Velvet gold mind: Psychopathy, addiction, ECT, and the psychology of Lou Reed

Regular readers of my blog will have no doubt picked up that one of my all time favourite bands is the Velvet Underground (VU) – often referred to as “The Psychopath’s Rolling Stones“. I bought my first VU album on vinyl back in 1980 as a 14-year old adolescent (a 12-track compilation that I still have simply called ‘The Velvet Underground’). When I bought it I had heard very few VU songs on the radio and one of the main reasons I bought it was because a number of my musical heroes at the time (Ian McCulloch the lead singer of the Echo and the Bunnymen being the one I seem to remember) kept listing VU songs in their ‘Top 10 Tracks’ in Smash Hits magazine.

Over time I have steadily accumulated a massive collection of VU and VU-related albums (mainly solo LPs of VU band members, most notably Lou Reed, John Cale, and Nico, as well as dozens and dozens of bootleg LPs). As much as I love the recorded solo outputs of Cale and Nico, it is Lou Reed that I have always found the most psychologically fascinating on both a musical and personal level (even though Cale was admittedly the better musician) – and because of his autobiographical lyrics (many of which were collated in his 1992 book Between Thought and Expression). Reed (along with a few other musicians such as John Lennon, Morrissey, David Bowie, Adam Ant, and Gary Numan) is someone I would love to have interviewed, as he was a psychological paradox and appeared to have so many different facets to his personality. During is early career, Reed was a self-confessed drug addict and wrote songs about both heroin (‘I’m Waiting For The Man‘ and admitting in his song ‘Heroin‘ that it was “my wife and it’s my life”) and amphetamines (‘White Light, White Heat‘). I would also argue that in later life he replaced these negative addictions with what Bill Glasser defined as a ‘positive addiction‘ in the form of t’ai chi ch’uan (i.e., tai chi).

In the 1960s and early 1970s, Reed’s lyrics covered topics that shocked many people. His song lyrics recounted life’s misfits and those that lived on the fringes (particularly of the life he had himself experienced in New York and as part of pop artist Andy Warhol’s entourage). His world was one of drug addiction, transvestite drag queens, bisexuality, and sado-masochism. Like many of the best and most literary writers, he wrote about what he knew and had experienced. As Reed himself pointed out many times, the subject matter of his songs were no different from his literary heroes such as Edgar Allen Poe, Hubert Selby Jr., William Burroughs, and Delmore Schwartz. Sex and drugs were common themes in novels and poetry. Reed wondered why listeners and rock critics alike were so horrified by the content of his songs when the same content could be found in books from the 1950s and early 1960s.

Reed was a much feared interviewee by music journalists and often poured vitriol on many rock critics (Lester Bangs and Robert Christgau being the most high profile). Just listen to his 1978 live LP Take No Prisoners that is remembered more for the acerbic monologues in between the songs than for the music. Although I would have loved to interview him, his experiences with psychologists and psychiatrists arguably left him emotionally scarred for life (or at the very least a deep mistrust of therapists). His affluent parents sent him for weekly sessions of electroconvulsive therapy (ECT) as a young teenager to “cure” him of his homosexual desires and urges. It had such a negative impression on him that he documented the experiences on his song ‘Kill Your Sons’ (from his 1974 LP Sally Can’t Dance). As he was quoted as saying in Legs McNeil and Gillian McCain’s 1996 book Please Kill Me:

“They put the thing down your throat so you don’t swallow your tongue, and they put electrodes on your head. That’s what was recommended in Rockland State Hospital to discourage homosexual feelings. The effect is that you lose your memory and become a vegetable”

Up until the ECT session, Reed appeared to have lead a relatively trouble-free childhood (although there were admittedly some juvenile delinquent activities). The ECT sessions may have been the catalyst that far from ‘curing’ him of his sexual urges confused the issue even more. Reed was more explicit in the lyrics to ‘Kill Your Sons’ about the whole experience of ECT and what he thought about it:

“All your two-bit psychiatrists are giving you electro shock/They say, they let you live at home, with mom and dad/Instead of mental hospital/But every time you tried to read a book/You couldn’t get to page 17/’Cause you forgot, where you were/So you couldn’t even read/Don’t you know, they’re gonna kill your sons”.

I have read almost every biography that has ever been published on Reed and there appears to be an almost unconscious pathological need to subvert the traditional rock cycle treadmill of fame and success. There is no doubt that Reed wanted to be respected and remembered for his literary writing – but many of his decisions and actions were self-defeating. In my own field of gambling, the psychologist Edmund Bergler speculated that addicted gamblers have an ‘unconscious desire to lose’ – a form of psychic masochism. If Reed was on Bergler’s couch, he may have come to the same conclusion about Reed.

There are so many points in Reed’s life where he appeared to deliberately sabotage his own career and commit what others have described ‘artistic suicide’. For instance, after David Bowie had befriended him in the early 1970s and produced his first hit LP (Transformer) and biggest hit (‘Walk On The Wild Side’), he fell out with Bowie and recorded what a number of rock critics have described as “the most depressing album of all time” (the 1973 LP Berlin). He then seemed to get his career back on course with his one and only top 10 US album (1974 LP Sally Can’t Dance) only to follow it up with the album consisting of four tracks of guitar feedback each 16 minutes in length (1975 album Metal Machine Music). James Wolcott writing for the Village Voice went as far as to say that  Metal Machine Music “crowned Reed’s reputation as a master of psychopathic insolence”. Although both “career killing” LPs have since been hailed as masterpieces in their own way, both releases provide an argument that Reed was a masochist on some level even if the original pain didn’t become pleasure until 30 years later.

The arguably self-inflicted pain didn’t end with his musical output. Almost every important person he looked up to in his life between 1964 and the early 1990s were cast aside and verbally and/or physically abused by Reed at some point. This included his managers (e.g., Andy Warhol, Steve Sesnick, Dennis Katz), his admirers and benefactors (e.g., David Bowie), his record company senior executives (e.g., Clive Davis), his lovers (e.g., Shelly Albin, Nico, Bettye Kronstad, Sylvia Morales, “Rachel” [Tommy] Humphries), and his musical collaborators (e.g., John Cale, Doug Yule, Robert Quine).

Some people have claimed Reed was almost psychopathic in some of his actions. The criminal psychologist Professor Robert Hare developed the Revised Hare Psychopathy Checklist (PCL-R), a psychological assessment that determines whether someone is a psychopath.

“At heart, Hare’s test is simple: a list of 20 criteria, each given a score of 0 (if it doesn’t apply to the person), 1 (if it partially applies) or 2 (if it fully applies). The list in full is: glibness and superficial charm, grandiose sense of self-worth, pathological lying, cunning/manipulative, lack of remorse, emotional shallowness, callousness and lack of empathy, unwillingness to accept responsibility for actions, a tendency to boredom, a parasitic lifestyle, a lack of realistic long-term goals, impulsivity, irresponsibility, lack of behavioural control, behavioural problems in early life, juvenile delinquency, criminal versatility, a history of ‘revocation of conditional release’ (i.e., broken parole), multiple marriages, and promiscuous sexual behaviour. A pure, prototypical psychopath would score 40. A score of 30 or more qualifies for a diagnosis of psychopathy”

Personally, I think there are psychopathic traits in almost any person with a successful career, and Reed (from the many biographies I have read) would certainly endorse some of the indicators in the list above. However, as he (i) became older, (ii) became teetotal and drug-free, (iii) studied Buddhist philosophy (including meditation and tai chi), and (iv) settled down and married performance artist and musician Laurie Anderson, he arguably became happier and produced some of the best music of his career.

The trio of ‘concept’ albums including his ‘warts ‘n’ all’ tribute to his home city (New York, 1989), his moving tribute to Andy Warhol (Songs for Drella, 1990, with John Cale), and his lyrical musings on illness, death and dying (1992, Magic and Loss) were all critically lauded (and among my own personal favourites). Songs for Drella (the VU’s nickname for Andy Warhol – a contraction of the names Cinderella and Dracula) is not just one of Reed’s best albums but it’s one of the best LP’s ever. The fact that the songs were heartfelt and full of remorse for the way Reed had treated Warhol in the latter years of his life, suggest that the characterization of Reed as a psychopath is unfair.

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

Further reading

Bockris, V. (1994). Lou Reed: The Biography. London: Hutchinson.

Bockris, V. & Malanga, G. (1995). Up-tight – The Velvet Underground Story.London:Omnibus Press.

Doggett, P. (1991). Lou reed – Growing Up in Public
. London: 
Omnibus Press.

Glasser, W. (1976), Positive Addictions. New York, NY: Harper & Row.

Henry, T. (1989), Break All Rules! Punk Rock and the Making of a Style, Ann Arbour MI: UMI Research Press.

Hare, R. D., & Vertommen, H. (2003). The Hare Psychopathy Checklist-Revised. Multi-Health Systems, Incorporated.

Heylin, C. (2005). All Yesterday’s Parties – The Velvet Underground In Print 1966-1971. Cambridge, MA: Da Capo Press.

Hogan, P. (2007). The Rough Guide To The Velvet Underground. London: Penguin.

Jovanovich, R. (2010). The Velvet Underground – Peeled. Aurum Press.

Kostek, M.C. (1992). The Velvet Underground Handbook
. London: 
Black Spring Press.

McNeil, Legs; McCain, G. (1996). Please Kill Me: The Uncensored Oral History of Punk. London: Grove Press.

Muggleton, D. & Weinzierl, R. (2003). The Post-subcultures Reader. Oxford: Berg.

Reed, L. (1992). Between Thought and Expression. 
London: Penguin Books.

Wall, M. (2013). Lou Reed: The Life. Croydon: Orion Books.

I drink, therefore I am: A brief look at alcohol dependence in Great Britain

Alcohol dependence is often viewed as a cluster of behavioural, cognitive, and physiological phenomena that in most affected people includes a strong desire to consume alcohol, and have difficulties in controlling their drinking. According to a 2013 report by Alcoholics Anonymous, alcoholism kills more people in the UK than any other drug apart from nicotine. Based on Government statistics, they claim one adult in every 13 is alcohol-dependent (although this is much higher than data collected from the most methodologically robust studies – see below). The General Household Survey (GHS) and the General Lifestyle Survey (GLF) have been measuring drinking behaviour for over 30 years. In relation to alcohol use, the latest 2013 Office for National Statistics (ONS) report notes that:

“The Department of Health estimates that the harmful use of alcohol costs the National Health Service around £2.7bn a year and 7% of all hospital admissions are alcohol related. Drinking can lead to over 40 medical conditions, including cancer, stroke, hypertension, liver disease and heart disease. Reducing the harm caused by alcohol is therefore a priority for the Government and the devolved administrations. Excessive consumption of alcohol is a major preventable cause of premature mortality with alcohol-related deaths accounting for almost 1.5% of all deaths in England and Wales in 2011”.

The ONS notes that obtaining reliable data on drinking behaviour is difficult. Compared to national alcohol sales, surveys carried out by social scientists consistently record lower levels of how much alcohol they consume because participants may consciously and/or unconsciously be underestimating alcohol consumption (e.g., alcohol use in the home may be based on the number of glasses of wine drunk with the amount poured into the glass being much greater than a standard unit of alcohol). In the most recent 2013 report (based on data collected in 2011), participants were asked two questions about their alcohol consumption. These were (i) maximum amount of alcohol drunk on any one day in the previous seven days, and (ii) average weekly alcohol consumption. The survey also obtained three measures of maximum daily alcohol consumption.

• Exceeding the recommended daily alcohol limit. This measure assessed the proportion of men and women exceeding the recommended units of alcohol on their heaviest drinking day (i.e. 4 units for men, 3 units for women).
• Engaging in binge drinking (i.e., intoxication). This measure assessed the proportion of men and women who exceeded the number of daily units considered as intoxicating (i.e., 8 units for men, 6 units for women).
• Engaging in heavy drinking. This measure assessed the proportion of men and women who drank more than three times the recommended daily units of alcohol (i.e., more than 12 units for men and more than 9 units for women).

The results indicated that:

• Over half of all adults (59%) reported that they had consumed alcohol in the week prior to the survey.
• Men (66%) were more likely than women (54%) to have had an alcoholic drink in the week before the survey
• More men (16%) drank on at least five out of seven days than women (9%) in the week prior to the survey.
• Almost one in ten men (9%) drank alcohol every day in the week prior to the survey compared to only one in twenty women (5%).
• More men (34%) exceeded the daily recommended units of alcohol than women (28%).
• More men (18%) were binge alcohol drinkers than women (12%)
• More men (9%) were heavy drinkers than women (6%)
• Heavy drinking was most prevalent in those aged 16 to 44 years
• Drinking alcohol was also associated with smoking nicotine with smokers being more likely to be binge drinkers and heavy drinkers.

Another major report on alcohol use in England was recently published by the Lifestyle Statistics, Health and Social Care Information Centre (in 2013). Their analyses were mainly obtained from the Health and Social Care Information Centre (HSCIC), Hospital Episodes Statistics (HES), and prescribing data. They reported that:

• 61% of men and 72% of women had either drunk no alcohol in the last week, or had drunk within the recommended levels on the day they drank the most alcohol.
• 64% of men drank no more than 21 units weekly, and 63% of women drank no more than 14 units weekly.
• 12% of school pupils had drunk alcohol in the last week. This continues a decline from 26% in 2001, and is at a similar level to 2010, when 13% of pupils reported drinking in the last week.
• In 2011/12, there were 200,900 admissions to English hospitals where the primary diagnosis was attributable to alcohol consumption (a 1% increase on the previous year).
• In 2011/12, there were an estimated 1,220,300 admissions to English hospitals related to alcohol consumption where an alcohol-related disease, injury or condition was the primary reason for hospital admission or a secondary diagnosis (an increase of 4% on the previous year).
• In 2012, there were 178,247 prescription items prescribed for the treatment of alcohol dependence in primary care settings or NHS hospitals and dispensed in the community (an increase of 6% on the previous year).

Arguably the most robust data on alcohol dependence in the UK comes from the 2009 Adult Psychiatric Morbidity Survey (APMS) carried out by the National Centre for Social Research and University of Leicester. Alcohol problems (including alcohol dependence) were measured using the AUDIT (Alcohol Use Disorders Identification Test) and the SADQ-C (Severity of Alcohol Dependence Questionnaire, community version). An AUDIT score of eight or more indicated hazardous drinking, and 16 or more indicated harmful drinking. SADQ-C scores of 4-19 indicated mild dependence; 20-34, moderate dependence; 35 or more, severe dependence.

Using the AUDIT, the prevalence of hazardous drinking was 24.2% (33.2% males, 15.7% females). A total of 3.8% of adults (5.8% males, 1.9% females) drank alcohol at harmful levels, i.e., around 1 in 25 adults. Among males, the highest prevalence of both hazardous and harmful drinking was in 25-34 year olds, whereas in females it was in 16 -24 year olds. Using the SADQ-C, the prevalence of alcohol dependence was 5.9% (8.7% males, 3.3% females), i.e., around 1 in 16 adults. For males, the highest levels of dependence were identified in those between the ages of 25-34 years (16.8%), whereas for females it was between the ages of 16-24 years (9.8%). Most of the recorded dependence levels were mild (5.4%), with relatively few adults showing symptoms of moderate or severe dependence (0.4% and 0.1% respectively). Compared to the previous APMS survey in 2000, the prevalence of alcohol dependence was lower for males in 2007, whereas it remained at a similar level for females.

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

Further reading

Lifestyle Statistics, Health and Social Care Information Centre (2013). Statistics on Alcohol: England, 2013. Located at: https://catalogue.ic.nhs.uk/publications/public-health/alcohol/alco-eng-2013/alc-eng-2013-rep.pdf

National Centre for Social Research/University of Leicester (2009). Adult Psychiatric Morbidity in England, 2007: Results of a Household Survey. London: NHS Information Centre

Office for National Statistics (2012). The 2010 General Lifestyle Survey. London: Office for National Statistics.

Office for National Statistics (2013). The 2011 General Lifestyle Survey. London: Office for National Statistics.

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

A burning for earning: A brief look at ‘wealth addiction’

Back in 1996, I published a paper on behavioural addictions in the Journal of Workplace Learning. One of my introductory paragraphs in that paper noted:

“There is now a growing movement (e.g. Miller, 1980; Orford, 1985) which views a number of behaviours as potentially addictive, including many behaviours which do not involve the ingestion of a drug. These include behaviours diverse as gambling (Griffiths, 1995), overeating (Orford, 1985), sex (Carnes, 1983), exercise (Glasser, 1976), computer game playing (Griffiths, 1993a), pair bonding (Peele and Brodsky, 1975), wealth acquisition (Slater, 1980) and even Rubik’s Cube (Alexander, 1981)! Such diversity has led to new all encompassing definitions of what constitutes addictive behaviour”.

The reason I mention this is that I was recently asked to comment on a story about ‘wealth addiction’ and I vaguely remembered that I had mentioned (in passing) Philip Slater’s 1980 book (also entitled Wealth Addiction). Slater’s book was written from a sociological standpoint and was both controversial and provocative. Slater claimed on the book cover that: ““Money is America’s most powerful drug. Here’s how it weakens us and how we can free ourselves”. I also came across an interesting 2012 article by journalist Scott Burns (on ‘wealth addiction revisited’) who noted that:

“One of the hallmarks of wealth addiction is very simple: more possessions but less use. We become so interested in possessing the thing that we lose the experience it provides. This can be as vast as owning homes all around the world, as some of the very rich do, as simple as Bernie Madoff’s shoe collection, or as obsessive as a collection of rare watches. Whatever it is, the wealth addict confuses possession with experience”.

Slater argued that our increasing reliance on money and all of the things that it can buy has the potential to become an obsession that can destroy individual lives. According to short article by Dr. Paul Hokemeyer, wealth addiction has three key characteristics:

• Tolerance: More and more money is needed to attain a baseline level of satisfaction.
• Withdrawal: The thought of losing money or not making it fills a person with fear, anxiety and stress.
• Negative consequences: In their pursuit of money, the person forgoes emotional fulfillment, intimate relationships and peace of mind.

These are actually three of the six criteria that I personally believe comprise genuine addictive behaviour (although I use the word ‘conflict’ rather than ‘negative consequences’; the other three criteria are salience, mood modification and relapse – see my previous blog on behavioural addiction for further details).

The reason why wealth addiction has made a re-appearance over the last month is because of an article published in the New York Times by Sam Polk, a former hedge fund trader that worked on Wall Street (and who since the article has been published has been compared to Jordan Belfort, the person that Leonardo DiCaprio portrayed in the true story film The Wolf of Wall Street).

Polk’s article is an interesting read (whether you think wealth addiction exists or not) and I thought I would pick out some of the text and relate it to my own views about what constitutes addictive behaviour.

• Extract 1: “In my last year on Wall Street my bonus was $3.6 million – and I was angry because it wasn’t big enough. I was 30 years old, had no children to raise, no debts to pay, no philanthropic goal in mind. I wanted more money for exactly the same reason an alcoholic needs another drink: I was addicted”

Here, Polk refers to his work bonuses becoming bigger and bigger and that they were never enough. To me, this sounds like some kind of tolerance effect with more and more money needed to achieve the desired (presumably mood modifying effect). Polk also claims – after the fact – that he had become addicted.

• Extract 2: “I was also a daily drinker and pot smoker and a regular user of cocaine, Ritalin and ecstasy. I had a propensity for self-destruction that had resulted in my getting suspended from Columbia for burglary, arrested twice and fired from an Internet company for fist fighting”.

Polk openly discusses his previous use of potentially addictive substances and made the comparisons himself between his self-confessed behavioural (wealth) addiction and his previous self-destructive chemical abuse. Some readers may jump to the conclusion that Polk had (or has) an ‘addictive personality’ but this is not something that I personally believe in. To me, Polk is displaying ‘reciprocity’ (swapping one potential addiction with another) rather than being a function of an underlying personality trait. Giving up one addiction often leaves a large void and sometimes the only way to fill it is by engaging in other behaviours that provide similar feelings and sensations.

• Extract 3: “My counselor didn’t share my elation [at earning more and more money]. She said I might be using money the same way I’d used drugs and alcohol – to make myself feel powerful — and that maybe it would benefit me to stop focusing on accumulating more and instead focus on healing my inner wound”.

Here, Polk’s therapist appears to hit the nail on the head in relation to what money represented for Polk. I would describe the feeling that Polk gained from both drugs and money was omnipotence (something that I have also written about in relation to my research on gambling).

• Extract 4: “I was terrified of running out of money and of forgoing future bonuses. More than anything, I was afraid that five or 10 years down the road, I’d feel like an idiot for walking away from my one chance to be really important. What made it harder was that people thought I was crazy for thinking about leaving. In 2010, in a final paroxysm of my withering addiction, I demanded $8 million instead of $3.6 million. My bosses said they’d raise my bonus if I agreed to stay several more years. Instead, I walked away”.

Polk’s language here is very much rooted in what addicts say about their drug or behaviour of choice (“terrified” of being without the thing they love doing). The weighing up of the costs clearly led to a decision for Polk to quit his “withering addiction” and there are obviously signs both here (and the rest of the article if you read it) that leaving behind the wealth left him with some feelings of regret.

• Extract 7: “The first year was really hard. I went through what I can only describe as withdrawal — waking up at nights panicked about running out of money, scouring the headlines to see which of my old co-workers had gotten promoted. Over time it got easier — I started to realize that I had enough money, and if I needed to make more, I could. But my wealth addiction still hasn’t gone completely away. Sometimes I still buy lottery tickets”.

Here, Polk uses addictive terminology (i.e., withdrawal) to describe giving up the activity that led to him gaining wealth. Again, the fear of running out of money appears psychologically similar to the fear that other more traditional addicts have about running out of their drug of choice. It could also be argued that he has given up one form of gambling (financial trading) with partially doing another (buying lottery tickets).

• Extract 8: “I was lucky. My experience with drugs and alcohol allowed me to recognize my pursuit of wealth as an addiction. The years of work I did with my counselor helped me heal the parts of myself that felt damaged and inadequate, so that I had enough of a core sense of self to walk away”

Polk uses his experiences in giving up drugs with the help of his therapist as a way of helping him give up wealth acquisition. Knowing you have managed to give up one addiction shows that you have the mental strength to give up another.

Obviously I have never met Polk and I can only go on how he described his experiences during his time on Wall Street, However, the insights shared do seem to suggest that some of the wealth acquisition behaviour had addictive elements and that there was at least some evidence that Polk – at least on some occasions – experienced salience, tolerance, withdrawal, conflict and mood modification. Whether he was genuinely addicted to money in the same way as drug addicts are addicted to psychoactive substances is debatable. However, theoretically, I can see how someone might be become addicted to wealth. There are also interesting questions as to whether wealth acquisition may be an underlying motivation for those addicted to work.

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

Further reading

Alexander, R. (1981). A cube popular in all circles. New York Times, 21 July, p. C6.

Burns, S. (2012). Beyond envy: Wealth addiction revisited. Dallas News, December 15: Located at: http://www.dallasnews.com/business/columnists/scott-burns/20121215-beyond-envy-wealth-addiction-revisited.ece?nclick_check=1

Carnes, P. (1983). Out of the Shadows: Understanding Sexual Addiction. CompCare, New York, NY.

Glasser, W. (1976). Positive Addictions. Harper & Row, New York, NY.

Griffiths, M.D. (1993). Are computer games bad for children? The Psychologist: Bulletin of the British Psychological Society, 6, 401-407.

Griffiths, M.D. (1995). Adolescent Gambling, Routledge: London.

Orford, J. (1985). Excessive Appetites: A Psychological View of the Addictions. Wiley: Chichester.

Peele, S. and Brodsky, A. (1975). Love and Addiction. Taplinger: New York, NY.

Polk, S. (2013). For the love of money. New York Times, January 29. Located at: http://www.nytimes.com/2014/01/19/opinion/sunday/for-the-love-of-money.html?_r=1

Slater, P. (1980). Wealth Addiction. E.P. Dutton: New York, NY.

Stats entertainment (Part 2): A 2013 review of my personal blog

My last blog of 2013 was not written by me but was prepared by the WordPress.com stats helper. I thought a few of you might be interested in the kind of person that reads my blogs. I also wanted to wish all my readers a happy new year and thank you for taking the time to read my posts.

Here’s an excerpt:

The Louvre Museum has 8.5 million visitors per year. This blog was viewed about 860,000 times in 2013. If it were an exhibit at the Louvre Museum, it would take about 37 days for that many people to see it.

Click here to see the complete report.

Excess in success: Are celebrities more prone to addiction?

One of the recurring questions I am often asked to comment on by the media is whether celebrities are more prone to addiction than other groups of people. One of the problems in trying to answer what looks like an easy question is that the definition of ‘celebrity’ is different to different people. Most people would argue that celebrities are famous people, but are all famous people celebrities? Are well-known sportspeople and politicians ‘celebrities’? Are high profile criminals celebrities? While all of us would say that Hollywood A-Listers such as Tom Cruise, Johnny Depp, Angelina Jolie, Brad Pitt and Julia Roberts are ‘celebrities’, many of the people that end up on ‘celebrity’ reality shows are far from what I would call a celebrity. Being the girlfriend or relative of someone famous does not necessarily famous.

Another problem in trying to answer this question is what kinds of addiction are the media actually referring to? Implicitly, the question might be referring to alcohol and/or illicit drug addictions but why should other addictions such as nicotine addiction or addiction to prescription drugs not be included? In addition to this, I have often been asked to comment on celebrities that are addicted to sex or gambling. However, if we include behavioural addictions in this definition of addiction, then why not include addictions to shopping, eating, or exercise? If we take this to an extreme, how many celebrities are addicted to work?

Now that I’ve aired these problematic definitional issues (without necessarily trying to answer them), I will return to the question of whether celebrities are more prone to addiction. To me, when I think about what a celebrity is, I think of someone who is widely known by most people, is usually in the world of entertainment (actor, singer, musician, television presenter), and may have more financial income than most other people I know. When I think about these types of people, I’ve always said to the media that it doesn’t surprise me when such people develop addictions. Given these situations, I would argue that high profile celebrities may have greater access to some kinds of addictive substances.

Given that there is a general relationship between accessibility and addiction, it shouldn’t be a surprise if a higher proportion of celebrities succumbs to addictive behaviours compared with a member of the general public. The ‘availability hypothesis’ may also hold true for various behavioural addictions that celebrities have admitted having – most notably addictions to gambling and/or sex. It could perhaps be argued that high profile celebrities are richer than most of us (and could therefore afford to gamble more than you or I) or they have greater access to sexual partners because they are seen as more desirable (because of their perceived wealth and/or notoriety).

Firstly, when I think about celebrities that have ‘gone off the rails’ and admitted to having addiction problems (Charlie Sheen, Robert Downey Jr, Alec Baldwin) and those that have died from their addiction (Whitney Houston, Jim Morrison, Amy Winehouse) I would argue that these types of high profile celebrity have the financial means to afford a drug habit like cocaine or heroin. For many in the entertainment business such as being the lead singer in a famous rock band, taking drugs may also be viewed as one of the defining behaviours of the stereotypical ‘rock ‘n’ roll’ lifestyle. In short, it’s almost expected. In an interview with an online magazine The Fix, Dr. Scott Teitelbaum, an American psychiatrist based at the University of Florida:

“Some people who become famous and get put on a pedestal begin to think of themselves differently and lose their sense of humility. And this is something you can see with addicts, too. Famous or not, people in the midst of their addiction will behave in a narcissistic, selfish way: they’ll be anti-social and have a disregard for rules and regulations. But that is part of who they as an addict – not necessarily who they would be as a sober person. Then there are some people who are narcissists outside of their disease, who don’t need a drug or alcohol addiction to make them feel like the rules don’t apply to them – and yes, I have seen in this in many athletes and actors. Of course, you also have non-famous people who struggle with both…People with addiction and people with narcissism share a similar emptiness inside. Those who are famous might fill it with achievement or with drugs and alcohol. That’s certainly not the case for everyone. But when you see people who are both famous and narcisstic – people who struggle with staying right-sized or they don’t have a real sense of who they are without the fame – you know that they’re in trouble… People with addiction and people with narcissism both seek outside sources for inside happiness. And ultimately neither the fame nor the drugs nor the drinking will work”.

The same article also pointed out that there is an increase in the number of people who (usually through reality television) are becoming (in)famous but have no discernable talent whatsoever. In my own writings on the psychology of fame, I have made the point that (historically) fame was a by-product of a particular role (e.g., country president, news anchorman) or talent (e.g., captain of the national sports team, a great actor). While the Andy Warhol maxim that everyone will be famous for 15 minutes will never be truly fulfilled, the large increase in the number of media outlets and number of reality television shows suggests that more people than ever are getting their 15 minutes of fame. In short, the intersection between fame and addiction is on the increase. US psychiatrist Dr. Dale Archer was also interviewed for The Fix article and was quoted as saying:

“Fame and addiction are definitely related. Those who are prone to addiction get a much higher high from things – whether it’s food, shopping, gambling or fame – which means it  [the behavior or situation] will trigger cravings. When we get an addictive rush, we are getting a dopamine spike. If you talk to anyone who performs at all, they will talk about the ‘high’ of performing. And many people who experience that high report that when they’re not performing, they don’t feel as well. All of which is a good setup for addiction. People also get high from all the trappings that come with fame. The special treatment, the publicity, the ego. Fame has the potential to be incredibly addicting”.

I argued some of these same points in a previous blog on whether fame can be addictive in and of itself. Another related factor I am asked about is the effect of having fame from an early age and whether this can be a pre-cursor or risk factor for later addiction. Dr. Archer was also asked about this and claimed:

 “The younger you are when you get famous, the greater the likelihood that you’re going to suffer consequences down the road. If you grow up as a child star, you realize that you can get away with things other people can’t. There is a loss of self and a loss of emotional growth and a loss of thinking that you need to work in relationship with other people”.

I’m broadly in agreement with this although my guess is that this only applies to a minority of child stars rather than being a general truism. However, trying to carry out scientific research examining early childhood experiences of fame amongst people that are now adult is difficult (to say the least). There also seems to be a lot of children and teenagers who’s only desire when young is “to be famous” when they are older. As most who have this aim will ultimately fail, there is always the concern that to cope with this failure, they will turn to addictive substances and/or behaviours.

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

Further reading

Griffiths, M.D. & Joinson, A. (1998). Max-imum impact: The psychology of fame. Psychology Post, 6, 8-9.

Halpern, J. (2007). Fame Junkies. New York: Houghton Mifflin Harcourt

McGuinness, K. (2012). Are Celebrities More Prone to Addiction? The Fix, January, 18. Located at: http://www.thefix.com/content/fame-and-drug-addiction-celebrity-addicts100001

Rockwell, D. & Giles, D.C. (2009). Being a celebrity: A phenomenology of fame. Journal of Phenomenological Psychology, 40, 178-210.

Fat chance: The British ‘obesity epidemic’

Obesity has become a major problem across the Western world including Great Britain. Some academic scholars claim that obesity is a natural consequence of ‘food addiction’. While I can share this viewpoint, there are many examples of obese people whose eating behaviour would not be classed as addicted using the addiction components model. However, that does not mean obesity is not a problem. Academically, I only became interested in obesity when I was appointed a member of the Department of Health’s Expert Working Group on Sedentary Behaviour, Screen Time and Obesity chaired by Professor Stuart Biddle and led to a major report that we published on obesity and sedentary behaviour in 2010 (see ‘Further reading).

Obesity is measured using a calculation based on a person’s Body Mass Index (BMI). BMI is calculated by dividing a person’s weight measurement [in kilograms] by the square of their height [in metres]. In adults, a BMI of 25kg/m² to 29.9kg/m² means that person is considered to be overweight, and a BMI of 30kg/m² or above means that person is considered to be obese. A recent 2013 report by the Health and Social Care Information Centre presented a range of information on obesity in England drawn together from a variety of sources. The report noted that:

“NICE [National Institute for Health and Care Excellence] guidelines on prevention, identification, assessment and management of overweight and obesity highlight their impact on risk factors for developing long-term health problems. It states that the risk of these health problems should be identified using both BMI and waist circumference for those with a BMI less than 35kg/m². For adults with a BMI of 35kg/m² or more, risks are assumed to be very high with any waist circumference”.

The main source of the report’s data on the prevalence of overweight and obesity is taken from the annual Health Survey for England (HSE) that is written by NatCen Social Research, and published by the Health and Social Care Information Centre (HSCIC). Most of the information presented in the 2013 report is taken from the HSE 2011.The main findings were that:

• The proportion of adults with a normal Body Mass Index (BMI) decreased from 41% to 34% among men and from 50% to 39% among women between 1993 and 2011.
• The proportion that were overweight including obese increased from 58% to 65% in men and from 49% to 58% in women between 1993 and 2011.

• There was a marked increase in the proportion of adults that were obese from 13% in 1993 to 24% in 2011 for men and from 16% to 26% for women.
• The proportion of adults with a raised waist circumference increased from 20% to 34% among men and from 26% to 47% among women between 1993 and 2011.
• In 2011, around three in ten boys and girls (aged 2 to 15) were classed as either overweight or obese (31% and 28% respectively), which is very similar to the 2010 findings (31% for boys and 29% for girls).
• In 2011/12, around one in ten pupils in Reception class (aged 4-5 years) were classified as obese (9.5%) which compares to around a fifth of pupils in Year 6 (aged 10-11 years) (19.2%).
• In 2011, obese adults (aged 16 and over) were more likely to have high blood pressure than those in the normal weight group. High blood pressure was recorded in 53% of men and 44% of women in the obese group and in 16% of men and 14% of women in the normal weight group.
• Over the period 2001/02 to 2011/12 in almost every year more than twice as many females than males were admitted to hospital with a primary diagnosis of obesity.
• In 2011, there were 0.9 million prescription items dispensed for the treatment of obesity, a 19% decrease on the previous year.

Using regression analysis, the HSE also examined the risk factors associated with being overweight and obese. For both men and women, being ‘most at risk’ was positively associated with: age; being an ex-cigarette smoker; self-perceptions of not eating healthily; not being physically active; and hypertension. Income was also associated with being ‘most at risk’, with a positive association for men and a negative association for women. It was also reported that among women only, moderate alcohol consumption was negatively associated with being ‘most at risk’.

Another summary report on adult weight published earlier this year by the National Obesity Observatory briefly reviewed the scientific data and concluded that in the UK: (i) an estimated 62% of adults (aged 16 and over) are overweight or obese, and that 2.5% have severe obesity; (ii) men and women have a similar prevalence of obesity, but men (41%) are more likely to be overweight than women (33%); (iii) the prevalence of obesity and overweight changes with age, and prevalence of overweight and obesity is lowest in the 16-24 years age group, and generally higher in the older age groups among both men and women; and (iv) women living in more deprived areas have the highest prevalence of obesity and those living in less deprived areas have the lowest, but there is no clear pattern for men.

The 2013 Health and Social Care Information Centre report also contextualized the obesity problem in the UK by comparing obesity rates with other European countries and worldwide using data published by the Organisation for Economic Co-operation and Development (OECD). In 2012, the OECD has published a number of ‘Health at a Glance’ reports including one on European health comparisons, and one on worldwide health comparisons (published in 2011). The data from these reports was summarised as follows:

“More than half (52%) of the adult population in the European Union reported that they were overweight or obese. The obesity rate has doubled over the last twenty years in many European countries and stands at between 7.9% in Romania and 10.3% in Italy to 26.1% in the UK and 28.5% in Hungary. The prevalence of overweight and obesity among adults exceeds 50% in 18 of 27 EU member states…[Worldwide] more than half (50.3%) of the adult population in the OECD reported that they were overweight or obese. The least obese countries were India (2.1%), Indonesia (2.4%) and China (2.9%) and the most obese countries were the US (33.8%), Mexico (30.0%) and New Zealand (26.5%). Obesity prevalence has more than doubled over the past 20 years in Australia and New Zealand. Some 20-24% of adults in Australia, Canada, the United Kingdom (UK) and Ireland are obese, about the same rate as in the United States in the early 1990s. Obesity rates in many western European countries have also increased substantially over the past decade. The rapid rise occurred regardless of where levels stood two decades ago. Obesity almost doubled in both the Netherlands and the UK, even though the current rate in the Netherlands is around half that of the UK”.

From an addiction perspective, there’s also some interesting data examining the co-relationship between obesity and drinking alcohol. For instance, a 2012 report by Gatineau and Mathrani examining the relationship between obesity and alcohol consumption reviewed the literature and made a number of conclusions. These were that (i) there is no clear causal relationship between alcohol consumption and obesity, although there are associations between alcohol and obesity and these are heavily influenced by lifestyle, genetic and social factors; (ii) many people are not aware of the calories contained in alcoholic drinks; (iii) the effects of alcohol on body weight may be more pronounced in overweight and obese people; (iv) alcohol consumption can lead to an increase in food intake; (v) heavy, but less frequent drinkers seem to be at higher risk of obesity than moderate, frequent drinkers; (vi) the relationships between obesity and alcohol consumption differ between men and women; (vii) excess body weight and alcohol consumption appear to act together to increase the risk of liver cirrhosis; and (viii) there is emerging evidence of a link between familial risk of alcohol dependency and obesity in women.

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

Further reading

Biddle, S., Cavill, N., Ekelund, U., Gorely, T., Griffiths, M.D., Jago, R., et al. (2010). Sedentary Behaviour and Obesity: Review of the Current Scientific Evidence. London: Department of Health/Department For Children, Schools and Families.

Gatineau, M & Mathrani, S. (2012). Obesity and alcohol: An overview. Oxford: National Obesity Observatory.

Health and Social Care Information Centre (2013). Statistics on Obesity, Physical Activity and Diet: England, 2013. London: Health and Social Care Information Centre.

Organisation for Economic Co-operation and Development (2011). Health at a Glance 2011. Available at: http://www.oecd.org/dataoecd/6/28/491 05858.pdf

Organisation for Economic Co-operation and Development (2012). Health at a Glance: Europe 2012. Available at: http://www.oecd.org/health/healthatagla nceeurope.htm

National Obesity Observatory (2013). Adult weight. Oxford: National Obesity Observatory.

Air raising experiences: Gambling as in-flight entertainment

Today’s blog is based on an article I was commissioned to write for The Independent and which was published on November 30, 2012. I originally entitled my piece as ‘Is it right for high flyers to become high rollers?” but The Independent changed it to ‘Casinos on a plane? Fine as long as it’s responsible”.

At the end of November 2012, Simon Calder wrote a report for The Independent about plans for in-flight casinos to be made available on long-haul flights for first and business class passengers. Gambling while airborne is nothing new – in fact I have flown back from Europe a number of times on budget airlines where I was offered scratchcards to play. Given that gambling already takes place on aeroplanes means that there is no moral or regulatory reason for other forms of gambling not to be introduced.

Gambling has always been considered as a revenue generator for many different types of commercial enterprise. Whether it’s playing slot machine in the pub or buying lottery tickets from the supermarket, most commercial businesses are happy to earn extra money by offering gambling products. We can now gamble online, gamble via the red button on our television sets via services like Skybet, and over the summer, the most popular social networking site Facebook launched its first gambling for money game in the shape of Bingo Friendzy. In short, gambling has always been considered as a revenue generator for among many different and diverse commercial operators, and the airline industry is no different.

What’s more, passengers on long-haul flights provide a captive audience. They will want entertainment to stave off the potential boredom. But is this something we should be concerned about? Although I have spent over 25 years studying problem gamblers, I am not anti-gambling in the slightest. I believe that adults should be free to make their own choices about how they spend their disposable income. However, I am also pro-responsible gambling. This means that gaming operators must put in place measures and protocols that protect players from spending too much and protect vulnerable and susceptible individuals (such as children and adolescents). Any service provider that offers gambling should have staff members that are trained in social responsibility.

Gambling is an activity that has the potential to change people’s mood states instantaneously. Just like drinking alcohol or having sex, gambling is a wonderful ‘mood modifier’. It can make us feel high, buzzed up and excited – or it can make us feel low, downbeat and downright depressed. A win (or even a near win) can get the body’s pleasure centre aroused in the form of increased adrenaline and increased endorphins (the body’s own morphine-like substances). Conversely, big losses can lead to irritability and intense frustration. In extreme cases, gambling losses can lead to anger, verbal abuse, and even physical aggression. In this sense, they are no different from someone who may be drunk from drinking too much alcohol. And what about those who drink while they are gambling in the confines of an air flight? Intoxication and large gambling losses are a heady mix that is best avoided as this could cause problems for both passengers and the airline crew.

The current plan appears to be to offer such gambling services to first and business class passengers only. I presume this is because the airline thinks this group of people will have the most disposable income. On the plus side, it may be the case that this group of individuals can afford to lose and are the least likely to be negatively affected (at least financially). On the negative side it could be viewed as targeted exploitation. And not everyone in business class is rich. I often travel business class but my air fares are paid for by the companies that I work for and not me personally. I certainly can’t afford to drop a hundred pounds here and there.

Overall, I am not anti-gambling on aeroplanes particularly if it is another service that passengers want. However, like drinking alcohol, gambling is a consumptive activity that is problematic to a small minority of individuals and that it should be done in moderation. If airlines want to get into the business of being gambling operators as a sideline, they need to have a socially responsible infrastructure in place that maximizes fun for those that want to gamble, and minimizes harm for those who may be vulnerable and susceptible.

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

Further reading

Calder, S. (2012). Wheels up, chips down: French design consortium develops plans for in-flight casino. The Independent, November 30. Located at: http://www.independent.co.uk/travel/news-and-advice/wheels-up-chips-down-french-design-consortium-develops-plans-for-inflight-casino-8372246.html

Griffiths, M.D. (2004). Betting your life on it: Problem gambling has clear health related consequences. British Medical Journal, 329, 1055-1056.

Griffiths, M.D. (2006). An overview of pathological gambling. In T. Plante (Ed.), Mental Disorders of the New Millennium. Vol. I: Behavioral Issues. pp. 73-98. New York: Greenwood.

Griffiths, M.D. (2008). Addiction and exposure. In W. Donsbach (Ed.), The International Encyclopaedia of Communication (Volume 1). pp. 34-36. Oxford: Wiley-Blackwell.

Griffiths, M.D. (2012). Internet gambling, player protection and social responsibility. In R. Williams, R. Wood & J. Parke (Ed.), Routledge Handbook of Internet Gambling (pp.227-249). London: Routledge.

Griffiths, M.D. & Parke, J. (2003). The environmental psychology of gambling. In G. Reith (Ed.), Gambling: Who wins? Who Loses? (pp. 277-292). New York: Prometheus Books.

Griffiths, M.D. & Wood, R.T.A. (2009). Centralised gaming models and social responsibility. Casino and Gaming International., 5(2), 65-69.