Category Archives: Popular Culture

Extremes of dreams (so it seems): The psychology of ‘Vanilla Sky’

Regular readers of my blog will know that when it comes to certain films and television shows (and their accompanying DVD box sets) I can be somewhat obsessive and fanatical (for instance see, my blog on my love of all things concerning Hannibal Lecter). I’m one of those individuals that will watch some films again and again looking for further insight and deeper meanings (such as Memento, The Usual Suspects, Donnie Darko, Inception, Shutter Island, Seven, and The Shining). One of the films I have watched many times is Cameron Crowe’s psychological thriller Vanilla Sky (starring Tom Cruise, Kurt Russell, Cameron Diaz and Penélope Cruz), a remake of the Spanish film Abre los Ojos (Open Your Eyes).

One of the reason I like the film is that it prominently features the concept of lucid dreaming. I’d never heard of lucid dreaming until 1988. I was doing my PhD at the University of Exeter at the time and one of my best friends (Robert Rooksby) was doing his PhD on lucid dreaming. As the Wikipedia entry on lucid dreaming notes:

“A lucid dream is any dream in which one is aware that one is dreaming. In relation to this phenomenon, Greek philosopher Aristotle observed: ‘often when one is asleep, there is something in consciousness which declares that what then presents itself is but a dream’…The person most widely acknowledged as having coined the term is Dutch psychiatrist and writer Frederik (Willem) van Eeden…In a lucid dream, the dreamer has greater chances to exert some degree of control over their participation within the dream or be able to manipulate their imaginary experiences in the dream environment…Lucid dreams can be realistic and vivid. It is shown that there are higher amounts of beta-1 frequency band (13–19 Hz) brain wave activity experienced by lucid dreamers, hence there is an increased amount of activity in the parietal lobes making lucid dreaming a conscious process”.

Much like the films of David Lynch (one of my favourite film directors), Vanilla Sky is a film forces you to think about what is going on and is one of those films that you can come to your own conclusions as to what it all means. As a psychologist, I love films that play with the mind and Vanilla Sky is one of those films, particularly as psychology in the form of dreams, subjective reality, and the unconscious lie at the heart of the film. The director Cameron Crowe added many obscure clues and hidden references throughout the film to help viewers further explain the film and to add more layers.  There are dozens of dedicated websites that have compiled lists of theories, messages and/or hidden clues. In the film’s production notes, Crowe later admitted: “We constructed the movie, visually and story-wise, to reveal more and more the closer you look at it. As deep as you want to go with it, my desire was for the movie to meet you there”. That alone is enough of a hook to get me watching repeatedly.

Another aspect of the film that I love is the perfect use of music. Almost every lyric of every song used throughout the movie interweaves seamlessly between the actors, the in-scene narrative, and the developing story line. The songs are expertly chosen. This is no surprise given that Crowe was formerly a music journalist and a contributing editor at Rolling Stone magazine. Like me, Crowe is a huge fan of The Beatles, and referred to the “clues” in Vanilla Sky as his own version of the ‘Paul McCartney is Dead’ rumour that swept the world in 1969 (i.e., the notorious Beatles hoax when fans worldwide became convinced through song lyrics, sonic tricks, and album art that Paul McCartney had died and was replaced by a look-alike). As Crowe commented: “Divorcing it from whether Paul was really dead or not, that was a really great parlour game: searching for clues, the excitement of different layers, some of them chilling, some of them really funny. It was a great model for us [on Vanilla Sky]”. One of the homages to The Beatles in the film concerns their song Revolution 9. The film contains countless references to the number (or time) 9:09 (on Aames’ wristwatch, a child’s shirt, the prison chalkboard, and multiple references to cats who, has myth has it, have nine lives).

I’m assuming that anyone that has read this far has seen the film (but if you haven’t – spoiler alert – some of what I’m about to write will likely reduce the enjoyment of watching the film for the first time). The thrust of the plot is as follows:

“From a prison cell where he has been charged for murder, David Aames (Tom Cruise, in a prosthetic mask, tells his life story to court psychologist Dr. Curtis McCabe (Kurt Russell). In flashback, David [who is acrophobic with an irrational fear of heights] is shown to be the wealthy owner of a large publishing firm in New York City which he inherited from his father, leaving its regular duties to his father’s trusted associates. As David enjoys the bachelor lifestyle, he is introduced to Sofia Serrano (Penélope Cruz) by his best friend and author Brian Shelby [who is writing a book on Aames] at a party. David and Sofia spend a night together talking, and fall in love. When David’s former lover, Julianna “Julie” Gianni (Cameron Diaz) hears of Sofia, she attempts to kill herself and David in a car crash. Julie dies but David survives, his face grotesquely disfigured, leading him to wear a mask to hide the injuries. With no hope to use plastic surgery to repair the damage, David cannot come to grips with the idea of wearing the mask for the rest of his life. One night on a night out with Sofia…David gets hopelessly drunk, and [is left by Sophia] to wallow in the street outside” (Wikipedia entry on Vanilla Sky)

It is generally accepted that everything from this point in the film is a dream (although others say the whole film is a dream). Rather than live out the rest of his life in a disfigured state, Aames has his body cryogenically frozen by a company called Life Extension after attempting suicide. He lives the rest of his life as a lucid dream from the moment he was found on the pavement after his drunken night out (“under the ‘vanilla sky’ from a Monet painting”). However, during cryogenic sleep, the lucid dream goes horribly wrong and starts to incorporate elements from his subconscious. After 150 years in suspended sleep, the company that placed Aames into cryogenic suspension calls in ‘Tech Support’ and Aames is offered a choice to either be reinserted into a corrected lucid dream, or to wake up by taking a leap of faith – literally – from the top of a high roof (that forces him to challenge his fear of heights).

Conquering his final fear, David jumps off the building, his life flashing before his eyes, and whites out immediately before hitting the ground. A female voice commands him to ‘open your eyes’ (a recurring theme in the movie), and the film ends with David opening his eyes” (Wikipedia entry on Vanilla Sky).

Many different websites examining the film claim there are five interpretations of the film’s ending (and this is supported by Crowe himself). The five interpretations (taken verbatim from the Wikipedia entry on the film) are:

  • “Tech support is telling the truth: 150 years have passed since Aames killed himself and subsequent events form a lucid dream.
  • The entire film is a dream, evidenced by the sticker on Aames’ car that reads “2/30/01″ (February 30 does not occur in the Gregorian Calendar).
  • The events following the crash form a dream that occurs while Aames is in a coma.
  • The entire film is the plot of the book that Brian [Shelby, his best friend] is writing.
  • The entire film after the crash is a hallucination caused by the drugs that were administered during Aames’ reconstructive surgery”.

(I’m most persuaded by the first interpretation). What I also love about the film is that Crowe added lots of little details that take a few viewings of the film before they are usually spotted. All of these help in both trying to interpret the film, as well as becoming a game where repeated watching becomes more rewarding. For instance:

  • In the first scene in which Julianna appears, the tune ringing on her cell phone is Row Row Row Your Boat that features the lyric “life is but a dream”.
  • At his birthday party, Aames is asked how it’s going to which he responds “Livin’ the dream, baby…livin’ the dream”.
  • At the same party, Aames’ best friend Brian Shelby comes into the second apartment wears a t-shirt with the words “fantasy” in sparkly sequins.
  • In one of the prison scenes, the word ‘DREAM’ is spelt out backwards on a chalkboard.
  • In the prison cell, the book, Memories, Dreams, and Reflections (by Carl Jung) is on the table while Aames is talking to his psychiatrist Dr. McCabe. The book concerns Jung’s personal dreams and how they helped uncover his “shadow” and removed his persona (his ‘mask’). In fact one critique of the film by Carlo Cavagna described the whole film as “overtly Jungian”. More specifically, he asserted that Vanilla Sky is fundamentally about the relationship between the ego and the unconscious, and practically a primer on the most fundamental concepts found in any Jungian glossary…For Jung, the unconscious includes desires repressed by our education and socialization, but there is more ‘psychic material that lies below the threshold of consciousness’. The unconscious is the foundation on which the conscious mind is based”.
  • On Aames’ prison uniform the name tag says “Frozen Guy”.
  • His patient number on his Life Extension cryogenic tank says “PL515NT 4R51MS” (which if the numbers are replaced with their corresponding letters of the alphabet, it almost spells “Pleasant Dreams”).
  • As Aames is getting his prison photograph taken, the slate spells ‘When did the dream become a nightmare?’ (in simple code).
  • Sofia calls Aames a “pleasure delayer” twice in the film (but says it so subtly that it’s hard to hear properly).
  • When Aames and Sophia are lying in bed after making love, Sophia asks “Is this is a dream?” and Aames replied “absolutely”.
  • At one point in the film, Dr. McCabe tells Aames that he’d had a nightmare the day before.  Aames replies that “It’s all a nightmare”.

I said earlier in the article that I thought the songs were perfectly chosen. Many fans of the film have noted that the lyrics repeatedly appear to match the emotion of the scene where it is played. As the Uncool website notes:

“For example, the song that plays over David leaving Sophia’s in the morning is Jeff Buckley’s, ‘Last Goodbye’…that morning was there last one true goodbye. Yes, they see each other after this, but after the car wreck when both of their lives are forever changed. ‘Last Goodbye’ also contains the lyrics: ‘Kiss me, please kiss me, but kiss me out of desire, babe not consolation’ which follows David’s plight rather well (as the next time he sees her is after the accident and he wants her affections but not sympathy for his disfigurement)…Bruce Springsteen’s ‘The River’ album (featured in the closing montage) also has some lyrical significance. One of the best lines from the song ‘The River’ is: “Is a dream a lie if it don’t come true, or is it something worse?” Also, two R.E.M. songs are featured. Don’t forget what R.E.M. stands for. Rapid eye movement. As in a state of sleep. It’s when you dream”.

It doesn’t take a psychologist to work out that I simply love the level of detail that went into making the film. I am not a great fan of psychodynamic (psychoanalytic) interpretation, but in Vanilla Sky, the mask that Aames wore became his ‘persona’ and the term was used by Carl Jung to describe the face that we as individuals present to society and (in some cases) to ourselves. Carlo Cavagna argues that:

“[Aames] attraction to [Sophie] is irresistible because she is his anima, his archetypal dream lover, the personification of the feminine nature in his own unconscious. Jung posited that all men carry an ideal image of woman in their heads and unconsciously project that image onto “the person of the beloved…David’s disfigured face, which he sometimes hides with his mask, represents his shadow. For Jung, the shadow is the inferior part of the personality, the sum of all personal and collective psychic elements that, because of their incompatibility with the chosen conscious attitude, are denied expression in life and therefore coalesce into a relatively autonomous “splinter personality” in the unconscious. Despite the negative connotations of the word ‘shadow’, Jung meant it to encompass all those qualities that are suppressed, both positive and negative. ‘The shadow personifies everything that the subject refuses to acknowledge about himself and yet is always thrusting itself upon him directly or indirectly’… [Aames] reality is subjective, and his shadow is breaking through into consciousness. This is the source of the film’s main conflict. In discussing dream therapy and the difficulty of processing and assimilating the unconscious, Jung wrote that several negative outcomes are possible – eccentricity, infantilism, paranoia, schizophrenia, or regression (the restoration of the persona). The revelation and assimilation of David’s unconscious is essentially the story of Vanilla Sky”.

Although there are many critics who hated the film, I love it on many different levels (including the underlying psychology).

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

Further reading

Cavagna, C. (2001, December). Vanilla Sky. Located at: http://www.aboutfilm.com/movies/v/vanillasky.htm

Jung, C.G. (1961). Memories, Dreams, Reflections. New York: Vantage.

Kummer, R. (2010). “What is happiness to you?” Vanilla Sky (2001) Film Analysis. Located at: http://rkummer.hubpages.com/hub/What-is-happiness-to-you-Vanilla-Sky-2001-Film-Analysis

Rooksby, R. and Terwee, Sybe J.S. (1990). Freud, van Eeden and lucid dreaming. Lucidity Letter, 9(2), 18–28. Located at: http://www.sawka.com/spiritwatch/freudvan.htm

Turner, R. (2014). Vanilla Sky movie review: Beyond lucid dreams. Located at: http://www.world-of-lucid-dreaming.com/vanilla-sky-review.html

The Uncool (2015). Vanilla Sky secrets. Located at: http://www.theuncool.com/films/vanilla-sky/vanilla-sky-secrets

Wikipedia (2015). Vanilla Sky. Located at: https://en.wikipedia.org/?title=Vanilla_Sky

Whirled piece: Dancing as an addiction

In previous blogs I have examined various (admittedly extreme) aspects of dancing including people that are sexually aroused by dancing (choreophilia), dancing as a form of frottuerism, people that are addicted to dancing (in this case, the Argentine tango), and people who have developed medical complaints as a result of dancing (‘breaker’s neck’ caused by break dancing). However, over the last few months I have been a co-author on two dance-related research papers with my research colleagues in Hungary (led by Aniko Maraz). The first one (published in the journal PLoS ONE) was about the development and psychometric validation of the ‘Dancing Motives Inventory’ (DMI). The second one (also published in PLoS ONE) was a study of dance addiction (and which I will describe in more detail below).

I’m sure many of you reading this will think that dancing is a somewhat trivial area to be carrying out scientific research. However, research has shown that dancing can have substantial benefits for physical and mental health such as decreased depression and anxiety, and increased physical and psychological wellbeing. After we developed the DMI, we realised that very little known about the psychological underpinnings of excessive dancing, and whether in extreme cases, dancing could be classed as an addictive behaviour. Given the lack of empirical research in dance addiction, we conceptualized dance addiction to be akin to exercise addiction. For example, a study published in the journal Perceptual and Motor Skills led by Dr. Edgar Pierce reported that dancers scored higher on the Exercise Addiction Scale compared to endurance and non-endurance athletes. Added to this, both exercise and dancing require stamina and physical fitness, and for this reason, dance is often classified as a form of exercise.

Over the last 20 years I have published many papers on exercise addiction (see ‘Further reading’ below) so there is no reason why dance addiction couldn’t theoretically exist (in fact, it could be argued that dance addiction – if it exists – is a sub-type of exercise addiction). There are also a handful of studies that have examined excessive dancing and whether it can be addictive to a small minority. A study by Edgar Pierce and Myra Daleng (again in Perceptual and Motor Skills) conducted a study with 10 elite ballet dancers and found that dancers rated thinner bodies as ideal and significantly more desirable than their actual body image despite being in the ‘ideal’ BMI range. The study also found that dancers often continue to dance despite discomfort, “because of the embedded subculture in dance that embraces injury, pain, and tolerance”. In a more recent study in the Journal of Behavioral Addictions (and which I reported at length in a previous blog), Dr. Remi Targhetta and colleagues assessed addiction to the Argentine tango. They found that almost half of their participants (45%) met the DSM-IV criteria of abuse, although a substantially lower prevalence rate (7%) was found when using more conservative criteria.

In our recently published study, we proposed that excessive social dancing would be associated with detriments to mental health. More specifically, we aimed to (i) identify subgroups of dancers regarding addiction tendencies, (ii) explore which factors account for the elevated risk of dance addiction, and (iii) explore the motivations underlying excessive dancing.

Our sample included 447 salsa and ballroom dancers (32% male and 68% female, with an average age of 33 years) who danced recreationally at least once a week. To assess ‘dance addiction’ we created the ‘Dance Addiction Inventory’ modified from the Exercise Addiction Inventory (that I co-developed back in 2004) in which we simply replaced the word ‘exercise’ with the word ‘dance’. We also assessed the dancers’ general mental health, borderline personality disorder, eating disorder symptoms, and dance motives.

As far as we are aware, our study is the first to explore the psychopathology and motivation behind dance addiction. Based on my criteria of addiction, five distinct types of dancers were identified. Only two of these types danced excessively. About one-quarter of our sample reported high values on all criteria of addiction but they reported no conflict with the social environment. However, 11% of dancers (and what we termed the ‘high risk’ group) scored high on all addiction symptoms and experienced conflict in their life as a consequence of their excessive dancing.

Our study also found that dance addiction was associated with mild psychopathology, especially with elevated number of eating disorder symptoms and (to a lesser extent) borderline personality traits (something which has also been found in research examining exercise addiction). Perhaps unsurprisingly, escapism (and to a lesser extent mood enhancement) was an especially strong indicator of dance addiction. I say ‘unsurprisingly’ because escapism has already been much reported in other types of behavioural addiction such as gambling and video gaming (including a lot of my own research). Here, escapism as a motivational factor refers to dancing in order to avoid feeling empty or as a mechanism to deal with everyday problems. Based on our findings, we believe that to a minority of individuals appear to be addicted to dancing and that it may be being used be a maladaptive coping mechanism.

Based on what we know in the exercise addiction literature, we proposed that future studies should also assess whether eating disorder is primary or secondary to dance addiction (i.e., whether the purpose of excessive dancing is weight-control and/or the motivation to perform leads to disturbances in eating patterns). I should also point out that although we found that distress was correlated with dance addiction, the association disappeared when other measures were added to the regression model. This may indicate that distress is not directly associated with problematic dancing and that it may arise from other problematic factors such as having an eating disorder.

Given the lack of research in the field, other studies are needed to confirm or refute the findings of our study. Given that dancing is a social activity, social conflicts may not arise when the person has only fellow dancers as partners or friends – therefore, the risky behaviour may remain somewhat hidden. Another question that could be examined is whether there is any difference between amateur and professional dancers in terms of addiction tendency (although among professional dancers there may be a debate about whether their behaviour is dancing addiction or ‘workaholism’). Also, we don’t know whether our findings can be extended to other dance genres (as we only surveyed ballroom and salsa dancers)

I would just like to end by saying that dancing is very clearly a healthy activity for the majority of individuals. However, our study does seem to suggest that excessive dancing may have problematic and/or harmful effects for a small minority. Although we couldn’t establish causality, dance addiction appears to have the potential to be associated with mild psychopathology.

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

Additional input: Aniko Maraz, Róbert Urbán and Zsolt Demetrovics.

Further reading

Allegre, B., Souville, M., Therme, P. & Griffiths, M.D. (2006). Definitions and measures of exercise dependence, Addiction Research and Theory,14, 631-646

Berczik, K., Szabó, A., Griffiths, M.D., Kurimay, T., Kun, B. & Demetrovics, Z. (2012). Exercise addiction: symptoms, diagnosis, epidemiology, and etiology. Substance Use and Misuse, 47, 403-417.

Berczik, K., Szabó, A., Griffiths, M.D., Kurimay, T., Kun, B. & Demetrovics, Z. (2012). Exercise addiction: symptoms, diagnosis, epidemiology, and etiology. Substance Use and Misuse, 47, 403-417.

Griffiths, M.D., Szabo, A. & Terry, A. (2005). The Exercise Addiction Inventory: A quick and easy screening tool for health practitioners. British Journal of Sports Medicine, 39, 30-31.

Griffiths, M.D., Urbán, R., Demetrovics, Z., Lichtenstein, M.B., de la Vega, R., Kun, B., Ruiz-Barquín, R., Youngman, J. & Szabo, A. (2015). A cross-cultural re-evaluation of the Exercise Addiction Inventory (EAI) in five countries. Sports Medicine Open, 1:5.

Kurimay, T., Griffiths, M.D., Berczik, K., & Demetrovics, Z. (2013). Exercise addiction: The dark side of sports and exercise. In Baron, D., Reardon, C. & Baron, S.H., Contemporary Issues in Sports Psychiatry: A Global Perspective (pp.33-43). Chichester: Wiley.

Maraz, A., Király, O., Urbán, R., Griffiths, M.D., Demetrovics, Z. (2015). Why do you dance? Development of the Dance Motivation Inventory (DMI). PLoS ONE, 10(3): e0122866. doi:10.1371/ journal.pone.0122866

Maraz, A., Urbán, R., Griffiths, M.D. & Demetrovics Z. (2015). An empirical investigation of dance addiction. PloS ONE, 10(5): e0125988. doi:10.1371/journal.pone.0125988.

Pierce, E.F. & Daleng, M.L. (1998) Distortion of body image among elite female dancers. Perceptual and Motor Skills, 87, 769-770.

Pierce, E.F., Daleng, M.L. & McGowan, R.W. (1993) Scores on exercise dependence among dancers. Perceptual and Motor Skills, 76, 531-535.

Ramirez, B., Masella, P.A., Fiscina, B., Lala, V.R., & Edwards, M. D. (1984). Breaker’s neck. Journal of the American Medical Association, 252(24), 3366-3367.

Targhetta, R., Nalpas, B. & Perney, P. (2013). Argentine tango: Another behavioral addiction? Journal of Behavioral Addictions, 2, 179-186.

Distraction plans: Excessive smartphone use and pain perception

In a previous blog I outlined many physical syndromes that had been reported in the 1980s medical literature, a number of which related to excessive video game playing. This included ‘Space Invader’s Wrist’ (published in the New England Journal of Medicine), ‘Pseudovideoma’ (Journal of Hand Surgery), ‘Pac-Man Phalanx’ (Arthritis and Rheumatism) and ‘Joystick Digit’ (Journal of the American Medical Association). More recently, other new medical complaints have been reported related to excessive mobile phone use including a report of ‘Blackberry thumb’ in a 2013 issue of the Canadian Medical Association Journal. 

Earlier this month saw the publication of a case report involving a tendon rupture in a man excessively playing a video game on his smartphone. The report appeared in JAMA Internal Medicine by Dr. Andrew Doan and his colleagues (the same Dr. Doan that reported a case study of someone “addicted” to Google Glass that I examined in a previous blog). The authors of the latest report wrote:

“We describe a patient with rupture of the extensor pollicis longus tendon associated with excessive video game play on his smartphone. A 29-year-old, right hand–dominant man presented with chronic left thumb pain and loss of active motion. Before the onset of symptoms, he reported playing a video game on his smartphone all day for 6 to 8 weeks. He played with his left hand while using his right hand for other tasks, stating that ‘playing was a kind of secondary thing, but it was constantly on.’ When playing the video game, the patient reported that he felt no pain. He reported no injuries or prior operations to either hand. He denied a history of inflammatory arthritis, quinolone use, or other predisposing medical condition for ten-don rupture. On physical examination, the left extensor pollicis longus tendon was not palpable, and no tendon motion was noted with wrist tenodesis. The thumb metacarpophalangeal range of motion was 10° to 80°, and thumb interphalangeal range of motion was 30° to 70°. The findings on physical examination of the patient’s right hand were unremarkable. The clinical diagnosis was rupture of the left extensor pollicis longus tendon. A magnetic resonance imaging study of his left hand revealed tendon attenuation and rupture of the tendon. Radiographic studies of the wrist found no bone spurs or prior or current fractures. The patient subsequently underwent an extensor indicis proprius (1 of 2 tendons that extend the index finger) to extensor pollicis longus tendon transfer. During surgery, rupture of the extensor pollicis longus tendon was seen between the metacarpophalangeal and wrist joints”

One of the things that I found interesting was that despite the tendon rupture, when the man was actually playing the game, he felt no pain. This is something I know only too well from personal experience. Unfortunately, I have a chronic and degenerative spinal complaint (herniated discs in my neck) but I feel no pain whatsoever when I am cognitively distracted. I find that work is a much better analgesic than dihydrocodeine (i.e., when I am working I feel no pain whatsoever). However, playing video games come a close second as when I am engaged in video game playing (even on simple casual games), the fact that it takes up all my cognitive resources means that I don’t feel any pain. This is nothing new and many medics are aware of the therapeutic benefits of gaming. There are now many studies showing that children undergoing chemotherapy need much less pain relief if they play video games after their treatment compared to children that don’t play video games. (In fact I’ve written a number of papers and book chapters on ‘video game therapy’ – see ‘Further reading’ below). This case report then went on to say:

“Video games suppress pain perception in pediatric patients and during burn treatments. Visual distraction and neuroendocrine hypothalamic-pituitary-adrenal arousal provide a plausible explanation for why the patient did not feel pain from his injury. Without the expected physiologic negative pain feedback, excessive gaming may have led to tendon attenuation and subsequent attritional rupture of the tendon. Attritional rupture at the midtendon differs from high- energy ruptures that occur where the tendon is thinnest or be- tween tendon and bone. Although this is only a single case report, research might consider whether video games have a role in clinical pain management and as nonpharmacologic alternatives during uncomfortable or painful medical procedures. They may also have a role in reducing stress. It may be interesting to ascertain whether various games differ in their ability to reduce the perception of pain…Research might also consider whether pain reduction is a reason some individuals play video games excessively, manifest addiction, or sustain injuries associated with video gaming”.

This conclusion does appear to suggest that the authors are unaware of the many hundreds of studies that have examined the therapeutic benefits of gaming (in fact there’s even an academic journal dedicated to such studies appropriately called the Games For Health Journal). As I have noted in a number of my writings about video gaming as a medical intervention for children:

  • Videogames are likely to engage much of a person’s individual active attention because of the cognitive and motor activity required.
  • Videogames allow the possibility to achieve sustained achievement because of the level of difficulty (i.e., challenge) of most games during extended play.
  • Videogames appear to appeal most to adolescents.

Consequently, videogames have also been used in a number of studies as ‘distractor tasks’. This latest case report highlights the simultaneous potential positive and negatives of gaming within a single individual but also highlights the fact that video gaming is both mobile and spreading to many more types of hardware. I’m now wondering which medical team will be the first to write about a new medical syndrome relating to the new Apple Watch.

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

Further reading

Behr, J.T. (1984). Pseudovideoma. Journal of Hand Surgery, 9(4), 613.

Gibofsky, A. (1983). Pac‐Man phalanx. Arthritis and Rheumatism, 26(1), 120.

Gilman, L., Cage, D.N., Horn, A. Bishop, F., Klam, W.P. & Doan, A.P. (2015). Tendon rupture associated with excessive smartphone gaming. JAMA Internal Medicine, doi:10.1001/jamainternmed.2015.0753

Griffiths, M.D. (2003). The therapeutic use of videogames in childhood and adolescence. Clinical Child Psychology and Psychiatry, 8, 547-554.

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., Kuss, D.J., & Ortiz de Gortari, A. (2013). Videogames as therapy: A review of the medical and psychological literature. In I. M. Miranda & M. M. Cruz-Cunha (Eds.), Handbook of research on ICTs for healthcare and social services: Developments and applications (pp.43-68). Pennsylvania: IGI Global.

McCowan, T.C. (1981). Space Invader’s wrist. New England Journal of Medicine, 304,1368.

Osterman, A. L., Weinberg, P., & Miller, G. (1987). Joystick digit. Journal of the American Medical Association, 257(6), 782.

O’Sullivan, B. (2013). Beyond BlackBerry thumb. CMAJ, 185, 185-186.

Soe, G.B., Gersten, L. M., Wilkins, J., Patzakis, M. J., & Harvey, J.P. (1987). Infection associated with joystick mimicking a spider bite. Western Journal of Medicine, 146(6), 748.

Yung, K., Eickhoff, E., Davis, D. L., Klam, W. P., & Doan, A. P. (2014). Internet Addiction Disorder and problematic use of Google Glass™ in patient treated at a residential substance abuse treatment program. Addictive Behaviors, http://dx.doi.org/10.1016/j.addbeh.2014.09.024.

Deal love: Bargain hunting as an addiction

“Bargain hunting may save money, but for some people, looking for the next ‘great deal’ becomes an addiction. The call of the clearance rack wins out over practical matters – like whether you need or want what you found, or even have a place to put it” (Tesh Media, ‘Are You Addicted To Bargain Hunting?’)

A couple of weeks ago, I did some background research for a newspaper interview on the psychology of bargain hunting (only for the journalist then to interview somebody else about it). Instead of wasting all the material collected, I decided to use it for this article. Most of the material in this article borders on ‘pop psychology’ but I found it interesting nonetheless. For instance, in a recent article on the BBC News website, the (anonymous) author provided some basic rules on how to be a more savvy shopper and bargain hunter (which I am quoting verbatim):

  • “Try to avoid stores that are too busy with loud music. This can confuse and distract you from judging what is a genuine offer.
  • Ask the sales rep to repeat the sales details in a clear and slow manner and if possible ask him/her to write them down.
  • Before you make a decision take a break, count from one to ten and think again about the benefits and perils of the offer.
  • Can you shop alone? Peer pressure has been proven to be a key indicator for individuals buying products that they do not need.
  • Never shop when you are feeling emotionally upset. Purchasing to overcome any mood or behavioural troubles is not beneficial in the long term.
  • Go shopping after a meal or when in a good and clear mood. There is evidence that shopping when you feel peckish can make you spend more than intended”.

As soon as we enter any shop (online or offline) we are being bombarded with psychological tactics in an attempt to get us to buy more products (such as selling products that have a price ending in 99p). The BBC article interviewed consumer psychologist Dr. Dimitri Tsivrikos who said:

“These prices are obviously used to convince you that you are spending less than you actually are. A price reduction makes it even more tempting. The bargain price is appealing to you because it challenges the status quo. The retailer appears not to be in complete control of the final price of the product, and this makes you feel that you are now in control. And because of that you feel you can negotiate the final price that you have to pay – whether that is the sale price or even a buy one get one free deal…Brain studies have shown that when we are excited by a bargain, this interferes with your ability to clearly judge whether it is actually a good offer or not”.

When I started researching online, I came across a number of articles claiming that for a small minority, bargain hunting was addictive (as the opening quote demonstrates). In another article on the Tesh Media website, reference was made to April Lane Benson’s edited book I Shop, Therefore I Am. According to that article (which merges bargain hunting addiction with shopping addiction more generally):

“[Benson] says that when it comes to bargain-hunting addictions, what people buy isn’t as important as how big the price reduction is. In fact, the bigger the price cut, the more tempting a purchase is. After all, if something’s 80% off the original price – you’re saving 80 percent! What you may not consider is that by not buying, you’ll save 100%. Bargain addicts also make illogical purchases, like grabbing up sale-price auto parts for cars they don’t own, or bargain kid’s clothes for children they don’t have…So, why is a bargain-hunting addiction so common? Tim Kasser, a professor of psychology at Knox College in Illinois, says it’s a way for people to ease insecurities, and feel more competent and in control. In fact, shopping addicts often don’t realize they have a problem, even when the bags and bills start stacking up. It usually takes a big event to bring it to their attention, like divorce, a new baby, unemployment, or retirement. Or they simply max out their credit cards, and have no more spending power”

In the same article published on the Tech Media website, it claimed the five signs of being ‘addicted’ to bargain hunter were:

  • “You hit sales and clearance racks when you feel angry or blue. Or you feel guilty after shopping and hide your purchases.
  • You spend more money than you can afford.
  • You see sales as opportunities you can’t pass up.
  • Another clue you’re a bargain addict: You spend so much time tracking down deals that it intrudes on your time with family and friends.
  • You often forget what you bought, and find things in your closets you’ve never used”.

Obviously some of these ‘warning signs’ tap into what I believe are the core components of addiction (such as the fourth bullet point that taps into ‘conflict’), however, most of the criteria have nothing to do with ‘addiction’ whatsoever. Using bargain-hunting as a way of making oneself feel better mirrors what is found in other addictions, but characteristics such as not being able to pass up a bargain, and forgetting what has been bought are not core signs of addiction but are idiosyncratic consequences that specifically relate to bargain hunting. Another online article also noted:

“According to new survey findings from Consumer Reports, 23% of women say they sometimes buy things they don’t need just because they’re on sale. For most of us, getting a discount is enough of a reward: 80% say they would hunt for a bargain even if money weren’t an issue for them. In general, the survey found bargain shopping has increased significantly, from 76% in 2011 to 83% today. That shift may be due in part to the growing use of smartphone coupons, which has increased from 11% in 2011 to 24% today. Human psychology may help explain the irresistible allure of a discount. Research suggests that people tend to enjoy bargains, regardless of whether any financial gain is involved. You might even be able to blame your bargain hunting on Mom and Dad, because some experts say genetic differences make certain people predisposed to finding pleasure in raiding the sale rack”.

This paragraph provided a hyperlink to some genuine academic research carried out by Dr. Peter Darke and his colleagues (published in a 2006 issue of the Journal of Applied Social Psychology). They carried out a couple of experiments examining both the financial and non-financial motivations underlying bargain hunting. They reported that:

“Subjects read scenarios that described the purchase of a television set. Scenarios differed in terms of whether a bargain was received, whether there was personal financial gain, and whether the sale was acquired through skill or luck. The results suggest that subjects generally enjoyed bargains regardless of any financial gain, thereby implying that nonfinancial motives might also be involved. Surprisingly, bargains acquired skillfully were not enjoyed more than lucky bargains. Thus, achievement motives could not explain why subjects enjoyed bargains when there was no associated financial gain. Instead, it seemed that acquiring a bargain was primarily considered a matter of luck”.

I was also interested in the claims that bargain hunting might be underpinned by genetic influences. These claims were made by Mark Ellwood in his 2013 book Bargain fever: How to shop in a discounted world. Ellwood summarized his book in an article for Time magazine and wrote:

“As it turns out, a passion for finding bargains is genetically preprogrammed in all humans, although it’s activated much more in some than others. Spotting special offers triggers a release of dopamine, the feel-good neurotransmitter that I like to think of as ‘buyagra’. Dopamine is such a powerful chemical that our brains have developed a built-in system to clean it up as quickly as possible. One in four Caucasians has an otherwise harmless flaw in what’s known as the COMT gene. While the rest of us can flush our brains free of dopamine with the efficiency of a Dyson, those with an iffy COMT gene can brandish only a hand broom. It takes more time and effort to flush their brains clean of buyagra – and so they are physiologically more prone to splurge, especially on bargains”.

Ellwood claimed that as soon as “bargain addicts sees one ‘Sale’ sign – cue a jolt of dopamine – they’re hooked”. More specifically, he goes on to argue that:

“Of course, a propensity for bargain hunting isn’t purely genetic…Many hardcore coupon cutters I’ve interviewed cite hardscrabble childhoods or food-bank visits as the foundation of their frugality. Certainly, in the past decade, deal hunting has gone from a sign of indigence to one of intelligence; thanks to the roiling economy and an uncertain future, more people have migrated to the markdown section than ever before…Internet-equipped smartphones turned price comparison into a one-step process in your palm — the practice known as showrooming that’s so detested by retailers. But in our search for bargains, we would do well to ask ourselves whether we are really trying to economize or whether we’re being driven by an even stronger impulse: the chemical drive to get a good price”.

Given that I believe shopping can be an addiction in a minority of individuals, it doesn’t take too much of a leap to suggest bargain hunting could be an addiction (or even a sub-type of shopping addiction). However, as far as I am aware, there has never been any empirical research examining ‘bargain hunting addiction’ more specifically. Based on the few online articles that I read, it certainly appears that we are living in a time and an age where such research would be worth carrying out.

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

Further reading

BBC News (2015). The psychology of shopping for bargains. Located at: http://www.bbc.co.uk/consumer/23818336

Benson, A.L. (2000). I Shop Therefore I Am: Compulsive Buying and the Search for Self. Jason Aronson Inc. Publishers.

Consumer Reports (2014). America’s bargain-hunting habits. What shoppers will and won’t do to save a buck. April 30. Located at: http://www.consumerreports.org/cro/news/2014/04/america-s-bargain-hunting-habits/index.htm

Darke, P. R., & Freedman, J. L. (1995). Nonfinancial Motives and Bargain Hunting1. Journal of Applied Social Psychology, 25(18), 1597-1610.

Davenport, K., Houston, J. & Griffiths, M.D. (2012). Excessive eating and compulsive buying behaviours in women: An empirical pilot study examining reward sensitivity, anxiety, impulsivity, self-esteem and social desirability. International Journal of Mental Health and Addiction, 10, 474-489.

Ellwood, M. (2013). The genetics of bargain hunting. Time, October 21. Located at: http://ideas.time.com/2013/10/21/the-genetics-of-bargain-hunting/

Ellwood, M. (2013). Bargain fever: How to shop in a discounted world. London: Portfolio.

Lebowitz, S. (2014). Extreme bargain hunters: How far would you go for a deal. LearnVest, May 2. Located at: http://www.learnvest.com/2014/05/extreme-bargain-hunters-how-far-would-you-go-for-a-deal-123/

Maraz, A., Eisinger, A., Hende, Urbán, R., Paksi, B., Kun, B., Kökönyei, G., Griffiths, M.D. & Demetrovics, Z. (2015). Measuring compulsive buying behaviour: Psychometric validity of three different scales and prevalence in the general population and in shopping centres. Psychiatry Research, 225, 326–334.

Tesh Media Group (2015). Are you addicted to bargain hunting? Located at: http://www.tesh.com/story/money-and-finance-category/are-you-addicted-to-bargain-hunting/cc/12/id/9141

Williams, A. (2013). Bargain fever: The new secrets of shopping in a discounted world. The Week, November 5. Located at: http://theweek.com/articles/457383/bargain-fever-new-secrets-shopping-discounted-world

Mould on tight: A brief look at plaster cast fetishism

Back in the early 2000s I remember watching Plaster Caster, a documentary film that looked at the life of artist and groupie, Cynthia Plaster Caster (i.e., Cynthia Albritton). Cynthia is in/famous for her plaster casting of rock star penises such as Jimi Hendrix and Noel Redding (both in the Jimi Hendrix Experience), Eric Burdon (The Animals), Wayne Kramer (MC-5), Jello Biafra (The Dead Kennedys), and Pete Shelley (Buzzcocks), She began her career in erotic plaster casting in 1968 but now includes women as her artistic clients (and typically makes plaster casts of their breasts). Her plaster casting skills have also been immortalized in song by both Kiss (‘Plaster Caster’) and Jim Croce (‘Five Short Minutes’). As her Wikipedia entry points out:

“In college, when her art teacher gave the class an assignment to ‘plaster cast something solid that could retain its shape’, her idea to use the assignment as a lure to entice rock stars to have sex with her became a hit, even before she made a cast of anyone’s genitalia. Finding a dental mould making substance called alginate to be sufficient, she found her first client in Jimi Hendrix, the first of many to submit to the idea. Meeting Frank Zappa, who found the concept of ‘casting’ both humorous and creative as an art form, Albritton found in him something of a patron”.

However, sexual plaster casting does not begin and end with Cynthia Plaster Caster. In a previous blog, I briefly mentioned the practice of mummification within a sadomasochistic context. According to Dr. Aggrawal’s 2009 book Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices, mummification is:

“An extreme form of bondage in which the person is wrapped from head to toe, much like a mummy, completely immobilizing him. Materials used may be clingfilm, cloth, bandages, rubber strips, duct tape, plaster bandages, bodybags, or straitjackets. The immobilized person may then be left bound in a state of effective sensory deprivation for a period of time or sensually stimulated in his state of bondage – before being released from his wrappings”.

One type of restrictive mummification practice not mentioned by Dr. Aggrawal is that of plaster cast fetishism. Although there is little academic research on the topic, a quick Google search throws up many dedicated online sites and hundreds of video clips for sale and/or sharing. For instance, I came across the Casted Angel website (that claims to be the oldest ‘cast and bandage site’), the Cast Fetish website, the Cast Paradise website, and the Fantacast website (please be warned that if you click on any of the links, all of these sites are sexually explicit)

The Wikipedia entry on mummification reports that such activity is typically used to enhance the feelings of total bodily helplessness (which would be totally fulfilled by those engaging in plaster cast fetishism), and is incorporated with sensation play (i.e., a group of erotic activities that facilitate particular physical sensations upon a sexual partner). As a 2010 article on ‘The Erotic Secrets of the Mummy’ notes:

“A variant of this extreme and spectacular form of bondage is mummification made with plaster…Anyone who has taken an arm or leg immobilized by a cast can imagine how restrictive it is to use this material for bondage. Obviously there are safety precautions which must be taken: you must cover the body of the person to be bound with a protective layer (e.g. plastic) so the plaster does not come into direct contact with skin, and make sure to have safety scissors around for easy removal of the bindings. It is also important to note that mummification increases body temperature and therefore sweating, so you must make sure to hydrate the person being bound. An example of complete plaster mummification can be seen in a nonsexual context, in the comedy After Hours by Martin Scorsese”.

As well as being a form of extreme mummification, plaster cast fetishism is also a sub-variant of ‘cast fetishism’ that according to the Encyclopedia Dramatica comprises erotic “concentration on orthopedic casts (plaster, polymer, bandage, etc.) It is usually related to the fetishes of feet, stockings, shoes and amputees”. Cast fetishists derive sexual pleasure and arousal from people (typically the opposite sex) wearing casts on their limbs (but may also be additionally aroused by people using crutches or who have a limp). I’ve come across dozens of people who have posted in online forums and claiming they have cast fetishes and/or fixations. Here are just a few:

  • Extract 1: “It is no bad thing to have a cast fetish when you have an ongoing foot injury. This morning I got [a plaster cast] for my left leg as my foot is giving trouble. Wanting to keep my foot up when riding in my friend’s car I put the window down and rested my cast on the top of the door. The wind blowing across my bare casted toes as we drove down the street was just the ultimate turn-on!”
  • Extract 2: “Since I was a child I had a strong fetish for casts and bandages. When I was 6 or 7 years old I saw a girl in at the local hospital, with a freshly applied plaster [cast] in her right leg, and how she cleaned her toes with a damp cloth. That’s still one of the memories that arouses me. Two years ago, I had a girlfriend, who came to know about my fetish, it was kinda difficult for me to say, but she liked the idea and I put her in a homemade [plaster cast], then I painted her toenails and put a toe-ring. It was a shame that it was one night only and the plaster didn’t dry at all, but it was so good to stay with her and kiss her toes wiggling out of her cast. It was one of the most pleasant nights that I’ve had”.
  • Extract 3: “I have been in love with casts since about 13 yrs old. I have had the chance to [wear a] dual hip [cast] and several short and long term casts but want to wear possibly a full body one day if I find the right cast partner”.
  • Extract 4: I’ve had an interest seeing girls in casts for quite some time now. I think it started when I was a little kid and broke my leg. Probably since then I have always wanted to be in a cast, but didn’t want to hurt myself! I just recently discovered the ease and community around the world of recreational casting. I have a short leg cast and it’s an amazing feeling!”
  • Extract 5: “I have always had a fascination for seeing people in a cast, and in particular girls in long leg casts. It may have something to do with the restricted movement I don’t know. I am not interested in the associated, implied pain aspect but more the caring aspect. I always thought that this was an idea peculiar to me but, I was recently inspired to search the net and found a whole community subscribing to the cast fetish idea with many images…I have never fractured a limb so I have never had a cast but, I have made a couple of attempts at self-casting”
  • Extract 6: “I love being in a cast. For years I have studied the casting processes in both plaster and fiberglass. I have honed these skills to the point [that] nobody, [not] even an orthopedic assistant can tell it was not applied professionally”
  • Extract 7: “I have always wanted to have a cast on my leg and or arm. I have tried hitting my hand on the ground but I still have not fractured it…I would even pay someone to break both my arm and leg”

One of the most detailed I have come across is this one:

“I have a strong sexual attraction to, and erotic fascination with, the sight of the female leg wearing an orthopaedic cast, particularly along its full extent, from toes to hip. Now in my mid-forties, I have been aware of this ‘interest’ since my early teens, which might explain my particular attraction to plaster casts, as were the norm at such a time, which somehow seem heavier and more of a physical entity than contemporary casts. For many years, I assumed this peculiar attraction to be mine alone, and looked forward to those rare occasions when I might see a woman with a leg in plaster in public or otherwise find a picture in a newspaper or magazine, which I would collect. However, since the advent of the internet, I have become aware that a number of like-minded souls exist all over the world, that the ‘cast fetish’ is out there in the world of cyberspace, is shared and enjoyed by people and is practised recreationally in the real, everyday world by those who have the inclination and means to do so”.

“As the online aspect of this fetish has developed over recent years, I now find I am able to better satisfy my visual needs through the large number of available images, of both medically and recreationally-worn leg casts. I have obsessively built a large collection of pictures of women wearing leg casts, and frequently enjoy these. Sometimes I feel a certain frustration that my need to satisfy the desire to find and see more images consumes more time than I have available to ‘waste’, but this is not something over which I have full control – it is a compulsion and needs to be fulfilled in this way, in the manner of such a condition, even if it never seems possible to have quite enough of such images, there is always the thrill of the anticipation of finding a new, ‘perfect’ picture of a cast and its wearer. I have always assumed that my obsession is based on the aesthetics of the leg cast, being related as it is to my general attraction to women’s legs, feet, toes, boots, etc. The leg cast is very much an ‘object of desire’ in its appearance and in the manner it objectifies the leg inside, I enjoy the way a cast looks and find this arousing”.

“However, I wonder whether my ‘interest’ may have other underlying, hidden causes and inspirations, and exactly what might have triggered this fetish? I wonder this because although I have never had occasion to wear a cast myself (and thus experienced the physical restrictions imposed by one), and neither has anyone with whom I might spend regular, extended periods of time, such as a family member or close friend, I have often imagined that female friends might have to have a leg in plaster that I might be around them, or that I might meet and form a relationship with a woman in such a situation (not that I have any desire to see anyone come to harm, suffer an injury, etc, but I would love to see the effect of such – the wearing of a cast – if it ever occurred). I have a very strong desire to be in the presence of a leg cast as it is being worn, that I might interact with it and the wearer, that I might experience the sexuality of such, and it is something about which I have frequent sexual fantasies, being the most arousing situation I am able to imagine”.

In a short 2006 article on ‘Women with Plaster Casts’ at the online Trendhunter website, Hernando Gomez Salinas wrote about the Cast Fetish website and then used the writings of Sigmund Freud to provide some theoretical insight into the fetish:

“According to Freud, fetishism is considered a paraphilia or sexual deviation as a consequence of an infantile trauma with the fear of castration. When a kid discovers the absence of penis in his mother, he looks away from her terrified, and the first object he stares at after the trauma turns into his fetish object. So, according to Freud, it is possible that the fans of [the Cast Fetish webpage] saw their fathers or a relative with a plaster cast”

I am not a fan of Freud’s theorizing, and I personally believe that the origin of such fetishes is most likely behavioural conditioning (classical and/or operant). However, given the complete lack of empirical research, this was the only article I came across that featured anything vaguely academic in relation to the fetishizing of plaster casts. It would appear from both anecdotal evidence that plaster cast mummification (particularly within a BDSM context) comprises a significant minority interest and is probably nowhere near as rare as some other sexual behaviours that I have covered in my previous blogs.

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

Further reading

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

Forbidden Sexuality (2004). Mummification bondage. Located at: http://www.forbiddensexuality.com/mummification_bondage.htm

Salinas, H.G. (2006). Women with plaster casts. Trend Hunter, November 29. Located at: http://www.trendhunter.com/trends/weird-fetishism-women-with-plaster-casts

Wikipedia (2013). Sensation play (BDSM). Located at: http://en.wikipedia.org/wiki/Sensation_play_(BDSM)

Wikipedia (2013). Total enclosure fetishism. Located at: http://en.wikipedia.org/wiki/Total_enclosure_fetishism

Wikipedia (2013). Mummification (BDSM). Located at: http://en.wikipedia.org/wiki/Mummification_(BDSM)

Prophet share: A case study of ‘addiction to fortune telling’

In the latest issue of the Journal of Behavioral Addictions, there are two papers that I co-authored on muscle dysmorphia as an addiction (see ‘Further reading’ below). The reason I mention this is because in the same issue there was a case study report by Dr. Marie Grall-Bronnec and her colleagues of a woman (Helen) that was ‘addicted’ to fortune tellers. As noted in their paper:

“Clairvoyance consulting, also known as fortune teller consulting, is a behavior that may seem harmless, but can also become excessive. Fortune telling is defined as the practice of predicting information about a person’s life, using for example…astrology, cartomancy or crystallomancy”.

As I have noted in a number of my previous blogs, I subscribe to the view that if there are clinical criteria for addiction and a behaviour fulfils the criteria, it should be classed as an addiction (irrespective of the behaviour). This has led to accusations of me “watering down the concept of addiction” because such criteria have been applied to behaviours as diverse as gardening and chewing gum. According to the authors of the ‘fortune telling addiction’ paper:

“Helen is a 45-year-old woman who declares early on suffering from ‘a clairvoyance addiction’…She has no particular medical history, except for two major depression episodes after romantic breakups, and does not take any medication. She regularly sees a psychiatrist for support psychotherapy because of negative life events (sexual abuse and death in her family). She is divorced and does not have any children. Her career as a manager seems to fully satisfy her. She decides to seek treatment on account of her excessive financial expenditures due to the consultation of fortune tellers. Another motivation that explains her decision is her age. Indeed, she says she is entering a new phase in her life, after renouncing to the idea of becoming a mother one day”.

According to the paper, Helen had been consulting fortune tellers since she was 19 years old. She started using such people for educational and career advice as she claimed that she was poor at reaching important decisions herself and thought the life choices she made would be wrong. The authors noted that her first meeting with a clairvoyant was an event that gave her a feeling of reassurance. In her mid-twenties, her visits to clairvoyants escalated significantly and ended up losing control of her use of fortune telling”. At that particular time, she was visiting clairvoyants to get relationship advice from them (e.g., “Does he really love me?” and “How long will our relationship last?”). Her current ‘addiction to clairvoyants’ dates back to her mid- to late-30s when she got divorced after the failure of her marriage:

“She repeatedly returned to fortune telling to reassure herself about the future of her relationship, and increasingly so as it deteriorated. The breakup worsened the disorder. Since her divorce, she consults fortune tellers – not always the same person – on the phone or online, in a compulsive way, more and more often (up to every day), for longer and longer periods of time (up to 8 hours a day) and spends each time more and more money (up to 200 euros per session). As she is never satisfied with the fortune tellers’ predictions, she will consult again very soon after the latest call or connection. Every choice she has to make, from the most trivial (going to the movies) to the most important (making relationship decisions), leads her to irrationally consult a fortune teller”

Before each consultation she said he got very excited at the prospect and that the experience relieved all of her psychological discomfort (at least in the short-term). However, not long after consultations she would feel incredibly guilty. The paper also reported that during consultations with the fortune tellers, she was totally convinced that they could see her future and that their predictions would come true. He authors went on to report:

“This excessive behavior gives her some kind of reassurance and allows her to make up for her lack of self-confidence. In that sense, the excessive behavior could be considered as an attempt at self-medication or as a way to cope with negative emotions. However, Helen knows that her belief in the fortune tellers’ ability to predict the future is completely irrational. This brings major adverse consequences, particularly in financial terms: despite a comfortable income, she is indebted. She also says having low self-esteem, due to her in- ability to resist her strong urge to consult fortune tellers, and due to her being isolated from the others because of the time spent consulting fortune tellers. Helen succeeds in limiting the consultation of fortune tellers during short periods of time, when her financial situation becomes too critical”.

The authors of the report also used different sets of addiction criteria to determine whether Helen was truly addicted to consulting clairvoyants. They also used my own six criteria (salience, mood modification, tolerance, withdrawal, conflict, and relapse). Here are the authors own description of the behaviour using my components model:

  • Salience: “Consulting fortune tellers becomes the most important activity in Helen’s life and dominates her thinking (preoccupation and cognitive distortions), feelings (cravings) and behavior (she has progressively quit all her leisure activities, particularly going out with friends)”.
  • Mood modification: “Helen says feeling excitement before each consultation, but also feels nervous tension and anxiety. This excessive behavior gives her some kind of reassurance and the excessive behavior could be considered as an attempt at self-medication or a way to cope with negative emotions”.
  • Tolerance: “Over time, Helen has been feeling a growing need to consult fortune tellers, and the consultations have to last longer to obtain the same effect of relief”.
  • Withdrawal: “When she attempts to resist the urge to consult or has to refrain from consulting fortune tellers (in the case of her financial situation being too critical, for example), she feels tense and nervous”.
  • Conflict: “Helen knows that her use of fortune telling is problematic, and that it brings very negative consequences. However, she cannot refrain from consulting fortune tellers, leading to an intra-psychic conflict and guilt”.
  • Relapse: “Over the years, Helen has made repeated efforts to reduce and stop this problematic behavior. Her clinical course is characterized by relapses and remissions”.

Based on the evidence presented, there is clear evidence that Helen’s behaviour was problematic. Whether it was genuinely addictive is debatable but the authors provided some evidence that (in this case at least) the behaviour appeared to include some addictive aspects. The authors conclude that in addition to individual risk factors, other situational and structural characteristics may have played a role in the development of problematic behaviour concerning Helen’s ‘addiction’:

Regarding the risk factors related to the object of addiction (i.e. fortune telling use), one might mention, inter alia, the possibility to consult online, which guarantees anonymity. Furthermore, the Internet increases both accessibility and availability. Finally, the money spent during fortune telling sessions seems virtual, which makes it all the more easy to spend. Increased risks related to the Internet have already been described on gambling (Griffiths, Wardle, Orford, Sproston & Erens, 2009). Regarding socio-environmental risk factors, today’s society encourages the need for control and does not give way to uncertainty. In Helen’s case, all the conditions were met for the fortune telling use to become excessive, and we are tempted to conclude that it is an addictive-like phenomenon”.

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

Further reading

Foster, A.C., Shorter, G.W. & Griffiths, M.D. (2015). Muscle Dysmorphia: Could it be classified as an Addiction to Body Image? Journal of Behavioral Addictions, 4, 1-5.

Grall-bronnec, M. Bulteau, S., Victorri-Vigneau, C., Bouju, G. & Sauvaget, A. (2015). Fortune telling addiction: Unfortunately a serious topic about a case report. Journal of Behavioral Addiction, 4, 27-31.

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

Griffiths, M. (2005). A “components” model of addiction within a biopsychosocial framework. Journal of Substance Use, 10, 191–197.

Griffiths, M.D., Foster, A.C. & Shorter, G.W. (2015). Muscle dysmorphia as an addiction: A response to Nieuwoudt (2015) and Grant (2015). Journal of Behavioral Addictions, 4, 11-13.

Griffiths, M., Wardle, H., Orford, J., Sproston, K. & Erens, B. (2009). Sociodemographic correlates of internet gambling: Findings from the 2007 British gambling prevalence survey. CyberPsychology and Behavior, 12, 199–202.

Hughes, M., Behanna, R. & Signorella, M. L. (2001). Perceived ac- curacy of fortune telling and belief in the paranormal. Journal of Social Psychology, 141(1), 159–160.

Shein, P. P., Li, Y. Y. & Huang, T. C. (2014). Relationship between scientific knowledge and fortune-telling. Public Understanding of Science, 23(7), 780–796.

Mourning sickness? A brief look at disaster tourism

Last week I did an interview with the Daily Mail about disaster tourism and why people flock to see disaster areas. I briefly mentioned the topic in a previous blog that I wrote on people that collect murder memorabilia (‘murderabilia’) and argued that the psychology behind disaster tourism and murderabilia were very similar. According to the Wikipedia entry:

“Disaster tourism is the act of travelling to a disaster area as a matter of curiosity. Disaster tourism took hold in the Greater New Orleans Area in the aftermath of Hurricane Katrina. There are now guided bus tours to neighbourhoods that were severely damaged and/or totally destroyed by the flooding”.

The same article also highlights the March and April 2010 eruptions of the Eyjafjallajökull volcano in Iceland. The article noted that disaster tourism quickly sprang up following the first eruption, with tour companies offering trips to see the volcano. Academically, disaster tourism is closely associated with ‘Dark Tourism’ and also has its own Wikipedia page:

“Dark tourism (also black tourism or grief tourism) has been defined as tourism involving travel to sites historically associated with death and tragedy. More recently it was suggested that the concept should also include reasons tourists visit that site, since the site’s attributes alone may not make a visitor a ‘dark tourist’. Thanatourism, derived from the ancient Greek word thanatos for the personification of death, refers more specifically to violent death; it is used in fewer contexts than the terms ‘dark tourism’ and ‘grief tourism’. The main draw to dark locations is their historical value rather than their associations with death and suffering”.

When I started researching this blog I was quite surprised by the amount of academic writing on the topic (although the vast majority of it is theorizing rather than the collection of empirical data). The academic field appears to have been kick-started by the publication of Malcolm Foley and John Lennon’s 2000 book Dark tourism: The attraction of death and disasters. Most of the papers I read speculated on the many motivations that people have for visiting places associated with death along with typologies of different kinds of dark tourism and what dark tourism means in a wider social and cultural context. In 2012, Dr. Maximiliano Korstanje speculated that “dark tourism could be a mechanism of resiliency helping society to recover after a disaster or catastrophe, a form of domesticating death in a secularized world”. However, many academics have different views and/or explanations. Before looking at some of the academic theorizing, I wanted to share some of the pros and cons of disaster tourism from an article on the WiseGeek site (‘What is disaster tourism?’) as non-academic articles seem to get straight to the point without the caveats and psychosocial babble:

“Disaster tourism is the practice of traveling to areas that have recently experienced natural or man-made disasters. Individuals who participate in this type of travel are typically curious to see the results of the disaster and often travel as part of an organized group. Many people have criticized disaster tourism as exploitation of human misery and a practice that demeans and humiliates local residents. Others argue that tourism to devastated areas can offer a boost to the local economy and raise awareness of the incident, both of which are often needed after a tragedy. When a geographical region suffers a major incident, the media may spend a great deal of time reporting on the situation and the plight of local residents…As a result, some people will actually visit the affected areas so they can experience the situation firsthand. These individuals are typically motivated by curiosity and do not necessarily plan to participate in relief efforts…In some cases, those who participate in disaster tourism will simply travel to an area on their own, while others will purchase a package tour from a travel business”.

Many of the more populist articles on disaster tourism and dark tourism would have readers believe that the phenomenon is new, but it isn’t. Throughout human history there are dozens of examples of people visiting places associated with death and destruction. As I argued in my interview with the Daily Mail, people are intrigued by death and the macabre (and was the subject of a previous blog I wrote on people’s fascination with death).

As a child I remember going on school trips to battlefields, visiting graveyards and cemeteries, and making brass rubbings from burial places in churches and cathedrals. As an adult I have visited Ground Zero in New York and Alcatraz prison island off San Francisco. Is this really that far removed from dark tourism? Many academic writers such as Dr. Philip Stone (who has written paper after paper on dark tourism and has his own ‘Institute for Dark Tourism Research at the University of Central Lancashire, UK) note that war-tourism is a small subset “of the totality of tourist sites associated with death and suffering”. He makes reference to people visiting assassination sites (e.g., the building where President John F. Kennedy was shot in Dallas), Holocaust sites (such as the Auschwitz concentration camp), celebrity death sites (of Elvis Presley, James Dean, Buddy Holly, etc.), terrorism sites, major disaster sites (e.g., plane crash sites, tsunami sites), slavery heritage attractions, and ‘entertainment’ locations (such as Vienna’s Funeral Museum, Whitby’s ‘Dracula Experience’, the Tower of London). In short, he argues that a full categorisation of dark tourism is extremely complex. He also goes on to say that:

“Despite the diverse range of sites and tourist experiences, Tarlow (2005) identifies dark tourism as ‘visitations to places where tragedies or historically noteworthy death has occurred and that continue to impact our lives’ – a characterisation that aligns dark tourism somewhat narrowly to certain sites and that, perhaps, hints at particular motives. However, it excludes many shades of dark sites and attractions related to, but not necessarily the site of, death and disaster…Consequently, Cohen (2011) addresses location aspects of dark tourism through a paradigm of geographical authenticity and sense of victimhood. Meanwhile, Biran, Poria, and Oren (2011) examine sought benefits of dark tourism within a framework of dialogic meaning making…Jamal and Lelo (2011) also explore the conceptual and analytical framing of dark tourism, and suggest notions of darkness in dark tourism are socially constructed, rather than objective fact….dark tourism may be referred to more generally as the ‘act of travel to tourist sites associated with death, suffering or the seemingly macabre’ (Stone, 2006)”

I was also surprised to learn from Dr. Stone and other papers that dark tourism has been given lots of other names in the academic literature including ‘morbid tourism’, ‘fright tourism’, ‘horror tourism’, ‘black spot tourism’, ‘hardship tourism’, ‘grief tourism’, ‘tragedy tourism’, ‘[extreme] thanatourism’, ‘warfare tourism’ and ‘genocide tourism’ all of which concern “milking the macabre” and “dicing with death”.

Dr. Jeffrey Podoshen (2013) has noted that an interest in death is general, and not person-specific and leads to the conclusion that there are a wide variety of potential manifestations related to dark tourism consumption motivations. Various academics have speculated that the motivations for dark tourism include sensation seeking and voyeurism. Citing the work of Dr. Richard Sharpley, he notes that “schadenfreude sparks dark tourism interest and likens these tourists to rubber-neckers who gaze at the tragedy of others”. However, as Philip Stone and Richard Sharpley note in a 2008 issue of the Annals of Tourism:

“The question of why tourists seek out such dark sites has attracted limited attention. Generally, visitors are seen to be driven by differing intensities of interest or fascination in death, in the extreme hinting at tasteless, ghoulish motivations. More specific reasons vary from morbid fascination or ‘rubber-necking’, through empathy with the victims, to the need for a sense of survival/continuation, untested factors which, arguably, demand verification within a psychology context”.

A recent study by Dr Takalani Mudzanani published in a 2014 issue of the Mediterranean Journal of Social Sciences examined why people visited the Hector Peterson Memorial and Museum in South Africa (named after one of the pupils who died during the Soweto riots). Via 15 in-depth interviews his study highlighted factors such as novelty, escapism, enhancement of kinship relations, nostalgia, education and the media played an important role in motivating visitors to visit the site. Finally, it’s worth noting that there are also those in the field that believe there are levels of dark tourism (such as Dr. William Miles in a 2002 issue of the Annals of Tourism Research) who talk of dark, darker, darkest tourism. Furthermore, most academics in the area would agree that dark tourism is not a single concept (something that with just a brief dip into this fascinating literature I totally agree with).

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

Further reading

Dann, G. M., & Seaton, A. V. (2001). Slavery, contested heritage and thanatourism. International Journal of Hospitality & Tourism Administration, 2(3-4), 1-29.

Foley, M., & Lennon, J. (2000). Dark tourism. Annals of Tourism Research, 19(1), 68-78.

Lennon, J. & Foley, M. (2000). Dark tourism: The attraction of death and disasters. London: Thomson Learning.

Miles, W. F. (2002). Auschwitz: Museum interpretation and darker tourism. Annals of Tourism Research, 29(4), 1175-1178.

Mudzanani, T. (2014). Why is Death so Attractive? An Analysis of Tourists’ Motives for Visiting the Hector Peterson Memorial and Museum in South Africa. Mediterranean Journal of Social Sciences, 5(15), 570-574.

Podoshen, J. S. (2013). Dark tourism motivations: Simulation, emotional contagion and topographic comparison. Tourism Management, 35, 263-271.

Sharpley, R., & Stone, P.R. (Eds.). (2009). The darker side of travel. Channel View Publications.

Stone, P. (2005). Dark tourism consumption: a call for research. E-Review of Tourism Research (eRTR), 3(5), 109-117.

Stone, P. (2006). A dark tourism spectrum: Towards a typology of death and macabre related tourist sites, attractions and exhibitions. Tourism: An Interdisciplinary International Journal, 54(2), 145-160.

Stone, P. R. (2011). Dark tourism and the cadaveric carnival: mediating life and death narratives at Gunther von Hagens’ Body Worlds. Current Issues in Tourism, 14(7), 685-701.

Stone, P. & Sharpley, R (2008). Consuming dark-tourism a thanatological perspective. Annals of Tourism Research, 35, 574–595.

Korstanje, M. & Ivanov, S. (2012). Tourism as a form of new psychological resilience: The inception of dark tourism. Cultur: Revista de Cultura e Turismo, 6(4), 56-71.

Miles, W. F. (2002). Auschwitz: Museum interpretation and darker tourism. Annals of Tourism Research, 29(4), 1175-1178

Strange, C., & Kempa, M. (2003). Shades of dark tourism: Alcatraz and Robben Island. Annals of Tourism Research, 30(2), 386-405.

The beast inside: What does your favourite animal say about you?

Every couple of months I get calls from the media asking me to comment on what some particular aspect or preference of human behaviour says about someone’s personality and/or demeanour. Most recently, I appeared on my local radio station (BBC Radio Nottingham) being interviewed about men’s and women’s favourite animals. The ‘hook’ of the story was a survey carried out by the polling organization YouGov on 190,000 people. The story appeared in the Daily Telegraph with the headline ‘Men identify with lobsters, women with miniature pigs’:

“Asked to pick the most stereotypically ‘manly’ of animals, we might opt for a shark, bear or bull. But a new poll by YouGov has found that lobsters may be the manliest animal of them all. The survey of 190,000 people asked respondents to name their favourite animal. The results were then broken down along gender lines. The animal which was most favoured by men compared to women was the lobster, followed by the alligator and stickleback fish. Meanwhile, miniature pigs, cats and ponies were disproportionately favoured by women. Completing the ‘masculine’ top ten were sharks, eagles, octopuses, ants, narwhals, scorpions and spiders. The next most ‘feminine’ animals were donkeys, chinchillas, pandas, rabbits, guinea pigs, zebras and – perhaps the most bizarre feature of this already bizarre survey – African pygmy hedgehogs. ‘In general, men are more likely to have sympathy for heroic, aggressive or creepy animals while women are more likely to prefer the cute, beautiful and exotic types,’ a researcher from YouGov wrote. He also noted that there were no mammals in the most typically male animals, while every animal in the women’s top 20 was a mammal, apart from the penguin and butterfly. The results were deemed ‘statistically significant’, with the full breakdown of preferred animals by gender available here”. 

The DJ that interviewed me hadn’t realised that the poll wasn’t about male and female ‘top 10’ favourite animals but was actually about the top differences between men and women’s favourite animals. Although the interview was enjoyable it had no scientific value whatsoever – so why did I do it? Well, I think the main reason was to please my university’s Press Office, but also in the back of my mind was a little exercise that one of my psychology lecturers made us do in a tutorial 30 years ago.

We were asked to name our three favourite animals and then to write three adjectives to describe the animals we had chosen. I chose the coelacanth* (rare, long-living, unchanging), the South American condor (high-flying, distinctive, endangered), and the duck-billed platypus (unique, nature-defying, electro-sensitive) – thankfully I was able to check my 1985 diary to check what adjectives I had used all those years ago. We were then told by our lecturer that: (i) our first choice represented how we think we are, (ii) the second choice represented how we think other people perceive us, and (iii) the third represented how we really are. Given that I am sharing it here, gives you an indication that I wasn’t overly unhappy with the outcome (and I’d like to think there is some truth in the insight given the adjectives I chose at the time – but that’s more to do with wishful thinking than science).

At best, these kinds of ‘personality insights’ are little more than pop psychology (although arguably fun to do). Arguably the most well-known ‘animal personality test’ can be found in Roy Feinson’s 1998 book The Animal In You: Discover Your Animal Type and Unlock the Secrets of Your Personality (and you can also check out the Animal In You website). According to the website:

“Are you a wolf, rugged and misunderstood, or more like the introspective mole? Take the Animal In You personality test and find out! To identify the animal that best matches you simply answer the questions as honestly as you can. For even more accurate results, you might want to get ratings from people that know you well or have them take the test for you! This test is based on the best selling book The Animal in You by Roy Feinson, which explores how biological and social pressure conspire to form our personalities. If you find it to be uncannily accurate, it’s due to the test’s sophisticated algorithms. When you’ve entered your personal data, the test will build a mathematical model that corresponds to your unique personality, match it to our database of animal profiles and choose the ones closest to you. Though you may have one or two other possible results, remember that each person properly matches only one animal personality”.

I have to admit that I have not personally taken the test myself, but I don’t see that much difference between this type of test and those that you find in astrology books. I have a little more faith in the Myers-Briggs Test (MBT; developed by Katharine Briggs and her daughter Isabel Myers) that is not a test of animal personality per se but has been extrapolated into animal personality types. The MBT draws on the theories of Carl Jung who theorized that there are four principal psychological functions by which humans experience the world: sensation, intuition, feeling, and thinking. In the MBT, these dichotomies (as outlined by the online article ‘What’s your animal personality type?’) are:

  • Worldview: Extroversion (E) or Introversion (I) 
- i.e. would you rather play with your pals or hang out at home with a book?
  • Information: Sensing (S) or Intuition (N) 
- i.e. when taking in something new, do you prefer to take it simply, at face value or interpret / add meaning based on your gut?
  • Decisions: Thinking (T) or Feeling (F)
 – i.e. when making up your mind about something, do you primarily rely on logic and structure, or do you gravitate towards emotion and empathy?
  • Structure: Judging (J) or Perceiving (P)
 – i.e. would you rather things in your life to be decided and set, or do you like to stay open to whatever options might come along?

Based on your scores on these four dimensions, your personality can (supposedly) be mapped onto one of the following animals: owl (INTP; ‘wise and clam’), fox (ESTP; ‘subtle and opportunistic’), sloth (ISFP; ‘harmless and sensitive’), lion (ENTJ; ‘king of the jungle’), deer (ISFJ; ‘territorial and protective’), octopus (INTJ; ‘solitary hunter’), cat (ISTP; ‘secret and unpredictable’), otter (ESFP; ‘fun and entertaining’), wolf (INFJ; ‘rare and fascinating’), dolphin (ENFP; ‘spontaneous and creative’), honey bee (ESTJ; ‘strict and aggressive’), beaver (ISTJ; ‘slow but tough’), dog (ENFJ; ‘loyal and affectionate’), meerkat (INFP; ‘free spirited and kind’), parrot (ENTP; ‘charming and clever’), and elephant (ESFJ; ‘gentle and caring’). Finally, if you are interested in taking the test, you can do so here.

 

*The Wikipedia entry on coelacanths note they “constitute a now rare order of fish…They follow the oldest known living lineage of Sarcopterygii (lobe-finned fish and tetrapods), which means they are more closely related to lungfish, reptiles, and mammals, than to the common ray-finned fishes…Since there are only two species of coelacanth and both are threatened, it is the most endangered order of animals in the world. The West Indian Ocean coelacanth is a critically endangered species. Coelacanths were thought to have undergone extinction 66 million years ago…The first recorded coelacanth fossil, found in Australia, was of a jaw that dated back 360 million years…The fossil record is unique because coelacanth fossils were found 100 years before the first live specimen was identified. In 1938, Courtenay-Latimer rediscovered the first live specimen…caught off the coast of East London, South Africa. In 1997, a marine biologist on honeymoon discovered the second live species…in an Indonesian market”.

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

Further reading

Barton, S.A. (2012). What’s your animal personality type? BuzzFeed, June 20. Located at: http://www.buzzfeed.com/summeranne/whats-your-animal-personality-type#.wtJJblrrQ

Dahlgreen, W. (2015). Lobsters for men, miniature pigs for women. YouGov UK, March 1. Located at: https://yougov.co.uk/news/2015/03/01/animals-gender/

Feinson, R. (1998). The Animal In You: Discover Your Animal Type and Unlock the Secrets of Your Personality. London: St. Martin’s Griffin.

Healthy Living Editors (2012). What animal matches your personality? Care2.com, October 21. Located at: http://www.care2.com/greenliving/whats-your-animal-personality.html

Merz, T. (2015). Men identify with lobsters, women with miniature pigs. Daily Telegraph, March 2. Located at: http://www.telegraph.co.uk/men/relationships/11444854/Men-identify-with-lobsters-women-with-miniature-pigs.html

Wikipedia (2015). Coelacanth. Located at: http://en.wikipedia.org/wiki/Coelacanth

Wikipedia (2015). Myers-Briggs Type Indicator. Located at: http://en.wikipedia.org/wiki/Myers–Briggs_Type_Indicator

Coining it in: Neologisms and ‘New Syndrome’ Syndrome

One of things I am very proud of in my academic career is the coining of the term ‘technological addiction’ back in 1995 (an umbrella term that I invented to describe a number of different person-machine addictions including slot machine addictions, video game addiction, television addiction, etc.). I’m also proud of coining the term ‘aca-media’ (relating to academics like myself that use the media to disseminate our research). A neologism (i.e., the name for a newly coined term) is often (according to Wikipedia) directly attributable to a specific event, person, publication, or period.

In the 1980s and early 1990s, there seemed to be a real upsurge is the naming of ‘new syndromes’ in the medical literature including many relating to excessive use of technology (such as ‘Space Invader’s Wrist’) and other leisure activities (such as ‘Cuber’s Thumb’ relating to excessive use of the Rubik’s Cube) – both of which made their appearance in 1981 issues of the New England Journal of Medicine. Other videogame medical complaints include ‘Pseudovideoma’ (in a 1984 issue of the Journal of Hand Surgery), ‘Pac-Man Phalanx’ (in a 1983 issue of Arthritis and Rheumatism) and ‘Joystick Digit’ (in a 1987 issue of the Journal of the American Medical Association). Another videogame-related medical complaint (in this case an infection), was reported in a 1987 issue of the Western Journal of Medicine by Dr. G.B. Soe and colleagues:

“We wish to focus WJM readers’ attention on another complication associated with video games-one that originally presented as an “infected spider bite. A 17-year-old right-handed boy noted progressive swelling and redness of his left hand seven days before admission. Two days before admission he was given penicillin intramuscularly and oral cephalexin to take at home. The swelling did not subside and the hand became very painful, so he came to the medical center for treatment. On admission his mother reported that she had seen many spiders around the house with a violin pattern on their backs, and that her son had probably been bitten by a spider…After seven days of parenteral antibiotic therapy, the edema, erythema and fever had disappeared and the patient was discharged home. Further questioning revealed that the young man was spending almost all of his time playing his favorite video game, which involved a fighting kung fu character. The patient used his left hand in manipulating a ball-shaped joystick to move the figure up, down, left and right, and his right in operating buttons to kick and jab. Extensive use of the joystick resulted in blisters on his left palm. He rubbed the blisters off, and an infection resulted that progressed to abscess formation. Neuromuscular complications of video games (‘pseudovideoma’, ‘Pac-Man phalanx’, ‘firing-finger syndrome’ and ‘Space Invaders wrist’) have been reported, as well as video game-induced seizures, but we have not come across any reports of an infectious complication of video games. Perhaps video game players should wear gloves to protect their palms, similar to ones worn by golfers and baseball players, who also need to get a firm grip on their respective sticks”.

Another one that I’d never heard of is ‘Nurd Knuckles’ coined by Dr. J.B. Martin in the Canadian Medical Association Journal in 1982:

“I wish to describe a case of painful knuckles associated with the use and manipulation of a new, allegedly therapeutic product, a Nurd. A Nurd is a head 10 cm across with a smiling face and large ears, reminiscent of the character Yoda of ‘Star Wars’. It is made of malleable material that can be stretched, twisted or deformed in any direction, yet with release of tension quickly resumes its original shape without a trace of distortion. A 32-year-old public school teacher presented with painful knuckles of his right hand. His students, perhaps feeling that their teacher was under increased stress during the marking of exams, had given him a Nurd for Christmas, and during a particularly trying day he had found occasion to use it. He repeatedly stretched its ears and twisted its neck without ill effect; however, on punching it he suffered sharp pain of his fourth and fifth metacarpophalangeal joints. On examination the joints were found to be reddened, with point tenderness over the fifth metacarpal head; there was no evidence of deformity. He was advised to stop beating his Nurd, and the pain subsided. While the Nurd is very plastic, yielding to the linear tension of stretching and twisting, it is very resistant to compression. Punching a Nurd does not cause the surface to give way, and, since the force of the blow is returned to the fist, it is conceivable that a fracture might result. Therefore, although stretching and twisting Nurds does not cause any harm, users should be cautioned against punching their Nurd. The Nurd is advertised as being a ‘punchable, stretchable, pushable and likeable alternative to tension, migraine headaches, drug abuse, alcoholism and manic depression’, but these claims are unsubstantiated. A MEDLINE search of the medical literature shows that no retrospective or prospective case control studies or controlled double blind crossover studies have been undertaken. Before the clinical efficacy of the Nurd can be taken seriously in the treatment of this broad spectrum of disease, full clinical trials must be completed. Subjects entering into trials must, however, be duly informed of the hazards of punching Nurds”.

Another one that caught my attention was a new affliction (‘Breaker’s Neck’) caused by the craze of ‘break dancing’ reported by Dr. Bertha Ramirez and her colleagues in a 1984 issue of the Journal of the American Medical Association. (The reason why I say it caught my eye is that I am currently involved in some research on ‘dancing addiction’ with some of my Hungarian colleagues and we have just had a new paper accepted in the journal PLoS ONE concerning the development of our ‘Dancing Motives Inventory’ – see ‘Further Reading’ below).

To be added to the rapidly growing list of socially acquired injuries, we report a case of traumatic cervical subluxation caused by a new dance technique. This technique, labeled ‘breaking’ by its devotees, involves a modified head stand, in which the dancer, using his arms and hands for balance, spins rapidly on his head, neck, or shoulders to the rhythm of disco music. He then lowers his body to the floor and performs a series of rotational motions using his arms as a fulcrum…A 15-year-old boy was seen in our pediatric emergency room complaining that, on awakening two days previously, he felt a ‘snap’ in his neck, followed by persistent neck stiffness. He reported having ‘danced on his head’ the night prior to this incident. On physical examination, his head was tilted to the left with an inability to flex”.

Engaging in excessive sporting activity has given rise to a number of medical syndromes. One such consequence is ‘Rower’s Rump’ reported by Drs. K Tomecki and J. Mikesell in a 1987 issue of the Journal of the American Academy of Dermatology. In a previous blog I examined addiction to cycling. In the 1980s there were many medical complaints reported as a result of excessive cycling. One such complaint (given the name of ‘Bicycling nipples’) was highlighted by Dr. B. Powell in a 1983 issue of the Journal of the American Medical Association:

“Bicyclists are likely to suffer from a number of maladies, including dysuria, numb penises, and more. During cool or cold weather, another problem, bicyclist’s nipples, may occur. This condition is similar to jogger’s nipples, but it is primarily a thermal injury instead of an irritation secondary to friction, as with the jogger’s complaint. Often the rider is out in the cold weather for some time, and his or her undershirt, jersey, and jacket can become moist from perspiration. Evaporation and the chill of the wind lower the temperature of the nipples. They get downright cold, and they hurt. The pain continues after the ride is over. Indeed, it can continue for several days. The nipples are sore, sensitive to both temperature change and touch”.

After reading this I found out that Dr. Fred Levit had reported a case of ‘Jogger’s Nipples’ in a 1977 issue of the New England Journal of Medicine. All of these related nipple conditions are all examples of fissure of the nipple as they are all caused by friction resulting in soreness, dryness or irritation to, or bleeding of, one or both nipples. The Wikipedia entry also notes that “the condition is also experienced by women who breastfeed, and by surfers who do not wear rash guards”. The article also noted that:

“Jogger’s nipple is caused by friction from the repeated rubbing of a t-shirt or other upper body clothing against the nipples during a prolonged period of exercise. The condition is suffered mainly by runners. Long-distance runners are especially prone, because they are exposed to the friction on the nipple for the greatest period of time. However, it is not only suffered by athletes; the inside of a badge, a logo on normal items of clothing, or breastfeeding can also cause the friction which results in this condition”.

Outside of the leisure sphere, there were two case study reports of ‘Diaper Doer’s Hand’ in a 1987 issue of the journal Clinical Rehabilitation by Dr. J.L. Cosgrove and colleagues:

“Three cases of stenosing tenosynovitis occurred three to six months postpartum. Childcare activities aggravated the symptoms of pain and swelling in both patients. In two cases, a specific method of carrying the child was implicated as the mechanism of injury. Although there was no evidence of generalized inflammatory arthritis, all patients had very low positive titres of anti-nuclear antibodies. While it is likely that tenosynovitis was caused by mechanical factors, the possibility of increased susceptibility to inflammatory disease in the postpartum period cannot be discounted. The patients were successfully treated with a low temperature plastic splint, superficial heat and gentle mobilization”.

All of these new syndromes lead to why I put this article together in the first place. I found this letter in the British Medical Journal by Dr. E.P. Hoare entitled ‘New Syndrome Syndrome’ that I found both funny and poignant:

“Your readers will be familiar with tennis elbow, brazier’s ague, and soap packer’s jig not to mention Achilles’ heel. More recently we have heard of Space Invader’s wrist, jogger’s nipples, and the ultimate futility of Cuber’s thumb. May I point out another occupational disease which I have noticed among patrons of the reading room medical journal correspondence column reader’s neck or, more succinctly, the new syndrome syndrome. Symptoms usually begin with muscular contraction of the eyebrows, hyperventilation, and involuntary utterances, which in severe cases can lead to coprolalia. These may be followed by drowsiness, disorientation, hysterical amblyopia, and double vision (of the deja vu variety). If untreated the condition can result in a chronic pain in the neck. Treatment is 200 ml of gin and tonic stat by mouth and complete rest; music can also be helpful. The long-term prognosis is poor, however, unless journal editors can be persuaded to ban further reports of occupational afflictions or at least print a health warning at the head of their correspondence columns”.

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

Further reading

Behr, J.T. (1984). Pseudovideoma. Journal of Hand Surgery, 9(4), 613.

Cosgrove, J. L., Welch, D. A., Richardson, G. S., & Nicholas, J. J. (1987). Diaper doer’s hand: stenosing tenosynovitis in the postpartum period. Clinical Rehabilitation, 1(3), 219-223.

Gibofsky, A. (1983). Pac‐Man phalanx. Arthritis and Rheumatism, 26(1), 120.

Griffiths, M.D. (1995). Technological addictions. Clinical Psychology Forum, 76, 14-19.

Griffiths, M.D. (1995). Pop psychology and “aca-media”: A reply to Mitchell. The Psychologist: Bulletin of the British Psychological Society, 8, 537-538.

Griffiths, M.D. (2001). A moral obligation in aca-media? The Psychologist: Bulletin of the British Psychological Society, 14, 460.

Hite, P. R., Greene, K. A., Levy, D. I., & Jackimczyk, K. (1993). Injuries resulting from bungee-cord jumping. Annals of emergency medicine, 22(6), 1060-1063.

Hoare, E.P. (1982). Points: New syndrome syndrome. British Medical Journal, 285(6352), 1429.

Levit, F. (1977). Jogger’s nipples. New England Journal of Medicine, 297(20), 1127.

Maraz, A., Király, O., Urbán, R., Griffiths, M.D., Demetrovics, Z. (2015). Why do you dance? Development of the Dance Motivation Inventory (DMI). PLoS ONE, in press.

Martyn, J. B. (1983). Nurd knuckles. Canadian Medical Association Journal, 129(3), 228.

McCowan, T.C. (1981). Space Invader’s wrist. New England Journal of Medicine, 304,1368.

Osterman, A. L., Weinberg, P., & Miller, G. (1987). Joystick digit. Journal of the American Medical Association, 257(6), 782.

Powell, B. (1983). Bicyclist’s nipples. Journal of the American Medical Association, 249(18), 2457-2457.

Ramirez, B., Masella, P. A., Fiscina, B., Lala, V. R., & Edwards, M. D. (1984). Breaker’s neck. Journal of the American Medical Association, 252(24), 3366-3367.

Soe, G.B., Gersten, L. M., Wilkins, J., Patzakis, M. J., & Harvey, J.P. (1987). Infection associated with joystick mimicking a spider bite. Western Journal of Medicine, 146(6), 748.

Tomecki, K. J., & Mikesell, J. F. (1987). Rower’s rump. Journal of the American Academy of Dermatology, 16(4), 890-891.

Torre, P. R., Williams, G. G., Blackwell, T., & Davis, C. P. (1993). Bungee jumper’s foot drop peroneal nerve palsy caused by bungee cord jumping. Annals of emergency medicine, 22(11), 1766-1767.

Waugh, D. (1981). Cuber’s thumb. New England Journal of Medicine, 305, 768.

Brain humour: The Ig Nobels are coming to Nottingham Trent (again)

I apologise in advance, but today’s blog is (i) a not-so thinly disguised plug (well, a blatant plug) for a national event that is being hosted by my university on Wednesday 18th March (2015) and (ii) a just a slight updating of a blog I published a couple of years ago when the Ig Nobels last came to NTU. The new blurb I was sent by our local organizer Phil Banyard proclaims:

“The Ig Nobel Prizes honour achievements that first make people laugh, and then make them think. The prizes are intended to celebrate the unusual, honour the imaginative — and spur people’s interest in science, medicine, and technology. The awards are held each year at Harvard University and each award is presented by a Nobel laureate such is the esteem of this event. Over the past few years Marc Abrahams has brought an Ig Nobels tour to the UK in the spring. The tours highlights some of the key awards from the Ig Nobels’ back catalogue and provides a great opportunity to promote science to a wider audience. This year’s programme will feature Marc Abrahams, organiser of the Ig Nobel Prizes, editor of the Annals of Improbable Research, and Guardian columnist, together with a gaggle of Ig Nobel Prize winners and other improbable researchers. The programme will include: Chris McManus (Ig Nobel winner, Scrotal asymmetry in ancient Sculpture and man); Richard Stephens (Ig Nobel winner, The effect of swearing on pain); Richard Webb (Tribute to John Hoyland, the father of Nominative Determinism)”.

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If that’s not enough to get you going, I would also like to add that science’s top journal Nature says: “The Ig Nobel awards are arguably the highlight of the scientific calendar” (and who am I to argue?). For those of you who know nothing about the Ig Nobels, they were initiated by one of my favourite journalists, Guardian columnist Marc Abrams. Abrams writes a weekly column for the Guardian called Improbable Research and he is also the editor of the Annals of Improbable Research.

Back in February 2010, I was delighted when Abrams did a whole column on my research into gambling entitled ‘Slot-machine gamblers are hard to pin down: Why are gamblers such a difficult subject for academic study?’ Secretly, I’m very proud that he dedicated a whole column to my research. (In fact, I found out while I was researching the original blog on this topic, is that my research also features in his 2012 book This is Improbable: Cheese String Theory, Magnetic Chickens, and Other WTF Research. Here are some of the things he wrote about my research into gambling:

It’s hard to get good payoffs from slot machines, yes. But it’s also hard to get good information from slot machine gamblers, and that made things awkward for psychologists Mark Griffiths, of Nottingham Trent University, and Jonathan Parke, of Salford University. They explained how, in a monograph called Slot Machine Gamblers – Why Are They So Hard to Study? Griffiths and Parke published it a few years ago in the Journal of Gambling Issues. ‘We have both spent over 10 years playing in and researching this area,’ they wrote, ‘and we can offer some explanations on why it is so hard to gather reliable and valid data. Here are three from their long list.

  • First, gamblers become engrossed in gambling. ‘We have observed that many gamblers will often miss meals and even utilise devices (such as catheters) so that they do not have to take toilet breaks. Given these observations, there is sometimes little chance that we as researchers can persuade them to participate in research’ 
  • Second, gamblers like their privacy. They ‘may be dishonest about the extent of their gambling activities to researchers as well as to those close to them. This obviously has implications for the reliability and validity of any data collected.’
  • Third, gamblers sometimes notice when a person is spying on them. “The most important aspect of non-participant observation research while monitoring fruit-machine players is the art of being inconspicuous. If the researcher fails to blend in, then slot-machine gamblers soon realise they are being watched and are therefore highly likely to change their behaviour.’

The gambling machines go by many names, ‘fruit machine’ and ‘one-armed bandit’ also being popular. But Griffiths and Parke don’t obsess about nomenclature. The two are giants in their chosen profession. The International Journal of Mental Health and Addiction ran a paean from a researcher who said: ‘In the problem gambling field we don’t exhibit the same adulation as music fans for their idols, but we have our superstars and, for me, Mark Griffiths is one.’

Professor Griffiths is one of the world’s most published scholars on matters relating to the psychology of fruit-machine gamblers, with at least 27 published studies that mention fruit machines in their title. These range from 1994’s appreciative Beating the Fruit Machine: Systems and Ploys Both Legal And Illegal to 1998’s admonitory Fruit Machine Gambling and Criminal Behaviour: Issues for the Judiciary*. Women get special attention (Fruit Machine Addiction in Females: a Case Study), as do youths (Adolescent Gambling on Fruit Machines and several other monographs). There is the humanist perspective (Observing the Social World of Fruit-Machine Playing) as well as that of the biomedical specialist (The Psychobiology of the Near Miss in Fruit Machine Gambling). Griffiths and Parke collaborate often. Strangers to their work might wish to begin by reading the classic The Psychology of the Fruit Machine. Their fruitful publication record reminds every scholar that, even when a subject is difficult to study, persistence and determination can yield a rewarding payoff”.

All I can say is that after re-reading this, I wonder how I can still get my head through the door.

More recently, one of my papers was actually reported by Marc Abrams on his Improbable Research website. More specifically, my case study published in the Archives of Sexual Behavior about eproctophilia (i.e., sexual arousal from flatulence), was given press coverage in over 100 newspaper and magazine stories around the world including those in the UK, Ireland, US, Greece, Italy, Holland, China, and Ghana (e.g., New York Daily News, Huffington Post, Daily Telegraph, Daily Mirror, The Sun, Metro, Times of Malta, Irish Examiner, Asian Image, and Cosmopolitan). However, it was actually Abrams who first reported the story under the headline Academic Study of a Young Man’s Sexual Attraction to Human Gas”. For those who don’t know, the underlying philosophy of the IR website is to feature “research that makes people laugh and then think”. More specifically, Abrams wrote:

“Professor Mark D Griffiths of Nottingham Trent University has published a remarkable new study. Here’s how we know this study is remarkable:  The university’s press office sent copies of it to many prominent science journalists, remarking that (1) ‘It’s the world’s first paper on eproctophilia – sexual arousal from flatulence’ and (2) ‘Professor Griffiths would be more than happy to talk to you in more detail’. A remarkable number of those journalists immediately sent it on to us at the Annals of Improbable Research. We are, in this blog entry you are reading right now, remarking upon that study. There is more. Lots more. In other respects, too, Professor Griffiths is an expert. So renowned is he that Wikipedia devoted an entire web page to him. One of the many things on which he is an expert is the academic study of gamblers. We have celebrated some of his abundant work on that subject. (We express our thanks, and other emotions, to the many journalists who instinctively decided that they should alert us to the existence of Professor Griffiths’s new line of research.) BONUS (unrelated): The 1998 Ig Nobel Prize for literature was awarded to Dr. Mara Sidoli of Washington, DC, for her illuminating report, ‘Farting as a Defence Against Unspeakable Dread’ [Journal of Analytical Psychology, vol. 41, no. 2, 1996, pp. 165-78.]”

Anyway, if you’d like to go see Marc Abrams in person, here are the further details:

Event: The Ig Nobels: A celebration of Science

Time and date: 6.30 pm, Wednesday 18th March

Location: The Newton Building on the City Campus of the University.

Booking details: The event is free but booking is essential.

Book at: www.ntu.ac.uk/ignobles2015 (direct link here)

Details of their UK events and more information about the Ig Nobels can be found on their website: http://www.improbable.com/improbable-research-shows/complete-schedule/

* I’ve never actually written a paper with this title but I think it’s an inadvertent mix of two or three papers I’ve written with similar titles

 

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

Further reading (i.e., the papers cited by Marc Abrams above)

Griffiths, M.D. (1991). The psychobiology of the near miss in fruit machine gambling. Journal of Psychology, 125, 347-357.

Griffiths, M.D. (1994). Beating the fruit machine: Systems and ploys both legal and illegal. Journal of Gambling Studies, 10, 287-292.

Griffiths, M.D. (1995). Adolescent Gambling. London: Routledge

Griffiths, M.D. (1996). Observing the social world of fruit-machine playing. Sociology Review, 6(1), 17-18.

Griffiths, M.D. (2003). Fruit machine addiction in females: A case study. Journal of Gambling Issues, 8. Located at: http://www.camh.net/egambling/issue8/clinic/griffiths/index.html.

Griffiths, M.D. (2013). Eproctophilia in a young adult male: A case study. Archives of Sexual Behavior, 42, 1383-1386.

Parke, J. & Griffiths, M.D. (2002). Slot machine gamblers – Why are they so hard to study? Journal of Gambling Issues, 6. Located at: http://jgi.camh.net/doi/full/10.4309/jgi.2002.6.7

Parke, J. & Griffiths, M.D. (2006). The psychology of the fruit machine: The role of structural characteristics (revisited). International Journal of Mental Health and Addiction, 4, 151-179.

Yeoman, T. & Griffiths, M.D. (1996). Adolescent machine gambling and crime (I). Journal of Adolescence, 19, 99-104.

Griffiths, M.D. & Sparrow, P. (1998). Fruit machine addiction and crime. Police Journal, 71, 327-334.

Griffiths, M.D. (2001). Cybercrime: Areas of concern for the judiciary. Justice of the Peace, 165, 296-298.

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