Monthly Archives: October 2012

The clothes of play: A look inside the world of uniform fetishism

One of the least researched sexual fetishes is that of uniform fetishism. This is one of many different clothing fetishes (that I examined in a previous blog) where individuals are obsessed and fixated by another person’s or themselves wearing a uniform. In the section on uniforms and sexual fantasy, the Visual Dictionary of Sex (edited by Dr. Eric J Trimmer) reported that the fetish world of dressing-up involves the following in rough rank order of popularity: cheerleader, waitress, nurse, maid, secretary, office worker, schoolgirl, fitness trainer, prison guard, postal worker, military, Cleopatra, ballerina, cab driver, and nun. However, I know of no empirical research that confirms the claims made by Dr. Trimmer. A Wikipedia article on uniform fetishism also made a number of similar claims about the most common uniforms used for sexual purposes (again with no empirical evidence): police officer, soldier, schoolgirl, nurse, French maid, waitress, cheerleader and Playboy bunny. The article also made reference to some people regarding nun’s habits and aprons as uniforms.

Although there are a wide range of populist writings on sexuality and uniforms (for instance, the 1990 book Leatherfolk by Thompson discussed the dress code of leather in sexuality), there are very few academic or clinical studies. Arguably the best academic paper on uniform fetishes was published back in 1996 in the journal Sexual and Marital Therapy by Dr. Dinesh Bhugra and Dr. Padmal De Silva.

Their paper looked at the function of uniforms, and their relationship with sexual fantasy and sexual fetishism. They noted that uniforms can be seen as ‘outer skins’ that can be material and attractive in sexual terms, and that can enable individuals to display and wield power (which may be important in sexual activities involving sadism and masochism). They also note that each uniform “denotes not only an image but also a certain authority that goes with it”. Bhugra and Da Silva described the functions of uniforms as comprising the ‘five F’s’ (formal, fashion, fun, fantasy and fetish):

  • Formal – The wearing of a uniform to show belonging of a person to a particular formal group (e.g., army, navy, police, nurse, etc.)
  • Fashion – The wearing of a uniform to show belonging of a person to a more informal group (e.g., a musical allegiance such as goth, punk, heavy metal, etc.)
  • Fun and frolic – The wearing of a uniform for fun and frolics (e.g., wearing fancy dress at a party)
  • Fantasy – The wearing of a uniform to aid fantasy (often sexual) such as the evocation of masculine control (e.g., fireman) or the evocation of female nurturing and caring (e.g., nurse). Here, sexual uniform does not fulfil all the criteria for sexual fetishism.
  • Fetish – The wearing of a uniform as part of a sexual fetish where the uniform has to be worn as an aid to sexual climax. This may include (for instance) rubber, plastic and leather clothing.

The authors also note that uniforms may denote expertise (e.g., the white coat of a doctor), nurturance (e.g., the uniform of a nurse or nanny), punishment (e.g., the uniform of a police or prison officer), and identity (e.g., school uniform). Therefore, the uniform may directly relate to the sexual act being performed and add to the ‘authenticity’. For instance, a klismaphiliac may want someone dressed in a doctor’s or nurse’s uniform to administer an enema, an infantilist may want someone dressed as a nanny change his nappy, or a masochist may require someone dressed in a policeman’s or policewoman’s uniform to put on and retrain them with a pair of handcuffs. They claimed that:

“Uniform as a fetish is not uncommonly reported in clinical settings. Fetishism is a paraphilia which involves being recurrently responsive to, and obsessively dependent on, an unusual or unacceptable stimulus. In order to have a state of erotic arousal initiated or maintained, and in order achieve or facilitate an orgasm, the affected individual needs exposure to the fetish object, in reality or in fantasy”.

Based on this definition, Bhugra and De Silva are adamant that uniform fetishes can and do exist. However, the academic literature on uniforms as a fetish is sparse. In A.J. Chalkley and G.E. Powell’s (1983) in-depth study of 48 clinical cases of sexual fetishism (with a total of 122 fetishes), only one case involved uniforms (although a further 28 had some kind of clothing fetish). A previous unpublished Master’s thesis study by A.J. Chalkley (1979) reviewing 170 fetishists reported only two with a uniform fetish.

A 1999 qualitative study by Kathleen O’Donnell published in Advances in Consumer Research examined the consumption of fetish fashion and the sexual empowerment of women. Based on her qualitative interviews with five women, she found support for “the theory-based propositions that females consume fetish fashions because doing so allows them to experience more positive self evaluations, and that over time these positive evaluations result in sexual empowerment in the form of increased control over sensual experience and sexual self presentation”. Obviously this was a very small sample and the study didn’t specifically examine the sexual fetishization of uniforms, but the use of sexual clothing as a form of empowerment was a novel founding.

As many clinicians have noted, there is a well known crossover relationship between fetishism, sado-masochism, and other paraphilias where the wearing of ‘uniforms’ play a critical role. However, as Bhugra and De Silva conclude:

“The relationship of uniforms in fantasy and fetish is a complex one. Often in clinical situations it becomes impossible to ascertain when fantasy leads to fetish in reality and how much of a role fantasy plays in arousal related to a fetish. From a preliminary pilot study with a small number of rubber fetishists it appears that the distinction between fetish and fantasy is difficult even for the individual”.

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

Further reading

Bhugra, D. & De Silva, P.  (1996). Uniforms – fact, fashion, fantasy and fetish. Sexual and Marital Therapy, 11, 393-406.

Chalkley, A.J. (1979). Some cases of sexual fetishism at a London teaching hospital. Unpublished M.Phil., University of London.

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

O’Donnell, K. (1999). Good girls gone bad: The consumption of fetish fashion and the sexual empowerment of women. Advances in Consumer Research, 26, 184-189.

Trimmer, E.J. (1978). The Visual Dictionary of Sex. London: Macmillan.

Wikipedia (2012). Uniform fetishism. Located at:

The fin crowd: A brief look at delphinophilia

Of all the books about zoophilic activity, one of the strangest is Wet Goddess, a novel by Malcolm Brenner based on his nine-month sexual relationship with a dolphin living at the Floridaland amusement park. Back in 1970, while studying at New College of Florida (Sarasota), Brenner had a relationship with a dolphin called Dolly. Brenner claims the dolphin made the first moves in their relationship. I have to admit that when it comes to dolphins and human sex, the only thing that came to mind before researching this article is the phrase waxing the dolphin one of the many euphemisms for male masturbation.

In a 2011 interview with the Huffington Post, Brenner said that Dolly became “more and more aggressive. She would thrust herself against me. I found that extraordinarily erotic. It’s like being with a tiger or a bear. This is an animal that could kill you in two seconds if it wanted to”. Brenner claimed the relationship ended when Dolly was moved to an oceanarium following the closure of the amusement park in Florida where Dolly was housed. In his interview he further added:

“I had every intention of going to visit the dolphin when I got back to the South, but it didn’t work out that way. I learned the hard way that dolphins are chattel, and much more emotionally vulnerable than I had ever imagined…Some people find it hard to imagine that I wasn’t abusing the animal. They didn’t see me interacting with the dolphin. They weren’t there. These creatures basically have free will. What is repulsive about a relationship where both partners feel and express love for each other? I know what I’m talking about here because after we made love, the dolphin put her snout on my shoulder, embraced me with her flippers and we stared into each other’s eyes for about a minute. This was not some dog trying to hump my leg, okay. This was a 400-lb. wild-born female dolphin. She was an awesome creature…As self-aware mammals, dolphins are capable of making profound emotional attachments to other dolphins and, apparently, to selected humans as well. A dolphin can die of loneliness, of a broken heart, of separation anxiety.”

Brenner’s story may be not as unique as one might first imagine. In 1991, a 38-year old British man, Alan Cooper, was accused of masturbating a tamed dolphin (called Freddie) in front of a number of swimmers in Northumbria (England), and charged with performing a “lewd act”. At Cooper’s trial, expert witnesses testified that male dolphins use their penile erections socially as well as sexually. As a consequence, Cooper was acquitted as it couldn’t be proved that the act was sexual. However, there are a range of websites that give practical advice on how to have sex with a dolphin, and how to tell if they want sex (such as the Sexwork website) as well as websites devoted totally to dolphin lovers (such as the Delphinophile website). There are also dozens of online confessions about either having sex (or wanting to have sex) with dolphins on the Beast Forum (be warned, these are very sexually explicit and all involve zoophilic activity). A recent online essay also examined the case of ‘Dragon-wolfe’, a self-confessed delphinophile who reported that:

“[Dolphins] enjoy the company of humans, and if a relationship develops between a human and a dolphin, as has happened with me, they will, on occasion, wish to express their trust and affection for you in the most direct way; through mating, or sex-play…One thing to note. Whether you masturbate or mate a fin, male or female, always spend time with them afterwards. Cuddle them, rub them, talk to them and most importantly show them you love them. This is essential, as it helps to strengthen the bond between you. Like a way of saying that this wasn’t just a one night fling. The dolphins appreciate it and they will want your company more the next time you visit them”.

So what do academics have to say about delphinophilia? The most recent studies of zoophilia since 2000 have typically collected their data online from non-clinical samples. This has included studies by Dr Andrea Beetz (University of Erlangen, Germany; 32 zoophiles), Dr Colin Williams and Dr Martin Weinberg (of Indiana University, USA; 114 zoophiles), and Dr Hani Miletski (Institute for Advanced Study of Human Sexuality, San Francisco, USA; 93 zoophiles). In all three studies, the most commonly preferred animals were either dogs or horses. However, sex with dolphins was not unheard of in these samples. For instance, the study of 114 zoophiles by Williams and Weinberg notes that one of the zoophiles had engaged in delphinophilia. Similarly, the study by Beetz also found one person whose preferred animal to have sex with was a dolphin. She also reported that when it came to animals favoured in masturbation fantasies, a total of two people (7%) favoured dolphins. In a interview with seven erotic dancers, Tim Keefe interviewed the ‘Manx Minx’ who as part of her interview admitted that:

“Currently, my favorite non-human fantasy has to do with going to Marine World and getting a job as an underwater mermaid and having the dolphins try to get me when I go in to feed them after the place closes. I majorly want to have sex with a dolphin, and I don’t know if I will ever get the chance. That’s my big quirk fantasy for the moment. They’re so smart, they must be good lovers, you know”.

If you really want to read about examples of human-dolphin sex, then check out an article on delphinophilia at the Vivid Random Existence website. There is a long online essay collating human’s experiences of having sex with dolphins. The author – a self-admitted zoophile – makes the following observations (ones which I feel duty bound to point out that I don’t personally agree with):

“There is nothing wrong with having sex with dolphins, so long as the dolphin consents to sex. As discussed in other posts, animals can consent to sex by using body language; they do not need to speak a human language to communicate what they want and don’t want. In addition, it is very clear when a dolphin does and does not want to have sex. And according to Internet sources, people have personally experienced dolphins becoming aroused at the sight of a human…People have had sex with dolphins, and from what these people described, both participants (the human and the dolphin) were satisfied by their blissful interactions…Additionally, remember that dolphins themselves are often sexually attracted to humans, in a phenomenon known as ‘reverse bestiality’. They have been known to demonstrate their attraction by making their bodies turn a pinkish color, and through certain behaviors. Of course, due to the taboo associated with bestiality and zoophilia, the ‘reverse bestiality’ dolphin fact will probably never be discussed by the mainstream media”.

My own brief look at delphinophilia certainly comes to the conclusion that it exists among a small minority of zoophiles, and that this has been confirmed by academic researchers in the zoophilia field. However, as I wrote in a my previous blog on herpetophilia (i.e., zoophilic activity between humans and lizards), the animals cannot give informed consent, so therefore such sexual activity is morally wrong. I am in agreement with Dr. Denise Herzing (of the Wild Dolphin Project in the US) who was reported as saying:

“Glorifying human sexual interactions with other species is inappropriate for the health and well being of any animal. It puts the dolphin’s own health and social behavioral settings at risk.”

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.

Beetz, Andrea (2002). Love, Violence, and Sexuality in Relationships between Humans and Animals. Germany: Shaker Verlag.

Brenner, M. (2009). Wet Goddess. Eyes Wide Open.

Farrier, D. (2011). Dolphin man Malcolm Brenner follow-up Q&A. 3 News, September 23. Located at:

Goebel, J. (2012). Zoophilia: Thinking through trans-species sexuality. A Geology of Borders, March 30. Located at:

Keefe, T. (2005). Some of my best friends are naked: Interviews with seven erotic dancers. In R. Kick (Ed.), Everything You Know About Sex is Wrong (pp.191-205).  New York: The Disinformation Company.

McCormack, S. (2011). Malcolm Brenner Chronicles his sexual relationship with dolphin in ‘Wet Goddess’. Huffington Post, September 29. Located at:

Vivid Random Existence (2010). Delphinic zoosexuality (or zoophilia): The sexual attraction to dolphins. December 5. Located at:

Wikipedia (2012). Zoophilia and the law. Located at:

Williams, C. J., & Weinberg, M. S. (2003). Zoophilia in men: A study of sexual interest in animals. Archives of Sexual Behavior, 32, 523–535.

Dead famous: Jimmy Savile and the necrophilia allegations

(The following blog is based an article that that I was commissioned to write for a national British newspaper – The Independent – following the allegations that British television presenter, disc jockey and charity fundraiser Jimmy Savile had engaged in necrophilic practices. My original article was published on October 24 [2012] by The Independent and is reproduced here along with some of the references that my article was based on. My article was the most read blog of all The Independent’s blogs that week).

Recent reports about the sexual preferences of Jimmy Savile have not only thrown up allegations of paedophilia but have also hinted that he engaged in other sexual paraphilias such as necrophilia (having sex with corpses). Paraphilias (from the Greek and translating as “beyond usual or typical love”) are uncommon types of sexual expression and often more commonly described as sexual deviations, sexual perversions or disorders of sexual preference. Many of these behaviours may appear bizarre and/or socially unacceptable, and represent the extreme end of the sexual continuum. A number of published news reports on Savile all allege that he made unaccompanied visits to mortuaries (such as the one at Stoke Mandeville) and that he spoke publicly to the media about his “fascination” with dead bodies.

Some definitions of necrophilia make reference to “the erotic attraction to corpses” but that on its own doesn’t necessarily mean the person enjoys sex with a dead person. Necrophilia is very rare and there are no reliable estimates as to how prevalent the activity is. This is because the statistics are biased by those who get caught and/or end up seeking psychiatric help for the condition (in fact, all the knowledge we have about necrophilia comes from published case studies). The overwhelming majority of necrophiles are male (as are most paraphiliacs more generally) but there are occasional female cases (the most infamous being Karen Greenlee, the American who fell in love and kidnapped a dead male from a funeral home).

Given the paedophilic and necrophilic allegations against Savile, some members of the press have speculated whether there is an association between the two paraphilic behaviours. The scientific literature on necrophilia shows that it has close associations and overlaps with some sexual paraphilias including sexual sadism (sexual pleasure from hurting someone), sexual cannibalism (sexual pleasure from eating someone), vampirism (sexual pleasure from drinking someone’s blood) and erotophonophilia (sexual pleasure from murdering someone). However, there is little research showing any association between necrophilia and paedophilia except for those individuals that practice necropedophilia (sexual contact with the corpses of children).

Perhaps unsurprisingly, some types of occupation that have the easiest access to dead bodies are most likely to engage in necrophilic acts (the most obvious being gravediggers and mortuary attendants). However, there is some evidence that necrophiles seek out such jobs in the first place. In the largest published study of 122 necrophiles from all over the world, more than half (57%) were employed in a profession that gave them easy access to dead bodies. Such behaviour is also common among paedophiles that seek out jobs providing easy and/or unhindered access to children. Such claims have also been levelled at Savile surrounding allegations of both paedophilia and necrophilia.

One common reason given for why some people engage in such behaviour is the fact that corpses cannot refuse, reject or resist sex from a necrophile. Additionally, they cannot inform anyone (such as those in the criminal justice system) of its occurrence. Similar reasons have been applied to Savile in relation to choosing mentally ill and/or very vulnerable victims who (in essence) didn’t have a voice (or a voice that would be believed).

In 2011, Dr Anil Aggrawal of Maulana Azad Medical College (New Delhi, India) published the most in-depth academic and clinical account of necrophilia in his book Necrophilia: Forensic and Medico-legal Aspects. One of the most interesting observations is his claim that there are many different types of necrophile. Dr. Aggrawal claims there are ten different types of necrophile differentiated by the motivation and/or the type of sexual contact the necrophile has with the corpse. For instance, there are ‘homocidal necrophiles’ (so-called ‘necrosadists’, who will kill people just so as they can have sex with the dead) and ‘exclusive necrophile (who are psychologically and physiologically incapable of having sex with anyone living). In relation to the behaviour allegedly engaged in by Savile, he would most likely be classed as an ‘opportunistic necrophile’ (someone who engages in other types of sexual behaviour but would have sexual intercourse with a dead person if the opportunity arose).

Academic research has shown that two-thirds of the necrophiles say that their main reason for engaging in sex with corpses is the desire to possess an unresisting and unrejecting partner. The sadistic side of necrophilia has certainly been reported in some of the more extreme case studies but this appears to be rare, even among most cases of necrophilia. However, a recently published study by Michelle Stein (John Jay College of Criminal Justice, New York, USA) and colleagues examined 211 sexual homicides. Sixteen cases involved necrophilia (8%). Their findings suggest that the most common explanation for necrophilia (i.e., the offender’s desire to have an unresisting partner) may not always be applicable in cases where necrophilia is connected to sexual murder.

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.

Aggrawal, A. (2009). A new classification of necrophilia. Journal of Forensic and Legal Medicine, 16, 316-320.

Aggrawal A. (2011). Necrophilia: Forensic and Medico-legal Aspects. Boca Raton: CRC Press.

Burg, B.R. (1982). The sick and the dead: The development of psychological theory on necrophilia from Krafft-Ebing to the present. Journal of the History of the Behavioral Sciences, 18, 242-254.

Ehrlich, E., Rothschild, M.A., Pluisch, F. & Schneider, V. (2000). An extreme case of necrophilia. Legal Medicine, 2, 224-226.

Kafka, M.P. (2010). The DSM Diagnostic Criteria for Paraphilia Not Otherwise Specified. Archives of Sexual Behavior, 39, 373-376.

Rosman, J.P. & Resnick, P.J. (1989). Sexual attraction to corpses: A psychiatric review of necrophilia. Bulletin of the American Academy of Psychiatry and the Law, 17, 153-163.

Shaffer, L. & Penn, J. (2006). A comprehensive paraphilia classification system. In E.W. Hickey (Ed.), Sex crimes and paraphilia. New Jersey: Pearson Prentice Hall.

Stein, M.L., Schlesinger, L.B. & Pinizzotto, A.J. (2010). Necrophilia and sexual homicide. Journal of Forensic Science, 55, 443-446.

Here’s looking at you: The Truman Show Delusion

Reality television shows have now became a staple of modern life. However, little is known about the effect they have on day-to-day living. Earlier this year, Joel Gold and Ian Gold published a paper in the journal Cognitive Neuropsychiatry about a new phenomenon that they coined the ‘Truman Show Delusion’ (TSD) based on (director) Peter Weir’s 1998 film that told the (fictional) story of Truman Burbank (played by Jim Carrey) whose whole life had been filmed and broadcast as real life a soap opera around the world (without his knowledge) from the day he was born. All the people around Truman were paid actors and extras.

The plot of The Truman Show revolved around Truman’s gradual awareness that there was something wrong about his life (i.e., that the world appears to revolve around him) and of his of his desire to escape the town in which he is living. Because of the high audience ratings, the show’s producers attempt to keep the show even when Truman begins to suspect there is something amiss in his life. The actors are then instructed by the show’s producers and writers to tell Truman that he is imagining these things and that he is (to all intents and purposes) mentally ill (i.e., a persecutory delusion). In their paper, Gold and Gold described the conditions as:

“…a novel delusion, primarily persecutory in form, in which the patient believes that he is being filmed, and that the films are being broadcast for the entertainment of others. We describe a series of patients who presented with a delusional system according to which they were the subjects of something akin to a reality television show that was broadcasting their daily life for the entertainment of others”

Gold and Gold highlighted five short case studies of patients who had presented for treatment in their psychiatric practices. The cases ‘diagnosed’ as having the TSD are the reverse of what occurred in the film as their reported symptoms recall that of Truman, without the knowledge and awareness that their attempts to understand their situation will lead to a [Hollywood] happy ending. Interestingly, three of the cases highlighted by the authors referred to The Truman Show by name. Here is a brief summary of the five reported cases.

  • Case 1 (‘Mr. A’): Mr A. claimed his life was like The Truman Show, a belief that he had held for five years without his family’s knowledge. He believed the 9/11 attacks of 9/11 were fabricated and travelled to New York to see if the Twin Towers were still standing (and if they were, it would prove that he was the star of his own show). He believed that everyone in his life were part of the conspiracy and that he had cameras implanted in his eyes (and when he was admitted to the psychiatry department he asked to speak to the ‘director’). He was diagnosed as having schizophrenia (and more specifically a chronic paranoid type versus substance-induced psychotic disorder).
  • Case 2 (‘Mr. B.’): Mr B. believed he was being continuously recorded for national broadcast. He formulated a “plan to come to NYC and meet an unknown woman at the top of the Statue of Liberty. He expected [her] to release him from the control of an extended network of individuals who [were]…taping him continually…and broadcasting the tapes nationally for viewers’ enjoyment as part of a scenario similar to…The Truman Show”. He believed he “was and am the centre, the focus of attention by millions and millions of people…my [family] and everyone I knew were and are actors in a script, a charade whose entire purpose is to make me the focus of the world’s attention”. He had attempted suicide three times due to dysphoria, hopelessness, and persecutory delusions. He was diagnosed with schizoaffective disorder (bipolar type) along with both crack cocaine and marijuana dependence.
  • Case 3 (‘Mr. C’): Mr. C. – a journalist – had a history of depression, and was manic and psychotic. He believed that stories – in newspapers, online, and on television – were created by his colleagues in the media for his personal amusement. He believed that those around him were paid actors, and that everything around him was fake, and that “all [his] associates are involved”. During his hospitalization, Mr. C. attempted to escape to confirm whether there were disparities between the news given on the ward and what was happening outside. He was diagnosed as having bipolar disorder with psychotic features.
  • Case 4 (‘Mr. D.’): Mr D. actually worked on a reality television show and came to believe that he was the person whose life was actually being broadcast. He thought he was “a secret contestant on a reality show and believed he was being filmed. He also believed all his thoughts were being controlled by a film crew paid for by his family. He was diagnosed with bipolar disorder, had manic episodes, and a marijuana abuser.
  • Case 5 (‘Mr. E’): Mr E. believed that the Secret Service was following him. He had attention deficit hyperactivity disorder and had bouts of depression. He described a “scheme” that he claimed was similar to The Truman Show. Gold and Gold reported that Mr. E. “believed that he was the master of the scheme, that it involved everyone in his life including the hospital staff, and that all these people were actors. He thought that he might be recorded while in hospital. He believed that the news was fabricated and that the radio was recorded for him…He believed that the scheme would end on Christmas Day and that he would be released then”. He was diagnosed with schizophreniform disorder versus methylphenidate-induced psychotic disorder.

Gold and Gold searched the academic and clinical literature for other similar scientific reports of patients with delusions of The Truman Show type but said there were none. However, they did cite a 2008 study by Dr. Fusar-Poli and colleagues in the British Journal of Psychiatry. They reported the case of a person who ‘‘had a sense the world was slightly unreal, as if he was the eponymous hero in the film The Truman Show [but] at no point did his conviction reach delusional intensity”. They also made reference to two news reports (one in 2007 and the other in 2009) of men who appear to have suffered from the TSD.

“In 2007, William Johns III, a psychiatrist from Florida, attempted to abscond with a child, Thorin Novenski, and subsequently attacked the child’s mother. A news report on the incident claims that ‘a friend of the psychiatrist reportedly told a judge that Johns said he had to go to New York to ‘get out of The Truman Show’.In 2009, Antony Waterlow, a Sydney man, murdered his father and sister while in a psychotic state. A news report stated that Mr Waterlow believed his family was behind a ‘world wide game’ to murder him or force him to commit suicide. A doctor who interviewed the man is reported to have said that Mr Waterlow told her in a consultation in February that he believed computers were accessing his brain through brainwaves and satellites. He said his family was screening his life on the Internet for the world to watch, akin to the film The Truman Show”.

Gold and Gold noted that their case studies gave rise to three general questions of interest: (1) How precisely should these peoples’ delusions be characterized? (2) What does the delusion contribute to the understanding of the role of culture in psychosis? (3) What does the influence of culture on delusion suggest about the cognitive processes underlying delusional belief? Obviously, watching reality television shows do not cause psychotic or delusional episodes. However, these cases appear to highlight that those with underlying illnesses (e.g., schizophrenia) who watch reality television shows may develop delusions that seem somewhat familiar. Gold and Gold concluded that cultural insights into delusions are an essential part of understanding how these phenomena operate.

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

Further reading

Fusar-Poli, P., Howes, O., Valmaggia, L., & McGuire, P. (2008). ’’Truman’’ signs and vulnerability to psychosis. British Journal of Psychiatry, 193, 168.

Gold, J. & Gold, I. (2012). The “Truman Show” delusion: Psychosis in the global village. Cognitive Neuropsychiatry, DOI:10.1080/13546805.2012.666113

Smoker face: A brief overview of capnolagnia

Watch any film or television programme made before 2000 that features a post-coital couple in bed, and odds on, one (if not both) of them will be smoking a cigarette. I started with that anecdotal observation just by way of establishing that sex and cigarette smoking are (quite literally) not so strange bedfellows. However, for a small minority of people, smoking in and of itself can be sexually arousing and for some may even be a sexual paraphilia (called capnolagnia). Dr. Anil Aggrawal in his 2009 book Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices defines capnolagnia as a sexual paraphilia in which individuals derive sexual pleasure and sexual arousal from watching others smoke. The Collar ‘n’ Cuffs website adds in an article on smoking fetishism that the smoking can either be normal cigarettes or the smoking of marijuana spliffs.

The defining features of capnolagnia are outlined at the Right Diagnosis website. It is claimed that people who experience one (or more) of the following symptoms are considered to have a smoking fetish: (i) sexual interest in watching other people smoking, (ii) recurring intense sexual fantasies involving watching other people smoking, and (iii) recurring intense sexual urges involving watching other people smoking. As far as I am aware, there is almost no empirical or clinical research on capnolagnia. Given that there are no treatment papers in the clinical and medical literature it suggests that either capnolagnia is rare and/or people who have the fetish live with it happily without feeling the need to seek treatment.

Arguably, it wasn’t really until the advent of the internet in the 2000s that people were even aware that smoking fetishes even existed. As with many other fetishes, like-minded people began to meet on online newsgroups (such as early groups like alt.smokers.glamour and and then escalated to trading stories, pictures, videos, and (now) DVDs. The overview on Wikipedia (arguably the most in-depth overview I’ve seen on smoking fetishism) claims that (like most fetishes) it has its roots in early childhood classical conditioning where smoking becomes paired with sexual response and/or psychodynamic theories rooted in Freud’s oedipal complex.

“These could include seeing the smoker as a stereotypically sweet, innocent individual behaving in ways that are considered taboo. For others, it stems from an attraction to more worldly people whose smoking epitomizes their strength and self-confidence. Within gay culture, this fetish often stems from the image of masculinity… Another cultural source for the fetish may be eroticized depictions of women who smoke that come from older motion pictures, especially from the film noir era… it has also been speculated that men who have smoking fetishes are more likely to have mothers who smoked, going back to the old belief that all men are secretly attracted to women who are just like their mothers”.

In a short article on “bizarre” fetishes, the Religious Sex website claims that there is a “darker and more extreme version” of capnolagnia found among the BDSM [bondage, dominance, submission, masochism) and female domination subcultures in which submissive partners may be treated like a human ashtray and forced by their dominant partner to swallow cigarette ash, have cigarette smoke blown continually into their face, and/or have cigarettes stubbed out on their naked flesh. The use of the submissive here as an inanimate item has overlaps with the humiliating and masochistic world of forniphilia (i.e., use of people as human furniture for sexual pleasure) that I examined in a previous blog.

The article in Wikipedia claims most smoking fetishists are heterosexual males but that there are significant minorities of gay men and bisexual men that also enjoy the behaviour (and an even smaller number of heterosexual women). More specifically, the article claims:

“Among heterosexual men, the fetish is often associated with oral fixations and fellatio and it is rather caused by the image of the woman smoking, than by the smell. It seems that the smell and taste of the cigarettes have a greater role to play in women’s smoking behavior than in that of men. Some fetishists have a fascination with the addictive properties of nicotine, and its ability to cause harm, and there is a sub-fetish relating to women being harmed by smoking, sometimes called “the dark side”, “black lung fetish” or “lung damage”. This has been interpreted as an element of misogyny in the community’s psychology”

The article on Wikipedia claims capnolagnia among gay men differs from that among heterosexual men. It is claimed that gay men become aroused at either ‘dominant’ men smoking or young (“innocent”) men initiating smoking for the first time. According to some online female domination sites, there are other sub-types of capnolagnia (described online as “sub-fetishes”), particularly in nicotine’s potential to cause harm and sometimes called “lung damage”.

For women this is seen in videos showing women smoking and coughing, suggesting self-destructiveness. More common videos are those showing a woman or a man in bondage, being forced to smoke or to inhale smoke. ‘Glamor’ smoking and ‘dark side’ smoking are the major divisions within the fetish. The glamor aspect of the fetish emphasizes the way smoking visually enhances women’s sexual appeal; the dark side links smoking to female domination, bondage and domination, and sadism/masochism. Both elements may be related to the appeal of the “bad girl” and the fantasy that even a “girl next door” type who smokes may be a tigress in the bedroom. A handful of producers specialize in videos appealing to one or both sides of the fetish…Ironically, as mainstream society has recognized the dangers of smoking, the effect has been to heighten interest in smoking fetishism. The more we recognize that smoking is bad for our health, the truer it becomes that only ‘bad’ girls smoke, and the more attractive they become to the smoking fetishist”.

I did a literature search on psychological databases for empirical research into capnolgania and identified only one paper that had even mentioned it. This was in a 2012 issue of the journal Tobacco Journal where the authors Dr Mary Carroll, Dr Ariel Shensa and Dr Brian Primack (all at the University of Pittsburgh, US) systematically analyzed YouTube videos with cigarette-related content. Their systematic search online yielded 66 cigarette-related videos for qualitative analysis. The researchers coded the overall portrayal of smoking as positive if the smoking was largely portrayed as attractive, fun, powerful, pleasurable, relaxing or sexy. Their findings showed that 9% of the videos analyzed contained fetishistic smoking content. Given the small sample size and the selective search methods used by the research team, we have no way of knowing if the results can be generalized.

However, I realized that after reading this paper that this was the latest in a number of studies that have looked at smoking and smoking fetish videos on YouTube (except in the previous studies no-one called it capnolagnia). For instance, an earlier study published in a 2010 issue of Nicotine and Tobacco Research, by Dr. Susan Forsyth and Dr. Ruth Malone (both at the University of California, US) examined 124 of the most popular YouTube videos about cigarette use. They reported that the videos they analyzed frequently associated cigarettes with sexual themes and commonly portrayed cigarette smoking in a positive light (however, smoking fetishism wasn’t studied in isolation).

In a 2002 issue of the Journal of Health Commerce, Dr. T. Hong and Dr. M.J. Cody conducted a content analysis study of 318 pro-tobacco websites and examined the models in the photographs displayed on these websites. They reported that female models were most often portrayed in sex/fetish sites and were slim and attractive. Similarly, in 2003 in the journal Health Education and Behavior, Dr. Kurt Ribisl and his colleagues in North Carolina (US) also conducted a content analysis of over 1600 photographs displayed on 30 smoking websites and examined the amount of smoking and nudity displayed. Five of the websites mentioned smoking fetishes and 7% of the photographs contained nudity and smoking.

Another study, in a 2007 issue of Tobacco Control by Dr. Becky Freeman and Dr. Simon Chapman (University of Sydney, Australia), examined YouTube videos with smoking content and identified those videos were most commonly watched. Perhaps unsurprisingly, the most watched pro-smoking videos were the smoking fetish and female smoking videos. Similarly, in a 2010 issue of the journal Health Communication, Dr Kyongseok Kim and colleagues conducted a content analysis of the smoking fetish videos on YouTube. Among the 139,000 videos that were located, a total of 2,220 (1.6% of all smoking videos) were smoking fetish videos. Although none of these studies tell us much about the etiology and psychology of smoking fetishes, they do tell us that there are a significant minority of smoking fetish sites out there, and that maybe capnolagnia is not as rare as first believed.

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.

Amos, A., & Haglund, M. (2000). From social taboo to “torch of freedom”: the marketing of cigarettes to women. Tobacco Control, 9, 3-8.

Carroll, M.V., Shensa, A. & Brian A Primack, B.A. (2012). A comparison of cigarette- and hookah-related videos on YouTube. Tobacco Control, doi: 10.1136/tobaccocontrol-2011-050253.

Collar ‘n’ Cuffs (2010). Smoking fetishism (capnolagnia). February 19. Located at:

Forsyth, S.R. & Malone, R.E. (2010). I’ll be your cigarette-Light me up and get on with it”: Examining smoking imagery on YouTube. Nicotine and Tobacco Research, 12, 810e16.

Freeman, B., & Chapman, S. (2007). Is ‘YouTube’ telling or selling you something? Tobacco content on the YouTube video-sharing website. Tobacco Control, 16, 207-210.

Hong, T., & Cody, M. (2002). Presence of pro-tobacco messages on the Web. Journal of Health Commerce, 7, 273-307.

Kim, K., Paek, H.J. & Lynn, J. (2010). A content analysis of smoking fetish videos on YouTube: regulatory implications for tobacco control. Health Communication, 25, 97-106.

Religious Sex (2012). “Bizarre” fetishes (Part 1). Gothic Fetish, May 8. Located at:

Ribisl, K.M., Lee, R.E., Henriksen, L., & Haladjian, H.H. (2003). A content analysis of Web sites promoting smoking culture and lifestyle. Health Education and Behavior, 30, 64-78.

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

Wikipedia (2012). Smoking fetishism. Located at:

Google surf: What does the search for sex online say about someone?

I recently read a transcript of a radio interview where Shankar Vedantam (the Science Correspondent of US National Public Radio) was talking about how analyzing Google searches could tell us things of national importance about what is happening before they reached the relevant public authorities. He gave a lovely example:

“A year or so ago, the folks at Google realized that as the flu was spreading from state to state, people’s search terms were changing. So people would search for things like ‘What do I do if I have a sore throat?’ or ‘What do I do if my child is running a high temperature?’. And by tracking these searches, Google discovered, long before public health authorities discovered, how the flu was spreading from state to state”.

Such observations tend to suggest that what people use online search engines for and what they type into them can be a useful indicant of human behaviour. But is the same true for sexual behaviour? A recent report in the Indian Times revealed that the people of Pakistan had the most searches for ‘sex’ on Google in 2011 (followed by India in second place) using Google Trends software. More interestingly, in an article by Alan Dunn for Business Insider (Top Google Searches – What do People Search for?) reported that:

The keywords sex, porn, free porn and porno pretty much blow any other keywords out of the water. The amount of exact match volume for these 4 terms alone is 22,820,000 searches a month. Individually they are ‘porn’ (11,100,000), free porn’ (7,480,000), sex’ (2,740,000), [and] porno’ (1,500,000). Sex is obviously not bad. It’s more popular than ever”.

Last year, Dr. Ogi Ogas and Dr. Sai Gaddam published their book A Billion Wicked Thoughts: What The Internet Tells Us About Sexual Relationships. Their book was an academic study of what people worldwide looked for sexually when they went online. As the title of their book suggests, they analysed millions of anonymous Web searches, pornographic websites, erotic videos, etc. The authors used the Dogpile search engine to analyse data from the major search engines (e.g., Google, Bing, Yahoo, etc.). Ogas and Gaddam’s book provided us with what the New York Post (NYP) claimed was “the most complete survey yet of our collective sexual id”. Maureen Callahan (who wrote the piece for the NYP) noted that there were many surprising findings. For instance:

“Straight men enjoy a wider variety of erotica than imagined, including sites devoted to elderly women and transsexuals. Foot fetishes aren’t a deviance; men are evolutionarily wired to look for small feet, which are a sign of high estrogen production, which itself is a sign of fertility. Gay men and straight men have nearly identical brains, and their favorite body parts, in order of preference, line up exactly: chests, buttocks, feet. Straight men prefer heavy women to thin ones. Straight women enjoy reading about and watching romances between two men – it’s not about the sex, which is downplayed, but the emotion, which is the focus. (The largest audience for ‘Brokeback Mountain,’ says the book, was straight women.) Straight men have a fascination with other men’s penises, which may be conscious or unconscious”.

In an interview with the NYP, Dr. Ogas said that “sex therapists haven’t known which interests are common and which are rare. We probably now know more than ever before.” He and Gaddam ranked the most popular terms types into the world’s leading search engines and compiled a ‘Top 10 sex terms list. The leading search terms related to sex were: youth (13.5%), gay (4.7%), MILFs (4.3%), breasts (4%), cheating wives (3.4%), vaginas (2.8%), penises (2.4%), amateurs (approx. 1%), mature (approx. 1%), and animation (1%). The data was analysed in great detail. The NYP article by Callahan reported that based on Ogas and Gaddam’s study:

Men fantasize about group sex far more than women and picture more men than women in the action. Straight men prefer to watch amateur porn online, and the authors theorize it’s because of perceived authenticity – a fake orgasm, it turns out, may be as disappointing as one in real life. One of the most popular and diverse areas of interest in sexuality is domination and submission, with straight women and gay men most interested in the latter role. Gay men enjoy straight porn in large numbers….Straight males enjoy a wide variety of erotica, including sites featuring transsexuals and elderly women. The study also found that both gay and straight men favor chests, buttocks and feet (in that order)”.

US academic Professor Donald Symons, one of the world’s leading evolutionary psychologists, was quick to point out some of the book’s flaws and did not seem to be persuaded that what people searched for online necessarily was directly related to what people found sexually desirable. For example, does the fact that someone watches ‘granny porn’ or transsexual sex indicate that they find it sexually alluring? Symons argues they may just be viewing such material out of curiosity. Symons was quoted as saying:

“One of the first things I asked Ogi about was curiosity versus arousal. Ogi is convinced that when people are searching for things, it’s primarily for sexual arousal. I’m not so sure about that. If there was a porn star with three breasts — I bet there would be a zillion hits. Would that be a sign men were suddenly aroused by that? I think not…If it had been the case that women were just like men, but society had been repressing women and once they’re online, they seek the exact mirror-image of porn – that could’ve happened. But it didn’t…The research shows that men, as evolutionary science has long held, are stimulated visually, while women require a host of stimuli – context, emotion, verbal expression…What would be really shocking would be fetish sites devoted to acne suffers, or people with no teeth – signifiers of poor health and high reproductive risk. I don’t necessarily think that all men are searching for women with clear skin, one head and two breasts. But when you’re doing a search, you’re usually looking for things that are uncommon”.

This is why Symons thinks there is lots of online searching for transsexual pornography. I also agree with Symons that the data that Ogas and Gaddam collected wasn’t based on a representative sample of online users (only those who typed in sexual words to search engines), and no-one knows what motivated the search. If anyone checked out my online surfing habits, there is no way anyone could infer what I liked sexually because almost all of what I type into search engines is for research purposes. Given the amount of coverage I devote to paraphilic behaviour in my blog, it’s not surprising that the sites I look at say little about my own sexual desires and sexuality.One of the arguments that Ogas and Gaddam have put forward is their assertion that sexual deviance is to all intents and purposes a myth. In his NYP interview, Ogas claimed:

“People who are attracted to mirrors, or to beards, or get turned on by ants in their pants – these are cases that, until now, have been diagnosed by clinicians who’ve seen patients. The Internet gives us a far better sense – rough, but still – of what is a likely anomaly and what is a far more common predilection. We discovered things even Kinsey didn’t know. Foot fetishes, for example, are common across all cultures. The discovery may lead to a re-classification; perhaps someday, the male interest in feet will be considered as normal an interest as breast size or facial attractiveness”.

Ogas is adamant that people who look at unusual sexual behaviour online are attracted to it. In response to Professor Symons’ view that most of the unusual viewing online may be curiosity-based, Ogas (again in his NYP interview) believes that his research:

“Proves that men who look at elderly women are actually turned on by elderly women. There are forums where men talk about picking up grannies, the kinds that they like. We studied AOL search histories over a period of months – if someone’s just curious, they’re not going to spend money for a subscription to a site, or search for something over and over again”.

I thought I’d end today’s blog with a little local analysis of my own. As my regular readers will aware, my own blog has its fair share of articles on sexual behaviour, and I always take an interest in what people are searching for to click onto my blog. Well here is a little insight for you. On October 15 (2012), I looked at all the search terms that people had used to locate my blog (which on that day I had a total number of page hits of around 115,000). I excluded all searches where people had typed in my name or ‘Mark Griffiths’ Blog’. Here are the top search terms that managed at least 50 hits:

My initial observations are that most people that stumble upon my blog are people interested in paraphilias (as the highest non-paraphilic term was ‘nose picking’ at 14, and 34 of the top 40 search terms are paraphilia-based). It certainly looks as though ‘sex sells’ even at a local level like my blog.

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

Further reading

Callahan, M. (2012). You’re not as kinky as you think: Massive Internet study finds that we’re all sexual deviants, New York Post, January 22: Located at:

Dunn, A. (2011). Top Google Searches – What do People Search for? Business Insider, December 21. Located at:

Griffiths, M.D. (2012). Internet sex addiction: A review of empirical research. Addiction Research and Theory, 20, 111-124.

Griffiths, M.D. (2012). The use of online methodologies in studying paraphilia: A review. Journal of Behavioral Addictions, in press.

Indian Times (2011). Pak tops Google search for sex, December 30. Located at:

Ogas, O. & Gaddam, S. (2011). A Billion Wicked Thoughts: What The Internet Tells Us About Sexual Relationships. Syracuse, NY: E.P. Dutton & Co Inc.

Smith, C. (2011). Top 10 Internet Search Terms About Sex: Study (Update). Huffington Post, April 26. Located at:

Werheimer, L. & Vedantam, S. (2012). Google searches are a window into our culture. Located at:

Dead tired: A beginner’s guide to Fatal Familial Insomnia

For most of my life I have “suffered” from insomnia. I deliberately put the word ‘suffered’ in quotation marks as for the vast majority of the time I have always seen my lack of sleep as something positive (i.e., I had more time to do other things. In fact, when people ask me how I find the time to write so much, I usually say “Insomnia” but I don’t usually say it as a joke, it’s a matter of fact). Given my personal interest in insomnia, I’ve always enjoyed reading papers on insomnia (and no, they don’t send me to sleep!) and sexsomnia (which I looked at in a previous blog). In 1990, a Finnish man named Toimi Soini stayed awake for over 11 days (276 hours) and broke the world record for not going to sleep. However, this record no longer appears in the Guinness Book of World Records as it was withdrawn on health grounds because lack of sleep – as I’ll show in today’s blog – can lead to death.

One of the strangest (and deadliest) types of insomnia is ‘fatal familial insomnia’ (FFI). This is actually an incredibly rare genetic sleep disorder that affects around 40 families worldwide. The cause of FFI is a genetic mutation that leads to prion disease and is therefore related to bovine spongiform encephalopathy (BSE; i.e., ‘mad cow disease’), Creutzfeldt–Jakob disease (the human form of BSE), and ‘Kuru’ (the incurable and degenerative neurological disorder found in the cannibalistic tribes in New Guinea and known as the ‘laughing disease’). The (online) Medical Dictionary is a little more technical and notes:

“Fatal familial insomnia (FFI) is a very rare, autosomal dominant inherited, disease of the brain. It is caused by a mutation in a protein called prion protein (PrP): asparagine- 178 is replaced by aspartic acid. The mutation changes the shape of PrP so that it becomes a prion and makes other, normal PrP molecules change to the abnormal shape. This causes amyloid plaques in the thalamus, the region of the brain responsible for regulation of sleep patterns. The dysfunction of the thalamus results in insomnia first of all, which progresses to more serious problems over several years”

All prion diseases (known more scientifically as ‘transmissible spongiform encephalopathies’) are rare progressive neurodegenerative disorders that can affect both animals and humans. All of the prion diseases (including FFI) typically have (i) long incubation periods, (ii) a failure to induce inflammatory response, and (iii) characteristic spongiform changes that are associated with neuronal loss. The first recorded case of FFI is thought to be an Italian man who died in Venice in 1765. There are many descriptions of the disease online including case study accounts. The Wikipedia entry on FFI described the case of the American music teacher, Michael Corke from Chicago:

“He suddenly began to have trouble sleeping not long after his 40th birthday in 1991, and his health and state of mind quickly deteriorated as his sleeplessness grew worse. Eventually, he couldn’t sleep at all, and he was soon admitted to the hospital. Doctors there weren’t sure what was wrong with him, initially diagnosing multiple sclerosis; in a bid to send him to sleep in the later stages of the disease, physicians induced a coma with the use of sedatives, but they found that his brain still failed to shut down. Corke died in 1992 a month before his 41st birthday, by which time he had gone without sleep for six months”

Another 2011 online article on “bizarre brain disorders” by Anna McGann also described a family case study (which is very similar to paper published in a 2000 issue of the Journal of Neurology, Neurosurgery and Psychiatry by Dr. C. Tabernero and colleagues):

“Dr. Ignazio Rottier gained unwanted firsthand experience when he and his wife, Elisabetta, watched her family fall victim to [FFI]. First known to fall ill was Elisabetta’s grandfather. Decades later, Elisabetta’s uncle, Silviano, was 53 when he lost his ability to sleep. A few short months following initial onset, Silviano fell into a coma and died…In the 70s, an aunt of Elisabetta’s passed on, one year after her own initial onset of sleeplessness. Yet another year later, a second aunt too lost her life battling the very same affliction”.

Research has also shown that the condition (in a few cases) can result from a non-inherited genetic mutation that has been called ‘sporadic fatal insomnia’ (sFI). Less than 10 cases of sFI have ever been documented in the medical literature. As the conditions worsen, sufferers experience a wide range of symptoms including delirium, hallucinations (auditory, visual and tactile), elevated heart rate and blood pressure, hyperhidrosis (i.e., excess sweating), hyperthermia, hypertension, impotence (in men), amenorrhea (cessation of periods) and early menopause (in women), constipation, and dementia. Treating the symptoms (via vitamin therapy, meditation, use of narcoleptics) may extend the quality of life (but as noted above, there is no known cure and most interventions are purely palliative). The disease typically has four stages, and takes between half a year and a year and a half to run its course:

  • Stage 1 (typically four months): Symptoms include insomnia, paranoia, phobias and panic attacks.
  • Stage 2 (typically five months): Symptoms include severe hallucinations and increasing panic attacks.
  • Stage 3 (typically three months): Symptoms include permanent insomnia, limited mental functioning, and rapid weight loss.
  • Stage 4 (typically six months): Symptoms include dementia and general non-responsiveness leading to death.

Writing in a 2006 issue of the Medscape General Medicine journal, Dr. Joyce Schenkein outlined the etiology and characteristics of FFI. She noted that it often begins in middle age (average age of onset being 50 years) and has no cure (even ‘gene therapy has been unsuccessful to date). Unfortunately, the prognosis following initial diagnosis is poor with FFI sufferers’ only living for an average of about a year and a half (with Dr. Schenkein noting that survival ranged from 7 to 36 months from diagnosis of FFI). It originates in the form of unexplained sleeplessness before rapidly developing into a fatal insomnia. Writing in an issue of the Journal of Clinical Neuroscience, Dr. S. Collins and colleagues in a paper on prion diseases (including FFI) concluded:

“FFI [is] likely [to] remain, [a] very rare disease, [and] will be increasingly recognised as heightened clinical awareness prompts appropriate confirmatory genetic and other testing. Similarly, continued molecular biological and allied research of these less common prion diseases will undoubtedly provide fundamental insights into the pathogenesis of this group of disorders in general, disproportionate to their numerical frequency”.

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

Further reading

Collins, S., McLean, C.A. & Masters, C.L. (2001). Gerstmann–Sträussler–Scheinker syndrome, fatal familial insomnia, and kuru: a review of these less common human transmissible spongiform encephalopathies. Journal of Clinical Neuroscience, 8, 387–397.

McGann, A. (2011). 5 bizarre brain disorders. Suite 101, November 25. Located at:

Moody, K.M., Schonberger, L.B., Maddox, R.A., Zou, W.Q., Cracco, L., & Cali, I. (2011). Sporadic fatal insomnia in a young woman: a diagnostic challenge: case report. BMC Neurology, 11, 136.

Schenkein, J. (2006). Self-management of fatal familial insomnia. Part 1: What Is FFI? Medscape General Medicine, 8(3), 65.

Schenkein, J. & Montagna, P (2006). Self-management of fatal familial insomnia. Part 2: Case report. Medscape General Medicine, 8(3), 66.

Tabernero, C., Polo, J.M., Sevillano, M.D., Muñoz, R., Berciano, J., Cabello, A., Báez, B., Ricoy, J.R., Carpizo, R., Figols, J., Cuadrado, N., Claveria, L.E. (2000). Fatal familial insomnia: clinical, neuropathological, and genetic description of a Spanish family. Journal of Neurology, Neurosurgery and Psychiatry, 68, 774–777.

Turner, R. (2012). Fatal Familial Insomnia: 
The FFI Sleep Disorder. World of Lucid Dreaming. Located at:

Wikipedia (2012). ‪Fatal familial insomnia‬. Located at:

It’s the pits: A brief look at maschalagnia

Dr. Anil Aggrawal’s 2009 book Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices defines maschalagnia as a fetish for armpits, and also defines maschalophilous (slightly differently) as arousal from armpits – although a quick internet search will highlight that most sources use these two words interchangeably to mean the same thing. According one (gay) fetish website, the attraction to armpits can be based on a number of factors and senses, but claims it is the olfactory (smell) and visual components are the most common sensory factors involved when it comes to armpit sexual arousal.

Other armpit related sexual practices include hircusophilism (a sexual preference for underarm hair), and axillism (the use of the armpit for sex, and known more colloquially as ‘bagpiping’). There are a surprising number of fetishistic websites purely devoted to the sexual allure of armpits (e.g., Armpit FetishArmpit Sex, Armpit Licking, Girl Pits [‘The Original Underarm Fetish Forum”], Man On Man Armpits). Most of these people enjoy kissing, tasting, smelling their partner’s armpits during sexual foreplay. Sometimes they ask their sexual partners not to shower, bathe or wash their armpits, so that the smell is as strong as possible. Brenda Love in her Encyclopedia of Unusual Sex Practices claims that sexual arousal from armpits:

“…is more common in Europe where women allow their armpit hair to grow. This area is very sensitive to the flicker the tongue or the warmth of a penis. Unshaven hair is also said to retain pheremones, the sex hormones that cause arousal when inhaled. The advantages of axillism for men are that of a tight fit, friction against the penis, close proximity to the breasts, and no risk of pregnancy or disease. Axillism, when engaged in within a day of shaving, produces more sensation but later underarm stubble can cause irritation of the penile skin”.

As far as I am aware, there is no empirical evidence suggesting that armpit fetishism is more prevalent in Europe and my feeling that this is educated guesswork on Dr. Love’s part. In Volume 4 of his Studies in the Psychology of Sex from the early 1900s, the British psychologist and early sexologist Havelock Ellis made many references to armpits and sex. For instance, he notes that:“Before coitus the sexual energy seems to be dissipated along all the nerve-channels and especially along the secondary sexual routes, the breasts, nape of neck, eyebrows, lips, cheeks, armpits, and hair”. He then goes on to say later in the book how the focus of sexuality can shift:

“The odour of the body, like its beauty, in so far as it can be regarded as a possible sexual allurement, has in the course of development been transferred to the upper parts. The careful concealment of the sexual region has doubtless favoured this transfer. It has thus happened that when personal odour acts as a sexual allurement it is the armpit, in any case normally the chief focus of odour in the body, which mainly comes into play, together with the skin and the hair”.

He also cites a case study from Féré’s 1902 book L’Instinct Sexuel. Féré is arguably the first academic to mention the fetishistic properties of armpits when he wrote:

“Sometimes the odour of the armpit may even become a kind of fetish which is craved for its own sake and in itself suffices to give pleasure. Féré has recorded such a case, in a friend of his own, a man of 60, with whom at one time he used to hunt…On these hunting expeditions he used to tease the girls and women he met…when he came upon them walking in the fields with their short-sleeved chemises exposed. When he had succeeded in introducing his hand into the woman’s armpit he went away satisfied, and frequently held the hand to his nose with evident pleasure. After long hesitation Féré asked for an explanation, which was frankly given. As a child he had liked the odour, without knowing why. As a young man women with strong odours had stimulated him to extraordinary sexual exploits, and now they were the only women who had any influence on him. He professed to be able to recognize continence by the odour, as well as the most favourable moment for approaching a woman”.

Ellis’ book also contains a section where he claims that some men can detect menstruating women from the smell of their armpits. Although this is not sexual in and of itself, more those men who engage in menophilia (a sexual paraphilia where individuals derive sexual arousal from menstruating females), the armpits may be an indirect sexual stimulus Ellis argues that the attraction is mostly directed towards the “strong pungent odour of the armpit” as it is the most powerful in the body, sufficiently powerful to act as a muscular stimulant even in the absence of any direct sexual association. As one website’s description of armpit fetishism notes:

Armpit odour is an aphrodisiac for some people. The smell acts as a muscular stimulant, naturally encouraging arousal, reminding armpit lovers of their favourite part of the opposite sex’s body. Compared to other fetishes, it’s not that weird. But don’t tell that to people in Singapore, where an armpit-loving man was recently sentenced to sentenced to 14 years in jail and 18 strokes of the cane”

One online essay at an “adult” site (you’ve been warned if you click on the link) has briefly examined armpit fetishes and had a small section entitled ‘psychological aspects’. However, it really didn’t give any psychological insight at all. The anonymous author speculated that:

“I think the act of licking another person’s armpit or breathing in their odour are a means of striving for intimacy, on a very base level. A person’s musk is very distinctive; very much a product of that individual and how their body processes various consumables…Or it could be a physical reaction having to do with the taste and smell of a man’s underarms, in their natural form: minus cologne, antiperspirant, and the like. Pheromones, commonly believed to trigger a social response in members of the same species, are produced by the skin’s apocrine sebaceous glands, secreted via armpits and found in sweat”

As with many of the paraphilias and fetishes that I’ve examined of late, there is little empirical research on maschalagnia or armpit sexual practices more generally. Reference to sexual aspects of armpits sometimes crop up in the academic literature on gay sexual preferences. For instance, in a 1987 issue of the journal Sexual Addiction and Compulsivity, Dr. David  Moskowitz and Dr. Michael Roloff examined sexual practices in relation to ‘bug chasing’ (relating to a small group of gay men who attempt to voluntarily contract the HIV virus). They noted that among gay BDSM (bondage, dominance, submission, (sado)masochism) practitioners, a small but significant minority were into dominant and/or submissive ‘armpit play’.

Maybe the area is just too trivial for academic and/or clinical study as it’s not a condition that requires medical, psychiatric and/or psychological intervention. In fact, the only snippet I came across was a 2006 book chapter in Key Topics in Sexual Health by Steve Baguley on ‘pediculosis pubis’ (crab lice) reminding readers that such lice (as part of a sexually transmitted disease) can be found in armpit hair as well as pubic hair.

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.

Baguley. S. (2006). Pediculosis pubis (crab lice). In S. Baguley, S. Kumar & R. Persaud (Eds.), Key Topics in Sexual Health (pp.150-162). London: Taylor and Francis.

Criminal Justice Degrees Guide (2008). 10 unusual fetishes with massive online followings. November 10. Located at:

Ellis, Havelock (1905). Studies in the Psychology of Sex (Volume 4). Located at:

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

Moskowitz, D.A. & Roloff, M.E. (1997). The ultimate high: Sexual addiction and the bug chasing phenomenon. Sexual Addiction and Compulsivity, 14, 21-40,

Wonderland Burlesque (2011). Acquired Tastes, Chapter II: Armpits, January 22. Located at:

Character building: Can the buying of virtual assets be addictive?

The potentially addicting nature of online gaming has been well documented over the last decade by many researchers (including many papers from my own research unit). One of the unforeseen consequences of the online gaming revolution is the (sometimes seemingly extraordinary) demand for virtual within-game assets (such as the buying of clothing, cosmetic items, and other accessories for online characters). Given the increase of companies whose only products are virtual gaming accessories, there is clear evidence for the growing demand by online gamers for such virtual assets. (In fact, a story published online reviewed the case of a Chinese woman who in her divorce case demanded a share of the couple’s virtual assets from their gaming).

From a personal perspective, I can see the attraction of having a personalized avatar. When I first bought a Wii console for my children, we spent hours creating our in-game characters (mine was quite easy for my kids to create as almost any Wii character with dark hair, beard, moustache, and glasses looks vaguely like me). I prefer playing Wii tennis and other sports with my own avatar. I also know that from my own psychological research into Facebook use, that users on social networking sites will spend real money to buy virtual assets for games like Farmville, as well as using real money to buy virtual currency to play games like poker (for points).

Over the weekend, I was sent an online article published by Priyanka Singh on the MMOBUX website about someone who claimed they were becoming addicted to the buying of virtual assets for the game he was playing online (MapleStory, a 2-D fantasy multiplayer online role playing game where progress in the game is determined by the successful playing of a series of quests). The article provided a first person account written by a female adolescent (presumably in her middle to late teens) about her increasing buying behaviour at a virtual ‘Item Mall’. According to the anonymous person who wrote the account provided by Singh:

“An Item Mall is a dangerous place for players who demand more from the game. Instead of focusing their efforts on the task at hand, players usually turn to the Item Mall to spend real world money in it. It is a trend which continues to happen now, across every MMO which can be labeled an obsession. [An Item Mall] is a place that host items which cannot be purchased directly through vendors. So much so…[that] purchasing cosmetic items in the Item Mall using real world money [can] transform into a deadly, yet uncontrollable obsession”

In 2006 the young woman in question started to play MapleStory. It was while playing the game that she started to notice the bespoke outfits worn by other characters playing the game. She then discovered that MapleStory had its own Item Mall where players could buy (among other things) character outfits, pets, pet accessories, weapons, etc. It was at the Item Mall that the player first bought a $30 (Canadian) game card (that was converted into 20,000 Nexon points) that can only be spent on virtual items for use in the MapleStory online game. She only bought a few of the available items but all of the Nexon points were spent. It was over a fairly short period of time that the gamer noticed she was spending more time in the Item Mall than playing the game itself. As she noted:

“I’d be entering the Item Mall more often to look at the new cosmetic items posted for purchase. Eventually I caved in and bought more items which included a staff, a cat and accessories. Needless to say the idea of buying virtual items was appealing to me. Through my purchases, I was constantly reminded these items lasted only 60 days until they expire. Regardless of the reminders, I continued to purchase more items until the point it became a direct obsession and a habit which couldn’t be mended easily”.

She browsed in the Item Mall for longer and longer periods and would mix and match clothing and accessories for her avatar. Spending $100 (Canadian) was not uncommon, and the buying of the virtual assets “became second nature” to the point where she spent more time in the Item Mall than playing and going on quests in MapleStory. The spending of money on virtual assets at the item Mall (that he couldn’t afford) went on for half a year, and led to a number of negative consequences:

“My grades dropped [and] I was placed on probation for the semester. Of course, in addition to failing my subjects, the tension at home intensified. I was banned from the laptop. Taking matters into my own hands, I stopped myself from playing MapleStory for a week but it was unbearable. Once I gained access back into the game, I immediately headed for the Item Mall and purchased new items. After a month or so, I began to realize what I was becoming – an Item Mall addict. By that point I realized this got a little too out of hand and I uninstalled the game before the damage was permanent”.

Such consequences certainly look like the negative detrimental effects that I have encountered in other behavioural addictions such as gambling addiction. The excessive behaviour (or simply spending much more than could be afforded) led to a negative impact on her education. When he tried to stop, it became “unbearable” (presumably because of the withdrawal effects of mot being able to log into the Item Mall). After a week she relapsed and logged on and bought more virtual assets for her online gaming character. By her own admission, she realized he might be becoming an ‘Item Mall addict’. She also provided a more reflective outlook on her past behaviour when in the Item Mall:

“Now when I look back at my behavior, it was unacceptable. Although I can understand and sympathize why buying virtual items was addicting; [my] character was dressed up in the most fashionable threads or holding a bad-ass weapons others couldn’t afford. It gives you a sense of ‘uniqueness’ if it can be called that. I’m glad I quit the game before it couldn’t be controlled. It was money wasted when placed into perspective. Though I was lucky (in a way) I had own my own credit card and I didn’t use my parents’ card for the purchases. In conclusion, buying virtual items is a waste of money and time. Most of if not all virtual items contain an expiry date after which the item disappears from your inventory…I was lucky I wasn’t a complete addict but I was close to being one”.

My own take on this is that because the virtual items are (in effect) ‘rented’ (as the items bought ‘expire’ after six months), it is almost a licence to print money for the company selling the virtual assets. I have no idea if the gamer that wrote the account of her Item Mall behaviour was a genuine obsession or addiction, but it was certainly a behaviour that was problematic and impacted negatively on her life. Spending hundreds and hundreds of dollars on virtual assets is not sustainable for most adolescents and is likely to lead to problems (irrespective of whether the behaviour can be defined as genuinely ‘addictive”). This is certainly an area where empirical research is needed as the buying of virtual assets is – for some gamers – likely to become a major part of how they spend their disposable income. This anecdotal case study also raises questions of whether the excessive spending of money on virtual assets for game characters is more of a female (than male) behaviour.

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

Further reading

Griffiths, M.D. (2010). Online video gaming: What should educational psychologists know? Educational Psychology in Practice, 26(1), 35-40.

Griffiths, M.D. (2010). Gaming in social networking sites: A growing concern? World Online Gambling Law Report, 9(5), 12-13.

Griffiths, M.D., Kuss, D.J. & King, D.L. (2012). Video game addiction: Past, present and future. Current Psychiatry Reviews, in press.

Hyped Talk (2010). Virtually addicted Chinese woman claims virtual assets in her divorce plea.

King, D.L., Delfabbro, P.H. & Griffiths, M.D. (2010). The convergence of gambling and digital media: Implications for gambling in young people. Journal of Gambling Studies, 26, 175-187.

King, D.L., Delfabbro, P.H., Griffiths, M.D. & Gradisar, M. (2012). Cognitive-behavioural approaches to outpatient treatment of Internet addiction in children and adolescents. Journal of Clinical Psychology: In Session, 68, 1185-1195.

Kuss, D.J. & Griffiths, M.D. (2011). Online social networking and addiction: A literature review of empirical research. International Journal of Environmental and Public Health, 8, 3528-3552.

Kuss, D.J. & Griffiths, M.D. (2011). Excessive online social networking: Can adolescents become addicted to Facebook? Education and Health, 29. 63-66.

Kuss, D.J. & Griffiths, M.D. (2012). Online gaming addiction in adolescence: A literature review of empirical research. Journal of Behavioral Addictions, 1, 3-22.

Singh, P. (2012). Maple Story Item Mall Addiction (A Virtual Asset Case Study). MMOBUX, October 12. Located at:

Sacred hearts: What is the relationship between sex and religion?

“I have a sexual attraction and fetish for religious objects and people who get off on having sex or masturbating while in a religious setting. People might think that this type of fetish is an act of deliberate blasphemy, complete with visions of Linda Blair ramming a crucifix into herself while mocking a priest” (quote supplied by ‘The Goddess’)

Sex and religion have always had a somewhat uneasy relationship. When the two intersect there is often controversy, heated debate, and/or scandal. A book chapter by David Steinberg on sexologist Alfred Kinsey (in Russ Kick’s 2005 edited collection Everything You Know About Sex Is Wrong) noted that:

“The publication of Kinsey’s study in 1948 [on male sexual behaviour] was the opening salvo of a monumental battle that has been raging ever since between science (factual information) and religion (moral judgment) on the subject of sex. [There is an] ongoing conflict between secular and theological forces for control of sexual desire and behavior in America”

In the same book, Joseph Slade also made the interesting observation that talking about pornography is a lot like talking about religion: Nearly everyone brings to the subject assumptions that color the debate”. When I started researching material for this article I came across a really interesting historical aside in relation to religion and fetishes. Dr. AnilAggrawal in his 2009 book Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices wrote that the word ‘fetishism’:

“…arose from ‘fetish’, a term used in anthropology for an object believed to have supernatural powers. Early Christians frequently attributed magical and metaphysical powers to such objects as skulls, bones of saints, severed and mummified fingers and arms, etc. These objects were referred to as ‘fetiches’ (sic). When 15th century Portuguese explorers arrived in West Africa and discovered that local people had their own fetiches in the form of religious carvings and other inanimate objects, they began to refer to those inanimate objects as fetiches too. The French writer Charles de Brosses (1709-1777) coined the term fetishism in 1756 (in an anthropological sense) and developed the concept of religious fetishism in his 1760 [book] Duculte des Dieux Fétiches, where he discussed the worship of material objects such as amulets and talismans among ancient and contemporary African populations. De Brosses called this cult ‘fétichisme’ after ‘fétiche’ derived from the Portuguese trading term ‘feitiço’, which designated the small objects and charms on which European merchants would take oaths in sealing commercial agreements with Africans”.

Dr. Aggrawal then noted that when early sexologists were looking for a term to describe sexual fixation on inanimate objects, they borrowed from the Portuguese term because – like a religious fetish – an erotic fetish “also possessed magical powers” (i.e., it had the capability to sexually arouse emotions in those who otherwise seemed asexual).

“If a person who could not be aroused by normal erotic stimuli (say, a nude woman) could be aroused by an inanimate object, say, a sandal or a shoe, the object did have a kind of magical power on that person, and was thus a fetish”.

However, there are small numbers of people who are allegedly sexually aroused by religious artefacts, rituals, and/or behaviour. For instance, hierophilia was defined by Dr. Anil Aggrawal in his 2009 book Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices as a sexual paraphilia in which individuals derive sexual pleasure and sexual arousal from religious and sacred objects. He also made reference to teleophilia (i.e., those individuals who derive sexual pleasure and sexual arousal from religious ceremonies). Aggrawal reported that elements of sexual sadism were present in several Western European medieval religious ceremonies involving flagellation. For instance, in an early 15th-century Catalan painting (The Flagellation of Christ), those inflicting pain on Jesus appeared to be deriving sexual pleasure from their activities.

Dr. Brenda Love in her Encyclopedia of Unusual Sex Practices described hierophilic acts as including masturbating with crosses or masturbating on church pews. She also notes that someone from Austin, Texas (US) wrote to her to say they had broken into churches at night to have sex on the altar. She also reported that:

‘Many of the early goddess religions revered sex and included it as part of their worship. Statues, animals, priests, and priestesses were all provided for congressants’ sexual gratification at one time or another”.

A 2005 book chapter by Dr. Jenny Wade (also in Everything You Know About Sex Is Wrong) makes some interesting connections between transcendent sex and religion. More specifically she says:

“The fact is, the ordinary act of lovemaking can be the most widely available path to higher consciousness for most people. People who have experienced a transcendent episode during sex usually believe they have tapped into divine forces, even if they are atheists or agnostics. These experiences are so extreme, they change people’s views of sex and spirituality…This provides an explanation for the sexual-spiritual basis of most ancient religions by showing that mystical experiences happen every day in the bedroom to a significant portion of the population. Sacred sex is still going on…The act of lovemaking can trigger intense episodes that feature the identical characteristics found in the highest spiritual states documented in such diverse religions as Buddhism, Christianity, Judaism, and Islam, as well as those cited in the annals of yoga and recent research on shamanism”.

In a previous blog examining genital self-mutilation (GSM), I noted that some research had indicated that some males who engage in GSM do so for religious reasons. 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).

A speculative online essay abut hierophilia written by ‘The Goddess’ made a number of claims about the behaviour although there was no empirical support to support her claims. The said that:

“The majority of those who reportedly practice hierophilia are in fact deeply devoted to their religion. Theories as to why a person may develop this unusual fetish go to both biological and psychological levels. Frequent churchgoers are often subjecting themselves to a very highly charged atmosphere (such as a religious revival) that tends to get emotions running high among the congregation. These joyous emotions can often manifest themselves into sexual arousal, especially if the members of the congregation have very close bonds to one another…It is not difficult for one to make the connection between religious settings and sexual arousal. Over a period of time, a hierophiliac becomes conditioned to respond to religious icons or locations with feelings of sexual excitement, or even begin to associate the act of sex itself as a religious experience”.

The article also claims that hierophilia is far less common among atheists. She also speculates that the hierophile derives sexual pleasure from the objects or in the places of their particular religion, but is simultaneously overwhelmed with the guilt that their sexual behaviour is sinful and that they are an evil person for having such thoughts. Because of this, the hierophilic behaviour is claimed to be sexually masochistic.

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.

Gibson, I. (1978). The English Vice: Beating, Sex and Shame in Victorian England and After. London: Duckworth.

The Goddess (undated). My strongest proclivities: Religious sexuality.

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.

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.

Steinberg, D.  (2005). Everybody’s sin is nobody’s sin: Alfred Kinsey and the breaking of sexual silence. In R. Kick (Ed.), Everything You Know About Sex is Wrong (pp.57-60).  New York: The Disinformation Company.

Wade, J. (2005). Transcendent sex. In R. Kick (Ed.), Everything You Know About Sex is Wrong (pp.13-17).  New York: The Disinformation Company.