case study of self-inflicted ear mutilation (as part of wider self-mutilation) in the journal Psychosomatics. Their case was a 35-year old male paranoid schizophrenic who presented for treatment following dermatological self-mutilation following severe lacerations (including the ear, arms, and face). They concluded that the self-mutilation behaviour appeared to be associated with his psychotic symptoms, and that the self-mutilation was exacerbated by failure to take his neuroleptic medication.

Dr. Christopher Alroe and Dr. Venkat Gunda reported some cases of self-inflicted ear mutilations in a 1995 issue of the Australian and New Zealand Journal of Psychiatry. They presented three cases of self-amputation of the ear by three white right-handed men. All three men had psychiatric problems (one having schizophrenia and two having personality disorders. They compared their cases with that of van Gogh. The authors also surveyed all Australian and New Zealand prisons to determine the frequency of self-mutilation of the ears within the last five years. They found only one other case. Based on the cases, they argued that connections exist between the self-amputees and supports the notion that self-mutilation is “contagious”.

It is also worth noting that there are cases of people who have cut off their ears but would not be classed as psychotic because they have done it for a very specific reason. The most recent case was that of British prisoner Michael O’Donnell who (on May 2, 2010) cut off his ear so that he could escape from an ambulance while he was being transported to hospital for treatment. In the end, it was all in vain as he was caught and re-arrested three weeks later.

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

Further reading

Alroe, C.J., & Gunda, V. (1995). Self-Amputation of the Ear: Three Men Amputate Four Ears within Five Months. Australian and New Zealand Journal of Psychiatry, 29, 508-512.

Edwards, G. (1998). A brief history of ear mutilation. Deluxe. Located at:

Menninger, K. (1935). A psychoanalytic study of the significance of self-mutilation. Psychoanalytic Quarterly, 4, 408-466.

Menninger, K. (1938). Man Against Himself. New York: Jovanovich.

Silva, J.A., Leong, G.B. & Weinstock, R. (1989). A case of skin and ear self-mutilation. Psychosomatics, 30, 228-230.

Press Association (2010). Prisoner who cut off ear to escape is recaptured. The Guardian, May 28. Located at:

Veale, D. (2006). A compelling desire for deafness. Journal of Deaf Studies and Deaf Education, 11, 369-372.

Kill crazy about you: A brief overview of erotophonophilia (aka ‘lust murder’)

Erotophonophilia is a sexual paraphilia in which individuals derive sexual pleasure and arousal from murdering (or imagining they are murdering) someone. Many academics in the forensic field refer to such killings as ‘lust murder’. However, there are countless slightly different definitions of sexual murder depending on which academic text you read. For instance, Dr. Louis Schlesinger in his 2004 book Sexual Murder noted all these slightly different terms and definitions for sexual killing:

  • Lust murder: “The connection between lust and desire to kill” and “The sadistic crime alone becomes the equivalent of coitus” (Krafft-Ebing, 1886)
  • Sadistic lust murder: “After killing the victim, the murderer tortures, cuts, maims, or slashes the victim … on parts [of the body] that contain strong sexual significance to him and serves as sexual stimulation” (De River, 1958)
  • Sadistic murder: “Distinguished from the sadistic homicide by the involvement of a mutilating attack or displacement of the breasts, rectum, or genitals” (Hazelwood & Douglas, 1980)
  • Lust murder:A sexual factor is clearly apparent … or deeper study will sometimes reveal that sexual conflict underlies the act of aggression” (MacDonald, 1986)
  • Sex murder: “Murder with evidence or observations that indicate[s] that the murder was sexual in nature” (Ressler, Burgess & Douglas, 1986)
  • Erotophonophilia: “Murder associated with sexual sadism as defined in [Diagnostic and Statistical Manual of Mental Disorders]” (Money, 1990)
  • Sexual homicide: “Involves a sexual element (activity) as the basis for the sequence of acts leading to death” (Douglas, Burgess, Burgess & Ressler, 1992)
  • Sadistic murder: “The offender derives the greatest satisfaction from the victim’s response to torture” (Douglas, Burgess, Burgess & Ressler, 1992)
  • Sexual murder: “The killing may also be closely bound to the sexual element of an attack … the offender’s control of his victim, and her pain and humiliation, become linked to his sexual arousal” (Grubin, 1994)
  • Lust killing: “The primary goal is to kill the victim as part of a ritualized attack … the motivation … is the enactment of some type of fantasy that has preoccupied him or her for some time” (Malmquist, 1996)

For many, erotophonophilia (or whichever definition you care to choose from the list above) is the most heinous of all paraphilias. Erotophonophiles have extreme violent fantasies and typically kill their victims during sex and/or mutilate their victims’ sexual organs (the latter of which is usually post-mortem). Most erotophonophiles are male although females with the paraphilia are known to exist. Lust murderers are known to be psychologically and behaviourally different from those who kill out of revenge or anger displacement.

Complete fantasy fulfillment is rarely achieved and the fantasy continually evolves based on experiences with prior victims. This is one of the reasons that the behaviour may be repeated continually until they die or caught by law enforcement agencies. Erotophonophilia may overlap with other sexual paraphilias including necrophilia, sexual sadism, and/or sexual cannibalism. Such behaviour may be fuelled by use of extreme pornography and/or psychoactive drug use (e.g., alcohol, cocaine, etc.). Unsurprisingly, the group of people most likely to be erotophonophiles are serial killers. Such people utilize sexual torture as a mechanism to degrade, humiliate, subjugate, and ultimately control their victims. However, Professor Don Grubin has written papers in journals such as Criminal Behavior and Mental Health and the British Journal of Psychiatry arguing that not all sex murderers are sadists.

Erotophonophiles typically choose their victims on the basis of sexual attractiveness although there might be one particular physical attribute that is sexualized by the killer (such as a particular body shape, hair style, skin colour, etc.). This is referred to as an erotophonophile’s “ideal victim type” (IVT). After a victim has been selected, and prior to the killing, the erotophonophile may engage in a range of predatory behavours (such as stalking).

Influential research carried out by Dr. R.P. Brittain in the 1970s and followed up by the U.S. Federal Bureau of Investigation (FBI) in the 1990s described a number of characteristics of typical lust murderers. They were characterized as over-controlled, timid, introverted, sexually inexperienced, highly deviant, and having violent sadistic fantasies. However, more recent research has not necessarily supported the early claims made by Brittain. Professor Grubin’s work suggests much of this early work is a composite picture of a lust murderer based more on clinical impressions as opposed to systematic research.

One of the most cited studies in the area of lust murder is a 1990 paper by Dr. P.E. Dietz and colleagues published in the Bulletin of the American Academy of Psychiatry and the Law. They examined 30 sexual sadists (most of which were sexual murderers). They found that the majority were employed white males (75%), married (50%), had a history of homosexual experience (43%), and cross-dressed (20%). They also reported that they had parents who had divorced or had marital infidelities (50%), suffered physical abuse (23%), suffered sexual abuse (20%), and abused drugs other than alcohol (50%). Almost all the sample had planned their offences (93%), the majority of which the victim was unknown to them (83%). The victims were typically abducted, held against their will for over 24 hours, blindfolded, bound and gagged. All victims were tortured, and typical activities included forced oral sex, rape, and forced insertion of foreign objects vaginally. Many subsequent studies have reported similar findings. However, the main problem with many of these studies is that there was no (non-sadistic) control group against which the results could be compared.

A study by Dr. T. Gratzer and Dr. J.M. Bradford published in the Journal of Forensic Sciences compared their results with that of the Dietz study by examining both sexual offending sadists (n=28) and non-sadists (n=29) many of whom were sexual murderers. Results were similar to those of the Dietz study, including high rates of offence planning (82%), torture (78%), and physical abuse during childhood (43%). However, they also noted some differences including greater use of bondage, and anal rape.

Studies carried out by the FBI have reported that that sexually sadistic murderers exhibit psychopathy and narcissism. However, other more recent studies have not found relationships with psychopathy so it has been suggested that FBI samples may represent a particularly extreme group of sadistic sex murderers compared to other published studies. Research by Professor Grubin (comparing 21 men who had murdered a woman during a sexual attack with 121 rapists who did not kill their victims) found that sexual murderers had significantly higher rates of social isolation and difficulties within sexual relationships. However, sexual murderers and rapists didn’t differ in their utilization of pornography and deviant sexual fantasy.

Finally, a couple of recent book chapters on sexually sadistic murderers (published in 2005 and 2006) by Drs. J. Proulx, E. Blais, and E. Beauregard (2005) have found that sadistic sexual offenders were more likely than non-sadistic sexual offenders to have (i) planned to kidnap their victims, (ii) used bondage and weapons, (iii) engaged in expressive violence, humiliation, and torture of victims, (iv) inserted objects into the victims’ vaginas, (v) strangled their victims, and (vi) engaged in intercourse and mutilation of their victims after death.

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.

Bartholomew, A., Milte, K., & Galbally, A. (1975). Sexual murder: Psychopathology and psychiatric jurisprudential considerations. Australian and New Zealand Journal of Criminology, 8, 152– 163.

Brittain, R. (1970). The sadistic murderer. Medicine, Science, and the Law, 10, 198-207.

De River, J.P. (1958). Crime and the sexual psychopath. Springfield, IL: Charles C Thomas.

Dietz, P.E., Hazelwood, R.R., & Warren, J. (1990). The sexually sadistic criminal and his offenses. Bulletin of the American Academy of Psychiatry and the Law, 18, 163–178.

Douglas, J.E., Burgess, A.W., Burgess, A.G., & Ressler, R.K. (1992). Crime classification manual. San Francisco: Jossey-Bass.

Gratzer, T., & Bradford, J. M. (1995). Offender and offense characteristics of sexual sadists: A comparative study. Journal of Forensic Sciences, 40, 450–455.

Grubin, D. (1994). Sexual murder. British Journal of Psychiatry, 165, 624–629.

Hazelwood, R.R. & Douglas, J.E. (1980). The lust murderer. FBI Law Enforcement Bulletin, 49, 1–5.

Hickey, E.W. (Ed.), Sex crimes and paraphilia. New Jersey: Pearson Prentice Hall.

Krafft-Ebing, R. von (1886). Psychopathia sexualis (C.G. Chaddock, Trans.). Philadelphia: F.A. Davis.

MacDonald, J.M. (1986). The murderer and his victims (2nd Edition.). Springfield, IL: Charles C Thomas.

Malmquist, C.P. (1996). Homicide: A psychiatric perspective. Washington, DC: American Psychiatric Press.

Money, J. (1990). Forensic sexology: paraphilic serial rape (biastophilia) and lust murder (erotophonophilia). American Journal of Psychotherapy, 44, 26-36.

Proulx, J., Blais, E., & Beauregard, E. (2005). Sadistic sexual offenders. In J. Proulx, E. Blais, & E. Beauregard (Eds.), Sexual murderers: A comparative analysis and new perspectives (pp. 107–122). Chichester, UK: Wiley.

Proulx, J., Blais, E., & Beauregard, E. (2006). Sadistic sexual aggressors. In W.L. Marshall, Y.M. Fernandez, L.E. Marshall, & G.A. Serran (Eds.), Sexual offender treatment: Controversial issues (pp. 61–77). Chichester, UK: Wiley.

Ressler, R.K., Burgess, A.W., and Douglas, J.E. (1988). Sexual homicide: Patterns and motives. New York: Free Press.

Schlesinger, L.B. (2004). Sexual murder: Catathymic and compulsive homicides. London: CRC Press.

Shrink rap: A beginner’s guide to Koro in females

In a previous blog, I examined Koro (the so-called genital retraction syndrome). This is a culture-bound syndromes found primarily in Asian regions (e.g., China, Singapore, Thailand, India). Koro refers to a kind of “genital hysteria” with “terror stricken” individuals (typically male) believing that that their genitals are shriveling, shrinking up, retracting into the abdomen and/or disappearing, and that this ultimately leads to death. Writing in a 1997 issue of the Journal of Psychology and Human Sexuality, Dr. J.T. Cheng noted of Koro that it:

“Is best perceived as a social malady supported by cultural myths which tend to affect young people who are deprived of proper sex information to explain their physical development”.

Koro is rarely described in women but published case studies in the academic literature do exist. All of these female cases report that the affected women reported the shrinking of the vulval labia, nipples, and/or the breasts. The interesting thing about Koro is that all the body parts affected (penis in males; breasts, nipples and labia in women) are those that naturally swell and shrink in response not only in relation to sexual arousal but also in response to temperature and climate changes, depression, anxiety, stress, fear, illness, and/or psychoactive drug ingestion.

Most Koro epidemics while primarily comprising males always appear to involve a small minority of females. For instance, Dr. Robert Bartholomew’s book Exotic Deviance reports the Koro epidemic that occurred in northeast Thailand at the end of 1976 that affected approximately 2,000 people (primarily rural Thai residents in the border provinces of Maha Sarakham, Nakhon Phanom, Nong Khai and Udon Thani). As with most Koro epidemics, the symptoms included the perception of genital shrinkage and impotence among males, whereas females typically reported sexual frigidity, with breast and vulva shrinkage. The origins of the epidemics can vary and include the supernatural. For instance, in a 1986 issue of the journal Curare, Dr. W.G. Jilek described an atmosphere of collective fear of ghosts during a Koro epidemic in Zhanjiang town (Guangdong in China). Those affected believed that ghosts would make the genitals of men and breast of women shrink and disappear into the abdomen and chest. To end the Koro epidemic, the villagers’ drove the ghosts out of their village used drum-beating, bell ringing and bursting of firecrackers.

In 2005, Vivian Dzokoto and Glenn Adams published a paper in Culture, Medicine and Psychiatry examining genital shrinking epidemics in West Africa. More specifically, they examined all media reports of genital shrinking in six West African nations between January 1997 and October 2003 (comprising a total of 56 media reports). Most of the reports were of males but Dzokoto and Adams noted that three Ghanaian news reports included females. All three women reported experiencing shrinking breasts and/or changes to their genitalia. They also noted that:

“One report described a woman whose ‘private parts sealed.’ Another report described a woman who reported that her genital organ (unspecified) was vanishing. Again, it is unclear whether references to sealing and vanishing of female genitalia represent different ways of describing the same experience or represent qualitatively distinct forms of subjective experience.In all reported cases, experience of symptoms tended to be brief and acute. There were no reported cases of recurrence”.

The earliest report of Koro in a female was arguably be in a 1936 book chapter entitled ‘Psychiatry and Neurology in the Tropics’ by Wulfften Palthe. Since then there have been sporadic reports of female Koro in the literature. One of the more notable cases reported was by Kovács and Osváth in a 1998 issue of the journal Psychpathology. This case was unusual because it was a case of genital retraction syndrome in Hungary (although the woman reported was a Korean woman by background).

In a 1982 issue of the Indian Journal of Psychiatry, Dr. D. Dutta and colleagues reported on the (then) recent epidemic of Koro that occurred in four districts of Assam (June 1982 to September, 1982). The 83 cases they reported included 19 females. Interestingly, all the female Koro cases in this particular sample believed it was their breasts that were affected in some way. More specifically, Dr. Dutta and his team reported that:

“9 out of 19 female cases (47.3%) suffered from genital symptoms in form of shrinkage or pull of the breast. Not a single female complained of labial shrinkage. 12 out of 19 cases (69.1%) reported retrosternal pain and other anxiety symptoms subsequently leading to dissociation of varying degree and duration”.

In 1994, Dr. Arabinda Chowdhury (who has written lots of papers on the topic of Koro) published a paper in the journal Transcultural Psychiatry comprising an analysis of 48 cases of female Koro (based on a population of women that claimed to have Koro in an Indian epidemic in the North Bengal region). In females, Dr. Chowdhury noted that “the cardinal symptom is the perception of retraction or shrinkage of nipple or breast mass into the chest cavity or of labia into the abdomen with acute fear of either imminent death or sexual invalidism”. This was the first paper in the world literature to explore the detailed clinical characteristics of Koro in females. Before examining the individual cases, Dr. Chowdhury examined the gender distribution in seven Koro epidemics. The following statistics were reported: Singapore (1969; 469 cases, 15 female), Thailand (1978; 350 cases, 12 female), Indonesia (1978; 13 cases, 2 female), India (1982; 83 cases, 19 female), India (1985; 31 cases, 13 female), India (1988; 405 cases, 48 female) and China (1988; 232 cases, 37 female).

Dr. Chowdhury reported that of the 48 female cases (aged 8 to 54 years), the mean age was nearly 24 years. In relation to Koro, 56% reported retracting nipples (both breasts in all but two cases), 13% reported a flattening of their breasts, 8% reported a retraction in both breasts, 8% reported a pricking sensation in both breasts, 8% reported retraction of the labia, and 5% reported vaginal pain.

It appears that in the same that penis size seems to be a near-universal concern and/or obsession of men, women also share a similar fear, but with different sexual body parts (i.e., vulvas, breasts, and nipples). All of these body parts in males and females (i.e., penis, scrotum, breasts, nipples) are physiologically capable of changing size not only in relation to sexual arousal but also from other non-sexual factors (temperature and climate change, anxiety, depression, stress, fear, illness, and/or psychoactive drug ingestion/intoxication).

One literature review of 84 case reports of Koro (and Koro-like disorders) published in a 2008 issue of the German Journal of Psychiatry by Dr. Petra Garlipp (Hannover Medical School Germany) concluded that there were two unifying features of the case reports cited in the clinical literature. These were (i) the diversity in relation to the clinical picture, the underlying mental disorder, the treatment approach and their classification and nomenclature chosen, and (ii) the symptom of fear.

In response to Dr. Garlipp’s paper, Dr. Arabinda Chowdhury noted that by only using published case studies, female Koro was hardly discussed (because most data about female Koro comes from data collected during Koro epidemics rather than case study interview data). why the review had been so biased towards males. Based on his own research, Dr. Chowdhury wrote that there were at least 146 female Koro case reports from seven epidemics in the years 1969 to 1988. He believed the large number of cases involving women offered many interesting clinical issues in the female expression of Koro, which should have been included in Garlipp’s review. His view was that the differences between male and female Koro in relation to psychodynamics, presentation and associated clinical features of Koro would have made Garlipp’s paper “more interesting”. However, Dr. Chowdhury’s paper didn’t mention what these differences were. Maybe there is not the data to do this. Although it is known that episodes of female Koro can endure for weeks or months, the origin of female anxiety over the absorption of their sex organs is at present unclear.

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

Further reading

Bartholomew, R. (2000). Exotic Deviance: Medicalizing Cultural Idioms from Strangeness to Illness. Boulder: University of Colorado Press.

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

Chowdhury, A.N. (1994). Koro in females: An analysis of 48 cases. Transcultural Psychiatry, 31, 369-380.

Chowdhury, A.N. (2008). Ethnomedical concept of heat and cold in Koro: study from Indian patients. World Cultural Psychiatry Research Review, July, 146-158.

Chowdhury, A.N. (2008). Cultural Koro and Koro-Like Symptom (KLS). German Journal of Psychiatry, 11, 81-82

Cheng, S.T. (1997). Epidemic Genital Retraction Syndrome: Environmental and personal risk factors in Southern China. Journal of Psychology and Human Sexuality, 9, 57-70.

Dutta, D., Phookan, H.R. & Das, P.D. (1982). The Koro epidemic in Lower Assam. Indian Journal of Psychiatry, 24, 370-374.

Dzokoto, V.A. & Adams, G. (2005). Understanding genital-shrinking epidemics in West Africa: Koro, Juju, or mass psychogenic illness? Culture, Medicine and Psychiatry, 29,53-78.

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

Jilek, W.G. (1986). Epidemic of “Genital Shrinking” (Koro): Historical review and report of a recent outbreak in south China. Curare, 9, 269-282.

Kar, N. (2005). Chronic koro-like symptoms – two case reports. BMC Psychiatry, 5, 34 (doi:10.1186/1471-244X-5-34).

Kovács, A. & Osváth P. (1988). Genital retraction syndrome in a Korean woman. A case of Koro in Hungary. Psychopathology, 31, 220-224.

Lehman, H. E. (1980). Unusual Psychiatric disorders. In: A.M. Freedman, H.I. Kaplan & B.J. Sadock (Eds.). Comprehensive Textbook of Psychiatry (Third Edition, Vol. II). Baltimore: Williams and Wilkins.

Palthe, P.M. (1936). Psychiatry and Neurology in the Tropics. In: C.D. de Langen and A. Lichtenstein (Eds.), A Clinical Textbook of Tropical Medicine (pp. 525-547). Batavia: G. Kolff and Company.

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

That smoke isn’t funny any more: Nicotine addiction and the ‘Stoptober’ campaign

Although most of my academic research is on behavioural addiction, I do publish the odd paper here and there are on more traditional addictions such as alcohol and nicotine addiction (particularly in relation to the relationship to behaviours like gambling). Over the last few months (on a personal rather than level) I have thought a lot about nicotine addiction as I have had to watch my mother fight a losing battle with smoking-related lung cancer and chronic obstructive pulmonary disease. She died last Saturday (September 8th, 2012 aged 66 years) and had chain-smoked most of her adult life. This followed the death of my father who also died of smoking-related heart disease (aged 54 years).

Last week, the British government’s Department of Health (DoH) launched the Stoptober campaign urging as many nicotine smokers as possible to give up smoking for 28 days from October 1st. This is the first time ever that such an innovative campaign has been launched on a national basis, and the DoH website claims that “people who stop smoking for 28 days are five times more likely to stay smoke free” compared to those that don’t give up for such a long period (I’m not sure on what empirical evidence that is based but it sounds reasonable). Those that decide to try and stop for the month will be given a lot of encouragement during the four-week period including access to the Smokefree Facebook page, and a downloadable Stoptober app. Those signing up to stop will also be sent daily emails providing additional encouragement. At present in the UK, smoking accounts for approximately one in four cancer deaths (and as I said, it’s something I’ve witnessed first hand).

I’m sure most people reading this are aware of the addictive nature of nicotine (it was one of the main reasons why my parents were never able to stop). As soon as nicotine is ingested via cigarettes, it can pass from lungs to brain within 10 seconds (and stimulates the release of the neurotransmitter dopamine). The release of dopamine into the body provides reinforcing mood modifying effects. Despite nicotine being a stimulant, many people use cigarettes for both tranquillising and euphoric effects. Most authorities accept that nicotine is one of the most addictive drugs on the planet and that smokers can become hooked quickly. One of the reasons my own parents were never able to give up was because of the prolonged withdrawal effects they experienced whenever they went more than a few hours without smoking. This would lead to intense cravings for a cigarette.

For those of you out there with an addiction to nicotine, I thought I would provide my 10 golden tips that may help you in taking steps towards giving up for good. The tips are not foolproof and I failed with my own parents. However, that doesn’t mean you shouldn’t give it a go.

  • Develop the motivation to stop smoking: Many smokers say they would like to stop but don’t really want to. When you take stock, make sure you are clear as to why you want to give up. It may be to save money, to improve your health, to prevent yourself getting a smoking-related disease, or to protect your family from passive smoking. (It could of course be all of the above). Really wanting to give up is the best predictor of successful smoking cessation.
  • Get all the emotional support you can get: Another good predictor of whether someone will overcome their addiction to nicotine is having a good support network. You need people around you that will support your efforts to quit. Tell as many people that you know that you are trying to quit. It could be the difference between stopping and starting again.
  • Avoid ‘cold turkey’: Although some people can stop through willpower alone, most people will need to reduce their nicotine intake slowly. Gradually cutting down the number of cigarettes smoked per day is a good starting strategy.
  • Use nicotine replacements: Cutting out nicotine completely is hard, so consider using some kind of nicotine replacement. Nicotine patches, chewing gums, and lozenges will help inhibit the cravings and will help you stabilize your behaviour.
  • Use non-nicotine shaped cigarette substitutes: Smoking is also a habitual behaviour where the feel of it in your hands may be as important as the nicotine it contains. The use of plastic cigarettes or e-cigarettes will help with the habitual behaviour associated with smoking but contain none of the addictive nicotine.
  • Use relaxation techniques: When cravings strike, use relaxation exercises to help overcome the negative feelings. At the very least take deep breaths. There are dozens of relaxation exercises online. Practice makes perfect.
  • Treat yourself: One of the immediate benefits of stopping smoking will be the amount of money you save. At the start of the cessation process, treat yourself to rewards with the money you save.
  • Focus on the positive: Giving up smoking is one of the hardest things that anyone can do. Write down lists of all the positive things that will be gained by stopping smoking. Constantly remind yourself of what the long-term advantages will be that will outweigh the short-term benefits of smoking a cigarette. In short, focus on the gains of stopping rather than what you will miss about cigarettes.
  • Know the triggers for your smoking: Knowing the situations that you tend to smoke can help in overcoming the urges to smoke. Lighting up a cigarette can sometimes be the result of a classically conditioned response (e.g., having a cigarette after every meal). These often occur unconsciously so you need to break the automatic response and de-condition the smoking. You need to replace the unhealthy activity with a more positive one and re-condition your behaviour.
  • Fill the void: One of the most difficult things when cigarette craving and withdrawal symptoms strike is not having an activity to fill the void. Some things (like engaging in physical activity) may help you in forgetting about the urge to smoke. Plan out alternative activities and distraction tasks to help fill the hole when the urge to smoke strikes (e.g., chew gum, eat something healthy like a carrot stick, call a friend, occupy your hands, do a word puzzle, etc.). However, avoid filling the void with other potentially addictive substances (e.g., alcohol) or activities (e.g., gambling).

Watching both my parents’ die of smoking-related diseases is enough incentive for me to never smoke a cigarette. Hopefully, you can find the incentives you need to help you give up permanently.

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

Further reading

BBC News (2012). ‘Stoptober’ stop-smoking campaign launched in England. BBC Health News, September 8. Located at:

Department of Health (2012). Stoptober campaign will encourage smokers to quit for 28 days. September 8. Located at:

Griffiths, M.D. (1994). An exploratory study of gambling cross addictions. Journal of Gambling Studies, 10, 371-384.

Griffiths, M.D. (1994). Co-existent fruit machine addiction and solvent abuse in adolescence: A cause for concern? Journal of Adolescence, 17, 491-498.

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

Griffiths, M.D., Parke, J. & Wood, R.T.A. (2002). Excessive gambling and substance abuse: Is there a relationship? Journal of Substance Use, 7, 187-190.

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

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

Resnick, S. & Griffiths, M.D. (2010). Service quality in alcohol treatment: A qualitative study. International Journal of Mental Health and Addiction, 8, 453-470.

Resnick, S. & Griffiths, M.D. (2011). Service quality in alcohol treatment: A research note. International Journal of Health Care Quality Assurance, 24, 149-163.

Resnick, S. & Griffiths, M.D. (2012). Alcohol treatment: A qualitative comparison of public and private treatment centres. International Journal of Mental Health and Addiction, 10, 185-196.

Sussman, S., Lisha, N. & Griffiths, M.D. (2011). Prevalence of the addictions: A problem of the majority or the minority? Evaluation and the Health Professions, 34, 3-56.

Umeh, K. & Griffiths, M.D. (2001). Adolescent smoking: Behavioural risk factors and health beliefs. Education and Health, 19, 69-71.

Blind faith: A brief overview of amaurophilia

“I have a blindness fetish. It’s something I’ve been obsessed with it all my life. Also, I would consider my sexual orientation to be asexual. I’m really not at all turned on by guys and I have no interest in sex – in fact, it honestly disgusts me. However, when indulging in my fetish, I do masturbate” (Susan at All Experts)

According to Dr.Anil Aggrawal in his 2009 book Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices amaurophilia is a sexual paraphilia where the individual derives sexual pleasure and arousal “by a partner who is blind or unable to see due to artificial means such as being blindfolded or having sex in total darkness”. A similar definition of amaurophilia was provided by Dr. Brenda Love in her Encyclopedia of Unusual Sex Practices who simply defined it as “a preference for a blind or blindfolded sex partner”.  She also added one exclusion criterion that if both partners are blind, then it wouldn’t be classed as amaurophilia. Dr. Love also made reference to a similar paraphilia called lygerastia, which refers to those individuals who derive sexual pleasure and arousal only in darkness. The critical similarity in both of these is that the individuals in question are sexually aroused by sexual partners who are unable to see them.

Amaurophilia is yet another paraphilia where there has been no academic and/or clinical research most probably because the focus of sexual arousal is fairly innocuous and it is highly unlikely people would come forward wanting any kind of treatment (i.e., amaurophiles are likely to live with their sexual preference without any problem). Most of what is known appears to be somewhat anecdotal. Brenda Love also wrote that:

“Amaurophilia usually manifests itself by an inhibition of sight with either one or both partners using a blindfold or having sex in total darkness. This might be caused by reasons such as religious guilt about nudity and sex, low self-esteem, or feelings of inadequacy. Other amaurophiles may have become conditioned to respond sexually only when a partner is asleep or has their eyes closed. They may have had childhood experiences of sex with siblings who were either sleeping or feigning sleep. Necrophiles also may be aroused by their partners keeping their eyes closed, but would further require a lack of movement”.

Much of this – while plausible – appears to be highly speculative. The comments about “childhood experience of sex with siblings” is unlikely to be a common factor among amaurophiles and in papers that I have read on sex between siblings, I have never seen a single reference to amaurophilia as a consequence. The comments in relation to sexual arousal while someone is asleep (i.e., somnophilia) and necrophilia again have no basis in empirical evidence (although I did talk about the psychological and behavioural overlaps between somnophilia and necrophilia in previous blogs). Dr. Love also notes that there may be other medical conditions that underlie amauarophilia. For instance:

“There is also a natural physical condition that causes people discomfort when attempting sex under bright lights. This discomfort can be great enough to interfere with some people’s sexual performance. An advantage of darkness is that tactile stimulation can reach the greatest sensitivity when all other senses are inhibited, particularly light”

Other online sources note that amaurophilia is extremely rare and that for some people, the simulation and/or role-playing of having sex with someone who is blind is also a sexual turn-on. This can be achieved with a wide range of accessories including sleep shades, blindfolds, eye patches, and/or or vision-restricting contact lenses. Furthermore, partners may swap roles.  One short online article claimed that:

“Some amaurophiliacs may even extend this play outside of sex through the use of blindfolds or contact lenses in conjunction with a white cane for mobility. Some amaurophiliacs may choose to learn Braille in order to enhance their experience during play sessions”.

This type of behaviour (if true – and I have yet to find any empirical evidence that it is) is very similar to the psychology and behaviour of ‘pretenders’ of the ‘DPW’ typology (i.e., “devotees, pretenders and wannabes”) that I wrote about previously in relation to apotemnophilia (i.e., those who derive sexual pleasure and arousal from the thought of being an amputee). Much of the psychology here is about the one-to-one attention that being disabled can bring and has been linked to factitious disability disorders such as Munchausen’s Syndrome. Should amaurophiles be like apotemnophiles, and based on the research of Dr. Robert Bruno, Director of the Post-Polio Institute (New Jersey, US) I would expect the following DPW characteristics:

  • Devotees would be non-blind people who are sexually attracted to people who are blind, typically those with obvious signs of blindness (i.e., use of white cane, guide dog, and/or dark glasses).
  • Pretenders would non-blind people who act as if they are blind by using assistive devices (e.g., white cane). This may be done in private or in public so that they can ‘feel’ blind or are perceived by others as being blind.
  • Wannabes would be people who actually want to become blind, going to extraordinary lengths to achieve it (e.g., self-enucleation). (There are clinical and medical cases of enucleation but none of those I have read are amaurophilia-related).

As with most other ‘niche’ fetishes and paraphilia, online communities of like-minded individuals have developed such as the Blind-Fetish Live Journal and the Blind One’s websites. Their page is “devoted to those with an interested in blindness and blindfolds from an erotic point of view”. The site’s founder informs readers that if they think amaurophilia “ is weird or sick, you don’t have to look at this page. I feel a bit weird about it myself, but for some reason I am really turned on by blind or blindfolded women”. Here are some insights I have come across online from self-confessed amaurophiles:

  • Extract 1: “For me, although I do enjoy blindfolding and being blindfolded, I am specifically interested in blind people. I don’t know why I feel that way. I’ve read that people who are attracted to the disabled are trying to save people they perceive as helpless. I don’t feel that way, and I don’t treat blind people like they’re helpless. I know they’re not, and I probably screw up sometimes, because everything you do is bound to offend someone, but I try to treat everyone the same… At some point, though, when I was young, a blind person or fictional character probably just had a big effect on me. Blindness just became another trait that I enjoy, like dark hair, and blind people are just as likely to love sex and be kinky as someone with dark hair”
  • Extract 2: “My particular interest deals with limitations of vision. All my life, I have found the experience of wearing a blindfold or some similar item to be very enjoyable. A couple of years ago, when I found that I needed glasses to see properly, I began to develop more of an interest in blindness”
  • Extract 3: I also have a blindness fetish. I would like to find someone who would agree to wear contacts that made them blind so that I could watch them try to make their way around without sight. I would also enjoy hurting them without them being able to see when it was coming. I might make him complete tasks for me blind so I could watch him struggle. With contacts instead of a blindfold I could still fully see their facial expressions, which are very important to me. Then I would be aroused enough to have sex with them. I would want them to still wear the contacts during sex so I was in complete control”

Unfortunately, very few of the accounts I have come across give any real indication as to how their blindness fetish developed. Should empirical research be carried out, the etiology and motivations for blindness fetishes would certainly be an obvious place to start.

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.

All Experts (2012). Fetishism/Amaurophilia. February 22. Located at:

Bruno, R.L. (1997). Devotees, pretenders and wannabes: Two cases of Factitious Disability Disorder. Journal of Sexuality and Disability, 15, 243-260.

Bukhanovsky, A.O., Hempel, A., Ahmed, W., Meloy, J.R, Brantley, A,C., Cuneo, D, Gleyzer, R., & Felthous, A.R. (1999). Assaultive eye injury and enucleation. Journal of the American Academy of Psychiatry and Law, 27, 590-602.

First, M.B. (2005). Desire for amputation of a limb: Paraphilia, psychosis, or a new type of identity disorder. Psychological Medicine, 35, 919–928.

Love, B. (1992). Encyclopedia of Unusual Sex Practices. Fort Lee, NJ: Barricade Books.

Wikibin (2012). Amaurophilia. Located at:

The needle and the damage done: An overview of musomania

“Music acts on our emotions and feelings. Drugs act on our emotions and feelings. We generally recognise that the feelings created by drugs are not ‘real’. Does the same apply to music? Is music a drug?” (Philip Dorrell, 2005; author of ‘What is Music? Solving a Scientific Mystery’)

This opening quote from Philip Dorrell is something that I have pondered many times – especially because people that know me can vouch that I am a self-confessed music obsessive. Today’s blog is based on an article that I had published in this month’s issue of Record Collector magazine on music mania and addiction. Although most lists of manias include ‘musomania’ (i.e., an obsession with music), there is very little in the way of academic or clinical literature on the topic. Jillyn Smith in her 1989 book Senses and Sensibilities interviewed Michael Koss (at the time, the President of the Koss Stereo Headphone Corporation. He was quoted as saying:

“The excitement that people, especially teenagers, get from high-decibel music results from activation of the peripheral nervous system by low frequency sound waves beating against the body…people can get ‘high’ from this feeling, because it switches on the body’s fight or flight mechanism, bringing a rush of adrenalin (a reason for battle music)”

There are certainly anecdotal reports of people being obsessed and/or ‘addicted’ to music’. One notorious case, is a Swedish man in his forties (Roger Tullgren) who receives state benefits from the Employment Service because of his ‘addiction’ to heavy metal music. Tullgren (with the help of three occupational psychologists) campaigned for ten years to get his condition classed as a ‘handicap’ so that he would not be discriminated against. In 2006 he claimed to have attended almost 300 heavy metal gigs and constantly missed work as a consequence. He was then sacked from his job because of his continual inability to turn up for work. With the help of psychologists, his lifestyle was subsequently classed as a disability (which in turn meant he was entitled to wage supplements). He now works at a hotel washing up and has been given a special dispensation to listen to heavy metal while he works. Other Swedish psychologists have found the ruling strange. Quoted in a Swedish newspaper, The Local, one unnamed male psychologist was reported to have said:

“I think it’s extremely strange. Unless there is an underlying diagnosis it is absolutely unbelievable that the job centre would pay out. If somebody has a gambling addiction, we don’t send them down to the racetrack. We try to cure the addiction, not encourage it”.

Part of me can empathize with Tullgren as I too constantly play music while I am working, and I play my i-Pod whenever I am in transit. However, my love of music has never interfered with my job, and as far as I am concerned there are no negative detrimental effects as a consequence of my excessive listening to music. However, that doesn’t mean that some people may not be addicted to music. In an online essay, Philip Dorrell explored the question theoretically and noted:

“For drugs like heroin, the notion of addiction is relatively uncontroversial…For a not-quite-so-strong drug like cocaine, it becomes less clear as to where the boundary between regular use and addiction lies. Looking at the more popular alcohol, some people get addicted to it, and some don’t…There is the weaker notion of “psychological dependence”, which implies that you will miss not having something, but not to the extent that you would deem yourself to be suffering. I think that might be a fair description of many people’s relationship with music…So, is music a drug? The short answer is ‘yes, sort of’”.

For Dorrell, the long answer to the question of whether music is a drug is that (theoretically) music could be considered “similar in the strength and nature of its effects to a mild recreational drug” because (i) it generates ‘false’ feelings, (ii) the maximum level of effect is roughly equivalent to a couple of ‘standard’ alcoholic drinks, (iii) it is not strictly addictive, but may cause psychological dependence, and (iv) excessive consumption can cause some health problems.

I have operationally defined addictive behaviour as any behaviour that features what I believe are the six core components of addiction (i.e., salience, mood modification, tolerance, withdrawal symptoms, conflict and relapse). I argue that any behaviour (e.g., excessive listening to music) that fulfils these six criteria can be operationally defined as an addiction. Theoretically, and in relation to “music addiction”, the six components would therefore be:

  • Salience – This occurs when music becomes the single most important activity in the person’s life and dominates their thinking (preoccupations and cognitive distortions), feelings (cravings) and behaviour (deterioration of socialised behaviour). For instance, even if the person is not actually listening to music they will be constantly thinking about the next time that they will be (i.e., a total preoccupation with music).
  • Mood modification – This refers to the subjective experiences that people report as a consequence of listening to music and can be seen as a coping strategy (i.e., they experience an arousing ‘buzz’ or a ‘high’ or paradoxically a tranquilizing feel of ‘escape’ or ‘numbing’).
  • Tolerance – This is the process whereby increasing amounts of listening to music are required to achieve the former mood modifying effects. This basically means that for someone engaged in listening to music, they gradually build up the amount of the time they spend listening to music every day.
  • Withdrawal symptoms – These are the unpleasant feeling states and/or physical effects (e.g., the shakes, moodiness, irritability, etc.) that occur when the person is unable to listen to music because they are without their i-Pod or have a painful ear infection.
  • Conflict – This refers to the conflicts between the person and those around them (interpersonal conflict), conflicts with other activities (work, social life, other hobbies and interests) or from within the individual themselves (intra-psychic conflict and/or subjective feelings of loss of control) that are concerned with spending too much time listening to music.
  • Relapse – This is the tendency for repeated reversions to earlier patterns of excessive music listening to recur and for even the most extreme patterns typical of the height of excessive music listening to be quickly restored after periods of control.

I have also argued that the temporal dimension and context of the addiction needs to be taken into account. With regard to the temporal dimension, most people can think of periods in their lives when listening to music has taken over for a short time (e.g., listening to music 12- to 16-hour days for a month). This alone does not mean that such people are addicted to listening to music. To be genuinely addictive, the activity must be something that has been sustained and have been going on over a long period of time. The difference between a healthy excessive enthusiasm and an addiction is that healthy excessive enthusiams add to life whereas addiction takes away from it.

Most recently, a 2011 study published in Nature Neuroscience reported that on a neurochemical level, the pleasurable experience of listening to music releases the neurotransmitter dopamine that is important for the pleasures associated with rewards such as food, psychoactive drugs and money. This led to many headlines in newspapers along the lines of ‘people who say that they are “addicted” to music are not lying’.

In their study, Dr. Valorie Salimpoor and her colleagues (at Montreal’s McGill University in Canada), measured dopamine release in response to music that elicited “chills”. Participants in their experiments were asked to listen to their favourite songs while their brains were being observed using a neuro-imaging technique known as Position Emission Tomography (PET). They found that changes in heart rate, skin conductance, temperature, and breathing, were correlated with how pleasurable the music was. Furthermore, their findings suggested that dopamine release was greater for pleasurable music when compared to “neutral” music. In newspaper interviews, Dr Salimpoor said:

“Dopamine is important because it makes us want to repeat behaviors. It’s the reason why addictions exist, whether positive or negative. In this case, the euphoric ‘highs’ from music are neurochemically reinforced by our brain so we keep coming back to them. It’s like drugs. It works on the same system as cocaine. It’s working on the same systems of addiction, which explain why we’re willing to spend so much time and money trying to achieve musical experiences. This is the first time that we’ve found dopamine release in response to an aesthetic stimulus. Aesthetic stimuli are largely cognitive in nature. It’s not the music that is giving us the ‘rush.’ It’s the way we’re interpreting it”.

The team also reported that just the anticipation of pleasurable music led to increased dopamine release. Therefore, this helps explain why individuals (like myself) continually repeat songs or albums all the time as we want to re-experience those sensations repeatedly.

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

Further reading

Dorrell, P. (2005). Is music a drug?, July 3. Located at:

Dorrell, P. (2005).What is Music? Solving a Scientific Mystery. Located at:

Griffiths, M.D. (2012). Music addiction. Record Collector, 406 (October), p.20.

The Local (2007). Man gets sick benefits for heavy metal addiction. June 19. Located at:

Morrison, E. (2011). Researchers show why music is so addictive. Medhill Reports, January 21. Located at:

Salimpoor, V.N., Benovoy, M., Larcher, K. Dagher, A. & Zatorre, R.J. (2011). Anatomically distinct dopamine release during anticipation and experience of peak emotion to music. Nature Neuroscience 14, 257–262.

Smith, J. (1989). Senses and Sensibilities. New York: Wiley.

Ready, teddy, go: A beginner’s guide to ursusagalmatophilia

Teddy bears and sex are two things that rarely appear in the same sentence. (Having said that, the film Ted was recently described in one film review as “rude, crude and lewd. We don’t expect our teddy bears to be like that, but foul language, weed smoking and promiscuous sex are all in a day’s work/play for the title creature in Ted”). However, earlier this year, there were many news reports of a 28-year old American man called Charles Marshall who was arrested for the fourth time since 2010 for being seen by a number of eyewitnesses having sex in public with a teddy bear in Ohio. On this latest occasion he was caught in an alleyway masturbating with a teddy bear near to where he could have been seen by children. His first arrest was back in February 2010 when he was caught masturbating with a stuffed animal in a public library toilet.  In late 2010 he was caught having sex with a teddy bear for a second time and Marshall admitted in court that having sex with stuffed teddy bears had been “an ongoing problem”. This appeared to be true as in August 2011 he was caught in public yet again having sex with a teddy bear.

This type of sexual behaviour is known as plushophilia and is something I looked at briefly in a previous blog. According to Dr. Anil Aggrawal’s 2009 book Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices, plushophilia is defined as a “sexual attraction to stuffed toys or people in animal costume, such as theme park characters”. However, as I also mentioned in that article, other online sources simply define plushophilia as a sexual paraphilia involving stuffed animals (particularly those people who are self-confessed plushophiles). The reason I am focusing in on sex with teddy bears is because there is actually a paraphilia that solely relates to deriving sexual pleasure and arousal from teddy bears known as ursusagalmatophilia. The online Urban Dictionary simply defines ursusagalmatophilia as “the fetish for teddy bears”.This is not only a sub-type of plushophilia but also (given the name of the paraphilia) appears to be a sub-type of agalmatophilia (in which individuals derive sexual arousal from an attraction to statues, dolls, mannequins and/or other similar body shaped objects) – a paraphilia I also wrote about in a previous blog. Interestingly, there are now press reports surfacing that the titular hero of the film Ted is becoming a sex symbol for plushophiles.

I ought to add at this point that when it comes to teddy bears, I probably know more than most people would care to admit as (a) my mother and aunt had a teddy bear shop in the town I grew up in (The House of Bruin in Loughborough, England) when I was younger, (b) my uncle [Frank Webster] is a renowned teddy bear maker, and (c) my aunt [Sue Webster] used to write a regular column in the Teddy Bear Times magazine. Most lovers of teddy bears have no sexual inclinations towards them at all and their hobby is known as arctophily. (However, in some circles, arctophilia is viewed as a sub-type of zoophilia and includes humans having sex with real bears).

As far as I can ascertain, there is no academic or clinical research on ursusagalmatophilia, although as the newspaper story on Charles Marshall (above) highlights, it does appear to exist, even if it is rare. It is also featured in most online lists of top 10 or top 20 weirdest fetishes and paraphilias (such as the ones as Coed Magazine, Pop Crunch, Dating Dish, Paraphilia Dramatica, Plucky Charms)

I’ve searched every database I can think of to get some information about teddy bear fetishes but there really isn’t a lot out there. You can certainly buy teddy bear fetish fiction on legitimate sites such as Amazon (such as Jade Scott’s short story – Taming My Teddy Bear: An Erotic Story) but it’s hard to know if such fiction is based on anything other than one person’s fantasy or whether it’s written from the position of personal experience. In one of the few online articles about ursusagalmatophilia, Toddy English wrote about her relationship with Adam, an ursusagalmatophile:

“He started showing me pictures of all these teddy bears. The photos of the Teddy Bears were really cute. I just found it bizarre that all of his wallet photos were of teddy bears. One of them was of him sitting on his bed surrounded by Teddy bears. Adam also had a picture of a really big bear (life-sized) that he named Robbie.I thought nothing about it, initially. It seemed innocent enough…That was until he told me what he liked to do with those damn bears. [Adam] got aroused having oral and anal copulation with ‘Robbie’…He further elaborated that he had been in actual threesomes with Robbie…At first I thought he was playing. But as he continued his expression never changed. Adam was being for real. Hell, the way he discussed it he LOOKED like he was getting turned on…I asked Adam had he ever had sex without a bear around. He answered honestly and said no”

Again, this is a second-hand account based on one person’s perception of another person’s behaviour. The first person account presented by English again suggests teddy bear fetishes exist, but there is no third party verification. Unless a person’s fetish becomes a criminal behaviour (like that of Charles Marshall), the behaviour is unlikely to be the topic of scientific investigation any time soon.

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.

Evans, K. (2008). The furry sociological survey. Located at:

FoxWolfie Galen’s Plushie Page (2012). Definitions. Located at:

Hill, D. (2000). Cuddle time: In the world of plushophiles, not all stuffed animals are created equal. Salon, June 19. Located at:

Peltzman, L. (2012). Ted’s titular bear is a sex symbol to some, an abomination to others. Gawker, June 30. Located at:

Rust, D.J. (2001). The sociology of furry fandom. Located at:

Show, C. (2012). Man arrested for the fourth time for having sex with a teddy bear in public. Daily Mail, June 15. Located at:

Wiki Fur (2012). Plushophilia. Located at:

Norse power: A brief look at Berserker rage

Ever since I was a young kid, I have used the word ‘beserk’ (to describe someone going into a mad, wild, uncontrolled and violent rage) in my day-to-day language. However, it wasn’t until I was in my teens when I bought the Gary Numan albums The Fury and Beserker that I came to realize the origin of the word.

Beserker rage is a culture-bound condition historically affecting Norsemen. The condition manifested itself among males only as an intense fury and rage (berserkergang, i.e., “going beserk”) and mostly occurred in battle situations (but could also occur when they were engaged in labour-intensive work). Dating back as far as the ninth century, the berserker Norse Warriors were alleged to be able to perform almost seemingly impossible super-human feats of strength. Nowadays, the word ‘berserker’ refers to anyone that fearlessly fights with a disregard to their own lives. Similar conditions have been noted in other cultures. For instance, the Irishman Cúchulainn (“Culann’s Hound”) was recorded as displaying ‘battle frenzy’ and ‘foaming at the mouth’ akin to berserkers in texts such as The Tain. The Malay phenomenon of ‘running amok’ (i.e., running mad with rage) also appears to bear a close resemblance to berserkers.

Those displaying beserker behaviour 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. The condition of berserkergang was described in the thirteenth century by Icelandic poet Snorri Sturluson:

“[Odin’s] men rushed forwards without armour, were as mad as dogs or wolves, bit their shields, and were strong as bears or wild oxen, and killed people at a blow, but neither fire nor iron told upon them. This was called Berserkergang”.

The ravenous self-induced rage before battle commenced enabled the Norsemen to indiscriminately ‘loot, plunder and kill’. 
A recent book about the Vikings claimed that some battle chiefs held their berserkers “in reserve” during a battle. The berserkers were only sent into fight if one section began to weaken. An article on berserkers in the Journal of World History by Dr. M. Speidel noted that Norse berserkers were very effective killers, but could not stop killing at will. Apparently, their berserker state was only turned off once all members of the opposition were dead. László Kürti, in a 2004 encyclopedia entry on shamanism claimed that berserker is a regional form of present-day shamanism that utilizes archaic Nordic techniques – particularly the ability to go into a trance-like state.

Various theories about the causes of the condition have been speculated. Some have alleged that psychoactive drugs (such as hallucinogenic agaric mushrooms or copious alcohol drinking) were used. Some botanists claim that berserker behavior can be caused by the ingestion of the plant bog myrtle, one of the main spices in Scandinavian alcoholic beverages. Other theories speculate either pre-existing genetic and/or medical conditions or pre-existing psychological disorders (e.g., mental illness, manic depression [i.e., bipolar disorder], epilepsy). Some have even speculated that the fury may just be a consequence of post-traumatic stress. For instance, clinical psychiatrist Dr. Jonathan Shay wrote in his 1994 book Achilles in Vietnam:

“If a soldier survives the berserk state, it imparts emotional deadness and vulnerability to explosive rage to his psychology and permanent hyperarousal to his physiology –  hallmarks of post-traumatic stress disorder in combat veterans. My clinical experience with Vietnam combat veterans prompts me to place the berserk state at the heart of their most severe psychological and psychophysiological injuries”

Professor Jesse L. Byock claimed in a 1995 issue of Scientific American, that berserker rage could perhaps have been a symptom of Paget’s Disease (i.e., uncontrolled skull bone growth that often causes painful pressure in the head). However, there doesn’t seem to be any conclusive evidence of this.

Other more esoteric theories surround spiritual and/or supernatural beliefs. For instance, some scholars have claimed that the Vikings believed in spirit possession and that berserkers were possessed by the animal spirits of wolves and/or bears. According to some theorists, berserkers learned to cultivate the ability to allow animal spirits to take over their body during a fight (an example of animal totemism) that also involved drinking the blood of the animal that they wished to be possessed by.

Back in 1987, Dr. Armando Simon published a paper in the journal Psychological Reports and argued that berserker rage (or as he termed it ‘Blind Rage Syndrome’) should be incorporated into the Diagnostic and Statistical Manual of Mental Disorders. Dr. Simon characterized the condition as (i) violent overreaction to physical, verbal, or visual insult, (ii) amnesia during the actual period of violence, (iii) abnormally great strength, and (iv) specifically target oriented violence. Some case studies are presented and a parallel is made with the Viking Berserkers of the Middle Ages. Dr. Simon also claimed that the condition had typically been diagnosed as part of other violent disorders (such as intermittent explosive disorder). However, it looks unlikely that berserkers will be making a separate entry into the DSM anytime soon.

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

Further reading

Armando, S. (1987) the berserker/blind rage syndrome as a potentially new diagnostic category for the DSM-III. Psychological Reports, 60, 131-135.

Kürti, L. (2004). Shamanism – Neo (Eastern Europe). Located at:

Nationmaster (2012). Berserker. Located at:

Shay, J. (1994). Achilles in Vietnam. New York: Scribner.

Simon, A. (1987). The berserker/blind rage syndrome as a potentially new diagnostic category for the DSM-III. Psychological Reports, 60, 131-135.

Speidel, M. (2002). Berserks: A history of Indo-European ‘mad warriors’. Journal of World History 13, 253-290.

Wikipedia (2012). Berserker. Located at:

Dressed to thrill: A brief look at clothing fetishes

Earlier this year, the Huffington Post reported a story that got me thinking about the relationship between clothing and sexual arousal. The news item reported that an ‘intimacy dress’ had been designed by Daan Roosegaarde that detects when the person wearing it is feeling aroused. It was reported that:

“The futuristic ‘Intimacy 2.0’ design is made of hi-tech fabric, leather and opaque e-foils and becomes transparent when it ‘detects’ a quickening heartbeat. The technical dress, dubbed ‘techno-poetry’ by the designer himself, operates with the help of wireless technology, LEDs and various electronics. Talking about his saucy design, Roosegaarde told the Daily Mail that ‘Intimacy 2.0 is a fashion project exploring the relation between intimacy and technology. Technology is used here not merely functional but also as a tool to create intimacy as well as privacy on a direct, personal level which in our contemporary tech society is becoming increasingly important’”.

Whether the dress serves any real practical purpose is debatable but clothes have long been a source (in and of themselves) as a source of sexual arousal and fetishization. In fact, the term ‘fetish fashion’ has now permeated into popular usage and related to any style or appearance in the form of a type of clothing and/or accessory that has been created to be deliberately extreme and/or provocative.

Clothing fetishes are sexual fetishes where individuals derive sexual arousal and pleasure from either (i) viewing or imagining very specific items of clothing, (ii) viewing or imagining a set of clothes (e.g., a particular uniform or fashion look), and/or (iii) individuals (themselves or others) wearing the clothing item or uniform. As with other fetishes, the item that the individual has fixated upon normally has to be present for sexual arousal to occur. The source of the arousal may also depend on the material from which the clothing items are made and/or the function of the clothing on the person wearing them (e.g., clothes that may restrict a person’s movement, or may accentuate a particular attribute of the body). Some clothing fetishists also collect particular clothing items.

In a previous blog on fetishism, I wrote at length about a study led by Dr G. Scorolli (University of Bologna, Italy) on the relative prevalence of different fetishes using online fetish forum data. It was estimated (very conservatively in the authors’ opinion), that their sample size comprised at least 5000 fetishists because fetishists may be subscribed to many fetish forums (but was likely to be a lot more). Their analysis included a breakdown of sexual preferences for objects associated with the body including clothing. Excluding footwear – which is associated more specifically with podophilia (i.e., foot fetishism) – the results of the study showed that the most fetishized items of clothing were underwear (12%; 10,046 fetishists), whole body wear such as coats, uniforms (9%, 9434 fetishists), upper body wear such as jackets, waistcoats (9%, 9226 fetishists), and head and neckwear such as hats, ties (3%, 2357 fetishists). From this particular study, the authors concluded that the most common clothing fetishes are footwear, underwear (including swimwear), and uniforms.

Clothing fetishes are known to overlap with other sexual paraphilias including transvestite fetishism, sexual sadism and sexual masochism. Obviously it is the restrictive types of clothing that are most associated with sadomasochistic activity (and which are often made from PVC or latex). This includes very narrow skirts that impede movement (often referred to as hobble skirts that are often ankle length to make walking almost impossible), and very high heel shoes (which make it difficult to walk). Another popular item of restrictive clothing is a tight corset. Those individuals in sexually submissive roles are often forced to wear a bondage corsets (also known as a ‘discipline corset’) as a form of punishment. This is also associated the masochistic sexual practice of ‘tightlacing’ (also known as corset training and waist training) where submissive partners (typically female) are forced to wear a tightly-laced corset that result in extreme body modifications to the submissive partner’s figure and posture (e.g., ‘hourglass’ figures in which the woman looks as though they have an incredibly small waist).

Kevin Almond (University of Huddersfield) published a conference paper investigating how the body has been distorted through the cut and construction of fashionable clothing. He noted that fetishists cover their bodies in rubber cat suits or are restricted by corsetry, and that the clothing promotes levels of sexual desire and satisfaction. Valerie Steele also makes an interesting observation in her 1996 book Fetish, Fashion, Sex and Power that”

“The corset, like the shoe, was one of the first items of clothing to be treated as a fetish, and it remains one of the most important fetish fashions. But it is crucial to distinguish between ordinary fashionable corsetry, as practiced by most nineteenth century women and the very different minority practice of fetishist tight lacing”.

Excluding footwear fetishes (which are very prevalent), there are many other particular types of clothing fetish. The most well known are arguable stocking and suspender fetishes, and uniform fetishes (for instance, a woman dressing up as a nurse or a man dressing up as fireman) which I will look at in future blogs. However, there are other less reported clothing fetishes including sock fetishes, denim jean fetishes, and coat/jacket fetishes. For instance, the Wikipedia entry on jacket fetishism makes the following observations (although none of them are referenced so there are issues around to what extent the information is reliable):

“Jacket fetishism in its pure form is most usually associated with padded nylon jackets though can be associated with leather jackets, particularly in association with bondage (BDSM). Jacket fetishists are generally (but not necessarily) male and gay in the 20 to 45 age range. The fetish often revolves around the feel and look of the nylon though can also relate to elements such as: padding thickness, nylon shiny through wear, orange lining (a well known element), dirty nylon (through normal wear or sexual use), and ripping the nylon. Part of the muddy/dirty fetish can also include getting jackets dirty and then ripping them up… Whilst jacket fetishism does not have the widespread popularity of other fetishes like bondage, it is a popular niche fetish and has numerous successful websites and discussion/picture groups dedicated to it”. 

A 1999 paper by Kathleen O’Donnell in Advances in Consumer Research examined the consumption of fetish fashion and the sexual empowerment of women in a qualitative interview study involving five women self-identifies as followers of fetish fashion. O’Donnell’s conclusions were interesting and perhaps surprising: Each of them spoke of the changes in posture that occurred as they slipped into their stilettos, their corsets or their latex dresses. By forcing them to stand tall, chest held high, the fetish gear instilled in them a sense of self-confidence that many indicated they had previously lacked. As they appeared more confident, self assured, and sexy, they also experienced increased attention from others, which further increased those feelings of self-confidence. Ultimately, fetish fashions gave these women the mechanism to tap into the power of their own sexuality and for that they seemed grateful”.

This is certainly area that would benefit from more empirical research

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

Further reading

Almond, K. (2009) ‘You Have to Suffer for Fashion’: An investigation into how the body has been distorted through the cut and construction of fashionable clothing. IFFTI Journal of Conference Proceedings (pp. 197-210).

Hazell, K. (2012). Dress ‘Becomes Transparent When Wearer Is Sexually Aroused’. Huffington Post, April 5. Located at:

Kunzle, D. (2006). Fashion & Fetishism: Corsets, Tight-Lacing and Other Forms of Body-Sculpture. London: The History Press.

Kathleen A. O’Donnell (1999). Good girls gone bad: The consumption of fetish fashion and the sexual empowerment of women. In Advances in Consumer Research Volume 26, eds. Eric J. Arnould and Linda M. Scott, Provo, UT: Association for Consumer Research, Pages: 184-189.

Scorolli, C., Ghirlanda, S., Enquist, M., Zattoni, S. & Jannini, E.A. (2007). Relative prevalence of different fetishes. International Journal of Impotence Research, 19, 432-437.

Steele, V, (1996), Fetish, Fashion, Sex and Power. Oxford: Oxford University Press.

Wikipedia (2012). Fetish fashion. Located at:

Wikipedia (2012). Jacket fetishism. Located at: