Monthly Archives: July 2013

Choker face: A brief look at suffocation roulette

When I was a kid (well about 12 or 13 years old) my friends and I used to occasionally play a game that we called ‘Headrush’ where I would have my breathing temporarily stopped by someone holding onto my chest after a deep expiration and hyperventilation (so that I couldn’t breathe), and it would induce feelings of light-headedness and dizziness followed by temporary unconsciousness (usually lasting 10-15 seconds). I did it twice and on both occasions I felt as though I had lived a whole other life while I was unconsciousness. I’m not condoning the behaviour (as it’s potentially life-threatening) but the experience was pretty mind-blowing (at least that’s my adolescent recollection). The only thing I can relate it to are the accounts I have read by others who have talked about their near death experiences.

I vividly remember the day that I said I would never do it again as my friends and I thought we had caused the death of another boy (a couple of years older than ourselves). My best friend at the time had induced the fainting reaction in our older friend and he was out cold for much longer than the 10-15 seconds we would normally have expected. We thought he was dead. However, after about 25-35 seconds our friend’s hands and feet were making strange movements. I remember his feet ‘clapping’ together constantly for about 20 seconds. After about a minute he came around and said that he had experienced a wonderful feeling that he had lived his life as a seal! Despite the fact that my friend lived to tell the tale, I never participated in the fainting game ever again.

I had not even thought about these adolescent experiences until a few months ago until I came across (quite by chance) a paper written by Dr. Gil Shlamovitz and colleagues on ‘suffocation roulette’ in a 2003 issue of Annals of Emergency Medicine. They reported the case of a 12-year-old boy admitted to hospital because of “recurrent syncopal episodes” (i.e., persistent fainting). The authors reported that the fainting episodes were due to a game they called ‘suffocation roulette’ (a term I had not heard before but was the same game that I described above). After reading this paper, I decided I would have a further look into this phenomenon and it became very clear that the game I played as a young teenager has been played by many others around the world (under dozens of different names that I’ve listed at the end of this blog). It also appears that what we were doing as kids was a form of ‘self-induced hypocapnia’ that refers to a state of reduced carbon dioxide in the blood).

Most academic reports refer to the phenomenon as a type of ‘asphyxial game’ (with ‘the choking game’ or ‘the fainting game’ appearing to be the most commonly reported). Sometimes these ‘games’ are played alone and typically involve self-strangulation, and sometimes with others (where like my own experiences, the cutting off of the oxygen supply was carried out by somebody else. As with autoerotic asphyxiation, the aim of the game is to intentionally cut off the oxygen supply to the brain to experience a feeling of euphoria (the only difference being that in children’s games, it is not done for a sexual reason). A Wikipedia entry on the topic notes:

“According to Dr. Steve Field, chairman of the Royal College of General Practitioners in London, the fainting game is pursued primarily by children and teens ‘to get a high without taking drugs.’ Children ‘aren’t playing this game for sexual gratification.’ It is frequently confused with erotic asphyxiation, which is oxygen deprivation for sexual arousal. Unlike erotic asphyxiation, practice of the fainting game appears to be uncommon in adulthood”.

My own personal experiences of this would support Dr. Field’s assertions. There has been relatively little research into the practice although a fairly recent (2010) paper by Dr. Joseph Drake and colleagues in the journal Academic Pediatrics claims that ‘thrill-seeking’ is risk factor. Another paper published in a 2009 issue of the journal Injury Prevention (led by Dr. A.J. MacNab) said there was a perception among those who engaged in it that inducing fainting was a low-risk activity (something that I can attest to until I thought my friend had accidentally killed someone).

The paper led by MacNab attempted to determine the prevalence of knowledge about and participation in asphyxial games and how best to raise awareness of this risk-taking behaviour and provide preventive education. The study collected data from children and adolescents (aged 9-18 years with an average age of 13.7 years) at eight middle and high schools in Texas (n=6) and Ontario (n=2). They also noted that there had been a recent death from playing the choking game in one of the Texas schools, and that two other fatalities had occurred within the state. Over 2500 questionnaires were completed. They reported that 68% of children had heard about the game, 45% knew somebody who played it, and 6.6% had tried it (and 40% perceived no risk from the activity). The study found that the most respected source of a preventive education message was parents for pre-adolescents (43%) or victim/victim’s family (36%) for older adolescents.

In the 2008 book The Path to Addiction: And Other Troubles We Are Born To Know, Richard McKenzie Neal also says the author reasons that children participate in fainting games include curiosity (as to what the act of fainting might feel like), peer pressure (including a challenge or a dare or a rites of passage into a particular social group), exploration of ways to ‘get high’ and intoxicated at no financial cost. I also read that:

“[In] self-induced hypocapnia blackouts the victim may experience dreaming or hallucinations, though fleetingly, and regains consciousness with short-term memory loss and involuntary movement of their hands or feet. Full recovery is usually made within seconds but these activities cause many permanent brain injuries or death”

This description matches my own personal experiences of playing the fainting game and also seems to match our friend’s account that he thought he was a seal while unconscious. Like autoerotic asphyxiation, the playing of asphyxial games among children and teenagers has occasionally led to fatalities and reported in the clinical and medical literature. For instance, a recent case was reported by Dr. M.K. Egge and colleagues in the journal Pediatric Emergency Care. Their case was a 12-year-old girl who was brought to the paediatric emergency department after her mother found her hanging from her bunk bed. She died five days after being admitted to hospital and it was eventually found that she had played the choking game. Most cases of asphyxial game playing have been reported in the US, UK and Australia, although I did come across papers written in both Spanish and French about the phenomenon.

How prevalent the activity is debatable as most of the academically published studies are case reports (usually when a problem – and in some cases, death – has occurred). One 2006 US (Ohio-based Youth Health Risk Behavioral Survey) study (but not peer reviewed as far as I can tell) reported that approximately one in ten teenagers (11%) aged 12 to 18 years had engaged at least once in fainting games with the figure rising to almost one in five older teenagers (19%) among those aged 17 and 18 years. No-one knows how many teenagers have suffered brain damage or died as a result of such activities. One of the better published studies on fainting/choking games was published by Dr. R.L. Toblin and colleagues in the Journal of Safety Research who reported:

Because no traditional public health dataset collects data on this practice, the [Centers for Disease Control and Prevention] used news media reports to estimate the incidence of deaths from the choking game. This report describes the results of that analysis, which identified 82 probable choking-game deaths among youths aged 6-19 years during 1995-2007. Seventy-one (86.6%) of the decedents were male, and the mean age was 13.3 years”.

The study also noted that deaths were recorded in 31 states and were not clustered by location, season or day of week. My brief examination of the literature suggests that a significant minority of adolescents have engaged in asphyxial game playing and that in extreme cases it may lead to death. It would certainly appear to be an activity that parents and teachers should be made more aware of.

  • According to the online Urban Dictionary, asphyxial games have many different names worldwide including: Airplaning, America Dream Game, Black Boxing, Black Out Game, Breath Play, Breathing the Zoo, Bum Rushing, California Blackout, California Choke, California Dreaming, California Headrush, California High, California Knockout, Catching Some Zs, Choking Game, Cloud Nine, Crank, Dream Game, Dreaming Game, Dying game, Fall Out Game, Flat Liner, Flatline Game, Flatliner Game, Funky Chicken, Getting Passed Out, Grandma’s Boy, Groobling, Halloween, Harvey Wall Banger, High Riser, Hoola Hooping, Hyperventilation Game, Indian Headrush, Knockout Game, Passing Out Game, Pass-out Game, Purple Dragon, Natural High, Neckies, Redline, Rising Sun, Rocket Ride, Sandboxing, Sleeper Hold, Sleepers, Space Monkey, Speed Dreaming, Suffocation Game, Suffocation Roulette, The Game, The Mysto World, Tingling Game, Trip to Heaven

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

Further reading

Barberia-Marcalain, E., Corrons-Perramon, J., Suelves, J.M., Alonso, S.C., Castella-Garcia, J. & Medallo-Muniz, J. (2010). [The choking game: a potentially lethal game]. Anales Pediatrica (Barcelona), 73, 264-267.

Centers for Disease Control and Prevention (2008). Unintentional strangulation deaths from the “choking game” among youths aged 6-19 years: United States, 1995-2007. Morbidity and Mortality Weekly Report, 57, 141-144.

Drake, J.A., Price, J.H., Kolm-Valdivia, N. & Wielinski, M. (2010). Association of adolescent choking game activity with selected risk behaviors. Academic Pediatrics, 10, 410-416.

Egge, M.K., Berkowitz, C.D., Toms, C. & Sathyavagiswaran, L. (2010). The choking game: A cause of unintentional strangulation. Pediatric Emergency Care, 26, 206-208.

MacNab, A.J., Deevska, M., Gagnon, F., Cannon, W.G. & Andrew, T (2009). Asphyxial games or “the choking game”: A potentially fatal risk behavior. Injury Prevention, 14, 45-49.

Neal, R.M. (2008). The Path To Addiction: And Other Troubles We Are Born To Know. Bloomington, Indiana: Author House.

Shlamovitz, G.Z., Assia, A., Ben-Sira, L. & Rachmel, A. (2003). “Suffocation roulette”: A case of recurrent syncope in an adolescent boy. Annals of Emergency Medicine, 41, 223-226.

Toblin, R.L., Paulozzi, L.J., Gilchrist, J. & Russell, P.J. (2008). Unintentional strangulation deaths from the “choking game” among youths aged 6-19 years -United States, 1995-2007. Journal of Safety Research, 39, 445-448.

Urkin, J. & Merrick, J. (2006). The choking game or suffocation roulette in adolescence (editorial). International Journal of Adolescent Medicine and Health, 18, 207-208.

To baldly go: A beginner’s guide to acomophilia

“Hello, I am a genuine single guy who just loves the look and have always wanted to date a bald lady – bald by choice or not. This is not a fetish or a flash in the pan. I am a forty something” (Alan, UK)

According to various online articles, acomophilia is a sexual paraphilia in which individuals derive sexual pleasure and arousal from bald people or with the shaved head and/or shaved genitals. Dr. Anil Aggrawal (in his book Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices) made a passing reference to being ‘acomoclitic’ but this only refers to being sexually aroused by hairless genitals. Dr. Brenda Love – in her Encyclopedia of Unusual Sex Practices – also briefly mentions ‘acomoclitic’ in her entry on sexual ‘depiliation’ (but again this only related to hairless genitals (rather than bald or shaved heads). In one (unscientific) survey asking a self-selected sample what their favourite fetish was, acomophilia accounted for 2.08% of all respondents (although the actual number of respondents was not reported) so it’s hard to evaluate how representative the findings were.

An online essay by Craig Butler examined the erotic potential of baldness (The ‘B’ Spot: An Examination of Erotic Fixations on Bald Men). He began with some quotes from a number of women:

  • “There’s nothing that really sends me into orbit like my man’s bald head”
  • “There are days when the way that the light glints off my guy’s beautiful, sleek dome makes me so ‘distracted’ that I can barely keep my mind on my work”
  • “I care way less about some guy’s money, or his brains, or even his ‘equipment’ than I do about how smooth his scalp is”

Assuming these are real quotes from real women (and I’ve no evidence that they are not), they appear to indicate that the focus of sexual attraction can be a bald head (in and of itself). It’s worth pointing out that to be classed as a paraphilia or fetish, the baldness is the prime source of the sexual pleasure and arousal (rather than being part of the overall look and/or general attractiveness of the person). In short, true acomophiles would have an erotic fixation on baldness and/or hairlessness. Butler interviewed psychologist Dr. Nancy Dreyfus for her thoughts on acomophilia. She said:

“An erotic fixation is a preoccupation with either an object, say, gloves or bathing suits or theoretically Saran wrap, or a non-genital body part – often feet – that is a habitual part of an individual’s sexual arousal system…Acomophilia is the formal word for a baldness fetish, although it is usually used in reference to a fetish related to bald women”.

Butler also interviewed Isadora Alman, a marriage and family therapist (who has also written for Psychology Today magazine’s Sex & Sociology blog). She was reported as saying:

“People have all sorts of erotic preferences. Some, such as American men and breasts, are cultural, and some, such as small high breasts versus large round ones, are fashion fads. Of course these are trends and not everyone in the culture or time period adheres to them. Some erotic preferences are conscious, but many are of unknown causes. I had a friend who liked thick ankles and legs on women – not a popular turn-on. He remembers being a baby crawling around under the table in his mother’s kitchen when her women friends, who all had thick ankles, visited; he found that exciting. One of my clients adored his partner’s bald head because he said it looked like a penis”.

Butler noted that while it’s perhaps flattering to be an object of intense erotic attraction, it could be off-putting for people who felt they were loved for their baldness and not themselves. In relation to this potential downside, Dr. Dreyfus commented that:

“If a man is a boob man, a woman wouldn’t reject him out of hand because he never tired of her breasts. She would just want to make sure that he loved her soul and liked her as a person. If a woman feels really liked and seen for who she is, the boob fascination is an add-on that could make her feel feminine. If she doesn’t feel cared for as a person, it will make her feel objectified and annoyed. I don’t think it’s that different with a baldness fixation. You have to ask yourself, ‘Does she like me as person and approach me with care?’ In some circles, male baldness is seen as cool and a little avant-garde, and you’d want to know if your lover’s interest was personally erotic or image-based. A man might wonder ‘Would you still want to make love with me if my hair grew back?’ The idea that any erotic connection with anyone, however intense, can last over time without real relating is a rarely achieved fantasy. If you have felt insecure over your baldness, a partner getting rapturous over it could temporarily be a reparative high, but it does not a relationship make”.

In her interview with Butler, Dreyfus admitted that she was in fact the partner of a 61-year-old man who has had alopecia universalis (i.e., no hair on his body at all) since his twenties. As a psychologist, she subsequently admitted that she may have been subconsciously drawn to her current partner because her (a) own father started going bald in his twenties, and (b) husband of two decades had lost most of his hair by the time they got together as a couple. She met her current partner online and was attracted to his baldness. However, she did comment that the fact he had “no eyebrows, eyelashes or pubic hair was an acquired taste”. She also claimed that:

“Studies have shown that the one quality that most women prize most in men is presence – a feeling of “there-ness” – and when you think of the sense you can get that a man is somehow hiding under a beard, mustache or excessive hair on the head, you can appreciate why many women find bald men sexy. [Women want] to be let in. A man with no hair, particularly one who has gotten that way against his own choosing, has had to battle a small demon, become more visible and self-accepting, and hopefully has become realer and less defended in the process. This is a man who is hiding less, and the woman he lets in will treasure him for it”.

I’m not aware of the studies she is referring to and much of what was said is speculative (to say the least). I know of no academic research on the topic of acomophilia, so any psychologist can speculate to their heart’s content.

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.

Butler, C. (2011). The “B” Spot: An examination of erotic fixations on bald men. September 27, Located at:

Cougar, C. (2009). Acomophilia. April 16. Located at:

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

Loss leaders: What is the best way to measure ‘gambling intensity’?

The issue of how to measure ‘gambling intensity’ is an important one in the gambling studies field. Gambling intensity is one of those concepts that means different things to different researchers but basically refers to how absorbed gamblers are based on the time and money they spend gambling. Over the last few years, this issue has become much more to the fore as researchers in various jurisdictions have been given access to behavioural tracking data (i.e., actual data showing what online gamblers actually do online such as the games they are playing, the time they spend online, the amount of money that they spend, etc.). This has initiated a whole new line of gambling research that is already providing insights about gambling that we never had before.

Many of these studies have used proxy measures for gambling intensity including variables such ‘bet size’ and ‘number of games played’. Another major problem with these studies is that they have tended to present data by single game type (e.g., only data from online poker players or sports bettors are presented). However, as researchers such as myself have noted, online gamblers typically gamble on a variety of games.

There are various ways to conceptualize gambling intensity. Such ways could include parameters involving the time spent gambling, the number of gambles made, and/or the amount of money won or lost while gambling. In almost all of the studies carried out to date, monetary involvement has tended to be the main proxy used measure for gambling intensity. However, I and my colleague Michael Auer have proposed a different proxy measure for the money risked while gambling. We define gambling intensity as the amount of money that players are putting at risk when playing. This might be considered easy to do (e.g., by using ‘bet size’), but the element of chance is rarely accounted for, especially when a random win occurs. For instance, two gamblers putting the same amount of money at risk might end up with very different wins or losses at the end of similar length gambling sessions because of the chance factor. For this reason, we are now using a measure that is completely independent of random events and takes into account the true amount of money that players are prepared to risk. The interesting aspect of this is that most of the time, gamblers themselves are probably not aware of the amount of money they risked at the end of a playing session.

Our first published paper in this area was a simulation study published last year in the journal Gaming Law Review and Economics. In that paper, we demonstrated that the most robust and stable measure for ‘gambling intensity’ is what we call the ‘theoretical loss’. Our fiest paper on this topic showed that all previous studies using proxy measures for ‘gambling intensity’ had failed to take into account the house advantage. Outcomes in games of chance over the long-term will always be dependent upon the house advantage of each different type of game. Dr. S. Li showed in a 2003 paper published in the Journal of Risk Research that ‘at risk’ decision-making in the short-term is totally different from decision-making over longer periods of time. Decision making over the long-term can be explained by the expected value whereas short-term decision-making does not seem to be based on any expectation rule. However, studies investigating decision-making in situations where people have to make choices assume that players have a real choice in which they can truly influence the outcome and (thus) the expected return. However, this is not the case in pure chance games. Whatever the player chooses to do in pure chance situations, the house advantage will determine the expected return in the long-term.

As we pointed out in our 2012 paper, games with a high house advantage lead to higher player losses and games with a low house advantage lead to lower player losses. Theoretical loss is the same measure that the gaming industry describes as Gross Gaming Revenue (GGR), and is the difference between ‘Total Bet’ and ‘Total Win’. The ‘theoretical loss’ of any given game is represented by the product of the bet size and the house advantage. Over very long periods of time, the theoretical loss corresponds to the GGR with increasing accuracy. The more diverse the gambling behaviour, the more that bet size deviates from the theoretical loss.

By incorporating the theoretical loss, the amount risked can be measured at a very detailed level. For instance, French roulette has a house advantage of 2.7% and keno has a house advantage of 10%. This means that a player who repeatedly bets $100 on roulette will end up with a loss of $2.7, and a player who repeatedly bets $100 on keno will end up with a loss of $10. Therefore, the product of bet size and theoretical loss represents the amount of money that player will lose in the long run. Previous studies that have used bet size (as a proxy measure for gambling intensity) would assign the same gambling of $10 intensity to the two players in the aforementioned example (and which obviously is not the case). The bet size is the one risk parameter that players are most likely to be aware of during gambling. However, it is deceptive as it does not take into account the expected return/loss that is controlled by the gaming operator via their house advantage.

Our simulation study of 300,000 online gamblers showed that bet size explained only 56% of the variance of the theoretical loss, and the number of games played explained 32% of the variance of theoretical loss. This means that when using bet size alone, 44% of the gambling behaviour remains unexplained. When using the number of games played alone, 68% of the variance is left unexplained. As this study was a simulation, we recently replicated our first study using real online gambler behavioural tracking data. There are many advantages and disadvantages with using data collected via behavioural tracking. However, the main advantages are that behavioural tracking data (a) provide a totally objective record of an individual’s gambling behaviour on a particular online gambling website, (b) provide a record of events and can be revisited after the event itself has finished, and (c) usually comprise very large sample sizes.

Our latest study on theoretical loss in the Journal of Gambling Studies comprised 100,000 online gamblers who played casino, lottery or poker games during a one-month period on the Austrian win2day gambling website. All games played by these gamblers were recorded and subsequently analysed. The game types were categorized into eight distinct groups: (i) Lottery – Draw/Instant, (ii) Casino – Card, (iii) Casino – Slot, (iv) Casino – Videopoker, (v) Casino – Table, (vi) Casino Other, (vii) Bingo and (viii) Poker. For each of the game types and each player, the ‘bet size’ and the ‘theoretical loss’ were computed for the recorded time period. In terms of house advantage these game types are very different. In general, lottery games have a relatively high house advantages (typically 50%) whereas slot machines have house advantages in the range of 1 to 5% depending on the gaming platform and the specific game. Poker on the other hand does not have a house advantage as such. In poker, the gaming involvement can be measured via the rake. The rake is a fixed percentage of the stake (bet size) that goes to the casino. The overall theoretical loss is thus comprised of the theoretical loss across all game types plus the poker rake.

Although we found a high correlation between the ‘bet size’ and the overall ‘theoretical loss’ across the eight game types for the 100,000 players, we also found the bet size alone explained only 72% of the variance of the theoretical loss (not as large as we found in our simulation study but that was most likely because we had more games in the simulation study and the games in the simulation study were approximated house advantages whereas the follow-up study used actual house advantages.

This study broadly confirmed the findings from our previous simulation study. The results of our most recent study suggest that future research and particularly those that utilize behavioural tracking approaches should measure their participants’ gambling intensity by incorporating the game-specific theoretical loss instead of using proxy measures such the bet size and/or the amount of money staked. Another implication is that previously published research could be re-analysed using the more robust measure of gambling intensity presented here (i.e., theoretical loss) rather than the proxy measures that were used in the original published studies. This study demonstrates that bet size does not reliably indicate the amount of money that players are willing to risk as it does not take into account the house advantage of each individual game that gamblers engage in. The house advantage represents the percentage held back by the gaming operator and is essential for the amount lost in the long-term and will eventually be equal to the total losses that a player accumulates. In order to further generalize our results, further empirical research utilizing data from other online gaming platforms as well as land-based casino premises needs to be carried out.

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

Additional input: Michael Auer

Further reading

Auer, M. & Griffiths, M.D. (2013). An empirical investigation of theoretical loss and gambling intensity. Journal of Gambling Studies, in press.

Auer, M., Schneeberger, A., & Griffiths, M.D. (2012). Theoretical loss and gambling intensity: A simulation study. Gaming Law Review and Economics, 16, 269-273.

Broda, A., LaPlante, D. A., Nelson, S. E., LaBrie, R. A., Bosworth, L. B. & Shaffer, H. J. (2008). Virtual harm reduction efforts for Internet gambling: effects of deposit limits on actual Internet sports gambling behaviour. Harm Reduction Journal, 5, 27.

Colbert, G., Murray, D., Nieschwietz, R. (2009). The use of expected value in pricing judgements. Journal of Risk Research, 12, 199-208.

Griffiths, M.D. & Auer, M. (2011). Online versus offline gambling: Methodological considerations in empirical gambling research. Casino and Gaming International, 7(3), 45-48.

Griffiths, M.D. & Whitty, M.W. (2010). Online behavioural tracking in Internet gambling research: Ethical and methodological issues. International Journal of Internet Research Ethics, 3, 104-117.

LaBrie, R.A., Kaplan, S., LaPlante, D.A., Nelson, S.E., & Shaffer, H.J. (2008). Inside the virtual casino: A prospective longitudinal study of Internet casino gambling. European Journal of Public Health, 18, 410-416

LaPlante, D. A., Schumann, A., LaBrie, R. A., & Shaffer, H. J. (2008). Population trends in Internet sports gambling. Computers in Human Behavior, 24, 2399–2414.

Li, S. (2003). The role of Expected Value illustrated in decision-making under risk: Single-play vs multiple-play. Journal of Risk Research, 6, 113-124.

Wardle, H., Moody, A., Griffiths, M.D., Orford, J. & and Volberg, R. (2011). Defining the online gambler and patterns of behaviour integration: Evidence from the British Gambling Prevalence Survey 2010. International Gambling Studies, 11, 339-356.

Getting the heads up: A beginner’s guide to partial unbirthing

In a previous blog, I briefly examined ‘unbirthing’ a fantasy-based sexual paraphilia in which individuals are sexually aroused by the idea of being enveloped and swallowed by a woman’s vagina. This is often termed ‘vaginal vore’ and is commonly viewed as a sub-type of vorarephilia (a sexual paraphilia in which individuals are sexually aroused by the idea of being eaten, eating another person, or observing this process for sexual gratification). While researching the blog on unbirthing, I came across quite a few references to ‘partial unbirthing’. For instance, according to the online Urban Dictionary:

“[Partial unbirthing is the] fetish of an adult head inside a vagina. [The] term was created a few decades ago when the fantasy of unbirthing was broken down into total and partial types with partial unbirthing being the only remotely possible form of the unbirthing fantasy. Even then it is an extremely rare activity and the practice of partial unbirthing, as opposed to the fantasy, is not a form of Vore”.

I had my doubts as to whether partial unbirthing could be anything but a fantasy-based sexual paraphilia until I came across what appear to be actual photographs and videos of the practice online (such as those on the partial unbirthing page of the Encyclopedia Dramatica (ED) website – please be warned that if you click on the hyperlink, the page that opens shows photographs of men with their heads inside female vaginas). In part of an online article on vorarephilia, the Serial Killer Calendar (a surprisingly knowledgeable website on paraphilic behaviours), it noted that partial unbirthing is also known as ‘adult heading’. Looking at the same online photographs as I had looked at, the article claimed “there is controversy about whether it has ever truly happened and disagreements about whether photos of the practice are Photoshop fakes”. The same article also questioned the feasibility of the practice in relation to the restriction of the oxygen supply for the person inserting their head (although this would arguably be an added turn-on for a hypoxyphiliac). The ED article also noted:

“Partial unbirthing (adult head insertion into the vagina) [is a] real practice as opposed to fantasy, it is not a category of ‘vore’. It is only done by sex partners who both find it safe and extremely enjoyable. It is a fetishism that is extremely rare and probably one of the rarest of all human sexual activities. The reason for this is that to be mutually enjoyable and erotic, it requires that the vagina must stretch to enormous size”

I have no evidence to dispute such claims but given the sheer pragmatics involved, the claims don’t seem unreasonable. One of the more in-depth articles on partial unbirthing can be found on the Wikibin (WB) website. It also claims that the activity is (unsurprisingly) “extremely uncommon” and “much more common as a pure fantasy than in actuality”. The WB article also claims that there have been attempts (but it doesn’t say by who or what) to sub-classify partial unbirthing under a new category called ‘endosomatophilia’. The article estimated that less than one in a million sexual partners have actually engaged in partial unbirthing (although personally I think this figure is still too high). The article also claims that it is mutually enjoyable and erotic for couples that engage in the practice:

“It requires that the vagina must stretch to enormous size. This requires a consenting, cooperative, and extended effort between the sexual partners, with both partners considering the same fetish to be erotic…This of course is only possible where the woman has an extremely huge opening of her pelvis. Such a huge or Justo Major Pelvis is also called ‘Giant Pelvis’. This condition is where the minimum pelvis size is enlarged uniformly in every direction by a linear factor of 1.5, or more than the average 11-inch wide pelvis. This 16.5-inch ‘or more’ Justo Major pelvic width is a condition that is only present in less than one in a thousand adult women”.

The article also claims that some normal sized women sometimes stretch their vaginas to facilitate orgasmic stimulation. This is sometimes as a consequence of the woman having a “fullness fetish” that according to the article is also known as a ‘bulk intromission’ fetish (I’ve tried to look for further information on this fetish but have not yet found anything). Although this would appear to be exceedingly rare, the WB article says that with “gradual repeated stretching they occasionally stretch almost to the walls of their pelvic bone opening” to the size of a newborn baby’s head.

There is still the fundamental issue of whether partial unbirthing is humanly possible. A number of partial unbirthing articles all carry exactly the same text about an alleged study that I have been unable to track down. The verbatim text used in most of these articles claims that:

“A well known government Hispanic study included the anthropometry (scientific measurement) of nearly 5000 adult women using anthropometric calipers to measure the largest pelvis at 19 inches bi-iliac width (side-to-side bone width). This made her 19-inch wide Justo Major pelvis have a huge 1.73 ratio when compared to the average size pelvis of only 11 inches width. This was even a larger size pelvis than a pelvis of ‘minimum’ Justo Major size (that requires at least a 1.5 ratio). If a woman with a pelvis of this very large size were to do the same vaginal stretching practice to near her bone opening size, she could then vaginally take inside her vagina a huge 24-inch adult head. That size head would be 24 minus 21 inches, or 3 inches, larger than the 21-inch circumference adult head that a pelvis of the minimum 1.5 ratio Justo Major size pelvis could potentially stretch around. This larger size 19-inch wide pelvis would require a lesser degree of stretching to be comfortable when taking inside a 21-inch (much smaller size) adult head. This degree of comfort might be comparable to a woman of average size being vaginally double fisted by hands of considerably smaller size, or even being fisted by just one large hand. This less common but larger size pelvis (one in five thousand) Justo Major pelvis would have a sufficient size to potentially make partial unbirthing much easier to achieve”. 

There is no academic or clinical research on partial unbirthing fetishes although I did come across a small unscientific poll on the Deviant Art website. The poll asked its clientele of self-admitted ‘sexual deviants’ what the strangest fetish was and 16% of the sample said partial unbirthing was the strangest. Unbirthing topped the poll (22%), followed by neophilia (18%; having sexual intercourse with baby children), and furry infantilism (11%; a form of paraphilic infantilism among the Furry Fandom in which adults pretend to be baby animals). Other strangest fetishes included cement fetishes (8%), necrofurs (5%; Furry fandom necrophilia), vorarephilia (5%), and zoophilia (3%).

After reviewing the scant anecdotal evidence I am convinced that that partial unbirthing fetishes exist at the very least in fantasy form and there are certainly examples of online fictional fantasy stories involving partial unbirthing. However, I remain ambivalent as to whether the practice can be achieved in actuality. The evidence (such that it is) suggests it is theoretically possible but whether there are genuinely recorded cases is suspect at best.

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

Further reading

Encyclopedia Dramatica (2011). Partial unbirthing. May 25. Located at:

Serial Killer Calendar (2012). Vorarephilia. Located at:

Urban Dictionary (2012). Partial unbirthing. Located at:

Wikibin (2012). Partial unbirthing fetishism. Located at:

Wikipedia (2012). Pelvis justo major. Located at:

Stumped? A beginner’s guide to xenomelia and body integrity and identity disorder

In a previous blog, I overviewed apotemnophilia, a sexual paraphilia in which individuals derive sexual pleasure and arousal from wanting to be an amputee. There are many case studies in the psychological literature where the individuals want to be an amputee but has no sexual motivation whatsoever. All of these published cases (irrespective of sexual or non-sexual motivation) are examples of what is often referred to as Body Integrity Identity Disorder [BIID]. Some psychologists – such as Dr. Robert Smith in a 2004 issue of the journal Psychiatry – also refer to BIID as ‘amputee identity disorder’.

A recent paper by Dr. Leoni Hiltie and her colleagues in the journal Brain, also reported a similar related condition that they call ‘xenomelia’ that is defined as “the oppressive feeling that one or more limbs of one’s body do not belong to one’s self”. (Having said that, it was actually Dr. Paul McGeoch and his colleagues who coined the term ‘xenomelia’ in a 2011 issue of Journal of Neurology, Neurosurgery and Psychiatry, where they reported four cases of individuals who wanted healthy limbs amputated – see below for more details of their study). However, just to confuse things further, another recent paper by Dr. Peter Brugger and his colleagues in the journal Frontiers in Psychology reports that xenomelia is the ‘foreign limb syndrome’ and is the new name of BIID characterized by the non-acceptance of one or more of one’s own extremities and the resulting desire for elective limb amputation or paralysis”. In yet another paper in a 2012 issue of American Behavioral Scientist, Dr. Jenny Davis refers to such individuals as being born ‘incorrectly-able bodied’ and thus defines the condition as ‘transableism’.

(I ought to add that I emailed Dr. Brugger to try and clarify the different defintions. He very helpfully replied that the “[Frontiers in Psychology paper] has a broader focus that the Brain paper. I more and more think that the social-psychological component of BIID [being equal to] xenomelia is larger than we assume. The many names (Jenny Davis used ‘transableism’) tell us that we are still in kind of pre-scientific state of research into the disorder. I prefer ‘xenomelia’ because it is neutral as to any interpretation”).

There are no estimates in the academic literature of the incidence or prevalence of BIID and related disorders. The website claims it has 1,500 visitors per day while another (unnamed) Yahoo! web group mentioned in a 2011 Newsweek article claims to have 1,700 members. Most academic papers on BIID report that those who suffer the disorder have a fixated desire to amputate one or more healthy limbs and often ask medical surgeons to amputate the limb(s) as a way to restore their psychological stability because they feel an “incomplete” person with four healthy limbs. Obviously this is very controversial but there is little evidence that medication and/or psychotherapy can successfully treat such individuals. The thinking of BIID sufferers is that an amputation would totally relieve their suffering. According the Wikipedia entry in BIID:

“The sufferer has intense feelings of envy toward amputees. They often pretend, both in private and in public, that they are an amputee. The sufferer recognizes the above symptoms as being strange and unnatural. They feel alone in having these thoughts, and don’t believe anyone could ever understand their urges. They may try to injure themselves to require the amputation of that limb. They generally are ashamed of their thoughts and try to hide them from others, including therapists and health care professionals. The majority of BIID sufferers are white middle-aged males, although this discrepancy may not be nearly as large as previously thought. The most common request is an above-the-knee amputation of the left leg”.

As I pointed out in my previous blog on apotemnophilia, many individuals who want to have a healthy limb amputated often pretend to be amputees and utilize prosthetics and assistive devices (e.g., crutches, wheelchairs, etc.) so that they can temporarily feel as if they are actually disabled and an amputee. Some psychologists, such as Dr. Robert Bruno (writing in a 1997 issue of the Journal of Sexuality and Disability, argue that those wanting to amputate a healthy limb are suffering from a Factitious Disability Disorder (FDD) and is akin to Munchausen’s Syndrome.

FDDs are conditions in which disability – real or pretended – provide an opportunity for the sufferer to be loved and attended to where no such opportunity has otherwise existed. The commonality between both conditions is they engage in the behaviour “for the sake of being a patient” (to receive the care and attention that would otherwise not be obtainable). Bruno argues that those with BIID need only one – albeit very extreme – medical intervention that leaves them with a lasting and obvious stigma of disability that they believe will permanently satisfy their need for love and attention.

However, other authors (such as Jenny Davis) point out that many such individuals simply believe they were born with an incorrectly-able body and that the desire for amputation has little to do with wanting to be a patient but want to have a healthy limb amputated just to feel normal and complete. Other similar conditions also exist such as those individuals who desire to become paralyzed, blind, deaf, etc. In a 2011 article in Newsweek by Jesse Ellison, it was reported that for some BIID sufferers, the compulsion is so strong that they successfully amputate their own limbs. The article reported the case of one man who had made many attempts to sever his left hand but finally managed to cut it off using a power saw (and told his family he had done it accidentally). Another man froze his own leg so that it had to be medically amputated.

One theory on the origin of BIID is that it is a neurological failing of the brain’s inner body mapping function (located in the right parietal lobe). The four individuals in the paper by Dr. McGeoch and colleagues underwent a magneto-encephalography (MEG) scan during tactile stimulation of sites above and below the desired amputation line. The authors reported that their findings revealed:

“Significantly reduced activation only in the [right parietal lobe] of the subjects’ affected legs when compared with both subjects’ unaffected legs and that of controls…[We] propose that inadequate activation of the [right parietal lobe] leads to the unnatural situation in which the sufferers can feel the limb in question being touched without it actually incorporating into their body image, with a resulting desire for amputation”.

Such findings suggest that the condition is more biologically than psychologically based and suggests why such people appear to be resistant to psychological treatments and interventions. This also leads to some interesting ethical questions about whether someone who is physically healthy should have a medical intervention (i.e., an amputation) to become psychologically healthy. An interesting paper by Dr. Tim Bayne and Dr. Neil Levy in a 2005 issue of the Journal of Applied Philosophy reported that:

“In 1997, a Scottish surgeon by the name of Robert Smith was approached by a man with an unusual request: he wanted his apparently healthy lower left leg amputated. Although details about the case are sketchy, the would-be amputee appears to have desired the amputation on the grounds that his left foot wasn’t part of him – it felt alien. After consultation with psychiatrists, Smith performed the amputation. Two and a half years later, the patient reported that his life had been transformed for the better by the operation. A second patient was also reported as having been satisfied with his amputation. Smith was scheduled to perform further amputations of healthy limbs when the story broke in the media. Predictably, there was a public outcry, and Smith’s hospital instructed him to cease performing such operations”.

Bayne and Levy argued that in the case of some people with BIID, the ‘healthy limb’ is not as healthy as it might appear mainly because the sufferer perceives the limb not to be their own. In essence, they argue that the disorder is one of depersonalization and that such disorders are “invisible to the outside world”. They conclude (and I have to admit that I am persuaded by their arguments) that just because we can’t see the problem doesn’t mean we should dismiss the suffering that the condition might cause. They acknowledge that question of whether amputation is an appropriate response to this suffering is a difficult, but believe that in some cases it might be justifiable to amputate a physically healthy limb.

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

Further reading

Bayne, T. & Levy, N. (2005). Amputees by choice: Body Integrity Identity Disorder and the ethics of amputation. Journal of Applied Philosophy, 22, 75-86.

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

Davis, J. (2012). Prosuming identity: The production and consumption of transableism on American Behavioral Scientist, 56, 596-617.

Ellison, J. (2011). Cutting desire. Newsweek, October 28. Located at:

Hilti, L.M., Hanggi, J., Vitacco, D.A., Kraemer, B., Palla, A., Luechinger, R., Jancke, L., & Brugger, P. (2012). The desire for healthy limb amputation: Structural brain correlates and clinical features of xenomelia. Brain, 136, 318-329.

Large, M.M. (2007). Body identity disorder. Psychological Medicine, 37, 1513-1514.

Smith, R.C. (2004). Amputee identity disorder and related paraphilias. Psychiatry, 3, 27-30.

Wikipedia (2013). Body integrity identity disorder. Located at:

McGeoch, P.D., Brang, D., Song, T., Lee, R.R., Huang, M. & Ramachandran, V.S. (2011). Xenomelia: A new right parietal lobe syndrome. Journal of Neurology, Neurosurgery and Psychiatry, 82, 1314-1319.

The short and tongue of it: A brief look at glossaphilia

“Is there such a thing as a tongue fetish? I wouldn’t be surprised if there is, people can have a fetish for the most weird things so it wouldn’t be surprising at all if there was such a thing, I personally haven’t heard of one before but would say its true” (Question and answer on

If you type in the words ‘tongue fetish’ into Google it lists hundreds (if not thousands) of websites (mainly in the form of pornographic video clips). This includes such websites as Tongue Fetish Organization (that claims to be “the leading tongue fetish site on the net”), and, as well as dedicated webpages on tongue fetishes at such sites as Daily Motion and Tongue Art (please be warned that these are all sexually explicit sites).

One of the strangest stories in recent years concerned Jafny Mohamed Sunny, a young male sex offender who had a fetish for young girls’ tongues. As was reported in the Asian Press:

[Jafny Mohamed Sunny] used his military police credentials to pass himself off as a police officer. And he did that with the vilest of intentions – so he could frighten and coerce his young, vulnerable victims – as young as 12 years old – into quiet places at HDB blocks, where he could molest and do horrible things to them. [He] also had a fetish. After cornering some of his female victims, he would ask them to stick out their tongues – just so he could touch them. He later explained to a psychiatrist that he did that because he had an urge to know the length of girls’ tongues. He claimed ‘voices’ in his head compelled him to do it, and said he would get inner satisfaction after checking the lengths of girls’ tongues. Jafny had checked the tongues of five girls on different occasions. [He] was sentenced to 8½ years’ jail and 12 strokes of the cane for three out of 10 charges that were proceeded against him”.

This case obviously concerned a fetishist where the behaviour that he engaged in was non-consensual and problematic. However, at Gaia Online, one person posted that they had “just discovered I have a tongue fetish”. When asked by another of the forum members what it involved, the person simply responded that when they saw a person’s tongue, they got sexually aroused (with the tongue being stuck out of the mouth in some sort of sexual manner obviously”). This led one person to assert that this was the “lamest fetish ever” he’d ever heard of. However, this doesn’t seem to be an isolated case as I have come across a number of examples of people who claim to have a tongue fetish. Here is a selection:

  • Extract 1 (male): “I have a friend who has a tongue fetish, specifically for girls and women making the ‘raspberry noise’ as has often been seen in comedy shows through the years…He’s a quiet person by nature”.
  • Extract 2 (male): “I’ve recently hooked up with this chick that has a really long tongue and I find myself strangely drawn towards it. Yeah that’s right, I think I have a fetish for long tongues on chicks”.
  • Extract 3 (male): “I have a tongue fetish, I love it when female’s use it [to lick my testicles]”.
  • Extract 4 (male): “Mine is a tongue fetish thing, had it since being a randy teen. Tongues are the most erotic thing for me and even the sort of woman you normally wouldn’t look at twice can turn herself into a sex goddess with a well timed tongue teaser. Doesn’t have to be used during sex, oral or whatever, just a glance at a woman with a seductive tongue can win me over”.
  • Extract 5 (female): “I have a tongue fetish whether I’m with a guy or thinking of a guy when I’m masturbating. I love tongues…In my mouth, receiving oral, or just having it explore my body its all good. I get really turned on using mine too, watching and feeling how a guy responds to the feel of my tongue on his body is a big turn on for me”.
  • Extract 6 (gender undetermined): I’m fairly sure I have a tongue fetish. Licking, specifically. But then again, what else can you really do with a tongue? Soft tongues are especially nice. I don’t really know why I like it so much, though”.

There doesn’t seem to be any kind of pattern from the examples that I have come across except that it appears (as are most fetishes) to be male dominated. I have also excluded examples of those with sexual tongue piercing fetishes (which I would argue are totally different), tongue licking as part of sexual humiliation in sadomasochistic practices (such as sexual slaves being forced to lick their master’s shoes clean), and those who would describe themselves as ‘licking fetishists’ as these people do not fetishize the tongue per se, but the actions and feelings of being licked (typically on a sexual body part). However, as noted in the examples above, the licking action of the tongue cannot be completely divorced from those who sexualize the tongue and find the tongue ‘sexy’ in and of itself.

As I have never seen this sexual behaviour officually listed in any reputable academic source (and it certainly does not appear in either Dr. Anil Aggrawal’s Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices or Dr. Brenda Love’s Encyclopedia of Unusual Sex Practices), I have decided to give such behaviour a name. The Greek word for ‘tongue’ is ‘glossa’ and the word ‘glossal’ usually refers to, relates to, and/or pertains to, the tongue. Therefore, I am naming the behaviour ‘glossaphilia’ – a sexual paraphilia in which individuals derive sexual pleasure and arousal from human tongues.

I deliberately used the word ‘human’ as I noted in a previous blog on zoophilic classification to what Dr. Anil Aggrawal calls fetishistic zoophiles that keep various animal parts that they then use as an erotic stimulus as a crucial part of their sexual activity. Such individuals have been reported in the clinical literature including the case of a woman (reported in a 1990 issue of the American Journal of Forensic Medical Pathology) who used the tongue of a deer as her primary masturbatory aid.

I’ve only come across one academic research paper that makes any mention of mouth-related fetishes. In a previous blog on odontophilia (a sexual paraphilia in which individuals derive sexual pleasure and arousal from teeth), 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 considerably more). Their results showed that there were 1697 fetishists (2% of all fetishists) with a sexual interest in aspects of the mouth on the websites they studied (although they only reported lips, teeth and the mouth in general, rather than a specific mention of the tongue).

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. (2011). A new classification of zoophilia. Journal of Forensic and Legal Medicine, 18, 73-78.

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

Randall, M.B., Vance, R.P., McCalmont, T.H. (1990). Xenolingual autoeroticism. American Journal of Forensic and Medical Pathology, 11, 89-92.

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.

No pain, no gain: A beginner’s guide to congenital analgesia

Arguably one of the most extreme of human conditions is having congenital insensitivity to pain (CIP). One of the most high profile portrayals of CIP (which is where I first became aware of the condition) was in The Girl Who Played With Fire (the sequel of The Girl With The Dragon Tattoo), where one of the peripheral characters (Ronald Niedermann – ‘The Giant’) had CIP and was seen as physically invulnerable by those around him.

CIP was first reported by Dr. G. Dearborn in 1932 (in the Journal of Nervous and Mental Diseases) and is also known as congenital analgesia. Those with CIP have no capacity to feel physical pain, usually because of a hereditary genetic mutation associated with the body’s pain receptors. However, there are also cases where the causes are non-genetic. For instance, there are a few cases of CIP that appear to be due to an increase in endorphins (the body’s own morphine-like chemicals) in the brain.

Although CIP might sound like a great (almost superhuman) condition to have, individuals with CIP are much more susceptible to death via trauma as they are completely unaware of what damage has been done to their body following accidents (so they can’t feel cuts, know if they have bitten their tongue, or know if they have broken bones). Furthermore, one of the behaviours associated with CIP is self-mutilation (as highlighted in a 2010 case study of a young boy in the Online Journal of Health and Allied Sciences by Dr. Praveen Kumar and his colleagues). Evolutionary psychologists would therefore argue that pain perception is an evolutionary necessity to avoid injury and/or death.

The condition is very rare (for instance, in the US, it is estimated that only around 100 people have the condition). However, there is a higher incidence of the disorder in societies where there is less biodiversity (so-called ‘homogenous societies’). For instance, an interesting 2006 paper by Dr. Jan Minde in the journal Acta Orthopaedica Supplementum reported that in the village of Vittangi (in the north Swedish Municipality of Kiruna) had documented 43 cases. Given the hereditary nature of CIP, many papers tend to report case studies within families. For instance, Dr. D.C. Thrush reported across two papers in a 1973 issue of the journal Brain, the case of four siblings with CIP that all reported numerous painless injuries, bone fractures, and autonomic dysfunction. Similarly, Dr. Karmani and colleagues reported on a family where three out of four children all had CIP in the Journal of the Royal Society for Medicine in 2001. They reported that in relation to the condition:

Presentation in childhood is commonly at the time of tooth eruption, with biting and self-mutilation of lips, tongue and digits. Pyrexia of unknown origin is another way the condition can show itself in early infancy. Cuts, abrasions and burns of the limbs are common”.

CIP is different from the group hereditary sensory and autonomic neuropathy (HSAN) disorders that inhibit specific sensations (which I’ll hopefully cover in a future blog). A 2002 paper in the Journal of Bone and Joint Surgery by Dr. E. Bar-On and colleagues reported that among those with CIP musculoskeletal manifestations are very common although the pathology, inheritance, and pathophysiology of these, as well as their relationship to the different subtypes, have only been partially clarified, mainly in case reports”. Other than the incapacity to feel pain, those with CIP are physically normal (although some individuals have difficulty in experiencing different temperatures). The Wikipedia entry on CIP also notes that:

“Children with this condition often suffer oral cavity damage both in and around the oral cavity (such as having bitten off the tip of their tongue) or fractures to bones. Unnoticed infections and corneal damage due to foreign objects in the eye are also seen. Because the child cannot feel pain they may not respond to problems, thus being at a higher risk of more severe diseases or otherwise. In some people with this disorder, there may be a mild intellectual disability”.

Another minority may have CIP in the ‘voltage-gates sodium channel SCN9A’ (and in the words of Vienna by Ultravox, “this means nothing to me”). There is a series of papers published by Dr. James Cox and his colleagues in journals like Nature and Human Mutation examining the hard-core genetics of CIP. I had hoped that the Wikipedia entry on the genetics of CIP might dumb things down a little but after reading the following, I am still generally none-the-wiser:

“Patients with such mutations are congenitally insensitive to pain and lack other neuropathies. There are three mutations in SCN9A: W897X, located in the P-loop of domain 2; I767X, located in the S2 segment of domain 2; and S459X, located in the linker region between domains 1 and 2. This results in a truncated non-functional protein…it is expected that a loss of function mutation in SCN9A will lead to abolished nociceptive pain propagation”.

Some people working in the field distinguish between pain insensitivity and pain indifference. Pain insensitivity refers to individuals who have absolutely no perception of the stimulus to pain (i.e., they are unable to describe the type or intensity of pain). Pain indifference refers to individuals that have perception of the stimulus to pain have inappropriate responses to the pain stimulus (e.g., they wouldn’t flinch if something very hot or on fire touched their flesh).

Finally, Dr. Praveen Kumar and colleagues report in the Online Journal of Health and Allied Sciences that there is “no single gold standard treatment available” for CIP and that there are some studies suggesting (the opioid antagonists) naloxone and naltrexone (most often used in the treatment of drug addictions) can be used to reverse the analgesic effects of CIP. However, they also note that treatment with opioid antagonists “lacks evidence and further support” and that most treatments are concerned with other associated conditions.

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

Further reading

Bar-On, E., Weigl, D., Parvari, R., Katz, K., Weitz, R. & Steinberg, T. (2002). Congenital insensitivity to pain. Journal of Bone and Joint Surgery, 84, 252-257.

Cox, J.J., Reimann, F. & Nicholas, A.K. (2006). An SCN9A channelopathy causes congenital inability to experience pain. Nature, 444, 894–8.

Cox, J.J., Sheynin, J., Shorer, Z., et al (2010). Congenital insensitivity to pain: Novel SCN9A missense and in-frame deletion mutations. Human Mutation, 31, E1670-E1686.

Dearborn, G. (1932). A case of congenital general pure analgesia. Journal of Nervous and Mental Diseases, 75, 612–615.

Karmani, S., Shedden, R. & De Sousa, C. Orthopaedic manifestations of congenital insensitivity to pain. Journal of the Royal Society of Medicine, 94, 139-140

Kumar, P.B, Sudhakar S. & Prabhat, M.P.V. (2010). Case report: Congenital insensitivity to pain. Online Journal of Health and Allied Sciences, 9(4).

Manfredi, M., Bini, G., Cruccu, G., Accornero, N., Berardelli, A. & Medolago, L. (1981). Congenital absence of pain”. Archives of Neurology, 38, 507-511.

Minde J (2006). Norrbottnian congenital insensitivity to pain. Supplementum 77, 2-32.

Nagasakoa, E.M., Oaklanderb, A.L., Dworkin, R.H. (2003). Congenital insensitivity to pain: an update. Pain, 101, 213–219.

Thrush, D.C. (1973). Congenital insensitivity to pain: A clinical, genetic and neurophysiological study of four children from the same family. Brain, 96, 369-86.

Thrush, D.C. (1973). Autonomic dysfunction in four patients with congenital insensitivity to pain. Brain, 96, 591-600.

Wikipedia (2012). Congenital insensitivity to pain. Located at:

Guilty pleasures: A brief look at pecattiphilia‬

Arguably one of the rarest sexual paraphilias is pecattiphilia. According to Dr. Anil Aggrawal’s 2009 book Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices, pecattiphilia refers to individuals that derive sexual pleasure from sinning or having committed an imaginary crime (although later on the same page, Dr Aggrawal simply defines it as “sexual arousal from sinning or guilt”). Dr. Brenda Love in her Encyclopedia of Unusual Sex Practices also provides a similar definition and says that pecattiphilia is “the sexual arousal one gets from sinning…this may also display itself as a form of guilt”. The Wikipedia entry on pecattiphilia is also similar and defines the behaviour as “sexual arousal from performing an act one believes is a sin”. The short entry then speculates that it “would presumably include, for example, such acts of lust as fornication or sodomy, or also the acting out any of the other seven deadly sins beside lust”.

Finally, the online medical website Right Diagnosis describes the symptoms of pecattiphilia as (i) sexual interest in stealing or sinning, (ii) recurring intense sexual urges involving stealing or sinning, and/or sexual arousal from stealing or sinning. As far as I am aware, there is absolutely no academic or clinical research on pecattiphilia, and much of what I have read on the topic is purely speculative. In her encyclopedia entry, Dr. Love wrote that:

“Religious teenagers sometimes suffer from a dilemma when they masturbate because they are taught that God will punish or perhaps kill them for this ‘perversion’. A few have grown up with a fascination for sex play that involves life and death risks in order to recapture the same emotional intensity that this fear created. Anther type of ‘sinner’ may intensify their feelings of guilt by seducing a virgin, a member of the clergy, wearing religious costumes, listening to hymns during sex, or breaking into a church and using the altar to engage in a form of ritual sex. They may also have their partner say things to make them feel shame or guilt”.

I have no idea where Dr. Love got her information but it certainly wasn’t from any scholarly texts. I would also argue that some of the types of behaviour listed above overlap with other sexual paraphilias and sexual fetishes including melognia (sexual arousal from music), parthenophilia (sexual attraction to, and arousal by virgins), harmatophilia (sexual arousal from sexual incompetence or mistakes), hierophilia (sexual arousal from religious and sacred objects) and uniform fetishism. Dr. Love then goes on to say (again in the absence of any empirical evidence) that:

“Those suffering from extreme pecattiphilia may feel an overabundance of guilt and try to reduce these feelings by having their partner chastise or punish them before they orgasm. This seems to relieve their guilt feelings. Some develop a fear of sexually transmitted diseases afterward or salve their conscience by judging their sex partner. In extreme cases, a psychotic person will murder their victim (usually a prostitute) to expiate both their sins”.

I’m not entirely sure how “extreme pecattiphilia” manifests itself any differently from less extreme pecattiphilia but the whole paragraph is highly speculative. Nothing that I have read on the origins relating to a fear of sexually transmitted diseases (such as my previous blog on syphilophobia) is linked to pecattiphilia. To conclude, Dr. Love writes about both the positive and negative role that guilt may play in the development of pecattiphilia:

“Guilt can have a positive force in our lives if it calls attention to conduct that requires more responsible action. Additional understanding of our behavior, values, and needs help to prioritize our goals and make relevant changes. Guilt can help us to become more empathetic toward the weaknesses of others making it easier to develop and maintain relationships. Conversely, guilt can have negative effects when people use it to judge and inflict emotional and physical pain on themselves and others. Some psychologists believe that guilt is higher among people who have a more limited awareness of life and who have a more limited awareness of life and who are stuck in a restrictive and repressive lifestyle. A person who imposes guilt on others is practicing a form of sadism because they expect the person to self-inflict emotional pain”.

Dr. Love’s assertion that imposing guilt upon others is a form of sexual sadism is not one that I personally adhere to as I personally think guilt is not a form of pain (although I acknowledge that for some people extreme guilt can be psychologically painful). The only other article I have found on pecattiphilia was an admittedly non-academic one by Susan Edwards writing on Lady Jaided’s Sex Talk for Wicked Women website. Her article noted:

“Sin is sexy. Probably has something to do with the belief that sex is sinful. The more taboo you make it, the more compelling it is. If I had known about [pecattiphilia] in junior high, I would have thought of it as the Catholic School Girl and Preacher’s Kid Fetish. Those were the two groups in my neighborhood who seemed to get off the most on sinning, who were the most creative in coming up with ways to sin and the most energetic in pursuing its pleasures. When Wynona Ryder got busted for shoplifting, people wondered why such a rich, famous person would so such a thing. Maybe she’s a pecattiphiliac”.

Although I started this blog by saying pecattiphilia is very rare, one very small (very unscientific and self-selected sample) 2007 survey of 40 people (32 men and 8 women) responded to the ‘First Ever Viner Fetish Survey’ at the Celestina Newsvine website. The survey listed dozens of sexual paraphilias and asked respondents to tick any of them that they had “enjoyed” or “think they would enjoy”. Four of the respondents (10%) responded affirmatively. Obviously, I have no why of knowing the extent to which the four people had or hadn’t engaged in a pecattiphilic cat (or whether they were even telling the truth). However, it is the only statistic I have ever come across relating to the behaviour. Given the arguable overlaps with other sexually paraphilic behaviours, I’m really undecided about whether pecattiphilia really exists. As far as I can see, there are no published case studies, no online forums for pecattiphiliacs to discuss their sexual preferences, and no niche pornographic sites associated with the behaviour. In short, I have found very little evidence (even anecdotally) that it exists and/or or is a genuine sexual paraphilia.

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.

Celestina (2007). First ever Viner fetish survey, December 3. Located at:

Edwards, S. (2008). Tempting transgressions. Sex Talk for Wicked Women, September 10. Located at:

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

Right Diagnosis (2013). Pecattiphilia. May 7. Located at:

Wikipedia (2013). Pecattiphilia. Located at:

Elasticity of demand: Can bungee jumping be addictive?

“Aaaaaaaggggggghhhhhhh” – or something like it – was the sound I made as I jumped from 300 foot above the River Thames with a piece of elastic tied round my ankles in my one and only bungee-jump. Was I brave? No. Insane? No (although others may take issue). Stupid? Possibly. Was I doing it for a bet? No. To raise money for a charity? No. To have a story to tell the grandchildren? No (but I will have). At the end of the day, I really don’t know what possessed me to take that jump. But I did it. I have about a hundred eyewitnesses, the certificate, the photos, and of course the video of my jump (“Drastic Elastic”).

So how did it all come about? Well, it was one of those spur of the moment things. I was with my partner and some of her friends all of whom had congregated at Battersea Power Station to see one of their long-standing friends do a bungee-jump. The bungee-jump at Battersea as I later found out is the highest in the UK but as I sat drinking bottled lager on the riverside boat bar all I was wondering was why the bloody hell is he going to do it? He had a few weeks to think about it. Thankfully when it came to my jump, I had about half an hour for it to sink in. The only bottle I really had was the one I had been holding full of lager.

Before I went on my jump, a couple of radio journalists went up to do a report. A couple of my colleagues have suggested that it was only the presence of the broadcast media that got me to jump. One jumper who came down while I was waiting described it as the worst experience of his life. What a time to tell me! What’s more, the person before me chickened out when she got to the top. I must admit than when I was finally hoisted up to that birds-eye view over London, I did momentarily think there was still time to change my mind. The forms that I signed before going up were certainly food for thought. There is a phrase in the small print that basically says that in the event of my death or serious injury that I do not hold the UK Bungee Club personally responsible.

As the crane slowly ascended to the jump point my heart got a little faster but I was still looking forward to it. The crane suddenly stopped. The door of the cage opened and there I was standing over the Thames. In three seconds time I would be making my oscillating descent downwards. One of the guys in the crane said he would count to three and then tap me on the shoulder which was my cue to jump. The other guy was holding the camcorder recording my every grimace.

“One. Two. Three. Jump”. I dived off the cage’s platform and hurtled towards my friends in the boat below. I bounced up and down for about half a minute before I realised it was nearly over. The rush I got from the whole experience hit me straight after the jump rather than during it. The term “adrenaline junkie” has now passed into everyday usage and although my main research area concentrates on very specific types of risky behaviour (e.g., gambling) and others perceive me to be someone who generally takes risks, I would be the first to admit that bungee jumping is not something that has ever been one of my lifelong desires.

It is therefore something of an irony that one of my ex-PhD students (Dr. Michael Larkin) did his research on the relationship between addiction and identity and interviewed bungee-jumpers about their experiences and whether they view their high-risk behaviour as addictive (research that we eventually published in the Journal of Community and Applied Social Psychology). I also realize that if I was interviewing myself about my experiences of bungee jumping I’d be hard pressed to give any kind of rational explanation of why I did it.

Large-scale research in the area of young people and risk-taking has tended to focus on ‘risk-takers’. This term clearly situates the ‘risky-ness’ within a particular kind of person, and captures only the negative aspect of such behaviours (i.e., risk). In our published research, Dr. Larkin and I purposefully used the term ‘risky-but-rewarding activities’ for two reasons. Firstly, the term situates ‘risky-ness’ within activities, rather than the persons engaging in them, and secondly, it captures both the positive and negative aspects of such activities (i.e., risk and reward).

In one of our studies, we used semi-structured interviews to explore the experiences and understandings of two small groups of participants engaging in either dangerous sports (i.e., bungee jumpers) or recreational drug use (i.e., Ecstasy users). We chose these two particular activities because they provided an opportunity to explore an interesting psychological question – how do individuals evaluate and understand the relationship between risk and pleasure?

All participants had what can best be described as ‘non-problematic’ relationships with their respective activities (i.e. they did not consider themselves as ‘addicted’. Furthermore, all of the participants in our study claimed they made informed and educated decisions about the risks involved in their respective activities – even though there were variations in each individual’s appraisal of how great this risk might actually be, and of how well-informed they were.

We found both similarities and differences between the bungee-jumpers and the Ecstasy users. Initiation into bungee jumping was presented as the consequence of an active, rational decision. Perhaps this was possible for the bungee-jumpers, in contrast to the ecstasy users, because they had fewer reservations to overcome. We also reported that there seemed to be no expectation of unknown, long-term risk associated with bungee jumping (as opposed to Ecstasy use). Secondly, bungee jumping does not represent an analogous ‘boundary point’ between relatively minor involvement, and more serious involvement, in dangerous sports, in the way that Ecstasy use and amphetamine use may do within general drug-taking activities. Thus, we can see that ‘contextual decisions’ may have a psychological function for the user, as a means of overcoming reservations (through denial of agency), and a discursive function for the speaker, as a means of rationalizing a ‘risky shift.’ However, even though bungee jumpers did not utilize this strategy, they still presented their activities as participatory, and acknowledged that social elements contributed to the rewards of the activity, and carried out a considerable amount of identity work in the interviews, which collectively suggests that (like Ecstasy-use) participation grants access to an identity, and gives the user a voice within a particular sub-culture.

We also found that first experiences of bungee jumping and Ecstasy-use were often ambivalent, and sometimes even unpleasant. This ambivalence was generally reported as leading to a stage of ‘learning to like it.’ This might be considered a key process in moving from initiation to maintaining use. Our analysis of the data sought to illuminate something of what it means to take risks for pleasure in our culture. From this process, a number of insights have emerged.

Firstly, it seemed that initiation into a risk-taking activity may require numerous strategies in order to overcome one’s own reservations, and also to accommodate perceived disapproval from others. These strategies include momentary denials of agency (such as the construction of ‘contextual decisions’ rather than ‘rational decisions’), emphasis on the value of ‘inclusion’ for maintaining friendship and cultural identity, the use of anticipated regret as a rationale for accepting possible consequences, and emphasis on the intrinsic value of collecting a broad range of experiences.

Secondly, while initiation may involve some denial of agency, once the person is initiated, and it perhaps becomes evident that the activity can be maintained relatively safely (costs; managing risks) and satisfactorily (learning to like it; learning to control it), then engagement in the activity becomes more rationalized. This involves the acquisition of information about the risks involved, espousing certain practices in response to those risks, and explaining accidents in terms of inappropriate engagement in the activity. In these ways, short-term risks can be managed and accepted as appropriate to the pleasure received.

One interesting feature of the accounts we collected is their positive, appetitive and wilful orientation toward risk. Our participants articulated a relationship with risk that allowed us to see it as a source of pleasure and reward, cultural identity and social participation, but also perhaps as a means of expressing resistance to conventional constraints. Risk-taking was not exactly ‘normal’ for our participants. Its very abnormality was part of its transgressive allure, but at the same time it was mediated by attempts to adopt safe practices, and as such it cannot be understood simply as negativistic action either. Instead, it makes more sense to understand the value of these transgressive acts in terms of access granted to both desirable identities and modified mood states. Whatever future research uncovers, I will always have my bungee jumping certificate that takes pride of place in my office and reads:

“This certifies that in a brief moment of bravado, Dr. Mark Griffiths being of sound mind did of their own choice leap from a 300ft platform. When they launched themselves into space their only touch with reality was a bungee cord attached to their ankles. This courageous person has hereby encountered “The Ultimate Adrenalin Experience”. Lesser beings should now show the respect and admiration due to the intrepid Bungee Jumper, who has undertaken to accept their fame with some restraint and modesty”

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

Further reading

Beck, U. (1992). The risk society: Towards a new modernity. London: Sage.

Douglas, M. (1994). Risk and blame. London: Routledge.

Griffiths, M.D. (2006). Bungee jumping madness: A personal case study. Psy-PAG Quarterly, 61, 34-36.

Larkin, M. (2002). Understandings and experiences: A post-constructionist cultural psychology of addiction and recovery in the 12-step tradition. Unpublished PhD. thesis, Nottingham Trent University.

Larkin, M., & Griffiths, M.D. (2002). Experiences of addiction and recovery: The case for subjective accounts. Addiction Research and Theory, 10, 281–311.

Larkin, M. & Griffiths, M.D. (2004). Dangerous sports and recreational drug-use: Rationalising and contextualising risk. Journal of Community and Applied Social Psychology, 14, 215-232.

Plant, M., & Plant, M. (1992). Risk-takers: Alcohol, drugs, sex and youth. London: Routledge.