Animal magic: The weird and wonderful world of the ‘bronies’

Over the years, I have been contacted a number of times by the national British media asking for a soundbite about whether someone can become ‘addicted’ to a particular television programme. Some academics have even carried out scientific research. For instance, back in 1997, Dr. Sandy Wolfson (University of Northumbria, UK) carried out a survey amongst Star Trek fans (so-called ‘Trekkies’). I saw her present her paper at a British Psychological Society conference and it got a lot of national press publicity (‘Star Trek is an addictive enterprise’, ‘Trekkies ‘hooked like addicts’, ‘Star Trek worse than heroin?’). However, as far as I can ascertain, Dr. Wolfson never formally published her findings in an academic journal. At the time, she reported (to the press) that:

“Some of these people are totally immersed in the activity. [The] research shows that about 5 to 10 percent of (Trek) fans meet the psychological criteria of addiction. They show withdrawal symptoms such as agitation and frustration if they miss an episode and develop higher tolerance levels, so they need increasing doses. They see so many positive benefits psychologically from being a Star Trek fan. Loads have met friends and even spouses through Star Trek. People who are normally a bit tongue-tied find it a good source of conversation. People also feel they get a lot of intellectual benefits. It’s a very moral kind of show. Each episode has some kind of ethical dilemma which gives people a lot to think about. I would use the term positive addiction for addictions where people feel they have a positive effect. Star Trek does seem to be something people feel has a positive influence on them and society. It makes them happy”

One story that caught my eye recently was the story of 32-year old Luke Allen, an unemployed computer programmer from Albuquerque (New Mexico, US) who “self-medicates by watching animated ponies have magical adventures”. And he’s not alone as a feature in Wired magazine noted that there was a whole adult male fan community – so called ‘bronies’ (‘bro ponies’) – that are ‘fixated’ on daily watching of the cartoon My Little Pony Friendship Is Magic. Luke Allen noted:

“First we can’t believe this show is so good, then we can’t believe we’ve become fans for life, then we can’t believe we’re walking down the pink aisle at Toys R Us or asking for the girl’s toy in our Happy Meal. Then we can’t believe our friends haven’t seen it yet, then we can’t believe they’re becoming bronies too. This weird alchemy that [the show’s creator] Lauren Faust tapped into when she set out to make the show accessible to kids and their parents hooks into the male geek’s reptilian hindbrain and removes a lifetime’s behavioural indoctrination against pink. As a person with Asperger syndrome, I learned more about theory of mind, friendships and social interactions from this season than I had in the previous 31 years of life.”

Most of us have favourite television shows that we don’t like to miss (The Sopranos, Prison Break and A Very Peculiar Practice being among my favourites). However, My Little Pony appears to be (for many people) an “unlikely object of fanboy love”. The Wired article reported that:

“Since the show debuted [in 2010] on cable channel Hub TV, it’s attracted a growing number of male fanatics. Their love of the show is internet neo-sincerity at its best: In addition to watching the show, these teenage, twenty- and thirtysomething guys are creating pony art, posting fan videos on YouTube and feeding threads on 4chan (and their own chan,Ponychan). They also risk life, limb and being trolled to death on the /co/ board to fawn over a small gaggle of ponies with names like Twilight Sparkle, Fluttershy and Rainbow Dash”.

Another self-confessed ‘brony’, Henri Yount, a 20-year-old male from Virginia (US) who gets hundreds of thousands of hits on TouTube for his homemade My Little Pony mash-up videos said:

“I believe the fan base for this new generation of [My Little Pony] is one of the most amazing/unexpected things to come out of the internet in a long while. When I say ‘amazing,’ I’m referring to the crazy amount of content and the hard-working people who produce material every day, which I haven’t seen in many other fan bases”.

I had a quick look on YouTube myself and couldn’t believe the number of videos that have been posted and (more unbelievably) how many views they get (yes, I’m jealous). There’s also lots of artwork on the deviantArt website (around 100,000 pieces of art), and there are also a number of dedicated websites (Equestria Daily and PonyChan) being the most popular. Equestria Daily is run by another ‘brony’ (Shaun, a 23-year old male from Arizona, US). Shaun was also quoted in the Wired article and said:

“If someone were to have told me I’d be writing a pony blog seven months ago, I would have called them insane [but] it has, obviously, evolved way past that. The brony hub gets roughly 175,000 page views per day now, up from about 20,000 just a few months ago. I honestly expected everything to die down a bit (mainly so I could finally get a break!), but it seems like the fans are more ravenous than ever for more content”.

According to the many fanboys, My Little Pony’s appeal is down to good illustration, good stories, excellent characters or, as Luke Allen puts it, a “perfect storm of ’80s nostalgia and cultural irony”.

It will come as no surprise that there is no empirical research on bronies and the only academic paper I found in my research was one by Walton Wood (in a 2011 issue of the journal Image Text: Interdisciplinary Comics Studies) although I personally found the media articles more enlightening on the phenomena than Wood’s essay. I seriously doubt that bronies will ever be the focus of mainstream psychological research although studying bronies may be useful as an adjunct to the psychological study of fanship (something that I briefly covered in a previous blog on ‘fanorexia’ and whether being a ‘fanatic’ can be addictive).

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

Further reading

Angel, R. (2012). Adult male My Little Pony fans? Bronies are true rebels. The Guardian, October 1. Located at: http://www.guardian.co.uk/commentisfree/2012/oct/01/my-little-pony-bronies-rebels

Hoffberger, C. (2011). Becoming a brony: 1 man’s foray into ‘My Little Pony’ fandom. The Daily Dot, October 12. Located at: http://www.dailydot.com/society/becoming-brony-my-little-pony-fandom/

Lelis, L. (1998). Normality…the final frontier. Psychology Today, January 1. Located at: http://www.psychologytoday.com/articles/199802/normality-the-final-frontier

Swain, H. (1997). Drive warps Trekkies. Times Higher Education, June 13. Located at: http://www.timeshighereducation.co.uk/story.asp?storyCode=100394&sectioncode=26

Watercutter, A. (2011). My Little Pony corrals unlikely fanboys known as ‘Bronies’. Wired, September 6. Located at: http://www.wired.com/underwire/2011/06/bronies-my-little-ponys/

Wikipedia (2012). ‪My Little Pony: Friendship Is Magic fandom‬. Located at: http://en.wikipedia.org/wiki/My_Little_Pony:_Friendship_Is_Magic_fandom

Wood, W. (2011). The Empirical Twilight: A Pony’s Guide to Science & Anarchism. Image Text: Interdisciplinary Comics Studies, 6(1). Located at: http://www.english.ufl.edu/imagetext/archives/v6_1/wood/

Wholly holy: A beginner’s guide to Jerusalem syndrome

In a previous blog I examined Stendhal Syndrome where some people when exposed to the concentrated works of art, experience a wide range of symptoms including physical and emotional anxiety (rapid heart rate and intense dizziness, that often results in panic attacks and/or fainting), feelings of confusion and disorientation, nausea, dissociative episodes, temporary amnesia, paranoia, and – in extreme cases – hallucinations and temporary ‘madness’. While researching that article, I also came across another condition that would appear to be related to Stendhal Syndrome, namely ‘Jerusalem Syndrome’ – a condition that I have some empathy with.

One of the things I love about my job is all the wonderful places I have been able to travel to and visit as part of my work. Back in 2010, I did some consultancy on social responsibility practices for the online gambling company 888 and was flown to Tel Aviv to speak to various departments about my work. Once my talks and meeting were over, I experienced one of the best days of my life when I given a personal guide around the whole of Jerusalem. I am not religious but I found myself totally overcome with emotion as I visited one tourist attraction after another.

I say all this by way of introduction to what has been reported in the psychological literature as the aforementioned ‘Jerusalem Syndrome’ where visitors to the holy city are totally overcome by the weight of its history. The condition was first described (perhaps unsurprisingly) by an Israeli psychiatrist – Haim Herman – in the 1930s. However, psychiatrists did not begin keeping comprehensive clinical and statistical information on these cases until the late 1970s. One of the most infamous cases often cited in relation to Jerusalem Syndrome occurred in 1969, when a male Australian tourist (Denis Michael Rohan) set alight the al-Asqa Mosque following an overwhelming feeling of divine mission.

In 1999, Dr. Eliezer Witzum and Dr. Moshe Kalian wrote the first paper on Jerusalem Syndrome in an issue of the Israelian Journal of Psychiatry and Related Sciences. The condition became more widely known in 2000, when Dr. Yair Bar-El and colleagues published a paper in it in the British Journal of Psychiatry (BJP). Since 1980, Dr. Bar-El and his colleagues reported that Jerusalem’s psychiatric services had encountered over 1000 tourists with Jerusalem Syndrome (approximately 100 a year and overwhelmingly evangelical Christians). All cases were sent to one central facility (the Kfar Shaul Mental Health Centre [KSMHC]) for psychological counselling, psychiatric intervention, and/or admission to hospital. Between 1980 and 1993 approximately 1200 tourists with severe, Jerusalem-generated mental problems were referred to the KSMHC (with 470 being admitted to hospital). Based on those requiring treatment, the 2000 BJP paper outlined what the authors believed were the three main categories of the syndrome.

• Type I: Comprises individuals that have already been diagnosed as having a psychosis (e.g., schizophrenia, bipolar illness) prior to visiting Israel. They usually travel alone and come to Israel for psychiatric religious ideation.
• Type II: Comprises individuals with mental disorders (e.g., personality disorders, obsessions) but don’t have a clear mental illness and whose strange thoughts would not be classified as delusional or psychotic. They usually travel in groups (but sometimes alone) and come to Israel for curiosity reasons.
• Type III: Comprises individuals that have no previous history of mental illness, but who become victim to a psychotic episode while in Israel (particularly Jerusalem). Type III individuals are said to recover spontaneously, and enjoy normality on their return to their home country. They usually travel with friends or family (often as part of an organized tour) and come to Israel as regular tourists (and have a religious home background).

The authors reported that the third type was the most was “perhaps the most fascinating” because it included individuals with no prior history of mental illness and whose symptoms were context-specific and recover spontaneously with little psychological intervention. Therefore, the authors noted that Type III Jerusalem Syndrome is not associated with other psychopathologies, and is this is a “pure” or “unconfounded” form of the syndrome. Of the 1200 or so cases, only 42 were classified as Type III.

Despite the many reported case of Jerusalem Syndrome, in subsequent responses to the BJP paper, Kalian and Witzum then disputed its existence and claimed it is just a variant of schizophrenic illness. They wrote in a letter that:

“Our accumulated data indicate that Jerusalem should not be regarded as a pathogenic factor, because the morbid ideation of the affected travelers started elsewhere. Jerusalem syndrome should be viewed as an aggravation of a chronic mental illness and not a transient psychotic episode. The eccentric conduct and bizarre behavior of these colorful but mainly psychotic travelers become dramatically overt once they reach the Holy City – a geographical locus containing the axis mundi of their religious beliefs”.

The authors of the original paper then responded with yet another letter and pointed out that:

“Our initial account of Jerusalem syndrome clearly distinguished between patients with Jerusalem syndrome who also have a history of psychotic illness – Jerusalem syndrome superimposed on a previous psychotic illness – and those with no previous psychopathology, whom we referred to as having the discrete form of the syndrome. In either case, the symptoms of the syndrome appear on arrival in Jerusalem and exposure to the holy places”.

There have been a number of explanations as to why Jerusalem Syndrome occurs. Some authors suggest that mental state changes can occur as a result of a significant change in routine and circumstances  (e.g., culture clash, geographical isolation, unfamiliar surroundings, proximity to strangers and/or foreigners). These factors compounded with the religious significance to many different faiths (Christians, Jews and Muslims), may be the stimuli that to trigger acute psychotic episodes. Such ‘spiritual’ travel may represent a modern-day version of a pilgrimage. There are of course limitations of the work by Bar-El and colleagues that the authors duly acknowledge including the fact that the study (i) was based on a phenomenological description and was not a research study, (jj) lacked follow-up information, and (iii) did not taken into account changes in circumstances associated with the expected influx of tourists in the millennial year.

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

Further reading

Bar-El, Y., Durst, R., Katz, G., Zislin, J., Strauss, Z. & Knobler, H.Y. (2000) Jerusalem syndrome. British Journal of Psychiatry, 176, 86-90.

Bar-El, Y., Kalian, M. & Eisenberg, B. (1991) Tourists and psychiatric hospitalization with reference to ethical aspects concerning management and treatment. Psychiatry, 10, 487 -492.

Bar-El, I., Witztum, E., Kalian, M., et al (1991) Psychiatric hospitalization of tourists in Jerusalem. Comprehensive Psychiatry, 32, 238 -244.

Fastovsky N, Teitelbaum A, Zislin J, et al (2000). The Jerusalem syndrome. Psychiatric Services, 5, 1052.

Gordon, H., Kingham, M. & Goodwin, T. (2004). Air travel by passengers with mental disorder. The Psychiatrist, 28, 295-297.

Halim, N. (2009). Mad tourists: The “vectors” and meanings of city-syndromes. In K. White (Ed.), Configuring Madness. Oxford: Inter-Disciplinary Press.

Kalian, M. & Witzum, E. (2000) Comments on Jerusalem syndrome. British Journal of Psychiatry, 176, 492.

Kalian M. & Witzum, E. (2002) Jerusalem syndrome as reflected in the pilgrimage and biographies of four extraordinary women from the 14th century to the end of the second millennium. Mental Health, Religion and Culture, 5, 1-16.

Monden, C. (2005). Development of psychopathology in international tourists. In van Tilburg, M. & Vingerhoets, A. (Eds.), Psychological Aspects of Geographical Moves: Homesickness and Acculturation Stress (pp. 213-226). Amsterdam: Amsterdam Academic Archive.

Witztum, E., & Kalian, M. (1999). The “Jerusalem syndrome” – fantasy and reality. A survey of accounts from the 19th century to the end of the second millennium. Israelian Journal of Psychiatry and Related Sciences, 36, 260-271.

A noise that annoys: A brief look at exploding head syndrome

Over the past few years I have suffered occasional bouts of tinnitus and have to say that when it occurs it completely dominates all my thoughts and thinking (although I’ve been told by more than one person that my excessive i-Pod use is to blame and therefore somewhat self-inflicted medical condition). A condition that must be a hundred times worse is that of ‘exploding head syndrome’ (EHS). The condition was first reported by the Welsh psychiatrist Dr. Robert Armstrong-Jones almost 100 years ago in The Lancet (and described as “a snapping of the brain”). A much more recent detailed description of 50 EHS cases was reported by British neurologist Dr. John Pearce in a 1989 issue of the Journal of Neurology Neurosurgery and Psychiatry (following an initial short report of 10 cases that Pearce published in a 1988 issue of The Lancet).

EHS is known to be a type of hypnagogic auditory hallucination where the person experiences a very sudden and brief loud (but usually painless) noise originating from inside their head for a fraction of a second. Some EHS sufferers also report that the loud noise may sometimes be accompanied by breathing irregularities and/or intense light flashes (so called ‘visual sleep starts’). Those who have experienced such loud noises have likened it not only to an explosion, but to a wide range of very loud noises. The 1989 paper by Dr. Pearce listed 50 patient descriptions that included gunshot, loud electrical buzzing, a loud Xmas cracker, thunderclap, a clash of cymbals, loud ringing, crashing waves, loud screaming and roaring, loud electrical static, and/or slamming car doors). There doesn’t appear to be any typical pattern among sufferers, although most EHS sufferers claim the number of attacks diminish over time following initial frequent occurrences. Some individuals experience it just once without any reoccurrence.

Any hypnagogic condition means by definition that it occurs around the onset of sleep (or the early stages of getting to sleep) and EHS is no different. (Hypnagogia refers to the state of being between awake and asleep, often called the ‘twilight of sleep’). Although the loud noise may be part of dreaming, many sufferers report that dreaming is not a necessary condition to induce the inner noise. Following an EHS attack (often experienced in the left side of the head), some individuals may experience fear and anxiety and/or heart palpitations. It is thought to be slightly less prevalent among men than women, and is more prevalent as people get older (i.e., there is much higher incidence in individuals aged over 50 years although there are reports among pre-pubescents).

Although there is no formal treatment for EHS, various therapies have been tried. Case reports have shown that some medicines appear to reduce EHS symptoms including clonezapam (reported in the journal Neurology [2008]), clomipramnine (reported in the journals Sleep [1991] and Cephalalgia [2008]), and nifedipine (reported in the journal Cephalalgia [2001]). Two cases were successfully treated using flunarizine (in the journal Cephalalgia [2008]). Other medications have been tried but EHS sufferers have not shown any improvement including doxepin, citalopram, trimipramine, and amitriptyline, valproic acid, amitriptyline, propranolol oxycodone, and gabapentin. The most recently published case study involving treatment of EHS that I am aware of was a short 2010 paper by Dr. Gaurang Palikh and Dr, Bradley Vaughn and published in the Journal of Clinical Sleep Medicine. They described the case of a women with EHS who was successfully treated using pharmacotherapy (in this case, topiramate medication). The authors reported that:

“A 39-year-old female reported symptoms of a loud bang and buzzing noise at sleep onset for 3 years. She said that, if the sound was external, her ‘husband should be able to hear it downstairs when she was up in her bedroom. Associated with this noise, she experienced brief jerking movement of her head, leg, or arms at sleep onset on a daily basis. She noted these symptoms for years; because of the increase in intensity and frequency, she saw a neurologist. The patient had become anxious about these events, fearing that they were a hallmark of more serious medical issues. Her neurological exam, laboratory test results, and neuroimaging were normal. Because of the stereotypic nature of the events and the level of disturbance to the patient, she was admitted for continuous video EEG monitoring for 4 days. Coincidently, the patient’s neurologist prescribed topiramate 50 mg twice a day for migraine prophylaxis…Two months after admission, she reported improvement in the intensity of the noise. At a daily dose of topiramate 200 mg, the patient reported the bang had significantly improved, and now sounded like a low buzzing noise. The frequency of the events was unchanged, but the intensity of the events decreased to the point of being mildly noticeable. She had marked improvement in subjective ability to fall asleep and felt these events were no longer disruptive”.

It is not known why EHS occurs although there is some speculation that it is associated with the withdrawal from prescription drugs, extreme fatigue, and/or stress. There are also some reports that EHS attacks sometimes occur when individuals have out-of-body experiences. As a consequence, some EHS sufferers develop insomnia because of a fear about going to sleep or resting. Others experience a loss in appetite. The mechanism by which the loud noise is heard is also unknown although there are speculative reasons such as being due to minor seizures in the brain’s temporal lobe (the location of hearing’s nerve cells) or sudden movements in the middle ear. Some research has monitored EEG brain activity during actual EHS attacks that show atypical brain activity among some (but certainly not all) EHS sufferers. Although the condition appears to be very rare, it certainly exists and most people appear to get better over time (with or without treatment).

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

Further reading

Armstrong-Jones, R. (1920). Snapping of the brain. The Lancet, 196, 720.

Chakravarty, A. (2008). Exploding head syndrome: Report of two new cases. Cephalalgia, 28, 399-400.

Gordon, A.G. (1988). Exploding head (letter), The Lancet, 198, 625-626.

Jacome, D.E. (2001). Exploding head syndrome and idiopathic stabbing headache relieved by nifedipine. Cephalalgia, 21, 617-618

Palikh, G.M. & Vaughn, B.V. (2010). Topiramate responsive exploding head syndrome. Journal of Clinical Sleep Medicine, 6, 382-383.

Pearce, J.M. (1988). Exploding Head Syndrome. The Lancet, 332, 270-271.

Pearce, J.M. (1989), Clinical features of the exploding head syndrome. Journal of Neurology Neurosurgery and Psychiatry, 52, 907–910.

Sachs, C. & Svanborg, E. (1991), The exploding head syndrome: polysomnographic recordings and therapeutic suggestions. Sleep, 14, 263-266.

Salih, F., Kleingebiel, R., Zschenderlein, R., & Grosse P. (2008). Acoustic sleep starts with sleep onset insomnia related to a brainstem lesion. Neurology, 70, 1935-1936.

Jacome, D.E. (2001). Exploding head syndrome and idiopathic stabbing headache relieved by nifedipine. Cephalalgia, 21, 617-618.

The slave betrayed: An overview of trokosi and sexual slavery

Regular readers of my blog will know that I take more than a passing academic interest in sexual fetishes. It was during one of my random Google fetish searches that I came across ‘fetish shrines’. I have to admit that I didn’t have a clue what a ‘fetish shrine’ was or what was involved so I started to do a little research into the topic and became horrified about what I read.

In short, I learned that a few counties in the world have fetish shrines as part of their religious culture, and that they are connected with a particular type of slavery known as “trokosi” (where young women are coerced to become “slaves or wives of the gods”). Because the gods of African religions are normally referred to as fetishes, the victims are usually referred to as fetish slaves, and the priests who serve the gods are referred to as fetish priests.

More specifically, trokosi is a type of ‘ritual servitude’ that is based on both patriarchal superstition and religious tradition. As far as I can tell, only four countries in the world still adhere to trokosi practices – Togo, Benin, Nigeria, and Ghana. According to Siman Abaxer in his publication Trokosi Situation on the Ground in Volta Region, the practice is not universal across these four countries but regional. Of these, it is Ghana that appears to have trokosi most embedded within its religious culture and/or is most written about. Despite being outlawed in Ghana since 1998, and with a minimum prison sentence of three years for those convicted of engaging in the practice, trokosi is still relatively widespread (although to date, no-one appears to have been prosecuted for such offences). The practice is very much connected to criminal wrongdoing and acts as a vehicle for religious atonement (a ‘living sacrifice’). When someone commits a crime (however, trivial), the family of the person committing the crime has to offer up a virginal daughter (usually aged between eight and fifteen years old) to the local fetish shrine where she becomes a sex slave to the local priest(s).

The priest has complete ownership of the girl and controls all actions and interactions in their life. The priest is allowed to (ab)use the girl in any way they deem fit which includes sex on demand. Such girls are kept in brutal conditions and used for both cheap labour and sexual gratification. Whether the girls receive food, education and access to health services is completely at the mercy of the priest, and there is no remuneration for any of the services provided by the girls. Those given up as slaves will usually be under the priest’s control for about ten years but can be more depending upon the nature and the severity of the crime committed by the girl’s relative. If the slave girl dies while under the priest’s control, the family have to pay up a large sum of money or (more usually) give up another of their daughters to the priest.

According to Sarah Aird, a staff writer for the Human Rights Brief, there are approximately 5,000 trokosi slaves within Ghana, and as many as 35,000 worldwide. (I tracked down the original source for these figures and they are from 1998 article by Amy Bilyeu in the Indiana International and Comparative Law Review). Aird also claimed that many Ghana families are so dedicated to the trokosi practice that they have sacrificed up to five generations of daughters to the fetish priests. She also reports that:

“The trokosi custom is part of a traditional fetish belief system, according to which gods or spirits reside in various ritual objects and shrine priests. Within Ghana, trokosi slavery endures primarily among the Ewe ethnic group, albeit in altered form since its 17th century origins. Trokosi slavery originated in Togo and Benin as a war ritual in the 1600s. Before entering combat, warriors would visit religious shrines where they offered women to the war gods in exchange for victory and a safe homecoming. Today, many Ghanaians revere priests of trokosi shrines, because they believe these priests communicate directly with the war gods and are particularly influential in the spirit world, even capable of determining life and death”.

As noted in the quote above, in Ghana (as in Togo), trokosi is practiced by the Ewe tribe, and in Benin and Nigeria it is practiced by the Fon people. It is also known by other names and variations including ‘fiashidi’ (Ghana), ‘woryokwe’ (Ghana), voodoosi (Togo and Benin), and vudusi. (Togo and Benin). According to the online Trokosi Dictionary, the word trokosi comes from the Ewe words ‘tro’ (i.e., deity or fetish) and ‘kosi’ (i.e., female slave).

Professor Sandra Greene in her 1996 book Gender, Ethnicity and Social Change on the Upper Slave Coast noted that in Ghana, trokosi dates back to at least the late 18th century (although as the quote above notes, it may date back even further). In a Wikipedia article on ritual servitude, it notes that in relation to trokosi, the fetish priest’s genitals are dedicated to the gods of the fetish shrine, therefore enslaved girls having sex with the priest is considered a sacred act (and in essence having sex with the gods). Many trokosi and vudusi have described beatings and other severe punishments imposed on them for refusing sex with the priest. In Ghana, it is claimed that fetish shrine slaves have an average of four children while in servitude. The fathers may not just be the priest, but may also be the elders of the shrines. In relation to the children born during servitude, Sarah Aird also wrote that:

“Any children born to trokosi slaves are also slaves of the priest and are known as trokosiviwo. When the priest dies, the priest next in line inherits his trokosi slaves and trokosiviwo children, so trokosi becomes a tradition in perpetuity. Only priests and shrine owners may release a trokosi slave from the shrine, with shrine owners maintaining the ultimate power to affect such releases…Fetish priests who favor trokosi slavery view the practice as an effective means to keep people from breaking community norms. They perceive trokosi slaves as links between the gods and the family, reminding family members to lead moral lives”.

In defence of their actions, the fetish priests claim that the practice deters community crime, and that the enslaved girls constitute role models, and save their family from punishment. However, as Mark Wisdom (Executive Director of Fetish Slaves Liberation Movement) noted:

“If it is intended to serve as a check to crime, then we can say that it is not effective because it has existed since time immemorial but people continue to commit crimes”.

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

Further reading

Abaxer, S. (2007). Trokosi Situation on the Ground in Volta Region. ECM Africa Publications.

Bilyeu, A.S. (1998). Trokosi – The Practice of Sexual Slavery in Ghana: Religious and Cultural Freedom vs. Human Rights. Indiana International & Comparative Law Review, 9.

Aird, S.C. (undated).  Ghana’s slave to the gods. Located at: http://www.wcl.american.edu/hrbrief/v7i1/ghana.htm

Bilyeu, A.S. (1998). Trokosi – The Practice of Sexual Slavery in Ghana: Religious and Cultural Freedom vs. Human Rights. Indiana International and Comparative Law Review, 9.

Hawksley, H. (2001). Ghana’s trapped slaves. BBC News, February 21. Located at: http://news.bbc.co.uk/1/hi/programmes/from_our_own_correspondent/1158115.stm

Greene, S.E. (1996). Gender, Ethnicity and Social Change on the Upper Slave Coast: A History of the Anlo-Ewe. Portsmouth: Heinemann.

Petraitis, R. (2000). Ju-Ju’s fetish slaves. The Reall (Rational Examination Association of Lincoln Land) News, 8(9), 1-2.

Wikipedia (2012). Ritual servitude. Located at: http://en.wikipedia.org/wiki/Ritual_servitude

A pining for dining: A brief overview of Gourmand Syndrome

In 2005, an article in the May 8th issue of the New York Times magazine reported the case of an unnamed European political journalist who had a stroke that caused some damage to the right frontal lobe in his brain. The journalist made a full recovery but experienced an unexpected side effect – he developed an unusual passion for gourmet food (that he didn’t have prior to his stroke).  He capitalized on his strange new behaviour and became a food columnist. Similarly, a 2011 article in the Huffington Post reported the story of Kevin Pearce, a snowboarder who sustained right hemispheric brain damage following an accident that nearly killed him. Waking up from a coma he developed a craving for basil pesto (something that he never did prior to his accident). Both of these cases are examples of a rare disorder that has been named Gourmand Syndrome, a strange behaviour first written about (clinically and academically) in the mid-1990s. Gourmand Syndrome basically comprises individuals becoming totally preoccupied and obsessed with food and ‘fine dining’.

This rare (and benign) condition only seems to occur in people who have sustained brain injuries involving the right frontal lobe and was first described (and named) by neuropsychologist Dr. Marianne Regard and neurologist Dr. Theodor Landis in a 1997 issue of the journal Neurology (one of only two empirical papers on the topic). The authors noted that hyper-orality is part of other conditions such as the Kluver-Bucy syndrome that occurs in patients with bilateral mesial temporal lesions (and which I examined in a previous blog).

Regard and Landid described the cases of two individuals who both had partial damage to the right anterior cerebral hemisphere of the brain. The first case was the political journalist briefly mentioned at the start of this article. He became totally preoccupied with gourmet food and continued after he had been discharged from hospital. The second case that Regard and Landis wrote about was a businessman who (following a stroke) also developed a passion for gourmet food. However, his preoccupation with gourmet food was part of a wider disturbance of impulse control as he also made repeated sexual advances towards the female nursing staff at the hospital he was in. (Interestingly, a later 2003 study by Regard and Landis on 21 pathological gamblers – and published in the journal Cognitive and Behavioral Neuropsychology – reported that 38% of them [n=8] were reported to have Gourmand Syndrome, again suggesting that these impulsive behaviours are highly inter-linked).

Having named this type of behaviour as Gourmand Sydrome, Regard and Landis then conducted a prospective study examining the frequency and the clinical and anatomical correlates of the syndrome. Over a three-year period, and using a self-constructed checklist, they carried out 723 neuropsychological examinations of patients with known (or strongly suspected) cerebral lesions. The specific criteria for Gourmand syndrome were: (i) the presence of a significant change in a person’s eating habits (i.e. preoccupation with the preparation and eating of fine-quality food), (ii) the onset of which was associated with a single cerebral lesion in the absence of other medical or social conditions, and (iii) previous eating disorders; or other neurological or psychiatric illness. A total of 36 people fulfilled the criteria for Gourmand Syndrome (5%).

Of those identified fulfilling the three criteria, 94% of them (n=34) appeared to have right hemisphere damage in the brain (in particular, the right anterior part of the brain involving basal ganglia, cortical areas, and limbic structures). Most of the individuals’ symptoms were caused by tumours (although there were other causes including focal seizures, head trauma [with focal concussion], haemorrhage, and cerebrovascular accidents). The authors concluded that:

“Most patients with the ‘gourmand syndrome’ had clinical and anatomical evidence of a unilateral right-sided lesion, mainly involving anterior cortico-limbicregions. The strong clinical-anatomical correlation suggests that gourmand eating can represent a neurological sign of diagnostic value. The eating behavior does not correspond to any known category of eating disorders. At most, it could be classified as a benign, non-disabling form of hyperphagia, but with a specific preference for fine food”

A later case study of Gourmand Syndrome by Dr. Mary Kurian and her Swiss colleagues was published in the journal Epilepsy and Behavior. They reported the case of a 10-year-old boy with epilepsy (and who had hemispheric brain damage (i.e., “right temporoparietal hemorrhagic lesion”). As with previous adult cases, he developed Gourmand Syndrome and experienced a significant change in his eating habits, or as the authors put it, an “abnormal preoccupation with the preparation and eating of fine-quality food…without any previous history of eating disorders or psychiatric illness”. More specifically, the boy’s parent’s noticed that he began to avoid eating at fast-food restaurants and would only eat or cook the finest foods. The authors argued that their case study confirmed previous observations relating to the importance of the right cerebral hemisphere in disturbed eating habits, not just in Gourmand Syndrome but eating disorders such as anorexia and obesity.

Both of the published empirical papers noted that Gourmand Syndrome includes an obsessive component along with other behavioural consequences typically associated with addiction (e.g., cravings, preoccupation, salience, etc.). They also notes that one-third of the 36 patients identified in their prospective study had symptoms of mania (e.g., aggression, diminished impulse control, disinhibition, affective lability). In recent a review of Gourmand Syndrome by trainee psychiatrist Alexandros Chatziagorakis in the Neuropsychiatry News concluded that:

“Owing to the rarity of further articles and reports of Gourmand syndrome, its diagnostic significance is yet to be proven. It would be worth using Regard [and] Landis’ checklist during neuropsychological assessment of neurological patients to establish its frequency and its clinical and anatomical correlates. At the same time, it would be worth performing a psychiatric assessment to determine whether Gourmand syndrome presents in the context of an already defined psychiatric syndrome such as mania. This will tell us whether Gourmand syndrome has indeed a diagnostic value as a neurological or even neuropsychiatric sign”.

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

Further reading

Chatziagorakis, A. (2012). Gourmand Syndrome. Neuropsychiatry News, 5 (Spring), 23-24.

Holt, T. (2005). Of two minds. New York Times (Magazine), May 8. Located at: http://www.communicationcache.com/uploads/1/0/8/8/10887248/the_way_we_live_now_-_of_two_minds.pdf

Huffington Post (2011). The Gourmand Syndrome: Brain Damage Can Trigger Food Obsession, Huffington Post, October 9. Located at: http://www.huffingtonpost.com/2011/07/11/the-gourmand-syndrome-food-obsession_n_894629.html

Kurian, M., Schmitt-Mechelke, T., Korff, C., Delavelle, J., Landis, T. & Seeck, M. (2008). “Gourmand syndrome” in a child with pharmacoresistant epilepsy. Epilepsy and Behavior, 13, 413-415.

Regard, M., Knoch, D., Gütling, E. & Landis, T (2003). Brain damage and addictive behavior: A neuropsychological and electroencephalogram investigation with pathologic gamblers. Cognitive and Behavioral Psychology, 16, 47-53.

Regard, M. & Landis, T (1997). ‘Gourmand syndrome’: Eating passion associated with right anterior lesions. Neurology, 48, 1185-1190.

Uher, R. & Treasure, J. (2005). Brain lesions and eating disorders. Journal of Neurology, Neurosurgery and Psychiatry, 76, 852–7.

Is sexed text a case of writing wrongs? A brief look at erotographomania

In a previous blog I briefly looked at graphomania, which in a psychiatric context, relates to a morbid mental condition that manifests itself in written ramblings and confused statements. Graphomania in a non-psychiatric context typically concerns the urge or need to write to excess (and not necessarily in a professional context). Today’s blog looks at what I see as a sub-variant of this that has been termed ‘erotographomania’ although compared to ‘graphomania’ more generally, there seems to be a lot of different operational definitions of what erotographomania actually refers to. For instance:

• Dr. Anil Aggrawal’s book Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices defines erotographomania as when individuals derive sexual pleasure and arousal from writing love poems or letters.
• Like Dr. Aggrawal’s book, Dr. Brenda Love’s Encyclopedia of Unusual Sex Practices defines erotographomania as sexual arousal from writing love poems or letters but adds that the condition was “more common before the invention of the telephone”.
• In the 2005 edition of the Comprehensive Textbook of Sexual Medicine (edited by Dr. Nilamadhab Kar and Gopal Chandra Kar), erotographomania is defined as sexual gratification through obscene writing. Citing from Dr. J.B. Mukherjee’s 1985 book Forensic Medicine and Toxicology, it is reported that erotographomania comprises “drawing obscene pictures and diagrams in lavatories, public urinals or writing obscene anonymous letters to young girls”.
• In an article on ‘manifestly manifolded manias’ in a 1986 issue of the Journal of Recreational Linguistics, Paul Hellweg defined erotographomania as the “abnormal interest in erotic literature”.
• The Right Diagnosis website claims that erotographomania can comprise either and/or the (i) compulsive desire to write love letters, (ii) compulsive desire to write love poems, and (iii) abnormal interest in erotic literature. It also claims that treatment for the condition “may not be sought unless the condition becomes problematic for the person in some way, and they feel compelled to address their condition. Many people simply learn to accept their fetish and manage to achieve sexual gratification in a satisfactory manner”.
• The Encyclo (online encyclopedia) defines erotographomania as (i) an obsession to write love letters or to write erotic or pornographic literature, (ii) an abnormal interest in erotic literature, and (iii) in psychiatry, a morbid impulse to write love letters (generally written anonymously).

Obviously the numerous definitions outlined have clear overlaps, but there is no consensus on the exact erotic or (potentially paraphilic) focus. In my research for this article I couldn’t find a single academic or clinical article on the topic, just brief definitional mentions (of which the above list was comprised). Brenda Love’s comment (above) that the condition was more common before the telephone may be why there appear more mentions of the condition historically than in contemporary texts (for instance, erotographomania was mentioned in Edward Podolsky’s 1953 Encyclopedia of Aberrations, although again, there was no substance to what was written).

I did come across two books both entitled ‘Erotographomania’. The first was published in 2005 by Mike Martin (the full title of which was Erotographomania: Cruel Nostalgia), while the second one was published in 2008 by Rebecca Smith (and simply called Erotographomania). However, neither book was academic and neither provided any insight into the condition. I also came across an online academic article written in 2010 on love letters written by Kristine Trever. Writing about her own urges to write love letters:

“What happens to that urge to write out our love and desires and emotions in some concrete, tangible way to someone else..? And more importantly where does that urge come from?…I recall an overwhelming need to express something because of the influence of something else, because of an experience that touched me, reminded me, inspired me to share. I read a story that included a poem and through the existence of these two external items, the urge hooked me, the impulse too great to deny. I was overcome. The power of the pencil took over…If this all sounds crazy, impulsive, erratic, wild, unabashed and/or idiotic, itʼs critical to note that there is an actual disease called erotographomania, which is the compulsive act of writing and writing and writing and writing and writing and writing love letters. The OCD recipe for lovers”.

The Australian musician and songwriter Nick Cave gave a lecture in 1999 on love songs and claimed that he and a friend both had erotographomania. In his lecture he said:

“The reasons why I feel compelled to sit down and write love songs are legion. Some of these came clearer to me when I sat down with a friend of mine, who for the sake of his anonymity I will refer to as J.J. and I admitted to each other that we both suffered from psychological disorder that the medical profession call erotographomania. Erotographomania is the obsessive desire to write love letters. My friend shared that he had written and sent, over the last five years, more than seven thousand love letters to his wife. My friend looked exhausted and his shame was almost palpable. I suffer from the same disease but happily have yet to reach such an advanced stage as my poor friend J. We discussed the power of the love letter and found that it was, not surprisingly, very similar to the love song. Both served as extended meditations on ones beloved. Both served to shorten the distance between the writer and the recipient. Both held within them a permanence and power that the spoken word did not. Both were erotic exercises, in themselves. Both had the potential to reinvent, through words, like Pygmalion with his self-created lover of stone, one’s beloved. Alas, the most endearing form of correspondence, the love letter, like the love song has suffered at the hands of the cold speed of technology, at the carelessness and soullessness of our age”.

Maybe there is something in the Australian psyche when it comes to erotographomania as (during my research) I came across an Australian art exhibition on the topic that featured the work of Dejan Kaludjerovic, Claire Lambe, Nancy Mauro-Flude, Sally Rees, Noel Skrzypczak, Ben Terakes, and Paul Emmanuel. The exhibition was curated by Sarah Jones, who wrote that:

“Erotographomania (originally a term for perverse and obsessive love letter writing) aims to make parallels between the unconscious investment that artists make to address an audience and the intense erotic delusions played out in the exchange of love letters. Both produce a circuit of libidinal exchange that demands recognition. Both involve a fraught transferential displacement centred on an object of communication. Erotographomania explores pathos; the element of sadness and regret that flows between the ‘sender’ and the ‘addressee’ that becomes injected into the dubious presence of the world of objects; reflected there; contaminated by a past relentlessly regurgitated into the present. The exchange between the artist, the work and the audience remains confused and in flux, like that of the lover, the loved, the author and the intended beneficiary”.

Given an almost complete absence of academic and clinical reference to erotographomania, it begs the question of why it’s not been a topic of empirical investigation. Maybe the topic is being actively researched but no-one is calling it erotographomania. Many cyberpsychologists (including myself) have studied cybersexual behaviour that includes the sending of sexually arousing erotic emails to each other. Some of my academic papers on online sex (a few of which I’ve listed in the ‘further reading’ section below) make reference to online behaviours that fit some of the operational definitions of erotographomania outlined at the start of this article. Maybe it’s about time I wrote an article letting the cyberpsychology community know that they are simply researching an old phenomenon in a new environment.

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.

Cave, N. (1999). Love Song Lecture September 25. Transcription of lecture at: http://everything2.com/title/Nick+Cave%2527s+Love+Song+Lecture

Encyclo Online Encyclopedia (2012). Erotographomania. Located at: http://www.encyclo.co.uk/define/erotographomania

Griffiths, M.D. (2000).  Excessive internet use: Implications for sexual behavior. CyberPsychology and Behavior, 3, 537-552.

Griffiths, M.D.  (2001).  Sex on the internet: Observations and implications for sex addiction. Journal of Sex Research, 38, 333-342.

Griffiths, M.D. (2004). Sex addiction on the Internet. Janus Head: Journal of Interdisciplinary Studies in Literature, Continental Philosophy, Phenomenological Psychology and the Arts, 7(2), 188-217.

Griffiths, M.D. (2012). Internet sex addiction: A review of empirical research. Addiction Research and Theory, 20, 111-124.

Hellweg, P. (1986). Manifestly manifolded manias. Journal of Recreational Linguistics, 19(2), 100-108.

Kar, N. & Kar, G.C. (2005). Comprehensive Textbook of Sexual Medicine. New Delhi: Jaypee Brothers Medical Publishers.

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

Martin, M. (2005). Erotographomania: Cruel Nostalgia. BookSurge Publishing.

Mukherjee, J.B. (1985). Forensic Medicine and Toxicology. London: Academic Publishers.

Podolsky, E. (1953). Encyclopedia of Aberrations: A Psychiatric Handbook. London: Arco.

Right Diagnosis  (2012). Erotographomania, February 1. http://www.rightdiagnosis.com/e/erotographomania/intro.htm

Smith, R. (2008). Erotographomania. Blurb Publishing (http://www.blurb.com/bookstore/detail/1468330)

Trever, K. (2010). How to write a love letter, or how do you write a love letter? Located at: http://www.kristinetrever.com/pdf/LoveLetter-Trever.pdf

Stats entertainment: A review of my 2012 blogs

My last blog of 2012 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:

About 55,000 tourists visit Liechtenstein every year. This blog was viewed about 180,000 times in 2012. If it were Liechtenstein, it would take about 3 years for that many people to see it. Your blog had more visits than a small country in Europe!

Click here to see the complete report.

Freak speak or lingo star? A beginner’s guide to Foreign Accent Syndrome‬

Today’s Daily Telegraph featured the story of Englishman Alun Morgan who following a stroke now speaks fluent Welsh. Doctors diagnosed the 81-year old Mr Morgan with aphasia, a form of brain damage that causes a shift in the brain’s language centre. Mr Morgan is now being taught to speak English again.

Although often treated as a joke, ‘Foreign Accent Syndrome’ (FAS) is a very rare speech disorder but now medically recognized condition. FAS is typically characterized by the (sometimes sudden) appearance of a new speaking accent, identifiably different from the person’s native language. Prior exposure and knowledge to the newly acquired accent is not needed for it to occur and it is usually perceived as foreign or dialectical by fellow natives and, usually, by the person themselves. Published case studies have reported that it is impossible to fake FAS. However, the FAS sufferers don’t suddenly acquire a foreign language (vocabulary, grammar, syntax, etc.) just the accent (although the Wikipedia entry on FAS made reference to a news report that coming out of a coma, a 13-year old Croatian girl allegedly gained the ability to speak fluent German). However, as far I am aware, there are no proven cases where someone with improved their language skills following the development of FAS.

FAS typically occurs following a traumatic brain injury (e.g., head trauma, stroke, cerebral haemorrhage) although other conditions (such as multiple sclerosis) have also led to the development of FAS. Those with FAS often suffer in other ways including poor concentration span, poor memory, and feelings related to loss of identity. Research examining the brain structures of those with FAS have highlighted there are commonalities in relation to specific parts of the brain that are (unsurprisingly areas that control various language functions). More recently, there is growing empirical evidence that the cerebellum (which controls motor function) appears to be critical in the development of some cases of FAS. For instance, Dr. D.A. Cohen and his colleagues published a case study in a 2008 issue of the journal Neurology and concluded that their case demonstrated “that abnormal right cerebellar activity can play a causal role in perpetuating the FAS rather than being merely an epiphenomenon of damage to the reciprocally connected left hemisphere”. A series of papers published by a team led by Dr. P. Mariën have all conformed the role of the cerebellum in the acquisition of FAS (Clinical Neurology and Neurosurgery, 2006; Folia Phoniatrica et Logopaedica, 2007; Cortex, 2009).

The disorder was first described over 100 years ago (in 1907) by Dr. Pierre Marie (a French neurologist). This was followed by a Czech case study published in German by Dr. A Pick in 1919. (Unfortunately, these first two cases were not written in English so I have been unable to gain any details of either of the two cases described)

The first published case study written in English is believed to be one dating back to 1947 by the neurologist Dr. Monrad-Krohn. He described the case of a 30-year old female (Astrid L) from Norway who was hit on the head by shrapnel during a German air raid on Oslo in 1941. The injury led to aphasia, hemiplegia, and seizure disorder. This caused speech problems but within a year of the injury, the woman’s speech began to improve but it was different to how she had spoken before her head injury. Monrad-Krohn described how the woman’s ‘rhythm and melody’ of her voice had dramatically altered and that she sounded like she had a foreign (German sounding) accent (even though she had never travelled outside of Norway). Consequently, she was shunned and/or ridiculed by many of her native Norwegians. Since these three early published case studies, around 60 cases of FAS have been documented worldwide including people who went from speaking British to French, American to British, Japanese to Korean, and Spanish to Hungarian. A 2006 article by Diane Garst and William Katz highlighted the common features of FAS. The ‘classic’ characteristics are:

• Monolingual patient is frequently mistaken for being a non-native speaker.
• Speech changes are not triggered by psychiatric or psychological problems.
• Idiosyncratic speech errors contribute to appearance of a cohesive ‘accent’
• Patient is aware of accent and unhappy about it.
• Voicing changes occur in both prosody (syllable-by-syllable timing, and abnormal pitch patterns) and segmentals (consonant distortions, substitutions, deletions; frequent problems with alveolar tap/flap; omplex or unusual vowel substitutions)

Writing in a 2007 issue of the Annals of General Psychiatry, Stéphane Poulin and colleagues noted that:

“Different explanations of the functional origin of FAS have been suggested, one of the more frequent being impaired access to verbal-motor patterns or a mild form of apraxia of speech. Clinical manifestations are heterogeneous among FAS patients but usually include segmental (e.g., changes in vowel length and tenseness) and prosodic (e.g., inappropriate word and sentence stress) deficits”.

A 2005 paper in the journal European Neurology by Edwards, Patel and Pople examined 35 case published case studies of FAS. Their analysis reported that the majority (n=26) of those with FAS resulted from cerebral infarct. The remainder resulted from head injury (n=6), multiple sclerosis (n=2) and psychosis (n=1). In one-third of the cases (34%), the person with FAS also had agrammatism (i.e., a form of expressive aphasia that refers to the inability to speak in a grammatically correct way). As Stéphane Poulin and colleagues note:

“In spontaneous speech, agrammatic patients speak non-fluently and produce telegraphic speech. They mainly use content words (nouns, verbs, adjectives) and tend to omit or substitute function words (prepositions, articles and auxiliaries) as well as inflections or other grammatical morphemes. Among reported FAS cases, few brain imaging studies have been done and there is no consensus regarding the precise region responsible for its occurrence. Neuroanatomically, the vast majority of the lesions described were in the dominant hemisphere and in most cases involved regions typically associated with Broca’s aphasia. Subcortical structures seem to be consistently affected”.

Thanks to the internet and broadcast media, there are many cases of FAS that have not been reported in the academic and clinical literature. I’ll leave you with a few you can check out yourself. Just click on each name to get the details.

• Tiffany Roberts: In 1999, 57-year old American woman Tiffany Roberts (from Indiana) had a stroke and developed an English accent.
  
• Linda Walker: In 2006, a 60-year old British woman with a Geordie accent (from Newcastle) had a stroke and developed a strange accent (described as Jamaican, Italian, French Canadian and Slovak).
  
• Rajesh: In 2007, a 14-year old Indian boy (from Uttar Pradesh) developed a broken American accent following corporal punishment from his father.
  
• Cindy Lou Romberg: In 2007, a middle aged American woman Cindy Lou Romberg (from Port Angeles, Washington) developed an English speaking Russian/German/French-sounding accent following her neck being adjusted by a chiropractor (although she had suffered a brain injury in a car crash back in 1991).
  
• Julie Frazier: In 2008, a 39-year old American woman Julie Frazier (from Fort Wayne, Indiana) developed a British-Russian accent following a severe hemiplegic migraine (the first such case involving migraine as the trigger episode).
  
• Sarah Colwill: In 2010, a 35-year old British woman Sarah Colwill (from Devon) developed a Chinese accent following an extreme migraine.
  
• Kay Russell: In 2010, a 49-year old British woman Kay Russell (from Gloucestershire) developed a French/Russian/Eastern European accent following a migraine.
  
• Karen Butler: In 2011, a middle-aged American woman Karen Butler (from Newport, Oregon) developed an Irish/Eastern European accent following oral surgery.
  

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

Further reading

Ardila, A. Rosselli, M., & O. Ardila. (1988) Foreign accent: an aphasic epiphonomenon? Aphasiology, 2,5, 493-499.

Aronson, A.E. (1990). Dysprosody of pseudo-foreign dialect. In Aronson, A.E. (Ed.), (2nd ed.) Clinical Voice Disorders  (pp. 119-124) New York: Thieme-Stratton.

Berthier, M., Ruiz, A., Massone, M., Starkstein, S., & R. Leiguarda. (1991). Foreign accent syndrome: behavioural and anatomical findings in recovered and non-recovered patients. Aphasiology, 5, 129-147.

Blumstein, S.E., Alexander, M.P., Ryalls, J.H., & W. Katz. (1987). On the nature of the foreign accent syndrome: A case study. Brain and Language, 31,215-244.

Coelho, C.A., & Robb, M.P. (2001). Acoustic analysis of Foreign Accent Syndrome: An examination of three explanatory models. Journal of Medical Speech-Language Pathology, 9, 227-242.

Cohen, D.A., Kurowski, K., Steven, M.S., Blumstein, S.E. & Pascual-Leone, A. (2008). Paradoxical facilitation: the resolution of foreign accent syndrome after cerebellar stroke. Neurology, 73, 566-567.

Edwards, R.J., Patel, N.K. & Pople, I.K. (2005). Foreign accent following brain injury: syndrome or epiphenomenon? European Neurology, 53, 87-91.

Garst, D. & Katz, W. (2006). Foreign Accent Syndrome. The ASHA Leader, August 15.

Marie P. (1907). Presentation de malades atteints d’anarthrie par lesion de l’hemisphere gauche du cerveau. Bulletins et Memoires Societe Medicale des Hopitaux de Paris, 1, 158–160.

Mariën P., Verhoeven J. (2007). Cerebellar involvement in motor speech planning: some further evidence from foreign accent syndrome. Folia Phoniatrica et Logopaedica, 59, 210-217.

Mariën P., Verhoeven J., Engelborghs, S., Rooker, S., Pickut, B. A., De Deyn, P.P. (2006). A role for the cerebellum in motor speech planning: evidence from foreign accent syndrome. Clinical Neurology and Neurosurgery, 108, 518-522.

Mariën, P., Verhoeven, J., Wackenier, P., Engelborghs, S. & De Deyn, P.P. (2009). Foreign accent syndrome as a developmental motor speech disorder. Cortex, 45, 870–878.

Moen, I. (2000). Foreign accent syndrome: A review of contemporary explanations. Aphasiology, 14, 5-15.

Monrad-Krohn, G.H. (1947). Dysprosody or altered “melody of language.” Brain, 70, 405-415.

Pick, A. (1919). Über Änderungen des Sprachcharakters als Begleiterscheinung aphasicher Störungen. Zeitschrift für gesamte Neurologie und Psychiatrie, 45, 230–241.

Hello, good buy: Another look at shopping addiction

With only a few shopping days left until Christmas, I thought I would take another (hopefully topical) look at shopping addiction. Earlier this year, the Journal of Psychoactive Drugs published a paper by Dr. Heidi Hartston on the case for shopping as an addiction. She argued that the main factors that contribute to shopping addictions are (i) a hyper-stimulating experience (or an experience that was hyper-stimulating during initial exposures); (ii) easy accessibility or a high likelihood of frequent engagement; and (iii) vulnerability to addiction, which can be genetically present or can be created by neuroadaptation or reward deficiency syndrome.

In the section of her paper on the creation of hyper-stimulating experiences, Hartston claimed that in 1903 when Coca-Cola removed the cocaine out of their product, their marketing research found increasingly sophisticated ways to act on the brain’s reward circuitry by utilizing (i) advertising, (ii) product experience and (iii) packaging. According to Harston:

“Neuromarketing is the use of scientific brain research to potentiate the effectiveness of product marketing. This research uses fMRI brain imaging, EEG, skin moisture levels, heart rate, breathing patterns, eye movement and pupil dilation among other scientific measures. Marketing firms have spent 6.8 billion dollars in research (leading to 117 billion in advertising) learning to maximize the influence that branding, packaging, product placement and ad content can have on shopper decisions to buy. Many neuromarketing studies bypass the conscious adult rational decision-making brain functions to maximize excitement, emotional attachment, brand attachment, reward pathway activation, medial prefrontal identification and oxytocin stimulation, influencing impulsive buying decisions in ways individuals are not aware of or informed about (Robischon 2010)”

She then went on to claim that huge multi-national companies like Disney, Google, Frito-Layand and CBS (as well as large election campaigns) use these neuromarketing techniques to examine reactions by consumers (and voters) to their brands (or candidates) and then alter their advertising strategies accordingly. To support these claims, Hartston notes:

“A few examples of scientifically informed marketing include incorporating the color red (think of the coke can) resulting in attributions of intelligence and power to owning a product or to sales people (Elliot & Aarts 2011). ‘Sneaker radio’, a muzak-like soundtrack designed for use in athletic shoe stores, is designed to slow a shopper’s pace through the store and increase impulsive purchases. Studies using fMRI scans can identify which ad strategies trigger the consumer to strongly desire a product, saying they are ‘itching to buy’ (Thompson 2003). Bypassing interaction with the cortex and maximizing stimulation of emotional and reward areas can create hyperstimulating and difficult to resist marketing and can sabotage a vulnerable shopper’s intentions and efforts to resist buying”.

Hartston also makes further interesting observations in how commercial companies can hyper-stimulate shopping by exaggerating the sense of importance to the buying of products, or to the process of shopping itself. Shopping is a behaviour that has the capacity to become a highly rewarding experience. Such rewards can include excitement, identity affirmation, accomplishment, and praise. For a minority, shopaholism may become a difficult behaviour to break. Such observations not only have implications for shopping purchases but also behaviours that I study in my own research such as gambling. In relation to shopping addiction and increased accessibility, Hartston noted that:

“Behaviors may not reach the intense level of [dopamine] hyperstimulation that drugs do when each separate exposure is compared. However, because addictive behaviors are more easily accessible and more frequently engaged in than drug use (more exposures per day or week), the net effect of many more frequent exposures can make an addictive behavior hyperstimulating enough to have similar behavioral and physiological consequences as drugs”.

Comparing two different drug addictions – nicotine addiction and heroin addiction – she notes that nicotine clearly has a much weaker reward stimulation (per exposure) but can be equally addictive as heroin. The key difference is obviously the frequency as smokers will continually smoke cigarettes throughout the day whereas the number of times a heroin addict will take heroin during the day will be considerably less. In essence, Hartston argued:

“More exposures means more pairings of use and mild hyperstimulation, more encoding of the positive associations with smoking in memory, more consistent hyperstimulation of DA reward areas and more ease in increasing use. Due to its ease of availability, someone who tries smoking is more likely to become addicted than someone who tries heroin (Hilts 2009)”.

Relating this to shopping, Hartston makes the point that shopping is no longer something that is time limited by closed shops. The internet has brought the potential for 24/7 shopping. As with other activities with the potential for addiction (e.g., gambling, video gaming, sex), the internet has brought easy access, high availability, convenience, anonymity, dishinibition, and escape. As Hartston rightly asserts:

“A shopper can browse or purposefully seek target items during many stolen moments each day, from almost any location, or for extended amounts of time whenever a break may occur. Impulses to buy can be acted on immediately, without the protective time delay there used to be. And the steps to completing a purchase have become shortened, with credit card numbers already saved and one-click purchasing options additionally catering to impulsivity”.

Finally, Hartston argues that brain changes associated with Reward Deficiency Syndrome make it harder to stop the behaviors like excessive shopping. There is growing evidence that both chemical and behavioural addictions not only trigger changes in dopamine reward physiology “but also to its cortical connections, thereby impairing self-regulation”. Any person is responsible for their own behaviour but Harston argues that changes to the brain’s physiology makes it harder for vulnerable and susceptible people to control such behaviours. As Harston points out:

“Actions ‘preferred’ (valued at higher importance) by hyperstimulated striatal neurons are more likely to occur despite the addict’s conscious insight (Lau & Glimcher 2008; Hikosaka et al. 2008; Hikosaka, Nakamura & Nakahara 2006). This means that when desires become addictions they can have an overriding command over behavior and decision making, which is difficult to interrupt even in the presence of insight or higher goals. Addicted brains also show less age-related expansion of white matter, reflecting a loss of learning capacity and difficulty making new choices, further inhibiting an addict’s control over impulsive reward seeking behaviors (Goldstein & Volkow 2002). People who find themselves in the trap of addiction, whether to a drug or a behavior like shopping, need to be able to access effective interventions and support in order to stop the problematic behavior and prevent relapses”

Shopping appears to be the latest normal everyday behaviour (along with behaviours like exercise, eating and sex) to have been pathologized. However, (as I noted in my previous blog on shopaholism), there does seem to be some empirical evidence that a small minority of people appear to display addictive-like symptoms as a result of their shopping behaviour. Dr. Harston has done a good job in pointing out of the biological and situational reasons for how and why such addictions may develop.

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

Further reading

Elliot, A. & Aarts, H. (2011). Perception of the color red enhances the force and velocity of motor output. Emotion, 11, 445–49.

Goldstein, R. & Volkow, N. (2002). Drug addiction and its underlying neurobiological basis: Neuroimaging evidence for the involvement of the frontal cortex. American Journal of Psychiatry, 159, 1642–52.

Griffiths, M.D. (2010). Internet abuse and internet addiction in the workplace. Journal of Worplace Learning, 7, 463-472.

Hartston, H. (2012). The case for compulsive shopping as an addiction. Journal of Psychoactive Drugs, 44, 64–67.

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Doggy day care: An overview of Puppy Pregnancy Syndrome

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Further reading

Bering, J. (2011). Puppy pregnancy syndrome: Men who think they are pregnant with dogs. Scientific American, November 15. Located at: http://blogs.scientificamerican.com/bering-in-mind/2011/11/15/puppy-pregnancy-syndrome-men-who-are-pregnant-with-dogs/

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

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

Voice of America (2012). Bizarre medical myth persists in rural India.Located at: http://www.voanews.com/content/bizarre-medical-myth-persists-in-rural-india-143818636/179310.html