Category Archives: Pain
I was taken to the operating theatre at about 8.30am. My surgery lasted about three hours and at about midday I woke up in the recovery room. The nurse asked me if I felt OK and after realising my surgery was over, I told her I was OK. I then realised I could speak. I could also wiggle my fingers and toes so I also knew I wasn’t paralysed. My very first thought was “If I can talk and I can type, I still have a job”. Within an hour I had drunk water and ate a sandwich and could do both without difficulty or being in pain. However, it became very clear very quickly that I wasn’t in full control of my own hands as well as being unable to walk at all (my right leg could do very little – wiggling my toes was about the limit of my movement). I was also catheterised for the first time in my life.
After eight hours in the recovery room (I should have only been there 1-2 hours but there were no ward beds available) I was moved into a ward just after 8pm with some very serious cases (mostly with individuals who had gone through major brain surgery). All of us on the ward had to have our ‘obs’ (observations – blood pressure, heart rate, temperature, blood sugar, etc.) taken hourly right through the night (so I got no sleep at all). I also had horrendous spasms in both my legs (over 1000 a night for the first week). I was put onto a drug called Baclofen (which I’m still on now).
The day after my operation was not the best. Because of COVID-19 no patients could have visitors. I briefly spoke to my partner on the phone. That was the day’s only highlight. I realised that I couldn’t do basic things with my hands like eat with a knife and fork or hold a pen. The latter really upset me. I keep a very detailed hand-written diary so not being able to write in it was very upsetting for me. I was also unable to give myself a wash so for the next few days I was given a daily body wash by the hospital staff. I couldn’t even hold a toothbrush properly to brush my teeth. I found the whole experience demoralising and degrading. Not being able to shower was horrible. Anyone who knows me will tell you how important showering is to me and my mental health. I shower a minimum twice a day. Not being able to shower felt like an abuse of my human rights. I never felt clean after a body wash. On the day after my operation, it became clear I wouldn’t be going home that day and it soon became apparent that I would be in hospital at least a week.
After a few days, some of my hand functionality began to return. I could just about use a knife and fork and I could pick up a flannel to wash my own face. However, holding a pen and writing with a pen was impossible. Unlike the other patients on the ward (a couple of who were sedated almost 24 hours a day), once I had awoken, I spent the whole day out of bed sat in a chair. I had my iPod so listened to a lot of music but did little else. Couldn’t hold a book or magazine long enough with my hands to read.
On Tuesday (April 20) I had my catheter removed. That seemed like a huge step forward. My partner also dropped my laptop off. I was unable to see her but at least it meant I could Skype her and my children. I also realised that typing was something I could so with my hands relatively easily. Writing a few emails was also good therapy for my fingers and I had a link to the outside world (I don’t have a smartphone, gave up using one in 2019). The hospital physiotherapists had given me hand and leg exercises to do and I spent a lot of time using the ward rotunda as a mini-gym. No-one else was capable of using it (as they were all confined to bed) so I had it 24/7. I was moved to another ward which I was told was “good news” as it meant I needed less specialist care. On Wednesday (April 21) I begged the doctor to allow me to shower. He said I could have one as long as I didn’t get my post-surgery dressing wet. Had to shower in a wheelchair (surreal to say the least) but despite this, it was heavenly to wash my hair and feel clean after six days of humiliating body washes. My dressing was drenched but I didn’t care. I felt clean and alive. I felt co-operative and communicative.
Just after the shower, I had an unexpected visitor. A doctor visited me and told me that I would be leaving Queen’s Medical Centre and would be moving to another hospital (City Hospital) to a specialist rehabilitation unit (Linden Lodge). She said she would try to get me a bed there for that weekend and that I would probably be there for 4-6 weeks. My emotions were mixed. I was glad to be moving to a place with dedicated and specialist care, but was surprised to hear that I would be in hospital for another 4-6 weeks.
At lunchtime that day, I got the unexpected news that there was a bed at Linden Lodge that evening and I was told to pack up all my stuff (not that I had much to pack). At 7pm I was transported by ambulance (first time I had ever been in one) over to my new temporary home. I was given my own room (which was great) and I unpacked the few things I had. My partner had dropped off clothes at the unit but again I was unable to see her due to the COVID-19 visiting restrictions. At one point in the evening, I decided to sit on the floor rather than the bed to get undressed for bed (I found it easier than being on the bed). When the nurse came in and found me sitting on the floor, she thought I had fallen (I hadn’t) but recorded in her notes that I had fallen.
On the Thursday morning (April 22, one week after my operation) I began life in Linden Lodge. I wasn’t allowed to shower until I had been “assessed” by an occupational therapist. I finally managed to have an unsupervised shower (in a wheelchair) early afternoon even though I was not “assessed”. I also moved room nearer the nursing staff because I was deemed as someone who needed to be watched more closely because they thought I had fallen on the floor the first night I was in here. The more I protested the less they believed me. It was even written up outside my room that I was susceptible to falls (which was true prior to my operation but not something I had done in hospital).
Since then, things have gone slowly. I was told after my initial assessments that I would likely be here for three months (i.e., until August). However, I left hospital on June 22 (after 67 days in hospital). The hardest thing I had to deal with was (until about 40 days into my stay) the ‘no visitors’ policy. I did see my partner a couple of times outside the unit through the iron bars (which felt a bit like being in prison). Over the past 12 weeks, a lot of my hand functionality has returned although I still have some difficulties. There are things that I now consider easy (typing, eating with a knife and fork, sponging myself in the shower), some that I can do but have to focus (writing with a pen, putting socks on, washing my hair, brushing my teeth, doing a crossword), and some things which are very difficult but I can do (e.g., shaving, tying shoelaces).
The first Sunday I was in the unit, I found a sentence that had all letters of the alphabet (“Pack my box with five dozen liquor jugs”) and spent hours trying to write it out in upper and lower case letters with a pen. Very difficult and very time consuming (but I did it). Over the next few weeks, I started to write my diary again. I began by writing the days events in bullet points in capital letters (writing in upper case capitals was easier than writing in lower case letters). I then progressed to writing the whole day’s events but all in capital letters. On May 19, I started writing my diary “normally” again (i.e., in sentence case rather than in capital letters). I use the word “normally” advisedly. I’m still very slow writing with a pen and it’s not the most legible, but any activity I do with my hands I still call “therapy”. As I type this, I still do not have full functionality in either of my hands and I have resigned myself to the fact that I never will.
You can read Part 1 of this blog here.
Dr. Mark Griffiths, Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
On April 15 I had an operation to decompress my spinal cord and to have the C5 disc in my neck replaced with a new titanium disc. I ended up in hospital for 67 days. Here’s the back story (no pun intended).
For the past 18 years I have lived with a compressed spinal cord. Although I had the condition since 2003, it wasn’t diagnosed until an MRI scan in 2007. The scan showed that the C5 disc in my neck was completely herniated and that the disc was pressing directly onto my spinal cord causing hundreds of electric shocks every single day. I was prescribed daily amitriptyline which significantly reduced the number of shocks I felt. I was also prescribed heavy duty painkillers (dihydrocodeine) but I soon realised that work was the best analgesic in the world. Instead of taking up to four doses of dihydrocodeine every day, I worked (and worked). I rarely took more than four doses of dihydrocodeine a year let alone a day. I was also given details of an operation I could have but just the very thought of it scared me – especially because of the risk of being left paralysed from the neck or chest down. I was told to come back if I changed my mind about having an operation.
I am not 100% sure what caused the complete herniation of the disc in my neck but I suspect it was a minor traffic collision I was involved in at the beginning of November 2003. I was sitting on the front seat on the top floor of a double decker bus when a taxi crashed into the right-hand side of the bus and I was propelled forward onto the bus’s front window where my head hit the glass window, smashed the glasses I was wearing, and left me concussed. I was highly stressed that day because I was on my way to have a CT scan to look at swollen lumps in my throat for suspected Hodgkin’s or non-Hodgkin’s lymphoma. Later that week I had a lymphadenectomy and the biopsy showed that I didn’t have cancer but was diagnosed with toxoplasma lymphadenitis. It was after this operation that I began to get the constant daily electric shocks (over 100 a day) every time I moved my neck. I assumed that the constant electric shocks were as a result of my operation but I was later told that the shocks were being caused by a compressed spinal cord and that my lymphadenectomy was not the cause.
Over the next decade or so, the pain caused the constant compression of my spinal cord got progressively worse. Walking became increasingly difficult but I used excessive work as the strategy to suppress the increasing physical pain. In short, work became the perfect distractor task. When I was 100% cognitively engaged (e.g., giving a paper or teaching, writing or editing papers, etc.) I was in no pain whatsoever. I returned to the workaholic tendencies that I had before I had children. One of my consultants also described me as having “unspent youthfulness” which masked my medical condition for years.
The lifestyle I was leading in the years leading up to my operation probably didn’t help. I was travelling excessively averaging 20-25 overseas trips a year for conferences, consultancy, and research meetings. Walking became increasingly difficult as I was unable to lift my right foot properly. During 2019, I had a number of really bad falls abroad (tripping over because my right foot wouldn’t lift) including three in Abu Dhabi and a couple in Auckland which left me with horrendous bursitis on both of my elbows.
During the lockdown period, my health deteriorated badly. I was not globe-trotting anymore and I was housebound for over a year. My working life (and social life) became increasingly sedentary. I was doing everything from home including all my teaching. I had not stepped foot in my university office since the end of February 2020 (and still haven’t).
In August 2020, I saw one of my consultants and told him that my health condition had got significantly worse and that I now wanted the operation. However, because my surgery was classed as ‘elective’ as opposed to ‘urgent’ a date for surgery never came as the Nottingham hospitals were full of very ill COVID-19 patients. At one point during the pandemic, Nottingham was the UK city with the most COVID-19 infections. By February 2020 I could hardly walk and was becoming increasingly immobile. I rang my consultant’s secretary every week asking if I could have an appointment. I finally got one at the end of March 2021 and after seeing how bad my mobility was, I got an operation date very quickly. Thursday April 15, 2021. I was told by my consultant who was performing the surgery that he expected my to be back home the next day if the surgery was successful.
I have to be honest and say that the operation still scared me. Although there was a small chance of dying, that didn’t worry me. It was the thought of waking up paralysed which dominated my thoughts for over a week prior to the operation. Loss of limb use. Loss of job and livelihood Loss of identity. Loss of salary. There are many risks with any operation but spinal surgery carries many extra risks. I was told that some of the consequences could be eating and drinking difficulties and voice loss (as they would be carrying out the surgical procedure through the front of my neck and having to decompress my spinal cord by going via my trachea and oesophagus). I told my consultant that I would rather be dead than paralysed from the chest or neck down.
As the day of the operation approached, I again used work to block out my fears and negative thoughts. On April 15, my partner dropped me off at the hospital at 7am in the morning. Before my operation I had talks with the anaesthetist and one of the surgical team. I then had to sign the consent form which included a very long list of all the things that could go wrong. However, the weeks prior to my operation were surviving not living. I felt I was in the last chance saloon.
Dr. Mark Griffiths, Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
Last week I was contacted by a journalist at the Red Bulletin Magazine who was “looking for an expert in gaming psychology to talk to for a piece on the mental benefits of endless running games, i.e. ‘the gameplay building strong reward learning in players’. It should be a fun and practical guide…Just let me know if you’d be interested.” I was interested. I had been teaching in the morning so I didn’t get the email until a couple of hours after it had been sent. I scribbled down a few notes, got back in touch, but by the time I did, the journalist had already interviewed someone else for the feature. Since I’d already made a few bullet points, I thought I would use them for the basis of a blog. (I really don’t like things going to waste).
Although much of my research examines problematic gaming, I am not anti-gaming (and never have been), and I have published many papers on the benefits of gaming including therapeutic benefits, educational benefits, and psychological (cognitive) benefits (see ‘Further reading’ below). Some of you reading this may not know what endless running games are, so here is the Wikipedia definition from its entry on platform games:
“‘Endless running’ or ‘infinite running’ games are platform games in which the player character is continuously moving forward through a usually procedurally generated, theoretically endless game world. Game controls are limited to making the character jump, attack, or perform special actions. The object of these games is to get as far as possible before the character dies. Endless running games have found particular success on mobile platforms. They are well-suited to the small set of controls these games require, often limited to a single screen tap for jumping. Games with similar mechanics with automatic forward movement, but where levels have been pre-designed, or procedurally generated to have a set finish line, are often called “auto-runners” to distinguish them from endless runners”.
Endless running games are incredibly popular and played by millions of individuals around the world (including myself on occasions). One of the best things about endless running games is that because they can be played on smartphones and other small hand-held devices they can be played anywhere at any time. Like any good game, the rules are easy to understand, the gameplay is deceptively simple, but in the end, it takes skill to succeed. The simplicity of endless running games is one of the key reasons for their global success in terms player numbers. For successful games, the mechanics should be challenging but not impossible. Such games can lead to what has been described as a state of ‘flow’ (coined by Mihaly Csíkszentmihályi in his seminal books Flow: The Psychology of Optimal Experience  and Flow: The Psychology of Happiness ).
With the flow experience, a game player derives intense enjoyment by being immersed in the gaming experience, the challenges of the game are matched by the player’s skills, and the player’s sense of time is distorted so that time passes without it being noticed. For some video game players, this may then mean repeatedly seeking out similar experiences on a regular basis to the extent that they can escape from their concerns in the ‘real world’ by being continually engrossed in a flow-inducing world. However, something like flow – viewed largely as a positive psychological phenomenon – may be less positive in the long-term for some video game players if they are craving the same kind of emotional ‘high’ that they obtained the last time that they experienced flow when playing a video game.
Flow has been proposed (by Jackson and Eklund, 2006) as comprising nine elements that include: (i) striking a balance between the challenges of an activity and one’s abilities; (ii) a merging of performance of actions with one’s self-awareness; (iii) possessing clear goals; (iv) gaining unambiguous feedback on performance; (v) having full concentration on the task in hand; (vi) experiencing a sense of being in control; (vii) losing any form of self-consciousness; (viii) having a sense of time distorted so that time seems to speed up or slow down; and (ix) the undergoing of an auto-telic experience (e.g., the goals are generated by the person and not for some anticipated future benefit). Endless running games are one of many types of videogame that can result in ‘flow’ experiences (which for the vast majority of gamers is going to result in something more positive (psychologically) than negative.
There are many studies showing that playing video games can improve reaction times and hand-eye co-ordination. For example, research has shown that spatial visualisation ability, such as mentally rotating and manipulating two- and three-dimensional objects, improves with videogame playing. Again, endless running videogames rely very heavily on hand-eye co-ordination and fast reaction to on-screen events. In this specific area, I see endless running games as having nothing but positive benefits in terms of improving hand-eye co-ordination skills, reflexes, and attention spans.
Although I’m not a neuroscientist or a neuropsychologist, I know that on a neurobiological level, when we engage in pleasurable activity, our bodies produce its own opiate-like neurochemicals in the form of endorphins and dopamine. The novelty aspects of endless running games will for many players result in the production of neurochemical pleasure which is rewarding and reinforcing for the gamer.
I also believe that endless running games have an appeal that crosses many demographic boundaries, such as age, gender, ethnicity, or educational attainment. They can be used to help set goals and rehearse working towards them, provide feedback, reinforcement, self-esteem, and maintain a record of behavioural change in the form of personal scores. Beating one’s own personal high scores or having higher scores than our friends and fellow gamers can also be psychologically rewarding.
Because video games can be so engaging, they can also be used therapeutically. For instance, research has consistently shown that videogames are excellent cognitive distractors and can help reduce pain. Because I have a number of chronic and degenerative health conditions, I play a number of cognitively-engrossing casual games because when my mind is 100% engaged in an activity I don’t feel any pain whatsoever. Again, endless running games tick this particular box for me (and others). Also, on a personal level, I am time-poor because I work so hard in my job. Endless running games are ideal for individuals like myself who simply don’t have the time to engage in playing massively multiplayer online games that can take up hours every day but will quite happily keep myself amused and pain-free on my commute into work on the bus.
As I have pointed out in so many of my research papers and populist writings over the years, is that the negative consequences of playing almost always involve a minority of individuals that are excessive video game players. There is little evidence of serious acute adverse effects on health from moderate play, endless running games included.
Dr. Mark Griffiths, Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
Csíkszentmihályi, M. (1990). Flow: The Psychology of Optimal Experience. New York: Harper and Row
Csíkszentmihályi, M. (1992). Flow: The psychology of happiness. London: Random House.
Griffiths, M.D. (2002). The educational benefits of videogames Education and Health, 20, 47-51.
Griffiths, M.D. (2003). The therapeutic use of videogames in childhood and adolescence. Clinical Child Psychology and Psychiatry, 8, 547-554.
Griffiths, M.D. (2004). Can videogames be good for your health? Journal of Health Psychology, 9, 339-344.
Griffiths, M.D. (2005). Video games and health. British Medical Journal, 331, 122-123.
Griffiths, M.D. (2005). The therapeutic value of videogames. In J. Goldstein & J. Raessens (Eds.), Handbook of Computer Game Studies (pp. 161-171). Boston: MIT Press.
Griffiths, M.D. (2010). Adolescent video game playing: Issues for the classroom. Education Today: Quarterly Journal of the College of Teachers, 60(4), 31-34.
Griffiths, M.D. (2019). The therapeutic and health benefits of playing videogames. In: Attrill-Smith, A., Fullwood, C. Keep, M. & Kuss, D.J. (Eds.). The Oxford Handbook of Cyberpsychology. (pp. 485-505). Oxford: Oxford University Press.
Griffiths, M.D., Kuss, D.J., & Ortiz de Gortari, A. (2017). Videogames as therapy: An updated selective review of the medical and psychological literature. International Journal of Privacy and Health Information Management, 5(2), 71-96.
Jackson, S.A. & Eklund, R.C. (2006). The flow scale manual. Morgan Town, WV: Fitness Information Technology.
Nuyens, F., Kuss, D.J., Lopez-Fernandez, O., & Griffiths, M.D. (2019). The experimental analysis of non-problematic video gaming and cognitive skills: A systematic review. International Journal of Mental Health and Addiction, 17, 389-414.
In a previous blog, I briefly looked at gastergastrizophilia (a sadomasochistic sexual paraphilia in which individuals derive sexual pleasure and arousal from bellypunching). I also noted that I had never seen it listed in any reputable academic source (and that it did not appear in either Dr. Anil Aggrawal’s Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices or Dr. Brenda Love’s Encyclopedia of Unusual Sex Practices). I also wondered whether it really existed. Since writing that blog I’ve had a few people write to me saying that it definitely exists (see the comment section of my previous blog). I also described it as “one of the weirdest sounding sexual paraphilias that I have come across”. Last week I received some feedback from a man who criticized my article on the topic. I always welcome feedback (however critical) so I thought I would use today’s blog to respond to the criticism I received. I have included all the feedback I received along with my responses. Although I have the name and email address of the man who contacted me, I have decided not to use them in this article as he did not give me permission to do so (although if he does, I will update this accordingly).
Gutpuncher: I must admit – coming from a phycologist [sic] – I find that opening statement (“one of the weirdest sounding sexual paraphilias that I have come across”) to be an exceedingly derogatory and leading comment, immediately stamping all that is to follow with a big, bold stigma… That statement is as perverted as it is pejorative. It erroneously throws all who enjoy and practice this fetish into the fringe of lawlessness and make them sexual deviants without ethics or conscience. It’s the insane equivalent of saying, “we have no idea how many people actually engage in sex, because the participants themselves aren’t really sure of what is consent and what is rape.” REALLY?! EVERYONE with whom I have EVER participated in this fetish, myself very much included, has ALWAYS done so with complete and total CONSENT. The only reason we might not so quickly stand up to be counted –– is we’re not so keen on pointed fingers labeling us as “weird.
My response: Obviously I am a psychologist not a ‘phycologist’. But more seriously, what I actually wrote was that it one of the “weirdest sounding” paraphilias. To me, ‘gastergastrizophilia’ does sound weird compared to hundreds of other paraphilias that I have written about. I used the word ‘weird’ as a synonym for ‘strange’ or ‘unusual’. I think ‘Gutpuncher’ interpreted “one of the weirdest sounding paraphilias” as being “one of the weirdest paraphilias” which is somewhat different. Having said that, even if I had written what ‘Gutpuncher’ appears to think I have written, I would still argue that the use of ‘weird’ is a legitimate word to use (and I think most individuals would agree). Also, ‘Gutpuncher’ appears to think that calling an activity “weird” means that the person doing it is ‘weird’ but this is simply not true. I have a number of self-acknowledged weird hobbies (some of which I’ve written about such as being a record collecting completist who will happily pay lots of money for something that I may not even like) but this does not make me (as an individual) weird. The activity and the individual are two distinct things. But I’d just like to reiterate, what I actually wrote was that ‘gastergastrizophilia’ is weird-sounding.
Gutpuncher: Having just come across your article, though, I honestly don’t even know if the true purpose of your blog is to actually “help” anyone with real questions, concerns, or confusion about their own lives or sexuality. After a quick check and realizing that your expertise lies in gaming and gambling addictions, quite possibly your dealing with matters of sexuality here may just be a fun outlet, a way of creating a relaxed, man-of-the-people presence here on the internet, without any real offerings of advice or council – well, other than proclaiming certain things as “weird.”
My response: My blog page clearly states on every article that I have ever published: “Welcome to my blog! If you are interested in addictive, obsessional, compulsive and/or extreme behaviours, you’ve come to the right place”. The primary purpose of my blog is to write about things that I think people might want to read. My aim is not to help people, but if it does, that’s great, but it’s not the primary purpose. ‘Gutpuncher’ says my “expertise lies in gaming and gambling addictions” and that “dealing with matters of sexuality here may just be a fun outlet”. I do indeed have expertise in gambling and gaming addictions as well as in many other behavioural addictions. While gambling and gaming are among my main areas of expertise, I’ve also published over 50 academic papers (as well as many populist articles) on human sexual behaviour including papers on paraphilias (a small selection of which I list in the ‘Further reading’ section below). I think this more than qualifies me to write about human sexual behaviour. Even if I didn’t have expertise in researching sexual behaviour, it still wouldn’t invalidate me from writing about things that interest me (which sex does).
Gutpuncher: I also take great offense at the included quote (though not your own, but presented nonetheless to be considered) that “nobody has any real numbers, in part because the participants themselves don’t know where the line actually divides consent and abuse.”
My response: Any quotes that I use in blogs are fully referenced and are the views of the person writing it. Quotes used may or may not match my own views. This doesn’t mean I can’t use them. The quote came from the Wikipedia entry on ‘bellypunching’ and it’s the only article on the topic that I found when I wrote the article at the time.
Gutpuncher: But still, as a male who (purely from a homoerotic perspective) finds great pleasure in this fetish (known in male form as “Gutpunching” or “ab punching”), and as one who has personally connected with 60+ other males in the flesh who – most definitely – also find arousal in this sexual proclivity, and as someone who has personally witnessed hundreds and hundreds of other males online (through profile-posting websites and video uploads) who also claim this fetish as their own, I wonder why the male perspective has been entirely ignored here? Since this blog post was to give a look, however “brief,” at the subject, that seems to me a rather large omission. Again, quite possibly, this blog may playfully lean toward titillation instead of factual inclusivity, and “gay” stuff may add a whole other unappealing level of “weird.” But, this fetish IS most assuredly both a female and a MALE subject, to be correct.
My response: This is useful anecdotal information from someone who has first-hand experience of the gutpunching community. I wrote my article on gastergastrizophilia in August 2015 (i.e., four years ago). As with all my blogs, I researched the area and referenced everything I was able to locate scientifically and empirically (I found nothing published on any academic database) and anecdotally (i.e., searching online). I referenced everything that I found and only located one article (on Wikipedia) and also found some first-person accounts on the Dark Fetish website, as well as reference to hundreds of bellypunching videos. I didn’t ignore (or deliberately omit) anything and I wrote about what I found. I look forward to you sending me more information so that I can do a follow-up article.
Dr. Mark Griffiths, Distinguished Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
Aggrawal A. (2009). Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices. Boca Raton: CRC Press.
Bőthe, B., Bartók, R., Tóth-Király, I., Reid, R.C., Griffiths, M.D., Demetrovics, Z., Orosz, G. (2018). Hypersexuality, gender, and sexual orientation: A largescale psychometric survey study. Archives of Sexual Behavior, 47, 2265-2276.
Bőthe, B., Kovács, M., Tóth-Király, I., Reid, R.C., Griffiths, M.D., Orosz, G., Demetrovics, Z. (2019). The psychometric properties Hypersexual Behavior Inventory using a large-scale nonclinical sample. Journal of Sex Research, 56, 180-190.
Bőthe, B., Tóth-Király, I., Zsila, Á., Griffiths, M.D., Demetrovics, Z., Orosz, G. (2018). The development of the Problematic Pornography Consumption Scale (PPCS). Journal of Sex Research, 55, 395-406.
Dhuffar, M. & Griffiths, M.D. (2015). A systematic review of online sex addiction and clinical treatments using CONSORT evaluation. Current Addiction Reports, 2, 163-174.
Dhuffar, M. & Griffiths, M.D. (2014). Understanding the role of shame and its consequences in female hypersexual behaviours: A pilot study. Journal of Behavioural Addictions, 3, 231–237.
Dhuffar, M.K. & Griffiths, M.D. (2015). Understanding conceptualisations of female sex addiction and recovery using Interpretative Phenomenological Analysis. Psychology Research, 5, 585-603.
Dhuffar, M., Pontes, H.M. & Griffiths, M.D. (2015). The role of negative mood states and consequences of hypersexual behaviours in predicting hypersexuality among university students. Journal of Behavioural Addictions, 4, 181–188.
Dhuffar, M. & Griffiths, M.D. (2016). Barriers to female sex addiction treatment in the UK. Journal of Behavioural Addictions, 5, 562–567.
Fernandez, D. & Griffiths, M.D. (2019). Psychometric instruments for problematic pornography use: A systematic review. Evaluation and the Health Professions. Epub ahead of print, doi: 10.1177/0163278719861688
Greenhill, R. & Griffiths, M.D. (2015). Compassion, dominance/submission, and curled lips: A thematic analysis of dacryphilic experience. International Journal of Sexual Health, 27, 337-350.
Greenhill, R. & Griffiths, M.D. (2016). Sexual interest as performance, intellect and pathological dilemma: A critical discursive case study of dacryphilia. Psychology and Sexuality, 7, 265-278.
Griffiths, M.D. (1999). Dying for it: Autoerotic deaths. Bizarre, 24, 62-65.
Griffiths, M.D. (2000). Excessive internet use: Implications for sexual behavior. CyberPsychology and Behavior, 3, 537-552.
Griffiths, M.D. (2001). Sex on the internet: Observations and implications for sex addiction. Journal of Sex Research, 38, 333-342.
Griffiths, M.D. (2001). Stumped! Amputee fetishes. Bizarre, 44, 70-74.
Griffiths, M.D. (2010). Addicted to sex? Psychology Review, 16(1), 27-29.
Griffiths, M.D. (2012). The use of online methodologies in studying paraphilias: A review. Journal of Behavioral Addictions, 1, 143-150.
Griffiths, M.D. (2013). Eproctophilia in a young adult male: A case study. Archives of Sexual Behavior, 42, 1383-1386.
Griffiths, M.D. (2019). Paraphilias and the press – Don’t always believe what you read. Medical Journal Armed Forces India, 75, 232-233.
Griffiths, M.D. (2019). Salirophilia and other co-occurring paraphilias in a middle-aged male: A case study. Journal of Concurrent Disorders, 1(2), 1-8.
Griffiths, M.D. & Dhuffar, M. (2014). Treatment of sexual addiction within the British National Health Service. International Journal of Mental Health and Addiction, 12, 561-571.
The Full Wiki (2013). Bellypunching. Located at: http://www.thefullwiki.org/Bellypunching
Love, B. (2001). Encyclopedia of Unusual Sex Practices. London: Greenwich Editions.
Van Gordon, W., Shonin, E., & Griffiths, M.D. (2016). Meditation Awareness Training for the treatment of sex addiction: A case study. Journal of Behavioral Addictions, 5, 363–372.
Today is three years since the tragic death of David Bowie. As I have noted in my previous articles on David Bowie (here, here and here), outside of my own friends and family, it’s still Bowie’s death that has affected me the most psychologically. Bowie inspired millions of people in many different ways. This blog looks at the things that I have learned from Bowie and how he influenced my career.
Persevere with your life goals – Most people are aware that it took years for Bowie to have has first hit single (‘Space Oddity’, 1969), five years after his first single (‘Liza Jane’, 1964). Even after the success of ‘Space Oddity’, it took another three years before he had his second hit single (‘Starman’, 1972) and in the early 1970s there were many who thought he would be a ‘one-hit wonder’ and a small footnote in music history. Bowie never gave up his quest for musical stardom and is arguably one of the best examples of the proverb “If at first you don’t succeed, try, try again”. I’ve often told others that they key to success is being able to learn from your mistakes and being able to handle rejection (which for academics is having papers rejected, grant bids rejected, and attempts at promotion rejected, etc.). Bowie personified perseverance and for this quality alone I am very grateful as it has been the bedrock of my career to date.
Encourage teamwork and collaboration – Despite being a solo artist for the vast majority of his post-1969 career (Tin Machine being the most high-profile notable exception), Bowie was (like me) a ‘promiscuous collaborator’ and much of his success would not have been possible without a gifted team around him whether it be his inner circle of musicians (Mick Ronson, Carlos Alomar, Robert Fripp, Mike Garson, etc.), his producers (Tony Visconti, Nile Rogers, Ken Scott, etc.), co-writers and inspirators (Iggy Pop, Lou Reed, Brian Eno, John Lennon, etc.), or those he jointly released music with (Mott The Hoople, Queen, Arcade Fire, Pet Shop Boys, Placebo, to name just a few). I have carried out and published research with hundreds of people during my 31-year academic career, and like Bowie, some are one-off collaborations and others are lifelong collaborations. Bowie taught me that although I can do some things by myself, it is the working with others that brings out the best in me.
Experiment to the end – Bowie was never afraid to experiment and try new things whether it was musical, pharmacological, spiritual, or sexual. Mistakes were part of the learning process and he pursued this – especially musically – until the very end of his life (for instance, on his ★ [Blackstar] album where he employed a local New York jazz combo led by saxophonist Donny McCaslin). Failure is success if we learn from it and this is one of the maxims that I live my life by. Bowie taught me that you can have lots of other interests that can be rewarding even if you are not as successful as your day job. Bowie liked to act (and obviously had some success in this area) and also liked to paint (but had much less success here than his other artistic endeavours). By any set of criteria, I am a successful academic but I also like to write journalistically and engage in a wide variety of consultancy (areas that I have had some success) and I like writing poetry (something that I have not been successful financially – although I did win a national Poetry Today competition back in 1997 and have published a number of my poems). Bowie taught me that success in one area of your life can lead to doing other more experimental and rewarding activities even if they are not as financially lucrative.
Push yourself (even in the bad times) – One of the things I love about Bowie was his ability to carry on working and being productive even when he was not at his physical best. Nowhere is this more exemplified than working on the ★ LP while undergoing chemotherapy for his liver cancer. There are also other times in his life such as when he was at the height of his cocaine addiction in 1975 where he produced some of the best music of his career (most notably the Young Americans and Station to Station LPs, the latter of which is one of my all-time favourite records). I have had a few low periods in my life due to various health, relationship and/or personal issues but I have learned through experience that work is a great analgesic and that even when you are at your lowest ebb you can still be highly productive.
Have a Protestant work ethic – Bowie was arguably one of the most hard-working musicians of all time and had what can only be described as a Protestant work ethic from the early 1960s right up until his heart attack in 2004. I am a great believer in the philosophy that “you get out what you put in” and Bowie exemplified this. Andy Warhol told Lou Reed while he was in the Velvet Underground that he should work hard, because work is all that really matters (and was the subject of the song ‘Work’ on the seminal Songs For Drella LP by Reed and John Cale). Bowie also appeared to live by this mantra and is something that I adhere to myself (and is why I am often described as being a workaholic). While Bowie isn’t my only role model in this regard, he’s certainly the most high-profile.
Lead by example but acknowledge your influences – Bowie had a unique gift in being able to borrow from his own heroes but turn it into something of his own (without ever forgetting his own heroes and influences – his Pin Ups LP probably being the best example of this). One of my favourite phrases is “Don’t jump on the bandwagon, create it”, and this has as underpinned a lot of the research areas that I have initiated and is something that I learned from Bowie. Maybe Bowie is a case of the quote often attributed to Oscar Wilde that “talent borrows, genius steals”.
Promote yourself – If there is one thing that Bowie was gifted in as much as his songwriting, it was his own art of self-promotion. Bowie always had the knack to generate news stories about himself and his work without seemingly trying. By the end of his career, it was the act of not saying anything or doing any personal publicity that was just as newsworthy. Bowie intuitively knew how to garner media publicity on his own terms in a way that very few others can. (I also argued that another one of my heroes – Salvador Dali – did the same thing in one of my articles on him in The Psychologist back in 1994). I’d like to think I am good at promoting my work and Bowie is one of my role models in this regard.
Be opportunistic and flexible – If there is one thing besides working hard that sums up my career to date, it is being opportunistic and flexible. As a voracious reader of all things Bowie since my early teens, I always loved Bowie’s sense of adventure and just following paths because they might lead you to something unexpected. Whether it was his use of the ‘cut up’ technique for writing lyrics (developed by Brion Gysin and William S. Burroughs), his use of Brian Eno’s ‘oblique strategy’ cards, or his love of studio improvisation (such as on the Berlin trilogy albums and the Outside LP), Bowie showed that inspiration for his musical and lyrical ideas could come from anywhere – from a person, from a fleeting observation, from something he read, from something he heard or saw in film or TV programme, and from his own life experiences. I too have taken this approach to my work and believe I am a much better person for it.
Be a mentor to others – Whatever career path you follow, mentors are key in developing talent and Bowie was a mentor to many people that he personally worked with (including many of the artists I named in the section on encouraging teamwork and collaboration above) as well as being an inspirational influence to those he never met (including myself).
Learn from those younger and less experienced than yourself – Paradoxically, despite being an influence on millions of people across many walks of life, Bowie was never afraid to learn from those much younger than himself and exemplified the maxim that you’re never too old to learn new things. He loved innovation and ideas and would soak it up from whoever was around him. As I have got older, this is something that I value more and am never afraid to learn from those much younger or seemingly less experienced than myself – particularly my PhD students.
Dr. Mark Griffiths, Distinguished Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
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Griffiths, M.D. (1994). Heroes: Salvador Dali. The Psychologist: Bulletin of the British Psychological Society, 7, 240.
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Pegg, N. (2011). The Complete David Bowie. London: Titan Books.
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Spitz, M. (2009). Bowie: A Biography. Crown Archetype.
Trynka, P. (2011). Starman: David Bowie – The Definitive Biography. London: Little Brown & Company.
Today’s blog takes a brief look at some of the stranger addictions that have been written about in the academic literature (or academics that have tried to argue these behaviours can be addictive). Some of these ‘addictions’ listed are not addictions by my own criteria but others have argued they are. The papers or books that have argued the case for the cited behaviour being a type of addiction are found in the ‘Further reading’ section.
- Argentine tango addiction: A French study published in a 2013 issue of the Journal of Behavioral Addictions by Remi Targhetta and colleagues argued that a minority of 1129 Argentine tango dancers they surveyed may be addicted to dancing. In 2015, I and some of my Hungarian colleagues developed the Dance Addiction Inventory (published in PLoS ONE) and also argued that a minority of dancers (more generally) might be addicted to dance and conceptualized the behaviour as a form of exercise addiction.
- Badminton addiction: While there are many behaviours I could have chosen here including addictions to box set television watching (aka ‘box set bingeing), bargain hunting, bungee jumping, blogging, and bodybuilding, a recent 2018 paper published in NeuroQuantology by Minji Kwon and colleagues carried out a neuroimaging study on a sample 45 badminton players. Using the Korean Exercise Addiction Scale, 20% of the sample were defined as being addicted to badminton.
- Carrot eating addiction: Again, there are many behaviours I could have chosen here including alleged addictions to crypto-trading, chaos, collecting, crosswords, and cycling, there are a number of published case studies in the psychological literature highlighting individuals addicted to eating carrots including papers by Ludek Černý and Karel Černý, K. (British Journal of Addiction, 1992), and Robert Kaplan (Australian and New Zealand Journal of Psychiatry, 1996).
- Death addiction: A recent paper by Dr. Marc Reisinger entitled ‘Addiction to death’ in the journal CNS Spectrums attempted to argue that attraction to death be considered an addiction similar to gambling addiction. Reisinger related the concept to individuals who have left Europe to join the jihad in Syria, and outlined the case of 24-year-old French-Algerian Mohamed Merah who committed several attacks in Toulouse in 2012 and who ‘glorified’ death. Te paper claimed that this “addiction to death is taught by Salafist preachers, whose videos, readily accessible on the internet, are kind of advertisements for death, complete with depictions of soothing fountains and beautiful young girls”.
- Entrepreneurship addiction: There are a couple of papers by April Spivack and Alexander McKelvie (a 2014 paper in the Journal of Business Venturing, and a 2018 paper Academy of Management) arguing that entrepreneurship can be addictive. They define ‘entrepreneurship addiction’ as “the excessive or compulsive engagement in entrepreneurial activities that results in a variety of social, emotional, and/or physiological problems and that despite the development of these problems, the entrepreneur is unable to resist the compulsion to engage in entrepreneurial activities”. They also make the case that that entrepreneurship addiction is different from workaholism.
- Fortune telling addiction: Although I could have included addictions to financial trading or fame, a 2015 paper in the Journal of Behavioral Addictions by Marie Grall-Bronnec and her colleagues reported the case study of a woman (Helen) that was ‘addicted’ to fortune tellers. They used my addiction criteria to assess whether Helen was addicted to fortune telling, and argued that she was.
- Google Glass addiction: In previous blogs I have written on addictions to gossip and gardening (although these were based more on non-academic literature). However, a 2015 paper published by Kathryn Yung and her colleagues in the journal Addictive Behaviors, published the first (and to my knowledge) only case of addiction to Google Glass (wearable computer-aided glasses with Bluetooth connectivity to internet-ready devices. The authors claimed that their paper, (i) showed that excessive and problematic uses of Google Glasscan be associated with involuntary movements to the temple area and short-term memory problems, and (ii) highlighted that the man in their case study displayed frustration and irritability that were related to withdrawal symptoms from excessive use of Google Glass.
- Hacking addiction: Back in the late 1990s and early 2000s I wrote a number of papers on internet addiction and included ‘hacking addiction’ as a type of internet addiction. Given the criminal element of this type of internet addiction I wrote about it in criminological-based journals such as The Probation Journal (1997) and The Police Journal (2000). One of the most infamous cases that I have written about took place in London in 1993, where Paul Bedworth was accused of hacking-related crime causing over £500,000 worth of damage. On the basis of expert witness testimony, he was acquitted on the basis that he was addicted to hacking. Since then, various papers have been published arguing that hacking can be an addiction. For instance, in an in-depth interview study of 62 hackers, Siew Chan and Lee Yao used addiction as a framework to explain their participants’ behaviour (see their paper in the Review of Business Information Systems, 2005).
- Internet search addiction: Although I was tempted to go for IVF addiction, I thought I would go for ‘internet search addiction’ which basically refers to constant ‘googling’ where individuals spend hours and hours every day using online databases to go searching for things. This behaviour was first alluded to by Kimberley Young in her 1999 classification of different types of internet addiction which she called ‘information overload’ and was defined as compulsive web surfing or database searches. More recently, Yifan Wang and her colleagues developed the Questionnaire on Internet Search Dependence (QISD) published in Frontiers in Public Health (FiPH). I criticized the QISD in a response paper published in FiPH, not because I didn’t think internet search addiction didn’t exist (because theoretically it might do, even though I’ve never come across a genuine case) but because the items in the instrument had very little to do with addiction.
- Joyriding addiction: There have been a number of academic papers published on joyriding addiction. Arguably the most well-known study was published by Sue Kellett and Harriet Gross in a 2006 issue of Psychology, Crime and Law. The study comprised semi-structured interviews with 54 joyriders (aged 15 to 21 years of age) all of whom were convicted car thieves (“mainly in custodial care”). The results of the study indicated that all addiction criteria occurred within the joyriders’ accounts of their behaviour particularly ‘‘persistence despite knowledge and concern about the harmful consequences’’, ‘‘tolerance’’, ‘‘persistent desire and/or unsuccessful attempts to stop’’, “large amounts of time being spent thinking about and/or recovering from the behaviour’’ and “loss of control”. The paper also cited examples of ‘withdrawal’ symptoms when not joyriding, the giving up of other important activities so that they could go joyriding instead, and spending more time participating in joyriding than they had originally intended.
- Killing addiction: The idea of serial killing being conceptualized as an addiction in popular culture is not new. For instance, Brian Masters book about British serial killer Dennis Nilsen (who killed at least 12 young men) was entitled Killing for Company: The Story of a Man Addicted to Murder, and Mikaela Sitford’s book about Harold Shipman, the British GP who killed over 200 people, was entitled Addicted to Murder: The True Story of Dr. Harold Shipman. In Eric Hickey’s 2010 book Serial Murderers and Their Victims, Hickey makes reference to an unpublished 1990 monograph by Dr. Victor Cline who outlined a four-factor addiction syndrome in relation to sexual serial killers who (so-called ‘lust murderers’ that I examined in a previous blog). One of the things that I have always argued throughout my career, is that someone cannot become addicted to an activity or a substance unless they are constantly being rewarded (either by continual positive and/or negative reinforcement). Given that serial killing is a discontinuous activity (i.e., it happens relatively infrequently rather than every hour or day) how could killing be an addiction? One answer is that the act of killing is part of the wider behaviour in that the preoccupation with killing can also include the re-enacting of past kills and the keeping of ‘trophies’ from the victims (which I overviewed in a previous blog).
- Love addiction: In the psychological literature, the concept of love addiction has been around for some time dating back to works by Sigmund Freud. Arguably the most cited work in this area is the 1975 book Love and Addiction by Stanton Peele and Archie Brodsky. Their book suggested that some forms of love are actually forms of addiction, and tried to make the case that some forms of love addiction may be potentially more destructive and prevalent than widely recognized opiate drugs. There have also been a number of instruments developed assessing love addiction including the Love Addiction Scale (developed by Hunter, Nitschke, and Hogan, 1981), and the Passionate Love Scale (developed by Hatfield, and Sprecher, 1986).
- Muscle dysmporphia as an addiction: In a paper I published with Andrew Foster and Gillian Shorter in a 2015 issue of the Journal of Behavioral Addictions, we argued that muscle dysmorphia (MD) could be classed as an addiction. MD is a condition characterised by a misconstrued body image in individuals who interpret their body size as both small or weak even though they may look normal or highly muscular. MD has been conceptualized as a body dysmorphic disorder, an eating disorder, and/or part of the obsessive-compulsive disorder symptomatology. Reviewing the most salient literature on MD, we proposed an alternative classification of MD that we termed the ‘Addiction to Body Image’ (ABI) model. We argued the addictive activity in MD is the maintaining of body image via a number of different activities such as bodybuilding, exercise, eating specific foods, taking specific drugs (e.g., anabolic steroids), shopping for specific foods, food supplements, and/or physical exercise accessories, etc.. In the ABI model, the perception of the positive effects on the self-body image is accounted for as a critical aspect of the MD condition (rather than addiction to exercise or certain types of eating disorder). Based on empirical evidence, we proposed that MD could be re-classed as an addiction due to the individual continuing to engage in maintenance behaviours that may cause long-term harm.
- News addiction: Although I could have chosen nasal spray addiction or near death addiction, a recent 2017 paper on ‘news addiction’ was published in the Journal of the Dow University of Health Sciences Karachi by Ghulam Ishaq and colleagues. The authors used some of my papers on behavioural addiction to argue for the construct of ‘news addiction’ as a construct to be empirically investigated. The authors also developed their own 19-item News Addiction Scale (NAS) although the paper didn’t give any examples of any of the items in the NAS. In relation to personality types (and like other addictions), they found news addiction was positively correlated with neuroticism and negatively correlated with conscientiousness. Given that this is the only study on news addiction that I am aware of, I’ll need a lot more research evidence before I am convinced that it really exists.
- Online auction addiction: A number of academics have made the claim that some individuals can become addicted to participating in online auctions. In a 2004 paper on internet addiction published in American Behavioral Scientist, Kimberley Young mentioned online auction [eBay] addiction in passing. The same observation was also made in a later 2009 paper by Tonino Cantelmi and Massimo Talls in the Journal of CyberTherapy and Rehabilitation. Other researchers have carried out empirical studies including a (i) 2007 paper by Cara Peters and Charles Bodkin in the Journal of Retailing and Consumer Services, (ii) 2008 paper by Chih-Chien Wang in the Proceedings of the Asia-Pacific Services Computing Conference, and (iii) 2011 study carried out by Dr. Ofir Turel and colleagues published in the MIS Quarerly. These papers indicated that those with problematic online auction use experienced (i) psychological distress, (ii) habitual usage, (iii) compulsive behaviour, (iv) negative consequences, and/or (v) dependence, withdrawal and self-regulation.
- Pinball addiction: Although I could have listed alleged addictions to plastic surgery and poetry, as far as I am aware, I am the only academic to have published a paper on pinball addiction. Back in 1992, I published a case study in Psychological Reports. My paper featured the case of a young man (aged 25 years) who (based on classic addiction criteria) was totally hooked on pinball. It was the most important thing in his life, used the behaviour to modify his moods, got withdrawal symptoms if he was unable to play pinball, had engaged in repeated efforts to cut down or stop playing pinball, and compromised all other activities in his life (education, occupation and relationships). To me, this individual had a gaming addiction but it was pinball rather than videogame addiction.
- Qat addiction: Qat (sometimes known as khat, kat, cat, and ghat) is a flowering plant traditionally used as a mild stimulant in African and Middle East countries (Somalia, Yemen, Ethiopia). Heavy qat users can experience many side effects including insomnia, anxiety, increased aggression, high blood pressure, and heart problems. There are numerous reports in the medical literature of qat addiction (see papers by Rita Manghi and colleagues in the Journal of Psychoactive Drugs, and Nezar Al-Hebshi and Nils Skuag in Addiction Biology).
- Rock climbing addiction: Over the past two years, a couple of papers by Robert Heirene, David Shearer, and Gareth Roderique-Davies have looked at the addictive properties of rock climbing specifically concentrating on withdrawal symptoms and craving. In the first paper on withdrawal symptoms published in 2016 in the Journal of Behavioral Addictions, the authors highlighted some previous research suggesting that there are similarities in the phenomenology of substance-related addictions and extreme sports (in this case rock climbing). The study concluded that based on self-report, rock climbers experienced genuine withdrawal symptoms during abstinence from climbing and that these were comparable to individuals with substance and other behavioural addictions. In a second investigation just published in Frontiers in Psychology, the same team reported the development of the Rock Climbing Craving Questionnaire comprising three factors (‘positive reinforcement’, ‘negative reinforcement’ and ‘urge to climb’).
- Study addiction: I was spoilt for choice on the letter ‘S’ and could have mentioned addictions to speeding, selfie-taking, shoplifting, Sudoko, and stock market speculation. However, there are now a number of published papers on ‘study addiction’ (individuals addicted to their academic study), three of which I have co-authored (all in the Journal of Behavioral Addictions and led by my colleague Pawel Atroszko). We have conceptualised study addiction as a type of work addiction (or a pre-cursor to work addiction) and in a series of studies (including longitudinal research) we have found empirical evidence of ‘study addiction’. Italian researchers (Yura Loscalzo and Marco Giannini) have also published research on ‘overstudying’ and ‘studyholism’ too (in the journals ARC Journal of Psychiatry, 2017; Social Indicators Research, 2018).
- Tanning addiction: There is now lots of empirical research examining ‘tanorexia’ (individuals who crave tanning and spend every day on sunbeds). However, I along with my colleagues in Norway recently reconceptualised tanorexia as a ‘tanning addiction’ and developed a scale to assess it (which was recently published in a 2018 issue of the British Journal of Dermatology). Our study was the largest over study on tanning (over 23,000 participants) and our newly developed scale (the Bergen Tanning Addiction Scale) had good psychometric properties.
- Upskirting addiction: Upskirting refers to taking a photograph (typically with a smartphone) up someone’s skirt without their permission. In the UK there have been a number of high profile court cases including Paul Appleby who managed to take 9000 upskirting photos in the space of just five weeks (suggesting that he was doing it all day every day to have taken so many photos), and Andrew MacRae who had amassed 49,000 upskirt photos and videos using hidden cameras at his workplace, on trains, and at the beach. Both men avoided a custodial sentence because their lawyers argued they were addicted and/or had a compulsion to upskirting. In a 2017 issue of the Law Gazette, forensic psychologist Julia Lam made countless references to upskirting in an overview of voyeuristic disorder. Dr. Lam also talked about her treatment of upskirting voyeurs and recounted one case which she claimed was a compulsion (and who was successfully treated). The case involved a male university student who was very sport active but who masturbated excessively whenever major sporting events or important exams were imminent as a coping strategy to relieve stress.
- Virtual reality addiction: Back in 1995, in a paper I entitled ‘Technological addictions’ in the journal Clinical Psychology Forum, I asserted that addiction to virtual reality would be something that psychologists would be seeing more of in the future. Although I wrote the paper over 20 years ago, there is still little empirical evidence (as yet) that individuals have become addicted to virtual reality (VR). However, that is probably more to do with the fact that – until very recently – there had been little in the way of affordable VR headsets. (I ought to just add that when I use the term ‘VR addiction’ what I am really talking about is addiction to the applications that can be utilized via VR hardware rather than the VR hardware itself). Of all the behaviours on this list, this is the one where there is less good evidence for its existence. Perhaps of most psychological concern is the use of VR in video gaming. There is a small minority of players out there who are already experiencing genuine addictions to online gaming. VR takes immersive gaming to the next level, and for those that use games as a method of coping and escape from the problems they have in the real world it’s not hard to see how a minority of individuals will prefer to spend a significant amount of their waking time in VR environments rather than their real life.
- Water addiction: In a blog I wrote back in 2015, I recounted some press stories on individuals who claimed they were ‘addicted’ to drinking water. My research into the topic led to a case study of ‘water dependence’ published a 1973 issue of the British Journal of Addiction by E.L. Edelstein. This paper reported that the excessive drinking of water can dilute electrolytes in an individual’s brain and cause intoxication. This led me to a condition called polydipsia (which in practical terms means drinking more than three litres of water a day) which often goes hand-in-hand with hyponatraemia (i.e., low sodium concentration in the blood) and in extreme cases can lead to excessive water drinkers slipping into a coma. There are also dozens and dozens of academic papers on psychogenic polydipsia (PPD). A paper by Dr. Brian Dundas and colleagues in a 2007 issue of Current Psychiatry Reports noted that PPD is a clinical syndrome characterized by polyuria (constantly going to the toilet) and polydipsia (constantly drinking too much water), and is common among individuals with psychiatric disorders. A 2000 study in European Psychiatry by E. Mercier-Guidez and G. Loas examined water intoxication in 353 French psychiatric inpatients. They reported that water intoxication can lead to irreversible brain damage and that around one-fifth of deaths among schizophrenics below the age of 53 years are caused this way. Whether ‘water intoxication’ is a symptom of being ‘addicted’ to water depends upon the definition of addiction being used.
- X-ray addiction: OK, this one’s a little bit of a cheat but what I really wanted to concentrate on what has been unofficially termed factitious disorder (FD). According to Kamil Jaghab and colleagues in a 2006 issue of the Psychiatry journal “FD is sometimes referred to as hospital addiction, pathomimia, or polysurgical addiction”. The primary characteristic of people suffering from FD is that they deliberately pretend to be ill in the absence of external incentives (such as criminal prosecution or financial gain). It is called a factitious because sufferers feign illness, pretend to have a disease, and/or fake psychological trauma typically to gain attention and/or sympathy from other people. Again, whether such behaviours can be viewed as an addiction depends upon the definition of addiction being used.
- YouTube addiction: I unexpectedly found my research on internet addiction being cited in a news article by Paula Gaita on compulsive viewing of YouTube videos (‘Does compulsive YouTube viewing qualify as addiction?‘). The article was actually reporting a case study from a different news article published by PBS NewsHour by science correspondent Lesley McClurg (‘After compulsively watching YouTube, teenage girl lands in rehab for digital addiction’). The story profiled a student whose obsessive viewing of YouTube content led to extreme behaviour changes and eventually, depression and a suicide attempt. Not long after this, I and my colleague Janarthanan Balakrishnan published what we believe is the only ever study on YouTube addiction in the Journal of Behavioral Addictions. In a study of over 400 YouTube users we found that YouTube addiction was more associated with content creation than watching content
- ‘Zedding’ addiction: OK, I’m using the Urban Dictionary’s synonym here as a way of including ‘sleep addiction’. The term ‘sleep addiction’ is sometimes used to describe the behavior of individuals who sleep too much. Conditions such as hypersomnia (the opposite of insomnia) has been referred to ‘sleeping addiction’ (in the populist literature at least). In a 2010 issue of the Rhode Island Medical Journal, Stanley Aronson wrote a short article entitled “Those esoteric, exoteric and fantabulous diagnoses” and listed clinomania as the compulsion to stay in bed. Given the use of the word ‘compulsive’ in this definition, there is an argument to consider clinomania as an addiction or at least a behaviour with addictive type elements.
Dr Mark Griffiths, Distinguished Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
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In a previous blog, I briefly overviewed the influence that the Catalonian surrealist artist Salvador Dali had made on psychology (based on a couple of articles I had published about him earlier in my academic career – see ‘Further reading’ below). In that blog I briefly mentioned some of the strange aspects in his life relating to his sexuality and sexual desires but did not go into any details. In this article, I delve a little deeper into Dali’s sexual psychology and concentrate on some of the more extreme aspects of his life. I’m certainly not the first person to do this given that there are various online articles covering similar ground such as ‘Five sadistic and depraved secrets of Salvador Dali’, ‘10 depraved secrets of Salvador Dali’, and ‘17 unbelievably weird stories most people don’t know about Salvador Dali’. In a nutshell (and if you believe everything you read about him), Dali didn’t like sexual intercourse, was ‘addicted to masturbation’, was a sexual voyeur, was obsessed by buttocks, had an interest in necrophilia, was sexually attracted to Adolf Hitler and hermaphrodites, and was a candaulist (i.e., he liked to watch his wife have sex with other men).
The first observation to make concerning Dali is that he had little interest in sexual intercourse. All Dali’s biographers make reference to this because this was something that Dali admitted himself (for instance in his book The Unspeakable Confessions of Salvador Dali). In Ian Gibson’s (1998) biography The Shameful Life of Salvador Dali, it notes that Dali had been fixated on his unusually complex sexuality since his teenage years. Dali wrote that:
”For a long time I experienced the misery of believing I was impotent…Naked, and comparing myself to my schoolfriends, I discovered that my penis was small, pitiful and soft. I can recall a pornographic novel whose Don Juan machine-gunned female genitals with ferocious glee, saying that he enjoyed hearing women creak like watermelons. I convinced myself that I would never be able to make a woman creak like a watermelon”.
It was in his teenage years that Dali acquainted himself with the pleasures of masturbation even though he had a fear that it would cause homosexuality, impotence, and madness. However, sexual self-gratification became his primary (and many biographers allege only) sexual activity he engaged in throughout his life, often in front of a mirror. It’s also been noted by many authors that Dali “associated sex with decay” and that the roots of this association were due to his father’s strange form of sex education (such as being shown sexually explicit photographs of individuals with advanced, untreated sexually transmitted infections that Dali described as “the color of hell”). After viewing the pictures of grotesque genitalia, Dali started to associate sexual activity with decay and putrefaction (which came to the fore in his paintings). In his 1942 autobiography (The Secret Life of Salvador Dali) he even claimed that he became interested in necrophilia but was then later “cured” of it (but to what level his interest spanned is unknown). Dali had many obsessions including a deep fascination of buttocks (both men’s and women’s) as well as many phobias including female genitalia and a fear of castration (and appears to be the basis of his infamous painting The Great Masturbator). As a 2014 article by Jackie Fuchs noted:
“These fears and obsessions – along with a lifelong fascination with ants – became recurrent motifs in his paintings. In ‘The Great Masturbator’, Dali’s first significant work, a woman believed to be Dali’s future wife Gala rises out of a downward-facing head, which is suspended over a locust swarming with ants. The positioning of the woman’s mouth next to a thinly clad male crotch suggests fellatio, while the trickle of blood on the male figure’s thighs reflects Dali’s castration anxiety (see below)”.
A 2011 online article in Living in Philistia by Joshua White makes other allegations about Dali’s early childhood saying that he might have been sexually abused by one of his schoolteachers and that he might have had an incestuous relationship with his sister (although I’ve found little evidence of these allegations):
“[Dali] later pinned his ‘impotence’ on his father, as well as his mother, and naturally Dali went on to fantasise of sodomising his dying father. This also might explain the direct kind of gynophobia Dali later developed. It has been suggested that he was molested by a teacher who used to have Dali sit on his lap while he stroked him. That would explain the artist’s lifelong hatred of being touched. The subject of twelve of his early paintings was Dali’s sister Ana Maria, a number of which tellingly depict her from the rear, which has led some to conclude that the relationship between them may have been incestuous. The sex life of Salvador Dali was not a common one to say the least”.
An online article by Mateo Sol also alluded to Dali’s poor relationship with his parents. On one occasion Dali exhibited an artwork in which he wrote “Sometimes, I spit for fun on my mother’s portrait.” His father asked him to publicly apologise but Dali declined to do so. Following this incident, Dali sent his father a condom in the post (into which he had added his own semen) with a short note that simply read: “This is all I owe you”.
Dali’s wife and muse Gala (born in Russia as Helena Diakanoff Devulina) appears to have dominated Dali from their first meeting in 1929 (figuratively, psychologically, and arguably sexually given that almost no physical intimacy took place between Dali and Gala). It’s also generally agreed among scholars that Dali was a virgin when he married Gala (at least heterosexually) and they remained married for 53 years until Gala’s death. Gala was ten years older than Dali and had many sexual conquests before they married. Gala might perhaps best be described as a ‘swinger’, and at the time she met Dali was married to Paul Éluard (the poet) who both adhered to the sexual philosophy of ‘free love’.
Many biographers describe Gala as a highly-sexed nymphomaniac. Éluard and Gala were constantly sexually unfaithful to each other and (according to some accounts) encouraged each other’s infidelity. Gibson’s biography recounted Dali and Gala’s ‘mutual degradation’ of each other and Dali became some who tolerated all her extra-marital lovers. According to Zuzanna Stranska in a 2017 article in the Daily Art Magazine, Dali bought Gala a castle in Púbol (Girona) in 1968, but Dali was not allowed to visit without Gala’s written permission (and described in Joshua White’s article as Gala’s “fuck-nest” rather than a ‘love-nest’). It was here that Gala entertained her younger lovers.
It’s also been claimed that Dali had a homosexual relationship with poet Federico García Lorca (but has never been verified). It’s been alleged by a number of authors that Lorca twice tried to seduce Dali (and Dali said “Lorca tried to screw me twice”). Lorca was shocked when Dali married Gala because (according to a 2009 paper in the PsyArt Journal by Zoltán Kováry) “he was convinced that the painter had erection only with a finger in his anus”. Although Dali claims never to have had a relationship with Lorca, it appears they did have one sexual liaison because Dali wrote that: “I tried sex once with a woman and it was Gala. It was overrated. I tried sex once with a man and that man was the famous juggler Frederico Garcia Lorca. It was very painful”. Dali also wrote that:
“Deep down I felt that [Lorca] was a great poet and that I owe him a tiny bit of the Divine Dali’s asshole. He eventually bagged a young girl, and she replaced me in the sacrifice. Failing to get me to put my ass at his disposal, he swore that the girl’s sacrifice was matched by his own: it was the first time he had ever slept with a woman”.
According to the article by Joshua White, Dali was arguably more homosexual than heterosexual. He claimed that:
“[Dali] developed a penchant for persuading youths to drop their trousers and masturbate as he watched. He hoarded thousands of photos with many different lads. There has been a long speculation over the exact sexuality of the exhibitionist painter. We might be able to trace the misogynistic, or more accurately gynophobic, tendencies of Dalinian art down to Dali’s fear of a particular part of the female anatomy. To put it more bluntly, Salvador Dalí was a self-professed worshiper of the female posterior. The extent of this obsession drew the concern of his fellow Surrealists, he denied he was coprophagic one minute and in the next instance would state ‘true love would be to eat one’s partner’s excrement.’ Perhaps we should keep in mind that the Catalonians are a very scatological people, for it is custom before eating to exclaim “Eat well, shit hard.” The specific preference he had was for hermaphrodites, which he never encountered and only ever fantasised about. Not masculine or feminine, androgyne was the order of the day”.
Consequently, masturbation became Dali’s only physical sexual activity throughout his life. While this might be psychologically devastating for most people, his sexual psyche, tortured sexuality, and sexual inadequacy are critical to understanding the great art he produced. It certainly appears he had a great fascination with masturbation. For instance, Brian Sewell, the British art historian, claimed that Dali once asked him strip naked, lie down in the foetal position, and masturbate in front of a sculpture of Christ. Dali’s voyeuristic tendencies have also documented by others, most notably the alleged weekly orgies that Dali used to host which not only catered for Dali’s love of voyeurism but also his candaulism (where he would enjoy other men having sex with his wife). The most infamous story was told by American singer and actress Cher who arrived at Dali’s apartment mid-orgy. She picked up “a beautiful, painted rubber fish. Just fabulous. It has this little remote-control handset, and I’m playing with it, and the tail is going back and forth, and I’m thinking it’s a child’s toy. So I said to Salvador: ‘This is really funny.’ And he said: ‘It’s wonderful when you place it on your clitoris’”.
It has also been claimed that Dali had a perverse obsession with Nazi leader Adolf Hitler. Most individuals in the surrealist movement were politically left-wing but Dali was expelled for being a Nazi sympathiser (an allegation that Dali strenuously denied). Whether he was a Nazi sympathiser or not, Dali definitely painted a number of artworks featuring the ‘great dictator’ including The Enigma of Hitler and Hitler Masturbating. In his book (The Unspeakable Confessions) Dali also said that he “often dreamed of Hitler as a woman” and that Hitler “turned [him] on in the highest…His fat back, especially when I saw him appear in the uniform with the Sam Browne belt and shoulder straps that tightly held in his flesh, aroused in me a delicious gustatory thrill originating in the mouth and affording me a Wagnerian ecstasy”. An online article by Stephan Roget notes that there’s a good chance that Dali said such things for shock value, but also notes that Dali didn’t appear to have problems with what the Fuhrer was doing in Nazi Germany.
Most Dali scholars believe he was a sexual voyeur and derived great sexual arousal from watching other people (including his wife) have sex. According to the article by Jackie Fuchs:
“[Dali] was attracted to androgynous bodies – women with small breasts and men having feminine lines. Dali wrote of his ‘penetrating voyeur experiences’ during childhood and even titled one of his early paintings ‘Voyeur’.”
Joshua White also noted that:
“Originally [Dali’s] art served as a vent for the eccentricities, fetishes and obsessions that lurked beneath the surface of a shy Catalonian boy. But as he crafted a persona through which he could express these same things with almost the same level of impunity, then the standard of his art went into a steep decline in his later years. The sexual ambiguity, explicit paraphilia and vivid androgyny found so exuberant in Dalinian artwork…The 20th Century leitmotifs of sex and paranoia are conjoined twins in Dali’s work…We find some of the worst nightmares of the 20th Century conjured up by the more sinister works he churned out, while the juxtaposition with sex introduces a sadomasochistic element into the situations portrayed”
Perhaps the best (or worst, depending upon your viewpoint) eye-opener concerning Dali’s alleged sex life was a book first published in 2000 by former dancer and (struggling) actor Carlos Lozano entitled Sex, Surrealism, Dali and Me (and translated into English by Clifford Thurlow; a reprinting of the book in 2004 with new material was published by Thurlow as The Sex Life of Salvador Dali: The Memoirs of Carlos Lozano). Given that Dali had been dead over a decade by the time this book was published it’s hard for any of the stories to be substantiated (particularly as Lozano died shortly after the book was published). After starting out as one of Dali’s nude models, Lozano claimed he became Dali’s young lover and was Dali’s main confidante in the last two decades of his life. Among the book’s revelations were that Dali: (i) orchestrated sex games for his celebrity guests (including the King of Spain, the artist Marcel Duchamp, actor Yul Brynner, and Prince Dado Ruspoli), (ii) was obsessed with humiliating friends for his own amusement and sexual gratification (such as forcing them to strip and then getting them to engage in sexual acts of his choosing) while he masturbated from the side lines, and (iii) forced a famous Hollywood actress to strip naked and crawl through a plastic ‘uterus’ to allow her to re-experience birth.
It is clear from reading about Dali’s various (s)exploits that his sexual behaviour and sexuality were extreme but that much of his early great art derived from his strange sexual psyche. While some of the alleged sexual behaviours may have been embellished over the years, all of the allegations appear to have some truth in them. Many may argue that Dali’s sex life (or absence of it) was as surreal as his paintings, but none of this takes away from the fact that his art is awe-inspiring to many (myself included).
Dr. Mark Griffiths, Distinguished Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
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Regular readers will know that I love music and that two of my favourite bands include the Beatles and the Velvet Underground (both of who I have written blogs about including the VU’s lead singer Lou Reed, as well as blogs here, here, and here). Many would argue that the two bands couldn’t have been further apart musically especially given the Velvet Underground’s reputation as an ‘extreme’ band. However, I thought I would try and gather stories, anecdotes, and make my own observations on where the music and lives of members of the two bands connected in some way. Most of you reading this will know the four members of the Beatles (John Lennon, Paul McCartney, George Harrison, and Ringo Starr) but some of you may not know the original Velvet Underground members (Lou Reed, John Cale, Sterling Morrison, and Moe Tucker, plus Nico as vocalist on three songs on their first LP). These are presented in no particular order although towards the end of the list, the associations become more tenuous.
- Both bands released their seminal LPs in 1967 (Sgt. Pepper’s Lonely Hearts Club Band by the Beatles and Velvet Underground and Nico by the Velvet Underground). Both of the covers were designed by ‘pop artists’ (Peter Blake and Andy Warhol, the latter being VU’s manager at the time) and both are regarded as iconic LP cover art. The Velvet Underground were in the minority who didn’t like Sgt. Pepper and John Cale dismissed the LP as a “theatrical statement”. Lou Reed went even further and was quoted as saying “I never liked The Beatles. I thought they were garbage”.
- In 1993, Richard Witts (who before being an academic was the lead singer in one of my favourite 1980s band The Passage, and who I wrote about in a previous blog), published a biography about Velvet Underground vocalist Nico (Nico: The Life & Lies of an Icon). Witts claimed that in 1967 (May 19), Nico attended one of Beatles’ manager Brian Epstein’s private parties where he previewed the Pepper for the British media. Nico said in Witts’ book that: “There is a song I liked on Sgt. Pepper, called ‘A Day in the Life. It has a beautiful song and then this strange sound like John Cale would make (he told me it was an orchestra, actually) and then this stupid little pop song that spoils everything so far. I told this to Paul [McCartney], and I made a mistake, because the beautiful song was written by John Lennon and the stupid song was written by Paul. It can be embarrassing when you speak the truth.” Witts book also claimed that Nico briefly stayed with Paul McCartney at his London home during this particular May visit.
- In 1968, both the Beatles and the Velvet Underground released eponymous LPs (i.e., The Beatles by the Beatles and The Velvet Underground by the Velvet Underground). The eponymous Beatles LP is usually referred to as the ‘White Album’ and the eponymous Velvet Underground LP is sometimes referred to as the ‘Grey Album’. The other LP that the Velvet Underground released in 1968 (i.e., White Light/White Heat) was an all-black cover apart from the name of the group and the album title in white whereas the Beatles eponymous album was completely white apart from the name of the album in black). This is sometimes refereed to ‘The Black Album’.
- According to a number of Lou Reed’s biographers, the Beatles’ manager Brian Epstein really liked the Velvet Underground’s debut LP and (like David Bowie) was given a promo copy before it had actually been released. Epstein was approached by Steve Sesnick (the Velvet Underground’s manager after Andy Warhol) who contacted him hoping to get a deal for Velvet Underground songs with Epstein’s publishing company. It has also been claimed that Epstein was setting up a European tour for the Velvet Underground but Epstein died just before the contracts were signed (in fact Epstein died on my first birthday, August 27, 1967). According to Richie Unterberger (author of the excellent book White Light, White Heat: The Velvet Underground Day-By-Day), Reed actually met Epstein: “In a semicomic incident, Lou Reed himself met Brian Epstein around spring 1967 when, at publicist Danny Fields’s instigation, Reed finagled a cab ride with the Beatles manager in New York in the hopes that some interest in the VU’s affairs might be ignited. Evidently nothing came of it, however, other than Epstein sharing a joint with Reed and telling Lou how much he liked the banana album”.
- Lou Reed was a long-term client/patient of German (but New York-based) Dr. Robert Freymann. Freymann (also known as ‘Dr. Feelgood’) was the subject of the 1966 Beatles song ‘Dr. Robert’ on their Revolver.
- Both bands have individuals that are often claimed to be the ‘fifth member’. There are the ‘fifth Beatles’ (George Martin, Brian Epstein, Mal Evans, Billy Preston) and the ‘fifth VU member’ (Nico, Billy Yule, Andy Warhol).
- Anthony DeCurtis (author of the 2017 biography Lou Reed: A Life) speculates that Lou Reed’s song ‘The Day John Kennedy Died’ includes lyrics that are conflated with Reed’s memories of the day John Lennon died. More specifically, Reed wrote that he heard about Kennedy’s death while watching an American football match but there was no game on that day (12.30pm on November 22, 1963). However, on the day John Lennon died, sports broadcaster Howard Cosell announced that Lennon had been shot dead during his evening TV programme Monday Night Football.
- Lou Reed’s 1980 LP Growing Up In Public was recorded in Monserrat at Beatles’ producer George Martin’s studio.
- The Velvet Underground’s first manager, the rock journalist Al Aronowitz, was the man who first introduced the Beatles to Bob Dylan on August 28, 1964 (and George Harrison became Dylan’s life-long friend and were both in the Traveling Wilburys).
- Both ‘leaders’ of the Beatles and Velvet Underground wrote songs about heroin use from a personal perspective (‘Cold Turkey’ by Lennon and ‘Heroin’ by Reed). Other members of both bands experienced alcoholism (Ringo Starr and John Cale), and almost all members of both bands dabbled in various drug use (some very heavily) in the 1960s and 1970s.
- Lou Reed and John Lennon have both collaborated with David Bowie. Bowie produced Reed’s album ‘Transformer‘, sang on the track ‘Hop Frog’ (on The Raven LP), and and sang live on stage together in 1972 and 1997 (at Bowie’s 50th birthday concert at Madison Square Garden). Bowie co-wrote his No.1 US hit ‘Fame‘ with Lennon at the end of the Young Americans LP sessions (and in a previous blog, I looked at other associations between Bowie and the Beatles). John Cale also collaborated on two songs with Bowie (‘Velvet Couch’ and ‘Piano-la’) but these were never officially released and are only found on bootlegs).
- In the song ‘Rooftop Garden’ (the song that closes Reed’s Legendary Hearts LP), Reed used the line ‘Sitting in my rooftop garden, waiting for the sun’ in which he swapped the word ‘English’ for ‘rooftop’ from the line in ‘I Am The Walrus’.
- Both Lou Reed and Ringo Starr appeared as guests on the 1985 anti-apartheid protest song ‘Sun City’ single and accompanying video put together by Steven Van Zandt. Reed and Starr were also both inducted into the US ‘Rock ‘n’ Roll Hall of Fame’ in 2015.
- In 2011, Lou Reed and Paul McCartney both appeared on the same tribute album (Rave On) to Buddy Holly. Reed sang ‘Peggy Sue‘ and McCartney sang ‘It’s So Easy‘ (and McCartney earned money from both as he owns Holly’s back catalogue).
- Both Lou Reed and George Harrison have been heavily influenced in their lives by various aspects of Buddhism.
- Both John Lennon and Lou Reed spent the last decade of their lives living in New York (although Reed never lived in anywhere but New York) and both released albums with New York in the title (Some Time in New York City by Lennon and New York by Reed).
Dr. Mark Griffiths, Professor of Behavioural Addictions, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
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Unwanted visual intrusions are characteristic of Post-Traumatic Stress Disorder (PTSD). According to Dr. Emily Holmes and her colleagues in a 2009 paper in the journal PLoS ONE, one innovative intervention for inhibiting unwanted intrusions is playing the Tetris videogame, described as a ‘cognitive vaccine’ in preventing intrusions after traumatic events. Playing Tetris consumes heavy visuospatial working memory resources that potentially compete with cognitive resources required for elaboration of visual imagery. Since Holmes and colleagues’ study, other studies have used Tetris to inhibit intrusive imagery including more studies by Holmes and her colleagues and others by Ella James’ research group, as well as some innovative studies using Tetris to reduce drug cravings by Jessica Storka-Brown and her colleagues (see ‘Further reading’ below). However, none of these studies assessed the role of videogame content after playing in relation to Game Transfer Phenomena (GTP), an area that we have carried out a lot of research into (see ‘Further reading’ below).
GTP research has investigated non-volitional experiences (e.g., altered sensorial perceptions and automatic mental processes/behaviours) mostly experienced after gaming. Gamers often report sensorial (visual/auditory) intrusions after playing (e.g., visual and auditory imagery, hallucinations). In a survey of 2,362 gamers that we published in a 2016 issue of the International Journal of Human-Computer Interaction, most (77%) had visualized images from a variety of videogames (including tile-puzzle games) with closed-eyes, and one-third (31%) had visualized images with open-eyes. Other studies have experimentally induced videogame-related visualizations at sleep onset (including studies by Stickgold and colleagues , Wamsley and colleagues , Kusse and colleagues  – see ‘Further reading’).
James and colleagues’ 2015 study in the journal Psychological Science was the first to make explicit reference to GTP (referred to as the ‘Tetris effect’ [TE]). In 2012, we argued the TE term is misleading as it suggests repetition is the core of transfer effects. However, other factors are involved. Research concerning GTP makes the distinction between sensorial modalities facilitating non-volitional phenomena with videogame content that occur along the continuum from mild to severe. Moreover, the descriptive constructs of GTP are empirically based on our analysis of 3,500+ gamers and have been examined via confirmatory factor analysis demonstrating good reliability and validity.
James and her colleagues tested if playing Tetris offered a protective mechanism against re-experiencing traumatic events. Healthy participants (n=56) were randomly assigned to either playing Tetris for 11 minutes, or doing nothing before exposure to a 12-minute traumatic film. Image-base memories about the film were then registered in a one-week dairy. However, playing Tetris as a proactive interference task before watching the film did not show significant results. James and colleagues offered different explanations including: (i) duration of the task in relation to film length, (ii) temporal contingencies between the tasks, (iii) differences between the task types, (iv) videogame types used, and (v) reactivation of gameplay during the film for aided interference. In a commentary paper published in a 2016 issue of Frontiers in Psychology, we discussed these findings and some of its shortcomings in relation to GTP literature.
- Duration of task in relation to film length: Playing Tetris for 11 minutes may not have been long enough to compete with the consolidation of memory of the 12-minute film. GTP are significantly more likely to occur when playing 3-6 hours. Our research reported only 4% of gamers reported GTP when playing sessions shorter than one-hour. Laboratory experiments have taken days of playing to induce game-related visualizations at sleep onset.
- Temporal contingencies between gaming and film watching: The tasks were performed minutes apart from each other. GTP mostly occur soon after stopping playing but our research has found that gamers have also reported GTP days after playing. In most cases, duration of experience is very short (seconds/minutes) but in some cases hours or longer.
- Differences between the tasks: Previous studies have demonstrated that similar tasks aid interference. However, watching a film is a passive activity while gaming is interactive requiring additional perceptual/motor skills. Therefore, it may be expected that gaming is more potent as interference task, particularly because inducing the subjective sense of presence in the virtual world may strengthen the interference.
- Type of videogame used as interference task and emotional content of film: The unrealistic (geometric) Tetris content may have been overwritten by the film’s traumatic images. Visualization of stereotypical games induced at sleep onset are characterized by lack of emotion, assuming that the amygdala and the reward system are not involved. In GTP research, emotions in tile-matching puzzle-games are incomparable to emotions in realistic videogames.
- Reactivation of gameplay during the film for aided interference: The use of cue reminders may have potential in reviving videogame content. In many cases, thoughts and altered perceptions are triggered by game-related cues. Selective attention toward game-related cues has been demonstrated in experiments. GTP have been reported in variety of videogame genres particularly those that have very realistic graphics and settings. Therefore, more realistic games may aid associations between real life stimuli and videogame content, and may be more effective in competing with memories of traumatic events.
In our Frontiers paper, we noted that playing Tetris is not only an effective visuospatial task (overloading working memory resources needed for imagery-formation while playing), but as demonstrated in our GTP studies, videogame content stays active after playing (e.g., mental imagery, sensory perceptions), and may offer additional benefits for managing unwanted intrusions. GTP may potentially strengthen effects of interference tasks but should be used cautiously, because videogame content not only targets unwanted intrusions, but also influences individual cognitions, perceptions, and behaviours in day-to-day contexts (e.g., attention bias, lack of task awareness, control inhibition failures). Moreover, our studies have shown distress and dysfunction have been reported with GTP.
Consequently, further research needs conducting to identify: (i) videogames that are most effective, (ii) playing duration, (iii) factors that reduce intervention efficacy and strategies to control them, and (iv) individuals that may benefit the most from such intervention. While using videogames as intervention tools for preventing unwanted imagery from traumatic experiences has potential, therapeutically it is still at an early stage.
- (Please note: This blog was co-written with Dr. Angelica Ortiz de Gortari and is based on an article we published in Frontiers in Psychology: Ortiz de Gortari, A.B. & Griffiths, M.D. (2016). Playing the computer game Tetris prior to viewing traumatic film material and subsequent intrusive memories: Examining proactive interference. Frontiers in Psychology, 7, 260. doi: 10.3389/fpsyg.2016.00260)
Holmes, E. A., James, E. L., Kilford, E. J., & Deeprose, C. (2010). Key steps in developing a cognitive vaccine against traumatic flashbacks: Visuospatial Tetris versus Verbal Pub Quiz. PloS ONE, 5(11), e13706.
James, E. L., Bonsall, M. B., Hoppitt, L., Tunbridge, E. M., Geddes, J. R., Milton, A. L., & Holmes, E. A. (2015a). Computer game play reduces intrusive memories of experimental trauma via reconsolidation-update mechanisms. Psychological Science. doi: 10.1177/0956797615583071
James, E. L., Zhu, A. L., Tickle, H., Horsch, A., & Holmes, E. A. (2015b). Playing the computer game Tetris prior to viewing traumatic film material and subsequent intrusive memories: Examining proactive interference. Journal of Behavior Therapy and Experimental Psychiatry. doi: 10.1016/j.jbtep.2015.11.004
Kusse, C., Shaffii-Le Bourdiec, A., Schrouff, J., Matarazzo, L., & Maquet, P. (2012). Experience-dependent induction of hypnagogic images during daytime naps: A combined behavioural and EEG study. Journal of Sleep Research, 21(1), 10-20.
Ortiz de Gortari, A. B., Aronsson, K., & Griffiths, M. D. (2011). Game Transfer Phenomena in video game playing: A qualitative interview study. International Journal of Cyber Behavior, Psychology and Learning 1(3), 15-33.
Ortiz de Gortari, A. B., & Griffiths, M. D. (2012). An introduction to Game Transfer Phenomena in video game playing. In J. I. Gackenbach (Ed.), Video Game Play and Consciousness (pp. 223-250). Hauppauge, NY: Nova Publisher.
Ortiz de Gortari, A. B., & Griffiths, M. D. (2014a). Altered visual perception in Game Transfer Phenomena: An empirical self-report study. International Journal of Human-Computer Interaction, 30(2), 95-105.
Ortiz de Gortari, A. B., & Griffiths, M. D. (2014b). Auditory experiences in Game Transfer Phenomena: An empirical self-report study. International Journal of Cyber Behavior, Psychology and Learning 4(1), 59-75.
Ortiz de Gortari, A. B., & Griffiths, M. D. (2014c). Automatic mental processes, automatic actions and behaviours in Game Transfer Phenomena: An empirical self-report study using online forum data. International Journal of Mental Health and Addiction, 12(4), 1-21.
Ortiz de Gortari, A. B., & Griffiths, M. D. (2015a). Game Transfer Phenomena and its associated factors: An exploratory empirical online survey study. Computers in Human Behavior, 51, 195-202.
Ortiz de Gortari, A.B. & Griffiths, M.D. (2016). Prevalence and characteristics of Game Transfer Phenomena: A descriptive survey study. International Journal of Human-Computer Interaction, 32, 470-480.
Ortiz de Gortari, A.B., Oldfield, B. & Griffiths, M.D. (2016). An empirical examination of factors associated with Game Transfer Phenomena severity. Computers in Human Behavior, 64, 274-284.
Ortiz de Gortari, A. B., Pontes, H. M. & Griffiths, M. D. (2015). The Game Transfer Phenomena Scale: An instrument for investigating the nonvolitional effects of video game playing. Cyberpsychology, Behavior, and Social Networking 10, 588-594
Skorka-Brown, J., Andrade, J., & May, J. (2014). Playing ‘Tetris’ reduces the strength, frequency and vividness of naturally occurring cravings. Appetite, 76 , 161-165.
Skorka-Brown, J., Andrade, J., Whalley, B., & May, J. (2015). Playing Tetris decreases drug and other cravings in real world settings. Addictive Behaviors, 51, 165-170.
Stickgold, R., Malia, A., Maguire, D., Roddenberry, D., & O’Connor, M. (2000). Replaying the Game: Hypnagogic images in normals and amnesics. Science, 290(5490), 350-353.
Wamsley, E. J., Perry, K., Djonlagic, I., Reaven, L. B., & Stickgold, R. (2010). Cognitive replay of visuomotor learning at sleep onset: Temporal dynamics and relationship to task performance. Sleep, 1(33), 59-68.