Category Archives: Drug use

Seedy CD*: A psychologist’s look at the music of Soft Cell

In a previous blog on examining all Adam Ant’s songs about sexual paraphilias, I noted that Soft Cell are probably the only other recording artists who come close to talking about the seedier side of sex. They are also artists that (like one of my other favourite bands, Throbbing Gristle) have never been afraid to sing about taboo topics including prostitution (‘Secret Life’, A Divided Soul’), a housewife’s sexual fantasy about the paper boy (‘Kitchen Sink Drama’), pure hedonism (‘Sensation Nation’), alternative therapies such as colonic irrigation, meditation, and crystal therapy (‘Whatever It Takes’), murder (‘The Best Way To Kill’, ‘Meet Murder My Angel’), suicide (‘Darker Times’, ‘Frustration’ and ‘Down In The Subway’ – “Jump on that train track and die”), incest (‘I Am 16’), psychopathic killers (‘Martin’ based on the story of a serial killer in a film of the same name), shopaholism (‘Whatever It Takes’), anorexia nervosa (‘Excretory Eat Anorexia’), and obsessional cleansing (‘Cleansing Fanatic’), to name but a few.

Soft Cell arguably saw themselves as outside of the norm. Their first official release, an EP entitled ‘Mutant Moments’ EP set out their psychological store (and where ‘Metro Mr. X’ was their “favourite mutant”). They also had a track on the seminal 1980 (various artists) Some Bizarre Album about a disfigured woman (‘The Girl With The Patent Leather Face’). Very few artists would ever sing about such topics (although there are a few exceptions such as Throbbing Gristle’s ‘Hamburger Lady’ based on the medical case notes of a badly burned woman).

Soft Cell’s reputation as a band that focused on the sleazy side of everyday life was cemented after the release of their 1981 debut album Non-Stop Erotic Cabaret (NSEC). The cover featured a photo of the band’s two members (Marc Almond and Dave Ball) taken outside the Raymond Revue Bar, a notorious strip joint in the heart of London’s Soho district.

Just as the Velvet Underground’s debut album was viewed as a ‘sex and drugs’ LP because of a couple of songs about sadomasochistic sex (‘Venus In Furs’) and drug-taking (‘Heroin’), NSEC’s reputation as a ‘sleazy sex’ album also rested on just a few songs – most notably ‘Seedy Films’ (about telephone sex as well as pornographic films), ‘Secret Life’ (about using prostitutes behind a wife’s back), and the (now infamous) ‘Sex Dwarf’ (a song glorifying sadomasochistic sex). Later songs and albums also touched on various aspects of sexuality (their third album This Last Night In Sodom raising a few eyebrows on its’ release in 1984). They wanted to “try all of the vices” (in ‘The Art Of Falling Apart’) and also sang about having sex in cars (‘It’s A Mug’s Game’ and ‘Where Was Your Heart [When You Needed It Most’).

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One of my personal favourite in the Soft Cell canon is the 2002 song ‘Perversity’ which was a bonus track on their comeback single ‘Monoculture’ after reforming in 2001. It talked about studying at the “university of perversity” and provided me with the title to my series of blogs on the A-Z of little known paraphilias and fetishes. As Marc Almond and Friends, there was also a great cover version of Throbbing Gristle’s ‘Discipline’ (a song about sadomasochism) and ‘Sleaze It, Take It, Shake It’ (by Almond’s side-project, Marc and the Mambas)

Soft cell’s second hit single ‘Bedsitter’ summed up my formative years as a teenage clubber and shares some of the same lyrical DNA as The Smiths classic ‘How Soon Is Now?’ (going to nightclubs in search of love and/or sex but going home alone). I’d also argue that Soft Cell sometimes give The Smiths a run for their money when it comes to songs about misery (e.g., ‘Chips On My Shoulder’, ‘Mr. Self-Destruct’, ‘Bleak Is My Favourite Cliché’, ‘Forever The Same’, ‘Down In The Subway’ and ‘Born To Lose’).

But Soft Cell aren’t just about sex, they also like songs about love more generally although their take on love is more about the unrequited love, the disintegration of love (‘Tainted Love’, ‘Say Hello, Wave Goodbye’, ‘Where Did Our Love Go?’, ‘All Out Of Love’, ‘Together Alone’, ‘Desperate [For Love]’, ‘L.O.V.E. Feelings’, ‘Whatever It Takes’, ‘Last Chance’, ‘What’, ‘Barriers’, ‘Disease And Desire’, ‘Her Imagination’, ‘Desperate’, and ‘Torch’). In short they focus on (as they describe in their song ‘Loving You, Hating Me’) “the other side of love” and the “devil in my bed” (‘from ‘God-Shaped Hole’). The only other band that have explored the ‘darker’ side of love lyrically in so many different songs are Depeche Mode (which I discussed in a previous blog on obsessional lyrics in pop music). Their songs aren’t afraid to feature one-night stands and casual sex (‘Numbers’, ‘Surrender To A Stranger’, ‘Heat’, ‘Where Was Your Heart [When You Needed It Most’ and ‘Fun City’). It’s also worth noting that Soft Cell were never afraid to talk about drug use in their songs including cocaine (‘Frustration’), LSD (‘Frustration’), alcohol (‘It’s A Mug’s Game’), valium (‘Tupperware Party’, ‘My Secret Life’), heroin (‘L’Esqualita’) and their “dealer in the hall” (‘Divided Soul’).

They also made cover versions that were often better than the originals. They sexed the songs up or made them mean, moody and menacing. Soft Cell were huge fans of Northern soul and is evident in their covers of songs like ‘Tainted Love’, ‘The Night’ and ‘Where Did Our Love Go?’ but their other cover versions came from a wide variety of artists including Jimi Hendrix (their 11-minute ‘Hendrix Medley’ comprising ‘Hey Joe’, ‘Purple Haze’ and ‘Voodoo Chile’), Johnny Thunders (‘Born To Lose’), Suicide (‘Ghostrider’), Lou Reed (‘Caroline Says’ as Marc and the Mambas), and John Barry (‘007 Theme’ and ‘You Only Live Twice’). From the very first note, this were instantly Soft Cell even though they didn’t write the songs.

Lyrically (and musically), some of their best songs were on their final 2000 studio album Cruelty Without Beauty. For instance, ‘Caligula Syndrome’ depicts sadomasochism (“crawling down on your hands and knees like slaves”), orgies, and “every kind of deviation on demand”. The song ‘Grand Guignol’ is about the Parisian theatre that operated from 1897 until it closed in 1962. The theatre specialised in naturalistic amoral horror entertainment shows horror shows or as Soft Cell put it: It’s Grand Guignol/It’s rock ‘n’ roll/It’s vaudeville and burlesque/All of human life is here/In the theatre of the grotesque”. A sentiment that (I would argue) also sums up the many of the blogs I have published on this website.

*With thanks to The Passage (one of my favourite bands) who used the homonym ‘Seedy’ when naming their first CD [C-D, geddit?] compilation.

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

Further reading

Almond, M. (1999). Tainted Life. London: Sidgwick and Jackson.

Almond, M. (2004). In Search Of The Pleasure Palace. London: Sidgwick and Jackson.

Fanni Tutti, C. (2017). Art Sex Music. Faber & Faber: London.

Lindsay, M. (2013). Sex music for gargoyles: Soft Cell’s The Art Of Falling Apart. The Quietus, December 12. Located at: http://thequietus.com/articles/14100-soft-cell-interview-marc-almond

Reed, J. (1999). Marc Almond: The Last Star. London: Creation Books.

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

Tebbutt, S. (1984). Soft Cell. London: Sidgwick and Jackson.

Wikipedia (2017). Marc Almond. Located at: https://en.wikipedia.org/wiki/Marc_Almond

Wikipedia (2017). Soft Cell. Located at: https://en.wikipedia.org/wiki/Soft_Cell

Group therapy: The psychology of the Beatles

Although I love many musical groups and singers, the Beatles have always been (and always will be) my all-time favourite band. Being an obsessive fan of the group is not cheap because there is almost a never-ending supply of products that can be bought including records, CDs, DVDs, books, and other merchandise such as mugs, t-shirts, coasters, and games. I’m a sucker for it all and as a record collecting completist, I have to have every single track they have ever recorded on both official releases and bootlegs (my latest acquisition being the 6-disc collector’s edition of Sgt. Pepper’s Lonely Hearts Club Band). It’s both fun and expensive (but thankfully I have few vices) and the Beatles are one of the few artists that I have spent thousands and thousands of pounds indulging my passion for their music (others include David Bowie, Adam Ant, The Smiths [and Morrissey], Gary Numan, Velvet Underground [and Lou Reed and John Cale], John Foxx [and Ultravox], Art of Noise [and other ZTT bands], and Iggy Pop [and The Stooges]).

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One of the reasons I chose to study psychology at university was because John Lennon underwent primal therapy (a trauma-based psychotherapy) in 1970 with its’ developer (US psychotherapist Dr. Arthur Janov). I read Janov’s first book (The Primal Scream) in 1983 just because of my love of Lennon’s work, and psychology sounded far more interesting than the ‘A’ levels I was doing at the time (maths, physics, chemistry and biology). As the Wikipedia entry on primal therapy notes:

The musician John Lennon and his wife, Yoko Ono, went through primal therapy in 1970. A copy of the just-released The Primal Scream arrived in the mail at Lennon’s home, Tittenhurst Park (sources differ about who sent the book). Lennon was impressed, and he requested primal therapy to be started at Tittenhurst. Arthur Janov and his first wife, Vivian Janov, went to Tittenhurst in March 1970 to start the therapy, which continued in April in Los Angeles. Arthur Janov went to Tittenhurst after giving instructions in advance about the isolation period and giving instructions to Lennon to be separated from Ono. Lennon and Ono had three weeks of intensive treatment in England before Janov returned to Los Angeles, where they had four months of therapy. According to some sources, Lennon ended primal therapy after four months…Lennon commented after therapy, ‘I still think that Janov’s therapy is great, you know, but I do not want to make it a big Maharishi thing’ and ‘I just know myself better, that’s all. I can handle myself better. That Janov thing, the primal scream and so on, it does affect you, because you recognize yourself in there…It was very good for me. I am still ‘primal’ and it still works.’ and ‘I no longer have any need for drugs, the Maharishi or the Beatles. I am myself and I know why’”.

Lennon didn’t undergo primal therapy until just after the Beatles had split up and it was his 1970 solo LP (John Lennon/Plastic Ono Band) that included many songs that were rotted in his primal therapy experiences including ‘Mother’, ‘My Mummy’s Dead’, ‘God’, ‘Working Class Hero’, ‘Remember’, and ‘Well Well Well’. Many describe this LP as Lennon at his most raw and the album is all the better for it.

At university, one of my favourite topics was Gestalt psychology and its basic tenet that ‘the whole is more than the sum of its parts’ to me encapsulates The Beatles as a whole. John Lennon, Paul McCartney, George Harrison and Ringo Starr were all brilliant in their own musical sphere but little of their best solo work – with the odd exception – was ever as good as the best of their work with the Beatles. For whatever reason, the Beatles working as a foursome – even when the songs had been written individually – produced music as a group that was better than music on their solo LPs. The Beatles early solo recordings (1970-71) included songs that had typically been written while they were still in The Beatles. For instance, many of the songs on George Harrison’s brilliant (and best) album, All Things Must Pass, had been practiced and rehearsed during the making of the Beatles’ final LP Let It Be.

In previous blogs I have looked at celebrities’ use of illicit drugs (one on celebrities in general and whether they are more prone to addiction, one on David Bowie, The Beatles and addiction, and a third one looking at the use of psychoactive substance use on the process of creativity). My first awareness of illicit drugs was reading about the Beatles’ use of various substances in many biographies I read during my early adolescence. When it came to drugs, the Beatles appeared to have seen and done it all. In their pre-fame days in early 1960s Hamburg they all lived on a diet of pills, poppers, and stimulants just to get through their hours of playing every single day. Like many hard working musicians they used a combination of ‘uppers’ and ‘downers’ to regulate their day-to-day living. By the mid-1960s they were all smoking marijuana and taking LSD which may or may not have helped the creative juices to flow. By the end of the 1960s, Lennon was hooked on heroin and recorded one of his most infamous hits about its withdrawal symptoms (‘Cold Turkey’).

By the late 1960s, the Beatles (along with many of the big pop stars of the day) were also searching for other mind altering experiences and the ‘meaning of life’ which led them to the Maharishi Mahesh Yogi (‘Maharishi’ meaning ‘great seer’) and his teachings on transcendental meditation (TM). I myself dabbled in TM during the early 1990s, and over the last few years I have developed a new line of research on mindfulness meditation with my colleagues Edo Shonin and William Van Gordon (see ‘Further reading’). The Beatles (and George Harrison particularly) stimulated me to learn more about Buddhist philosophy. One of the Beatles most innovative songs ‘Tomorrow Never Knows’ – the final track on the 1966 Revolver album – was written by Lennon after reading The Psychedelic Experience: A Manual Based on The Tibetan Book of the Dead written by Timothy Leary, Ralph Metzner and Richard Alpert. However, it was Harrison who was most swayed and his spiritual beliefs rooted in Buddhism stayed with him until his dying day. Although I am not religious in the slightest, the lyrics to some of Harrison’s best songs while he was in The Beatles dealing with Buddhist philosophy are simply beautiful (‘Within You, Without You’ and ‘The Inner Light’ being the best examples; arguably you could add Lennon’s ‘Across The Universe’ to this list).

When I first started listening to The Beatles at the age of around 5 or 6 years of age, it was the music and the melodies that I loved (particularly the 1962-1965 period). By my late teens it was the later songs (1966-1969) and the more sophisticated musical layers that I loved (and still do). Now when I listen to their songs I am most interested in what the songs are trying to say and their philosophical or psychological underpinnings. Any analysis of their songs over time demonstrates that they went from a repertoire dominated by songs about love and relationships (‘Love Me Do’, ‘Please Please Me’, ‘From Me To You’, ‘She Loves You’, and ‘I Wanna Hold Your Hand’, ‘Eight Days A Week’) to a much wider range of topics many of which covered psychological topics such as childhood nostalgia (‘In My Life’, ‘Strawberry Fields Forever’, and ‘Penny Lane’), mind-wandering (‘Fixing A Hole’), domestic violence (‘Getting Better’), jealousy (‘Run For Your Life’, ‘You Can’t Do That’, ‘What Goes On’), casual sex/one-night stands (‘The Night Before’, ‘Day Tripper’), prostitution (‘Polythene Pam’, ‘Maggie Mae’), [alleged] drug use (‘Dr. Robert’, ‘A Day In The Life’, ‘Happiness Is A Warm Gun’, ‘What’s The New Mary Jane‘), running away from home (‘She’s Leaving Home’), homelessness (‘Mean Mr. Mustard’), insomnia (‘I’m So Tired’), depression due to relationship troubles (‘I’m Down’, ‘I’m A Loser’, ‘Help’, ‘Baby’s In Black’, ‘Yesterday’, ‘You’ve Got To Hide Your Love Away’, ‘Ticket To Ride’, ‘For No-One’), suicide (‘Yer Blues’), murder (‘Maxwell’s Silver Hammer’), and death (‘She Said She Said’, ‘Tomorrow Never Knows’).

There were also those songs that were overtly political (‘Taxman’, ‘Revolution’), self-referential (‘Glass Onion’), and autobiographical (‘The Ballad of John and Yoko’, ‘Julia’, ‘Dear Prudence’, ‘Norwegian Wood [This Bird Has Flown]) to songs that were rooted in surrealism (most notably ‘I Am The Walrus’, ‘Lucy In The Sky With Diamonds’, ‘What’s The New Mary Jane‘) and the experimental avant garde (‘Revolution 9’, ‘You Know My Name [Look Up The Number]‘, and – the yet to be released and holy grail for Beatles collectors – ‘Carnival of Light’).

In short, repeated listening to The Beatles’ output brings me continued pleasure. I feel good when I listen to the Beatles. I can listen to The Beatles and create playlists to reflect the mood I’m in. I can simply read the lyrics to their songs and look for meanings that probably weren’t intended by the songwriter. In short, I am constantly rewarded by listening to (and analysing the lyrics of) The Beatles. For me, listening to The Beatles is quite simply “group therapy”!

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

Further reading

The Beatles (1988). The Beatles Lyrics: The Songs of Lennon, McCartney, Harrison and Starr. London: Omnibus Press.

Davies, H. (2009). The Beatles: The Authorised Biography. London: Ebury.

Goldman, A. (1988). The Lives of John Lennon. W. Morrow.

Lewisohn, M. (1990). The Complete Beatles Chronicle. London: Harmony Books.

Janov, A. (1970). The Primal Scream. New York: Dell Books.

Janov A (1977). Towards a new consciousness. Journal of Psychosomatic Research, 21, 333–339.

Janov, A. (1980). Prisoners of Pain: Unlocking The Power Of The Mind To End Suffering. New York: Anchor Books.

Norman, P. (2011). Shout! the Beatles in their generation. New York: Simon and Schuster.

Sheff, D., & Golson, G. B. (1982). The Playboy Interviews with John Lennon and Yoko Ono. New York: Penguin Group.

Shonin, E., Van Gordon W., Compare, A., Zangeneh, M. & Griffiths M.D. (2015). Buddhist-derived loving-kindness and compassion meditation for the treatment of psychopathology: A systematic review. Mindfulness, 6, 1161–1180.

Shonin, E., Van Gordon W., & Griffiths, M.D. (2014). Current trends in mindfulness and mental health. International Journal of Mental Health and Addiction, 12, 113-115.

Shonin, E., Van Gordon W., & Griffiths M.D. (2014). The emerging role of Buddhism in clinical psychology: Towards effective integration. Psychology of Religion and Spirituality, 6, 123-137.

Shonin, E., Van Gordon, W. & Griffiths, M.D. (2015). Does mindfulness work? Reasonably convincing evidence in depression and anxiety. British Medical Journal, 351, h6919 doi: 10.1136/bmj.h6919.

Shonin, E., Van Gordon, W., & Griffiths, M.D. (2016). Mindfulness and Buddhist-derived Approaches in Mental Health and Addiction. New York: Springer.

Van Gordon, W., Shonin, E., & Griffiths, M.D. (2017). Buddhist emptiness theory: Implications for the self and psychology. Psychology of Religion and Spirituality, in press.

Van Gordon W., Shonin, E., Griffiths M.D. & Singh, N. (2015). There is only one mindfulness: Why science and Buddhism need to work together. Mindfulness, 6, 49-56.

Wenner, J. (2001). Lennon Remembers. Verso.

Wikipedia (2017). Arthur Janov. Located at: http://en.wikipedia.org/wiki/Arthur_Janov

Wikipedia (2017). Primal therapy. Located at: http://en.wikipedia.org/wiki/Primal_therapy

Art in the right place: Cosey Fanni Tutti’s ‘Art Sex Music’

Five years ago I wrote a blog about one of my favourite bands, Throbbing Gristle (TG; Yorkshire slang for a penile erection). In that article, I noted that TG were arguably one of “the most extreme bands of all time” and “highly confrontational”. They were also the pioneers of ‘industrial music’ and in terms of their ‘songs’, no topic was seen as taboo or off-limits. In short, they explored the dark and obsessive side of the human condition. Their ‘music’ featured highly provocative and disturbing imagery including hard-core pornography, sexual manipulation, school bullying, ultra-violence, sado-masochism, masturbation, ejaculation, castration, cannibalism, Nazism, burns victims, suicide, and serial killers (Myra Hindley and Ian Brady).

I mention all this because I have just spent the last few days reading the autobiography (‘Art Sex Music‘) of Cosey Fanni Tutti (born Christine Newbie), one of the four founding members of TG. It was a fascinating (and in places a harrowing) read. As someone who is a record-collecting completist and having amassed almost everything that TG ever recorded, I found Cosey’s book gripping and read the last 350 pages (out of 500) in a single eight-hour sitting into the small hours of Sunday morning earlier today.

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TG grew out of the ‘performance art’ group COUM Transmissions in the mid-1970s comprising Genesis P-Orridge (‘Gen’, born Neil Megson in 1950) and Cosey. At the time, Cosey and Gen were a ‘couple’ (although after reading Cosey’s book, it was an unconventional relationship to say the least). TG officially formed in 1975 when Chris Carter (born 1953) and Peter ‘Sleazy’ Christopherson (1955-2010). Conservative MP Sir Nicholas Fairburn famously called the group “wreckers of civilisation” (which eventually became the title of their 1999 biography by Simon Ford).

As I noted in my previous article, TG are – psychologically – one of the most interesting groups I have ever come across and Cosey’s book pulled no punches. To some extent, Cosey’s book attempted to put the record straight in response to Simon Ford’s book which was arguably a more Gen-oriented account of TG. Anyone reading Cosey’s book will know within a few pages who she sees as the villain of the TG story. Gen is portrayed as an egomaniacal tyrant who manipulated her. Furthermore, she was psychologically and physically abused by Gen throughout their long relationship in the 1970s. Thankfully, Cosey fell in love with fellow band member Chris Carter and he is still the “heartbeat” of the relationship and to who her book is dedicated.

Like many of my favourite groups (The Beatles, The Smiths, The Velvet Underground, Depeche Mode), TG were (in Gestaltian terms) more than the sum of their parts and all four members were critical in them becoming a cult phenomenon. The story of their break up in the early 1980s and their reformation years later had many parallels with that of the Velvet Underground’s split and reformation – particularly the similarities between Gen and Lou Reed who both believed they were leaders of “their” band and who both walked out during their second incarnations.

Cosey is clearly a woman of many talents and after reading her book I would describe her as an artist (and not just a ‘performance artist’), musician (or maybe ‘anti-musician in the Brian Eno sense of the word), writer, and lecturer, as well as former pornographic actress, model, and stripper. It is perhaps her vivid descriptions of her life in the porn industry and as a stripper that (in addition to her accounts of physical and psychological abuse by Gen) were the most difficult to read. For someone as intelligent as Cosey (after leaving school with few academic qualifications but eventually gaining a first-class degree via the Open University), I wasn’t overly convinced by her arguments that her time working in the porn industry both as a model and actress was little more than an art project that she engaged in on her own terms. But that was Cosey’s justification and I have no right to challenge her on it.

What I found even more interesting was how she little connection between her ‘pornographic’ acting and modelling work and her time as a stripper (the latter she did purely for money and to help make ends meet during the 1980s). Her work as a porn model and actress was covert, private, seemingly enjoyable, and done behind closed doors without knowing who the paying end-users were seeing her naked. Her work as a stripper was overt, public, not so enjoyable, and played out on stage directly in front of those paying to see her naked. Two very different types of work and two very different psychologies (at least in the way that Cosey described it).

Obviously both jobs involved getting naked but for Cosey, that appeared to be the only similarity. She never ever had sex for money with any of the clientele that paid to see her strip yet she willingly made money for sex within the porn industry. For Cosey, there was a moral sexual code that she worked within, and that sex as a stripper was a complete no-no. The relationship with Gen was (as I said above) ‘unconventional’ and Gen often urged her and wanted her to have sex with other men (and although she never mentioned it in her book, I could speculate that Gen had some kind of ‘cuckold fetish’ that I examined in a previous blog as well as some kind of voyeur). There were a number of times in the book when Cosey appeared to see herself as some kind of magnet for unwanted attention (particularly exhibitionists – so-called ‘flashers’ – who would non-consensually expose their genitalia in front of Cosey from a young age through to adulthood). Other parts of the book describe emotionally painful experiences (and not just those caused by Gen) including both her parents disowning her and a heartfelt account of a miscarriage (and the hospital that kept her foetus without her knowledge or consent). There are other sections in the book that some readers may find troubling including her menstruation art projects (something that I perhaps should have mentioned in my blog  on artists who use their bodily fluids for artistic purposes).

Cosey’s book is a real ‘warts and all’ account of her life including her many health problems, many of which surprisingly matched my own (arrhythmic heart condition, herniated spinal discs, repeated breaking of feet across the lifespan). Another unexpected connection was that her son with Chris Carter (Nick) studied (and almost died of peritonitis) as an undergraduate studying at art at Nottingham University or Nottingham Trent University. I say ‘or’ because at one stage in the book it says that Nick studied at Nottingham University and in another extract it says they were proud parents attending his final degree art show at Nottingham Trent University. I hope it was the latter.

Anyone reading the book would be interested in many of the psychological topics that make an appearance in the book including alcoholism, depression, claustrophobia, egomania, and suicide to name just a few. In previous blogs I’ve looked at whether celebrities are more prone to some psychological conditions including addictions and egomania and the book provides some interesting case study evidence. As a psychologist and a TG fan I loved reading the book.

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

Further reading

Cooper, D. (2012). Sypha presents … Music from the Death Factory: A Throbbing Gristle primer. Located at: http://denniscooper-theweaklings.blogspot.co.uk/2012/02/sypha-presents-music-from-death-factory.html?zx=c19a3a826c3170a7

Fanni Tutti, C. (2017). Art Sex Music. Faber & Faber: London.

Ford, S. (1999). Wreckers of Civilization: The Story of Coum Transmissions and Throbbing Gristle. London: Black Dog Publishing.

Kirby, D. (2011). Transgressive representations: Satanic ritual abuse, Thee Temple ov Psychick Youth, and First Transmission. Literature and Aesthetics, 21, 134-149.

Kromhout, M. (2007). ‘The Impossible Real Transpires’ – The Concept of Noise in the Twentieth Century: a Kittlerian Analysis. Located at: http://www.mellekromhout.nl/wp-content/uploads/The-Impossible-Real-Transpires.pdf

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

Sarig, R. (1998). The Secret History of Rock: The Most Influential Bands You’ve Never Heard Of. New York: Watson-Guptill Publications.

Walker, J.A. (2009). Cosey Fanni Tutti & Genesis P-Orridge in 1976: Media frenzy, Prostitution-style, Art Design Café, August 10. Located at: http://www.artdesigncafe.com/cosey-fanni-tutti-genesis-p-orridge-1-2009

Wells, S. (2007). A Throbbing Gristle primer. The Guardian, May 27. Located at: http://www.guardian.co.uk/music/musicblog/2007/may/29/athrobbinggristleprimer

Fun in the sun? Does ‘tanorexia’ (addiction to sunshine) really exist?

If the many media reports are to be believed, a 2014 study published in the journal Cell claimed that “sunshine can be addictive like heroin”. In an experiment carried out on mice, a research team led by Dr. Gillian Fell at the Harvard Medical School in Boston (US) reported that ultraviolet exposure leads to elevated endorphin levels (endorphins being the body’s own ‘feel good’ endogenous morphine), that mice experience withdrawal effects after exposure to ultraviolet light, and that chronic ultraviolet causes dependency and ‘addiction-like’ behaviour.

Although the study was carried out on animals, the authors speculated that their findings may help to explain why we love lying in the sun and that in addition to topping up our tans, sunbathing may be the most natural way to satisfy our cravings for a ‘sunshine fix’ in the same way that drug addicts yearn for their drug of choice.

Reading the findings of this study took me back to 1998 when I appeared as a ‘behavioural addiction expert’ on Esther Rantzen’s daytime BBC television show that featured people who claimed they were addicted to tanning (and was dubbed by the researchers on the programme as ‘tanorexia’). I have to admit that none of the case studies on the show appeared to be addicted to tanning at least based on my own behavioural addiction criteria (i.e., salience, mood modification, tolerance, withdrawal, conflict, and relapse) but it did at least alert me to the fact that some people thought sunbathing and tanning was addictive (in fact, the people on the show said their excessive tanning was akin to nicotine addiction).

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There certainly appeared to be some similarities between the people interviewed and nicotine addiction in the sense that the ‘tanorexics’ knew they were significantly increasing their chances of getting skin cancer as a direct result of their risky behaviour but felt they were unable to stop doing it (similar to nicotine addicts who know they are increasing the probability of various cancers but also feel unable to stop despite knowing the health risks).

Since then, tanorexia has become a topic for scientific investigation (and I looked at the topic in a previous blog). For instance, in a 2006 study published in the Journal of the American Academy of Dermatology by Dr. Mandeep Kaur and colleagues reported that frequent tanners (those who tanned 8-15 times a month) that took an endorphin blocker normally used to treat drug addictions (i.e., naltrexone) significantly reduced the amount of tanning compared to a control group of light tanners.

A 2005 study published in the Archives of Dermatology by Dr. Molly Warthan and colleagues claimed that a quarter of the sample of 145 “sun worshippers” would qualify as having a substance-related disorder if ultraviolet light was classed as the substance they crave. Their paper also reported that frequent tanners experienced a “loss of control” over their tanning schedule, and displayed a pattern of addiction similar to smokers and alcoholics.

A 2008 study published in the American Journal of Health Behavior by Dr. Carolyn Heckman and colleagues reported that 27% of 400 students they surveyed were classified as “tanning dependent”. The authors claimed that those classed as being tanning dependent had a number of similarities to substance use, including (i) higher prevalence among youth, (ii) an initial perception that the behaviour is image enhancing, (iii) high health risks and disregard for warnings about those risks, and (iv) the activity being mood enhancing.

Another study by Dr. Heckman and her colleagues in the American Journal of Health Promotion surveyed 306 female students and classed 25% of the respondents as ‘tanning dependent’ based upon a self-devised tanning dependence questionnaire. The problem with this and most of the psychological research on tanorexia to date is that almost all of the research is carried out on relatively small convenience samples using self-report and non-psychometrically validated ‘tanning addiction’ instruments.

Based on my own six criteria of behavioural addiction although some studies suggest some of these criteria appear to have been met, I have yet to be convinced that any of the published studies to date show genuine addiction to tanning (i.e., that there is evidence of all my criteria being endorsed) but that doesn’t mean it’s not theoretically possible. However, I’ve just done a study on tanorexia with my research colleagues at the University of Bergen and when we publish our findings I’ll be sure to let my blog readers know about it.

(Please note: A version of this article first appeared in The Conversation and The Washington Post)

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

Further reading

Fell, G.L., Robinson, K.C., Mao, J., Woolf, C.J., & Fisher, D.E. (2014). Skin β-endorphin mediates addiction to UV light. Cell, 157(7), 1527-1534.

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

Griffiths, M.D. (2014). Sunshine addiction is a hot topic – but does ‘tanorexia’ really exist? The Conversation. June 20. Located at: https://theconversation.com/sunshine-addiction-is-a-hot-topic-but-does-tanorexia-really-exist-28283

Griffiths, M.D. (2014). Sunshine: As addictive as heroin? Washington Post. June 24. Located at http://www.washingtonpost.com/posteverything/wp/2014/06/24/sunshine-as-addictive-as-heroin/

Heckman, C.J., Cohen-Filipic, J., Darlow, S., Kloss, J.D., Manne, S.L., & Munshi, T. (2014). Psychiatric and addictive symptoms of young adult female indoor tanners. American Journal of Health Promotion, 28(3), 168-174.

Heckman, C.J., Darlow, S., Kloss, J.D., Cohen‐Filipic, J., Manne, S.L., Munshi, T., … & Perlis, C. (2014). Measurement of tanning dependence. Journal of the European Academy of Dermatology and Venereology, 28(9), 1179-1185 .

Heckman, C.J., Egleston, B.L., Wilson, D.B., & Ingersoll, K.S. (2008). A preliminary investigation of the predictors of tanning dependence. American Journal of Health Behavior, 32(5), 451-464.

Kaur, M., Liguori, A., Lang, W., Rapp, S.R., Fleischer, A.B., & Feldman, S.R. (2006). Induction of withdrawal-like symptoms in a small randomized, controlled trial of opioid blockade in frequent tanners. Journal of the American Academy of Dermatology, 54(4), 709-711.

Warthan, M.M., Uchida, T., & Wagner, R.F. (2005). UV light tanning as a type of substance-related disorder. Archives of Dermatology, 141(8), 963-966.

More cock tales: A brief look at genital drug injection

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

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

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

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

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

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

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

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

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

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

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

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

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

Further reading

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Higher and higher: Can psychoactive substance use enhance creativity?

In a previous blog I examined whether celebrities are more prone to addictions. In that article I argued that many high profile celebrities have the financial means to afford a drug habit like cocaine or heroin. For many in the entertainment business such as being the lead singer in a famous rock band, taking drugs may also be viewed as one of the defining behaviours of the stereotypical ‘rock ‘n’ roll’ lifestyle. In short, it’s almost expected. There is also another way of looking at the relationship between celebrities and drugs and this is in relation to creativity, particularly as to whether the use of drugs can inspire creative writing or music. For instance, did drugs like cannabis and LSD help The Beatles create some of the best music ever such as Revolver? Did the Beach BoysBrian Wilson’s use of drugs play a major role in why the album Pet Sounds is often voted the best album of all time? Did the use of opium by Edgar Allen Poe create great fiction? Did William S. Burroughs’ use of heroin enhance his novel writing?

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To investigate the question of whether drug use enhances creativity, I and my research colleagues Fruzsina Iszáj and Zsolt Demetrovics have just published a review paper in the International Journal of Mental Health and Addiction examining this issue. We carried out a systematic review of the psychological literature and reviewed any study that provided empirical data on the relationship between psychoactive substance use and creativity/artistic creative process that had been published in English in peer-reviewed journals or scientific books. Following a rigorous filtering process, we were surprised to find only 19 studies that had empirically examined the relationship between drug use and creativity (14 empirical studies and five case studies).

Six of the 19 studies (four empirical papers and two case reports) were published during the 1960s and 1970s. However, following the peak of psychedelia, only three papers (all of them empirical) were published in the following 20 years. Since 2003, a further 10 studies were published (seven empirical papers and three case studies). The majority of the studies (58%) were published in the USA. This dominance is especially true for the early studies in which six of the seven empirical papers and both case studies that were published before mid-1990s were written by US researchers. However, over the past 14 years, this has changed. The seven empirical papers published post-2000 were shared between six different countries (USA, UK, Italy, Wales, Hungary, Austria), and the three case studies came from three countries (USA, UK, Germany).

Seven empirical papers and two case studies dealt with the relationship between various psychoactive substances and artistic creation/creativity. Among the studies that examined a specific substance, six (three empirical papers and three case studies) focused on the effects of either LSD or psilocybin. One empirical study focused on cannabis, and one concerned ayahuasca.

With the exception of one study where the sample focused on adolescents, all the studies comprised adults. More non-clinical samples (15 studies, including case studies) were found than clinical ones (four studies). Three different methodological approaches were identified. Among the empirical studies, seven used questionnaires comprising psychological assessment measures such as the Torrance Test of Creative Thinking (TTCT).

According to the types of psychoactive substance effect on creativity, we identified three groups. These were studies that examined the effect of psychedelic substances (n=5), the effect of cannabis (n=1), and those that did not make a distinction between substances used because of the diverse substances used by participants in the samples (n=7). In one study, the substances studied were not explicitly identified.

The most notable observation of our review was that the findings of these studies show only limited convergence. The main reason for this is likely to be found in the extreme heterogeneity concerning the objectives, methodology, samples, applied measures, and psychoactive substances examined among the small number of studies. Consequently, it is hard to draw a clear conclusion about the effect of psychoactive substance use on creativity based on the reviewed material.

Despite the limited agreement, most of the studies confirmed some sort of association between creativity and psychoactive substance use, but the nature of this relationship was not clearly established. The frequently discussed view that the use of psychoactive substances leads to enhanced creativity was by no means confirmed. What the review of relevant studies suggests is that: (i) substance use is more characteristic in those with higher creativity than in other populations, and (ii) it is probable that this association is based on the inter-relationship of these two phenomena. At the same time, it is probable that there is no evidence of a direct contribution of psychoactive substances to enhanced creativity of artists.

It is more likely that substances act indirectly by enhancing experiences and sensitivity, and loosening conscious processes that might have an influence on the creative process. This means the artist will not be more creative but the quality of the artistic product will be altered due to substance use. On the other hand, it appears that psychoactive substances may have another role concerning artists, namely that they stabilize and/or compensate a more unstable functioning.

Beyond the artistic product, we also noted that (iii) specific functions associated with creativity appear to be modified and enhanced in the case of ordinary individuals due to psychoactive substance use. However, it needs to be emphasized that these studies examined specific functions while creativity is a complex process. In light of these studies, it is clear that psychoactive substances might contribute to a change of aesthetic experience, or enhanced creative problem solving. One study (a case study of the cartoonist Robert Crumb) showed that LSD changed his cartoon illustrating style. Similarly, a case study of Brian Wilson argued that the modification of musical style was connected to substance use. However, these changes in themselves will not result in creative production (although they may contribute to the change of production style or to the modification of certain aspects of pieces of arts). What was also shown is that (iv) in certain cases, substances may strengthen already existing personality traits.

In connection with the findings reviewed, one should not overlook that studies focused on two basically different areas of creative processes. Some studies examined the actual effects of a psychoactive substance or substances in a controlled setting, while others examined the association between creativity and chronic substance users. These two facets differ fundamentally. While the former might explain the acute changes in specific functions, the latter may highlight the role of chronic substance use and artistic production.

It should also be noted that the studies we reviewed differed not only regarding their objectives and methodology, but also showed great heterogeneity in quality. Basic methodological problems were identified in many of these studies (small sample sizes, unrepresentative samples, reliance on self-report and/or non-standardized assessment methods, speculative research questions, etc.). Furthermore, the total number of empirical studies was very few. At the same time, the topic is highly relevant both in order to understand the high level of substance use in artists and in order to clarify the validity of the association present in public opinion. However, it is important that future studies put specific emphasis on adequate methodology and clear research questions.

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

Further reading

Belli, S. (2009). A psychobiographical analysis of Brian Douglas Wilson: Creativity, drugs, and models of schizophrenic and affective disorders. Personality and Individual Differences, 46, 809-819.

Dobkin de Rios, M. & Janiger, O. (2003). LSD, spirituality, and the creative process. Rochester, VT: Park Street Press.

Edwards, J. (1993). Creative abilities of adolescent substance abusers. Journal of Group         Psychotherapy, Psychodrama & Sociometry, 46, 52-60.

Fink, A., Slamar-Halbedl, M., Unterrainer, H.F. & Weiss, E.M. (2012). Creativity: Genius, madness, or a combination of both? Psychology of Aesthetics, Creativity, and the Arts, 6(1), 11–18.

Forgeard, M.J.C. & Elstein, J.G. (2014). Advancing the clinical science of creativity. Frontiers in Psychology, 5, 613.

Frecska, E., Móré Cs. E., Vargha, A. & Luna, L.E. (2012). Enhancement of creative expression and entoptic phenomena as after-effects of repeated ayahuasca ceremonies. Journal of Psychoactive Drugs, 44, 191-199

Holm-Hadulla, R.M. & Bertolino, A. (2014). Creativity, alcohol and drug abuse: The pop icon Jim Morrison. Psychopathology, 47,167-73

Iszáj, F. & Demetrovics, Z. (2011). Balancing between sensitization and repression: The role of opium in the life and art of Edgar Allan Poe and Samuel Taylor Coleridge. Substance Use and Misuse, 46, 1613-1618

Iszaj, F., Griffiths, M.D. & Demetrovics, Z. (2016). Creativity and psychoactive substance use: A systematic review. International Journal of Mental Health and Addiction. doi: 10.1007/s11469-016-9709-8

Jones, M.T. (2007). The creativity of crumb: Research on the effects of psychedelic drugs on the comic art of Robert Crumb. Journal of Psychoactive Drugs, 39, 283-291.

Jones, K.A., Blagrove, M. & Parrott, A.C. (2009). Cannabis and ecstasy/ MDMA: Empirical measures of creativity in recreational users. Journal of Psychoactive Drugs. 41(4), 323-329

Kerr, B. & Shaffer, J. & Chambers, C., & Hallowell, K. (1991). Substance use of creatively talented adults. Journal of Creative Behavior, 25(2), 145-153.

Knafo, D. (2008). The senses grow skilled in their craving: Thoughts on creativity and addiction. Psychoanalytic Review, 95, 571-595.

Lowe, G. (1995). Judgements of substance use and creativity in ’ordinary’ people’s everyday lifestyles. Psychological Reports. 76, 1147-1154.

Oleynick, V.C., Thrash, T. M., LeFew, M. C., Moldovan, E. G. & Kieffaber, P. D. (2014). The scientific study of inspiration in the creative process: challenges and opportunities. Frontiers in Human Neuroscience, 8, 436.

Plucker, J.A., McNeely, A. & Morgan, C. (2009). Controlled substance-related beliefs and use: Relationships to undergraduates’ creative personality traits. Journal of Creative Behavior, 43(2), 94-101

Preti, A. & Vellante, M. (2007). Creativity and psychopathology. Higher rates of psychosis proneness and nonright-handedness among creative artists compared to same age and gender peers. Journal of Nervous and Mental Disease, 195(10), 837-845.

Schafer, G. & Feilding, A. & Morgan, C. J. A. & Agathangelou, M. & Freeman, T. P. &      Curran, H.V. (2012). Investigating the interaction between schizotypy, divergent thinking and cannabis use. Consciousness and Cognition, 21, 292–298

Thrash, T.M., Maruskin, L.A., Cassidy, S. E., Fryer, J.W. & Ryan, R.M. (2010). Mediating between the muse and the masses: inspiration and the actualization of creative ideas. Journal of Personality and Social Psychology, 98, 469–487.

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.

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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 Voy.com 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: http://www.hannibalstudiolo.com/phpBB2/viewtopic.php?t=1095&start=-1&sid=0f25ca4b4c2dca0bd9f85038ae600a03)

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: http://www.bizarremag.com/fetish/fetish/10393/medical_fetish.html?xc=1

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: http://en.wikipedia.org/wiki/Medical_fetishism

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.

the-associates-billy-mackenzie-by-gilbert-blecken-1994-1images

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 Snopes.com 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? Snopes.com, May 23. Located at: http://www.snopes.com/music/songs/gloomy.asp

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: https://en.wikipedia.org/wiki/Alan_Rankine

Wikipedia (2016). Billy Mackenzie. Located at: https://en.wikipedia.org/wiki/Billy_Mackenzie

Wikipedia (2016). Gloomy Sunday. Located at: https://en.wikipedia.org/wiki/Gloomy_Sunday

Wikipedia (2016). Martha Ladly. Located at: https://en.wikipedia.org/wiki/Martha_Ladly

Wikipedia (2016). Michael Dempsey. Located at: https://en.wikipedia.org/wiki/Michael_Dempsey

Wikipedia (2016). The Associates (band). Located at: https://en.wikipedia.org/wiki/The_Associates_(band)