Monthly Archives: December 2012

Hair gripped: A beginner’s guide to trichophilia

Back in November 2011, I recalled seeing a Daily Mail headline Ritualistic hair-fetish killer serving life in British prison is convicted in Italy of 1993 teen murder”. The story concerned Danilo Restivo – a man with a fetish for cutting off women’s hair – who was sentenced to 30 years in prison following his killing of 16-year old Elisa Claps in 1993 (in Potenza, Italy). He was also convicted of killing 48-year old Heather Barnett in 2002 (in Bournemouth, UK). The murders were described as ritualistic and both killings involved the victims’ breasts being cut off and strands of their hair being placed in her hands. Another link between the two cases, were that 15 women had reported their hair being involuntarily cut on buses in both Bournemouth and Potenza around the time of the murders. Clearly, Restivo is not a typical trichophile (i.e., hair fetishist), and is not representative of those who enjoy this paraphilia. However, it is one of the few times that hair fetishism has been highlighted by the mass media.

According to Dr. Anil Aggrawal’s 2009 book Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices, trichophilia is a sexual paraphilia (sometimes called trichopathophilia, hirsutophilia, and/or hair fetishism) in which individuals derive sexual pleasure and arousal from human hair (most commonly head hair). The source of sexual arousal may be derived from viewing, touching, or (in extreme cases) eating hair. Although head hair is the most common source for arousal, other types of hair may be equally if not more arousing for some people including pubic hair (i.e., pubephilia), armpit hair, chest hair, or facial hair such as beards (i.e., pogonophilia). Some authors – such as Dr. Brenda Love in her Encyclopedia of Unusual Sex Practices – use the word ‘hirsutophilia’ to refer to fetish for armpit hair only. Dr. Love also claims that some hair fetishes are more favoured by particular genders (e.g., she claims chest hair is more likely to be preferred by females).

The fetish has been observed in both males and females (although as with most fetishes and paraphilia, it appears to be predominantly male). Those with hair fetishes may also have very specific attributes as to what is most sexually arousing (such as the hair being from a stranger rather than someone they know, hair length, hair colour, hair style, and whether the hair is wet or dry). They may also prefer hair to have been washed with a particular shampoo or hairspray suggesting an overlap with olfactophilia (i.e., the deriving of sexual pleasure and arousal from particular smells).

Other variants may include the deriving of sexual pleasure from having hair cut, shaved, and/or washed (in fact, a fetish for manipulating and/or shampooing hair is known as tripsoplagnia). Freud believed that men cutting long female hair may represent a man’s fear of castration (i.e., the woman’s hair represents a symbolic penis and that a male feels dominance by cutting it off). There is absolutely no empirical evidence for such claims but Freud is one of the few people to put forward a psychological explanation. The Fetish Connections website makes a number of assertions about hair fetishes, who engages in it, and different subtypes:

Enthusiasts claim an interest since childhood and are especially interested in shampoo commercials on TV. A few hetero voyeurs like the look of women with hairy underarms, or men with hairy chests, but there’s also a gay sub-community involving “musclebears” with hairy chests. Then, there’s transvestite hair salons or spas where the full treatment involves a haircut, hair massage, shampoo, and rollers. The shampoo and rollers ritual is also shared by straight enthusiasts. Long, upright hair (beehive, flip, etc.) is perhaps the most common fetish, followed by long, straight hair, followed by curly hair, followed by short, stubbly hair. Enthusiasts like to put the hair in their mouth during sex, but many achieve orgasm just by touching the hair or by masturbating (sometimes on the hair itself, but not always)”.

I haven’t come across a single empirical study to support any of these claims but given the absence of any academic research literature, the assertions made (at the very least) provide direction for confirmatory studies to be carried out. In their book Death/Sex, biologist Tyler Volk and author Dorion Sagan claim that the roots (no pun intended) of trichophilia may lie in the physiological feelings that the body experiences when hair is played with in some way. More specifically, they claim that:

“Being groomed, having one’s hair cut, like a massage, caresses, or laughter can produce endogenous endorphins, the body’s own pleasure drugs”

I have yet to track down the study (or studies) demonstrating this, but based on other pleasurable activities that have been shown to produce endorphins, there is no reason not to think this isn’t the case with hair grooming. 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 (but was likely to be a lot more). Their results showed that body part fetishes were most common (33%) with trichophilic fetish sites accounting for 7% of all sites studied (6,707 fetishists in total). A further 864 fetishists comprised other types of body hair including depilation sites, beards, and pubic hair.

To date, there are no detailed accounts of trichophilia in the clinical literature. Dr. Richard von Krafft-Ebbing noted the case of a man married to a bearded lady who was distraught after her death and constantly searched for another (although here the trichophilia is implied). However, Dr. Magnus Hirschfield in his book Sexual Anomalies and Perversion recounted a more detailed case of a male (gay) trichophile. He noted:

“When the patient (a highly placed civil servant now aged 50) was seven years old, it happened one night that when he was already in bed the maid-servant, who was leaving, came up to him and embraced him. The patient still remembers quite clearly how he pushed his fingers through her hair. At the age of puberty he begun to experience sexual excitement whenever he saw or touched nicely dressed hair. But from then on, excitement was only induced by the hair of men; the hair of women exercised no effect whatsoever on him, and even in men he was only interested in sleek, dark brown hair, which had to be brushed right back…He derives particular pleasure and sexual excitement from dressing other people’s hair. He executes this operation in the following manner. He stands behind the other man, applies hair oil, which, together with combs, he always carries with him, then he combs the hair back. As the comb reaches the top of the head, ejaculation takes place…the patient, whose behavior has frequently attracted attention, is known by the nickname ‘The Hairdresser’”.

Unfortunately, there is very little information provided by Hirschfield in his case study to make any serious informed speculation as to the causes and/or motivations for his fetish. It obviously started in childhood and developed over the subsequent years. It would also appear that these early experiences appear to have been paired with sexual excitement and that the fetishistic behaviour most likely developed via classically conditioned experiences. Like many other fetishes and paraphilias that I have examined in my blogs, this is yet another one where there is a great need for further research.

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

Further reading

Allen, E. (2011). Ritualistic hair-fetish killer serving life in British prison is convicted in Italy of 1993 teen murder. Daily Mail, November 12. Located at:

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

Fetish Connections (2005). Fetish V [Hair fetishes]. Located at:

Hirschfeld, M. (1948). Sexual Anomalies and Perversions. New York: Emerson.

Krafft-Ebing, R. (1977). Psychopathia Sexualis. New York: Paperback Library (1965 reprint).

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

Parfitt, A. (2007). Fetishism, transgenderism, the concept of castration. Psychoanalytic Psychotherapy, 21, 61–89.

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.

Tyler Volk, T. & Sagan, D.  (2009). Death/Sex. White River Junction, VT: Chelsea Green Publishing.

Palm offensive: A beginner’s guide to alien hand syndrome

Some of you reading this blog may have seen Stanley Kubrick’s 1964 film Dr. Strangelove in which he titular character played by Peter Sellers suffers from alien hand syndrome (AHS), and where his hand clutches his own throat and (at other times) carries out a Nazi salute. Far from being fictional, AHS is one of the strangest neurological disorders and is where an individual’s hand appears to have a mind of its own and acts autonomously (and where the person feels as though their hand doesn’t belong to them and may be seen as ‘disobedient’ – even though they can feel a normal sensation in the ‘alien’ hand). In a 2004 literature review of AHS by Dr. I. Biran and Dr. A. Chatterjee in the Archives of Neurology, the authors note that:

“This syndrome is characterized by a limb that seems to perform meaningful acts without being guided by the intention of the patient. Patients find themselves unable to stop the alien limb from reaching and grabbing objects, and they may be unable to release these grasped objects without using their other hand to pry open their fingers. These patients frequently express astonishment and frustration at the errant limb. They experience it as being controlled by an external agent and often refer to it in the third person”.

AHS was first identified in 1908 by German Dr. K. Goldstein, but was not clearly defined until 1972 by French neurologists Dr. S. Brion and Dr. C.P. Jedynak. However, according to a 2000 editorial in the Journal of Neurology, Neurosurgery and Psychiatry by Dr. Gary Goldberg, the term ‘alien hand syndrome’ was coined by Joseph Bogen to describe a curious wayward behaviour occasionally seen during recovery from certain types of brain surgery. Dr. Goldberg writes that “such patients would react with surprise, concern, and perplexity at the capacity of their non-dominant hand to perform purposeful acts over which they felt no control”.

Cases of AHS have been reported among patients who have had the left and right brain hemispheres separated through surgery (as has been the case in very severe cases of epilepsy where the corpus callosum that connects the two hemispheres is cut). AHS may also occur due to other types of brain surgery as well as some types of infections and strokes. According to an online article on AHS by Charles Bryant, there have only been around “four dozen reported cases” of alien hand syndrome (confirmed by a more scientific paper in the journal Behavioral and Cognitive Neuroscience Reviews, by Dr. Lisa Scepkowski and Dr. Alice Cronin-Golomb who said there are “no more than 50 published cases”).

AHS sufferers typically display sensory deficits as a consequence of dissociating themselves from the actions of their hand. The Wikipedia entry on AHS notes that:

“Alien behaviour [in the hand] can be distinguished from reflexive behaviour in that the former is flexibly purposive while the latter is obligatory. Sometimes the sufferer will not be aware of what the alien hand is doing until it is brought to his or her attention, or until the hand does something that draws their attention to its behaviour”

A 1992 paper by Dr. R.S. Doody and Dr. J. Jankovic on “the alien hand and related signs” in the Journal of Neurology, Neurosurgery and Psychiatry said there were four classic hallmarks of AHS. These were: (i) a feeling of foreignness of the limb, (ii) failure to recognize ownership of it when visual clues are removed, (iii) autonomous motor activities that are perceived as involuntary and are different from other identifiable movement disorders, and (iv) personification of the affected body part.

Research does indeed indicate that AHS sufferers often personify the alien hand and may believe the hand is ‘possessed’ by some other spirit or alien life form. Their hands may even appear to act in opposition to each other (such as when AHS sufferers who are also cigarette smokers put a cigarette in their mouth to set it alight, only for the alien hand to pull it out and throw the cigarette away). Such behaviour is an example of ‘intermanual conflict’ and has been given the name ‘diagnostic ideomotor apraxia’. This type of AHS behaviour is typically caused by damage to the corpus callosum where an injury to a right-handed person would typically give rise to purposeful movements of the left hand.

However, other variants of AHS exist including those who have suffered frontal lobe brain damage (that tend to trigger purposive reaching and grasping movements), and those who have suffered parietal and occipital lobe damage (that tend to trigger hand withdrawal and/or levitation movements away from tactile stimuli). It has also been reported that more complex hand movements (e.g., unbuttoning clothes) are more associated with strokes, brain tumours, and aneurysms. The Wikipedia entry on AHS claims that the common emerging factor in AHS is that “the primary motor cortex controlling hand movement is isolated from premotor cortex influences but remains generally intact in its ability to execute movements of the hand”. Having said that, Dr. Scepkowski and Dr. Cronin-Golomb in their Behavioral and Cognitive Neuroscience Reviews paper assert that:

“The lack of uniformity in reported assessment methods (behavioural tests, neuroimaging) in published cases contributes to the difficulty in establishing clear subtypes of alien-hand phenomena”

Unfortunately, there is no known treatment for AHS although the symptoms can be minimized and managed to some extent by keeping the affected hand occupied and involved in a task (e.g., by giving it an object to hold in its grasp). Some research on case studies note that particular learned tasks can in some cases restore voluntary control to the alien hand. Charles Bryant’s online article on AHS concludes that “regardless of how few cases of alien hand syndrome exist, or how little we know about its cause, the mystery and intrigue of the condition will no doubt continue to inspire writers and filmmakers to explore its horrific and comedic potential”. For the same reasons, I hope it inspires further empirical research.

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

Further reading

Biran, I. & Chatterjee, A. (2004).Alien Hand Syndrome. Archives of Neurology, 61, 292-294.

Brion, S. & Jedynak, C.P. (1972). Troubles du transfert interhemisphérique (callosal disconnection). A propos de trois observations de tumeurs du corps calleux. Le signe de la main étrangère. Revue Neurol, 126, 257- 266.

Bundick, T. & Spinella, M. (2000). Subjective experience, involuntary movement, and posterior alien hand syndrome. Journal of Neurology, Neurosurgery and Psychiatry, 68, 83-85.

Carrilho, P.E.M., Caramelli, P. Cardoso, F. Barbosa, E.R., Buchpiguel, C. & Nitrini, R. (2001). Involuntary hand levitation associated with parietal damage. Another alien hand syndrome. Arquivos Neuro-Psiquiatria, 59 (3-A), 521-525.

Doody, R.S. & Jankovic, J. (1992). The alien hand and related signs. Journal of Neurology, Neurosurgery and Psychiatry, 55, 806-810.

Goldberg, G. (2000). When aliens invade: multiple mechanisms for dissociation between will and action. Journal of Neurology, Neurosurgery and Psychiatry, 68, 7.

Goldberg, G. & Bloom, K.K. (1990). The alien hand sign. Localization, lateralization and recovery. American Journal of Physical and Medical Rehabilitation, 69, 228-238.

Goldstein, K. (1908). Zur lebre der motorischen apraxia. Z Physiol Neurol, 11, 169-187.

Heilman KM, Valenstein E Bogen JE (1993) The callosal syndromes. in Clinical neuropsychology. eds Heilman KM, Valenstein E (Oxford University Press, New York), 3rd ed. pp 337–407.

Scepkowski, L.A. & Cronin-Golomb, A. (2003). The alien hand: Cases, categorizations, and anatomical correlates. Behavioral and Cognitive Neuroscience Reviews, 2, 261-277.

Wikipedia (2012). Alien hand syndrome. Located at:

One foot in the crave: A beginner’s guide to podophilia

Of all the types of sexual fetishes, one of the most common is foot fetishism. In a book chapter on sexual fetishism, Dr. Chris Gosselin and Dr. Glenn Wilson reported that the three most common body part fetishes are feet, hands, and hair. As for myself, I have never seen the attraction of feet, mainly because I taught health psychology to podiatrists and chiropodists for five years. I used to sit in on student clinics where I was surrounded by people with the most awful bunions, corns, calluses, blisters, and verrucas (enough to put anyone off feet for life). On the plus side, I did manage to turn my teaching experiences into academic papers (including a 1994 paper in the Journal of British Podiatric Medicine!).

Many names have been applied to the sexual love of feet including foot fetishism, foot worship, and foot partialism. Others see the behaviour as a sexual paraphilia. For instance, both Dr. Anil Aggrawal (in his book Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices) and Dr. Brenda Love (in her Encyclopedia of Unusual Sex Practices) describe individuals who have a pronounced interest in (and derive sexual pleasure and arousal from) feet as having podophilia. [It is also worth noting that there are some individuals who have a pronounced interest in feet for aesthetic (attractiveness) reasons but without any sexual motive. Such people would not be classed as either foot fetishists or podophiles in the definitions provided by Dr. Aggrawal and Dr. Love].

If you go online and do a Google search for ‘foot fetishes’, not only do hundreds of web pages come up, but the sheer diversity of what people are into are perhaps bewildering to a novice who knows nothing about such fetishes. (I also discovered a number of [in]famous people who were allegedly foot fetishists including singer Elvis Presley, pop artist Andy Warhol, author and adventurer Casanova, serial killer Ted Bundy, and novelist and poet Thomas Hardy). Foot fetishes can be very specific and the individual dimensions and features are critical to the podophile. They are usually interested in the size (of the foot, the toes, the heel), the shape (e.g., flat footed, high arches), the adornments (e.g., footwear, jewellery, toe ring, ankle bracelets, etc.), embellishments (nail varnish, tattoos, pedicure, etc.), non-visual sensory features (e.g., the touch, smell), and – perhaps most importantly – the type of interaction (massaging, touching, kissing, tickling, licking, sucking). There are also sub-dimensions of the fetish including those who are really into footwear rather than the feet (i.e., retifism, from the French novelist Nicolas Edme Rétif who wrote extensively about his own footwear fetish), or those that like naked feet as apposed to footwear adornments (i.e., aretifism).

In a previous blog on sexual fetishism more generally, I wrote 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 (but was likely to be a lot more). Their results showed that there were 44,722 members of online fetish forums with a fetishistic and/or paraphilic sexual interest in feet (47% of all ‘body part’ fetishists that they encountered) Among those people preferring objects related to body parts, footwear (shoes, boots, etc.) was the second most preferred (26,739 online fetish forum members; 32% of all ‘objects related to body parts) just behind objects wore on the legs and/or buttocks (33%). A 2006 report by AOL (called The Sexmind of America) ranked all fetish search words and phrases used by their subscribers and found that the most common fetish searched for related to feet.

Most psychological theorizing concerning both fetishes in general and foot fetishes concern early childhood imprinting and conditioning experiences (where sexual responses are typically paired with non-sexual objects). For instance, the Wikipedia entry on the psychological origins and development of sexual fetishism notes:

“Behaviorism traced fetishism back to classical conditioning and came up with numerous specialized theories. The common theme running through all of them is that sexual stimulus and the fetish object are presented simultaneously causing them to be connected in the learning process…The super stimulus theory stressed that fetishes could be the result of generalization. For example, it may only be shiny skin that arouses a person at first, but in time more common stimuli, such as shiny latex, may have the same effect. The problem with such a theory was that classical conditioning normally needs many repetitions, but this form would require only one. To account for this the preparedness theory was put forward; it stated that reacting to an object with sexual arousal could be the result of an evolutionary process, because such a reaction could prove to be useful for survival”. 

In her sexual encyclopedia, Dr. Brenda Love states that in relation more specifically to foot fetishism that:

“There are many reasons feet are said to be arousing. Feet are often the first part of a mother or father which a toddler touches. Likewise, parents often play with toddlers’ by pushing them with their feet or letting them ride one of their feet. Another aspect involved in the sexual attraction of feet is that love objects always have a barrier or obstacle to attainment and feet are less available to many partners than the genitals. The feet are also less threatening for those with coital difficulty because, unlike the genitals of a partner, they do not make demands for perfect sexual performance”.

The neurologist professor Vilayanaur Ramachandran believes that podophilia may arise because the feet and genitals occupy adjacent areas of the brain’s somatosensory cortex. He believes that there may be some “neural crosstalk” between the two brain areas. An interesting study published in a 1989 issue of Psychological Reports by Dr. James Giannini and his colleagues speculated that the incidence of foot fetishism may increase as a response to epidemics of STDs (sexually transmitted diseases). They noted that there were significant increases in the sexual interest concerning feet during STD epidemics dating back to the 12th century. More recently, there was a marked increase in foot fetishism during the period of the current AIDS epidemic and is viewed by such enthusiasts as a safe-sex alternative. Dr. Aggrawal in his 2009 book Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices wrote that:

It has been suggested that the foot’s shape is distinctly phallic and is viewed by the fetishist to replicate the female or male genitals or the shape of a female body. Another view is that the feet and the genitals are in the same visual window, and when looking at one, the other will be in view as well; thus the two (genitals and feet) become associated in the mind”

In the 1990s, Dr Martin Weinberg, Dr. Colin Williams and Dr. Cassandra Calhan published two papers (one in the Archives of Sexual Behavior [ASB], and one in the Journal of Sex Research [JSR]) about data collected from 262 gay and bisexual foot fetishists. As this was a non-clinical sample, they believed their data was more representative than those seeking treatment (although the sample did not include heterosexual foot fetishists). In their 1994 ASB paper, they reported that their sample’s sexual interests changed over time, and that the fetishistic foot arousal was related to both sensual and symbolic aspects of the fetish. More specifically, they noted:

“Symbolically, it was the theme of masculinity that made male feet/footwear arousing, showing parallels to femininity evoked by female feet/footwear for male heterosexual fetishists. For many of the respondents, fetishism did not seem to be a substitute for living persons. Respondents had intimate relationships and were able to incorporate their fetish interests into stable relationships and less intimate ones. Considerable involvement in sadomasochistic practices was also found as was involvement in the gay world”.

In their 1995 JSR paper, Dr. Weinberg and his colleagues reported that foot fetishism typically began around the start of adolescence and that the experiences were viewed as positive. Their sexual behaviour was a product of learning from other males in their environment (fathers, brothers, older peers) and not as a result of social isolation (often seen as a precursor and/or risk factor in fetishistic behaviour). The men did not seem to be of one particular personality type either.

Compared to many other types of sexually fetishistic behaviour, foot fetishism has received a fair amount of empirical attention both in the academic and clinical literature, and this may be because foot fetishes are more prevalent than most other types. Most podophiles appear happy and contented with their sexual preference and as a consequence do not generally seek treatment.

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.

Giannini, A.J., Colapietro, G., Slaby, A.E., Melemis, S.M. & Bowman, RK (1998). Sexualization of the female foot as a response to sexually transmitted epidemics: a preliminary study. Psychological Reports, 83, 491-498.

Gosselin, C. & Wilson, G. (1984). Fetishism, Sadomasochism and Related Behaviours. In K. Howells. The Psychology of Sexual Diversity, pp. 89-110. London: Blackwells.

Griffiths, M.D. (1995). Is there a role for psychology in podiatry teaching? Journal of British Podiatric Medicine, 50, 59-60.

Kunjukrishnan, R., Pawlak, A. & Varan, L.R. (1988). The clinical and forensic psychiatric issues of retifism. Canadian Journal of Psychiatry, 33, 819-825.

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

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.

Weinberg, M.S., Williams, C.J. & Calhan, C. (1994). Homosexual foot fetishism. Archives of Sexual Behavior, 23, 611-626.

Weinberg, M.S., Williams, C.J. & Calhan, C. (1995). “If the shoe fits…” Exploring male homosexual foot fetishism. Journal of Sex Research, 32,17-27.

Wikipedia (2012). Sexual fetishism. Located at:

Drag chasing: A beginner’s guide to gynemimetophilia

If you were a regular viewer of the American drama Dirty Sexy Money you may remember that one of the stories played out across the series was the on-off relationship between Patrick Darling IV (played by William Baldwin) and his transgender mistress girlfriend Carmelita Rainer (played by Candis Cayne who in real life became the first transgender actress to play a recurring transgender character on prime time television). Although Patrick Darling’s relationship with Carmelita was fictional, there is a minority of men who have a sexual preference for women who were born men.

In a review of paraphilias not otherwise specified (P-NOS), Dr Joel Milner and colleagues briefly overviewed this condition that was termed gynemimetophilia by the sexologist Professor John Money (from the Greek, gyne [woman], mimos [mime], and philia [love]). Dr. Milner and his colleagues define gynemimetophilia as a sexual paraphilia where an individual (usually male) derives sexual arousal and pleasure from sexual partners who are gynemimetic (typically a sex-reassigned, male-to-female transsexual). Such people are colloquially known as ‘transfans’ (although other names include ‘tranny chasers’ and ‘tranny hawk’). Milner and colleagues also note a related condition termed gynemimesis that normally refers to a homosexual male who engages in female impersonation without sex reassignment (such as a drag queen). Among females, the paraphilic equivalent (also coined by Professor Money) is andromimetophilia (from the Greek, andros [man], mimos [mime] and philia [love]). The T-Vox website provides advice, information and support website on the internet for transgendered individuals. It claims that:

“Gynemimetophilia may be a word assigned to both chasers and admirers. People who are attracted to female identified transgender people may be of any gender or sexual orientation. They may or may not think of their attraction as a fetish. Some people may have a more sex positive view of fetish and not be bothered by the idea of objectification while other people may view fetish and objectification as oppressive and dangerous”.

Attraction to transgendered individuals doesn’t necessarily have to be paraphilic although the (sexual and/or romantic) attraction is said to be enduring. Some academics distinguish between those who are attracted to those individuals who have undergone gender reassignment surgery, and those who are attracted to those who simply dress as the opposite sex. To be classed as a paraphilia, the attraction would normally have to be an exclusive or primary sexual preference for trans men and/or trans women. Some clinically oriented academics characterize transgender attraction as a medical diagnosis to be managed, but it would appear that most individuals who are attracted to transgendered individuals do not seek treatment (therefore it may not be clinical condition in most cases). According to a the Wikipedia entry on transgender attraction:

“Many members of the transgender community (particularly in the MTF [male-to-female] population use ‘tranny chaser’ in a pejorative sense, because they consider it a fetish-like attraction to the penis of a pre-operative or non-operative trans woman MTF or to the vagina of a pre- or non-operative trans man. In [the 1996 book] ‘True Selves’ [Mildred] Brown and [Chloe] Rounsley suggested that tranny chasing men may be homosexual men in denial. The term tranny (or trannie) is itself considered a slur in some circles”.In [the book] ‘Diary of a Drag Queen’, Danny Harris describes four types of men interested in him while he was cross-dressed: heterosexual men who wanted the presumed superior oral services of another male, homosexuals who were only interested in his genitals, other cross dressers, and men who were intrigued by the mixture of masculinity and femininity he represented”.

The reasons for attraction differ from one person to another but a recent 2011 paper by Dr. Jeffrey Escoffier in the journal Studies in Gender and Sexuality highlightsthat the exoticism of the transgendered individual can be a primary attraction and that such people are “often both hyperfeminine in appearance and sexual aggressive”. He claimed that the phenomenon is fairly new and claims that the first known cases occurred in 1953 following the first case of male-to-female sex change (i.e., Christine Jorgensen). Others may be attracted to what transgendered individuals represent and the way they challenge male/female sexual orthodoxy.

However, a 2008 qualitative study in the journal AIDS and Behavior led by Dr. Don Operario examined men who have sex with transgender women (or MSTGWs as they termed them). Operario and his colleagues conducted in-depth semi-structured individual interviews with 46 MSTGWs living in San Francisco. Approximately three-quarters of those they interviewed described themselves as heterosexual or bisexual. They reported great diversity in the ways MSTGWs explained their sexual orientation, and reported there was “no consistent patterns between how men described their sexual orientation identity versus their sexual behavior and attraction to transgender women”. As one of their interviewees said: I like women with dicks. I like tits and I like dicks…Something erotic about getting fucked by someone who is a woman”.

A 2010 sociological study by Dr. Martin Weinberg and Dr. Colin Williams examined men who were sexually interested in trans women (MSTW) in the Journal of Sex Research. In their study, trans women were defined as genetic males who used estrogen to feminize their body but retained their penis. They examined the nature of MSTW’s sexual attraction towards trans women, and then examined how this related to their sexual orientation identity. Their main finding was that those MSTWs who identified as heterosexual tended to gloss over the fact that the trans woman had a penis, while the bisexually identified MSTWs were more likely to incorporate the trans woman’s penis into the sexual experience. Finally, it is worth noting that the T-Vox website is not in favour of using the word ‘gynemimetophilia’ because:

“The word gynemimetophilia has a negative connotation and is a somewhat loaded or controversial term in the transgender community, particularly since associated with paraphilia or fetish. In order to promote positive gender identity, many transgender people would rather not use terms which refer to fetish because of the connotation of sexual objectification in relationship to transgender people… Gynemimetophilia is a primarily psychological term and psychological practitioners should take care in using this label as it can be psychologically damaging”.

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

Further reading

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

Blanchard, R., & Collins, P.I. (1993). Men with sexual interest in transvestites, transsexuals, and she-males. Journal of Nervous and Mental Disease, 181, 570–575.

Brown, M.L. & Rounsley, C.A. (1996). True Selves: Understanding Transsexualism: For Families, Friends, Co-workers, and Helping Professionals. Jossey-Bass.

Escoffier, J. (2011). Imagining the she/male: Pornography and the transsexualization of the heterosexual male. Studies in Gender and Sexuality, 12, 268–281.

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

Money, J. (1984). Paraphilias: Phenomenology and classification. American Journal of Psychotherapy, 38, 164-78.

Money, J. (1986). Lovemaps: Clinical Concepts of Sexual/Erotic Health and Pathology, Paraphilia, and Gender Transposition of Childhood, Adolescence, and Maturity. New York: Irvington Publishers.

Operario, D., Burton, J., Underhill, K., & Sevelius, J. (2008). Men who have sex with transgender women: Challenges to category-based HIV prevention. AIDS and Behavior, 12, 18-26.

T-Vox (2012). Gynemimetophilia. Located at:

Weinberg, M.S. & Williams, C.J. (2010). Men sexually interested in transwomen (MSTW): Gendered embodiment and the construction of sexual desire. Journal of Sex Research, 47, 374-383.

Wikipedia (2012). Attraction to transgender people. Located at:

Die another day: A brief look at ‘addiction to near death’

In previous blogs I have examined both people’s fascination with death and human near death experiences (NDEs). Another aspect to NDEs that I didn’t mention in those articles was the idea of people being “addicted” to NDEs. Arguably, most people’s perceptions of ‘near death addiction’ are probably based on the 1990 US film Flatliners. In that film, a group of five medical students (played by Keifer Sutherland, Kevin Bacon, Julia Roberts, Oliver Platt and William Baldwin) attempt to examine whether there is anything beyond death by carrying out experiments into NDEs. Keifer Sutherland’s character (Nelson) is continually made to experience clinical death (i.e., flatlining with no heartbeat) before being brought back to life by his classmates.

This Hollywood portrayal of possible ‘near death addiction’ bears little resemblance to the academic literature – most of which has been written from a psychodynamic perspective – and relates more to continual self-destructive experiences (usually by adolescents or young adults). The concept of ‘addiction to near death’ (ATND) originates from the writings of Dr. Betty Joseph, a distinguished psychoanalytic clinician often lauded as “the psychoanalysts’ psychoanalyst” and known for her work with highly resistant ‘difficult to treat’ patients. Dr. Joseph first wrote about the ‘addiction to near death’ concept in a 1982 issue of the International Journal of Psychoanalysis. This form of masochistic pathology was a concept that she found useful when working with psychologically dysfunctional adolescents. As Dr. Janet Shaw noted in a more recent 2012 paper on ATND in the Journal of Child Psychotherapy:

“At [the adolescent] stage of development, there is a tendency for adolescents who are troubled to turn to destructive or self-destructive behaviour, suicidal ideation, self-harm, self-starvation and inappropriate sexual behaviour. This is often profoundly shocking and alarming to others, especially if the young person finds the impact on others pleasurable. [Betty] Joseph described a patient addicted to near death as being caught up in a wish to gain pleasure by destroying both himself and the analytic relationship…[She] described masochistic destruction of the self taking place with libidinal satisfaction, despite much concomitant pain. The masochistic position is deeply addictive and this way of using pain for the purposes of pleasure becomes habitual. She summed this up as, ‘the sheer unequalled sexual delight of the grim masochism’ and described the awful pleasure that is achieved in this way”.

However, as Dr. Shaw rightly points out, not all types of destructive and self-destructive behaviour fall into such a category. In her 1982 paper, Dr. Joseph outlined case studies she had treated psychoanalytically from her private practice. Here, she described the masochistic dynamics of her patients, and how hard it was for them to alter these dynamics and get better. She noted that one of the key aspects of the dynamics she described was that her patients derived immense libidinal satisfaction from engaging in destructive near-death behaviours. More specifically, she wrote:

“There is a very malignant type of self-destructiveness, which we see in a small group of our patients, and which is, I think, in the nature of an addiction – an addiction to near-death. It dominates these patients’ lives; for long periods it dominates the way they bring material to the analysis and the type of relationship they establish with the analyst; it dominates their internal relationships, their so-called thinking, and the way they communicate with themselves. It is not a drive towards a Nirvana type of peace or relief from problems, and it has to be sharply differentiated from this. The picture that these patients present is, I am sure, a familiar one – in their external lives these patients get more and more absorbed into hopelessness and involved in activities that seem destined to destroy them physically as well as mentally, for example, considerable over-working, almost no sleep, avoiding eating properly or secretly over-eating if the need is to lose weight”.

In a 2006 issue of Psychanalytic Psychology, Dr. William Gottdeiner also noted that the ATND is such a strong motive that successful treatment of such individuals is unusually difficult. However, Dr. Gottdeiner asserted that one of the severe weaknesses of Joseph’s writings is that she failed to provide in-depth clinical examples of anyone who had engaged in potentially deadly activities. This, Gottdeiner contended, threatened the validity of the ATND construct. Despite such inherent weaknesses, Gottdeiner still believed the ATND construct had strong face validity (i.e., “there are people who seem to repeatedly engage in potentially lethal behavior, making the ATND construct plausible”). Consequently, Gottdeiner tested the construct validity of ATND on females with substance use disorders (SUDs). His argument was that:

“If individuals who are diagnosed with an SUD are successfully treated and they continue to engage in potentially deleterious behavior, then that finding would support the notion that the individual has an addiction to near-death experiences, and that the individual’s substance abuse was a comorbid disorder”.

Gottdeiner’s paper attempted to validate the ATND construct via secondary analysis “of data from a treatment outcome study of individuals who were in residential therapeutic community treatment for SUDs and who received simultaneous safe-sex education during treatment”. His study findings showed that despite safe-sex education and sexual activity in the therapeutic communities being prohibited, that some of the participants still engaged in risky sexual behaviour (irrespective of whether their sexual partners were HIV-positive or not). Gottdeiner argued that these findings tentatively supported the ATND construct. However, Gottdeiner was the first to admit that his study had inherent weaknesses. As he noted:

The limitations were: data were from retrospective self-reports [and] contained no baseline measures of sexual activity, safe-sex knowledge, condom use, HIV status; it had no male participants, no specific questions about near-death behavior, nor whether alternative safe-sex activities were practice…The limitations of [the] study are considerable, and some might even argue that the connection between the ATND construct and the data presented herein is too much of a stretch to be scientifically useful…Obviously, stronger data would lead to stronger conclusions. Despite the limitations of this study, the findings should motivate clinicians to more seriously consider the existence of an addiction to near-death in their clients”.

More recently, Dr. Janet Shaw examined the ATND construct through the description and evaluation of an in-depth case study account of an adolescent female (‘Susan’). Her paper explored “the way in which pleasure, which is sadistic and masochistic in nature, is associated with cruelty towards the self or others in adolescence”. Dr. Shaw wrote that it felt as if Susan’s main aim was to torment her. As Shaw reported:

“In addition to suicide threats, similar to those she made in the assessment, she made constant reference to systematically starving herself. She was painfully thin, although not actually anorexic and she was poisoning herself by repeatedly taking paracetamol. Susan’s threats to self-harm had a deeply disturbing quality and she clearly enjoyed making them. There was a wish to punish me, as well as herself, through her phantasised attacks…The case material is an example of an adolescent girl with ‘an addiction to near death’ constituting a dominant way of relating to others. Her relentless and manipulative references to self-harm, suicide and dangerous behaviour at various stages of the work were designed to shock and alarm…Susan’s self-destructive behaviour was also continuing in relation to her self- starvation. She said she took laxatives in an attempt to lose more weight. She was becoming dangerously thin and three years into her psychotherapy an appointment with the referring psychiatrist resulted in a diagnosis of anorexia nervosa”.

This quote doesn’t do justice to the very detailed account that Dr. Shaw provided in her lengthy paper. However, her written account is heartfelt and brutally honest. Shaw concludes that the compelling power of addiction overviewed in Susan’s case mustn’t be underestimated. As she notes:

“The narcissistic idealisation of sadistic and masochistic behaviour offers some protection from fear and terror for the patient, but the consequence is to severely limit capacity for thought and imagination, and to restrict awareness. ‘Addition to near death’ forms a small but significant component of the clinical casework of a child and adolescent psychotherapist: it is hoped that Susan’s case material serves to illuminate the phenomenon further and its technical challenges”.

Whether the clinical case of Susan provides any more evidence for validation for Joseph’s ATND construct than the more empirical work of Gottdeiner is debatable. However, this is certainly a fascinating – if somewhat harrowing – area of clinical and academic work that certainly warrants further empirical examination.

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

Further reading

Gottdiener, W.H. (2006). A preliminary test of the Addiction-to-Near-Death construct. Psychoanalytic Psychology, 23, 661-666.

Joseph, B. (1982). Addiction to near death. International Journal of Psychoanalysis, 449-456.

Joseph, B. (1988). Addiction to near death. In Bott Spillius, E. (Ed.) Melanie Klein Today (pp.311-323). London and New York: Routledge.

Ryle, A. (1993). Addiction to the death instinct? A critical review of Joseph’s paper ‘Addiction to near death’. British Journal of Psychotherapy, 10, 88–92.

Shaw, J. (2012). Addiction to near death in adolescence. Journal of Child Psychotherapy, 38, 111-129.

Nappy talk: A beginner’s guide to diaper fetishes

In a previous blog I examined paraphilic infantilism (i.e., individuals who get sexually aroused from being an adult baby). Of those who enjoy being adult babies, it appears that many of them fetishize particular aspects such as lactophiles who are sexually aroused by being wet-nursed. Others may be sexually aroused by urinating themselves, defecating themselves, being spanked, and/or just getting very messy (and therefore may have other sexually paraphilic interests such as urophilia, coprophilia, masochism, and/or salirophilia). Another aspect that may be fetishized by the paraphilic infantilist is the wearing of diapers (or nappies as we prefer to call them here in the UK). It could also be argued that diaper fetishism is a sub-type of garment fetishism. For instance, Dr. Aggrawal in his 2009 book Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices noted that:

“Garment fetishes revolve around, or fixate on, a particular type of garment. Common examples are shoes, stockings, diapers, gloves, underwear and bras. The affected person is fixated on the specific garment to such an extent that it exists as an exclusive or recurrent stimulus for sexual gratification”.

In a previous blog on fetishism more generally, 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 (but was likely to be a lot more). Their results showed that there were 483 diaper fetishists (less than 1% of all fetishists). This suggests that while not the most popular type of fetishistic behaviour, it certainly exists. Again in Dr. Aggrawal’s book he reported a case study that had been published in a 2005 Turkish psychiatric journal:

“Oguz and Uygurdescribe a case of diaper fetishism in a 22-year old man. His mother was psychologically distant from him. The fetish object (the diaper) was recognized during childhood at around the age of four. The patient exhibited his first perverted behavior when he was six. At twelve the perverted behavior became sexually arousing. During puberty, the fetish object became sexually attractive. Later, the patient could control this behavior”.

However, prior to this case study, there were a number of published papers concerning males with diaper fetishes. In an early (1964) issue of the American Journal of Psychiatry, Tuchman and Lachman reported the case of a man who continually wore rubber pants over his diaper and enjoyed urinating and masturbating while wearing it. In another case reported in the same journal a couple of years later, Malitz reported the case of a 20-year-old college student who had a compulsion to wear diapers underneath rubber pants and defecate in them. While defecating he would typically reach orgasm even if he didn’t masturbate (and suggests that he also had coprophilic tendencies). In 1967, Dinello (again in the American Journal of Psychiatry) reported the case of a 17-year-old male who in his mid-teens started wearing diapers under his clothing, and masturbated while wearing the diaper. He eventually, gave up wearing nappies and began dressing in women’s clothing. In a 1980 issue of the Medical Journal of Australia, Pettit and Barr published the case of 24-year-old man who began dressing in female clothes at the age of 10 years and by the age of 15 years began to dress as a baby and developed a fetish for nappies.

More recently (2003) in the American Journal of Psychiatry, Dr Jennifer Pate and Dr Glenn Gabbard reported the case of a 35-year-old single man who began wearing diapers for sexual pleasure from the age of 17 years. It was reported that the wearing of diapers had begun to compromise his personal relationships. He admitted that the wearing of diapers was “a kind of a sexual thing” and like the aforementioned cases, he enjoyed masturbating while wearing the diapers (in fact, the only time he masturbated was when he was wearing the diaper). He wore and used up to five nappies a day as he would always urinate and/or defecate in them. Pate and Gabbard concluded that the object of sexual arousal was the diapers and that the behaviour was a paraphilia.

In 2004, Croarkin and colleagues reported a case (yet again) in the American Journal of Psychiatry of a 32-year-old male who gained his sexual arousal from wearing diapers. In a 2003 paper by Dr. Gregory Lehne and Professor John Money, they described the case of a man who showed “multiplex paraphilia” over a lifetime including paraphilic infantilism and diaper fetish. They reported that:.

“At age 7 [years] the subject was dressed in public as a girl wearing a diaper as a humiliation for bed-wetting. This experience had 3 paraphilic components that were separately manifested at different times in his life: fetishistic transvestism, pedophilic incest, and infantilism…At age 45 [years] he reported a sudden recurrence of paraphilic preoccupation. He did not engage in cross-dressing, but he had become involved in sexual fantasies and more frequent and adventuresome sexual relations with his wife. The main fantasy that was emerging was being an ‘adult baby’. He described the main fantasy and associated activity: I enjoy ‘living as a baby whenever I have an opportunity. I love to lie in a diaper, powder myself and pin myself in tightly. I then slip on my rubber pants and prepare for bed’. The experience of wearing and wetting in a diaper is the focus of this fantasy and behavior. He would use a nursing bottle to drink infant formula, and then wet in his diapers, change the diapers and later fall asleep. He engages in this activity about once or twice a week, sleeping in a baby bedroom apart from his wife on these nights. He described the experience as sexual, with a feeling of tremendous calm and satisfaction during these activities, but no genital arousal or ejaculation. He read and wrote fantasy stories about infantilism, in the course of which he would become aroused and masturbate. This practice of infantilism has continued as his paraphilic activity for 20 years”.

Unfortunately, nothing is known about the incidence or prevalence of diaper fetishes, and there is no consensus on the etiology but has been linked to maladaptive learning in childhood, faulty childhood imprinting, and erotic targeting errors. The case studies, while similar, are relatively rarely reported in the clinical literature and there is no way of knowing how representative these case study examples are.

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.

Croarkin, P., Nam, T., & Waldrep, D. (2004). Comment on adult baby syndrome. American Journal of Psychiatry, 161, 2141.

Dinello, F.A. (1967). Stages of treatment in the case of a diaper-wearing seventeen-year-old male. American Journal of Psychiatry, 124, 94-96.

Lehne, G. K. & Money, J. (2003). Multiplex versus multiple taxonomy of paraphilia: Case example. Sexual Abuse: A Journal of Research and Treatment, 15, 61-72.

Malitz, S (1966). Another report on the wearing of diapers and rubber pants by an adult male. American Journal of Psychiatry, 122, 1435-1437.

Oguz N, Uygur N. (2005). [A case of diaper fetishism]. Turk Psikiyatri Derg, 16,133-138.

Pate, J. & Gabbard, J.O. (2003). Adult baby syndrome. American Journal of Psychiatry, 160, 1932-1936.

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.

Tuchman, W.W. & Lachman, J.H. (1964). An unusual perversion: the wearing of diapers and rubber pants in a 29-year-old male. American Journal of Psychiatry, 120, 1198-1199

Doggy day care: An overview of Puppy Pregnancy Syndrome

In my previous blogs, I have looked separately at pregnancy delusions (i.e., women and men who think and claim they are pregnant but are not – including Couvade Syndrome) and culture bound syndromes (i.e., a combination of psychiatric and/or somatic symptoms viewed as a recognizable disease within specific cultures or societies). Since writing those blogs I unearthed a fascinating academic paper examining one of the strangest culture bound syndromes I have ever come across. While idly looking for some inspiration for a new blog, I happened (by chance) to come across a blog written in November 2011 by Jesse Bering on the Scientific American website which began with this opening paragraph.

Are you suffering abdominal pain or discomfort, fatigue, nausea, flatulence, heartburn, and acid reflux? Have you been having difficulty urinating, or experiencing pain while doing so? Oh, and one other question – have you been spontaneously expelling microscopic bits of disintegrated dog fetuses through your urethra? If you answered “yes” to all of the above, then you may be suffering from “Puppy Pregnancy Syndrome”.

Bering’s report was based on a 2003 paper published in the International Journal of Social Psychiatry, entitled Puppy pregnancy in humans: A culture-bound disorder in rural West Bengal, India”. The paper described a phenomenon that has only ever been reported in this one Indian area (near Kolkata) where both and women are convinced that it is possible to become pregnant and carrying a canine foetus if they are bitten by dogs – particularly if the dog is sexually aroused and because the dog’s saliva contains dog gametes. The phenomenon is a fairly recent one as there are few reports of ‘puppy pregnancy’ prior to 2000.

The paper, by Dr. Arabinda N. Chowdhury (Professor of the Institute of Psychiatry, Kolkata, India) and colleagues featured seven cases of people suffering from puppy pregnancy (six males and one female). The men claim to give birth to the puppies via their penis (in a similar excruciating fashion to the way that men have to pass kidney stones). At night, the female case claimed she could hear the puppies barking in her abdomen.

They also interviewed a further 42 adult villagers to see how prevalent the belief in puppy pregnancy was. They reported that three-quarters of the villagers interviewed believed with “definite certainty” that puppy pregnancy existed (73%), while only 9% had no belief in the phenomenon. In fact, it was reported that almost all the villagers could name someone whose unexplained death they believed was the direct consequence of a toxic puppy pregnancy (including those who were among the most well educated). The authors noted that in relation to the cases they outlined that:

“Psychiatric status showed that there was a clear association of obsessive-compulsive disorder in two cases, anxiety-phobic locus in one and three showed no other mental symptom except this solitary false belief and preoccupation about the puppy pregnancy…One case (11-year-old child) exemplified how the social imposition of this cultural belief made him a case that allegedly vomited out an embryo of a dog foetus… the cases presented a mix of somatic and psychological complaints and their help-seeking behaviour was marked”.

Due to the widespread belief in the existence of puppy pregnancy fact, the village community has their own “medical” specialists who “treat” the condition called bara ojhas. These so-called specialists provide remedies and/or perform abortion-inducing rituals. During the early stages of “pregnancy”, the use of herbal medicines by bara ojhas are said to help dissolve the puppy foetuses so that they are naturally expelled through the person’s genitals in an unobtrusive way. In Jesse Bering’s account of puppy pregnancy, he describes the case of a male:

“After one 24-year-old college graduate had an encounter with a stray dog that scratched him on the leg six months earlier, he became extremely wary of dogs because he was deathly afraid that one might knock him up. He was so preoccupied with dogs that even in the interview room he was apprehensive that a dog may come out from under the table. To address his unending circular ruminations about puppy pregnancy, his dog anxiety, and his obsessive-compulsive need to search for microscopic fetal canine parts in his urine, he was prescribed Clomipramine (an antidepressant) and Thioridazine (an antipsychotic). Importantly, he also underwent a month of behavioral reconditioning with a dog while being treated as an inpatient”.

Obviously, the condition may have no medical basis, but on a psychological level, the people in the Indian community experiencing a puppy pregnancy believe it is real. Dr. Chowdhury and colleagues believe that the crux of the condition is “the absence of any realistic consideration about the absurdity of asexual animal pregnancy and pregnancy in males (to the degree of delusional conviction).”

Dr. Chowdhury and colleagues believe that Puppy Pregnancy Syndrome meets the criteria for a genuine Culture-Bound Disorder because the mass delusional belief occurs as a consequence of “emotionally fuelled social transmission” only found in a very particular community (in this case, rural West Bengal), and that the disorder needs “proper cultural understanding for its effective management”.

Jesse Bering’s blog also made reference to another culture where giving birth to animals is a widely held belief. Bering cited the anthropologist E.E. Evans-Pritchard’s account of the Azande people in Africa who believe that some women can give birth to cats. I actually managed to get hold of Evans-Pritchard 1976 book Witchcraft, Oracles, and Magic among the Azande. The Azande believe that many animals are witches or dead witches inhabiting the animals. The most feared animal by the Azande are wildcats (called the adandara) that they believe have sex with female villagers. These women then allegedly give birth to kittens who are then said to breastfeed them like human children. The appendices in Evans-Pritchard’s book (based on his interviews with the Azande) reported:

The male cats have sexual relations with women who give birth to kittens and suckle them like human infants. Everyone agrees that these cats exist and that it is fatal to see them…There are not many women who give birth to cats, only a few. An ordinary woman cannot bear cats but only a woman whose mother has borne cats can bear them after the manner of her mother”.

When interviewing Azande people, Evans-Pritchard said that his personal contacts included only two cases of people who had actually seen adandara. He then went on to note:

“Azande often refer to lesbian practices between women as adandara…This comparison is based upon the like inauspiciousness of both phenomena and on the fact that both are female actions which may cause the death of any man who witnesses them…Homosexual women are the sort who may well give birth to cats and be witches also. In giving birth to cats and in lesbianism the evil is associated with the sexual functions of women”.

Given that so little information was given in Evans-Pritchard’s book, I have no idea if the belief in adandara could be classed as a culture-bound syndrome, but there do seem to be similarities with Puppy Pregnancy Syndrome.

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

Further reading

Bering, J. (2011). Puppy pregnancy syndrome: Men who think they are pregnant with dogs. Scientific American, November 15. Located at:

Chowdhury, A., Mukherjee, H., Ghosh, H.K. & Chowdhury, S. (2009). Puppy pregnancy in humans: A culture-bound disorder in rural West Bengal, India. International Journal of Social Psychiatry, 49, 35-42.

E.E. Evans-Pritchard (1976). Witchcraft, Oracles, and Magic among the Azande. Oxford: Clarendon Press.

Voice of America (2012). Bizarre medical myth persists in rural India.Located at: