Category Archives: Drug use

No joking on smoking: My top ten tips for giving up smoking this Stoptober

Although most of my academic research is on behavioural addiction, I have published quite a few papers on more traditional addictions such as alcohol addiction and nicotine addiction (see ‘Further reading’ below). In 2012, I had to watch my mother fight a losing battle with smoking-related lung cancer and chronic obstructive pulmonary disease. She died in September 2012 aged 66 years, and had chain-smoked most of her adult life. This followed the death of my father who also died of smoking-related heart disease, aged just 54.

In my previous blog I looked at ways to reduce alcohol intake as part of the ‘Go Sober For October‘ campaign. In today’s blog I provide my advice for giving up smoking as part of the annual ‘Stoptober’ campaign. In the UK smoking accounts for approximately one in four cancer deaths, and as I said, it’s something I’ve witnessed first-hand. I’m sure most people reading this are aware of the addictive nature of nicotine. As soon as nicotine is ingested via cigarettes, it can pass from lungs to brain within ten seconds and stimulates the release of the neurotransmitter dopamine. The release of dopamine into the body provides reinforcing mood modifying effects. Despite nicotine being a stimulant, many people use cigarettes for both tranquillising and euphoric effects.


Most authorities accept that nicotine is one of the most addictive drugs on the planet and that smokers can become hooked quickly. One of the reasons my own parents were never able to give up was because of the prolonged withdrawal effects they experienced whenever they went more than a few hours without smoking. This would lead to intense cravings for a cigarette. Watching both my parents’ die of smoking-related diseases is enough incentive for me to never smoke a cigarette. Hopefully, others can find the incentives they need to help them give up permanently. Here are my top ten tips to help you (or someone you know and love) stop smoking:

  • (1) Develop the motivation to stop smoking: Many smokers say they would like to stop but don’t really want to. When you take stock, make sure you are clear as to why you want to give up. It may be to save money, to improve your health, to prevent yourself getting a smoking-related disease, or to protect your family from passive smoking. (It could of course be all of the above). Really wanting to give up is the best predictor of successful smoking cessation.
  • (2) Get all the emotional support you can: Another good predictor of whether someone will overcome their addiction to nicotine is having a good support network. You need people around you that will support your efforts to quit. Tell as many people that you know that you are trying to quit. It could be the difference between stopping and starting again.
  • (3) Avoid ‘cold turkey’: Although some people can stop through willpower alone, most people will need to reduce their nicotine intake slowly. The best way of doing this is to replace cigarettes with a safe form of nicotine such as those available from the pharmacy, or on prescription from the doctor.
  • (4) Get support from a professional: Even if you are using a safe form of nicotine from your pharmacist or doctor, cutting out cigarettes completely can be hard. Getting support from a trained NHS stop smoking adviser can double your chances of stopping smoking. To find your nearest free NHS stop smoking service (in the UK call 0300 123 1044) or visit the Smokefree website.
  • (5) Use non-nicotine cigarette shaped substitutes: Smoking is also a habitual behaviour where the feel of it in your hands may be as important as the nicotine it contains. The use of plastic cigarettes or e-cigarettes will help with the habitual behaviour associated with smoking but contain none of the addictive nicotine.
  • (6) Use relaxation techniques: When cravings strike, use relaxation exercises to help overcome the negative feelings. At the very least take deep breaths. There are dozens of relaxation exercises online. Practice makes perfect.
  • (7) Treat yourself: One of the immediate benefits of stopping smoking will be the amount of money you save. At the start of the cessation process, treat yourself to rewards with the money you save.
  • (8) Focus on the positive: Giving up smoking is one of the hardest things that anyone can do. Write down lists of all the positive things that will be gained by stopping smoking. Constantly remind yourself of what the long-term advantages will be that will outweigh the short-term benefits of smoking a cigarette. In short, focus on the gains of stopping rather than what you will miss about cigarettes.
  • (9) Know the triggers for your smoking: Knowing the situations in which you tend to smoke can help in overcoming the urges. Lighting up a cigarette can sometimes be the result of a classically-conditioned response (e.g. having a cigarette after every meal). These often occur unconsciously so you need to break the automatic response and de-condition the smoking. You need to replace the unhealthy activity with a more positive one and re-condition your behaviour.
  • (10) Fill the void: One of the most difficult things when cigarette craving and withdrawal symptoms strike is not having an activity to fill the void. Some things (like engaging in physical activity) may help you in forgetting about the urge to smoke. Plan out alternative activities and distraction tasks to help fill the hole when the urge to smoke strikes (e.g. chew gum, eat something healthy like a carrot stick, call a friend, occupy your hands, do a word puzzle, etc.). However, avoid filling the void with other potentially addictive substances (e.g. alcohol) or activities (e.g. gambling).

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

Further reading

Griffiths, M.D. (1994). An exploratory study of gambling cross addictions. Journal of Gambling Studies, 10, 371-384.

Griffiths, M.D. (2005). A ‘components’ model of addiction within a biopsychosocial framework. Journal of Substance Use, 10, 191-197.

Griffiths, M.D. (2012). First person: Highly-addictive drug killed both of my parents. Nottingham Post, October 1, p.13.

Griffiths, M.D., Parke, J. & Wood, R.T.A. (2002). Excessive gambling and substance abuse: Is there a relationship? Journal of Substance Use, 7, 187-190.

Griffiths, M.D., Wardle, J., Orford, J., Sproston, K. & Erens, B. (2010). Gambling, alcohol consumption, cigarette smoking and health: findings from the 2007 British Gambling Prevalence Survey. Addiction Research and Theory, 18, 208-223.

Griffiths, M.D., Wardle, J., Orford, J., Sproston, K. & Erens, B. (2011). Internet gambling, health. Smoking and alcohol use: Findings from the 2007 British Gambling Prevalence Survey. International Journal of Mental Health and Addiction, 9, 1-11.

Resnick, S. & Griffiths, M.D. (2010). Service quality in alcohol treatment: A qualitative study. International Journal of Mental Health and Addiction, 8, 453-470.

Resnick, S. & Griffiths, M.D. (2011). Service quality in alcohol treatment: A research note. International Journal of Health Care Quality Assurance, 24, 149-163.

Resnick, S. & Griffiths, M.D. (2012). Alcohol treatment: A qualitative comparison of public and private treatment centres. International Journal of Mental Health and Addiction, 10, 185-196.

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

Umeh, K. & Griffiths, M.D. (2001). Adolescent smoking: Behavioural risk factors and health beliefs. Education and Health, 19, 69-71.

Getting to the point: A brief look at injection fetishes

In a previous blog I examined ‘medical fetishism’. One of the sub-types of medical fetishism comprises individuals who derive sexual pleasure and arousal from being the recipients of a medical or clinical procedure (typically some kind of bodily examination). This includes genital and urological examinations (e.g., a gynaecological examination), genital procedures (e.g., fitting a catheter or menstrual cup), rectal procedures (e.g., inserting suppositories, taking a rectal temperature, prostate massage), the application of medical dressings and accessories (e.g., putting on a bandage or nappy, fitting a dental retainer, putting someone’s arm in plaster), and the application and fitting of medical devices (e.g., fitting a splint, orthopaedic cast or brace).

One type of medical fetish that I did not mention was that involving individuals that have ‘injection fetishes’. Obviously this fetish appears to be a very niche sexual behaviour within medical fetishism but there are various online forums and websites that cater for individuals who derive sexual pleasure from the giving or receiving of injections (or watching such acts). For instance, there is a dedicated forum within the website where individuals share their injection stories, the Real Injection website (which features stories and clips from films and news stories where injections are administered), the Needing Needles page on Tumblr (which mainly consists of photographic pictures featuring hypodermic needles), The Injection Girls website (which doesn’t appear to be overtly sexual but would be highly arousing for those with an injection fetish), the Fetish Clinic website (featuring lots of medical fetish videos including injections), and even a dedicated Facebook page on the topic.

In researching this article I came across many online accounts (of various degrees of detail) of people claiming to have an injection fetish. I can’t vouch for the veracity of the statements but they appeared genuine to me:

  • Extract 1: “I am an injection fetish person. [I] Iike to watch injection pictures [and] videos particularly a female being the administrator”.
  • Extract 2: “At [the] age of 18 [years] I was hospitalized for a week. I had to [have an] injection every day [from a] nurse…On [the] first two days she told me to lower my pants [to give the] injection. [She] slowly injected the needle in my fatty butt. On [the] third day I told her to [take] down my jeans by herself. First she hesitated, but [did] it. [The] next day she came and [did it without me asking]. She lowered my jeans…[and] gave [me the] injection on [my] butt…She gave me injections and then made me horny by keeping her hand & finger on [where she had injected me. It felt] uncomfortable. but she still smiled. She obviously teased me and on the same day I [returned] home with an injection fetish”.
  • Extract 3: “I ejaculate [and am] more happy if a nice woman dressed in nurse [gives] me an injection…I like very much the preparation protocol before injection…I have [had] this fetish since I received [my] first injection made by a nurse when I was 10 years old…This is a nice fetish. I know that is not very common but I know some people [who] like it, so we are not alone [in having] curious pleasures”.
  • Extract 4: “I have an injection fetish…When I was younger I got a shot from a nurse and after injected she was getting very fresh and touchy with me. I could not turn her down when she said we must go somewhere and get it on…I have never felt so satisfied after she [injected] me. That’s where it started. She was forceful and demanding. The [injection] shot was large and scary. I wasn’t real thrilled about getting it but she said it [was in my] best interest. So I bent over. She swabbed me. I was a bit resistant. She was persuasive in her words…It was hurting. Then while she was injecting that was hurting too. I was squirming and moaning. But I would love for this to happen again someday”
  • Extract 5: “I have an ‘injection fetish’. That means that I get only sexually attracted when thinking about women getting injections in their butt. I also like to have fantasies about myself getting injections in the butt by woman. This fetish is apparently rare, but also not that uncommon…As such, a fetish might not be something bad, but this one prevents me from having orgasm in normal sexual intercourse. The female vagina does not sexually really attract me…It basically destroys any relationship because I cannot have an orgasm or ejaculate during normal sexual intercourse…Has this specific type of medical fetish (or similar ones…suppositories, enemas, gyno) been researched in medical/psychological science? Once I know where this [fetish] is from, I can understand it and I can control it…To me, it appears I had this fetish from day one (of course, that was not the case, but [that is how] it feels)”.

Unlike the others quoted here, this last extract is from a person also provided further description about himself. He was 39 years of age when he posted his comments and claimed to have developed the fetish in childhood some time between the ages of six to eight years. He claims not to know where the fetish originated, and his only description of his childhood was that he had a father who used to beat him and who wouldn’t let him bring any friends to his house (including girlfriends). Although the accounts here are brief, all five are males, and three of the five extracts mention getting an injection from a nurse at some point on their lives had kick-started their injection fetish and would appear to suggest that associative pairing took place and that their sexual arousal from injections arises as a result of classical conditioning.

It’s also worth mentioning that there are also hard-core pornographic films where injections are central to the ‘plot’ – the 2011 film Lethal Injection being the most infamous example. (I say “infamous” because many newspapers – such as a piece in the Daily Mail – reported that China’s leading state-run news agency Xinhua posted the screen shots from the film on its website under the headline ‘Actual Record of Female Inmate’s Execution – Exposing the World’s Darkest Side’ and claimed it showed a real execution by lethal injection in the United States. In the film itself, a doctor has sex with a woman after she has been given a lethal injection and arguably is more about necrophilia and lust murders than it is about injection fetishes).

Academically, I’m not aware of any research specifically focusing on injection fetishes although a paper by Dr. Allen Bartholomew published back in 1973 in the Australian and New Zealand Journal of Psychiatry alluded to behaviours that have similarities to injection fetishes. Bartholomew was studying the characteristics of intravenous drug users and noted three cases of autohaemofetishism (i.e., deriving sexual pleasure from sight of blood drawn into a syringe during intravenous drug practice, something that I briefly mentioned in a previous blog on vampirism as a sexual paraphilia). He also noted three cases of ‘injection masochism’ in which users were sexually aroused from giving themselves injections. In both of these two features, it was argued by Bartholomew that both of the two features were considered to be brought about by classical conditioning.

More recently, in 2012 issue of the journal Rhizomes in Emerging Knowledge, Dr. Varpu Rantala examined the recurrence of drug injection scenes in contemporary mainstream cinema from a cultural studies perspective. She argued that in cinematic terms:

Injection is a fetish – not only of drug users but a collective one. The injection shots momentarily fix the images of what is thinkable and sayable about intravenous drug use, centering it on an overindulgence in injection and reducing ‘addicted bodies”.

However, the word ‘fetish’ in this context is not being used in any sexual sense. She also makes reference to the portrayal of drug addicts in the work of US writer William Burroughs. Again, this is not used in a sexual sense but she does make some interesting observations about obsession and addiction:

The coolness in Burroughs’s description of a junkie is paradoxically both ice-cold and mobilizing, or attractive, as understood in relation to the attraction image. These images may also be fetishized. Intravenous drug users may develop a fetish for injection, the ‘needle fixation’, an addiction to the injection itself that is often experienced as both repulsive and seductive (Pates et al 2001). But, it seems that “needle fixation” is not only about intravenous drug users: this kind of ambiguous fascination with the injection image as part of late modern mainstream everyday audiovisual culture may even be described a ‘cinematic obsession’: as the ‘hold [of drugs] on the modern imagination [is] seemingly as strong as the hold it has over those addicted to it’ (Boothroyd 2007, 9), ‘it is the ambiguity and duality of the symbolism [of the syringe] that is the source for conflict, and intense pleasurable obsession’ (Fitzgerald 2010, 205). The recurrence of these images in their over-indulgence of sensuous material of extreme explicitness reminds one of the processes of addiction as unwilled repetition of excessive sensual experience: a cinematic addiction…Repetitive, fixed and fetishized, late modern drug injection images are clichés that may ‘penetrate each one of us’ (Deleuze 2005, 212). This may also be about an intense encounter that moves us. In case of the injection shot, they form a place of intensity in a film; an attraction image (Gunning 1990) that reaches towards the viewer and that Williams (1991) has further discussed with respect to porn, horror and melodrama”

Finally, (and staying with films), a few years ago there was an interesting article on the Hannibal Studio Lo website (a site dedicated to critical analysis of all things Hannibal Lecter). Unfortunately, the website is no longer on the internet but one of the contributors to the site made the observation that the author of all the ‘Hannibal Lecter’ books (Thomas Harris) has (in his writing) a fetish for injections, a love-hate relationship for the meaning of getting an injection and its purpose”. The article made references to the many passages in Harris’ books that concern injections but asserts that:

“The most impressive descriptions of injections in the [novel] of ‘Hannibal’ are those given by Dr. Lecter to Clarice Starling. Appearing in Chapter 94 there is a ‘Tiny sting of the finest needle – Starling did not even look down’ and in Chapter 91 there is ‘Day and evening again, the smell of fresh flowers in the house, and once the faint sting of a needle’. The essence of those injections, which would lead her from one life to another and help her cross the final threshold to her transformation. So what do you think is the significance of injections according to the Harris realm? Could it be that one of the ingredients of a dark and profound romance is the intimate enigmatic comfort of Hannibal’s injections? I think it is very interesting to note how Harris’s equation promises that from an ambiguous act that could be considered controlling, true freedom and tranquility are born”.

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

(Note: the original weblink for the article concerning Thomas Harris’ “fetish for injections” was at:

Further reading

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

Bartholomew, A. A. (1973). Two features occasionally associated with intravenous drug users: A note. Australian and New Zealand Journal of Psychiatry, 7(3), 206-207.

Bizarre Magazine (2010). Medical fetishism. December 1. Located at:

Boothroyd, D. (2007). Cinematic heroin and narcotic modernity. In Ahrens, R. and Stierstorfer, K. (eds.), Symbolism: An International Annual of Critical Aesthetics (pp. 7-28). New York: AMS Press.

Deleuze, G. (2005a) Cinema 1: The Movement-Image. London: Continuum.

Fitzgerald, J. (2010). Images of the desire for drugs. Health Sociology Review, 12(2), 205-217.

Pates, R.M., McBride, A.J., Ball, N. & Arnold, K (2001). Towards an holistic understanding of injecting drug use: An overview of needle fixation. Addiction Research and Theory, 9, 3-17.

Rantala, V. (2012). Hardcore: Schizoanalysis as audiovisual thinking of cinematic drug injection images. Rhizomes: Cultural Studies in Emerging Knowledge, 24, 1-12

Wikipedia (2012). Medical fetishism. Located at:

Williams, L. (1991). Film bodies: Gender, genre and excess. Film Quarterly, 44(4), 2-13.

Occupational hazards: The relationship between workaholism, ADHD, and psychiatric disorders

A few weeks ago, my colleagues and I received a lot of media coverage around the world for our latest study on workaholism that was published in the journal PLoS ONE. The study involved researchers from the University of Bergen (Norway) and Yale University USA) and is probably the largest ever study done on the topic as it included 16,426 working Norwegian adults. Our study got a lot of press attention because we examined the associations between workaholism and a number of different psychiatric disorders.

We found that workaholics scored higher on all the psychiatric symptoms than non-workaholics. For instance we found that among those we classed as workaholics (using the Bergen Work Addiction Scale that we published in the Scandinavian Journal of Psychology four years ago and which I talked about in a previous blog), we found that:

  • 32.7% met ADHD (attention-deficit/hyperactivity disorder) criteria (12.7 per cent among non-workaholics).
  • 25.6% met OCD (obsessive-compulsive disorder) criteria (8.7 per cent among non-workaholics).
  • 33.8% met anxiety criteria (11.9 per cent among non-workaholics).
  • 8.9% met depression criteria (2.6 per cent among non-workaholics).

These were all statistically significant differences between workaholics and non-workaholics.

I think a lot of people wondered why we looked at the relationship between workaholism and ADHD to begin with. Firstly, research has consistently demonstrated that Attention-Deficit/Hyperactivity Disorder (ADHD) increases the risk of various chemical and non-chemical addictions. ADHD is prevalent in 2.5–5% of the adult population, and is typically manifested by inattentiveness and lack of focus, and/or impulsivity, and excessive physical activity. Individuals with ADHD may often stop working due to their disorder, and may have trouble in getting work health insurance as they are regarded as a risk group. For this reason, we thought that individuals with ADHD may compensate for this by over-working to meet the expectations required to hold down a job. Although this is a contentious issue, there are a number of reasons why ADHD may be relevant to workaholism.

Firstly, we argued that the inattentive nature of individuals with ADHD causes them to spend time beyond the typical working day (i.e., evenings and weekends) to accomplish what is done by their fellow employees within normal working hours (i.e., the compensation hypothesis). In addition, as they may have a hard time concentrating while at work due to environmental noise and distractions (especially office work in open landscape environments), they might find it easier to work after co-workers have left their working environment or work from home. Their attentive shortcomings may also cause them to overly check for errors on the tasks given, since they often experience careless mistakes due to their inattentiveness. This may cause a cycle of procrastination, work binges, exhaustion, and – in some cases – a fear of imperfection. Although ADHD is associated with lack of focus, such individuals often have the ability to hyper-focus once they find something interesting–often being unable to detach themselves from the task.

Secondly, we argued that the impulsive nature of individuals with ADHD causes them to say ‘yes’ and taking on many tasks without them thinking ahead, and taking on more work than they can realistically handle–eventually leading to workaholic levels of activity. Thirdly, we also argued that the hyperactive nature of individuals with ADHD and the need to be constantly active without being able to relax, causes such individuals to keep on working in an attempt to alleviate their restless thoughts and behaviors. Consequently, work stress might act as a stimulant, and they may choose active (and often multiple) jobs with high pressure, deadlines and activity (e.g., media, sales, restaurant work) – where they have the opportunity to multitask and constantly shift between tasks (e.g., Type-A personality behavior).

In line with this, Type-A personality has often been associated – and sometimes used inter-changeably – with workaholism in previous research. This line of reasoning also relates to the workaholic type portrayed by Dr. Bryan Robinson (in his 2014 book Chained to the desk: A guidebook for workaholics, their partners and children, and the clinicians who treat them), in which he actually denoted “attention-deficit workaholics” (who tend to start many projects but become bored easily and need to be stimulated at all times). His description of the “relentless” type also corresponds well with ADHD symptoms (i.e., unstoppable in working fast and meeting deadlines, often with many projects going on simultaneously). In other words, these types may utilize work pressure to obtain focus, constantly seeking stimulation, crisis, and excitement – and therefore like risky jobs.

Finally, people with ADHD are often mistaken as being lazy, irresponsible, or unintelligent because of their difficulties with planning, time management, organizing, and decision-making. Feeling misunderstood might cause individuals with ADHD to push themselves to prove these misconceptions as wrong – and resulting in an excessive and/or compulsive working pattern. Such individuals are often intelligent, but may feel forced or motivated to start up their own business (i.e., entrepreneurs), as they find it troubling to adjust to standard work schedules or organizational boundaries. Previous research has highlighted that workaholism is prevalent among entrepreneurs and the self-employed. Often failing in other aspects of life (e.g., family), work for such individuals may become even more important to them (e.g., self- efficacy). This is why we hypothesized that ADHD symptoms will be positively associated with workaholism in our study (and that is what we found).

Obsessive-Compulsive Disorder (OCD) is another underlying psychiatric disorder that increases the likelihood of developing an addiction. Full-blown OCD occurs in approximately 2-3% of children and adults, and is commonly manifested by intrusive thoughts and repetitive behaviors of checking, obsessing, ordering, hoarding, washing, and/or neutralizing. It has been suggested that addictive behaviors might represent a coping and/or escape mechanism of OCD symptoms, or as an OCD-behavior that eventually becomes an addiction in itself. Previous workaholic typologies such as those described by Dr. Kimberly Scotti and her colleagues in the journal Human Relations have incorporated the ‘compulsive-dependent’ and ‘perfectionistic’ workaholic types, and some empirical studies have demonstrated that obsessive-compulsive traits are present among workaholics. The OCD tendency of having the need to arrange things in a certain way (i.e., a strong need for control) and obsessing over details to the point of paralysis – may predispose workers with such traits to develop workaholic working patterns. Again we found in our study that OCD symptoms were positively related to workaholism.

It has also been reported that other psychiatric disorders such as anxiety and depression may also increase the risk of developing an addiction. Approximately 30% of people will suffer from an anxiety disorder in their lifetime, and 20% will have at least one episode of depression. These conditions often occur simultaneously, as most people who are depressed also experience acute anxiety. Consequently, anxiety and/or depression can lead to addiction, and vice versa. A number of studies have previously reported a link between anxiety, depression, and workaholism. Furthermore, we know that workaholism (in some instances) develops as an attempt to reduce uncomfortable feelings of anxiety and depression. Working hard is praised and honored in modern society, and thus serves as a legitimate behavior for individuals to combat or alleviate negative feelings – and to feel better about themselves and raise their self-esteem. This is why we hypothesized that there would be a positive association between anxiety, depression, and workaholism (and that is what we found). In relation to our study’s findings as a whole, the lead author of our study (Dr. Cecilie Andreassen) told the world’s media:

“Taking work to the extreme may be a sign of deeper psychological or emotional issues. Whether this reflects overlapping genetic vulnerabilities, disorders leading to workaholism or, conversely, workaholism causing such disorders, remain uncertain…Physicians should not take for granted that a seemingly successful workaholic does not have ADHD-related or other clinical features. Their considerations affect both the identification and treatment of these disorders”.

Our findings clearly highlighted the importance of further investigating neurobiological differences related to workaholic behaviour. Finally, in line with our previous research published two years ago (also in the PLoS ONE journal) using a nationally representative sample, 7.8% of the participants in our latest study were classed as workaholics compared to 8.3% in our previous study.

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

Further reading

Andreassen, C.S., Griffiths, M.D., Hetland, J., Kravina, L., Jensen, F., & Pallesen, S. (2014). The prevalence of workaholism: A survey study in a nationally representative sample of Norwegian employees. PLoS ONE, 9(8): e102446. doi:10.1371/journal.pone.0102446.

Andreassen, C.S., Griffiths, M.D., Hetland, J. & Pallesen, S. (2012). Development of a Work Addiction Scale. Scandinavian Journal of Psychology, 53, 265-272.

Andreassen, C.S., Griffiths, M.D., Sinha, R., Hetland, J. & Pallesen, S. (2016). The relationships between workaholism and symptoms of psychiatric disorders: A large-scale cross-sectional study. PLoS ONE, 11(5): e0152978. doi:10.1371/journal. pone.0152978.

Griffiths, M.D. (2005). Workaholism is still a useful construct. Addiction Research and Theory, 13, 97-100.

Griffiths, M.D. (2011). Workaholism: A 21st century addiction. The Psychologist: Bulletin of the British Psychological Society, 24, 740-744.

Griffiths, M.D. & Karanika-Murray, M. (2012). Contextualising over-engagement in work: Towards a more global understanding of workaholism as an addiction. Journal of Behavioral Addictions, 1(3), 87-95.

Karanika-Murray, M., Duncan, N., Pontes, H. & Griffiths, M.D. (2015). Organizational identification, work engagement, and job satisfaction. Journal of Managerial Psychology, 30, 1019-1033.

Karanika-Murray, M., Pontes, H.M., Griffiths, M.D. & Biron, C. (2015). Sickness presenteeism determines job satisfaction via affective-motivational states. Social Science and Medicine, 139, 100-106.

Orosz, G., Dombi, E., Andreassen, C.S., Griffiths, M.D. & Demetrovics, Z. (2016). Analyzing models of work addiction: Single factor and bi-factor models of the Bergen Work Addiction Scale. International Journal of Mental Health and Addiction, in press

Quinones, C. & Griffiths, M.D. (2015). Addiction to work: recommendations for assessment. Journal of Psychosocial Nursing and Mental Health Services, 10, 48-59.

Quinones, C., Griffiths, M.D. & Kakabadse, N. (2016). Compulsive Internet use and workaholism: An exploratory two-wave longitudinal study. Computers in Human Behavior, 60, 492-499.

Robinson, B.E. (2014). Chained to the desk: A guidebook for workaholics, their partners and children, and the clinicians who treat them. New York: New York University Press.

Scotti, K.A., Moore, K.S., & Miceli, M.P. (1997). An exploration of the meaning and consequences of workaholism. Human Relations, 50, 287–314.

Shonin, E., Van Gordon, W., & Griffiths M.D. (2014). The treatment of workaholism with Meditation Awareness Training: A case study. Explore: Journal of Science and Healing, 10, 193-195.

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

Mack, the life: The psychology of Billy Mackenzie and The Associates

For the past month, the only music I have listened to on my iPod is all the albums by The Associates (along with the solo albums by their lead singer Billy Mackenzie), and have just finished reading Tom Doyle’s excellent biography of Mackenzie The Glamour Chasealso the title of their 1988 LP but remained unreleased until 2002). Mackenzie committed suicide in 1997, a few months before his 40th birthday. Following the death of his mother in the summer of 1996 (who he was very close to), Mackenzie became clinically depressed and took his on January 22nd, 1997 (following a previous suicide attempt on New Year’s Eve 1996).

I have loved The Associates since the early 1980s and became hooked on their music following the 1981 singles ‘White Car in Germany’ and ‘Message Oblique Speech’ (two of the great six singles they released that year and all available on their second LP, Fourth Drawer Down). Even if people don’t like Mackenzie’s recorded outputs, I doubt many people who have heard him sing would dispute how good his multi-octave voice was.


Most people will know The Associates for their classic 1982 top ten album Sulk and the three British hit singles that year – ‘Party Fears Two’ (No.9), ‘Club Country’ (No.13), and ’18 Carat Love Affair’ (No. 21) but I’ve followed their whole career through thick and thin and have every one of their six albums (seven if you include the partial re-recording/remixing of their first album The Affectionate Punch) as well as the three BBC Radio 1 session LPs, the three compilation ‘greatest hits’ collections (Popera, Singles, and The Very Best of Associates), the rarities LP Double Hipness, and their only live album (Billy Mackenzie and The Associates In Concert).

Hailing from Dundee (Scotland), The Associates (Billy Mackenzie and Alan Rankine the two lynch-pin members) formed as punk exploded in 1976. Before changing their name to The Associates in 1979 they used the moniker Mental Torture (a name that biographer Doyle described as “biographically embarrassing”) but as a psychologist a choice of name that I find interesting. The ‘classic’ line-up of The Associates ended at the height of their commercial success in 1982 when Rankine left the band. Following that, many view the next three Associates’ LPs as Billy Mackenzie solo albums in all but name and that he never reached such critical acclaim ever again. That’s a viewpoint I share (despite there being many other great songs in his post-1982 catalogue). The creative and artistic chemistry he shared with Rankine was never bettered in the last 15 years of his life, and even the handful of demos he recorded with Rankine in a short-lived reunion in 1993 (available on the Double Hipness album and on the latest The Very Best of Associates compilation) clearly demonstrated Gestalt psychology’s underlying maxim that the whole was greater than the sum of its parts.

So what was it in Mackenzie’s psyche that killed the goose that laid the golden egg? Rankine didn’t leave the band because of clichéd “creative differences” but left after Mackenzie refused to go on a lucrative US tour (and Rankine knew that touring to promote their music was the only viable option to maintain a successful national and international profile). There appeared to be a combination of factors that led to Mackenzie’s decision including stage fright (i.e., performance anxiety which surfaced throughout his career) and the fact Mackenzie didn’t want to do the usual cycles of making an album, doing the obligatory media circuit, followed by the big tour. In short he didn’t want to play by the accepted rules and conventions – something the underpinned his whole persona. He wanted to be a ‘studio band’ – something that Rankine thought would never work.

My blog had always focused on life’s extremities and much of what Mackenzie did was about living life at the extreme. The liner notes of The Associates most recent CD compilation by Martin Aston neatly sums it up:

“In some ways, The Associates music mirrored their behavioural excess, pioneered by the naughty boy that was Billy Mackenzie, music both lush and visceral, abrasive and ravishing, pure pop and reckless adventurism, devoured and sprayed over an unsuspecting audience”.

(The “sprayed over an unsuspecting audience” was more in reference to the fact that Mackenzie had an unusual ‘gift’ of being able to projective vomit and something he demonstrated on fans in the front row in an early gig where The Associates supported Siouxsie and the Banshees). When it came to music, most of Mackenzie’s collaborators (musicians, singers, producers) describe him as obsessive and a perfectionist. Michael Dempsey, a founding member of The Cure and bass guitarist with The Associates in the early 1980s said: “He was obsessive, always on top of every detail. It was even down to whether you were wearing the right shoes because that was part of the composition and the production to him”. Tom Doyle’s biography is full of stories about Mackenzie taking hours in the studio to get the sound of one right or taking 40 takes to do one song (almost the opposite of David Bowie – one of Mackenzie’s musical heroes – who often recorded songs in one or two takes). Musical collaborators also talk about Mackenzie’s ability to “see” music in his head (which is perhaps not as strange as it sounds as there are countless reports in the psychological and neurological literature of synaesthesia (a neurological phenomenon in which stimulation of one sensory or cognitive pathway leads to automatic, involuntary experiences in a second sensory or cognitive pathway” – for example, some people can see specific colours when they hear a particular piece of music). His obsessiveness was not just restricted to music. His flatmates described his “mildly obsessive hygiene and beauty routines: using an entire tube of toothpaste in one single brushing, spending an eternity rubbing lotions into his skin before he would shave”.

Mackenzie arguably had only three passions in his life – his music, his family, and his love of dogs (and more specifically whippets). He never had any significant romantic relationship in his life (although had a very brief marriage in his teens to American Chloe Dummar when he briefly lived in California). Like Morrissey, Mackenzie was fiercely private about his sexuality and rarely talked about his personal life to the press. It was only in a 1994 interview in Time Out magazine that he first spoke publicly of his bisexuality. I mention Morrissey because it was rumoured that Mackenzie had a brief relationship with him and that Mackenzie was the subject of The Smiths‘ British (No.17) hit single ‘William, It Was Really Nothing’. This appeared to have some legitimacy when during the Associates brief 1993 re-union, Mackenzie wrote a song called ‘Stephen, You’re Really Something’ (Stephen, of course, being Morrissey’s first name).

In both Doyle’s biography (and in a profile piece on The Associates in the latest issue of Mojo magazine by Tom Sheehan), it is noted that Mackenzie had a “particular idea of his own sexuality” and that it was “beyond male and female, beyond sexuality”. Martha Ladly (of one-hit wonders Martha and the Muffins, and backing singer in The Associates in the 1980s) describes him as being “omnisexual…he didn’t see sexuality in people, he saw it in situations and in all things”. The online Urban Dictionary says that omnisexual is “generally interchangeable with pansexual, one whose romantic, emotional, or sexual attractions are geared towards others regardless of sex and/or gender expression” – check out my previous blog on pandrogyny in relation to Throbbing Gristle’s lead ‘singer’ Genesis P. Orridge). In the Mojo article, Rankine said Mackenzie was “very compartmentalised. All the way through [The Associates] it never occurred to me that Bill was having affairs. Everyone he came across he was shagging”. He was arguably a little vain (and overly conscious of his receding hairline in the last decade of his life) and always sought reassuring compliments from those around him about his looks. His obsessive grooming habits appear to provide a good indication of how important his look was to him but I’ve read nothing to suggest that he was narcissistic (although perfectionism is known to be a trait associated with narcissism).

The other personal characteristic that Mackenkie was infamous for was spending money and loved life’s luxuries. One of my research areas is shopping addiction and compulsive buying but on reading Doyle’s biography I don’t think Mackenzie would be classed as a shopaholic or compulsive spender by my own criteria (but did end up bankrupt so was a problematic spender at the very least). Like many people, Mackenzie believed that money was for spending and he spent loads of other people’s money (usually the record company’s) on everything from clothes and daily taxis (including many a black cab ride from London to Dundee), to the best hotel rooms. My view is that he was much more of an impulsive (rather than compulsive) spender.

Many people were surprised (including me) that he was clinically depressed during the last few months of his life because up to the point of his mother’s death, he appeared was always outgoing and extraverted. In his earlier life he was hedonistic and engaged in heavy alcohol drinking and recreational drug use but as he matured the use of psychoactive substances all but disappeared from his life. No-one around him thought he would be the type of person to commit suicide (although it’s worth noting there appears to be an association between perfectionism and depression, and depression is one of the major risk factors for suicide along with stress caused by severe financial difficulties).

One of Mackenzie’s best known songs in The Associates back catalogue is Rezső Seress’ Hungarian suicide song ‘Gloomy Sunday’ (from their 1982 masterpiece Sulk). The Wikipedia entry about the song has a dedicated sub-section on urban legends connected to the song and Doyle’s biography also discussed it:

“While Mackenzie had first encountered ‘Gloomy Sunday’ through the version recorded by Billie Holiday in 1941 that – along with ‘Strange Fruit‘ – remained one of the dark show-stoppers forming a significant element of her repertoire, the song has a morbid history that stretches back to pre-war Hungary. Rezro [sic] Seress composed the mournful song in 1933, the lyric expressing a feeling of futility and helplessness following the death of a loved one, unusual in that it is directed at the person, the narrator detailing numberless shadows and conveying thoughts of suicide”.

Doyle goes on to tell some of the stories that came to be associated with the song being cursed:

“The first reported death associated with ‘Gloomy Sunday’ was that of Joseph Keller, a Budapest shoemaker whose suicide note in 1936 quoted the lyric. In the Hungarian capital alone, seventeen other similar deaths apparently followed, bearing some connection with the song: a couple were said to have shot themselves while a gypsy band performed ‘Gloomy Sunday’; there was talk that a fourteen-year-old girl had thrown herself into a river clutching the sheet music. The song was eventually banned in Hungary, although even these days the occasional piano rendition is performed in the Kis Papa restaurant in Budapest where Seres first aired the song. The legend of ‘Gloomy Sunday’ grew as its apparent effects became further reaching. In New York in the [1940s], there were reports that a typist gassed herself, leaving instructions for the song to be played at her funeral. In London, a policeman was alerted to the fact that a recorded instrumental of the song was being repeatedly played by an unseen female neighbour who, when her flat was entered, was discovered to have overdosed on barbiturates while an automatic phonograph played the song over and over again. Doubtful these tales have been embellished over the years in an effort to emphasize the myth surrounding ‘Gloomy Sunday’, but certain facts remain: the BBC ban imposed on the song in the [1940s] has not been lifted to this day: Holiday suffered a tragic premature death at forty-three form heroin-related liver cirrhosis in 1959; Seress, the song’s composer, himself committed suicide in 1968”.

The Wikipedia entry on ‘Gloomy Sunday’ covers similar ground but is a bit more sceptical. It also references an article on the myth-busting website and notes the BBC ban on the song was lifted in 2002:

“Press reports in the 1930s associated at least nineteen suicides, both in Hungary and the United States, with ‘Gloomy Sunday’, but most of the deaths supposedly linked to it are difficult to verify. The urban legend appears to be, for the most part, simply an embellishment of the high number of Hungarian suicides that occurred in the decade when the song was composed due to other factors such as famine and poverty. No studies have drawn a clear link between the song and suicide. In January 1968, some thirty-five years after writing the song, its composer did commit suicide. The BBC banned Billie Holiday’s version of the song from being broadcast, as being detrimental to wartime morale, but allowed performances of instrumental versions. However, there is little evidence of any other radio bans; the BBC’s ban was lifted by 2002”.

Here is Doyle’s take in relation to Mackenzie in the months after Mackenzie’s mother had died where Mackenzie was having a ‘house leaving’ party:

“The personal grief at the time imbues the song’s lyrics an uneasy resonance that could not have escaped [Mackenzie]. As he lay there singing in the early hours of the Sunday morning following the party, Billy alternated the line ‘Let them not weep, let them know that I’m glad to go’ with his own lamenting alternative: ‘Let them not weep, let them know that I’m sad to go’”.

Arguably his life was a paradox personified. It took him years to get noticed but when he finally made the limelight, he appeared to shun the fame. He lived life his own way on his own terms. Thankfully, while Mackenzie is no longer with us, his music – and his legacy – lives on.

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

Further reading

Dalton, S. (2016). 18-carat love affair. Electronic Sound, 2.0, 70-75.

Doyle, T. (2011). The Glamour Chase: The Maverick Life of Billy Mackenzie (Revised Edition). Edinburgh: Bloomsbury Publishing.

Mikkelson, D. (2007). Gloomy Sunday: Was the song ‘Gloomy Sunday’ banned because it led to too many suicides?, May 23. Located at:

Reynolds, S. (2006). Rip It Up and Start Again: Postpunk, 1978–1984. New York: Penguin.

Sheehan, T. (2016). Beautiful dreamer. Mojo, 272, 50-55.

Vive Le Rock (2016). A rough guide to…The Associates, Vive Le Rock, 35, 84-85.

Wikipedia (2016). Alan Rankine. Located at:

Wikipedia (2016). Billy Mackenzie. Located at:

Wikipedia (2016). Gloomy Sunday. Located at:

Wikipedia (2016). Martha Ladly. Located at:

Wikipedia (2016). Michael Dempsey. Located at:

Wikipedia (2016). The Associates (band). Located at:

Myth world: Addictive personality does not exist

(Please note: This article is a slightly expanded and original version of an article that was first published in The Conversation).

“Life is a series of addictions and without them we die”. This is my favourite quote in the academic addiction literature and was made back in 1990 in the British Journal of Addiction by Professor Isaac Marks. This deliberately provocative and controversial statement was made to stimulate debate about whether excessive and potentially problematic activities such as gambling, sex and work can really be classed as genuine addictive behaviours. Many of us might say to ourselves that we are ‘addicted’ to tea or coffee, our work, or know others who we might describe as having addictions watching the television or using pornography. But is this really true?

The issue all comes down to how addiction is defined in the first place as many of us in the field disagree on what the core components of addiction are. Many would argue that the word ‘addiction’ or ‘addictive’ is used so much in everyday circumstances that word has become meaningless. For instance, saying that a book is an ‘addictive read’ or that a specific television series is ‘addictive viewing’ renders the word useless in a clinical setting. Here the word ‘addictive’ is arguably used in a positive way and as such it devalues the real meaning of the word.

The question I get asked most – particularly by the broadcast media – is what is the difference between a healthy excessive enthusiasm and an addiction and my response is simple – a healthy excessive enthusiasm adds to life whereas an addiction takes away from it. I also believe that to be classed as an addiction, any such behaviour should comprise a number of key components including overriding preoccupation with the behaviour, conflict with other activities and relationships, withdrawal symptoms when unable to engage in the activity, an increase in the behaviour over time (tolerance), and use of the behaviour to alter mood state. Other consequences such as feeling out of control with the behaviour and cravings for the behaviour are often present. If all these signs and symptoms are present I would call the behaviour a true addiction. However, that hasn’t stopped others accusing me of ‘watering down’ the concept of addiction.

A few years ago, Dr. Steve Sussman, Nadra Lisha and I published a large and comprehensive review in the journal Evaluation and the Health Professions examining the co-relationship between eleven different potentially addictive behaviours reported in the academic literature (smoking tobacco, drinking alcohol, taking illicit drugs, eating, gambling, internet use, love, sex, exercise, work, and shopping). We examined the data from 83 large-scale studies and reported an overall 12-month prevalence of an addiction among U.S. adults varies from 15% to 61%. We also reported it plausible that 47% of the U.S. adult population suffers from maladaptive signs of an addictive disorder over a 12-month period, and that it may be useful to think of addictions as due to problems of lifestyle as well as to person-level factors. In short – and with many caveats – our paper argued that at any one time almost half the US population are addicted to one or more behaviours.

There is a lot of scientific literature showing that having one addiction increases the propensity to have other co-occurring addictions. For instance, in my own research I have come across alcoholic pathological gamblers and we can all probably think of individuals that we might describe as caffeine-addicted workaholics. It is also very common for individuals that give up one addiction to replace it with another (which we psychologists call ‘reciprocity’). This is easily understandable as when an individual gives up one addiction it leaves a large hole in the waking lives (often referred to as the ‘void’) and often the only activities that can fill the void and give similar experiences are other potentially addictive behaviours. This has led many people to describe such people as having an ‘addictive personality’.

While there are many pre-disposing factors for addictive behaviour including genetic factors and psychological personality traits such as high neuroticism (anxious, unhappy, prone to negative emotions) and low conscientiousness (impulsive, careless, disorganised), I would argue that ‘addictive personality’ is a complete myth. Even though there is good scientific evidence that most people with addictions are highly neurotic, neuroticism in itself is not predictive of addiction (for instance, there are individuals who are highly neurotic but are not addicted to anything so neuroticism is not predictive of addiction). In short, there is no good evidence that there is a specific personality trait (or set of traits) that is predictive of addiction and addiction alone.

Doing something habitually or excessively does not necessarily make it problematic. While there are many behaviours such as drinking too much caffeine or watching too much television that could theoretically be described as addictive behaviours, they are more likely to be habitual behaviours that are important in an individual’s life but actually cause little or no problems. As such, these behaviours should not be described as an addiction unless the behaviour causes significant psychological and/or physiological effects in their day-to-day lives.

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

Further reading

Andreassen, C.S., Griffiths, M.D., Gjertsen, S.R., Krossbakken, E., Kvan, S., & Ståle Pallesen, S. (2013). The relationships between behavioral addictions and the five-factor model of personality. Journal of Behavioral Addictions, 2, 90-99.

Goodman, A. (2008). Neurobiology of addiction: An integrative review. Biochemical Pharmacology, 75(1), 266-322.

Griffiths, M.D. (1996). Behavioural addictions: An issue for everybody? Journal of Workplace Learning, 8(3), 19-25.

Griffiths, M.D. (2005). A ‘components’ model of addiction within a biopsychosocial framework. Journal of Substance Use, 10, 191-197.

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. & Larkin, M. (2004). Conceptualizing addiction: The case for a ‘complex systems’ account. Addiction Research and Theory, 12, 99-102.

Kerr, J. S. (1996). Two myths of addiction: the addictive personality and the issue of free choice. Human Psychopharmacology: Clinical and Experimental, 11(S1), S9-S13.

Kotov, R., Gamez, W., Schmidt, F., & Watson, D. (2010). Linking “big” personality traits to anxiety, depressive, and substance use disorders: A meta-analysis. Psychological Bulletin, 136(5), 768-821.

Larkin, M., Wood, R.T.A. & Griffiths, M.D. (2006). Towards addiction as relationship. Addiction Research and Theory, 14, 207-215.

Marks, I. (1990). Behaviour (non-chemical) addictions. British Journal of Addiction, 85, 1389-1394.

Nakken, C. (2009). The addictive personality: Understanding the addictive process and compulsive behavior. Hazelden, Minnesota: Hazelden Publishing.

Nathan, P. E. (1988). The addictive personality is the behavior of the addict. Journal of Consulting and Clinical Psychology, 56(2), 183-188.

Musical flares: Bowie, The Beatles, psychology, songs, and addiction

It’s been only two weeks since David Bowie’s untimely death and the Bowie obsessive in me is still finding it difficult to accept. I have never been more upset by the death of someone that I didn’t know personally. The only other celebrity death that left me with such an empty feeling was that of John Lennon back in December 1980. I was only 14 years old but I remember waking up to the news on that Tuesday morning (December 9, the morning after he had been shot in New York by Mark David Chapman). I went to school that day with a feeling I had never experienced before and I got it again two weeks ago when Bowie (co-incidentally) died in New York.

Bowie and The Beatles (and Lennon in particular) are arguably the two biggest musical influences on my life. With my interest in addictive behaviours, Bowie and Lennon are just two of the many celebrities that have succumbed to substance abuse and addiction over the years (and was a topic I covered in a previous blog – ‘Excess in success: Are celebrities more prone to addiction?’). Thankfully, neither of their addictions was that long-lasting, and neither of them wrote that many songs about their drug-fuelled experiences (although Lennon’s ‘Cold Turkey’ about his heroin addiction is a notable exception).

Lennon was arguably one of Bowie’s musical heroes although Bowie’s 1973 covers LP Pin-Ups was notable for the absence of Beatle covers. By 1973, Bowie had covered songs by The Rolling Stones, The Kinks, Pink Floyd, The Pretty Things, and The Who on vinyl but never The Beatles. Having said that, two Beatle songs did play a small part in his concerts between 1972 and 1974. Most notably, The Beatles very first British single ‘Love Me Do’ was often played as a medley with ‘The Jean Genie’. (On the 1990 Sound and Vision Tour, a snippet of ‘A Hard Day’s Night‘ was also sometimes incorporated into ‘The Jean Genie’. He also sang a snippet of ‘With A Little Help From My Friends‘ in the encore of his final concert in 1978). Bowie also occasionally covered ‘This Boy’ (the b-side of ‘I Want To Hold Your Hand’, their fifth British hit single in his concerts) as part of the early ‘Ziggy Stardust’ shows. (I’m probably one of the few people in the world that has this song on bootleg). Speaking of bootlegs, the Chameleon Chronicles CD featured a cover of the 1967 single ‘Penny Lane‘ allegedly by Bowie along with The Monkees song ‘A Little Bit Me, A Little Bit You’ (written by Neil Diamond). Although these songs sound like 1960s Bowie, they were actually from a 1967 LP (Hits ’67) and sung by session singer (Tony Steven). Nicholas Pegg (in his great book The Complete David Bowie) also noted that Bowie’s late 1960s group Feathers included ‘Strawberry Fields Forever‘ in their live set and that Bowie performed ‘When I’m Sixty-Four‘ in his 1968 live cabaret show after his own song ‘When I’m Five‘).

It was in 1975 that Bowie worked with Lennon musically, and Lennon appeared on two songs of Bowie’s 1975 LP Young Americans (although Bowie gave Lennon a name check in his 1971 song ‘Life On Mars‘ – “Now the workers have struck for fame/’Cause Lennon’s on sale again”). The most well-known was ‘Fame’ (one of my own personal favoutrites) which went to No.1 in the US chart (but only No.17 here in the UK) and had a Bowie co-writing credit with Lennon (along with Bowie’s guitarist Carlos Alomar). Lennon was apparently reluctant to be acknowledged as co-writer but Bowie insisted (probably just to say he had a ‘Bowie/Lennon’ song in his canon and maybe because he was a little starstruck). The song should arguably include other co-writers as the riff was based on the song ‘Foot Stompin’’ (also covered by Bowie) by the doo-wop band The Flares (sometime referred to as The Flairs). Lennon also played on a version of The Beatles’ song ‘Across The Universe’ but was arguably the weakest song on the LP. It’s also worth mentioning that the title track also included a line – and tune –  from The Beatles ‘A Day In The Life‘ (“I heard the news today, oh boy”). Bowie and Lennon were also photographed together at the 1975 US Grammy Awards (where Bowie presented the award for the best ‘rhythm and blues’ performance by a female vocalist Aretha Franklin). This was around the height of Bowie’s cocaine addiction and he subsequently went in to say that he has no recollection of being there at all. In the same year, Bowie also appeared on singer Cher‘s US television show and sang a medley of songs that included ‘Young Americans‘ and The Beatles ‘Day Tripper‘.

Like millions of people around the world (including myself), Lennon’s death in 1980 hit Bowie hard. Not only had he lost a good friend, but he began to think of his own mortality and how easy it would be for a crazed fan to kill him in some kind of copycat assassination. At the time, Bowie was receiving rave reviews for his portrayal of Joseph Merrick in The Elephant Man on Broadway. (I’ve always been interested in The Elephant Man as I may even be a distant relation as my grandmother was a Merrick). He soon stepped down from the role and went into ‘semi-retirement’ before re-emerging in 1983 with his biggest selling single and album Let’s Dance.

Since Lennon’s death, Bowie has covered three Lennon solo tracks (‘Imagine’, ‘Mother’, and ‘Working Class Hero’). He sang ‘Imagine’ at a concert in Hong Kong (December 8, 1983) three years to the day since Lennon had been shot (a soundboard recording of which appears on a number of different Bowie bootlegs). In 1989, Bowie recorded the first of two Lennon songs taken from Lennon’s most psychologically inspired album, John Lennon/Plastic Ono Band (1970) written while undergoing primal therapy (see my previous blog for an overview on primal therapy in music). The first was ‘Working Class Hero’ for the 1989 ill-fated album Tin Machine (often voted one of Bowie’s worst cover versions by fans). The second track he recorded was ‘Mother’ (in 1998) for a John Lennon tribute album that Lennon’s widow (Yoko Ono) was putting together. Unfortunately, the album was never released but in 2006 it was leaked on the internet and has now appeared on many Bowie bootlegs. Although Bowie and Lennon never collaborated musically again, they remained close friends until Lennon’s death.

As far as I am aware, the only other Beatle-related song that Bowie has ever recorded was ‘Try Some, Buy Some’ that appeared on George Harrison’s 1973 LP Living In The Material World. Bowie covered the song for his 2003 album Reality, and although this was recorded not long after Harrison’s death from throat cancer, Bowie claimed that he thought it was Ronnie Spector’s song (ex-lead singer of The Ronettes), as she was the first artist to record in 1971. It was also claimed by German newspaper Frankfurter Allgemeine Zeitung (26 January 2013) that Bowie’s 2001 song from Heathen, ‘Everyone Says ‘Hi’’ was a tribute to Harrison but I have yet to see this conformed by anyone within the Bowie camp. Harrison met Bowie in Memphis during his 1974 Dark Horse tour. In a 1974 interview to a New York radio station, Harrison said:

“I just met David Bowie [during the Dark Horse Tour]…David Bowie, these were my very words, and I hope he wasn’t offended by it because all I really meant was what I said. I pulled his hat up from over his eyes and said: ‘Hi, man, how are you, nice to meet you,’ pulled his hat up and said, you know, ‘Do you mind if I have a look at you, to see what you are because I’ve only ever seen those dopey pictures of you.’ I mean, every picture I’ve ever seen of David Bowie, or Elton John, they just look stupid to me…I want to see, you know, who the person is”.

It wasn’t until 1974 that Bowie and Lennon first met each other at a Hollywood party hosted by actress Elizabeth Taylor. Lennon was with his girlfriend May Pang at the time (during his 18-month separation from Yoko). According to Pang, Bowie and Lennon “hit it off instantly” and kept in touch. When John went back to Yoko, Pang remained friends with Bowie and eventually married Tony Visconti, Bowie’s long-time record producer.

One of the more interesting articles on the relationship between Bowie and The Beatles was by Peter Doggett – author of books on both artists. In a 2011 blog he noted:

“I was struck during the research of [my book ‘The Man Who Sold The World’] by the influence that the Beatles had on Bowie’s work in the 70s. Some of that influence is obvious – the McCartney-inspired piano styling of ‘Oh! You Pretty Things‘, for example. As early as 1965, in an obscure song entitled ‘That’s Where My Heart Is’, Bowie sounded as if he was learning how to write songs by listening to [The Beatles second 1963 album] ‘With The Beatles’…in the book I talk about the apparent Fab Four influence on ‘Blackout‘ from the ‘Heroes‘ LP. But the single most dramatic role played by the Beatles in Bowie’s 70s work was exerted by John Lennon’s ‘Plastic Ono Band’ album. You can hear a touch of Lennon in the way Bowie sings ‘Space Oddity’ in 1969; some Beatles-inspired backing vocals on ‘Star’ from the Ziggy Stardust album; and, of course, yer actual Lennon voice and guitar on Bowie’s cover of ‘Across The Universe’ and his hit single ‘Fame’. All of which made me wish that Bowie had made a whole album (1980’s Scary Monsters, perhaps) in similar vein. So I was intrigued to learn from Bowie fan Martyn Mitchell that guitarist Adrian Belew recalled working on a whole set of Plastic Ono Band-inspired tracks with Bowie around this period, but that Bowie never completed or issued them. Perhaps he was hoping that he might persuade Lennon himself to join him in the studio – until fate, and a madman, intervened”.

Following Bowie’s death, the remaining Beatles (Paul McCartney and Ringo Starr) both played tribute to Bowie’s genius. Ringo (who appeared in the Ziggy Stardust and the Spiders From Mars movie filmed in 1973 and released 1983) tweeted a short message, while McCartney’s message was a little more heartfelt:

“Very sad news to wake up to on this raining morning. David was a great star and I treasure the moments we had together. His music played a very strong part in British musical history and I’m proud to think of the huge influence he has had on people all around the world. I send my deepest sympathies to his family and will always remember the great laughs we had through the years. His star will shine in the sky forever”.

As far as I am aware, Bowie only met McCartney a few times in his life most notably at the July 1973 premiere of the James Bond film Live and Let Die (with McCartney writing the theme song), and at the Live Aid concert in 1985 (where Bowie was on of the backing singers as McCartney performed ‘Let It Be’). Yoko movingly described Bowie as a “father figure” to their son Sean Lennon following Lennon’s death:

“John and David respected each other. They were well matched in intellect and talent. As John and I had very few friends, we felt David was as close as family. After John died, David was always there for Sean and me. When Sean was at boarding school in Switzerland, David would pick him up and take him on trips to museums and let Sean hang out at his recording studio in Geneva. For Sean, this is losing another father figure. It will be hard for him, I know. But we have some sweet memories which will stay with us forever”.

It could perhaps be argued that Bowie and Lennon were cut from the same psychosocial cloth. They both had middle class backgrounds and had many of the same musical heroes (Little Richard, Chuck Berry, and Elvis Presley being the most salient – Bowie sharing Presley’s birthday on January 8). They were both interested in the arts more generally and they were both singers, songwriters, artists, and writers (to a greater or lesser extent). Although Lennon rarely engaged in acting, he always appeared at ease in front of the camera. They both knew how to use the media for their own artistic advantage. In short, there’s a lot that psychologists can learn from both of them.

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

Further reading

Buckley, D. (2005). Strange Fascination: David Bowie – The Definitive Story. London: Virgin Books.

Doggett, P. (2009). The Art and Music of John Lennon. London: Omnibus Press.

Doggett, P. (2012). The Man Who Sold The World: David Bowie and the 1970s. London: Vintage.

Goddard, S. (2015). Ziggyology. London: Ebury Press.

Leigh, W. (2014). Bowie: The Biography. London: Gallery.

Pegg, N. (2011). The Complete David Bowie. London: Titan Books.

Seabrook, T.J. (2008). Bowie In Berlin: A New Career In A New Town. London: Jawbone.

Spitz, M. (2009). Bowie: A Biography. Crown Archetype.

Trynka, P. (2011). Starman: David Bowie – The Definitive Biography. London: Little Brown & Company.

“Turn and face the strange”: A personal goodbye to David Bowie

“There is a well known cliché that you should never meet your heroes but if David Bowie or Paul McCartney fancy coming round to my house for dinner I’m pretty sure I wouldn’t be lost for words”.

This was the last sentence I wrote in my blog on the psychology of being starstruck less than a month ago. I, like millions of others, was deeply shocked to learn of Bowie’s death from liver cancer earlier this week (January 10) two days after his 69th birthday.

I first remember hearing David Bowie on a 1975 edition of Top of the Pop(when the re-release of ‘Space Oddity’ reached No.1 in the British singles chart). Although I heard the occasional Bowie song over the next few years (‘Golden Years’, ‘Sound and Vision’ and ‘Boys Keep Swinging’ being some of the songs I taped off the radio during the weekly chart rundown) it wasn’t until ‘Ashes To Ashes’ reached the UK No. 1 spot in the week of my 14th birthday (late August 1980) that I became a Bowie convert.

I still vividly remember buying my first Bowie album – a vinyl copy of his first greatest hits LP (Changesonebowie) on the same day that I bought the third album by The Police (Zenyatta Mondatta) and the latest issue of Smash Hits (that had Gary Numan on the cover with a free yellow flexidisc of the track ‘My Face’ by John Foxx). It was Saturday October 4th, 1980. Ever since that day I’ve been collecting David Bowie music and now have every single song that he has ever commercially released along with hundreds of bootlegs of unreleased songs and live recordings.

My collection of Bowie books is ever growing and I have dozens of Bowie DVDs (both his music and films in which he has appeared). In short, I’m a hardcore fan – and always will be. Like many other fans, I’ve spent all this week listening to his final studio LP (Blackstar) and poring over the lyrics knowing that he wrote all these songs knowing that he had terminal cancer. The first line of ‘Lazarus’ appears particularly poignant in this regard (Look up here, I’m in heaven/I’ve got scars that can’t be seen/I’ve got drama, can’t be stolen/Everybody knows me now/Look up here, man, I’m in danger/I’ve got nothing left to lose”).

Anyone who’s been a regular reader of my blog will know that when I get a chance to mention how important he has been in my life, I do so (and do so in writing). I mentioned him in my articles on the psychology of musical preferences, on the psychology of a record-collecting completist, on record collecting as an addiction, and on the psychology of pandrogyny. I’ve also mentioned him (somewhat predictably) in my articles on the psychology of Iggy Pop, and the psychology of Lou Reed (two more of my musical heroes).

I’ve also been sneaking the titles of his songs into the titles of my blog articles ever since I started my blog including ‘Space Oddity’ (in my article on exophilia), ‘Holy Holy’ (in my article on Jerusalem Syndrome), ‘Ashes To Ashes’ (in my article on ‘cremainlining‘), ‘Under Pressure’ (in my article on inflatable rubber suit fetishism), and ‘Changes’ (in my article on transformation fetishes).

When I started writing this article I did wonder whether to do ‘the psychology of David Bowie’ but there is so much that I could potentially write about that it would take more than a 1000-word blog to do any justice to one of the most psychologically fascinating personalities of the last 50 years (Strange Fascination by David Buckley being one of the many good biographies written about him).

Trying to get at the underlying psychology of someone that changed personas (‘the chameleon of pop’) so many times during his career is a thankless task. However, his desire for fame started early and he was determined to do it any way he could whether it was by being a musician, a singer, an actor, a mime artist, an artist, or an entrepreneur (arguably he has been them all at one time or another). Being behind a mask or creating a persona (or “alternative egos” as Bowie called them) was something that got Bowie to where he wanted to be and I’m sure that with each new character he became, the personality grew out of it.

As an academic that studies addiction for a living, Bowie would be a perfect case study. Arguably it could be argued that he went from one addiction to another throughout his life, and based on what I have read in biographies a case could be made for Bowie being addicted (at one time or another) from cocaine and nicotine through to sex, work, and the Internet.

Bowie also had a personal interest in mental health and various mental disorders ran through his family (most notably his half-brother Terry Burns who was diagnosed as a schizophrenic and committed suicide in January 1985 by jumping in front of a moving train. A number of his aunts were also prone to clinical depression and schizophrenia). Bowie first tackled his “sad [mental] inheritance” in ‘All The Madmen’ (on his 1971 The Man Who Sold The World LP) and was arguably at his most candid on the 1993 hit single ‘Jump They Say’ that dealt with is brother’s mental illness and suicide.

Like John Lennon, I’ve always found Bowie’s views on almost anything of interest and he was clearly well read and articulate. He described himself as spiritual and recent stories over the last few days have claimed he almost became a Buddhist monk. Whether that’s true is debatable but he was certainly interested in Buddhism and its tenets. Now that I am carrying out research into mindfulness with two friends and colleagues who are also Buddhist monks (Edo Shonin and William Van Gordon), I have begun to read more on the topic. One of the things that Buddhism claims is that identity isn’t fixed and nowhere is that more true than in the case of David Bowie. Perhaps the chorus one of his greatest songs – ‘Changes’ from his 1971 Hunky Dory LP says it all:

Ch-ch-ch-ch-changes/Turn and face the strange/Ch-ch-changes/Don’t want to be a richer man/Ch-ch-ch-ch-changes/Turn and face the strange/Ch-ch-changes/Just gonna have to be a different man/Time may change me/But I can’t trace time”

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

Further reading

Buckley, D. (2005). Strange Fascination: David Bowie – The Definitive Story. London: Virgin Books.

Cann, K. (2010). Any Day Now: David Bowie The London Years (1947-1974). Adelita.

Goddard, S. (2015). Ziggyology. London: Ebury Press.

Hewitt, P. (2013). David Bowie Album By Album. London: Carlton Books Ltd.

Leigh, W. (2014). Bowie: The Biography. London: Gallery.

Pegg, N. (2011). The Complete David Bowie. London: Titan Books.

Seabrook, T.J. (2008). Bowie In Berlin: A New Career In A New Town. London: Jawbone.

Spitz, M. (2009). Bowie: A Biography. Crown Archetype.

Trynka, P. (2011). Starman: David Bowie – The Definitive Biography. London: Little Brown & Company.

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:

Cured meets: Treating addictive behaviours

Addiction is a highly prevalent problem within today’s society and there is a lot of time and many spent in trying to prevent and treat the behaviour. There has also been a move towards getting addicts motivated to want to change their behaviour. The most influential model worldwide is probably the ‘stages of change’ model by Dr. James Prochaska and Dr, Carlo Di Clemente that identifies an individual’s ‘readiness for change’ and tries to get a person to a position where they are highly motivated to change their behaviour. The individual stages of this model are:

  • Precontemplation – This is where the person unaware of the consequences of his or her own behaviour and no change in behaviour is foreseeable.
  • Contemplation – This is where the person aware problem exists and is contemplating change.
  • Preparation – This is where the person has decided to change in the near future (e.g., New Year resolution).
  • Action – This is where the person effects change (e.g., gets rid of all association items related to the behaviour).
  • Maintenance – This is where the person consolidates behaviour change over time.
  • Relapse – This where the person reverts to a former behaviour pattern (e.g., contemplation, preparation).

People can stay in one stage for a long time and it is also possible for unassisted change such “maturing out” or “spontaneous remission”. Various techniques can be used to help people prepare for readiness include motivational techniques, behavioural self-training, skills training, stress management training, anger management training, relaxation training, aerobic exercise, relapse prevention, and lifestyle modification. The goal of treatment can be either abstinence or simply to cut down.

The intervention and treatment options for the treatment of addiction include, but are not limited to counselling/psychotherapies, behavioural therapies, cognitive-behavioural therapies, self-help therapies, pharmacotherapies, residential therapies, minimal interventions and combinations of these (i.e., multi-modal treatment packages). The most important of these are outlined below.

Pharmacotherapy: Pharmacological interventions basically consist of addicts being given a drug to help overcome their addiction. These are mainly given to those people with chemical addictions (e.g., nicotine, alcohol, heroin, etc.) but are increasingly being used for those with behavioural addictions (e.g., gambling, sex, work, exercise, etc.). For instance, some drugs produce an unpleasant reaction when used in combination with the drug of dependence, replacing the positive effects of the drug of dependence with a negative reaction. For instance, alcoholics are sometimes prescribed disulfiram (more commonly known as Antabuse), that when combined with alcohol may produce nausea and vomiting. Other common therapies include methadone and the use of opioid antagonists (such as nalaxone or naltrexene) for heroin addiction. The methadone prevents withdrawal symptoms, block the effects of heroin use, and decreases craving. The main criticism of all these treatments is that although the symptoms may be being treated, the underlying reasons for the addictions may be being ignored. On a more pragmatic level, what happens when the drug is taken away? Often, the addicts return to their addiction if this is the only method of treatment used.

Behavioural therapy: Behavioural therapies are based on the view that addiction is a learned maladaptive behaviour and can therefore be ‘unlearned’. These have mainly been based on the classical conditioning paradigm and include aversion therapy, in vivo desensitisation, imaginal desensitisation, systematic desensitisation, relaxation therapy, covert sensitisation, and satiation therapy. All of these therapies focus on cue exposure, and relapse triggers (like the sight and smell of alcohol/drugs, walking through a neighbourhood where casinos are abundant, pay day, arguments, pressure, etc.). The theory is that through repeated exposure to ‘relapse triggers’ in the absence of the addiction, the addict learns to stay addiction free in high-risk situations. It could be argued that if the addiction is caused by some underlying psychological problem, (rather than a learned maladaptive behaviour), then behavioural therapy would at best only eliminate the behaviour but not the problem. This therefore means that the addictive behaviour may well have been curtailed but the problem is still there so the person will perhaps engage in a different addictive behaviour instead.

Cognitive-behavioural therapy: A more recent development in the treatment of addictive behaviours is the use of cognitive-behavioural therapies (CBT). There are many different CBT approaches that have been used in the treatment of addictive behaviours including rational emotive therapy, motivational interviewing, and relapse prevention. The techniques assume that addiction is a means of coping with difficult situations, dysphoric mood, and peer pressure. Treatment aims to help addicts recognise high-risk situations and either avoid or cope with them without use of the addictive behaviour. In relapse prevention, the therapist helps to identify situations that present a risk for relapse (both intrapersonal and interpersonal). Relapse prevention provides the addict with techniques to learn how to cope with temptation (positive self statements, decision review, and distraction activities), coupled with the use of covert modelling (i.e., practicing coping skills in one’s imagination). It also provides skills for coping with lapses (by redefining what is happening), and utilizes graded practice (a desensitization technique where addicts encounter real life situations slowly). Overall, CBT approaches are better researched than the other psychological methods in addiction but are probably no more effective (Luty, 2003).

Psychotherapy: Psychotherapy can include everything from Freudian psychoanalysis and transactional analysis, to more recent innovations like drama therapy, family therapy and minimalist intervention strategies. The therapy can take place as an individual, as a couple, as a family, as a group and is basically viewed as a ‘talking cure’ consisting of regular sessions with a psychotherapist over a period of time. Most psychotherapies view maladaptive behaviour as the symptom of other underlying problems. Psychotherapy often is very eclectic by trying to meet the needs of the individual and helping the addict develop coping strategies. If the problem is resolved, the addiction should disappear. In some ways, this is the therapeutic opposite of pharmacotherapy and behavioural therapy (which treats the symptoms rather than the underlying cause). There has been little evaluation of its effectiveness although most addicts go through at least some form of counselling during the treatment process.

Self-help therapy: The most popular self-help therapy worldwide is the Minnesota Model 12-Step Programme (e.g., Alcoholics Anonymous, Gamblers Anonymous, Narcotics Anonymous, Overeaters Anonymous, Sexaholics Anonymous, etc.). This treatment programme uses a group therapy technique and uses only ex-addicts as helpers. Addicts attending 12-Step groups involves them accepting personal responsibility and views the behaviour as an addiction that cannot be cured but merely arrested. To some it becomes a way of life both spiritually and socially and compared with almost all other treatments it is especially cost-effective (even if other treatments have greater success rates) as the organization makes no financial demands on members or the community. For the therapy to work, the 12-Step Programme asserts that the addict must come to them voluntarily and must really want to stop engaging in their addictive behaviour. Further to this, they are only allowed to join once they have reached “rock bottom”. To date there has been little systematic study of 12-Step groups but drop out rates are very high (typically 80-90%). There are a number of problems preventing evaluation, particularly anonymity, sample bias, and what the criterion for success is. The empirical evidence suggests that self-help support groups’ complement formal treatment options and can support standardized psychosocial interventions.

When examining all the literature on the treatment of addiction, there are a number of key conclusions that can be drawn. These include that: (i) treatment must be readily available, (ii) no single treatment is appropriate for all individuals., (iii) it is better for an addict to be treated than not to be treated, (iv) it does not seem to matter which treatment an addict engages in as no single treatment has been shown to be demonstrably better than any other, (v) a variety of treatments simultaneously appear to be beneficial to the addict, (vi) individual needs of the addict have to be met (i.e., the treatment should be fitted to the addict including being gender-specific and culture-specific), (vi) clients with co-existing addiction disorders should receive services that are integrated, (vii) remaining in treatment for an adequate period of time is critical for treatment effectiveness, (viii) medications are an important element of treatment for many patients, especially when combined with counselling and other behavioural therapies, (ix) recovery from addiction can be a long-term process and frequently requires multiple episodes of treatment, (x) there is a direct association between the length of time spent in treatment and positive outcomes, and (xi) the duration of treatment interventions is determined by individual needs, and there are no pre-set limits to the duration of treatment.

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

Further reading

Griffiths, M.D. (1996). Pathological gambling and its treatment. British Journal of Clinical Psychology, 35, 477-479.

Griffiths, M.D. & Dhuffar, M. (2014). Treatment of sexual addiction within the British National Health Service. International Journal of Mental Health and Addiction, 12, 561-571.

Griffiths, M.D. & H.F. MacDonald (1999). Counselling in the treatment of pathological gambling: An overview. British Journal of Guidance and Counselling, 27, 179-190.

Hayer, T. & Griffiths, M.D. (2015). The prevention and treatment of problem gambling in adolescence. In T.P. Gullotta & G. Adams (Eds). Handbook of Adolescent Behavioral Problems: Evidence-based Approaches to Prevention and Treatment (Second Edition) (pp. 539-558). New York: Kluwer.

King, D.L., Delfabbro, P.H., Griffiths, M.D. & Gradisar, M. (2012). Cognitive-behavioural approaches to outpatient treatment of Internet addiction in children and adolescents. Journal of Clinical Psychology, 68, 1185-1195.

Luty, J. (2003). What works in drug addiction? Advances in Psychiatric Treatment, 9, 280–288.

National Institute on Drug Abuse (1999). Principles of drug addiction treatment: A research-based guide. NIDA.

Potenza, M. & Griffiths, M.D. (2004). Prevention efforts and the role of the clinician. In J.E. Grant & M. N. Potenza (Eds.), Pathological Gambling: A Clinical Guide To Treatment (pp. 145-157). Washington DC: American Psychiatric Publishing Inc.

Prochaska, J.O. and DiClemente, C.C. (1984). The transtheoretical approach: Crossing the traditional boundaries of therapy. Melbourne, Florida: Krieger Publishing Company

Rigbye, J. & Griffiths, M.D. (2011). Problem gambling treatment within the British National Health Service. International Journal of Mental Health and Addiction, 9, 276-281.

United Nations Office on Drugs and Crime/World Health Organization (2008). Principles of Drug Dependence Treatment: Discussion paper. UN/WHO.

Glum drone pleasures: The psychology of Ian Curtis and Joy Division

“Now there’s a really good book…[by French economist] Jacques Attali wrote in the late [1970s] called ‘Noise: The Political Economy of Music’…and the main tenet of that book is that…music is the best form of prophecy that we have…so that working with music or sound is our best way of divining a future, and being able to show to ourselves what’s round the corner in that psychological, or even psychic sense” (writer and graphic designer Jon Wozencroft being interviewed for the 2007 film Joy Division)

As a poverty stricken teenager in the early 1980s, all of my minimal disposable income was spent on buying records, cassettes, and music magazines (and to be honest, 35 years later nothing much has changed except I now buy far too many CDs instead of cassettes). Unlike most of my friends at the time I refused to be pigeon holed as a new romantic, a punk, a mod, or a goth because I liked music from all those genres. In the early 1980s was as equally as likely to buy a record by Adam and the Ants and Bauhaus as I was to buy records by Secret Affair and The Clash. I was also into city music scenes with my favourites being the ‘Liverpool scene’ (Echo and the Bunnymen, Teardrop Explodes, Wah! etc.), the ‘Sheffield scene’ (Human League, Heaven 17, Cabaret Voltaire, etc.), and the ‘Manchester scene’ (Magazine, Buzzcocks, Joy Division, The Smiths, The Passage, etc.).

The Manchester music scene was incredibly buoyant although often portrayed by the music press at the time as psychologically and emotionally ‘miserablist’. My parents could never understand what I saw in the “depressing and alienating music” (as they saw it) of bands like Joy Division and The Smiths. But it was through these bands that I developed an interest in psychology and what could be described as ‘psychgeography of post-punk’. In the case of Joy Division, their geographical location in Manchester and its surrounding area (Salford, Macclesfield) was integral to their music. In fact, a number of commentators (such as Liz Naylor, the co-editor of City Fun fanzine) have asserted that Joy Division “relayed the aura of Manchester” in the late 1970s and early 1980s.

All of my information about Joy Division came from reading the NME, listening to the John Peel Show on Radio 1, and listening to their two studio LPs (Unknown Pleasures and Closer) and assorted singles (that I mainly taped off the radio as most of them were not widely available). I was too young to go to gigs and they rarely appeared on television. Of the four members of Joy Division – Ian Curtis (vocals), Peter Hook (bass guitar), Bernard ‘Barney’ Sumner (guitar), and Stephen Morris (drums) – it was Curtis that captivated my adolescent attention. It was through Curtis’ documented medical conditions that helped develop my interest in psychology. Curtis suffered from epilepsy (like one of musical heroes Jim Morrison of The Doors) and clinical depression. It has also been alleged that he suffered from bipolar disorder (i.e., what used to be called ‘manic depression’) although this was never formally diagnosed (and many of those close to Curtis claim that such a claim is speculative at best).

Descriptions of Curtis’ behaviour on first sight look like bipolar disorder given the reports by his wife and others of his severe mood swings (where on one day he could have feelings of happiness and elation but on the next day could have feelings of intense depression and despair). However, other members of the band claimed that the mood swings were caused by the epilepsy medication Curtis was taking. However, bipolar disorder is not uncommon among musicians given many other high profile rock and pop stars have suffered from it including Brian Wilson (Beach Boys), Syd Barrett (Pink Floyd), Kurt Cobain (Nirvana), Ray Davies (The Kinks), Sinéad O’Connor, Poly Styrene (X-Ray Spex), and Adam Ant (to name just a few). Curtis was never afraid to write about psychological and medical conditions and the song ‘She’s Lost Control’ is arguably the most insightful song ever written about epilepsy (based not on his own experiences, but his observations of a female epileptic client who died while he was an Assistant Disablement Resettlement Officer based at the Job Centre in Macclesfield).

As any Joy Division fan knows, as a result of his severe depression, Curtis committed suicide by hanging himself on May 18, 1980 (a date I always remember because it was my favourite gran’s birthday), just two days before Joy Division were due to go on their first US tour. Even as a 14-year old teenager, I remember going to my local library in Loughborough not long after his death to learn more about depression, epilepsy, suicide, and attempted suicide (as he had two previous attempts to commit suicide earlier that year). I’m not saying that this alone was responsible for my career choice but it certainly facilitated my growing interest in psychology and mental health issues.

It was also through Joy Division that I started to read history books (and still do) on various psychological and non-psychological aspects of Nazism (and is evidenced by my previous blogs on the personality of Adolf Hitler and Nazi fetishism). Back in the late 1970s and early 1980s, Joy Division were often accused of having Nazi tendencies. It didn’t help that their name came from the 1955 novella House of Dolls by Jewish writer and Holocaust survivor Yehiel De-Nu (writing under his pen name Ka-tzetnik 135633). The ‘Joy Division’ was the name given to a group of Jewish women in World War II concentration camps whose only purpose was to provide sexual pleasure to Nazi soldiers. I have to admit I’ve never read any of De-Nu’s books. According to an online article by David Mikies (‘Holocaust Pulp Fiction’), De-Nu’s writings were “often lurid novel-memoirs, works that shock the reader with grotesque scenes of torture, perverse sexuality, and cannibalism“. In the 2006 book Joy Division and the Making of Unknown Pleasures, Jake Kennedy asserted that “Curtis’ fascination with extremes would hint to anyone willing to look beyond the headlines that the choice of name was probably an old fashioned punk exercise,  matter of old habits dying hard”.

One of the bands earliest songs ‘Warsaw’ (which was also their band name prior to becoming Joy Division) is arguably a lyrical biography of Hitler’s deputy Führer Rudolf Hess. The song even begins with the lyric “3 5 0 1 2 5 Go!” (Hess’ prisoner of war serial number after he was captured after flying to the UK in 1941). Another of their early songs ‘No Love Lost’ features a spoken word section with a complete paragraph from The House of Dolls. A 2008 article by music writer Jon Savage in The Guardian newspaper noted that Curtis’ songs “such as ‘Novelty’, ‘Leaders of Men’ and ‘Warsaw’ were barely digested regurgitations of their sources: lumpy screeds of frustration, failure, and anger with militaristic and totalitarian overtones”.

Deborah Curtis (Ian’s wife) also remembered that her husband had a book by John Heartfield that included photomontages of the Nazi Period and that graphically documented the spread of Hitler’s ideals. The cover artwork of the band’s first record, the ‘An Ideal For Living’ EP, also featured a boy member the Hitler Youth drawn by guitarist Barney Sumner banging on a drum. Much of the flirtation with Nazi symbolism was arguably juvenile fascination and playful naivety. It’s also been noted that Joy Division’s early music concentrated on the nihilistic provocations of industrial music’s pioneers Throbbing Gristle (whose music I also examined at length in a previous blog). An interesting 2010 article by Mateo on the A View From The Annex website defended Joy Division’s use of Nazi imagery and lyrics:

“The Labour government´s betrayal of the working class during the 1970s and the rise of Thatcherism at the end of the 1970s heralded a future of mass unemployment, government repression and decaying industry. The perspective taken by Ian Curtis, the band´s sole lyricist, towards this growing authoritarianism and despair is crucial to understand if one is to place the references to fascism found in the band´s album art in the context intended by the artist, that is, a despairing anti-Nazism…Punk at that time was a unique music scene in which battles between anti-racists and neo-nazis were being thrashed out at concerts as the skinheads tried to appropriate the punk aesthetic and hijack the following of alienated, disillusioned working class youth who gravitated towards such a sub-culture in places like Manchester at the beginning of the 1980s…The lyrics of Ian Curtis made it clear that this was a presence suffered and feared as opposed to tolerated or toyed with by the band…Joy Division feared fascism, they did not flirt with it and the artwork and lyrics in ‘An Ideal for Living’ serves as a warning of growing fascistic tendencies in British society…For this, Curtis and his bandmates should be lauded for tackling such a controversial issue and expressing such a well-grounded fear and hostility towards such a veritable enemy of the working class during a swift turn to the right in Britain”.

By all accounts, Curtis was a voracious reader and read books by William Burroughs, Fyodor Dostoyevsky, Franz Kafka, Friedrich Nietzsche, Nikolai Gogol, Jean-Paul Sartre, Hermann Hesse and J.G. Ballard, many of which made their way into various Joy Division songs (an obvious example being their song ‘Interzone’ taken directly from a collection of short stories by William Burroughs). As Jon Savage noted:

“Curtis’s great lyrical achievement was to capture the underlying reality of a society in turmoil, and to make it both universal and personal. Distilled emotion is the essence of pop music and, just as Joy Division are perfectly poised between white light and dark despair, so Curtis’s lyrics oscillate between hopelessness and the possibility, if not need, for human connection. At bottom is the fear of losing the ability to feel”.

J.G. Ballard was a particular inspiration to Curtis (particularly the books High Rise and Crash, the latter of which was about the suffering of car accident victims and sexual arousal, and which I wrote about in a previous blog on symphorophilia). One of Joy Division’s best known songs (the opening ‘Atrocity Exhibition’ from their second LP Closer) took its’ name from Ballard’s collection of ‘condensed novels’ (and given its focus on mental asylums is of great psychological interest). So distinct is Ballard’s work that it gave rise to a new adjective (‘Ballardian’) and defined by the Collins English Dictionary as “resembling or suggestive of the conditions described in J.G. Ballard’s novels and stories, especially dystopian modernity, man-made landscapes and the psychological effects of technological, social or environmental developments”. Given this definition, many of Joy Division’s songs are clearly Ballardian as they examine the emotional and psychological effects of everything around them (including personal relationships on songs such as their most well known and most covered song, and only British hit ‘Love Will tear Us Apart’).

The overriding psychology and underlying philosophy of both Ian Curtis and Joy Division are both contradictory and complex but ultimately the band members were a product of the environment they were brought up in and the sum of their musical and literary influences. At the age of 24 years, Curtis’ suicide was undoubtedly tragic and like many other literary and musical ‘artists’, his death has been somewhat romanticized by the mass media. Although he didn’t quite make it into the infamous ‘27 Club’ of ‘rock martyr’ musicians that died when they were 27 years (e.g., Dave Alexander [The Stooges], Chris Bell [Big Star], Kurt Cobain [Nirvana], Richey Edwards [Manic Street Preachers], Pete Ham [Badfinger], Jimi Hendrix, Robert Johnson, Brian Jones [Rolling Sones], Janis Joplin, Jim Morrison [The Doors], Amy Winehouse) he is surely a candidate for being a prime honorary member (along with Jeff Buckley). Retrospectively looking at his lyrics (In the shadowplay, acting out your own death, knowing no more” from ‘Shadowplay’, you can’t help but wonder (given that many of them were autobiographical) whether Curtis’ death could have been prevented by those closest to him.

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

Further reading

Curtis, D. (1995). Touching From A Distance. London: Faber and Faber.

Curtis, I., Savage, J. & Curtis, D. (2015). So This Is Permanence: Joy Division Lyrics and Notebooks. London: Faber and Faber.

Gleason. P. (2015). This Is the Way: “So This Is Permanence” by Ian Curtis. Located at:

Hook, P. (2013). Unknown Pleasures: Inside Joy Division. London: Simon and Schuster.

Kennedy, J. (2006). Joy Division and the Making of Unknown Pleasures. London: Omnibus.

Mikies, D. (2012). Holocaust pulp fiction. The Tablet, April 19. Located at:

Morley, P. (2007). Joy Division: Piece by Piece: Writing About Joy Division 1977-2007. London: Plexus Publishing.

Reynolds, S. (2006). Rip It Up and Start Again: Postpunk, 1978–1984. New York: Penguin.

Savage, J. (2008). Controlled chaos. The Guardian, May 10. Located at: