Feline purrversions: A beginner’s guide to aelurophilia

In a previous blog on a hoax form of zoophilia (emysphilia – sexual arousal from turtles), I briefly mentioned other various specific sub-types of zoophilia including aelurophilia. In 2006, Dr. Lisa Shaffer and Dr. Julie Penn developed a comprehensive paraphilia classification system and published it as a book chapter in Dr. William Hickey’s book Sex Crimes and Paraphilia. In that chapter they defined aelurophilia deriving sexual gratification from cats. The same definition was also provided by Dr. Anil Aggrawal in his new 2011 classification of zoophilia in the Journal of Forensic and Legal Medicine. Before I take a closer academic look at the clinical literature on aelurophilia, I’d like to share this story reported in the Russian newspaper Pravda from March 2004:

 “Two women attempted to experience sexual pleasure from an intimate contact with a cat. The weird endeavor ended rather sad for one of the women [Svetlana]: she was hospitalized with severe genital injuries. Doctors arrived to hospitalize a woman, who had suffered from unexpected bleeding…They saw a woman lying on the sofa. …Streaks of blood could be seen on her legs. The woman’s friend was speechless to explain what happened. The woman was taken to the gynecological department of the local hospital, where doctors determined the unusual character of the genital injuries…When the woman recovered, she confessed that she had been injured during her love act with a cat…Svetlana was bored and she decided to visit her friend, Vera. The two women had some wine and started talking about intimate matters. Vera was the first, who suggested trying something totally unusual…Vera brought in a cat [called Timka]…Vera took her clothes off, put the light out and played an adult movie on the video recorder. She lied down, took a bottle of valerian and poured some on her most intimate body part. When the cat smelled valerian, he started licking it away, putting Vera in the state of ecstasy. Vera told Svetlana…there is nothing better than the cat’s little tongue. When the cat started licking valerian off from Svetlana, something happened to the animal. Timka probably took too much of the medication: he started licking the liquid away but all of a sudden he seized the genitals of the poor woman with his claws and teeth. Svetlana screamed and tried to push the fierce pet lover away from her, but the cat wouldn’t let go. Vera hurried to help her friend: she emptied a bucket of water on the cat and threw the animal out of the house. When she saw that Svetlana was bleeding, she called an ambulance. Boris [Svetlana’s husband] could not take the fact that his wife preferred having oral sex with a cat [and] kicked Svetlana out of the house…It is noteworthy that lonely women often use their pets (cats or dogs, regardless of sex) to satisfy their sexual needs. Such pet adventures often lead to lamentable consequences – not for pets, but for orgasm-craving women, as a rule. An overdose of valerian can make the loveliest cat become a fierce and aggressive animal”.

I did an academic literature search on aelurophilia and thought I had found an article in the Journal of Feline Medicine and Surgery but the editorial by Margie Scherk used the term ‘aelurophilia’ in it most literal sense to refer to introduce a special issue of the journal that had brought together the “aelurophilic veterinary community” (i.e., vets who love cats but not in any sexual sense). I also thought I had located a relevant conference paper by Dr. A Franklin about people who go looking for big wild cats in the country. He noted that:

“For some reason it appears that people now believe [wild cats] to be there but more than that, they want them to be there, they have become the focus for a new form of aelurophilia, or the love of (wild) cats”.

Again, like the editorial in the Journal of Feline Medicine and Surgery, the term ‘aelurophilia’ is used in its’ most literal sense. Thankfully, there are a few references in the more general zoophilia literature to people who have had sexual relationships with cats (although none of these authors mention the word ‘aelurophilia’). For instance, the Kinsey Reports (of 1948 and 1953) reported that 8% of males and 4% females had at least one sexual experience with an animal. The most frequent sexual acts engaged in with animals comprised calves, sheep, donkeys, large fowl (ducks, geese), dogs and cats. It probably won’t surprise you to learn that the internet has plenty of websites where people have confessed sexual relationships with cats such as those at the Is It Normal?, Zoklet, Zoo Destiny and Tribal War websites. There are also a number of dedicated websites with advice on engaging in human-cat sex such as the Beast Forum’s ‘The ultimate guide: How to make love to big cats’ and Zoophile.Net’s “How to make love to felines’.

In a 2001 issue of the Journal of Small Animal Practice, Dr. H. Munro and Dr. M. Thrusfield (2001) reported that they had collected data on animal abuse from over 400 British vets. They reported that 6% of their cases involved sexual abuse based on their observations of injuries in the animals’ genital and anal areas. Of these, 21 cases referred to dogs and three to cats.

Dr Andrea Beetz carried out a study comprising 32 male zoophiles. She reported that sex had occurred with dogs (78%), horses (53%), cats (13%) and farm animals (19%). She also reported that many of the zoophiles (including the cat lovers) had a very close emotional attachment to their animals and reported that they love their animal partner as others love their human partner (and are devastated when their animal partner dies). In a later paper in a 2004 issue of the Journal of Forensic Psychology Practice, she also wrote:

“Besides the whole range of sexual practices with more or less common mammals of a suitable size and anatomy, including deer, tapirs, antelopes, and camels (Massen, 1994), sexual contacts with more unusual species were mentioned in the literature. Insertion of fish – eels seem to be preferred – and snakes into the vagina and sexual stimulation through the movements of the animal (Dekkers, 1994), masturbation of male or female cats and letting cats lick the human genitalia or eat food from the penis or the vagina (Miletski, 2002) are further practices”.

Dr. Hani Miletski (2002) conducted one of the largest studies in this area examining 93 zoophiles (82 men and 11 women). Her study found that most of her sample had sexual contact with dogs (90%). However, she also reported that 19.5% of her participants admitted to having had sexual contact with female felines (large cats or domestic cats) and 17% with male felines (large cats or domestic cats).

Although there are only a few studies that have examined aelurophilia, the data quite clearly show that minorities of both men and women have engaged in human-feline sex although compared to other animals that people have had sex with cats are much lower in the zoophilic preference league.

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

Further reading

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

Beetz, A.M. (2000, June). Human sexual contact with animals: New insights from current research. Paper presented at the 5th Congress of the European Federation of Sexology, Berlin.

Beetz, A. (2004): Bestiality/zoophilia: A scarcely investigated phenomenon between crime, paraphilia, and love. Journal of Forensic Psychology Practice, 4(2), 1-36.

Dekkers, M. (1994). Dearest pet: On bestiality. New York: Verso.

Franklin, A, (2011, November). Imagined big cats in the English countryside. Proceedings of 2011 TASA Conference: Local Lives/Global Networks. Newcastle, Australia.

Kinsey, A. C., Pomeroy, W. B., Martin, C.E., Gebhard, P.H. (1953). Sexual Behavior in the Human Female. Philadelphia, PA: W.B. Saunders Company.

Kinsey, A. C., Pomeroy, W. B., Martin, C.E., (1948). Sexual Behavior in the Human Male. Philadelphia, PA: W.B. Saunders Company.

Massen, J. (1994). Zoophilie. Die sexuelle Liebe zu Tieren. Koln: Pinto Press.

Miletski, H. (2002). Understanding bestiality-zoophilia. Bethesda, MD: Author.

Munro, H.M.C., & Thrusfield, M.V. (2001). “Battered pets”: Sexual abuse. Journal of Small Animal Practice, 42, 333-337.

Pravda (2004). Cat rapes woman after performing oral sex on her. November 10. Located at: http://english.pravda.ru/news/society/sex/10-11-2004/60215-0/

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

Scherk, M.A. (2009). FIP – A disease full of curiosities. Journal of Feline Medicine and Surgery, 11, 223.

Blind faith: A brief overview of amaurophilia

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Further reading

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

All Experts (2012). Fetishism/Amaurophilia. February 22. Located at: http://en.allexperts.com/q/Fetishism-2835/2012/2/amaurophilia.htm

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

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

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

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

Wikibin (2012). Amaurophilia. Located at: http://wikibin.org/articles/amaurophilia.html

Urine demand: A beginner’s guide to urophilia

In an earlier blog, I examined coprophilia (i.e., a paraphilia in which people are sexually aroused by faeces). Another related paraphilia is urophilia in which people are sexually aroused by urine (i.e., the sight or thought of either the act of urination or the urine itself). The condition is known by many different names. In scientific circles it can also be called urophagia, urolagnia, renifleurism, undinism, and ondinisme. In non-scientific circles it is more popularly called ‘water sports’, ‘golden showers’ and (most crudely) ‘piss play’. This has also led to dedicated websites where ‘pee lovers’ can meet up.

Press reports have reported a few celebrities engaging in the activity. For instance, in an interview with the music magazine Blender, the Puerto Rican popstar Ricky Martin stated that he enjoyed ‘golden showers’. The actor Andy Milonakis and host of MTV’s ‘The Andy Milonakis Show’ said in an interview with People Magazine that liked the feeling of “warm urine” on his chest during sexual intercourse. Interestingly, it was recently discovered that Havelock Ellis – one the ‘founding fathers’ of sexology – was aroused by the sight of a woman urinating.

“In childhood, as his autobiography reveals, Ellis had exclusive attention from his mother during long absences of his sea captain father. Ellis was the eldest child and only son, whose intimacy with his mother included sponging her back and being present when he was twelve and older as she urinated. (His sister, when she heard of one incident, thought that their mother was being flirtatious, since normally she was rather a reserved person.) The consequences of this malimprinting Ellis dignified with the term urolagnia, which he denied had become a real perversion or a dominant interest in his sexual life. His candour had limits, and the evidence is otherwise… In Ellis’s instance the trauma of witnessing his mother urinate was converted into the hostile pleasure of humiliating other women, women in no way connected with his mother, by persuading them to do something for reasons mainly unintelligible to them. When he had the gratification of inducing Franroise [his partner] to urinate in crowded Oxford Circus, she may not have felt especially humiliated. With such an initiate his satisfaction was mainly symbolic…The perversion was enough on his mind for him to write it into his seventh volume of Studies in the Psychology of Sex. There he dignifies the pathological sounding “urolagnia” with the new and enticing term “undinism”. Grosskurth thinks that this volume came into existence principally to defend the perversion which is not discussed elsewhere” (Andrew Brink’s book review of Phyllis Grosskurth’s biography of Havelock Ellis, 1980).

In the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (and like coprophilia), urophilia is listed as a ‘paraphilia not otherwise specified’ (PNOS). As with all paraphilias in the PNOS category, diagnosis is only made “if the behavior, sexual urges, or fantasies cause clinically significant distress or impairment in social, occupational, or other important areas of functioning…Fantasies, behaviors, or objects are paraphilic only when they lead to clinically significant distress or impairment (e.g., are obligatory, result in sexual dysfunction, require participation of non-consenting individuals, lead to legal complications, interfere with social relationships)”.

Urophiliacs typically derive sexual pleasure from urinating on (and/or being urinated upon by) another person. Some urophiliacs may also bathe in urine, enjoy smelling people in urine-soaked clothes, and/or engage in urophagia (i.e., drinking the urine). For urophiliacs, the drinking of the urine typically takes place while someone else urinates directly into their mouth. Urophagia (in and of itself) is not necessarily a sexually arousing activity as there are many urine drinkers who don’t do it for sexual pleasure but for other reasons (e.g., ritualistic and ceremonial purposes or they think there are health or cosmetic benefits as witnessed by those who engage in ‘urine therapy’).

However, for urophiliacs, the act of urophagia may be sexually stimulating for them. They may also engage in the activity as part of other paraphilic activity such as sadism, masochism, voyeurism, and infantalism (i.e., being sexually excited from dressing as an adult baby). Some urophiliacs may also experience sexual arousal from having a full bladder and/or feel sexually attracted to someone else who has a full bladder (‘bladder desperation’) or wets themselves (i.e. ‘panty wetting’ or wetting the bed). In Japan, this latter parahilic behaviour occurs as part of a fetish subculture known as ‘omorashi’ and is seen as different from urophilia.

In 2009, Dr Garth Mundiger-Klow (Beverly Hills Institute of Sexual Health Research, USA) published a whole book comprising 15 urophiliac case studies (The Golden Fetish) but despite the academic credentials of the author, and the lengthy accounts, the book was little more than a collection of erotic stories based around urophiliacs with little analysis provided by the author.

To date, there has been very little scientific research and almost all of what is known is based on either case studies or as a co-occurring behaviour with other paraphilias. For instance, in a survey of 561 non-incarcerated individuals seeking treatment for paraphilias, Dr Gene Abel, and colleagues found that many paraphiliacs engaged in more than one paraphilic behaviour. For instance, all the zoophiles in the sample reported more than one paraphilia and for a small number this included urophilia. However, it appears that urophilia is mostly likely associated with sadomasocism. For instance, in a study of 245 male sadomasochists, Dr Andreas Spengler (University of Hamburg, Germany) reported that 10% of those surveyed had an interest in urophilia. This finding is similar to that of Dr Neil Buhrich (St. Vincent’s Hospital, New South Wales, Australia) who found that 8% of his sample of sadomasichists reported an interest in urophilia.

A paper in a 1982 edition of the Canadian Journal of Psychiatry by Dr R. Denson found that the urine fulfilled many different functions for urophiles. The functions of urine included it (i) serving as a fetishistic object, (ii) being used to humiliate or be humiliated (i.e., through urinating on another person or being urinated upon), and/or (iii) capturing the spirit of a sexual partner. Based on the case studies examined, Dr Denson also argued that urination may serve masochistic and/or sadistic purposes and that therefore it should be labeled ‘uromasochism’ or ‘urosadism’.

While most explanations for paraphilic urophilia focus on early behavioural conditioning in childhood and adolescence, I also came across an interesting snippet in Professor John Money’s 1980 book Love and Love Sickness: The Science of Sex, Gender Difference and Pair-bonding:

“Some years ago, when I visited the Yerkes primate laboratory in Atlanta…How, I asked, did a wild chimpanzee mother keep its baby clean from soiling? The answer was that, as in many other species, she licks it clean…Among the people of Bali, in Indonesia, small dogs lick the babies clean…The dog’s assigned duty is to provide diaper service by licking clean the baby, and the mother, whenever the baby soils. Subsequently I have learned that Eskimo mothers once had a custom of licking their babies clean. Even though human primates have graduated from using the mother’s snout end to keep the baby’s tail end clean, it is safe to assume that, as a species, we still possess in the brain the same phyletic circuitry for infant hygiene as do the subhuman primates. Just as males and females have nipples, so also do both sexes have these brain pathways that relate to drinking urine and eating feces. These are the pathways that, when they become associated with neighboring erotic/sexual pathways, produce urophilia and coprophilia as paraphilias”.

Additionally, an internet essay examining ‘forced retention of bodily waste’ among children, Laurie Couture makes the following observations in relation to the origin of urine-related paraphilias:

“Some sufferers of forced waste retention develop sexual fetishes involving waste and waste retention…adult respondents reported using masturbation as a way to dissociate from the pain of a full bladder. Websites that cater to the sadomasochistic desires of urolagnia (“water sports”) enthusiasts are prevalent on the Internet…Adults who engage in urolagnia are often reenacting scenes from childhood, some of which involved denial of toilet use by school teachers or caretakers for purposes of punishment or containment…Due to the close proximity of the urethra and bladder to the sex organs, some adults who chronically suffered this form of bodily control as children developed a conditioned response in which wetting themselves or bladder tension was association with sexual arousal”

Clearly, there is still much to learn in this area but there are certainly some interesting speculations as to the origins and initiation of urophilic behaviour.

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

Further reading

Abel, G. G., Becker, J. V., Cunningham-Rathner, J., Mittelman, M., & Rouleau, J. L. (1988). Multiple paraphilic diagnoses among sex offenders. Bulletin of the American Academy of Psychiatry and the Law, 16, 153-168.

Buhrich, N. (1983). The association of erotic piercing with homosexuality, sadomasochism, bondage, fetishism, and tattoos. Archives of Sexual Behavior, 12, 167-171.

Collacott, R.A. & Cooper, S.A. (1995). Urine fetish in a man with learning disabilities. Journal of Intellectual Disability Research, 39, 145-147.

Couture, L.A. (2000). Forced retention of bodily waste: The most overlooked form of child maltreatment. Located at: http://www.nospank.net/couture2.htm

Denson, R. (1982). Undinism: The fetishizaton of urine. Canadian Journal of Psychiatry, 27, 336–338.

Grosskurth, P. (1980). Havelock Ellis: A Biography. Toronto: McClelland and Stewart.

Massion-verniory, L. & Dumont, E. (1958). Four cases of undinism. Acta Neurol Psychiatr Belg. 58, 446-59.

Money, J. (1980). Love and Love Sickness: The Science of Sex, Gender Difference and Pair-bonding, John Hopkins University Press.

Mundinger-Klow, G. (2009). The Golden Fetish: Case Histories in the Wild World of Watersports. Paris: Olympia Press.

Skinner, L. J., & Becker, J. V. (1985). Sexual dysfunctions and deviations. In M. Hersen & S. M. Turner (Eds.), Diagnostic interviewing (pp. 211–239). New York: Plenum Press.

Spengler, A. (1977). Manifest sadomasochism of males: Results of an empirical study. Archives of Sexual Behavior, 6, 441–456.

From the university of perversity: An A to Z of non-researched sexual paraphilias (Part 5)

Today’s blog is the fifth part in my review of little researched (and in most cases non-researched) sexual paraphilias and strange sexual behaviours. (You can read Part 1 here, Part 2 here, Part 3 here, and Part 4 here). I’ve tried to locate information on all of these alleged sexual behaviours listed below and in some cases have found nothing more than a definition (some of which were in Dr. Anil Aggrawal’s book Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices and/or Dr. Brenda Love’s Encyclopedia of Unusual Sex Practices).

• Antholagnia: This refers to deriving sexual arousal from smelling flowers (and the arousal may depend on the sight and/or smell of the flowers), and is a specific form of olfactophilia (sexual arousal from smell which I looked at in a previous blog). The Kinkly website notes (without empirical evidence to back up any of the claims made) that: “People with antholagnia typically have a preference for certain flowers, just as most people are sexually aroused by certain body types. They are likely to become aroused while visiting a florist shop, a floral nursery, or a botanical garden. They may also seek out images of flowers online for sexual gratification”.
• Blennophilia: This refers to deriving sexual arousal towards slime. It is also known as myxophilia and appears to be a specific form of salirophilia (sexual arousal from mess and dirt), a paraphilia that I recently published a case study about in the Journal of Concurrent Disorders.
• Chezolagnia:  This refers to deriving sexual arousal from masturbating while defecating. However, some definitions refer to it being a condition in which an individual derives sexual excitation and/or gratification from the act of defecation but this wider definition refers to coprophilia (which I looked at in a previous blog).
• Dermatophilia: A few websites refer to this as deriving sexual arousal from skin lesions and/or skin diseases although it appears this this is just the lexical opposite of dermatophobia. I did write a previous blog on acnephilia which could arguably be a specific type of dermatophilia.
• Epistaxiophilia: This refers to deriving sexual pleasure from nosebleeds (presumably seeing others have nosebleeds rather than the individuals themselves). I did write a previous blog on the relationships between sex and nosebleeds but did not mention epistaxiophilia.
• Febriphilia: This refers to deriving of sexual arousal from fever. I’ve only ever seen this listed on a few websites such as the Alpha Dictionary. I did find one person claiming to have this paraphilia: “I have a very, um, unusual fetish. It’s known as febriphilia. So far, I’ve heard of no one that shares this attraction, and I’m starting to wonder if there are any closet febriphiles out there. I’ve always liked weakness, helplessness, and illnesses in general, but fevers are the biggest thing. Someone being warmer than usual is, for some reason, something I find very attractive”. Someone did eventually respond over four years later and said: “I have to say you are not alone…There are not many febriphiles out there, it’s very hard to find people who share our attraction, but take solace in the fact that you are not alone and you are not a freak”.
• Geniophilia: Over the years I’ve written blogs on fetishes for almost every body part but I’ve never written one on geniophilia (which refers to deriving sexual arousal from chins). This was listed in the JMAC Times as being among the “19 strangest turn-ons ever”.
• Hexakosioihexekontahexaphilia: This refers to deriving sexual pleasure from the number ‘666’. This appears to be a hypothetical paraphilia although the band Vulgarizer did have a track of this name on their album Adonyne.
• Idrophrodisia: This refers to deriving sexual arousal from the odour of perspiration, especially from the genitals. This appears to be a sub-type of osmophilia (deriving sexual pleasure and arousal caused by bodily odours, such as sweat, urine or menses, and which I looked at in a previous blog).
• Japanophilia: This refers to deriving sexual arousal from Japanese people. However, most people use the word ‘Japanophile’ in a non-sexual context as referring to the love of all things Japanese (in fact, one reader of my blog emailed me to ask if I was a Japanophile given the many blogs I had written on various aspects of Japanese sexual behaviour including Oshouji, Tamakeri, Shokushu Goukan, Nyotaimori, Omorashi, and Burusera).
• Kymophilia: Sometimes spelt ‘cymophilia’, this refers to deriving sexual arousal towards waves or wave-like motions. I’ve not some across any evidence that this actually exists but it appears on many other online lists of paraphilias.
• Lutraphilia: This is a very specific type of zoophilia and refers to deriving sexual arousal from otters. I would like to think this is totally hypothetical but there are otter videos on various zoophile online forums. I didn’t click on the videos as you can’t un-see what you have seen. There are also sex toys in the shape of otters. You have been warned.
• Metrophilia: This refers to deriving sexual arousal from poetry (presumably erotic poetry although definitions never mention this) and could arguably be a sub-type of narratophilia (sexual arousal from sexual story telling).
• Nosocomephilia: This refers to deriving sexual arousal from hospitals. This may be a sub-aspect of medical fetishism which I have written about at length in a number of different previous blogs).
• Ochophilia: This refers to deriving sexual arousal from vehicles and is presumably the more generic name for various sub-types of objectum sexuality including individuals who have had sexual relationships with their cars (such as those I have looked at in previous blogs here and here).
• Porphyrophilia: We all know that the musician Prince appeared to love all things sexual and maybe he had porphyrophilia which refers to deriving sexual pleasure from the colour purple.
• ‘Queer women’ fetishism: This type of fetishism was outlined in an article in Mel magazine about heterosexual men whose preferred sexual partner is a lesbian.
• Rheophilia: This refers to deriving sexual arousal from spending time in running water. This may be a sub-type of aquaphilia (sexual arousal from water and/or watery environments including bathtubs or swimming pools) and ablutophilia (sexual arousal from baths or showers) which I looked at in a previous blog.
• Staurophilia: This refers to deriving sexual arousal from crosses or crucifixes. I haven’t seen any evidence that this is a genuine paraphilia although the band Fetish Altar had a track entitled ‘The Latex Crucifix’ (the b-side of ‘Sodomize Angelic Figures’).
• Thlipsosis: This refers to deriving sexual arousal from being pinched or pinching others and is a sadomasochistic behaviour. This is not a plug for the Medical Toys website but they have a lot of products on their ‘Thlipsosis’ page.
• Urethral fetishism: In previous blogs I have examined urethral sex play in its many forms and with its own lexicon (so if you want to read about it in more detail, read more here).
• Venustraphilia: I’m a little unclear how this is a paraphilia because this refers to deriving sexual arousal from beautiful women.
• Wiccaphilia: This refers to deriving sexual arousal from witches and witchcraft and I wrote an article on this paraphilia previously.
• Xyrophilia: This behaviour refers to those individuals who derive sexual arousal from razors (and its name is derived from its opposite condition – xyrophobia). However, there are online forums for razor fetishists and there may be crossover with those that have blood fetishes (which I’ve looked at in various previous blogs).
• ‘Yellow Fever’ fetish: I don’t want to be accused of being racist or passive racism so I will leave this definition to Yuan Ren writing in the Daily Telegraph: “Ever heard of yellow fever?No, not the disease you can pick up when travelling to certain countries. I’m talking about when Caucasian men develop an acute sexual preference for East Asian women – even becoming a fetish, for some”.
• Zip fetishism: Recent news stories have highlighted men who have zip fetishes. On the ‘Is It Normal?’ website, a whole thread was devoted to the topic with various individuals claiming they had such a fetish.

Dr. Mark Griffiths, Distinguished Professor of Behavioural Addiction, 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.

Bering, J. (2014). Perv: The Sexual Deviant In All Of Us. London: Doubleday.

Downing, L. (2010). John Money’s ‘Normophilia’: diagnosing sexual normality in late-twentieth-century Anglo-American sexology. Psychology and Sexuality, 1(3), 275-287.

Gates, K. (2000). Deviant Desires: Incredibly Strange Sex. New York: RE/Search Publications.

Griffiths, M.D. (2019). Salirophilia and other co-occurring paraphilias in a middle-aged male: A case study. Journal of Concurrent Disorders, 1(2), 1-8.

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.

Serrano, R.H. (2004). Parafilias. Revista Venezolana de Urologia, 50, 64-69.

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

Write World (2013). Philias. Located at: http://writeworld.tumblr.com/philiaquirks

The night stuff: A very brief look at nyctophilia and scotophilia

According to Dr. Anil Aggrawal in his 2009 book Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices nyctophilia is a sexual paraphilia where the individual derives sexual pleasure and arousal by a “love of night”. In the same book, Aggrawal defines similar (if not the same conditions) including scotophilia (“turned on by darkness”), lygophilia (“love of darkness”) and achluophilia (“arousal from darkness”). Another related condition is arguably amaurophilia (“arousal by a partner who is blind or unable to see due to artificial means such as being blindfolded or having sex in total darkness”, a paraphilia that I examined in depth in a previous blog). Other sources (such as Dr. Brenda Love’s Encyclopedia of Unusual Sex Practices doesn’t mention any of these, apart from amaurophilia) whereas other medical dictionaries conflate darkness and night together and define nyctophilia as a “preference for the night or darkness. Also called scotophilia”.

As far as I can ascertain, there is no empirical research on this topic at all. There are many references to the similar sounding scopophilia (viewed by many as another term for ‘voyeurism’) but as Dr. Aggrawal notes:

“Several terms have been used as synonyms of voyeurism, although some writers have constantly pointed out subtle differences. The terms scopophilia and scoptophilia are taken as synonyms to voyeurism by most writers. However, others have pointed out a minor difference. If the victim is unsuspecting and non-consenting, the act is voyeurism, but if the other party is consenting, the act is scopophilia or scoptophilia. Furthermore, if the person watched is in the act of disrobing, or nude, the act is voyeurism, but if the person watched is engaged in sex, the act is either mixoscopia (if the watched person is the voyeur’s lover) or allopellia (if the watched persons are complete strangers)”.

The reason I mention this is because in a paper by Dr. Patrick Mahony on voyeurism in a 1989 issue Journal of the American Psychoanalytic Association noted that the “alternate spelling scoptophilia, preferred by some of the older German psychoanalysts, must not be confused with scotophilia or love of darkness”. This appears to have happened in other academic papers I found directly referring to ‘scotophilia’. For instance, one paper dating back almost 70 years was that of Dr. F.S. Caprio who wrote a paper entitled ‘Scotophilia–exhibitionism: A case report’ in the Journal of Clinical and Experimental Psychopathology but it was actually a paper about voyeurism. More specifically, the paper reported the cases of a mother and son who constantly watched residents for sexual arousal in the mother’s rooming house via drilled holes in the wall. A 1966 theoretical review paper by Dr. Jerome Sattler on embarrassment and blushing published in the Journal of Social Psychology claimed that “stage-fright and erythrophobia [fear of blushing] are not simply expressions of the warding off of heightened exhibitionism and scotophilia but also develop as a result of previous instinctual conflict”. Here again, scotophilia appears to be a synonym for voyeurism rather than a sexual love of darkness.

I was pleasantly surprised to find dozens of references to nyctophilia in the scientific literature but the overwhelming majority of papers were biological in origin and all referred to non-human species. For instance, a recent 2016 paper Dr. Luis Espinasa and colleagues in the journal Subterranean Biology reported that cave amphipods are eyeless troglobitic crustaceans found in caves located in the Northeastern (Allegheny) region of the United States and who “exhibit nyctophilia” (literally meaning they love darkness, and has absolutely nothing sexual whatsoever).

I only managed to find one non-biological academic reference on nyctophilia and this was a 1994 paper by Dr. Lewis Lawson in the journal Papers on Language and Literature. In actuality, the use of the word ‘nyctophilia’ was mentioned in passing and noted that the term was defined by psychoanalyst Bertram Lewin as “an erotic pleasure in darkness, which enters as a wish-fulfillment element on fantasies of being in the ‘womb,’ or more properly, as the German word Mutterlieb suggests, of being in the mother’s body”. I was unable to track down the original source so I don’t know the context in which Lewin used the word but the definition is certainly used in a sexual sense rather than the general ‘love of darkness’ used in the biologically-based papers.

In a more general search on the internet, located dedicated photographic sites for nyctophilia, a number of fictional books with the title of Nyctophilia (such as the novel by Welsh author K.A. Hambly), and even the name of a 2014 film (although details about it are sketchy to say the least). I also came across one first-person account of nyctophilia online from someone who has written a number of different articles about the condition such as ‘What is nyctophilia?’, ‘What is it like to have nytophilia?’ and ‘Everything you wanted to know about nyctophilia symptoms’. However, detailed reading of these articles suggests that any sexual element is secondary to a general love of darkness. Here are a few extracts from the articles:

Extract 1: “I have a confession to make. I am a nyctophiliac…Well, a lot of people have told me that I am an insomniac. An insomniac is someone who has difficulty sleeping at night. But I have realized over time that I am not just an insomniac. Insomnia is a physical condition, not a psychological one. Nyctophilia, on the other hand, is purely a psychological condition. Many say that nyctophiliacs are sexually aroused by the dark. Is that true? Well, yes and no. I like darkness, but I am not always sexually aroused by it. I just love it for what it is. It gives me a sense of relief and it makes me happy”.

Extract 2: “To help you understand nyctophilia symptoms, [here] I reveal some uncomfortable details of my life. Every night, I try to sleep at 10 pm. I take sleeping pills such as Klonopin and get myself a good book to read. When I do fall asleep, at around 10:30 pm or 10:45 pm, I find myself waking up at 12:00 am sharp, as fresh as the day, as though I’ve been asleep for 9 hours. I am wide awake at this time and no matter what I do, I cannot go to sleep. Unlike an insomniac, who would turn the lights on and perhaps watch TV, that’s the last thing on my mind. I just want to sit in the bedroom chair in the dark, all alone, with just darkness as my company. I love the darkness. It makes me happy. I feel a sense of relief as I sit in the dark and listen to the sound of the clock ticking by. I know it’s not good for me to stay awake like this, like a ghost, in complete darkness. I tell that to myself several times and often I try my very best to sleep. That is when I get those dreams. Those horrible dreams. The nightmares. I find myself in impossible situations, either getting tortured like Mel Gibson in Braveheart or dying of a dreadful disease, like a child affected by the Ebola virus in Africa”.

Extract 3: “There isn’t much of an awareness of nyctophilia, or nyctophilia symptoms, out there on the Web…The UrbanDictionnary.com defines nyctophilia as ‘The love of darkness or night, or feeling like you belong in the dark” and adds that the condition ‘usually applies to those who often feel sadness!’ Nyctophilia is a condition that makes you want to sit in the dark all by yourself late at night, wide awake…You may wander off late at night in the dark. This will get you in trouble with the authorities, who do not really understand the nyctophilia meaning and cannot even comprehend how you feel. So you may get mistaken for a sex addict or a pervert, or possibly a criminal. Your neighbors would avoid you and report you to the law enforcement agencies. They would want you to leave the neighborhood and move somewhere else. They would feel distinctly uncomfortable about your condition and word would get around about the fact that you stay up all night in the dark, basically doing nothing”.

Extract 4: “There are many who say that nyctophialiacs find darkness sexually arousing. They compare the condition to a form of sex addiction. Indeed, have been given medication for sex addiction, such as GnRH, a long lasting gonadotropin releasing hormone that suppresses sexual desires. If you feel that you have any of the nyctophilia symptoms…it is important to get yourself treated by a qualified psychiatrist, preferably someone who has experience of working with modern or unusual psychiatric conditions. Take the medications that are suggested to you and ask support from your friends and family”

In all the reading I have done on this topic, there appears to be very little genuine evidence that scotophilia and nyctophilia exist, and if the condition does exist, few people appear to suffer major problems as a consequence, unless their love of the dark leaves the person feeling so sleep-deprived that it interferes with their day-to-day functioning. Maybe this condition is a sub-type of insomnia but that the underlying reasons for not going to sleep are very different from the usual reasons for not being able to sleep.

Dr. Mark Griffiths, Professor of Behavioural Addiction, 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.

Caprio, F. S. (1949). Scoptophilia, exhibitionism; a case report. Journal of Clinical and Experimental Psychopathology, 10(1), 50-72.

Espinasa, L., Collins, E., Finocchiaro, A., Kopp, J., Robinson, J., & Rutkowski, J. (2016). Incipient regressive evolution of the circadian rhythms of a cave amphipod. Subterranean Biology, 20, 1-13.

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

Lawson, L. A. (1994). The dream screen in The moviegoer. Papers on Language and Literature, 30(1), 25.

Mahony, P. J. (1989). Aspects of nonperverse scopophilia within an analysis. Journal of the American Psychoanalytic Association, 37(2), 365-399.

Sattler, J. M. (1966). Embarrassment and blushing: A theoretical review. Journal of Social Psychology, 69(1), 117-133.

Car-struck: Another look at mechanophilia and objectum sexuality

“There is no one in the world Darius Monty loves more than Goldie. With her perfect curves and flawless body, she’s a beauty. And the pub boss’s sex life with the hot model less than half his age is better than with any previous girlfriends. But shockingly the object of his full-on passion is a CAR. While many men claim to love their motors, Darius is IN love with his gold-coloured X-Type Jaguar – and makes love to ‘her’” (Sunday Mirror, July 30, 2017).

The opening quote comes from a story that appeared in last weekend’s Sunday Mirror and for which I also supplied some accompanying text in the published article. I described Darius as more of an objectophile than a mechanophile (although he does fit both definitions). According to Dr. Anil Aggrawal’s 2009 book Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices, mechanophilia refers to those being sexually turned on by machines although Cynthia Ceilán in her 2008 book Weirdly Beloved: Tales of Strange Bedfellows, Odd Couplings, and Love Gone Bad describes the same sexual paraphilia as ‘mechaphilia’.

Objectum sexuality refers to those individuals who develop deep emotional and/or romantic attachments to (and have relationships with) specific inanimate objects or structures. Such objectophiles express a loving and/or sexual preference and commitment to particular items or structures (and this is why I view Darius as more of an objectophile than a mechanophile). It has also been claimed (by academics such as Amy Marsh – see ‘Further reading’ below) that such individuals rarely (if ever) have sex with humans and they develop strong emotional fixations to the object or structure. Unlike sexual fetishism, the object or structure is viewed as an equal partner in the relationship and is not used to enhance or facilitate sexual behaviour. Some objectophiles even believe that their feelings are reciprocated by the object of their desire. According to the Sunday Mirror article:

“Darius fell in love with his Jaguar after buying the executive saloon two years ago [in 2015]. His second-hand limo, which was built…in 2004, has startled Darius with the feelings it has aroused. Yet Darius could not fight the urge to live out his sexual fantasies with the car. His passion for Goldie soon became a daily ritual after he returned from his night shift at the pub. And eventually he realised he could no longer hide it from his loved ones. Darius resisted professional help because he thought his liaisons with his motor would become less exciting with time. Despite the negative reaction from his mates, Darius refused to give up on Goldie. Bizarrely, Darius says his relationship with Goldie has gone from strength to strength. He has even retired her from life on the road to keep her in pristine condition. Astonishingly, Darius would still like to find a human girlfriend”.

Unlike most objectophiles I have read about, Darius had sexual relationships with women prior to falling in love with Goldie, and still wants sex with women in the future. In his interview with the Sunday Mirror, he was reported as saying:

 “I don’t expect people to understand because it’s not something I fully understand myself. I didn’t choose this but I have fallen for a car, just like other people fall for women. I find her arousing, I love spending time with her and she is very important to me. I don’t see her as an object, I look at her and I see my lover. Before I bought Goldie I was in a normal loving relationship with a woman. I didn’t see anything strange about myself or my sexuality at all. I’ve always been a car lover, but if someone told me it was possible to have sexual feelings towards something that’s not human I’d have laughed them off just like people laugh at me now. I can’t really explain what triggered it, but I went to view Goldie and had always wanted an X-Type Jaguar. Her colour is so unique and after I’d handed over the cash, all I wanted to do was go and polish her. I pulled into the jet wash and was making circular motions on her bonnet with a cleaning cloth when I suddenly felt unexpectedly aroused. It was something about the smooth, shiny paintwork and the perfect curves of the car that got me turned on. I tried to ignore the feeling and just put it down to excitement about having a new car. But when I got home and sat down to watch TV I had a real urge to venture into the garage and visit her in private”.

The unexpected sexual arousal that Darius felt when first polishing Goldie appears to be the initial spark of his relationship with the car. Psychologists like myself would claim that this unexpected associative pairing of polishing the car with sexual arousal is something that repeatedly played on Darius’ mind and that this formed the basis for a classically conditioned response where the car itself ended up causing the sexual arousal. As he also explained in his newspaper interview:

“I had a girlfriend at the time and I didn’t dare tell her what was going through my mind so I used the excuse that I’d left my wallet in the car and headed out. I wasn’t exactly sure what would happen as the feelings were all new to me. I just knew I felt really turned on by the notion of having sexual intercourse with my new car. Immediately afterwards I felt ashamed and guilty, but I knew right then it wouldn’t be the last time. I walked away feeling so confused about what I’d just done. As disturbing as it was, I told myself I couldn’t be the only person in the world who had experienced these kinds of feelings”.

And Darius was right. There are dozens of objectophiles around the world, and while the behaviour is rare, he is certainly not alone. For instance, in a previous blog I recounted the stories of Edward Smith (an American man who has who has had sex with over a 1000 cars), and Robert Stewart (a British man who ended up in court after being caught having sex with a bicycle). It was when Darius started doing his own research on his behaviour that he began to feel better, knowing there were other objectophiles:

“Knowing others had [sexual and romantic] feelings towards cars, bikes or planes definitely put me at ease but it was a really difficult thing for me to accept. I was enjoying having sex with my car more than with my girlfriend. I even missed the car when I went up to bed at night and felt bad for leaving her alone in the garage. When I broke the news to my girlfriend she left me right away. I could understand her thinking my behaviour was odd, but deep down there was a sense of relief there for me in knowing that I had got things out in the open and I was free to pursue my relationship with Goldie”.

Having accepted that the feelings towards his car were not unique, Darius began to share the details of his new love with his closest friends:

“They laughed at first thinking I was joking, but once they realised I was being serious they told me I was weird and that I need to get psychological help. It really upset me knowing I didn’t have any kind of support or understanding from other people. My feelings for [the car] just grew stronger and stronger. I have never had loving or sexual feelings for any other vehicle, and I firmly believe I have something special with Goldie. I realise most people will think what I do is wrong in some way, but I’m not hurting anyone so what’s the harm?”

In my commentary on the case for the newspaper, I claimed that there was nothing wrong with Darius in a psychological sense. Yes, his behaviour is strange, yes his behaviour seems bizarre to most people, and yes it’s unusual, but he Darius doesn’t appear to need psychological treatment. I noted that if Darius wanted to spend the rest of his life living in a non-normative relationship with Goldie that does no harm to him or anybody else, that was OK by me. I have no problems with anybody’s sexual behaviour as long as it’s consensual (and in this case, the car can’t say it’s not OK). If others see his behaviour as bizarre, it is totally irrelevant. Darius can seek treatment if it’s psychologically harming him, but it sounds like he knows it’s unusual and he seems fine with it. As he went on to say:

“[Goldie] doesn’t cheat on me or moan about me not doing the washing up. She doesn’t have the ability to be in a bad mood. I haven’t lost sight of the fact Goldie is a machine and probably doesn’t love me back – I am not delusional in the sense I’d think she has her own mind. I’ve met a few women since falling in love with Goldie and I am always completely open about her from the start. A couple of them have been open to giving things a go, but when I take my trips out to the garage to see her they say they just find it all too weird. I’d love to get married and have a family if I’m honest. But the next woman I date will have to be OK about sharing me with Goldie”.

In a previous blog, I provided details of the only academic paper that has been published concerning a car-loving objectophile but that case was very different to that of Darius. The paper was a case study by Dr Padmal De Silva and Dr Amanda Pernet published in a 1992 issue of the journal Sex and Marital Therapy. The case involved an unusual sexual deviation in a young 20-year old British man (‘George’) who had little social interaction and was incredibly shy. They reported that his main sexual interest and excitement was from cars – particularly Austin Metro cars. George’s family belonged to a strict religious sect who strongly disapproved of any sexual involvement by their son with women. Things changed for George when his parents bought an Austin Metro car. George began masturbating inside the car, and then outside masturbating outside the car while crouching down next to the car’s exhaust pipe. So that he couldn’t be caught masturbating, he would go to great lengths to find deserted places to engage in his sexual activity with the car.

George used to become very sexually excited when the car’s exhaust pipe was running and pumping out car fumes. This aspect of “elimination” – according to De Silva and Pernet – was an important central element in George’s other sexual preferences – particularly his fascination of urination. As a very young child he had an unusual interest in dogs urinating. After the age of 10 years, he was more interested in children and adult women urinating. The authors also speculated there may have been an increase in George’s arousal due to a “reduction of oxygen intake and related asphyxiation”. This was possibly seen as a mild form of hypoxyphilia.

As you can see, the case of ‘George’ and Darius share few similarities apart from the fact they both have sexual relationships with cars. The fact that two case studies can be so different is terms of aetiology and development of the behaviour suggests that car-loving objectophiles should be an avenue of further research because there are likely to be very different explanations and motivations for the behaviour.

Dr Mark Griffiths, Professor of Behavioural Addiction, 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.

Browne, R.B. (1982). Objects of Special Devotion: Fetishism in Popular Culture. Popular Press.

Ceilán, C. (2008). Weirdly Beloved: Tales of Strange Bedfellows, Odd Couplings, and Love Gone Bad. The Lyons Press.

De Silva, P. & Pernet, A. (1992). Pollution in ‘Metroland’: An unusual paraphilia in a shy young man. Sexual and Marital Therapy, 7, 301-306.

Hickey, E.W. (2006), Sex crimes and paraphilia. New Jersey: Pearson Prentice Hall.

Levy, D. (2017). Man’s bizarre medical condition means he’s in love with his CAR and even has sex with motor he calls Goldie. Sunday Mirror, July 29. Located at: http://www.mirror.co.uk/news/uk-news/mans-bizarre-medical-condition-means-10896296

Marsh, A. (2010). Love among the objectum sexuals. Electronic Journal of Human Sexuality, 13, March 1. Located at: http://www.ejhs.org/volume13/ObjSexuals.htm

Nelson, S. (2012). Fetish spotlight: Mechanophilia. Located at: http://www.thehoneybunnys.com/fetish-spotlight-mechanophilia/

Schlessinger (2003). Mechaphilia: Sexual Attraction to Machines. Please Press.

Thompson, S.L. (2000). The arts of the motorcycle: Biology, culture, and aesthetics in technological choice. Technology and Culture, 41, 99-115.

Wikipedia (2017). Mechanophilia. Located at: http://en.wikipedia.org/wiki/Mechanophilia

The song and binding mode: Musical hallucinations in video game playing

According to a 2015 review in the journal Frontiers in Psychology by Jan Coebergh and colleagues, musical hallucinations (MHs) “are auditory hallucinations characterized by songs, tunes, melodies, harmonics, rhythms, and/or timbres…and that the mechanisms responsible for the mediation of MH are probably diverse”. While Danilo Vitorovic and Jose Biller reported in a 2013 issue of Frontiers in Neurology that the prevalence rate of MHs among the general population is at present unknown and/or rare, ‘involuntary musical imagery’ (INMI) is thought to be more commonplace. For instance, in a 2012 Finnish study in the journal Psychology of Music, Lassi Liikkanen reported that 89% of the total sample (n=12,519) reported experiencing INMI at least once a week. Music hallucination prevalence rates among various groups have been reported including obsessive-compulsive disorder patients (41%; Journal of Clinical Psychiatry, 2004), elderly people with auditory problems (2.5%; International Journal of Geriatric Psychiatry, 2002), and general hospital setting patients (0.16%; Psychosomatics, 1998).

Although Coebergh and colleagues described MHs, they were not explicitly defined. In a review in a 2014 issue of the Journal of Medical Case Reports, Woo and colleagues defined MHs as “complex auditory perceptions in the absence of an external acoustic stimulus and are often consistent with previous listening experience” whereas the 2013 review by Vitorovic and Biller (see above) noted that MHs “represent a specific form of auditory hallucinations whereby patients experience formed songs, instrumental music, or tunes, without an external musical stimulus”. In a 2015 paper in the journal Psychomusicology: Music, Mind, and Brain, Tim Williams provided a classification of INMI and noted they cover a number of different types of involuntary musical experience (including MHs). Despite the lack of detailed definition, it is known that MHs occur within the context of an individual’s culture and are often viewed by those experiencing them as intrusive and sometimes unpleasant.

In 2015, Dr. Angelica Ortiz de Gortari and I wrote a commentary paper on musical hallucinations in videogame playing in response to the review by Coebergh and colleagues. As far as we were aware, we noted that no review paper examining musical hallucinations had ever included papers referring to musical hallucinations arising from playing video games. The earliest report in the psychological literature is by Sean Spence (published in 1993 in the Irish Journal of Psychological Medicine) who reported the case of a 20-year-old female patient with a family history of psychosis. She presented with persecutory delusions, suicidal ideation, violent behaviour and third-person auditory hallucinations comprising 48 hours of constant MHs from the Mario Brothers videogame that developed into delusional thoughts. No drugs were found in her urinary system and her EEG was normal when MHs occurred. The MHs from the videogame decreased within 48 hours of treatment (using antidepressants and neuroleptics).

More recently, a series of papers by Dr. Ortiz de Gortari and I examined Game Transfer Phenomena (GTP). GTP research has demonstrated how the videogame can keep on playing even after the game has been turned off. GTP are non-volitional phenomena (e.g., altered perceptions, automatic mental processes, and involuntary behaviors). In an analysis of over 1600 gamers’ self-reports, our research has shown that videogame playing can lead to (i) perceptual distortions of physical objects, environments, and/or sounds, (ii) misperceptions of objects and sounds that are similar to those in the videogame, (iii) interpretation of events in real life contexts that utilize the logic of the videogame, (iv) ghost perceptions and sensations of images, sounds, and tactile experiences, and (v) involuntary actions and behaviors based on experiences from the videogame.

One study that we published in a 2014 issue of the International Journal of Cyber Behavior, Psychology and Learning specifically examined auditory GTP experiences. Gamers’ experiences identified as GTP in one or more modalities (e.g., visual, auditory) were collected from 60 online videogame forums over seven months. Of these, there were 192 auditory experiences from 155 gamers collected. The largest numbers of experiences (90%) were identified as involuntary auditory imagery. This manifested as hearing music (n = 73), sound (n = 83), or voices from within the game (n = 12). Some experiences were triggered by external cues associated with the game, while others were not. Experiences with music included hearing high pitch music in addition to calm and classical music.

Music from the videogames was usually experienced persistently, while sound effects or voices appeared to have occurred more episodically. Hearing the music persistently provoked sleep deprivation, annoyance, and uncertainty. When the music was re-experienced very vividly, the gamers attributed them to external sources associated with the videogame. More specifically, when auditory cues were associated with adverse videogame content, they resulted in irrational thoughts, reactions and changes in behaviour. In many cases, the gamers said that they had been playing intensively (i.e., either playing long sessions or playing frequently). Previous studies have linked hearing music in absence of auditory stimuli with the recent or repeated exposure to music (see ‘Further reading’ below including: Gardner, 1985; Gerra et al., 1998; Hyman et al., 2012).

In our study, one gamer said that he heard the sound of music coming out from the speakers so he stood up to check them while another heard music from Pokémon when vacuuming. It also appears that musical hallucinations can cross sensory modalities. For instance, some gamers have reported hearing music while seeing images from the video game. An online survey about GTP with a convenience sample of 2,362 gamers found that hearing music from videogames when not playing were the more prevalent (74%) than hearing sounds (65.0%) or voices (46%) when not playing (Ortiz de Gortari & Griffiths, 2015b).

Based on what is known empirically, our paper concluded that (i) MHs from videogame playing – although not well documented – appear to be relatively commonplace among gamers and prevalence appears to be higher than found in other populations, (ii) individual interpretation of MHs from videogames are influenced by the meanings and uses of auditory cues in the videogames, (iii) MHs can manifest beyond one sensory modality and has been reported across-sensory channels (e.g., hearing music while seeing ghost images from the game), (iv) there is little evidence that MHs among videogame players are linked to other underlying pathology (e.g., epilepsy, psychiatric disorder, etc.), (v) those researching in the field of MHs and INMI appear to have overlooked the literature on these phenomena related to videogame playing, and (vi) better definitions are needed for MHs and a distinction between MHs and INMI is required.

(Please note: This blog is based on material used in the following paper: Griffiths, M.D. & Ortiz de Gortari, A.B. (2015). Musical hallucinations: Review of treatment effects. Frontiers in Psychology, 6, 1885. doi: 10.3389/fpsyg.2015.01885).

Dr. Mark Griffiths, Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Coebergh, J. A. F., Lauw, R. F., Bots, R., Sommer, I. E. C., & Blom, J. D. (2015) Musical hallucinations: review of treatment effects. Frontiers in Psychology, 6, 814.

Cole M.G., Dowson, L., Dendukuri, N., & Belzile, E. (2002). The prevalence and phenomenology of auditory hallucinations among elderly subjects attending an audiology clinic. International Journal of Geriatric Psychiatry (2002) 17, 444–52.

Fukunishi, I., Horikawa, N., & Onai, H. Prevalence rate of musical hallucinations in a general hospital setting. Psychosomatics (1998) 39, 175.

Hermesh H. (2004). Musical hallucinations: prevalence in psychotic and nonpsychotic outpatients. Journal of Clinical Psychiatry, 65, 191–7. doi:10.4088/JCP.v65n0208

Gardner, M. P. (1985). Mood states and consumer behavior: A critical review. Journal of Consumer Research, 12, 281-300.

Gerra, G., Zaimovic, A., Franchini, D., Palladino, M., Giucastro, G., Reali, N., . . . Brambilla, F. (1998). Neuroendocrine responses of healthy volunteers to `techno-music’: relationships with personality traits and emotional state. International Journal of Psychophysiology, 28(1), 99-111.

Griffiths, M.D. & Ortiz de Gortari, A.B. (2015). Musical hallucinations: Review of treatment effects. Frontiers in Psychology, 6, 1885. doi: 10.3389/fpsyg.2015.01885

Hyman, I. E., Burland, N. K., Duskin, H. M., Cook, M. C., Roy, C. M., McGrath, J. C., & Roundhill, R. F. (2012). Going gaga: Investigating, creating, and manipulating the song stuck in my head. Applied Cognitive Psychology, 27, 204-215.

Liikkanen, L. A. (2012). Musical activities predispose to involuntary musical imagery. Psychology of Music, 40(2), 236-256.

Ortiz de Gortari, A. B, Aronsson, K. & Griffiths, M. D. (2011). Game Transfer Phenomena in video game playing: A qualitative interview study. International Journal of Cyber Behavior, Psychology and Learning, 1(3), 15-33.

Ortiz de Gortari, A. B. & Griffiths, M. D. (2014). Auditory experiences in Game Transfer Phenomena: An empirical self-report study. International Journal of Cyber Behavior, Psychology and Learning, 4(1), 59-75.

Ortiz de Gortari, A. B. & Griffiths, M. D. (2014). Altered visual perception in Game Transfer Phenomena: An empirical self-report study. International Journal of Human-Computer Interaction, 30, 95-105.

Ortiz de Gortari, A.B. & Griffiths, M.D. (2014). Automatic mental processes, automatic actions and behaviours in Game Transfer Phenomena: An empirical self-report study using online forum data. International Journal of Mental Health and Addiction, 12, 432-452.

Ortiz de Gortari, A.B. & Griffiths, M.D. (2015). Game Transfer Phenomena and its associated factors: An exploratory empirical online survey study. Computers in Human Behavior, 51, 195-202.

Ortiz de Gortari, A. B., Pontes, H. M. & Griffiths, M. D. (2015). The Game Transfer Phenomena Scale: An instrument for investigating the non-volitional effects of video game playing. Cyberpsychology, Behavior and Social Networking, in press.

Ortiz de Gortari, A.B. & Griffiths, M.D (2015b). Prevalence and characteristics of Game Transfer Phenomena: A descriptive survey study. Manuscript under review.

Spence, S. A. (1993). Nintendo hallucinations: A new phenomenological entity. Irish Journal of Psychological Medicine, 10, 98–99.

Vitorovic, D. & Biller, D. (2013). Musical hallucinations and forgotten tunes – case report and brief literature review. Frontiers in Neurology, 4, 109. doi: 10.3389/fneur.2013.00109

Williams, T. I. (2015). The classification of involuntary musical imagery: The case for earworms. Psychomusicology: Music, Mind, and Brain, 25(1), 5-13.

Woo, P. Y. M. Leung, L. N. Y., Cheng, S. T. M. & Chan, K-Y. (2014). Monoaural musical hallucinations caused by a thalamocortical auditory radiation infarct: a case report. Journal of Medical Case Reports, 8, 400.

To pee or not to pee? Another look at paraphilic behaviours

Strange, bizarre and unusual human sexual behaviour is a topic that fascinates many people (including myself of course). Last week I got a fair bit of international media coverage being interviewed about the allegations that Donald Trump hired women to perform ‘golden showers’ in front of him (i.e., watching someone urinate for sexual pleasure, typically referred to as urophilia). I was interviewed by the Daily Mirror (and many stories used my quotes in this particular story for other stories elsewhere). I was also commissioned to write an article on the topic for the International Business Times (and on which this blog is primarily based). The IBT wanted me to write an article on whether having a liking for strange and/or bizarre sexual preferences makes that individual more generally deviant.

Although the general public may view many of these behaviours as sexual perversions, those of us that study these behaviours prefer to call them paraphilias (from the Greek “beyond usual or typical love”). Regular readers of my blog will know I’ve written hundreds of articles on this topic. For those of you who have no idea what parahilias really are, they are uncommon types of sexual expression that may appear bizarre and/or socially unacceptable, and represent the extreme end of the sexual continuum. They are typically accompanied by intense sexual arousal to unconventional or non-sexual stimuli. Most adults are aware of paraphilic behaviour where individuals derive sexual pleasure and arousal from sex with children (paedophilia), the giving and/or receiving of pain (sadomasochism), dressing in the clothes of the opposite sex (transvestism), sex with animals (zoophilia), and sex with dead people (necrophilia).

However, there are literally hundreds of paraphilias that are not so well known or researched including sexual arousal from amputees (acrotomophilia), the desire to be an amputee (apotemnophilia), flatulence (eproctophilia), rubbing one’s genitals against another person without their consent (frotteurism), urine (urophilia), faeces (coprophilia), pretending to be a baby (infantilism), tight spaces (claustrophilia), restricted oxygen supply (hypoxyphilia), trees (dendrophilia), vomit (emetophilia), enemas (klismaphilia), sleep (somnophilia), statues (agalmatophilia), and food (sitophilia). [I’ve covered all of these (and more) in my blog so just click on the hyperlinks of you want to know more about the ones I’ve mentioned in this paragraph].

It is thought that paraphilias are rare and affect only a very small percentage of adults. It has been difficult for researchers to estimate the proportion of the population that experience unusual sexual behaviours because much of the scientific literature is based on case studies. However, there is general agreement among the psychiatric community that almost all paraphilias are male dominated (with at least 90% of all those affected being men).

One of the most asked questions in this field is the extent to which engaging in unusual sex acts is deviant? Psychologists and psychiatrists differentiate between paraphilias and paraphilic disorders. Most individuals with paraphilic interests are normal people with absolutely no mental health issues whatsoever. I personally believe that there is nothing wrong with any paraphilic act involving non-normative sex between two or more consenting adults. Those with paraphilic disorders are individuals where their sexual preferences cause the person distress or whose sexual behaviour results in personal harm, or risk of harm, to others. In short, unusual sexual behaviour by itself does not necessarily justify or require treatment.

The element of coercion is another key distinguishing characteristic of paraphilias. Some paraphilias (e.g., sadism, masochism, fetishism, hypoxyphilia, urophilia, coprophilia, klismaphilia) are engaged in alone, or include consensual adults who participate in, observe, or tolerate the particular paraphilic behaviour. These atypical non-coercive behaviours are considered by many psychiatrists to be relatively benign or harmless because there is no violation of anyone’s rights. Atypical coercive paraphilic behaviours are considered much more serious and almost always require treatment (e.g., paedophilia, exhibitionism [exposing one’s genitals to another person without their consent], frotteurism, necrophilia, zoophilia).

For me, informed consent between two or more adults is also critical and is where I draw the line between acceptable and unacceptable. This is why I would class sexual acts with children, animals, and dead people as morally and legally unacceptable. However, I would also class consensual sexual acts between adults that involve criminal activity as unacceptable. For instance, Armin Meiwes, the so-called ‘Rotenburg Cannibal’ gained worldwide notoriety for killing and eating a fellow German male victim (Bernd Jürgen Brande). Brande’s ultimate sexual desire was to be eaten (known as vorarephilia). Here was a case of a highly unusual sexual behaviour where there were two consenting adults but involved the killing of one human being by another.

Because paraphilias typically offer pleasure, many individuals affected do not seek psychological or psychiatric treatment as they live happily with their sexual preference. In short, there is little scientific evidence that unusual sexual behaviour makes you more deviant generally.

Dr. Mark Griffiths, Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Abel, G. G., Becker, J. V., Cunningham-Rathner, J., Mittelman, M., & Rouleau, J. L. (1988). Multiple paraphilic diagnoses among sex offenders. Bulletin of the American Academy of Psychiatry and the Law, 16, 153-168.

Buhrich, N. (1983). The association of erotic piercing with homosexuality, sadomasochism, bondage, fetishism, and tattoos. Archives of Sexual Behavior, 12, 167-171.

Collacott, R.A. & Cooper, S.A. (1995). Urine fetish in a man with learning disabilities. Journal of Intellectual Disability Research, 39, 145-147.

Couture, L.A. (2000). Forced retention of bodily waste: The most overlooked form of child maltreatment. Located at: http://www.nospank.net/couture2.htm

Denson, R. (1982). Undinism: The fetishizaton of urine. Canadian Journal of Psychiatry, 27, 336–338.

Greenhill, R. & Griffiths, M.D. (2015). Compassion, dominance/submission, and curled lips: A thematic analysis of dacryphilic experience. International Journal of Sexual Health, 27, 337-350.

Greenhill, R. & Griffiths, M.D. (2016). Sexual interest as performance, intellect and pathological dilemma: A critical discursive case study of dacryphilia. Psychology and Sexuality, 7, 265-278.

Griffiths, M.D. (2013). Eproctophilia in a young adult male: A case study. Archives of Sexual Behavior, 42, 1383-1386.

Griffiths, M.D. (2012). The use of online methodologies in studying paraphilias: A review. Journal of Behavioral Addictions, 1, 143-150.

Griffiths, M.D. (2013). Bizarre sex. New Turn Magazine, 3, 49-51.

Massion-verniory, L. & Dumont, E. (1958). Four cases of undinism. Acta Neurol Psychiatr Belg. 58, 446-59.

Money, J. (1980). Love and Love Sickness: The Science of Sex, Gender Difference and Pair-bonding, John Hopkins University Press.

Mundinger-Klow, G. (2009). The Golden Fetish: Case Histories in the Wild World of Watersports. Paris: Olympia Press.

Skinner, L. J., & Becker, J. V. (1985). Sexual dysfunctions and deviations. In M. Hersen & S. M. Turner (Eds.), Diagnostic interviewing (pp. 211–239). New York: Plenum Press.

Spengler, A. (1977). Manifest sadomasochism of males: Results of an empirical study. Archives of Sexual Behavior, 6, 441–456.

More cock tales: A brief look at genital drug injection

The idea for this blog was initiated when I read a snippet in The Fortean Times about a 34-year old man from New York who injected cocaine into his penis and ended up with gangrene and further medical complications. It turns out that this report was based on a letter published in a 1988 issue of the Journal of the American Medical Association by Drs. John Mahler, Samuel Perry and Bruce Sutton (and subsequently reported in a June 1988 issue of the New York Times).

The man in question came in for medical treatment following three days of priapism (i.e., prolonged and painful penile erection) and paraphimosis (i.e., foreskin in uncircumcised males can no longer be pulled over the tip of the penis). To enhance his sexual performance, he had administered cocaine directly into his urethra. After three days, both the priapism and the paraphimosis “spontaneously resolved”. However, the blood that had caused the priapism then leaked to other areas of his body over the next 12 hours (including his feet, hands, genitals, chest, and back). To stop the spread of gangrene, the medics had to partially amputate both of his legs (above the knee), and nine of his fingers. Following this, his penis also developed gangrene and fell off by itself while he was taking a bath. The exact reason for the spread of gangrene was unknown but sexologists (such as Professor John Money) speculated that it may have been because of impure cocaine being used.

When I started to search for medical literature on the topic of injecting drugs directly into male genitalia I was surprised to find quite a few papers on the topic (but unsurprisingly all case study reports given the rarity of such behaviour). One of the earliest I located was one from 1986 in the Journal of Urology by Dr. W. Somers and Dr. F. Lowe. They reported the cases of four heroin abusers with localized gangrene of the genitalia, although only one of these had actually injected heroin directly into his genitalia, in this case his scrotum and perineum (the area between the anus and the scrotum). This latter case developed more severe gangrene and was described as a “more lethal entity” than the gangrene in the other three heroin users’ genitalia.

Later, in a 1999 issue of the American Journal of Forensic Medicine and Pathology, Dr. Charles Winek and his colleagues reported the rare case of a fatality due to a male injecting heroin directly into his penis. The cause of death was determined to be due to heroin and ethanol intoxication. More recently, in a 2005 issue of the Medical Journal of the Iranian Red Crescent, Dr. Z. Ahmadinezhad and his colleagues reported a case of heroin-associated priapism. In their paper, they reported the case of a 32-year old man who was admitted to hospital following pain and swelling after injecting heroin into his penis two weeks earlier. Unfortunately, the person left the hospital following initial consultation and never came back so the outcome of the treatment provided is unknown.

In a 2011 issue of the Internet Journal of Surgery, Dr. I. Malek and colleagues reported the case of a 35-year old long-term intra-venous drug user who injected citric acid laced with heroin into the dorsal vein of his penis. This caused worsening pain and his penis developed gangrene. Over the (non-operative) treatment period, the man’s pain became worse and he had trouble urinating (so he was catheterised). Eventually, the treatment with antibiotics led to a good recovery at three-month follow-up.

Another unusual case was reported by Dr. Francois Brecheteau and his colleagues in a 2013 issue of the Journal of Sexual Medicine. They reported the successful treatment of a 26-year old male drug addict who had injected the opiate drug buprenorphine directly into the dorsal vein of his penis. After unsuccessful antibiotic treatment on its own, they then used a number of simultaneous treatments including heparin, anti-platelet drugs, antibiotics, and hyperbaric oxygen therapy, the man made a successful recovery.

Returning to cocaine rather than opiates, a case report by Dr. V. B. Mouraviev and his colleagues in a 2002 issue of the Scandinavian Journal of Urology and Nephrology reported the case of a 31-year-old Canadian man who had injected cocaine directly into his penis. He turned up at the emergency having endured penile pain for 22 hours following the injection. Twelve hours after injecting the cocaine, the man noticed swelling and bruising starting to appear on the right side of his penis where he had made the injection. As a consequence, his penis developed gangrene (“localized death and decomposition of body tissue, resulting from obstructed circulation or bacterial infection”) most probably from bacterial infection via the injection. He had to undergo reconstructive skin graft surgery and was given antibiotics. In this particular case, the treatment was successful. Other similar reports of medical complications (usually gangrene) following the injection of cocaine into the penis have since appeared in a number of papers including a 2013 paper by Dr. Fahd Khan and colleagues in the Journal of Sexual Medicine.

Cocaine and heroin aren’t the only recreational drugs to have been injected into male genitalia. A paper in a 2014 issue of Urology Case Reports by Dr. Cindy Garcia and her colleagues reported the case of a 45-year-old male intravenous drug user who developed an abscess after he injected amphetamine into his penis. The man chose a penile vein after being unable to find any other suitable peripheral vein. He was treated with intravenous antibiotics and had to have his abscess drained via a penile incision. Within a month he had been all but successfully treated. In their paper (which also included a review of the literature on penile abscesses), they concluded that:

“Penile abscesses are an uncommon condition. There are multiple aetiologies of penile abscesses, including penile injection, penile trauma, and disseminated infection. Penile abscesses might also occur in the absence of an underlying cause. The treatment of penile abscesses should depend on the extent of infection and the cause of the abscess. Most cases of penile abscess necessitate surgical debridement [removal of dead or infected tissue]”.

Similarly, in a 2015 issue of Case Reports in Urology, Dr. Thomas W. Gaither and his colleagues reported two cases of men who had injected metamphetamine into their penis. The first case was a 47-year-old gay man who had a history of “methamphetamine use, prior penile abscesses, urethral foreign body insertions, HIV, hepatitis C, and diabetes mellitus”. He attended the hospital emergency department suffering from severe penile pain and scrotal swelling having injected methamphetamine into the shaft of his penis a few days before. On the same day that he went to the emergency department he was immediately taken into the operating room where an incision was made in his penis, and the abscess was drained of its “purulent foul-smelling fluid” and washed out with saline solution. The second case was a 33-year-old heterosexual male with no previous medical history (apart from a history of depression) turned up at the hospital emergency department with acute penile pain, a day after he had injected methamphetamine directly into his penis. Again, he was immediately taken to the operating room where his penile abscess was drained after an incision. Neither of the cases involved any penile gangrene and both men were also given antibiotics to treat the infected area. In both cases, the authors speculated that the abscesses formed as a result of direct contamination from repeated penile injections.

Finally, Dr. Lucas Prado and his colleagues reported a case study in a 2012 issue of the Journal of Andrology of a 31-year-old man who was admitted to the emergency department after he had injected 10ml of methadone into his penis in an attempt to commit suicide (the first case of penile methadone injection). The man had a 15-year history of drug abuse over the past year and had attempted a drug-related suicide three times. This particular suicide attempt led to acute liver and renal failure as well as erectile dysfunction. Although the man survived, ten months after the suicide attempt, the man still had complete erectile dysfunction.

Although I didn’t do a systematic review of all the literature, it is clear that the injection of recreational drugs directly into male genitalia appears to be relatively rare although all the literature I located was based on those who end up seeking treatment for when things go horribly wrong. There could of course be many hundreds or thousands of people out there that have engaged in such practices but don’t end up in a hospital emergency ward. However, I certainly wouldn’t recommend such a practice to anyone.

Dr. Mark Griffiths, Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Ahmadinezhad, Z., Jabbari, B.H., Saberi, H., Khaledi, F., & Safavi, F. (2005). Heroin associated priapism. Medical Journal of the Iranian Red Crescent, 7(3), 67-68.

Brecheteau, F., Grison, P., Abraham, P., Lebdai, S., Kemgang, S., Souday, V., … & Bigot, P. (2013). Successful medical treatment of glans ischemia after voluntary buprenorphine injection. Journal of Sexual Medicine, 10(11), 2866-2870.

Cunningham, D.L., & Persky, L. (1989). Penile ecthyma gangrenosum: Complication of drug addiction. Urology, 34(2), 109-110.

Gaither, T.W., Osterberg, E.C., Awad, M. A., & Breyer, B.N. (2015). Surgical intervention for penile methamphetamine injections. Case Reports in Urology, 467683, doi.org/10.1155/2015/467683

Garcia, C., Winter, M., Chalasani, V., & Dean, T. (2014). Penile abscess: a case report and review of literature. Urology Case Reports, 2(1), 17-19.

Khan, F., Mukhtar, S., Anjum, F., Tripathi, B., Sriprasad, S., Dickinson, I. K., & Madaan, S. (2013). Fournier’s gangrene associated with intradermal injection of cocaine. Journal of Sexual Medicine, 10(4), 1184-1186.

Malek, I., Parmar, C., McCabe, J., & Irwin, P. (2011). Successful non-operative management of penile wet gangrene following self-injection of heroin in dorsal vein of penis. Internet Journal of Surgery, 11(1), 1-3.

Mireku-Boateng, A.O., & Tasie, B. (2001). Priapism associated with intracavernosal injection of cocaine. Urologia Internationalis, 67(1), 109-110.

Mouraviev, V. B., Pautler, S. E., & Hayman, W. P. (2002). Fournier’s gangrene following penile self-injection with cocaine. Scandinavian Journal of Urology and Nephrology, 36(4), 317-318.

Munarriz, R., Hwang, J., Goldstein, I., Traish, A.M., & Kim, N.N. (2003). Cocaine and ephedrine-induced priapism: case reports and investigation of potential adrenergic mechanisms. Urology, 62(1), 187-192.

Prado, L. G., Huber, J., Huber, C. G., Mogler, C., Ehrenheim, J., Nyarangi‐Dix, J., … & Hohenfellner, M. (2012). Penile methadone injection in suicidal intent: Life‐threatening and fatal for erectile function. Journal of Andrology, 33(5), 801-804.

Singh, V., Sinha, R. J., & Sankhwar, S. N. (2011). Penile gangrene: A devastating and lethal entity. Saudi Journal of Kidney Diseases and Transplantation, 22(2), 359.

Somers, W.J., & Lowe, F.C. (1986). Localized gangrene of the scrotum and penis: A complication of heroin injection into the femoral vessels. Journal of Urology, 136, 111-113.

Winek, C. L., Wahba, W. W., & Rozin, L. (1999). Heroin fatality due to penile injection. American Journal of Forensic Medicine and Pathology, 20(1), 90-92.

Dying for it: Bizarre autoerotic deaths (Part 2)

In my previous blog I examined some of the most bizarre autoerotic deaths reported in the medical forensic literature. Here are another five.

Case 1: Autoerotic death by aerosol propellant

Source: Medicine, Science and the Law. Personal details:  32-year old white US man. Single. Computer programmer.

• Bizarre death event: Found dead in bed with cassette recorder next to him. He was wearing headphones which playing “snorting” horse sounds. There was also a can of aerosol propellant. At the end of the bed was a large painting of a male strapped to the hind legs of a horse who was being anally penetrating by the horse. The horse was ridden by a leather-clad woman. He was also wearing some kind if homemade masturbatory device. His death was recorded as cardio-respiratory failure consistent with aerosol propellant abuse (death by misadventure). Self-administration of the chemical agent to modify the sensations of masturbation. He was covered in dry semen stains.

Case 2: Autoerotic death by clothing

Source: Medicine, Science and the Law. Personal details:  25-year old Japanese male. Single.

• Bizarre death event: Man found dead in his bed one morning. naked except for clothing wrapping his head and underpants which were pulled down. He was covered in dry semen stains. He had put a black skirt on his face and then pulled a second skirt upside down over his head and turned down the bottom of it. He then put a plastic bag over these two garments followed by a pair of tights. The legs of the tights were used to tie a knot around the bottom of the skirts. He then wrapped a third skirt around all of this. Death was due to suffocation.

Case 3: Autoerotic death by hanging (female)

Source: Handbook of Forensic Pathology. Personal details:  19-year old white female. Single. College student.

• Bizarre death event: Woman was found dead in her bedroom hanging from the hinge of her closet door dressed as an Oriental “harem girl”. A window sash cord was tied around her body in a complicated fashion and she was also wearing a blindfold and mouth gag (made from the belt of her dressing gown). Next to her lay an underground magazine (this was folded out and showed a bizarre dance involving a clock – the minute hand being a nude male who would make love with the other figure on the hour), a paperback Hitchcock book which explained her fantasy. The paperback contained the story about an Oriental harem master. In this story the harem master provides girls to his lord who stored them by hanging them around his walls on hooks

Case 4: Autoerotic death by vacuum cleaner

Source: American Journal of Forensic Medicine and Pathology. Personal details: 57-year old white US male. Single. History of heart disease and chronic pancreatitis

• Bizarre death event: Man was found naked slumped over his vacuum cleaner after a neighbour wondered why the vacuum cleaner had been on continuously for a long time. The man was found leaning against the dining table with his testicles, buttocks and thighs tightly bound with women’s tights. Near the table was a jar of urine, jars of lubricant and a wooden table leg covered in fecal excrement. The man was covered in burns from the vacuum cleaner. No defect was found in the vacuum cleaner. The man basically had a heart attack while engaged in autoerotic activity. The wooden table leg had been used in an attempt to stimulate orgasm via anal penetration. His wife had caught him masturbating with the vacuum cleaner before (they hadn’t had sex for five years). The death was classed as natural rather than accidental.

Case 5: Autoerotic death by hydraulic tractor shovel

Source: Journal of Forensic Sciences. Personal details:  62 year-old US white male. Married. Farmer.

• Bizarre death event: Found dead in a barn lying on his front pinned under the hydraulic shovel of his tractor. His body was covered with semen stains and there was evidence of masochistic sexual bondage. His clothes were folded neatly away nearby. He was found naked except for a pair of women’s red shoes (with 8 inch heels), knee high stockings and tape duct wrapped around his ankles. Ropes led from his feet to the tractor which when raised would lift his inverted body causing complete suspension. It is not known exactly what happened but it is likely that the engine stalled and he was crushed underneath the tractor shovel. He died of positional asphyxiation by chest compression. This was an atypical autoerotic fatality because he did not purposely use asphyxiation but it did cause his death.

Dr. Mark Griffiths, Professor of Behavioural Addiction, 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.

Byard, R. W. (1994). Autoerotic death—characteristic features and diagnostic difficulties. Journal of Clinical Forensic Medicine, 1(2), 71-78

Cordner, S.M. (1983). An unusual case of sudden death associated with masturbation. Medicine, Science and the Law, 23(1), 54-56

Dietz, P. E., & O’Halloran, R.L. (1993). Autoerotic fatalities with power hydraulics. Journal of Forensic Science, 38(2), 359-364.

Ikeda, N., Harada, A., Umetsu, K., & Suzuki, T. (1988). A case of fatal suffocation during an unusual auto-erotic practice. Medicine, Science and the Law, 28(2), 131-134.

Imami, R. H., & Kemal, M. (1988). Vacuum cleaner use in autoerotic death. American Journal of Forensic Medicine and Pathology, 9(3), 246-248.

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

Sauvageau, A., & Racette, S. (2006). Autoerotic deaths in the literature from 1954 to 2004: A review. Journal of Forensic Sciences, 51(1), 140-146.