Category Archives: Case Studies

The highs of cries: Another look at dacryphilia

In a previous blog I examined the sexual paraphilia dacryphilia. Dr. Anil Aggrawal in his book Forensic and Medico-legal Aspects of Sexual Crimes and Unususal Sexual Practices defines as “arousal from seeing tears in the eyes of a partner”. In my previous article I widened the definition of dacryphilia to include (i) sexual arousal from someone displaying strong emotion and/or (ii) sexual arousal from the emotional release that accompanies crying (i.e., an ‘emotional catharsis’). Dr. Aggrawal’s definition implies that sadism may form an inherent part of dacryphilia and implicitly indicates the potential presence of dacryphilic masochism in the recipient of sadistic dacryphilic activity. My widened definition suggested that dacryphilia could represent an extension of normative human behaviour towards crying (i.e., an extension of the desire to give attention to and comfort a crier).

Based on anecdotal data collected from online dacryphilia forums, my previous blog speculated that two distinct types may exist within the dacryphilic community: those with sadistic dacryphilic interests and those with voyeuristic dacryphilic interests. As such, dacryphilia creates a number of potential dichotomies: (i) sadomasochistic dacryphilic interests versus emotional dacryphilic interests; (ii) sadistic dacryphilic interests versus masochistic dacryphilic interests; and (iii) individuals who actively engage in dacryphilia versus individuals who passively engage in dacryphilia.

The potential contrast between sadomasochistic and emotional dacryphilic interests is of particular interest, as both of these interests occupy differing and almost opposing aspects of human sexual experience. Likewise, the potential existence of sadistic vs. masochistic, and active vs. passive interests within dacryphilia suggest that it is a non-normative sexual interest with enough variety for an interesting dataset and analysis. Furthermore, the possibility that dacryphilia represents an extension of normative human behaviour towards crying and tears raises the question of why some individuals might find sexual arousal in crying and tears. Thus, on the whole, there are a number of prospective research avenues that are implied within the limited literature on dacryphilia, but as I mentioned in my previous article there had been no empirical research into the area.

However, my research colleague Richard Greenhill and I recently published a qualitative paper on dacryphilia in the International Journal of Sexual Health. Our study comprised online interviews with eight dacryphiles (six females and two males; aged 20 to 50 years; five from the US with the others from the UK, Romania, and Belgium) and proposed a new typology of dacryphilia based on the interviews (and as far as we are aware is the first ever published study of the topic). Our participants were recruited via recruitment posts on one specific dacryphilia forum (i.e., CryingLovers), one general fetish forum (i.e., FetLife) and one BDSM forum (i.e., The data were analysed using thematic analysis.

The three main thematic areas of dacryphilia we identified were: (i) compassion; (ii) dominance/submission; and (iii) curled-lips. Half of the participants (n = 4, all female) expressed their dacryphilia primarily through compassion, meaning that they enjoyed or were aroused by the compassion of comforting a crier. Four sub-themes were identified as characteristic of compassionate interests within dacryphilia: (i) dacryphilia as comforting; (ii) negative feelings towards sadomasochistic dacryphilia; (iii) dacryphilia as a natural role and/or duty; and (iv) subversion of societal and/or gender norms. For many of these participants (n = 3), the idea of dacryphilia as a comforting action from themselves to the crier forms an important part of their dacryphilic identity.

Three of the other participants (two submissive females and one dominant male) expressed their dacryphilia primarily through dominance/submission, meaning that they were aroused by either causing tears in a consenting submissive individual or being made to cry by a consenting dominant individual. Although this type of dacryphilia is often characterized as sadomasochistic by those with compassionate interests, dominant/submissive was deemed a more appropriate description, as participants in this group identified more with dominance/submission than sadomasochism. Two sub-themes were identified as characteristic of dominant/submissive interests within dacryphilia: (i) emotional and physical pain; and (ii) tears and crying as a secondary component of dominance/submission. All of those with dominant/submissive interests (n = 3) enjoyed both emotional and physical pain. 

The remaining participant (male) did not express an interest consistent with either compassion or dominance/submission. Instead, he expressed his dacryphilia primarily through an interest in curled-lips, meaning that he was aroused specifically by the curling of the lip during crying. Two sub-themes were identified as characteristic of this individual’s interest in curled-lips: (i) attraction to lips during crying; and (ii) rarity of this dacryphilic interest.

Our study not only suggested three initial areas of interest within dacryphilia, but the data we collected implied that dacryphilia may comprise a continuum of interests that can differ from each other, but which are all connected by an overarching enjoyment or arousal from tears and crying. Our study aimed to discover the different interests within dacryphilia and explore the range of dacryphilic experience. This was successfully achieved through the implementation of a set of online interviews that focussed attention on three initial possible interests within dacryphilia and assisted in reaching a sensitive and predominantly American population. Without the use of online recruitment and data collection, it is unlikely that we would have been able to carry out our study.

However, our sample size was small and may not reflect the experiences of other individuals with dacryphilic preferences and may display gender and cultural bias. A larger sample size may have led to the construction of further interests, as the interests outlined in the present study only relate to the eight participants who were interviewed. However, the fact we identified three different types of dacryphile in a sample of only eight people suggests that there are definite sub-types of dacryphilia. In particular, there appears to be a distinct difference between those who experience sexual arousal from compassionate interests and those who experience sexual arousal from dominant/submissive interests. Based on the sample in the present study, there appears to be a gender bias towards women and a cultural bias towards Americans. However, this may be a result of the limited nature of the small sample size and, as such, any extrapolation should be treated with caution.

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

Additional input: Richard Greenhill

Further reading

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

Greenhill, R. & Griffiths, M.D. (2014). The use of online asynchronous interviews in the study of paraphilias. SAGE Research Methods Cases. Located at:

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

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

Holmes, S.T. & Holmes, R.M. (2002). Sex Crimes: Patterns and Behavior. Thousand Oaks: Sage.

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

Monroe, W. (2012). Fetish of the week: Dacryphilia. February 23. Located at:

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.

Wikipedia (2012). Dacryphilia. Located at:

Williams, D. J. (2006). Different (painful!) strokes for different folks: A general overview of sexual sadomasochism (SM) and its diversity. Sexual Addiction and Compulsivity, 13, 333-346.

Money for nothing (and your clicks for free?): Why do gamers buy ‘virtual assets’?

Video gaming has evolved from a single-player platform to a multi-player realm where interaction with other players is often a necessity. In order to enter the game, players must first create an avatar, a representation of their self in the game that is used to explore and interact with the virtual environment. When creating an avatar, players can also buy virtual assets to augment and/or enhance their online character. Virtual assets are items or customisations for video game avatars, bases, and characters that are purchased with real money.

In a previous blog, I looked at some of the anecdotal evidence that claimed a few individuals had become ‘addicted’ to buying virtual assets. At the time I wrote that article, there was almost nothing published academically on the psychology of virtual assets and why people bought virtual assets. A few months ago, Jack Cleghorn and I published a qualitative paper in the journal Digital Education Review based on our interviews with gamers that regularly bought virtual assets. Today’s blog looks at some of our findings.

For researchers, the buying of virtual assets provides an opportunity to try and understand why people become so immersed in games and what motivates gamers to spend real money on items that some would consider as having no value. In a multi-player environment, it becomes clear that the avatars seen on screen are graphical representations of someone real and may be part of human desires to be noticed, respected, and interacted with. Furthermore the gamer controlling their avatar has motivations, emotions, thoughts, and feelings. Virtual item purchases are therefore likely to impact on a gamer’s psychological wellbeing.

The growing market for virtual items indicates that transactions are becoming commonplace in gaming. The virtual market functions similarly to real markets in that there is demand, fluctuating markets, and profits to be made. The importance of virtual items to some people is illustrated by a divorce claim in a story on Hyped Talk in which a wife made a claim for over half of her husband’s virtual assets. In a different case (outlined in a 2005 issue of The Lawyer), Qiu Chengwei, a middle-aged man killed a fellow gamer over a dispute involving a virtual item. Obviously these cases are extreme but they highlight the fact that virtual items can have both financial and psychological value for gamers.

But why do people buy virtual items? Performance and general quality of an item is seen to be an important motivation whether the item is real or virtual. Online, an appeal to social status may be a better predictor for purchase behaviour than function. However, some claim that appealing to social status has no motivational significance in purchase behaviour. Another unique element of buying virtual items is the potential exclusivity. Exclusive or limited items tend to be unattainable through gameplay and instead must be bought with money. Exclusivity online has been shown to be of importance, and segmentation is a technique used by the games producers that limits certain items to certain classes, levels, or races. This has been shown to stimulate purchase behaviour. The amount of time invested in a game is also key to understanding spending patterns, and gamers will often buy virtual items after a dedicated amount of gameplay has been spent building an avatar.

Naturally, the longer the amounts of time that are spent online and in-game, the more the player emotionally and psychologically invests in the game. The concept of ‘flow’ (formulated by Mihaly Csikszentmihalyi in many papers and books) has been applied to gaming and can involve becoming emotionally attached to a character (in fact I published a paper on this with Damien Hull and Glenn Williams in a 2013 issue of the Journal of Behavioral Addictions). Flow is the feeling of complete absorption in an activity and affects consciousness and emotions of the individual experiencing it. A key element of feeling ‘flow’ is the experience and perception of the world of the avatar and has been applied to electronic media. The adaptation of ‘flow’ to the virtual world suggests that just like other leisure activities, an individual investing time in an environment where they feel socially accepted can become emotionally attached to their avatar. Gaming has been shown to affect consciousness and emotions of gamers that are both necessary in experiencing ‘flow’. It could be that purchasing of virtual items is also motivated – at least in part – by the feeling of emotional attachment to an avatar.

Gamers are being drawn in to an environment by the appeal of social interaction, manipulation of objects, exploration, and identification with the avatar. To some gamers, the virtual world can takes on more significance than ‘actual’ life and residency in their preferred games is what they consider their actuality. This suggests that the reward of gaming is great, indicating that those individuals who buy virtual items are doing so because they feel involved in an environment that benefits them personally.

Given the lack of empirical research, the qualitative study I published with Jack Cleghorn was based on in-depth interviews with six gamers who all regularly bought in-game virtual assets. We examined the (i) motivations for purchasing virtual items, (ii) psychological impact of purchasing virtual items on self-esteem and confidence, (iii) social benefits of gaming and virtual asset purchasing, (iv) emotional attachment to an avatar, (v) choice of items and customisation of the avatar as a form of self-expression, (v) impulsivity versus thoughtfulness in purchase intentions of virtual items, and (vii) impact of transaction machinery on the ‘game experience’ from a gamer’s perspective.

Using interpretative phenomenological analysis (IPA), the study was exploratory and aimed to understand the psychology underlying purchase intention of virtual items and assets among online gamers. As a result of interviewing the gamers, seven theses emerged: (i) motivation for purchase, (ii) social aspects of the gaming and purchasing, (iii) emotional attachment to the avatar, (iv) psychological reward and impact, (v) self-expression, (vi) ‘stock market gaming’ and gaming culture, and (vii) research/impulse buying. The use of IPA allowed each gamer to share their unique experience of playing and purchase behaviour.

Despite the negative aspects of online gaming, the gamers in our study emphasised a more positive side to buying virtual items and gaming more generally. Item exclusivity and item function were major motivating factors and contributed to an item’s importance in-game. Another key motivation for purchase behaviour was the appeal to social status. Attainment of items demonstrates to others how powerful the gamer is. Naturally, if an item has benefits for the avatar it is more likely that the gamer will spend money to obtain it. Function linked to progression, purchasing items, and buying in-game currency are all sometimes a necessity to progress. Novelty and collectability were also important motivators for some of our gamers. Despite subjective motivations, purchasing virtual items arose out of gaming as a predominant pastime. All of the gamers in our sample were dedicated gamers who spent relatively large amounts of time online and, as perhaps expected, larger gaming commitment to led to purchase behaviour.

An integral part of multiplayer gaming is the interaction with other gamers. The feeling of ‘social presence’ in an online environment is reliant on an emotional response to social interaction and the gamers in our study felt social satisfaction. The game sometimes enabled social interaction that might not otherwise be present. Previous research has shown how emotional attachment to games affects behaviour. Our study highlighted the role of emotional attachment to an avatar as a predictor for purchase intention. As well as emotional attachment increasing likelihood of spending, the spending of real money on items increases the attachment felt. It could be that purchasing virtual items may be a cyclical behaviour. It is also the case that purchasing affects the cognitions and emotions of gamers – ‘pride’ was a feeling that resonated among our interviewed gamers.

Our study also highlighted how gamers research items before purchasing them. It might be expected that easy-to-use transaction machinery might facilitate spending. However, in reality, the gamers we interviewed were guarded with their spending online and recommendations from friends playing a major role in purchase behaviour. Virtual assets can be then researched and the placing of real monetary value on the virtual items indicates the value they may hold to the gamer. Unlike media coverage focussing on the more negative impact of online gaming, our study highlighted the positive aspects of purchasing virtual assets for the gamer. They are able to feel connected socially, feel confidence in themselves and their success, express their inner and ideal self without constraint or fear, build lasting relationships, impress people, and generally benefit from gaming and buying virtual items.

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

Further reading

Bowman, N. D., Schultheiss, D., & Schumann, C. (2012). ‘‘I’m attached, and I’m a good guy/gal!’’: How character attachment influences pro- and anti-social motivations to play massively multiplayer online role-playing games. CyberPsychology, Behavior and Social Networking, 15(3), 169-174.

Csikszentmihalyi, M., & Csikszentmihalyi, I. (1992). Optimal experience: Psychological studies of flow in consciousness. Cambridge: Cambridge University Press.

Cole, H. & Griffiths, M. D. (2007). Social interactions in Massively Multiplayer Online Role-Playing gamers. CyberPsychology and Behavior, 10, 575-583.

Griffiths, M. D. (2010). The role of context in online gaming excess and addiction: Some case study evidence. International Journal of Mental Health and Addiction, 8, 119-125.

Griffiths, M.D., Hussain, Z., Grüsser, S., Thalemann, R., Cole, H. Davies, M.N.O. & Chappell, D. (2013). Social interactions in online gaming. In P. Felicia (Ed.), Developments in Current Game-Based Learning Design and Deployment (pp.74-90). Pennsylvania: IGI Global.

Guo, Y., & Barnes, S. (2011). Purchase behavior in virtual worlds: An empirical investigation in Second Life. Information and Management, 48(7), 303-312.

Hamari, J. & Lehdonvirta, V. (2010). Game design as marketing: How game mechanics create demand for virtual goods. International Journal of Business Science and Applied Management, 5(1), 14-29.

Hassouneh, D., & Brengman, M. (2011). Shopping in virtual worlds: Perceptions, motivations and behaviour. Journal of Electronic Commerce Research, 12(4), 320-335.

Huang, E. (2012). Online experiences and virtual goods purchase intention. Internet Research, 22(3), 252-274.

Hull, D., Williams, G. A. & Griffiths, M. D. (2013). Video game characteristics, happiness and flow as predictors of addiction among video game players: A pilot study. Journal of Behavioral Addictions, 2, 145-152.

Hyped Talk (2010). Virtually addicted Chinese woman claims virtual assets in her divorce plea. Available at: [Accessed: 6 March 2013].

Lee, P. (2005). The growth in the computer game market is leading to real legal issues in virtual worlds. The Lawyer, 19 (19), 14.

Lehdonvirta, V. (2009) Virtual item sales as a revenue model: Identifying attributes that drive purchase decisions. Electronic Commerce Research, 9(1-2), 97-113.

Li, Z. (2012). Motivation of virtual goods transactions based on the theory of gaming motivations. Journal of Theoretical and Applied Information Technology, 43(2), 254-260.

Manninen, T. & Kujanpää, T. (2007). The value of virtual assets – the role of game characters in MMOGs. International Journal of Business Science and Applied Management, 2(1), 21-33.

Beating the habit: A brief look at ‘cane therapy’ as a treatment for addiction

In 2014, I was the resident psychologist on 12-episode television series called Forbidden made for the Discovery Channel. One of the strangest stories that the series reported on was ‘cane therapy’ for the ‘Twisted Treatments’ episode. Before I was interviewed for the story, I had to research the story and was also given some production notes as background material. According to the material I was provided with: 

Caning treatment was pioneered in Siberia by Dr Sergei Speransky a biologist from the Novosibirsk Institute of Medicine who together with Dr Marina Chuhrova released a research report in 2005 on whipping as a therapy. Dr Speransky and Dr Chukhrova developed the medical theory behind caning. Importantly Dr Chukhrova notes that, ‘It is not some warped sado-masochistic activity,’ but has a clear medical purpose. Apparently, there are some sound scientific principles behind these beatings. Namely the theory that pain activates the body’s immune system, causing it to perform much more effectively than under ‘normal circumstances.’ Dr Chukhrova taught [Dr. German Pilipenko] the theory as a student at university and controversially he has taken her theory and put it into practice, combining it with his own unique psychology treatment. 50-year old German Pilipenko has been caning people for nine years. In his spare time German enjoys the blissful serenity of mountain skiing in his local town. But in his professional life German has to bear the yelps, tears and groans of his patients – German canes and whips people for a living. German started to practice cane therapy in a medical clinic in 2004. Though the clinic no longer exists he’s continued the controversial practice as a private psychologist in a rented 14 square meter room in Novosibirsk’s Business Centre”.

Dr. Pilipenko is a psychotherapist and a hypnotist and claims that cane therapy can cure addictions (both chemical addictions such as alcohol and other drug addictions, and behavioural addictions such as sex addiction and work addiction), depression, phobias and neuroses. Along with Dr. Chukhrova, they have successfully treated over 1000 individuals (aged between 17 and 70 years) of their problems. The therapy appears to be arguably similar to primal therapy (which I briefly examined in a previous blog) and according to Pilipenko can be used as a kind of anti-stress injection”. Via intense caning sessions Pilipenko not only draws physical pain from his clients but also their emotional reactions. It is the release of these emotions (as with primal therapy) is what he believes cures his patients of their addictions, stresses, depression, and anxieties. (If you are a journalist or an artist he offers the therapy free as a way of promoting his therapeutic practice). For the television programme, one of Dr. Pilipenko’s female clients (Anzhelika Alexeyev, a 22-year old, fifth-year medical student) was interviewed. The production notes I was given noted:

“Anzhelika is only at the beginning of her life, but she’s already experienced hardship and emotional difficulties. Receiving a beating from Dr Pilipenko has been her solution. She’s already visited him once but German believes there is more work to be done. [The programme will] follow Anzhelika through pain and tears as she returns for more caning. She also introduces her father to the treatment and we see her bring him for a session…Her first caning experience was at the start of [the] year…Anzhelika had been suffering stress after miraculously surviving a car crash. German’s advice was that ‘she really needed a lashing.’ She agreed. Initially at the start of the session Anzhelika wanted to leave. She suffered through the first beating in tears, though she persisted, knowing the pain was temporary. She believes the treatment has been successful in curing her trauma and stress related to the accident. In fact she is a big supporter of German’s caning and believes it helps to get rid of emotions that are deeply hidden, unacknowledged and out of control”.

Many newspaper reports have covered the ‘therapy’ over the last few years but nothing has been published on it in peer-reviewed scientific journals. According to one report on the Alternet news site:

“Practitioners Dr. German Pilipenko and Professor Marina Chukhrova say that their treatment is grounded in science: ‘We cane the patients on the buttocks with a clear and definite medical purpose’…The pair say that addicts suffer from a lack of endorphins, and that pain can stimulate the brain to release the feel-good chemicals, ‘making patients feel happier in their own skins.’ Mainstream doctors dismiss the practice, saying that exercise, acupuncture, massage, chocolate or sex are all better at stimulating endorphin secretion. Dr. Pilipenko admits, ‘we get a lot of skepticism…but so do all pioneers.’ The Siberian Times reports that ‘the reaction of most people is predictable: to snigger, scoff or make jokes loaded with sexual innuendo.’ And one recipient of the treatment, 41-year-old recovering alcoholic Yuri, says his girlfriend accused him of simply visiting a dominatrix. But he adds that although ‘the first strike was sickening…Somehow I got through all 30 lashes. The next day I got up with a stinging backside but no desire at all to touch the vodka in the fridge. The bottle has stayed there now for a year’.”

The Alternet story also interviewed another patient (Natasha, a 22-year-old recovering heroin addict with several months clean) who had been paying $100 for a two-hour session and claimed:

“I am the proof that this controversial treatment works, and I recommend it to anyone suffering from an addiction or depression. It hurts like crazy – but it’s given me back my life…With each lash, I scream and grip tight to the end of the surgical table. It’s a stinging pain, real agony, and my whole body jolts…I’m not a masochist. My parents never beat me or even slapped me, so this was my first real physical pain and it was truly shocking. If people think there’s anything sexual about it, then it’s nonsense.”

The article reported that Natasha had received 60 strokes of the cane per session (noting that drug addicts get double the number of lashes than alcoholics). Professor Chukhrova was then quoted as saying that extreme care is taken to ensure patient safety, and that:

“The beating is really the end of the treatment. We do a lot of psychological counseling first, and also use detox. It is only after all the counseling, and heart and pain resistance checks, that we start with the beating. [We use willow branches because they] are flexible and can’t be broken nor cause bleeding…If any patients get sexual pleasure from the beatings, we stop immediately…This is not what our treatment is about. If they’re looking for that, there are plenty of other places to go.” 

According to Dr Pilipenko, the unusual combination of psychology and corporal-style punishment is designed to train patients in endurance, tolerance and resistance as ways of coping with stress. Pilipenko believes he provides his clients with the tools to deal with stress and problems in their lives. More specifically he claims that:

Psychological stimulation is aimed to convince a patient that aggression, idleness and depression will cause problems in life…Usually a patient is prescribed three separate visits, before they can be cured but it might be necessary for anything up to 10 sessions, depending on the severity of the individual case”.

Dr. Pilipenko also claims that cane therapy that was practiced by monks in the Middle Ages. However, I also noted that following each caning, his clients receive both psychotherapy and hypnotherapy. This begs the question as to whether it is these additional forms of intervention that are key to therapeutic success rather than the caning in and of itself.

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

Further reading

Alternet (2013). Weird science: Siberian psychologists caning patients “on the buttocks” in new addiction treatment. January 7. Located at:

Daily News (2014). Russian patients pay therapists to cane them in bizarre treatment. October 2. Located at:

Siberian Times (2013). Beating the addiction out of you – literally. January 7. Located at:

Stewart, W. (2013). How to beat your demons, literally: Siberian psychologists thrash patients with sticks to help them kick their addictions. Daily Mail, January 7. Located at:

Are you ‘intexticated’?: Another look at excessive smartphone use

Yesterday, I received a copy of a new book called Too Much Of A Good Thing: Are You Addicted To Your Smartphone? by Dr. James Roberts (a Professor of Marketing at Baylor University in Waco, Texas). It’s a populist and easy-to-read book that you can read from cover to cover inside two hours. It’s not an academic book but there’s lots of input from various academics around the world (including me – which is why I was sent a copy of the book). It’s a fun read and is written by someone (who like myself) loves technology and all the great benefits it brings us.

The main thrust of the book doesn’t concern addiction per se, but is more concerned with how smartphones take us away from or compromises other things in our lives like our friends, our loved ones, our hobbies and (in extreme cases) our jobs. Roberts describes this as ‘cellularitis’ – “a Socially Transmitted Disease (STD) that results in habitual use of one’s cell phone to the detriment of his or her psychological and physical health and well-being”. In the second chapter, Dr. Roberts uses my addiction components model to describe his ‘Six Signs of Cell Phone Addiction Scale’ (although uses an older version of the components model taken from a paper I published on internet addiction back in 1999 in The Psychologist).

One of the chapters on the phenomena of ‘phubbing’ (i.e., phone snubbing – where someone you are socially interacting with would rather be on their smartphone, rather than talking to you). One recent paper by Dr. Roberts published in the journal Computers in Human Behavior even had the title ‘My life has become a major distraction from my cell phone’. The chapter also contains a 9-item ‘Phubbing Scale’ that Roberts developed with his colleague Dr. Meredith David (and a later chapter also includes the ‘Partner Phubbing Scale’). Academic research into phubbing has already started (see ‘Further reading below) and I’ll hopefully write a blog on that in the future. I also liked the concept of being ‘intexticated’ defined as being “distracted by the act of texting to such a degree that one seems intoxicated”.

In previous blogs I have examined the concept of mobile phone addiction, the most recent of which argued that there was nowhere near enough empirical evidence to be able to confirm whether addiction to smartphones exists. Dr. Roberts asked me about the topic for his book and here are the answers to the questions he asked me.

Can someone be addicted to their cell phone? Why or why not?

That depends on how ‘addiction’ is defined. I believe that anything can be potentially addictive if constant rewards and reinforcement are present. Some people may confuse habitual use of such technology as an addictive behaviour (when in reality it may not be). For instance, some people may consider themselves cell phone addicts because they never go out of the house without their cell phone, do not turn their cell phone off at night, are always expecting calls from family members or friends, and/or over-utilise cell phones in their work and/or social life. There is also the importance of economic and/or life costs. The crucial difference between some forms of cell phone use and pathological cell phone use is that some applications involve a financial cost. If a person is using the application more and is spending more money, there may be negative consequences as a result of not being able to afford the activity (e.g., negative economic, job-related, and/or family consequences). High expenditure may also be indicative of cell phone addiction but the phone bills of adolescents are often paid for by parents, therefore the financial problems may not impact on the users themselves.

It is very difficult to determine at what point cell phone use becomes an addiction. The cautiousness of researchers suggests that we are not yet in a position to confirm the existence of a serious and persistent psychopathological addictive disorder related to cell phone addiction on the basis of population survey data alone. This cautiousness is aided and supported by other factors including: (a) the absence of any clinical demand in accordance with the percentages of problematic users identified by these investigations, (b) the fact that the psychometric instruments used could be measuring ‘concern’ or ‘preoccupation’ rather than ‘addiction, (c) the normalisation of behaviour and/or absence of any concern as users grow older; and (d) the importance of distinguishing between excessive use and addictive use.

What signs or symptoms would you look for when deciding if someone is addicted to their cell phone?

You could argue that a person is no more addicted to their phone than an alcoholic is addicted to the bottle. Individuals tend to have addictions on their mobile phone rather than to their phone. For me to class someone as addicted to their mobile phone they would have to fulfill the following six criteria:

  • Salience – This occurs when the mobile phone use becomes the single most important activity in the person’s life and dominates their thinking (preoccupations and cognitive distortions), feelings (cravings) and behaviour (deterioration of socialised behaviour). For instance, even if the person is not actually on their phone they will be constantly thinking about the next time that they will be (i.e., a total preoccupation with their mobile phone).
  • Mood modification – This refers to the subjective experiences that people report as a consequence of mobile phone use and can be seen as a coping strategy (i.e., they experience an arousing ‘buzz’ or a ‘high’ or paradoxically a tranquilizing feel of ‘escape’ or ‘numbing’) when on the phone.
  • Tolerance – This is the process whereby increasing amounts of mobile phone use are mobile phone users gradually build up the amount of the time they spend on their phone every day.
  • Withdrawal symptoms – These are the unpleasant feeling states and/or physical effects (e.g., the shakes, moodiness, irritability, etc.) that occur when the person is unable to use their phone because there is no signal, mislaid or broken phone, etc.
  • Conflict – This refers to the conflicts between the person and those around them (interpersonal conflict), conflicts with other activities (social life, hobbies and interests) or from within the individual themselves (intra-psychic conflict and/or subjective feelings of loss of control) that are concerned with spending too much on their mobile phone.
  • Relapse – This is the tendency for repeated reversions to earlier patterns of excessive mobile phone use to recur and for even the most extreme patterns typical of the height of excessive mobile phone use to be quickly restored after periods of control.

What is one suggestion you could offer to help someone better control their cell phone use?

I don’t have a single suggestion. If there was a single suggestion to overcome or better control problematic phone use then I could give up my whole research career. However, my tips on digital detox can be found here.


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

Further reading

Bianchi, A. & Phillips, J.G. (2005). Psychological predictors of problem mobile phone use. Cyberpsychology and Behavior, 8, 39–51.

Billieux, J. (2012). Problematic use of the mobile phone: A literature review and a pathways model. Current Psychiatry Reviews, 8, 299–307.

Billieux, J., Maurage, P., Lopez-Fernandez, O., Kuss, D.J. & Griffiths, M.D. (2015). Can disordered mobile phone use be considered a behavioural addiction? An update on current evidence and a comprehensive model for future research. Current Addiction Reports, DOI 10.1007/s40429-015-0054-y

Carbonell, X., Chamarro, A., Beranuy, M., Griffiths, M.D. Obert, U., Cladellas, R. & Talarn, A. (2012). Problematic Internet and cell phone use in Spanish teenagers and young students. Anales de Psicologia, 28, 789-796.

Chóliz M. (2010). Mobile phone addiction: a point of issue. Addiction. 105, 373-374.

Griffiths, M.D. (1999). Internet addiction: Fact or fiction? The Psychologist: Bulletin of the British Psychological Society, 12, 246-250.

Griffiths, M.D. (2007). Mobile phone gambling. In D. Taniar (Ed.), Encyclopedia of Mobile Computing and Commerce (pp.553-556). Pennsylvania: Information Science Reference.

Griffiths, M.D. (2013). Adolescent mobile phone addiction: A cause for concern? Education and Health, 31, 76-78.

Karadağ, E., Tosuntaş, Ş. B., Erzen, E., Duru, P., Bostan, N., Şahin, B. M., … & Babadağ, B. (2015). Determinants of phubbing, which is the sum of many virtual addictions: A structural equation model. Journal of Behavioral Addictions, 4, 60-74.

Lopez-Fernandez, O., Honrubia-Serrano, L., Freixa-Blanxart, M., & Gibson, W. (2014). Prevalence of problematic mobile phone use in British adolescents. Cyberpsychology, Behavior and Social Networking, 17, 91-98.

Lopez-Fernandez, O., Kuss, D.J., Griffiths, M.D., & Billieux, J. (in press). The conceptualization and assessment of problematic mobile phone use. In Z. Yan (Ed.), Encyclopedia of Mobile Phone Behavior (Volumes 1, 2, & 3). Hershey, PA: IGI Global.

Roberts, J.A. (2016). Too Much Of A Good Thing: Are You Addicted To Your Smartphone? Austin: Sentia Publishing.

Roberts, J. A., & David, M. E. (2016). My life has become a major distraction from my cell phone: Partner phubbing and relationship satisfaction among romantic partners. Computers in Human Behavior, 54, 134-141

Smetaniuk, P. (2014). A preliminary investigation into the prevalence and prediction of problematic cell phone use. Journal of Behavioral Addictions, 3(1), 41-53.

Ugur, N. G., & Koc, T. (2015). Time for digital detox: Misuse of mobile technology and phubbing. Procedia-Social and Behavioral Sciences, 195, 1022-1031.

Step toe and fun: Another look at trampling fetishism

“I’m a guy and I LOVE being walked on by women wearing high heels. It doesn’t hurt. Is this normal to have women step on my guy parts with high heels?” (Question posted on a Yahoo! website).

In a previous blog I briefly looked at ‘trampling fetishism’. According to a relatively new Wikipedia entry on the behaviour:

“Trampling refers to the sexual activity that involves being trampled underfoot by another person or persons. Trampling is common enough to support a sub-genre of trampling pornography. Because trampling can be used to produce pain, the trampling fetish for some adherents is closely linked to sadomasochistic fetishism. A similar fetish is to imagine themselves as being tiny under another’s feet, or being normal size, but being trampled by a giant person. This is known as ‘giant/giantess fetishism’ or macrophilia. It is not the same as trampling. The most common form of trampling is done by a male or female walking on a male or female submissive and is usually done barefooted, in socks, nylons, or shoes. The trampler will predominantly walk, jump and stomp on the person’s back, chest, stomach, genitalia, face and in some rare instances, the neck”.

If you type ‘trampling fetish’ into Google, lots of YouTube video clips appear instantly. Video clips of trampling have been present on the internet since 1997 courtesy of an number of infamous American tramples such as ‘Daddo’ ‘Kingfish’ and ‘LAF’. If you’re not into the visual side, you can read various forms of trampling fan fiction such as the stories at the Trample and Crushing website.

Since writing my previous blog on this topic, I filmed an interview about a trampling fetishist as part of the television program Forbidden (on which I was the resident psychologist). The television program that I participated in followed the story of a man called Frank O’Brien. Frank recalls his fetish developing during early to mid- adolescence. As a 15-year old teenager, he would trick the girls he knew into stepping on him by inventing games that resulted in him being trampled upon. As the show’s production notes reported:

“[Frank would] invent games to race girls to the door of his cubby house and have them wrestle or sit on him in the process. In the backyard pool he’d encourage them to step on him underwater. Ever since he can remember Frank has wanted to get under a girl’s foot…You could say Frank gets a ‘kick’ out of it. And among friends Frank is known simply as ‘Step on Me.’ For Frank, there’s nothing finer than having a woman walk all over him”.

By his early thirties Frank’s trampling fetish began to take up more and more of his time. In his social life he started attending as many sadomasochistic shows that he could and he longed and desired dominant mistresses that would help cater for his trampling fetish. The back-story I received about Frank noted that:

“The mistresses he saw early in life largely turned Frank away from the idea of trampling. They were more prostitutes than professional mistresses with an idea of what he really wanted. Back in those days there was no training for mistresses in trampling and this really has only taken off in Australia since the early 2000s. Now there are mistresses who train specifically in trampling”.

According to Frank, Melbourne is the centre of Australia’s BDSM culture and he introduced the Forbidden film crew to the niche trampling community that exists there. Frank’s favourite club is ‘Provocation’ that hosts a monthly fetish social event.

“But his idea of getting down on the dance floor is a little different to most. When Frank gets down, he literally gets down. He has a special mat that he lies on to make the experience slightly more bearable but comfort is not exactly what Frank is looking for. He’ll bring with him a platform that he’ll set up beside his mat; written across it are the words ‘step up here – girls only’. And that’s exactly what Frank wants. He’ll lie there for hours in the club, enjoying the feeling of women trampling him. Some wear stilettos, some are in platform shoes and others go barefooted – he doesn’t discriminate about what kind of footwear is permitted, but generally sharper and more pointy shoes offer greater satisfaction for [him]”.

Frank describes himself naturally submissive and he now has weekly trampling sessions with ‘Mistress Spanklet’ who is Frank’s long-term friend and a Dom-sub ‘play partner’. Frank describes these weekly sessions as his “drug fix” and something he “couldn’t live without”. Despite having some of his bowel removed (and it being dangerous for him for someone to trample on his stomach), he cannot stop it. He now tries to avoid ‘tummy trampling’ but notes that:

“Trampling can be on any part of the body, including the more sensitive regions of the face, throat and genitalia. [He] enjoys cock and ball trampling on a weekly basis with Spanklet. His face, arms and legs are also prime trampling ground in private and in public”.

In fact, Frank claims that he was responsible for the first ever penis trampling photograph on the internet. In 1999, Frank claimed he took the full weight of a woman in sharp red stilettos twisting as hard as she could on his penis. Frank claims the photograph (taken by the woman’s sexual partner) kick-started “the worldwide cock trampling trend”.

There appears to be little academic research on the topic but anecdotal evidence suggests there is (unsurprisingly) an overlap between trampling fetishes and foot fetishes (podophilia) – on which there is quote a lot of academic research given it appears to be the most prevalent type of fetishism. Obviously Frank’s case is extreme and is heavily interwoven into his life. While there appear to be addictive elements to his behaviour, I don’t believe that Frank’s trampling fetish is an addiction. Bizarre and extreme – yes. Addictive – no. But I’m happy to be proved wrong.

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

Further reading

Semple, K. (2009). Bartender, make it a stiletto. New York Times, June 10. Located at:

Sexy Tofu (2012). National Fetish Day: Interview with a trampler. January 20. Located at:

Wikipedia (2012). Talk: Crush fetish. Located at:

Wikipedia (2012). Trampling. Located at:

Penned in: How to become an excessive (and productive) writer

Many people that I know would probably describe me as a ‘writaholic’ based on the number of articles and papers that I have had published. When it comes to addictions in academia, ‘writing addiction’ is just about the best one you can have. I don’t believe I have an addiction to writing but it is a very salient activity in my life and I am a habitual writer and I write every day. In previous blogs I examined diary writing and psychological wellbeing as well as an article on graphomania (obsessive writing). Today’s blog briefly examines some of the things that make people more productive writers (and by definition a more excessive writer). During my career I’ve published many articles on the writing process (see ‘Further reading’ below) and today’s blog looks at some of my beliefs and practices.

Before outlining some general advice, it’s also worth exploring many of the false beliefs that many of us have about writing – beliefs which may explain why many of us don’t like writing. For instance:

  • Writing is inherently difficult: Like speaking, writing doesn’t need to be perfect to be effective and satisfying.
  • Good writing must be original: Little, if any, of what we write is truly original. What makes our ideas worthwhile communicating is the way we present them.
  • Good writing must be perfect preferably in a single draft: In general, the more successful writers are more likely to revise manuscripts.
  • Good writing must be spontaneous: There appears to be a belief that writing should await inspiration. However, the most productive and satisfying way to write is habitually, regardless of mood or inspiration. Writers who overvalue spontaneity tend to postpone writing, and if they write at all, they write in binges that they associate with fatigue.
  • Good writing must proceed quickly: Procrastination goes hand in hand with impatience. Those writers who often delay writing suppose that writing must proceed quickly and effortlessly. However, good writing can often proceed at a slow pace over a lengthy period of time.
  • Good writing is delayed until the right mood with big blocks of undisrupted time available: Good writing can take place in any mood at any time. It is better to write habitually in short periods every day rather than in binges.
  • Good writers are born not made: Good writing is a process that can be learned like any other behaviour.
  • Good writers do not share their writing until it is finished and perfect: Although some writers are independent, many writers share their ideas and plans at an early stage and then get colleagues to read over their early drafts for comments and ideas.

Even when these false beliefs about writing are dispelled, many of us can still have problems putting pen to paper or finger to keypad. Insights about writing only slowly translate into actions. For most professionals, writing is only done out of necessity (i.e., a report that they have to hand in). This produces a feeling of ‘having to write’ rather than ‘wanting to write’ and can lead to boredom and/or anxiety. Furthermore, most people appear to view writing as a private act in which their problems are unique and embarrassing. Strategies for overcoming this include getting colleagues to criticize their own work before going ‘public’, sharing initial plans and ideas with others, and practising reviewing other people’s work.

It is generally acknowledged that there is no one proven effective method above all others for teaching people to become better writers. It is also a process that can be learned and can aid learning (i.e., a skill learned through opportunities to write and from instructional feedback). Although there are no ‘quick fixes’ to becoming a better writer, here are some general tips on how to make your writing more productive. I would advise you to:

  • Establish a regular place where all serious writing is done
  • Remove distracting temptations from the writing site (e.g., magazines, television)
  • Leave other activities (e.g., washing up, making the dinner) until after writing
  • Limit potential interruptions (e.g., put a “Do not disturb” sign on the door, unplug the telephone)
  • Make the writing site as comfortable as possible
  • Make recurrent activities (e.g., telephone calls, coffee making) dependent upon minimum periods of writing first
  • Write while ‘feeling fresh’ and leave mentally untaxing activities until later in the day
  • Plan beyond daily goals and be realistic about what can be written in the time available
  • Plan and schedule writing tasks into manageable units
  • Complete one section of writing at a time if the writing is in sections
  • Use a word processor to make drafting easier
  • Revise and redraft at least twice
  • Write daily rather than ‘bingeing’ all in one go
  • Share writing with peers as people are more helpful, judgmental and critical on ‘unfinished’ drafts

Obviously, the problem with such a prescriptive list such as this is that not every suggestion will work for everyone. Many of us know our own limitations and create the right conditions to help get the creative juices going. Some people can’t write in silence or with others in the room. By reading this short blog I cannot make you become a more productive and excessive writer overnight. However, it has hopefully equipped my blog readers with some tips and discussion points that may help in facilitating better writing amongst yourselves and colleagues.

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

Further reading

Griffiths, M.D. (1994). Productive writing in the education system. The Psychologist: Bulletin of the British Psychological Society, 7, 460-462.

Griffiths, M.D. (2001). How to…get students to write with confidence. Times Higher Education Supplement, June 8, p.24.

Griffiths, M.D. (2004). Tips on…Report writing. British Medical Journal (Careers), 328, 28.

Griffiths, M.D. (1998). Writing for non-refereed outlets (Part 1 – Professional journals and newsletters). Psy-PAG Quarterly, 29, 41-42.

Griffiths, M.D. (1999). Writing for non-refereed outlets (Part 2 – Newspapers and magazines). Psy-PAG Quarterly, 30, 5-6.

Griffiths, M.D. (2000). Writing and getting published – My top 10 tips. Psy-PAG Quarterly, 34, 2-4.

Griffiths, M.D. (2005). Addiction, fiction and media depiction: A light-hearted look at scientific writing and the media. Null Hypothesis: The Journal of Unlikely Science, 2(2), 16-17.

Griffiths, M.D. (2010). Top tips on…Writing with confidence. Psy-PAG Quarterly, 76, 33-34.

Griffiths, M.D. (2013). How writing blogs can help your academic career. Psy-PAG Quarterly, 87, 39-40.

Griffiths, M.D. (2014). Top tips on…Writing blogs. Psy-PAG Quarterly, 90, 13-14.

Making an online killing: A brief look at “suicide fetishes” and “addiction” to suicide websites

Back in March 2011, a then 46-year old American ex-nurse William Melchart-Dinkel from Minnesota was convicted of persuading two people he met online to commit suicide. Melchart-Dinkel was accused of having a “suicide fetish” because he got his kicks from frequenting online suicide chat rooms. Posing as a female nurse, he would chat online and feign compassion to depressed individuals and encourage them to commit suicide.

More specifically, a US court found him guilty of aiding the suicides of 18-year old Canadian student Nadia Kajouli (who jumped into a river and drowned), and 32-year old British IT technician Mark Drybrough (who hanged himself). During the trial, Nadia’s mother shared extracts of the online chats that took place between her daughter and Melchart-Dinkel (who was using various aliases including ‘Cami’, ‘Falcon Girl’ and ‘Li Dao’). A Minnesotan Internet crimes task force forensically examined Melchert-Dinkel’s computer and located online chats that he had with the Canadian teenager. The online conversation demonstrated that Melchart-Dinkel had urged Nadia to hang herself (rather than kill herself by drowning) and provided detailed instructions on how to kill themselves:

“If you wanted to do hanging we could have done it together online so it would not have been so scary for you…Most important is the placement of the noose on the neck…knot behind the left ear and rope across the carotid is very important for instant unconsciousness and death…I’m just trying to help you do what is best for you not me”.

Melchart-Dinkel even urged Nadia to kill herself while they were chatting online. A few hours after chatting with Melchart-Dinkel, Nadia emailed her roommate and told her she was going to “brave the weather and go ice skating” (in an effort to make it look like an accident). Nadia jumped into a frozen river (but her body was not found until 11 days after she had jumped in). In Mark’s case, Melchert-Dinkel replied to a question posted online by Mark about how he could hang himself if he didn’t have a high ceiling. Following a long email conversation, Melchert-Dinkel instructed him on what to do and convinced Mark that ‘she’ was suicidal too. Melchert-Dinkel wrote:

“I keep holding on to the hope that things might change. Caught between being suicidal and considering it. Same old story!…I don’t want to waste anyone’s time. If you want someone who’s suicidal, I’m just not there yet…Sorry. I admire your courage. I wish I had it”. 

Mark killed himself a few days later. Mark’s mother Elaine called Melchert-Dinkel her son’s “executioner”. She also told the Daily Mail in the UK:

“Mark had had a nervous breakdown and he was depressed and incredibly susceptible. [Melchert-Dinkel ]was there whispering in his ear every time he logged on. In the last email, [he] claimed to be a nurse, saying he had medical training, and proposed a suicide pact”

With the help of Celia Blay (a youth worker from Wiltshire in the UK), Mark’s mother managed to track Melchert-Dinkel. It was during their own investigation they discovered dozens of people had received similar emails to Mark’s:

“We found out everything about him on Google, including where he lived in Minnesota. He befriended them using a female identity, was very loving and sympathetic, but never suggested an alternative to death, even when they were only teenagers. He’d tell them that he intended to kill himself too, and said they should set up a web camera and he would do the same thing so they could watch each other die over the internet”.

During his testimony, Melchert-Dinkel admitted that he had asked between 15 and 20 people to commit suicide on camera while he watched (although when he was first caught, he said the online chatting must have been his teenage daughters). One report on Melchert-Dinkel’s case noted:

“While he never actually witnessed a suicide, he did believe that at least five of the people he had talked to were successful in taking their own lives. He also entered into around 10 ‘suicide pacts’ where he promised to kill himself simultaneously with the person he had been chatting with…Melchert-Dinkel was admitted to a hospital where he told doctors he had a ‘suicide fetish’ and an addiction to suicide websites”.

Before the trial, the Associated Press had interviewed Professor Jonathan Turley (George Washington University Law School), an expert on doctor-assisted suicide. It was reported that:

“[Professor Turley has] never heard of anyone being prosecuted for encouraging a suicide over the Internet. Typically, people are prosecuted only if they physically help someone end it all – for example, by giving the victim a gun, a noose or drugs. Last month, a Florida man was charged in his wife’s suicide after allegedly tossing several loaded guns onto their bed. Turley said if prosecutors file charges against Melchert-Dinkel, convicting him will be difficult – especially if the defense claims freedom of speech. The law professor said efforts to make it illegal to shout ‘Jump!’ to someone on a bridge have not survived constitutional challenges. ‘What’s the difference between calling for someone to jump off a bridge and e-mailing the same exhortation?’ he said”.

This line of defence was used by Melchert-Dinkel’s legal team. His behaviour was described as “abhorrent” by his own lawyer (Terry Watkins) but argued in court that his client’s actions were protected by the freedom of speech. Watkins said in court that:

“Freedom means you have to allow things to happen that some would find disgusting and completely unacceptable from a community or moral standpoint”.

However, the presiding judge (Thomas Neuville) said that the accused had “imminently incited the victims to commit suicide” and described Melchart-Dinkel’s online written comments as “unprotected speech”. He was sentenced to almost a year in prison (360 days) but was delayed until a ruling from the Supreme Court (SC). Earlier this year, the SC in Minnesota overturned Melchert-Dinkel’s conviction, and ruled that Minnesota’s law prohibiting the “encouraging” of suicide was unconstitutional and (as Professor Turley claimed) violated a person’s freedom of speech. However, the case (as far as I am aware) is still continuing because the original state prosecutors are trying to argue that Melchert-Dinkel “assisted” (rather than “encouraged”) people’s suicides.

My own take on this case is that Melchart-Dinkel committed a criminal act and that his claim to medics that he was addictedto encouraging people to commit suicide was made as a way of absolving responsibility for what he did. There was nothing about his online behaviour to suggest it was in any way addicted (at least not by my own criteria). Also, his own use of the word fetish is inappropriate in this instance. Although he did appear to get some kind of kick from his activity, there was nothing sexual in it. Again, his use of the word ‘fetish’ to describe his behaviour also appears to be another linguistic device to distance himself from taking the blame for his actions.

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

Further reading

Associated Press (2011). Nurse William Melchart-Dinkel had ‘suicide fetish’, went online to provoke two people’s deaths: cops. New York Daily News, October 17. Located at:

Caulfield, P. (2011). ‘Suicide fetish’ nurse found guilty of provoking people he found online to kill themselves. Daily News, March 16. Located at:

Firth, N. (2010). Revealed: The suicide voyeur nurse who ‘encouraged people to kill themselves online’. Daily Mail, March 20. Located at:

Guariglia, M. (2014). William Melchert-Dinkel: 5 Fast facts you need to know. Heavy News, March 19. Located at:

Murray, Rheana. (2008). A search for death: How the internet is used as a suicide cookbook. Chrestomathy, 7, 142-156.

Yount, K. (2014). Minnesota Supreme Court turns its back on mentally ill. (i)Pinion, March 27. Located at:

Meet markets: The psychology of school reunions

I was recently interviewed for a feature in The Observer newspaper about the psychology of school reunions. The journalist that interviewed me wanted to know the different types of people that go to them and why people would go to them in the first place. I have to admit that I’ve never come across any academic research on the topic and I’ve never ever gone to one myself so I had to rely on pure speculation.

Around the time of the interview I also got an email via LinkedIn from someone I was at junior school with and then spent the next week catching up on what she had been up to in the 35 years since I last saw her. The reason I mention this is that the psychology of why someone would correspond with someone else from their junior or secondary school after years of no communication whatsoever is probably similar (or the same) as the reasons for attending school reunions. So here are the reasons I came up with as to why someone might want to attend a school reunion (or catch up with an old class colleague on social media)

To catch up with old friends: Perhaps the most obvious reason for attending school reunions is simply to catch up, talk and socialise with old friends. This may also involve seeing what your old classmates have been up to and/or the see how their lives progressed (or in a minority of cases ended). I think we can all think of cases where we say to ourselves “I wonder what ever happened to [XXX]?” School reunions are perfect for finding some of the answers as none of us knew when we were in junior school what we would end up being later in our lives. Fundamentally, reunions are about reconnecting with others and connection is what many people want and need. As one of the few online articles on the psychology of reunions noted:

“A connection to school was a safe haven for many. Some could submerge themselves in academic life; others could forget about their cares in the reverie of an infatuation. Adolescent friendship may have been the guardian of your self-esteem, or the absence of connection, even if you were in a crowd, may have resulted in loneliness”.

To re-live good times and memories: It’s often said that school days were the best days of our lives and that school was a safe haven (even if it didn’t feel that way at the time). Some people will want to talk with old friends about the japes and pranks they used to get up to and have a laugh. Basically, people may attend school reunions for primarily nostalgic reasons.

To see how people have physically changed: Some people attending school reunions might want to see how people have changed and/or aged. Have your friends gone grey? Do they even still have hair? Have they turned from an ‘ugly duckling’ into a beautiful swan?

To change perceptions of how people remembered you: Another possible reason for attending a school reunion might be to change people’s perceptions of how your classmates remembered you. Maybe you were the class joker, the class bad boy, the class nerd, or the class wallflower. The school reunion might provide the perfect situation to correct people’s views and prejudices. 

To settle scores: For a small minority of individuals, the class reunion may be a way of getting revenge or settling scores. Similarly, it might be about getting closure on events that happened decades ago.

To compare and/or show off: Some people might want to attend school reunions simply as an opportunity to show off (or attempt to show off) how well they’ve done for themselves since leaving school and to engage in a little bit of ‘one-upmanship’ (defined by various dictionaries as “the technique or practice of gaining an advantage or feeling of superiority over another person” or a situation in which someone does or says something in order to prove that they are better than someone else). There may also be an element of ‘keeping up with the Joneses’ (i.e., “referring to the comparison to one’s neighbor as a benchmark for social class or the accumulation of material goods”) combined with social comparison theory (SCT). “[SCT], initially proposed by social psychologist Leon Festinger in 1954 centers on the belief that there is a drive within individuals to gain accurate self-evaluations. The theory explains how individuals evaluate their own opinions and abilities by comparing themselves to others in order to reduce uncertainty in these domains, and learn how to define the self” (Wikipedia entry on SCT).

In one of the few online articles I located on the psychology of school reunions noted:

“The problem with school reunions is that there is inevitable anxiety about how your life will compare to others. For some people this this may be about physical appearance; for others educational achievement or maybe financial status. It seems to be one of those things humans can’t resist doing. We need to compare ourselves to others to try to judge how we’re doing. This kind of behaviour is seen across many species as it’s crucial in judging whether you can beat a rival without putting yourself at risk…Simply put we look at those less successful than us and focus on how we are different from them. We then look at those more successful and focus on how we are similar to them”

The article also went on to say that:

“It’s common for high school reunions to trigger anxiety about appearance and status. Most of us want to forget our teenage self-conscious emotions that resulted from hormonal changes and social pressures. But years later, at a class reunion, those old insecurities get triggered. They rear their ugly head in the imagined judgment of peers: What will they think? Will I be successful enough? Will I look good to them? Resurfacing of emotional memories, it’s important to recognize that reunions are not at all about comparisons and judgments”.

I have to concur with much of this speculation as I’ve often had similar thoughts when meeting up with people I’ve not seen for years. Given that school reunion events are commonplace in many parts of the world, the biggest mystery is why there is little in the psychological literature on such social practices.

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

Further reading

Festinger, L. (1954). A theory of social comparison processes. Human Relations, 7(2), 117-140.

Russ (2013). The psychology of school reunions. Virtually Free, June 25. Located at:

Choking aside: Another look at self-asphyxial risk-taking behaviour in adolescence

In a previous blog I examined the ‘choking game’ (also known by dozens of names including the ‘fainting game’ and ‘suffocation roulette’). This was a game that I played a couple of times as an adolescent (although we called it ‘Headrush’). This was a game where I would have my breathing temporarily stopped by someone holding onto my chest after a deep expiration and hyperventilation (so that I could not breathe). It induced feelings of light-headedness and dizziness followed by temporary unconsciousness (usually lasting 10 to 15 seconds).

This activity that I engaged in as a teenager is an example of self-asphyxial risk-taking behaviour (SARTB). It also appears that what I did when I was an adolescent was a form of ‘self-induced hypocapnia’ (i.e., a state of reduced carbon dioxide in the blood). It has also been reported that these ‘games’ can be played alone and typically involve self-strangulation, or sometimes with others, and where like my own experiences, the cutting off of the oxygen supply was carried out by somebody else.

Reports of SARTB date back to the early 1950s in the medical literature (for instance, Dr. P. Howard and his colleagues reported a case in a 1951 issue of the British Medical Journal). SARTB has been defined by R.L. Toblin and colleagues in a 2008 issue of the Journal of Safety Research as self-strangulation or strangulation by another person with the hands or a noose to achieve a brief euphoric state caused by cerebral hypoxia. As with autoerotic asphyxiation (i.e., suffocation as a way of enhancing sexual arousal), the aim of SARTB is to intentionally cut off the oxygen supply to the brain to experience a feeling of euphoria (the only difference being that in children’s games, it is not done for a sexual reason).

How prevalent the activity is debatable as most of the academically published studies are case reports (usually when a problem – and in some cases, death – has occurred). However, a comprehensive systematic review of SARTB was recently published by Busse et al (2015). They attempted to assess the prevalence of engagement in SARTB and associated morbidity and mortality in children and adolescents (and up to early adulthood). Busse and colleagues examined every survey and case study that had been published on SARTB, and more specifically examining the behaviour among those aged 
0–20 years (excluding any study where the motive was autoerotic, suicidal or self-harm). They reported that 36 studies had examined child and adolescent SARTB in 10 different countries (North America and France being the most common, but also reports in the UK).

Risk factors for SARTB were hard to assess because most of the studies examining such risks did not control for other confounding variables. However, five of the studies reported an association between SARTB and a number of other risky behaviours including substance misuse, risky sexual behaviours, poor mental health, poor dietary behaviours, and engagement in risky sports. The review also reported that there did not seem to be any association between SARTB and engagement in physical activity, and experiencing accidents, and/or hospital admissions. It was also noted that a number of other behaviours increased the likelihood of engaging in SARTB including experiences of violence, being more impulsive, having a thrill-seeking personality, and having lower school achievement. However, only six of the 36 studies they reviewed reported the potential for SARTB to be associated with other risky behaviours. No consistent findings were found between SARTB and gender, age and other demographic factors (such as socio-economic status).

Examining the studies as a whole, Busse and colleagues reported that awareness of SARTB ranged from 36% to 91%, and that the median lifetime prevalence of engagement in SARTB was 7.4% (however, these were studies that used convenience sampling, therefore none of the studies were necessarily representative). In the SARTB literature, a total of 99 fatal cases were reported (and of the 24 detailed case reports, most of the deaths occurred when individuals were engaged in SARTB alone and used some type of ligature).

In a different analysis in the Journal of Safety Research, Dr. R.L. Toblin and colleagues used US news media reports to estimate the incidence of deaths from SARTB. Their report identified 82 probable SARTB deaths among youths aged 6-19 years during 1995 and 2007. Of these 82 cases, 71 (86.6%) were male, and the mean age of death was just over 13 years of age. The study also noted that deaths were recorded in 31 US states and were not clustered by location, season or day of week. Busse and colleagues assert the importance of education and prevention and more specifically note:

“As it has been suggested that knowledge and identification of symptoms and signs of engagement in [SARTB] could have possibly enabled early identification and possible prevention of fatal cases, we believe that clinicians, paediatricians, health professionals and teachers should receive education on the symptoms and signs of [SARTB]. The need to educate health professionals has been highlighted as awareness of [SARTB] will enable these individuals to identify symptoms and signs and to act as educators to young people and their parents…We further recommend that more research is carried out together with young people to develop appropriate education material. In line with recommendations from others, we further recommend removing existing videos about [SARTB] from the internet and ensuring that preventative website rather than promotional websites appear first on internet searches” (p.8).

This brief examination of the literature suggests that a significant minority of adolescents have engaged in SARTB and that in extreme cases it may lead to death. Despite being known about for over 60 years, the data concerning SARTB are still limited and relatively little is known about the associated risk factors. However, SARTB certainly appears to be an activity that parents and teachers should be made more aware of even if the prevalence of such activity among children and adolescents is low.

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.

Busse, H., Harrop, T., Gunnell, D. & Kipping, R. (2015). Prevalence and associated harm of engagement in self-asphyxial behaviours (‘choking game’)
in young people: A systematic review. Archives of Disease in Childhood, doi:10.1136/archdischild-2015-308187.

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

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

Griffiths, M.D. (2015). A brief review of self-asphyxial risk-taking behaviour in adolescents. Education and Health, 33, 59-61.

Howard, P., Leathart, G. L., Dornhorst, A.C., & Sharpey-Schafer, E.P. (1951). The mess trick and the fainting lark. British Medical Journal, 2, 382-384.

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

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

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

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

Hoovers and shakers: Another look at vacuum cleaner sex

In a previous blog I briefly looked at the medical literature relating to penile injuries arising from autoerotic interactions from vacuum cleaners. While researching that blog I also came across other literature that had examined vacuum cleaners being used for sexual purposes that I thought I would make another interesting blog. A number of references in the psychological literature make reference to particular types of people using vacuum cleaners as a source of sexual stimulation for masturbatory purposes. For instance, in a 2005 chapter by Lynne Moxon about sexuality and Asperger Syndrome (i.e., an autism spectrum disorder typically characterized by major difficulties in social interaction and non-verbal communication) noted that among Asperger’s sufferers:

“Lack of awareness of the use of the imagination for sexual fantasy can lead to the use of more physical forms of stimulation, such as the vibration of washing machines or public transport, or the use of vacuum cleaner pipes, holes in chair backs, socks, bottles and more unusual items, such as TV remote controls and golf clubs. Females unaware of the use of sex toys have used deodorant cans, scissors, keys and candles”.

In a 2013 study by Dr. Remigiusz Kijak published in the journal Sexuality and Disability, 133 people (mainly older age teenagers with ages ranging from 17 to 25 years) with mild intellectual disability were surveyed about their sexuality and sexual practices. Dr. Kijak reported that:

“During the studies it has also been determined that 7 % of the studied teenagers stimulate themselves in an untypical manner. The teenagers studied admitted to masturbating with tools, certain objects or to masturbating in a way other than a natural one. The study subjects masturbate using grease, food, furniture and even vacuum cleaners. Such masturbation can be determined as dangerous, mainly due to the fact that it fixes a certain, repeatable chain of strange rituals, often impossible to use in a partner relationship, and may result in a pleasure decrease”. 

As noted in my previous blog on the use of vacuum cleaners as a masturbatory aid, most writings on the topic concern penile injuries that have come to the attention of medics when things go wrong. However, there are a couple of case studies in the forensic literature that have featured vacuum cleaners in autoerotic deaths. In 1988, Dr. R.H. Imami and Dr. M. Kemal published a paper in the American Journal of Forensic Medicine and Pathology about a 57-year old white American male with a history of heart disease and chronic pancreatitis. The 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 faecal excrement. The man was covered in burns from the vacuum cleaner. No defect was found in the vacuum cleaner. The autopsy revealed that the man had a heart attack while engaged in the 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 (and they hadn’t had sex for five years). The death was classes as natural rather than accidental.

In 1994, Dr. Clive Cooke, Dr. Gerard Cadden and Dr. Karin Margolius published a paper concerning four “unusual fatalities where death occurred during autoerotic practice”. Three of the four accidental deaths (electrocution, hanging, and courgette inhalation) involved young to middle-aged men. However, it is the fourth case that is of interest here. This involved an elderly man that (like the previous case) had heart disease. The authors reported that:

“The naked body of this 77[-year] old widower was found in the bathroom of his home…Adjacent to the body, and switched on and working, were a vacuum cleaner and a hair dryer. A pair of men’s underpants was impacted in the hose of the vacuum cleaner. Autopsy examination showed the body of an elderly man of normal build. There was no evident injury; in particular there were no apparent marks of electrical injury. Internal examination showed enlargement of the heart with extensive ischemic fibrous scarring of the thickened left ventricular myocardium. Extensive calcified coronary arteriosclerosis was present, with no thrombosis. There was no significant valvular disease. The lungs were mildly congested and there was benign hypertensive nephrosclerosis. Toxicological analysis was unremarkable. The vacuum cleaner and hair dryer, together with the electric circuitry of the house, were assessed by an electrical inspector and cleared of malfunction. The cause of death was therefore believed to be combined arteriosclerotic and hypertensive heart disease. The scene examination suggested the likelihood that the electrical appliances were being used autoerotically”.

In their discussion of this particular case, Cooke and colleagues noted that sudden autoerotic deaths due to a natural disease process (e.g., heart disease) have seldom been reported in the forensic literature. To their knowledge, only two previous case reports had been published prior to their own study – both males who after autopsy:

“…showed significant arteriosclerotic cardiovascular disease. One was the case of a 61 [-year] old man who died whilst bound with chain restraints; a vibrator was nearby [Hazelwood, Dietz & Burgess, 1981]. The second case was of a 57 [-year] old man whose body was found naked alongside a running vacuum cleaner; the testicles, thighs and buttocks were tightly bound with pantyhose [Imami & Kemal, 1988]. Such deaths are probably less frequent than sudden natural death associated with heterosexual or homosexual activity, particularly if with a novel partner [Malik, 1979]”.

Finally, the only other vacuum cleaner-related autoerotic death I located in the forensic literature was a 2005 case study report by Dr. Andrew Hitchcock and Dr. Roger Start in the Journal of Clinical Forensic Medicine. This was actually a case of hypoxyphilia where the device built to cut off the oxygen supply involved a vacuum cleaner. More specifically, the paper reported:

“A case is reported of a 36-year-old man who died following occlusive entrapment within a device for the purpose of hypoxyphilic gratification. The device was constructed in his own home using instructions found on his home computer down-loaded from the Internet. The device comprised a tough plastic cocoon large enough to accommodate an adult human and incorporating a system of plastic piping connected to a household vacuum cleaner for the evacuation of air within the cocoon. The mechanism of death was thought to be traumatic asphyxia after examination of the deceased and re-construction of the apparatus with the body in situ”.

The prevalence of autoerotic acts involving the use of vacuum cleaners is unknown as only those cases that result in serious genital injury and/or death come to the attention of medics and/or forensic scientists. As noted in my previous blog, the number of cases that are being reported is on the decrease but this may be because the topic is less novel than it used to be and may not be seen by journal editors as worthy of publication.

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

Further reading

Benson, R. (1985). Vacuum cleaner injury to penis: A common urologic problem? Urology, 25(1), 41-44.

Citron, N.D., & Wade, P.J. (1980). Penile injuries from vacuum cleaners. British Medical Journal, 281(6232), 26.

Cooke, C.T., Cadden, G.A., & Margolius, K.A. (1994). Autoerotic deaths: Four cases. Pathology, 26(3), 276-280.

Hazelwood, R.R., Dietz, P. E., & Burgess, A.W. (1981). The investigation of autoerotic fatalities. Journal of Police Science & Administration, 9, 404-411.

Hitchcock, A., & Start, R.D. (2005). Fatal traumatic asphyxia in a middle-aged man in association with entrapment associated hypoxyphilia. Journal of Clinical Forensic Medicine, 12, 320-325.

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

Kijak, R. (2013). The sexuality of adults with intellectual disability in Poland. Sexuality and Disability, 31(2), 109-123.

Klintschar, M., Grabuschnigg, P., & Beham, A. (1998). Death from electrocution during autoerotic practice: Case report and review of the literature. American Journal of Forensic Medicine and Pathology, 19, 190-193.

Malik, M. O. (1979). Sudden coronary deaths associated with sexual activity. Journal of Forensic Sciences, 24, 216-220.

Moxon, L. (2005). Diagnosis, disclosure and self-confidence in sexuality and relationships. In D. Murray (Ed.), Coming out Asperger: Diagnosis, Disclosure and Self-Confidence (pp. 214-229). London: Jessica Kingsley Publishers.

Rossi, M., Cascini, F., & Torcigliani, S. (1991). [Penile injuries caused by masturbation with a vacuum cleaner. Description of a case and review of the literature]. Minerva Urologica e Nefrologica, 44(1), 43-45.


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