Category Archives: Sex

Sense and sense-ability: A brief look at ‘virtual reality addiction’

Ever since I started researching into technological addictions, I have always speculated that ‘virtual reality addiction’ was something that psychologists would need to keep an eye on. In 1995, I coined the term ‘technological addictions’ in a paper of the same name in the journal Clinical Psychology Forum. In the conclusions of that paper I asserted:

“There is little doubt that activities involving person-machine interactivity are here to stay and that with the introduction of such things [as] virtual reality consoles, the number of potential technological addictions (and addicts) will increase. Although there is little empirical evidence for technological addictions as clinical entities at present, extrapolations from research into fruit machine addiction and the exploratory research into video game addiction suggest that they do (and will) exist”.

Although I wrote the paper over 20 years ago, there is little scientific evidence (as yet) that individuals have become addicted to virtual reality (VR). However, that is probably more to do with the fact that – until very recently – there had been little in the way of affordable VR headsets. (I ought to just add that when I use the term ‘VR addiction’ what I am really talking about is addiction to the applications that can be utilized via VR hardware rather than the VR hardware itself).

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VR’s potential in mass commercial markets appears to be finally taking off because of mass-produced affordable hardware such as Oculus Rift, HTC Vive, PlayStation VR and the (ultra-cheap) Google Cardboard (in which a smartphone can be inserted into cardboard VR headset frame). Last year, a report by the marketing and consulting company Tractica claimed that spending on virtual reality hardware could be as much as $21.8 billion (US) by 2020. A more recent report by online and digital market research company Juniper estimated that global sales of VR headsets would rise from 3 million in 2016 to 30 million by 2020. Three markets are likely drive sales, and they all happen to be areas that I research into from an addiction perspective – video gaming, gambling, and sex. I’ve noted in many of my academic papers over the years (particularly my early papers on online gambling addiction and online sex addiction) that when new technological advances occur, the sex and gambling industries always appear to be the first to invest and produce commercial products and services using such technologies, and VR is no different. As an online article in Wareable by Dan Sung on VR sex noted:

“What [VR] headsets offer is immersion; 180-degree (or more), stereoscopic action with you as the star of the show and the adult actors and actresses looking deep and lustfully into your eyes as they tend to your genitalia. It’s small wonder that users have been donning their headsets and earphones in numbers and praying to their god that nobody walks in. Yet gambling and porn are synonymous with addiction, and increasingly, questions are being asked about whether the VR revolution could finally ensnare us humans into virtual worlds”.

I was interviewed by Sung for the same article and I made a number of different observations about VR sex. I commented that in terms of people feeling reinforced, aroused, rewarded, sex is the ultimate in things that are potentially addictive. Sex is one of those activities that is highly reinforcing, it’s highly rewarding and how people feel is probably better than the highs and buzzes from other behaviours. Theoretically, I can see that VR sex addiction would be possible but I don’t think it’s going to be on the same scale as other more traditional addictions. The thing about VR (and VR sex) – and similarly to the internet – is that it’s non-face-to-face, it’s non-threatening, it’s destigmatising, and it’s non-alienating. VR sex could be like that whether it’s with fictitious partners, someone that you’re actually into, or someone that you’ve never met before. Where VR sex is concerned, if you can create a celebrity in a totally fictitious way, that will happen. There may be celebrities out there that will actually endorse this and can make money and commercialise themselves to do that. It can work both ways. Some people might find it creepy while others might see something they can make money from.

In one of my previous blogs I looked at the area of ‘teledildonics’, a VR technology that has been around for over two decades (in fact I was first interviewed on this topic on a 1993 Channel 4 television programme called Checkout ’93). Dan Sung also interviewed Kyle Machulis who runs the Metafetish teledildonics website for his article. He said that in relation to VR sex there is a problem with haptics (i.e., the science of applying tactile sensation and control to interaction with computer applications):

 “We’re good on video and audio but haptics is a really, really hard problem…A lot of toys out there right now are horrible and it’s very hard to come up with something quality. So, instead, what the porn industry is aiming for right now is immersion. It may not feel better but they’re so much closer to the action that it may be better, and I think we’re on the cusp of that right now.” First, we need consumer hardware. We need things to be released and available to customers to see if it’s really going to take off or not. But when this happens – late this year, the beginning of next – as soon as the headsets are available, the media is ready and waiting…Of course, there’s straight women, gay men and gay women to develop for too but, for a lot of people, the perfect porn experience is doing something that’s not even physically possible – either through the laws of physics or the laws of land, and that’s something that only VR can solve…Even so, what we saw in teledildonics in gaming is that people used them to begin with but there’s always a lot of fall off with new technologies like this. So, there’s going to be a hardcore set of people who stay with VR porn but it’s hard to say how popular it will be beyond that. We’re all still guessing at the moment. This time next year it will be a completely different story”.

Another area that we will need to monitor is how the gambling industry will harness VR technology. The most obvious application of VR in the gambling world is in the online gambling sector. I can imagine some online gamblers wanting their gambling experiences to be more immersive and for their online gambling sessions to be more akin to gambling offline surrounded by the sights and sounds of an offline gambling venue. There is no technical reason that I know of why people that gamble via their computers, laptops, smartphones or tablets could not wear VR headsets and be playing poker opposite a virtual opponent while still sat on the sofa at home. As Paul Swaddle (CEO of Pocket App) noted in a recent issue of Gambling Insider:

We already know that participation in online gambling is snowballing, so if the entertainment industry can use VR to simulate the experience of being inside a video game, or social media sites can give you the opportunity to not just see your friends’ pictures, but to walk through them, why shouldn’t online casinos be able to do the same? VR may actually be the hook that mobile and online casinos need to draw in more millennials, with the average age of players in mobile casinos currently being 40 [years old], and the average age of mobile gamblers in general being 35 [years old]. Millennials simply aren’t engaging with mobile and online casinos to the same extent as older generations, and I suspect that this is down to younger players being much more used to immersive and sociable gaming, as a result of the cutting-edge developments that are being constantly rolled out in the video gaming industry”.

I agree with Swaddle’s observations as the gambling industry are constantly thinking about the ways to bring in newer players. Today’s modern screenagers love technology and do not appear to have any hang-ups about using wearable technology including Fitbit and the Apple Watch. As Swaddle goes on to say:

“By using 
VR technology to transport players and their friends to exciting locations for their online gambling experience, such as a famous casino in Las Vegas, or a smoky basement room in 1920s New York, or even to the poker table in the James Bond film Casino Royale, mobile and online casinos may stand a better chance of drawing in younger audiences if they use VR to gamify the casino experience”.

Again, this makes a lot of sense to me and I wouldn’t bet against this happening. Swaddle thinks that such VR gambling experiences will become commonplace in the years to come and that the gambling industry needs to get on the VR bandwagon now. 

Perhaps of most psychological concern is the use of VR in video gaming. There is a small minority of players out there who are already experiencing genuine addictions to online gaming. VR takes immersive gaming to the next level, and for those that use games as a method of coping and escape from the problems they have in the real world it’s not hard to see how a minority of individuals will prefer to spend a significant amount of their waking time in VR environments rather than their real life.

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

Further reading

Ashcroft, S. (2015). VR revenue to hit $21.8 billion by 2020. Wareable, July 29. Located at: http://www.wareable.com/vr/vr-revenues-could-reach-dollar-218-billion-by-2020-1451

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

Griffiths, M.D. (1996). Gambling on the internet: A brief note. Journal of Gambling Studies, 12, 471-474.

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

Griffiths, M.D. (2003). Internet gambling: Issues, concerns and recommendations. CyberPsychology and Behavior, 6, 557-568.

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

Griffiths, M.D., Király, O., M. Pontes, H.M. & Demetrovics, Z. (2015). An overview of problematic gaming. In Starcevic, V. & Aboujaoude, E. (Eds.), Mental Health in the Digital Age: Grave Dangers, Great Promise (pp.27-55). Oxford: Oxford University Press.

Juniper Research (2016). White paper: The rise of virtual reality. Available from: http://www.juniperresearch.com/document-library/white-papers/the-rise-of-virtual-reality

Király, O., Nagygyörgy, K., Koronczai, B., Griffiths, M.D. & Demetrovics, Z. (2015). Assessment of problematic internet use and online video gaming. An overview of problematic gaming. In Starcevic, V. & Aboujaoude, E. (Eds.), Mental Health in the Digital Age: Grave Dangers, Great Promise (pp.46-68). Oxford: Oxford University Press.

Stables, J. (2016).  Gambling, gaming and porn: Research says VR is set to blast off. Wareable, September 15. Located at: http://www.wareable.com/vr/gaming-gambling-and-porn-research-says-vr-is-set-to-blast-off-1682

Swaddle, P. (2016). Is virtual reality the future of mobile and online gambling? Gambling Insider, 23, June 3, p.9

Sung, D. (2015). VR and vice: Are we heading for mass addiction to virtual reality fantasies? Wareable, October 15. Located at: http://www.wareable.com/vr/vr-and-vice-9232

Tractica (2015). Virtual reality for consumer markets. Available at: https://www.tractica.com/research/virtual-reality-for-consumer-markets/

Stars in their eyes: Another look at Celebrity Worship Syndrome

Last week I did a number of media interviews about Celebrity Worship Syndrome (CWS) including the Metro newspaper (‘From Beyonce to Elvis, here’s the ugly truth about why we worship celebrities’) and the International Business Times (‘Crazy about Kylie Jenner? Professor of Behavioural Addiction explains celebrity obsession’). I also wrote an article for the Huffington Post. The ‘hook’ for all these stories was the DVD release of the film Kill The King (also known by the title Shangri La Suite) which tells the story of two 20-year old damaged lovers – Jack and Karen (played by Luke Grimes and Emily Browning) – who head to Los Angeles to kill rock ‘n’ roll legend Elvis Presley in the summer of 1974. While Jack’s obsession with Elvis is somewhat extreme, over the last two decades there has been an increasing amount of research into CWS.

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CWS has been described as an obsessiveaddictive disorder where an individual becomes overly involved and interested (in short, completely obsessed) with the details of the personal life of a celebrity. Any person who is ‘in the public eye’ can be the object of a person’s obsession (e.g., authors, politicians, journalists), but research and criminal prosecutions suggest they are more likely to be someone from the world of television, film and/or pop music. Research suggests that CWS exists and that according to Dr. John Maltby and his colleagues (see ‘Further reading’ below) there are three independent dimensions of celebrity worship. These are on a continuum and named (i) entertainment-social, (ii) intense-personal, and (iii) borderline pathological.

  • The entertainment-social dimension relates to attitudes where individuals are attracted to a celebrity because of their perceived ability to entertain and to become a social focus of conversation with likeminded others.
  • The intense-personal dimension relates to individuals that have intensive and compulsive feelings about a celebrity.
  • The borderline-pathological dimension relates to individuals who display uncontrollable behaviours and fantasies relating to a celebrity.

Among adults, their research has shown that there is a correlation between the pathological aspects of CWS and poor mental health such as high anxiety, more depression, high stress levels, increased illness, and poorer body image. Among teenage females there is a relationship between intense-personal celebrity worship and body image (basically, teenage girls who identify with celebrities have much poorer body image compared to other groups). In addition, most celebrity-obsessed individuals often suffer high levels of dissociation and fantasy-proneness. Maltby’s research suggests about 1% of his participants have obsessional tendencies towards celebrities.

Research has also shown that worshipping celebrities can have both positive and negative consequences. People who worship celebrities for entertainment and social reasons have been found to be more optimistic, outgoing, and happy. Those who worship celebrities for personal reasons have been found to be more obsessive, more depressed, more anxious, more solitary, more impulsive, more anti-social and more troublesome. My own thoughts on CWS and celebrity culture are provided below and are from the interviews I did with the Metro and the International Business Times (IBT).

IBT: In a world filled with Kardashians, social media and vast consumerism, why do you think people are more obsessed with celebrities than ever?

MG: The first thing I would say is that most people are not obsessed with celebrities but there are probably a lot more people who are obsessed compared to a couple of decades ago (although this is speculation on my part as no research has ever examined the prevalence of celebrity obsession among a nationally representative sample). One study did estimate about 1% of their sample being obsessed with celebrities but there is no comparative study prior to that. However, I do think that the numbers of people who have celebrity obsessions has increased over the last 20 years and much of this is most likely due to the rise of celebrities using social media (and the fact that celebrities can now interact – if they want – hour by hour with their fan base) and the increase in general media coverage surrounding celebrity and celebrity lives (including a large increase in reality TV starring celebrities and an increase in the number of celebrity gossip magazines). These types of media and social media can give rise to what we psychologists call parasocial relationships. With respect to celebrities, parasocial relationships are one-sided relationships, where fans express interest, time, money, and/or emotion in and/or on the celebrity (while the celebrity is totally unaware of the fan in any singular or specific sense).

IBT: Do you know what happens in the mind when we form an obsession or infatuation with some things? 

MG: Celebrity infatuations are nothing to particularly worry about because they tend to be intense but relatively short-lived admiration for the person. Celebrity obsessions can be of a lot more concern. At their simplest level, a celebrity obsession is when someone constantly thinks about a particular celebrity in a way that most people would describe as abnormal. This can be to the point where the obsession conflicts with most other things in the individual’s life including job or education, other relationships, and other hobbies. A person’s whole life can revolve around the celebrity and such individuals can end up spending way beyond their disposable income by buying their merchandise (CDs, DVDs, books, perfumes, clothing lines, etc.) and/or seeing them live on stage (singing, acting, etc.). There is no single explanation as to why someone might develop a celebrity obsession but many appear to start with a sexual attraction to the celebrity in question and have fantasies of what they would do if they met the object of their desire. Research has shown that there is a correlation between the pathological aspects of celebrity worship and poor mental health such as high anxiety, more depression, high stress levels, increased illness, and poorer body image. Among teenage females there is a relationship between intense-personal celebrity worship and body image (basically, teenage girls who identify with celebrities have much poorer body image compared to other groups). In addition, most celebrity-obsessed individuals often suffer high levels of dissociation and fantasy-proneness.

IBT: What does it have to take about a ‘celebrity’ for people to become obsessed?

MG: At a micro-level, any person who is ‘in the public eye’ can be the object of a person’s obsession (e.g., authors, politicians, journalists), but research and criminal prosecutions suggest they are more likely to be someone from the world of television, film and/or pop music. This is most likely because such celebrities tend to be more popular and have bigger followings in the public eye in media and on social media. At a micro-level, we are all individuals it could be something very idiosyncratic but given that the little research carried out tends to report that celebrity worshippers are sexually attracted to their celebrity of choice, then being good looking (at least in the eyes of the beholder) appears to be a common denominator.

IBT: How do you think today’s modern obsession with celebrity influenced and resounded throughout Kill the King?

MG: One of Jack’s reasons for being sent to a rehab centre – in addition to a drug addiction problem – is because of his “increasingly abnormal obsession” with Elvis Presley. While Jack’s obsession with Elvis is somewhat extreme and arguably a type of ‘Celebrity Worship Syndrome’, his character doesn’t seem to overlap too much with modern day celebrity worshippers. Jack’s character is more akin to celebrity stalkers or celebrity assassins (like John Lennon’s killer Mark Chapman) than the archetypal young female totally obsessed and besotted with their favourite pop star or actor. Given that Kill The King was set in 1974 and celebrity obsession (and Celebrity Worship Syndrome) is a more modern day phenomenon, I wouldn’t have expected that much overlap anyway.

 

Metro: Should we be worried about this kind of social media ‘bond’, seeing as icons like John Lennon were assassinated by fans who became obsessed with them?

MG: The chances of those things happening are few and far between. If someone is absolutely hooked on the idea of killing a celebrity, they’ll go and do it. I don’t think it’s to do with the rise of the mass media or anything like that. Most research says fandom is actually good for people. It gives them a hobby. Fans talk to other fans. It brings us together, and it can be life-affirming. I’m a massive, massive David Bowie fan. I’m a record collector, too and I’m probably more on the obsessive side than most people. But I don’t think I’m a worse person for that.

Metro: So what’s the difference between you and someone who spends thousands and thousands of pounds on plastic surgery to look more like their idol?

MG: Those are the real extreme cases. The good news is that recent research has shown that less than one per cent of people are really unhealthily obsessed with stars. And of those people, most are not going to do things that have negative effects on their life. In my opinion, the difference between a healthy enthusiasm and an unhealthy obsession is that enthusiasm adds to life, and addictions or obsessions take away from it. For most people, even those who have a compulsive element to their fandom like myself, it doesn’t have a negative effect on their quality of life. It’s probably better to buy records and memorabilia than designer handbags. Sometimes it’s not just about money, it’s about the time you spend as well. For one person, an obsession can be fine, and for another it can be very problematic. If a fan works in Tesco and they’re following their hero around the country, watching them night after night on tour and buying merchandise, they just don’t have the disposable income to do it. I could do that, thanks to my salary, but I can’t afford the time.

Metro: Is there a link between someone’s social background and their preference for celebrity culture?

MG: I don’t know the scientific link there, but I wouldn’t be surprised if the lower the socio-economic class you’re in the more likely you are to be involved and like celebrity culture. ‘Gogglebox’ stars, for instance. The middle class, well-to-do people like current affairs, news and politics and those who are less well-off are probably more interested in EastEnders and things like that.

Metro: Are there any psychological issues that lead to celebrity worship?

MG: Those with celebrity worship syndrome tend to have worse mental health. They’re more likely to be anxious, depressed, to have high stress levels, increased bouts of illness and a poor body image. But it’s a case of the chicken or the egg, because these people might self-medicate through these parasocial relationships with celebs they’ll never even meet. 

Metro: What are the effects of celebrity culture? Particularly for young people?

MG: We know that young people are not as engaged with politics. They just don’t trust politicians, and it’s linked to the rise of social media. Celebrities have more pull, and followers, than [British Prime Minister] Theresa May or [leader of the Labour Party] Jeremy Corbyn will ever have. I’m not in a position to say whether people should be more interested in X or Y. Certain things in life make people feel good. As humans we seek out things that get us high, aroused, excited –  or we seek out things which tranquilise and numb us. Celebrities tend to give us a thrill. 

Metro: Are celebrities vulnerable themselves?

MG: I certainly wouldn’t like to be in a position where cameras are waiting outside my house. Stardom can bring positive things, but also a lot of unexpected negatives too. We have to remember at the end of the day that celebrities are just human beings, with all the same emotional foibles and weaknesses we have – and sometimes they’re magnified times a hundred because of the pressure and stress of the spotlight. And the internet, too. It’s no wonder some of them fall prey to serious addictions. 

Metro: People like Amy Winehouse? She’s the most recent example I can think of.

MG: Before she died, Amy Winehouse had got to that stage where she was very famous, and she was earning a lot of money. And that meant she was surrounded by sycophants and ‘yes’ people. Those kinds of people say things they think you want to hear, and they’re not necessarily looking out for you. Amy was surrounded by people thinking about their own wages and careers. No, it’s not a surprise when these things happen, and people could see it coming. Like with Kurt Cobain’s death. Amy didn’t get the help she needed. We can say that in hindsight.’

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

Further reading

BBC News (2003). Worshipping celebrities ‘brings success. August 13. Located at: http://news.bbc.co.uk/1/hi/health/3147343.stm

Chapman, J. (2003). Do you worship the celebs? Located at: http://www.dailymail.co.uk/tvshowbiz/article-176598/Do-worship-celebs.html

Griffiths, M.D. (2016). Does ‘Celebrity Worship Syndrome’ really exist? Huffington Post, November 18. Located at: http://www.huffingtonpost.co.uk/dr-mark-griffiths/does-celebrity-worship-sy_b_13012170.html

McCutcheon, L.E., Lange, R., & Houran, J. (2002). Conceptualization and measurement of celebrity worship. British Journal of Psychology, 93, 67-87.

Maltby, J., Houran, M.A., & McCutcheon, L.E. (2003). A Clinical Interpretation of Attitudes and Behaviors Associated with Celebrity Worship. Journal of Nervous and Mental Disease, 191, 25-29.

Maltby, J., Houran, J., Ashe, D., & McCutcheon, L.E. (2001). The self-reported psychological well-being of celebrity worshippers. North American Journal of Psychology, 3, 441-452.

Maltby, J., Day, L., McCutcheon, L.E., Gillett, R., Houran, J., & Ashe, D. (2004). Celebrity Worship using an adaptational-continuum model of personality and coping. British Journal of Psychology. 95, 411-428.

Maltby, J., Giles, D., Barber, L. & McCutcheon, L.E. (2005). Intense-personal Celebrity Worship and Body Image: Evidence of a link among female adolescents. British Journal of Health Psychology, 10, 17-32.

Maltby, J., Day, L., McCutcheon, L.E,. Gilett, R., Houran, J. & Ashe, D.D. (2004), ‘Personality and Coping: A Context for Examining Celebrity Worship and Mental Health. British Journal of Psychology, 95, 411-428.

Maltby, J., Day, L., McCutcheon, L.E., Houran, J. & Ashe, D. (2006). Extreme celebrity worship, fantasy proneness and dissociation: Developing the measurement and understanding of celebrity worship within a clinical personality context. Personality and Individual Differences, 40, 273-283.

Wikipedia (2012). Celebrity Worship Syndrome. Located at: http://en.wikipedia.org/wiki/Celebrity_Worship_Syndrome

Specific limb: A brief look at ‘restless legs syndrome’

Those that know me well often comment that I have a general inability to sit still and that I am a ‘fidget’. (This is not necessarily a bad thing and in fact there are some positives to fidgeting that I outlined in a previous blog on bad behaviours that are sometimes good for you). There is certainly some truth to the observation that I fidget but sometimes the fidgeting is out of my control. Every few weeks my right lower leg appears to take on a life of its own and I will get strange (uncomfortable) sensations (such as tingling, itching, and aching, and occasionally cramp-like feelings) that force me to move my right leg and foot around. It only happens when I am in a resting and relaxing state and usually lasts about 30 minutes (but can occasionally last much longer). On occasions it disrupts my work and sleep but I find that just getting up and moving around is sometimes enough to alleviate the uncomfortable feelings.

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A few years ago I Googled my ‘symptoms’ and was surprised to find that I am not the only person who appears to experience such effects and that there is a whole medical literature on what has been termed ‘restless legs syndrome’ although in my case it would be in a singular rather than plural form). I’ve had the condition for about 15 years now and it may be related to some of the medication I take for an unrelated chronic degenerative health condition that I have. According to the Wikipedia entry on restless legs syndrome (RLS):

“The first known medical description of RLS was by Sir Thomas Willis in 1672. Willis emphasized the sleep disruption and limb movements experienced by people with RLS…The term ‘fidgets in the legs’ has also been used as early as the early nineteenth century. Subsequently, other descriptions of RLS were published, including those by Francois Boissier de Sauvages (1763), Magnus Huss (1849), Theodur Wittmaack (1861), George Miller Beard (1880), Georges Gilles de la Tourette (1898), Hermann Oppenheim (1923) and Frederick Gerard Allison (1943). However, it was not until almost three centuries after Willis, in 1945, that Karl-Axel Ekbom (1907–1977) provided a detailed and comprehensive report of this condition in his doctoral thesis, Restless legs: clinical study of hitherto overlooked disease. Ekbom coined the term “restless legs” and continued work on this disorder throughout his career. He described the essential diagnostic symptoms, differential diagnosis from other conditions, prevalence, relation to anemia, and common occurrence during pregnancy. Ekbom’s work was largely ignored until it was rediscovered by Arthur S. Walters and Wayne A. Hening in the 1980s. Subsequent landmark publications include 1995 and 2003 papers, which revised and updated the diagnostic criteria”.

As well as being referred to as RLS, it is sometimes referred to as Willis-Ekbom Disease or Willis-Ekbom Syndrome. Since being ‘rediscovered’ in the 1980s, there have been a lot of scientific papers published on the phenomenon although many of these are medical case studies (I don’t think my own experiences are extreme enough or strong enough to appear in any medical textbook. The Wikipedia entry on RLS provides a good summary of what is known medically and empirically:

“Restless legs syndrome (RLS) is a disorder that causes a strong urge to move one’s legs. There is often an unpleasant feeling in the legs that improves somewhat with moving them. Occasionally the arms may also be affected. The feelings generally happen when at rest and therefore can make it hard to sleep. Due to the disturbance in sleep, people with RLS may have daytime sleepiness, low energy, irritability, and a depressed mood. Additionally, many have limb twitching during sleep. Risk factors for RLS include low iron levels, kidney failure, Parkinson’s disease, diabetes, rheumatoid arthritis, and pregnancy. A number of medications may also trigger the disorder including antidepressants, antipsychotics, antihistamines, and calcium channel blockers. There are two main types. One is early onset RLS which starts before age 45 [years], runs in families and worsens over time. The other is late onset RLS which begins after age 45 [years], starts suddenly, and does not worsen. Diagnosis is generally based on a person’s symptoms after ruling out other potential causes… Females are more commonly affected than males and it becomes more common with age…Some doctors express the view that the incidence of restless leg syndrome is exaggerated by manufacturers of drugs used to treat it. Others believe it is an under-recognized and undertreated disorder…An association has been observed between attention deficit hyperactivity disorder (ADHD) and RLS or periodic limb movement disorder. Both conditions appear to have links to dysfunctions related to the neurotransmitter dopamine, and common medications for both conditions among other systems, affect dopamine levels in the brain”.

According to a review by Dr. Richard Allen and Dr. Christopher Earley in the Journal of Clinical Neurophysiology, RLS affects 2.5-15% of the US population. In another review on sleep disorder in the journal American Family Physician, Dr. Kannan Ramar and Dr. Eric Olson reported that RLS is typically characterized by four essential features: These are:

“(1) the intense urge to move the legs, usually accompanied or caused by uncomfortable sensations (e.g., “creepy crawly,” aching) in the legs; (2) symptoms that begin or worsen during periods of rest or inactivity; (3) symptoms that are partially or totally relieved by movements such as walking or stretching; and (4) symptoms that are worse or only occur in the evening or at night”.

Various online articles and papers report a variety of potential treatments based on the notion that RLS might be caused by a dopamine imbalance in the body. Some medics advise a regular sleep routine (such as that advised for those with insomnia), and cutting out the drinking of alcohol and the smoking of cigarettes. Pharmacological treatments include the use of drugs that are also used in the treatment of Parkinson’s disease such as L-DOPA and pramipexole, and the use of magnesium sulphate therapy (as reported in a 2006 paper in the Journal of Clinical Sleep Medicine – magnesium is known to be a natural muscle relaxant). In a 2011 issue of the journal Sleep Medicine, In an online article about RLS, Dr Michael Platt, author of the 2014 book Adrenalin Dominance, claims that RLS sufferers can be treated using a progesterone cream:

“Excess adrenalin during the night can cause restless leg syndrome. People often have associated symptoms also resulting from elevated adrenalin, such as teeth grinding, the need to urinate, and tossing and turning, and they often awaken in the morning with low back pain. Characteristically, RLS patients have an excess of adrenaline, may toss and turn all night, be quick to anger, might be workaholics, will usually have fibromyalgia (aches and pains – low back, side of the hips, and grind their teeth), they might drink too much, and will be hypoglycemic (sleepy between 3-4 p.m. or when in a car), and so on. There is an associated over-production of insulin and an under-production of progesterone…[By using a progesterone cream] I have had 100% success with eliminating RLS by getting hormones into balance, often within the first week. Patients feel more relaxed, they can sleep at night, rage disappears, and they can focus more easily”.

Dr. Luis Marin and his colleagues reported a different treatment for RLS altogether. They reported the case of a 41-year-old male RLS sufferer who after being on medication for RLS discovered his own solution – having sex. Following sex, the man reported that all RLS symptoms would disappear. Marin and colleagues speculated that the release of dopamine following orgasm might alleviate RLS symptoms. This appears to be a reasonable speculation given the findings of research published in the Journal of Neuroscience by Dr. Gert Holstege and his colleagues who examined brain activation at the point of ejaculation. In their paper they reported the similarity between ejaculation and using heroin in terms of brain activation:

“We used positron emission tomography to measure increases in regional cerebral blood flow during ejaculation compared with sexual stimulation in heterosexual male volunteers. Manual penile stimulation was performed by the volunteer’s female partner. Primary activation was found in the mesodiencephalic transition zone, including the ventral tegmental area, which is involved in a wide variety of rewarding behaviors. Parallels are drawn between ejaculation and heroin rush”.

It could well be that the increase in dopamine following ejaculation acts in a similar way to the medications that are given to RLS sufferers. Of all the treatments for RLS that I have read about, I think I know which one I would prefer!

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

Further reading

Allen, R.P., & Earley, C.J. (2001). Restless legs syndrome: A review of clinical and pathophysiologic features. Journal of Clinical Neurophysiology, 18(2), 128-147.

Bartell S1, Zallek S. Intravenous magnesium sulfate may relieve restless legs syndrome in pregnancy. Journal of Clinical Sleep Medicine, 15, 187-188.

Chaudhuri, K.R., Appiah-Kubi, L.S., & Trenkwalder, C. (2001). Restless legs syndrome. Journal of Neurology, Neurosurgery & Psychiatry, 71(2), 143-146.

Ekbom, K., & Ulfberg, J. (2009). Restless legs syndrome. Journal of Internal Medicine, 266(5), 419-431.

Holstege, G., Georgiadis, J. R., Paans, A. M., Meiners, L. C., van der Graaf, F. H., & Reinders, A. S. (2003). Brain activation during human male ejaculation. Journal of Neuroscience, 23(27), 9185-9193

Leschziner, G., & Gringras, P. (2012). Restless legs syndrome. British Medical Journal, 344, e3056.

Marin, L.F., Felicio, A.C., & Prado, G.F. (2011). Sexual intercourse and masturbation: Potential relief factors for restless legs syndrome? Sleep Medicine, 12(4), 422.

Ondo, W. G. (2009). Restless legs syndrome. Neurologic Clinics, 27(3), 779-799.

Ramar, K; Olson, EJ (Aug 15, 2013). Management of common sleep disorders. American Family Physician, 88, 231–238.

Satija, P., & Ondo, W. G. (2008). Restless legs syndrome. CNS Drugs, 22(6), 497-518.

Stitches brew: A brief look at self-harm lip sewing

In previous blogs I have examined both self-harming behaviour (such as cutting off one’s own genitals, removing one’s own eye, removing one’s own ear, self-asphyxial risk taking in adolescence, and religious self-flagellation) and extreme body modification. One area where these two areas intersect is lip sewing. According to the Wikipedia entry on lip sewing:

“Lip sewing or mouth sewing, the operation of stitching together human lips, is a form of body modification. It may be carried out for aesthetic or religious reasons; as a play piercing practice; or as a form of protest. Sutures are often used to stitch the lips together, though sometimes piercings are made with needle blades or cannulas and monofilament is threaded through the holes. There is usually a fair amount of swelling, but permanent scarring is rare. Lip sewing may be done for aesthetic reasons, or to aid meditation by helping the mind to focus by removing the temptation to speak. BMEzine, an online magazine for body modification culture, published an article about a 23-year-old film student Inza, whose quest for body modifications was very varied. She spoke about her experiences with lip sewing as a form of play piercing”.

My reason for writing this blog was prompted by a case study published by Dr. Safak Taktak and his colleagues in the journal Health Care Current Reviews. (I ought to add that I have read a number of papers by Taktak and his colleagues as they have reported some interesting other interesting case studies including those on shoe fetishism, semen fetishism, and fetishes more generally – see ‘Further reading’ below). In this particular paper, they reported the case of a male prisoner who had continually sewed his lips together. Although they were aware of cases of sewing lips together as a form of protest, they claimed that there had never been any case reported in the medical literature.

lip-sewing

The case report involved a male 37-year old Turkish (imprisoned) farmer, father of two children, with only basic education. After sewing his lips together, the man was brought into the hospital by the police, along with a handwritten note that read: “My jinns imposed speech ban to me and they made me sew my lips unwillingly. Otherwise, they threaten me with my children. I want to meet a psychiatrist urgently”. (Jinns I later learned are – in Arabian and Muslim mythology – intelligent spirits of lower rank than the angels, able to appear in human and animal forms and are able to possess humans). Not only were his lips sown together with black thread but he had also sewn both of his ears to the side of his head (these are also photographed in the paper and you can download the report free from here). This was actually the fourth time the man had sewed his lips together (but the first that he had sewn his ears). Each time, the doctors took out the stitches and dressed the wounds. The authors examined previous documentation about the man and reported that the man had been in prison for four years after injuring someone (no details were provided) and had been diagnosed with both anxiety disorder and anti-social personality disorder. On a prison ward comprising ten other prisoners, he had attempted suicide when trying to hang himself (in fact, you can clearly see the marks on his neck in the paper’s photographs). The authors reported that:

[The man] had blunted affect. He wasn’t able to stay in the [prison] ward because of the directive voices in his head. He declared he needed to stay in the ward alone. He heard all the words as swearing and he was punished by some people as well as some entities. He also said that some jinns in the form of animals threatened him not to speak and listen to anyone; otherwise they were going to kill his kids. He wanted to protect his children [and] he stitched his lips not to speak anyone and stitched his ears not to hear anyone. In his family history, he stated that his uncle committed suicide by hanging himself and saying ‘the birds are calling me’; his father was schizophrenia-diagnosed”.

The authors then reported:

“The patient stated that he sewed his lips with any colour of thread he could find. He had approximately fifteen pinholes on his upper and lower lips. He tended to suicide with directive auditory and visual hallucination (sic) and reference paranoid delirium. As he was imprisoned, he wasn’t able to use drugs. The patient who was thought to have a psychotic disorder was injected [with] 10 mg haloperidol intramuscularly and he was sent to a safe psychiatry hospital”.

As I have noted in my previous blogs on self-harming behaviour (and as noted in this particular paper), there are many different definitions of what constitutes self-destructive behaviour. This particular case was said to be suited to the psychotic behaviours characterised by Dr. Armando Favazza’s three self-destructive behaviours (i.e., compulsive, typical, and psychotic) outlined in his 1992 paper ‘Repetitive self-mutilation’ (published in the journal Psychiatry Annals). In their discussion of the case, the authors noted:

“The cases like sewing one’s own lips which we observe as a different type of destructing oneself in our case are mostly regarded as intercultural expression of feelings. The ones, who sew their lips in order to protest something, show their reactions by blocking the nutrition intake organ to the ones who want to continue their superiority. It can be expected in psychotic cases that the patients or his beloved ones might be harmed, damaged or affected emotionally. Thus, the patient who is furious and anxious might react by [attempting] violence as a reaction to these repetitive threats. Auditory hallucinations giving orders can cause the aggressive behaviours to start…In our psychotic case, this kind of behaviour is a way to prevent the voices coming from his inner world, not to answer them and hence making passive defending to world which he does not want to interact. By this means, he may harmonise with the secret natural powers which affect him and he may protect himself his children…[also] there can be a relief through sewing lips and ears or strangulation against the oppression created by the person not being able to adapt the prison…It should not be forgotten that the prison is a stressful environment and stressful living [increases] the disposition to psychopathologic behaviour that the living difficulties in prisons can affect the way of thinking and the capacity of coping and it may cause different psychiatric incidences”.

As noted at the start of this article, lip sewing is typically attributed to religious reasons, reasons of protest or aesthetic reasons. In this particular case, none of these reasons was apparent (and therefore notable – in the medical and psychiatric literature at the very least). The addition of sewing his ears appears to be even more rare, and thus warrants further research.

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

Further reading

Favazza, A.R. (1992). Repetitive self-mutilation. Psychiatric Annals, 22(2), 60-63.

Taktak, S., Ersoy, S., Ünsal, A., & Yetkiner, M. (2014). The man who sewed his mouth and ears: A case report. Health Care Current Reviews, 2(121), 2.

Taktak, S., Karakus, M., & Eke, S. M. (2015). The man whose fetish object is ejaculate: A case report. Journal of Psychiatry, 18(276), 2.

Taktak, S., Karakuş, M., Kaplan, A., & Eke, S. M. (2015). Shoe fetishism and kleptomania comorbidity: A case report. European Journal of Pharmaceutical and Medical Research, 2, 14-19.

Taktak, S., Yılmaz, E., Karamustafalıoglu, O., & Ünsal, A. (2016). Characteristics of paraphilics in Turkey: A retrospective study – 20years. International Journal of Law and Psychiatry, in press.

Wikipedia (2016). Lip sewing. Located at: https://en.wikipedia.org/wiki/Lip_sewing

Higher and higher: Can psychoactive substance use enhance creativity?

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

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

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

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

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

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

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

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

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

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

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

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

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

Further reading

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Gaming desires: A brief look at ‘venatophilia’

In a previous blog on sexual paraphilias that have yet to be studied empirically, I briefly mentioned ‘venatophilia’.  In an online article about cartoon quicksand fetishes (which I discuss below), there was mention of a fetish group called ‘Giant Video Game Girls’ and they appear to have coined the term ‘venatophilia’ from the Latin venatus, meaning ‘game’ and describes sexual attraction to or fascination with video game characters. Venatophilia also gets a mention on the Wiktionary protologism page (a page that lists prototype neologisms) where it listed alongside venatology (“the study of games, the act of playing them, and the players and cultures surrounding them”), venatomania (an obsession with games), and venatophobia (a fear of games). Personally I find this somewhat strange as most paraphilias derive from Greek (rather than Latin) names. If this paraphilia exists I would argue that it is a sub-type of toonophilia (sexual attraction to cartoon characters) that I examined in a previous blog.

Cartoon quicksand fetishes are an integration of quicksand fetishes (itself a form of ‘stuck fetishism‘ that I examined in a previous blog) and (as mentioned above) cartoon fetishism (‘toonophilia‘). The Motherboard article by Jagger Gravning featured an interview with ‘quicksand artist’ A-020 who draws fictional damsels, women that are stuck in quicksand typically wearing a “tight miniskirt, pantyhose, heels, and boots”. (If you are interested, there is lots of art featuring women stuck in quicksand on the Deviant Art webpage). A-020 said:

 “I’m open with [my quicksand cartoon fetish] online because I’m comfortable under a screenname…Though when it comes to knowing me in person, it’s pretty much a secret! I haven’t been in a situation where I had to reveal this fetish…I was pretty young, maybe 7 or 8, when I started seeing quicksand scenes in a movie or a TV show. Some of those films I recall seeing were Beastmaster, Neverending Story, A Nightmare on Elm Street 4 and Ursus in the Valley of the Lions…Once in a while, I’d fantasize about it”.

Gravning makes the point that there are other fetishes that cartoonists incorporate into their videogame graphics. Some of these are strange behaviors that I outlined in a previous blog – ‘unbirthing’ (i.e., returning to the womb) such as that featuring ‘Princess Peach’ and Pokemon characters (such as those here and here) and vore (vorarephilia). In fact, Zeus Tipado wrote an online article for The Stoned Gamer about the “vore fetish of game characters swallowing each other whole”. There are also online articles that examine the best sexual moments in videogame history. In an online article entitled ‘Gamers as fetishists‘  by Gus Mastrapa on the Joystick Division website notes:

“Nowadays we equate fetishism with perversity, but the roots of the word are about perceiving power in objects or things. A religious idol is a fetish object. In the days when more and more parts of our lives are digital it is easy to fetishize the physical. Gamers, I think, have a bit of a head start. Because the videogames we play have long been about making our imaginations physical – by embodying and creating the ideals and fantasies we carry around with us. I mean just look at the characters in a Final Fantasy game and tell me that gamers aren’t serious fetishists…There’s a huge swath of the gaming community who love JRPGs [Japanese role playing games] like Final Fantasy and Persona – where characters are defined more by what they wear than their facial features. Costumes are a huge concern for these fans…It is easy to pick on anime nerds and their weird fixation with trench coats, boots and nerdy glasses. But this exercise would be pointless without self-examination…Gamer fetishism goes beyond the aesthetic…Games encourage obsession. They draw it out of us or provide a vessel for us to pour it into. And so it makes sense that they’d also be filled with objects of our obsession. Weapons, riches, vehicles, clothing, other people – they’re all things we want because we fill them with our dreams and desires”

Earlier this year, the makers of World of Warcraft launched a new videogame, Overwatch which according to an article in Maxim magazine by Zeynep Yenisey is “an over-sexualized first-person shooter featuring tons of big-breasted anime chicks”. Yenisey reported that after the game was released, there had been an 817% increase on Pornhub for Overwatch-related searches particularly for the buxom character Tracer.

So what is the psychology behind fetishes and sexual attraction to videogame characters? Gravning interviewed the evolutionary psychologist Dr. Catherine Salmon

“If somebody has attached to a character because they play a game a lot and fantasize about that character, it wouldn’t be surprising that they take that character and stick it somewhere else. It’s not surprising that some of the female characters in video games who are heroines and are portrayed as very sexual characters in terms of the way that they’re drawn might end up as the stars of gamers’ sexual fantasies. The social aspect of using familiar characters is another reason for using them in quicksand imagery and other fetishes. If you use a known character for a fetish, it gives your work some degree of a built-in audience, a device often used for fanfiction…There is a community of men who are creating and sharing these stories or these images. If they share an interest in the original material as well, then using that original material creates an additional commonality of interest. It’s one thing to have your sexual fantasies and it’s another thing to share your sexual fantasies. If you’re creating art or fiction and you’re putting it on the web, you’re not just doing it for yourself, it’s not just your fantasy that you’re jerking off to, you’re giving that to other people as well. To do that, you find a built-in community if you’re using a shared character”.

Gravning notes some of the “shared characters” find themselves in “exactly the same situations that these artists fetishize” and asked Dr. Salmon whether witnessing individuals repeatedly stuck in quicksand when a child could possibly lead to such unusual fetishes:

“It could be something like that. Whether it’s quicksand or tar pits, there’s things like that in children’s cartoons. It could be something as simple as that. Part of it is the damsel in distress kind of image. Watching ‘Wonder Woman’ caught in that kind of circumstance when people are younger – [it’s] an image that’s eroticized, a very sexually drawn, very feminine image. And they might enjoy watching that sort of thing or the struggle, as she’s trying to get out of whatever that circumstance is. There are a lot of unusual circumstances in cartoons and fantasy and you may get aroused while you’re watching it and then carry some of that too”.

Gravning also interviewed the sex therapist Dr. Elizabeth Lars (who shares my own view on this by alluding to classical conditioning). Dr. Lars calls such associations “accidents of learning” in which the associations “don’t have to be exactly like the fantasy that comes, it just has to resemble it”. Furthermore, she went on to speculate:

[Quicksand fetishists] probably fantasized and got into the feeling that goes with that, not just watching. It could [also] be identifying with it. The kid imagining himself stuck in quicksand in the victim’s place, for example, could be part of its erotic appeal. You could either be observing it or experiencing it. You could be doing both at the same time in a fantasy. Some evidence certainly suggests that sexual patterns are already there, for sure in males, by the age of eight. They may or may not have begun masturbating to fantasies until adolescence, but something is going on internally at a very young age. This highly influential period of age eight through adolescence is also probably for many a prime time for the ingestion of the bizarre imagery and situations contained in video games and cartoons, which often also incorporate sexualized heroines. It looks like what we call fetishes are remarkably easy to install in the early learning experiences. Same thing about fears too.”

Back in the late 1990s, I had a regular column with the now defunct magazine Arcade. My very first column (which you can download here) was on the psychology of Tomb Raider and the sexualization of lead character Lara Croft and the influence it might have on young boys and emerging adolescents. This is echoed by the neuroscientist Dr. Ogi Ogas who when interviewed by Gravning said that pubertal males probably spending a lot of time with sexualized videogame characters like Lara Croft.

“They are seeing these characters during their formative time. They are kind of perfect and ideal – and you don’t have to actually interact with them. Psychologically, it’s truly like a stripped-down, pure erotic stimuli. So it’s much easier to imprint on that, to fetishize that. Part of the fascination is simply being culturally exposed to characters like Lara Croft…[In relation to quicksand fetishes], the notion of being smothered or trapped is universal in the sense that it exists to greater and lesser degrees all over. It’s not just one or two people that have it. It is found in a lot of places. Clearly our normal brain design is not that far removed from [wanting to be] enveloped. It’s probably something to do with our tactile system, our touch system of the brain, that’s quite naturally wired to our sexual arousal system. The tactile system is also interconnected with sensations like being smothered and being interred, being doused with water. Probably, somehow – and I’m speculating here – that’s what got crossed up for whatever reasons. How someone’s brain entangles sexual arousal with the notion of being trapped or smothered might simply be a perturbation of the neural system. A quirk in the brain, essentially. It could be some randomness in the seemingly infinite complexity of your DNA. So, from a perspective rooted in computational neuroscience, niche sexual desires needn’t be wholly, or at all, explained as the result of social construction or evolutionary adaptation. As we’re learning more about the genetics of brain construction, “we’re coming to understand the genetic expression that leads to different neural wiring is highly variable and dependent on so many things [that] could happen in the womb, things that happen in early life, different environmental things. There’s just myriad, myriad factors that can cause unusual neural wiring to arise.”

Dr. Ogas also claimed are fundamental to the human condition and that one in particular (domination/submission) seems to underlie many fetishes:

“The most important, underappreciated sexual interest in our species is an interest in domination and submission. This interest in manifestations of domination and submission applies to people worldwide. To men, women, whether they be gay, lesbian, straight, or anything else. Everybody. Whether your mindset is to be dominant or submissive sexually is fundamental to your sexual identity even though this interest is thought of culturally as an atypical fetish. The concept that one person has power, one person doesn’t, runs through all forms of erotica across the world”.

Based on what I’ve seen and read online, venatophilia appears to exist although it could be argued that videogame fetishes are just sub-classes of other types of fetishes and paraphilias such as vorarephilia, unbirthing, and stuck fetishism.

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.

Gravning, J. (2016). The fetish for video game characters trapped in quicksand. Motherboard, March 19. Located at: http://motherboard.vice.com/read/quicksand

Griffiths, M.D. (1998). Shrink rap: The Croft Report. Arcade, 1 (November), p. 49.

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

Mastrapa, G. (2011). Gamers are fetishists. Joystick Division, March 9. Located at: http://www.joystickdivision.com/2011/09/gamers_are_fetishists.php

McCombs, E. (2008). Toonophilia: Is it porn? Huffington Post, October 1st. Located at: http://www.asylum.com/2008/10/01/toonophilia-is-it-porn/

Monroe, W. (2012). Fetish of the week: Schediaphilia (toonophilia). ZZ Insider, March 12. Located at: http://www.zzinsider.com/blogs/view/fetish_of_the_week_schediaphilia_toonophilia

Tipado, Z. (2015). Exploring the vore fetish of game characters eating each other whole. The Stoned Gamer, October 25. Located at: http://thestonedgamer.com/features/item/351-exploring-the-vore-fetish-of-game-characters-swallowing-each-other-whole

Yenisey, Z. (2016). How the bizarre ‘overwatch’ fetish is getting gamers hot and bothered. Maxim, May 11. Located at: http://www.maxim.com/entertainment/overwatch-pornhub-2016-5

One giant step for man: Another look at macrophilia

Earlier this week, an article by Felicity Monk was published on the Broadly website about macrophilia (individuals derive sexual arousal from a fascination with giants and/or a sexual fantasy involving giants) and also known as giant (or giantess) fetishism. Broadly is an offshoot of Vice.com and is a website is a website “devoted to representing the multiplicity of women’s experiences”. I have been interviewed by both Broadly and Vice over the last few years on a number of topics including gambling, dacryphilia, and Alice in Wonderland Syndrome. I was interviewed for the Broadly article mainly because I’m one of the few academics ever to have written an article on the topic. I was quoted as saying in the Broadly article that “no-one has ever published even so much as an interview with a macrophile in an academic journal”.

In the Broadly article, Monk managed to interview a couple of macrophiles including Katelyn, a bisexual female in her thirties (five foot two inches tall) who has a number of co-occurring fetishes including macrophilia (in which she is sexually aroused by the thought of being a giant). She also has her own giantess website (which can be accessed here, but please be warned that the site features sexually explicit content) which she set up so that macrophiles could come and “worship” her. For Katelin, her macrophilic tendencies started from watching Tom and Jerry cartoons and the disparate size of the characters. As Katelyn said:

“The first time I had a good tingly feeling was when I was watching Tom have so much fun trying to catch Jerry. I always liked how Jerry got away so that the game would continue. I so badly wanted to be that cat. Little did I know it was the start of my sexuality. [By the time I got to high school I] was fantasising about literally crushing [my] high school crushes, swallowing [my] boyfriends and girlfriends alive, and putting [my] entire foot through the school. Most of the time I felt out of place and very alone sexually. [My preferred size of being a giant] changes depending on what mood [I’m] in. Some days I’m in the mood to play with the entire earth/galaxy, and other times I’m in the mood to attack a lone city as a 100ft woman. I rarely go below 100 feet. Most commonly, however, I’m fantasizing about being mega – 3000-plus feet tall”.

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Katelyn has now monetized her fetish by turning her website into a commercial venture. As the article in Broadly notes:

“[On Katelyn’s website you] will find videos for sale – many of which feature miniature, plastic people being swallowed or crushed under huge feet. There are also stories, comics, photographs, collages, a blog, and a link to Katelyn’s Amazon wish list, so her worshippers can purchase her gifts: underwear, Starbucks gift cards, vitamins so she can ‘grow’ bigger, and non-stick saucepans. Visiting the site is free, but each month around 700 of her fans make a purchase”.

My own research into macrophilia suggests that the overwhelming majority of macrophiles appear to be heterosexual males that are sexually attracted to female giantesses. However, I’ve also noted that even non-sexual scenarios involving giants can result in sexual stimulation. Each fantasy situation is different for every macrophile as the behaviour is fantasy-based. Even the preferred heights of the fantasy giants differ between individuals. For instance, some macrophiles have a preference for people only a few feet taller than themselves, whereas others involve giants who are hundreds of feet high.

In the Broadly article, Katelyn admitted she had other sexual fetishes including an “extreme mouth fetish” of similar intensity to her giantess fetish as well as furry and hentai fetishes (anime and manga pornography). This concurs with what I noted in my previous blog on macrophilia where I said that it had also been associated with other sexual paraphilias. I claimed the most noteworthy were:

  • Breast fetishism: This is a sexual fetish in which an individual derives sexual arousal from being pressed against, or placed in between, the breasts of a giant woman.
  • Dominance/submission: This is a sexual fetish in which an individual derives sexual pleasure being at the mercy of a giant, or from being in control of a tiny person.
  • Sadism/masochism: This is a sexual paraphilia in which an individual derives sexual pleasure from being physically harmed or even killed (in this case by a giant).
  • Vorarephilia: This is a sexual paraphilia in which individuals derive sexual arousal from the idea of being eaten, eating another person, or observing this process. Although there are cases of real life vorarephilia (that I wrote about in a previous blog), the behaviour is typically fantasy-based (e.g., fictional stories, fantasy art, fantasy videos, and bespoke video games).
  • Zoophilia: This is a sexual paraphilia in which individuals derive sexual pleasure from sex with animals (in this case, the desire is to have sex with a giant animal that is given human characteristics (i.e., anthropomorphism). This also has some crossover with furries (those individuals who – amongst other behaviours – like to dress as animals when having sex)
  • Crush fetishism: This is a sexual fetish in which an individual derives sexual arousal from being stepped or sat on by a giant person, and is also a variant of sexual masochism.

When Monk interviewed me, one of the most important questions she wanted an answer for was how people develop macrophilic tendencies. I told her that the roots of most fetishes lie in childhood and early adolescence where sexual arousal is, at first, accidentally associated with giants – maybe watching a TV programme where a giantess initiates feelings of sexual arousal. Over time the giant itself is enough to cause sexual arousal through classical conditioning. However, as there are no case studies in the literature, this is complete speculation on my part. However, she also interviewed one of Katelyn’s ‘worshippers’ (‘Mark’) who appeared to confirm my speculative thoughts.

“[I remember] seeing a re-run of Attack of the 50 Foot Woman when [I] was around 13 years old. The [point of view] of Allison Hayes walking across the desert was the first time I can recall being turned on. Seeing her tear the roof off of the building to get at her husband overwhelmed my young brain at the time. Shortly after that, another movie called Village of the Giants did the same thing. I can remember one of the giantesses in the movie said something like ‘Oh, why don’t I just step on him?’ which again turned my underage mind on like nothing prior. I would be uncontrollably drawn to [the giantess’] beauty and power despite the danger such an encounter would bring. As a superior being, she would have little regard for me other than supplying her own needs. Whether it be as food to nourish her superior body, or as a sexual play toy to be used and broken after, I would have no other choice other than submit myself to her. To have my life be hers to do with as she pleased would become the sole purpose for my existence. The exhilaration, danger, fear and sexual excitement would outweigh my very instinct for survival. I only wish it would become real”.

For her article, Monk also interviewed the Australian sex and relationship therapist Pamela Supple. Supple claimed that:

“Power, domination and vulnerability are at the heart of macrophilia. It’s allowing your mind to go wherever it wants to go, whilst engaging in play to gain the maximum sexual arousal. Some want to feel and experience terror – being crushed or controlled. Everyone is different in what they want to experience.”

Both I and Supple agree that macrophilia has enjoyed a massive surge in popularity in the past few years, with both of us citing the crucial role of the internet in helping to both create and facilitate the fetish “and, in some cases, introducing the fetish to those who have been looking for a name for what they feel”. This was confirmed by another one of Katelyn’s worshippers (‘Semeraz’). As he explained:

“[I didn’t know macrophilia’ was a thing” until [I] discovered Katelyn’s website. Before then, remember being in fifth grade and playing a game where the teacher assigned team names of ‘predator’ and ‘prey’ and becoming excited when a girl taunted him saying: ‘We’re going to eat you!’ But I never thought of it as a sexual fetish until running into Katelyn’s site”.

Since writing my article on macrophilia over four years ago, the presence of maxcrophilia online appears to have grown. Katelyn claims that her website was very niche when she set it up a number of years ago:

“It only had a handful of websites and contributors, a lot of lurkers – fetishes were much more taboo a decade ago – the content production was scarce and I was the only girl who had come out of the closet with the giantess fetish. Members thought there was no way a girl could have the giantess fetish. That made me feel alone, because I was the only giantess, and a lot of people doubted my sexuality. Nowadays, there’s so much giantess fetish content that you wouldn’t be able to see everything in a lifetime. There are millions of collages, stories, artists, producers, models, videos, and more.”

I’m not sure there are “millions of collages, stories, artists, producers, models, videos” out there on the internet but macrophilia is probably a lot less rare than I thought a few years ago.

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

Further reading

Biles, J. (2004). I, insect, or Bataille and the crush freaks. Janus Head: Journal of Interdisciplinary Studies in Literature, Continental Philosophy, Phenomenological Psychology and the Arts, 7(1), 115-131.

Bowen, J. (1999). Urge: A giant fetish. Salon, May 22. Located at: http://www.salon.com/1999/05/22/macrophilia/

Gates, K. (2000). Deviant Desires: Incredibly Strange Sex. New York: RE/Search Publications.

Love, B. (1992). Encyclopedia of Unusual Sex Practices. Fort Lee, NJ: Barricade Books.

Monk, F. (2016). The men who want to have sex with actual giants. Broadly, October 26. Located at: https://broadly.vice.com/en_us/article/macrophilia-fetish-the-men-who-want-to-have-sex-with-actual-giants

Pearson, G.A. (1991). Insect fetish objects. Cultural Entomology Digest, 4, (November).

Ramses, S. (undated). Introduction to macrophilia. Located at: http://www.pridesites.com/fetish/mac4black/intro2macro.htm

Slothrop, T. (2012). The Bible and Macrophilia: He Thong’s Goliath Art. Remnant of Giants, February 6. Located at: https://remnantofgiants.wordpress.com/2012/02/06/the-bible-and-macrophilia-he-thongs-goliath-art/

Dying for it: Bizarre autoerotic deaths (Part 2)

In my previous blog I examined some of the most bizarre autoerotic deaths reported in the medical forensic literature. Here are another five.

Case 1: Autoerotic death by aerosol propellant

Source: Medicine, Science and the Law. Personal details:  32-year old white US man. Single. Computer programmer.

  • Bizarre death event: Found dead in bed with cassette recorder next to him. He was wearing headphones which playing “snorting” horse sounds. There was also a can of aerosol propellant. At the end of the bed was a large painting of a male strapped to the hind legs of a horse who was being anally penetrating by the horse. The horse was ridden by a leather-clad woman. He was also wearing some kind if homemade masturbatory device. His death was recorded as cardio-respiratory failure consistent with aerosol propellant abuse (death by misadventure). Self-administration of the chemical agent to modify the sensations of masturbation. He was covered in dry semen stains.

Case 2: Autoerotic death by clothing

Source: Medicine, Science and the Law. Personal details:  25-year old Japanese male. Single.

  • Bizarre death event: Man found dead in his bed one morning. naked except for clothing wrapping his head and underpants which were pulled down. He was covered in dry semen stains. He had put a black skirt on his face and then pulled a second skirt upside down over his head and turned down the bottom of it. He then put a plastic bag over these two garments followed by a pair of tights. The legs of the tights were used to tie a knot around the bottom of the skirts. He then wrapped a third skirt around all of this. Death was due to suffocation.

Case 3: Autoerotic death by hanging (female)

Source: Handbook of Forensic Pathology. Personal details:  19-year old white female. Single. College student.

  • Bizarre death event: Woman was found dead in her bedroom hanging from the hinge of her closet door dressed as an Oriental “harem girl”. A window sash cord was tied around her body in a complicated fashion and she was also wearing a blindfold and mouth gag (made from the belt of her dressing gown). Next to her lay an underground magazine (this was folded out and showed a bizarre dance involving a clock – the minute hand being a nude male who would make love with the other figure on the hour), a paperback Hitchcock book which explained her fantasy. The paperback contained the story about an Oriental harem master. In this story the harem master provides girls to his lord who stored them by hanging them around his walls on hooks

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Case 4: Autoerotic death by vacuum cleaner

Source: American Journal of Forensic Medicine and Pathology. Personal details: 57-year old white US male. Single. History of heart disease and chronic pancreatitis

  • Bizarre death event: Man was found naked slumped over his vacuum cleaner after a neighbour wondered why the vacuum cleaner had been on continuously for a long time. The man was found leaning against the dining table with his testicles, buttocks and thighs tightly bound with women’s tights. Near the table was a jar of urine, jars of lubricant and a wooden table leg covered in fecal excrement. The man was covered in burns from the vacuum cleaner. No defect was found in the vacuum cleaner. The man basically had a heart attack while engaged in autoerotic activity. The wooden table leg had been used in an attempt to stimulate orgasm via anal penetration. His wife had caught him masturbating with the vacuum cleaner before (they hadn’t had sex for five years). The death was classed as natural rather than accidental.

Case 5: Autoerotic death by hydraulic tractor shovel

Source: Journal of Forensic Sciences. Personal details:  62 year-old US white male. Married. Farmer.

  • Bizarre death event: Found dead in a barn lying on his front pinned under the hydraulic shovel of his tractor. His body was covered with semen stains and there was evidence of masochistic sexual bondage. His clothes were folded neatly away nearby. He was found naked except for a pair of women’s red shoes (with 8 inch heels), knee high stockings and tape duct wrapped around his ankles. Ropes led from his feet to the tractor which when raised would lift his inverted body causing complete suspension. It is not known exactly what happened but it is likely that the engine stalled and he was crushed underneath the tractor shovel. He died of positional asphyxiation by chest compression. This was an atypical autoerotic fatality because he did not purposely use asphyxiation but it did cause his death.

Dr. Mark Griffiths, Professor of Behavioural Addiction, 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.

Byard, R. W. (1994). Autoerotic death—characteristic features and diagnostic difficulties. Journal of Clinical Forensic Medicine, 1(2), 71-78

Cordner, S.M. (1983). An unusual case of sudden death associated with masturbation. Medicine, Science and the Law, 23(1), 54-56

Dietz, P. E., & O’Halloran, R.L. (1993). Autoerotic fatalities with power hydraulics. Journal of Forensic Science, 38(2), 359-364.

Ikeda, N., Harada, A., Umetsu, K., & Suzuki, T. (1988). A case of fatal suffocation during an unusual auto-erotic practice. Medicine, Science and the Law, 28(2), 131-134.

Imami, R. H., & Kemal, M. (1988). Vacuum cleaner use in autoerotic death. American Journal of Forensic Medicine and Pathology, 9(3), 246-248.

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

Sauvageau, A., & Racette, S. (2006). Autoerotic deaths in the literature from 1954 to 2004: A review. Journal of Forensic Sciences, 51(1), 140-146.

Dying for it: Bizarre autoerotic deaths (Part 1)

In previous blogs I have examined many different sexual paraphilias that have ended up in death for individuals engaged in such practices. Many of these are from autoerotic asphyxiation but also from other sexual practices such as electrophilia and anaesthesiophilia. Today’s blog takes a brief look at some of the most bizarre autoerotic deaths reported in the medical forensic literature.

Case 1: Autoerotic death by car

Source: Journal of Forensic Sciences. Personal details: 40-year old white US male airline pilot. Married and father of two children.

  • Bizarre death event: A man left his home at 6am in the morning and told his wife that he was going shooting in the country. He was found naked except for a large-link 10-foot chain harness secured around his body. (The harness was tied around the man’s neck in a moderately tight loop and bolted. The chain then went down his chest and was tied into another loop around his waist. This was tied to the bumper of the car) at 7.30am in the morning in a remote area crushed against the left fender of his car (equivalent of a VW beetle). The engine was still running, ignition was on and the driver’s door was still open. The steering wheel was tied so that it would go round in anti-clockwise circles. His clothes were in the boot of the car. Reconstruction of the events leading to his death showed that he was either being dragged round by the car or following the car producing feelings of asphyxia. When he had finished his sexual turn-on he had tried to approach the car door but had forgotten to undo the chain from the bumper. The chain had got tangled up in the car’s axle and the man was found strangled to death by the chain.

Case 2: Autoerotic death by hanging (male)

Source: American Journal of Forensic Medicine and Pathology. Personal details: 57-year old white US male. Single.

  • Bizarre death event: Early one winter’s morning, two joggers found a partially clothed man hanging from a tree five inches from the ground. He was hanging from a rope tied round his neck but also had two other loops of rope harness around his thighs which also encircled his chest. His neatly folded clothes lay two feet away along with lipstick and a jar of Vaseline. He was wearing a woman’s brown wig and a stuffed white bra. He also wore a pair of men’s red underpants, a pair of tights and a pair of high-heeled women’s shoes. He was also found to have a carrot protruding from his anus. Basically his seat harness slipped and he asphyxiated himself on the ropes.

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Case 3: Autoerotic death by blankets

Source: American Journal of Forensic Medicine and Pathology. Personal details: 60-year old white US male. Single. Diagnosed schizophrenic and had various sexual compulsions. Well educated former teacher.

  • Bizarre death event: After being reported missing from work by his employer, a man was found dead rolled up in 14 different blankets which had been sewn together (the two outermost layers were found fixed with adhesive tape in various places which raised the possibility of murder). Inside the blankets he was dressed in two pairs of hotpants, a pair of long johns and a vest. The body was wet and his hands and arms were outstretched above his head. They found a plastic bag over his penis into which he had ejaculated. He was masturbating while inside the blankets but he had become too hypoxic and died. He was immobilized inside the blankets and was unable to free himself. Over the last few years he had bought an astonishing number of blankets by mail order (over 60 found in his apartment most of which seemed to have some ritual or obsessive meaning by the way were laid out. No pornography was found in the place.

Case 4: Autoerotic death by dental anaesthetic

Source: American Journal of Forensic Medicine and Pathology. Personal details: 59-year old white US male. Single. Antiques dealer

  • Bizarre death event: Found dead in his locked apartment. He was seated in front of a dental anaesthetic machine with the anaesthetic face-mask over his face. He was sucking on a rubber teat similar (but much bigger) than a baby’s feeding bottle. There were other anaesthetic machines around the apartment as well as a lot of sexual literature (magazines, photographs, paintings, manuscripts all concerned with his elaborate fetish some of which included photographs of himself in these situations). He was wearing a rubber type apron, three woollen cardigans, a woman’s blouse and two pairs of women’s trousers and a pair of women’s bloomers.

Case 5: Autoerotic death by electrocution

Source: Medicine, Science and the Law. Personal details: 36-year old UK male. Gay (with partner). Unemployed ex-television engineer

  • Bizarre death event: Man found dead with a wire cradle applied to his scrotum with another loop of wire (end folded over) inserted into his Vaseline-lubricated anus. The wires were connected to the two terminals that supplied the loudspeaker within the television. When switched on, these wires carried a current of 0.6 amps at 2.2 volts (a quarter of the current needed to light a small torch). The body had two significant injuries. One on the right side of his face (entrance mark of the current), and the other over the left side of his scrotum (where the loop of the wire had been). Unfortunately, one of the wires had broken off resulting in a cessation of the stimulating activity. The man looked inside the back of the open TV set and his face came into contact with an exposed metal cap which zapped 2500 volts through him. The metal cap was the only live part of the television set and it was this that killed him.

(Part 2 can be found here).

Dr. Mark Griffiths, Professor of Behavioural Addiction, 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.

Eriksson, A., Gezelius, C., & Bring, G. (1987). Rolled up to death: An unusual autoerotic fatality. American Journal of Forensic Medicine and Pathology, 8(3), 263-265.

Hazelwood, R. R., Burgess, A. W., & Groth, A. N. (1981). Death during dangerous autoerotic practice. Social Science & Medicine. Part E: Medical Psychology, 15(2), 129-133.

Hiss, J., Rosenberg, S. B., & Adelson, L. (1985). ” Swinging in the park”: An investigation of an autoerotic death. American Journal of Forensic Medicine and Pathology, 6(3), 250-255.

Klintschar, M., Grabuschnigg, P., & Beham, A. (1998). Death from electrocution during autoerotic practice: case report and review of the literature. American Journal of Forensic Medicine and Pathology, 19(2), 190-193.

Leadbeatter, S. (1988). Dental anesthetic death: An unusual autoerotic episode. American Journal of Forensic Medicine and Pathology, 9(1), 60-63.

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

Minyard, F. (1985). Wrapped to death. Unusual autoerotic death. The American Journal of Forensic Medicine and Pathology, 6(2), 151-152

Rupp, J. C. (1973). The love bug. Journal of Forensic Science, 18(3), 259-262.

Sauvageau, A., & Racette, S. (2006). Autoerotic deaths in the literature from 1954 to 2004: A review. Journal of Forensic Sciences, 51(1), 140-146.

Confession session: The psychology of apology

(Please note: The following blog is an extended version of an article that was first published earlier this year in the Nottingham Post).

Back in March 2016, Nottingham Labour Councillor Alan Rhodes made a public apology after the former social worker Andris Logins was jailed for 20 years for rape and abuse of children at a Nottinghamshire care home. Mr Rhodes said: “It was our role to keep children safe and we clearly didn’t” and that “we failed in our duty of care”. Although most of us apologise for all sorts of things each day, it’s becoming increasingly common for a ‘non-celebrities’ to say sorry in a public way – particularly for historical events that the person giving the apology had no part in.

There are three main ways of saying sorry. The first is the apology with no excuse, when we don’t try to justify what we’ve done. We simply take full responsibility and promise it will never happen again. Secondly, there’s the excuse apology when we say we’re sorry but also add it wasn’t our fault. For instance, we might blame someone else, an accident, human error, or a lapse of judgement. With the third type of apology, we don’t feel we’ve done wrong, but offer some sort of justification. If we’ve wronged someone, we might say they deserved it. We might even feel what we’ve done is so trivial it’s not even worth bothering about. Dr. Aaron Lazare, author of the 2005 book On Apology, says that an apology is one of the most profound interactions that two human beings can have between one another

But why do we apologise? Psychologist Dr. Guy Winch views apologies as linguistic tools that help us acknowledge violations of social expectations and norms. He also says that apologies help us take direct responsibility for the impact of our actions on other individuals and provide a way of asking for forgiveness. Consequently, we are able to repair our relationships with those individuals, restore our own social standing, and help ease guilt and/or shame. Confessing and saying sorry is a simple way to get rid of all those negative feelings. The guilt created by transgressions, such as lying on a CV, or cheating in an exam, can eat away at some people for years.

There also appear to be gender differences. Research studies have tended to find that women appear to say sorry far more than men, because men feel they’re ‘one down’ to someone if they offer an apology. In contrast, women will say sorry for things they haven’t done because they prefer to smooth things over quickly and keep relationships going. However, the differences may be more nuanced. One study found no differences between men and women in the number of the proportion of offenses that prompted apologies but men apologized less frequently than women because they had a higher threshold for what constitutes offensive behaviour. Another study found that men apologized more frequently to women than they did to other men.

We also appear to have developed a ‘confessional culture’ over recent years in which celebrities and politicians are keener than ever to publicly admit to their private indiscretions. It could be that we’re more forgiving of public figures and that because we know more about the pressures of fame, we empathise with them. Another reason might be we no longer care because we don’t think what someone does in the private life affects their job. One thing we do expect from public figures is for their apologies to be sincere.

Arguably one of the most high profile examples was former US president Bill Clinton and his sexual relationship with Monica Lewinsky. Although Clinton continually denied for seven months any such relationship, when he eventually said sorry in August 1998, it was seen as sincere and many people sympathised with him. By apologising sincerely, or appearing to, public figures demonstrate they’re human, with weaknesses just like the rest of us.

bill-clinton-monica-lewinsky

These days, celebrities are quick to admit to what they’ve done. Lots of actors, comedians, singers and sports people have confessed to their addictions to drugs, alcohol and gambling before checking into high profile clinics like The Priory. For some, it’s no doubt a cynical move to help their public image. By apologising promptly, they’re seen as being brave, and any bad publicity will die down more quickly. Those who offer belated, grudging apologies see their image suffer.

Apologies can also help those who receive them. Police forces up and down the country have piloted schemes where criminals are confronted by their victims and offered a chance to apologies (known as ‘restorative justice’). Many victims say the one thing they’d really appreciate is an apology, and they’re often grateful to receive on. As the saying goes, “sorry seems to be the hardest word” but it has the potential to mean so much to so many.

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

Further reading

Bachman, G. F., & Guerrero, L. K. (2006). Forgiveness, apology, and communicative responses to hurtful events. Communication Reports, 19(1), 45-56.

Griffiths, M.D. (2000). Saying sorry can make you feel so much better. The Sunday Post, January 23, p. 30-31.

Griffiths, M.D. (2016). Sorry may be the hardest word but more people than ever are saying it. Nottingham Post, April 11, p.14.

Fehr, R., & Gelfand, M.J. (2010). When apologies work: How matching apology components to victims’ self-construals facilitates forgiveness. Organizational Behavior and Human Decision Processes, 113(1), 37-50.

Frantz, C.M., & Bennigson, C. (2005). Better late than early: The influence of timing on apology effectiveness. Journal of Experimental Social Psychology, 41(2), 201-207.

Lazare, A. (2005). On Apology. Oxford: Oxford University Press.

Scher, S. J., & Darley, J. M. (1997). How effective are the things people say to apologize? Effects of the realization of the apology speech act. Journal of Psycholinguistic Research, 26(1), 127-140.

Struthers, C. W., Eaton, J., Santelli, A. G., Uchiyama, M., & Shirvani, N. (2008). The effects of attributions of intent and apology on forgiveness: When saying sorry may not help the story. Journal of Experimental Social Psychology, 44(4), 983-992.

Takaku, S. (2001). The effects of apology and perspective taking on interpersonal forgiveness: A dissonance-attribution model of interpersonal forgiveness. Journal of Social Psychology, 141(4), 494-508.

Takaku, S., Weiner, B., & Ohbuchi, K.I. (2001). A cross-cultural examination of the effects of apology and perspective taking on forgiveness. Journal of Language and Social Psychology, 20(1-2), 144-166.

Winch, G. (2013). Emotional First Aid: Healing Rejection, Guilt, Failure, and Other Everyday Hurts. London: Penguin.