Category Archives: Sex

Come undone: A beginner’s guide to Traumatic Masturbatory Syndrome

I’m not quite sure where I first read about it, but Traumatic Masturbatory Syndrome (TMS) appears to be a controversial phenomenon that is not widely accepted in the medical and sexological communities. According to the Healthy Strokes website:

“[Traumatic Masturbatory Syndrome] is the habit of masturbating in a face-down position against a bed or floor, which puts excessive pressure on the penis, and can interfere with sexual relations. The most common problems TMS sufferers have are inorgasmia – inability to reach orgasm during intercourse – or delayed orgasm. Many TMS sufferers also experience erectile dysfunction”. 

The term ‘Traumatic Masturbatory Syndrome’ originates from a 1998 paper in the Journal of Sex and Marital Therapy by Dr. Lawrence Sank. His paper described what he believed was “a previously unreported pattern of atypical masturbatory behavior, which presents as either an erectile or orgasmic disorder in men”. He outlined four case studies of men who masturbated daily in a prone position over many years. I wrote to Dr. Sank and he kindly sent me his paper. Sank’s paper began by outlining the fact that there are many texts and manuals for women on how to masturbate and how to overcome being non-orgasmic, but little for men. He pointed out that problems in erectile functioning and orgasm among males appears to result, not from their inability to masturbate but from the inability to masturbate correctly (Sank’s emphasis on the word ‘correctly’). The four cases that Sank reported on were all physically healthy and there were no problems urogenitally, neurologically, hormonally or vascularly. Here are brief summaries of the four cases Dr. Sank wrote about:

  • Case 1 [Mr. A]: A 62-year old heterosexual married Black male who was referred for impotence – “He had been married over two years but the couple had not had successful intercourse…He learned at age 8, from his local priest, that any pleasure from touching his penis was the equivalent of ‘re-crucifying Jesus’…The compromise that Mr. A reached was to not use his hand but to rub his penis against his bed clothes and/or pillow without manual guidance. He believed that this would mitigate the seriousness of his sin…This method of sexual expression lasted through several decades of almost daily practice….Mr. A pursued a series of relationships with women…He would rub extremely vigorously against his partner usually to a point where any erection was lost… Mr. A’s masturbatory history is significant for the unique prone position that he engaged in daily over many years”.
  • Case 2 [Mr. B]: A 35-year old gay single Asian male referred for an inability to attain or sustain any erection and an inability to achieve orgasm during intercourse – “Mr. B’s history was significant for the absence of what he called a ‘phallic oriented puberty’…He was not able to achieve orgasm until his early 20s. At that time all masturbation was accomplished by rubbing his penis against his mattress in a prone position while fantasizing about being penetrated by a male. He would do this on a daily basis, always eventuating in orgasm. In his late 20’s he found a male lover with whom he would characteristically engage in mutual, manual masturbation…Any stimulation by his partner eventuated in mutual exhaustion since no effort was sufficient, no matter how prodigious, to trigger Mr. B’s orgasm…Mr. B reported that masturbation, while in a prone position, felt ‘more natural’, was speedier, and required far less effort. Mr. B’s explanation was that he imagined his masturbatory preference to be a logical outgrowth of his shame at not having ‘good, working equipment’…Being face down allowed him to hide his embarrassment”.
  • Case 3 [Mr. C]: A 24-year old gay white male referred for inability to reach orgasm – “When, on rare occasions, Mr. C did achieve orgasm, it was always with a flaccid penis and never accompanied by any pleasurable sensation…Positionally, Mr. C would invariably masturbate while lying on his stomach, his hands made into fists with his penis between his thumbs. He would thrust downward creating intense friction between the lateral portion of his penile shaft and the knuckles of his thumbs. There would be no erection. The frequency of masturbation was 5-7 times per week. Before treatment, when Mr. C tried masturbating in a more typical fashion he was capable of obtaining an erection but never a strong one nor was there any subsequent orgasm”.
  • Case 4 [Mr. D]: A 35-year old heterosexual single white male referred for primary erectile dysfunction – “Mr. D masturbated on a daily basis since adolescence. The quality of the erection during masturbation was reported to be of ‘poor rigidity’…but always eventuated in orgasm. Positionally, Mr. D would be prone, lying on his face and chest, using both hands – one hand grasping his penis, the other hand placed over the first…Only subtle changes in pressure from his hand served to heighten his arousal to the point of obtaining a semi-rigid, non penetrable erection and then orgasm…He has never been able to sustain his erection beyond several seconds of intercourse nor has he achieved orgasm…When asked as to why he masturbated in this statistically unusual manner, Mr. D expressed surprise that it was so unusual and hypothesized that it must have arisen out of being a shameful activity at which he wouldn’t have wanted to be caught. In addition, the tight clutching of his penis during masturbation parallels Mr. C’s traumatizing handling of his penis during masturbation and Mr. A’s vigorous, exhaustive masturbatory rubbing against his bedding or partner”.

Dr. Sank duly acknowledged that the case material presented was anecdotal and he made it clear in his paper that he wasn’t suggesting the “distinguishing variables of position plus frequency or either, alone, are necessary or sufficient for causing the erectile or orgasmic dysfunctions described in these cases”. In the cases of A, C and D:

“The punishing handling of the penis might co-occur with these two variables because a prone position, due to its awkwardness and lack of freedom of motion, would seem to require a great deal of intensity if the subject is to derive the requisite pleasurable sensations associated with masturbatory activity. The daily regimen of masturbation might also have served to raise the threshold of sensation, thus requiring even more intense stimulatory activity to enable orgasm. Unfortunately this heightened intensity would likely raise the threshold for pleasurable sensation even higher…the proverbial vicious circle”

Dr. Sank reported that all his patients were successfully treated and overcame their presenting symptoms. Sank did not describe the treatment in any detail (saying it was beyond the scope of the paper) but involved the “re-sensitizing what the patient treats as a desensitized organ through both individualized behavioral exercises and psychotherapy when appropriate”.

On the basis of his admittedly anecdotal findings, Dr. Sank recommends that pubescent teenagers should be taught proper masturbatory techniques (either by parents, by teachers, and/or by paediatricians). However, as far as I am aware, no other academic or clinical paper has followed up the work of Sank. The Wikipedia entry relating to TMS was removed in 2009 (presumably because of lack of evidence). However, according to an article on masturbation on the Right Diagnosis website, some sources, still continue to give credence to the idea of TMS. The article cites the 1994 book by sex therapist Eva Margolies (Undressing The American Male) who condemned masturbation by rubbing against a pillow or mattress. The same article also quotes the work of and Dr. Josie Lipsith and her colleagues in a 2003 issue of Sexual and Relationship Therapy that suggests masturbation could play a part in male psychogenic sexual dysfunction (although this seems to be little more than citation of Dr. Sank’s original paper).

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

Further reading

Go Ask Alice (2006). Traumatic Masturbatory Syndrome. November 17. Located at:

Healthy Strokes (2013). Facts about prone masturbation. Located at:

Lipsith, J., McCann, D. & Goldmeier, D. (2003). Male Psychogenic Sexual Dysfunction: The Role of Masturbation. Sexual and Relationship Therapy, 18, 448-471.

Margolies, E. (1994). Undressing the American Male: Men with Sexual Problems and What Women Can Do to Help Them. New York: Penguin.

Right Diagnosis (2013). Masturbation. Located at:

Sank, L.I. (1998). Traumatic masturbatory syndrome. Journal of Sex and Marital Therapy, 24, 37-42.

Crossing the see: A brief look at ‘strabismusophilia’

Some time ago I came across a 2012 online article entitled ‘18 Sexual Fetishes That Sound Made Up (But They’re Not)’ on The Date Report website. Of the 18 fetishes listed, I knew about 17 of them (15 of which I have written articles on for this blog including emetophilia [sexual arousal from vomit], dendrophilia [sexual arousal from trees], pyrophilia [sexual arpusal from fire], taphephilia [sexual arousal from being buried alive], and arachnephilia [sexual arousal from spiders]). The one that I had little awareness of was ‘cross-eyed fetishism’ (although I was aware of the sexual paraphilia ‘oculophilia’ in which individuals are sexually aroused by eyes and which I also covered in a previous blog). The article contained only one sentence relating to cross-eyed fetishes which read “Not sure what the scientific name for this fetish is, but this is good news for Dannielynn Birkhead, Anna Nicole Smith’s cross-eyed offspring”. If such a fetish exists, I would name it strabismusophilia (as strabismus is the medical condition of having non-aligned eyes).

Having already written my previous blog on eye fetishes more generally, I would argue that strabismusophilia is a sub-type of oculophilia as the condition manifests itself in a desire for actual physical contact and interaction with the eye (albeit a very particular type of eye). An online article at the Page Pulp website about sexual fetishes of famous authors alleged that F. Scott Fitzgerald had a foot fetish, James Joyce had a fart fetish, Lord Byron was a sex addict, Marquis de Sade had a fetish for “anything and everything”, (the most notable being sadomasochism), and that the philosopher Rene Descartes had a cross-eye fetish.

Descartes’ sexual fetish for cross-eyed women is well documented including the work of psychiatric sexologist Richard von Krafft-Ebing. Descartes himself wrote that:

“As a child I was in love with a girl of my own age, who was slightly cross-eyed. The imprint made on my brain by the wayward eyes became so mingled with whatever else had aroused in me the feeling of love that for years afterwards, when I saw a cross-eyed woman, I was more prone to love her than any other, simply for that flaw…The impression made in my brain when I looked at her wandering eyes was joined so much to that which also occurred when the passion of love moved me, that for a long time afterward, in seeing cross-eyed women, I felt more inclined to love them than others, simply because they had that defect; and I did not know that was the reason.”

Descartes’ passion for cross-eyed women was also discussed in a 2011 paper in the Annals of the New York Academy of Sciences, (by Alex Voorhoeve, Elie During, David Jopling, Timothy Wilson, and Frances Kamm). In one of the passages by Dr. Voorhoeve, he discussed Queen Christina of Sweden asking Descartes what causes us to “love one person rather than another before we know their merit”. According to Voorhoeve:

“Descartes replied that when we experience a strong sensation, this causes the brain to crease like a piece of paper. And when the stimulus stops, the brain uncreases, but it stays ready to be creased again in the same way. And when a similar stimulus is presented, then we get the same response, because the brain is ready to crease again. And what did he mean by all this? Well, he gave an example. He said that all his life he had had a fetish for cross-eyed women. Whenever he came across a cross-eyed woman, desire would enflame him. And he figured out…after introspection, that this was because his brain had been strongly creased by his first childhood love, who was cross-eyed”.

This classical conditioning type explanation was also alluded to in a 2011 article on the Psychology Today website by Dr. Aaron Ben-Zeév that examined ‘Why Did Descartes Love Cross-Eyed Women?’ Dr. Ben-Zeév noted:

“It would appear that when Descartes fell in love with the young girl, he loved her whole Gestalt, which included other characteristics, but her crossed eyes were the most unique. This feature of the girl distinguished her from most other girls. It is as if he subconsciously thought that every woman who shared that distinctive feature would have the other positive characteristics of the girl with whom he had originally fallen in love and would therefore generate the same profound love. This attitude makes him perceive these women as beautiful…However, the fact that the girl he fell in love had the distinctive feature of crossed eyes did not mean that her other characteristics would be shared by other women who have the same feature. In fact, however, this mistaken association set off a feeling of love when he encountered this characteristic in other women…It is a kind of Pavlovian response which makes us more likely to love this person”.

It appears there are modern day adherents to cross-eyed fetishism as I found these extracts in online forums discussing the fetish:

  • Extract 1: “I get insanely turned on when I see a girl crosses her eyes. I go on video and image sites to see girls crossing their eyes. I have requested custom videos of girls crossing their eyes. I am not sure how to break this fetish. It is something that is hard for me to talk about and I recently revealed it to my girlfriend in a text. I have asked her to cross her eyes for me but she cannot do it. In fact my last two girlfriends have not been able to cross their eyes. I feel like if maybe we could play out that fetish in my personal life it would deter me from looking online at stuff. I am not sure what to do”
  • Extract 2: “I am attracted to people that have lazy eyes. The more lazy their eye, the more attractive it is to me.
It’s a huge turn-on, especially eyes that turn outward (e.g., exotropia)”
  • Extract 3: Them cross-eyed girls drive me wild! I’m a lazy eye man myself. I like when one gets a lil’ googly after they’ve had a few drinks”

Although there is no academic research on cross-eye fetishism, I did come across two other types of fetishistic behavior that overlaps with being cross-eyed. The first is in relation to balloon fetishism (i.e., individuals that get sexually aroused from inflating, deflating and/or popping balloons). I came across online sex videos that were tagged ‘cross-eyed balloon inflation’ comprising women blowing up big balloons where they were also cross-eyed (and to which male ‘looners’ found this both erotic and arousing. After watching one of these idiosyncratic videos, one looner commented: “I for one really enjoyed this [cross-eyed woman inflating a balloon] – makes it looks like she’s really concentrated on the inflation, which I like to see. And variety is nice; I, for one, get tired of clips that are too alike”. Perhaps more worryingly is the association of being cross-eyed with sexually sadistic acts of women being strangled on film on hard-core BDSM videos. As the blurb on one sex video available online noted: “There are women that are strangled, and sometimes become cross-eyed. It’s the stupid impression somehow, you will not ever afford to worry about such a thing is the person being strangled. Your beauty is one of [being] cross-eyed”.

I also wonder whether cross-eyed fetishism is a sub-type of teratophilia – typically defined as being sexually aroused by ugly people? According to Dr. Anil Aggrawal’s book Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices, teratophilia is defined as those people who derive sexual pleasure and arousal from “deformed or monstrous people”. The online Urban Dictionary defines it as “the ability to see beauty in the unusual [and] clinically described as a sexual preference for deformed people”. Being cross-eyed could arguably fit these definitions (particularly the one from the Urban Dictionary of seeing beauty in the unusual).

From my own research, I have come to the conclusion that cross-eyed fetishism (that I have termed ‘strabismusophilia’) probably exists but is very rare with an incredibly low prevalence rate among the general population. It may be a sub-type of both oculophilia and teratophilia but further research is needed to confirm such speculations.

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.

Ben-Zeév, A. (2011). Why did Descartes love cross-eyed women? The lure of imperfection, Psychology Today, November 29. Located at:

Descartes, R. (1978). His Moral Philosophy and Psychology (translated by John J. Blom). New York: New York University Press.

Divine Caroline (2012). 18 Sexual Fetishes That Sound Made Up (But They’re Not). The Date Report, September 20. Located at:

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

Love, B. (2005). Cat-fighting, eye-licking, head-sitting and statue-screwing. In R. Kick (Ed.), Everything You Know About Sex is Wrong (pp.122-129). New York: The Disinformation Company.

Page Pulp (2014). Sexual fetishes of famous authors. Located at:

Voorhoeve, A., During, E., Jopling, D., Wilson, T., & Kamm, F. (2011). Who am I? Beyond “I think, therefore I am”. Annals of the New York Academy of Sciences, 1234(1), 134-148.

Wikipedia (2014). Oculophilia. Located at:

The highs of cries: Another look at dacryphilia

In a previous blog I examined the sexual paraphilia dacryphilia. Dr. Anil Aggrawal in his book Forensic and Medico-legal Aspects of Sexual Crimes and Unususal Sexual Practices defines as “arousal from seeing tears in the eyes of a partner”. In my previous article I widened the definition of dacryphilia to include (i) sexual arousal from someone displaying strong emotion and/or (ii) sexual arousal from the emotional release that accompanies crying (i.e., an ‘emotional catharsis’). Dr. Aggrawal’s definition implies that sadism may form an inherent part of dacryphilia and implicitly indicates the potential presence of dacryphilic masochism in the recipient of sadistic dacryphilic activity. My widened definition suggested that dacryphilia could represent an extension of normative human behaviour towards crying (i.e., an extension of the desire to give attention to and comfort a crier).

Based on anecdotal data collected from online dacryphilia forums, my previous blog speculated that two distinct types may exist within the dacryphilic community: those with sadistic dacryphilic interests and those with voyeuristic dacryphilic interests. As such, dacryphilia creates a number of potential dichotomies: (i) sadomasochistic dacryphilic interests versus emotional dacryphilic interests; (ii) sadistic dacryphilic interests versus masochistic dacryphilic interests; and (iii) individuals who actively engage in dacryphilia versus individuals who passively engage in dacryphilia.

The potential contrast between sadomasochistic and emotional dacryphilic interests is of particular interest, as both of these interests occupy differing and almost opposing aspects of human sexual experience. Likewise, the potential existence of sadistic vs. masochistic, and active vs. passive interests within dacryphilia suggest that it is a non-normative sexual interest with enough variety for an interesting dataset and analysis. Furthermore, the possibility that dacryphilia represents an extension of normative human behaviour towards crying and tears raises the question of why some individuals might find sexual arousal in crying and tears. Thus, on the whole, there are a number of prospective research avenues that are implied within the limited literature on dacryphilia, but as I mentioned in my previous article there had been no empirical research into the area.

However, my research colleague Richard Greenhill and I recently published a qualitative paper on dacryphilia in the International Journal of Sexual Health. Our study comprised online interviews with eight dacryphiles (six females and two males; aged 20 to 50 years; five from the US with the others from the UK, Romania, and Belgium) and proposed a new typology of dacryphilia based on the interviews (and as far as we are aware is the first ever published study of the topic). Our participants were recruited via recruitment posts on one specific dacryphilia forum (i.e., CryingLovers), one general fetish forum (i.e., FetLife) and one BDSM forum (i.e., The data were analysed using thematic analysis.

The three main thematic areas of dacryphilia we identified were: (i) compassion; (ii) dominance/submission; and (iii) curled-lips. Half of the participants (n = 4, all female) expressed their dacryphilia primarily through compassion, meaning that they enjoyed or were aroused by the compassion of comforting a crier. Four sub-themes were identified as characteristic of compassionate interests within dacryphilia: (i) dacryphilia as comforting; (ii) negative feelings towards sadomasochistic dacryphilia; (iii) dacryphilia as a natural role and/or duty; and (iv) subversion of societal and/or gender norms. For many of these participants (n = 3), the idea of dacryphilia as a comforting action from themselves to the crier forms an important part of their dacryphilic identity.

Three of the other participants (two submissive females and one dominant male) expressed their dacryphilia primarily through dominance/submission, meaning that they were aroused by either causing tears in a consenting submissive individual or being made to cry by a consenting dominant individual. Although this type of dacryphilia is often characterized as sadomasochistic by those with compassionate interests, dominant/submissive was deemed a more appropriate description, as participants in this group identified more with dominance/submission than sadomasochism. Two sub-themes were identified as characteristic of dominant/submissive interests within dacryphilia: (i) emotional and physical pain; and (ii) tears and crying as a secondary component of dominance/submission. All of those with dominant/submissive interests (n = 3) enjoyed both emotional and physical pain. 

The remaining participant (male) did not express an interest consistent with either compassion or dominance/submission. Instead, he expressed his dacryphilia primarily through an interest in curled-lips, meaning that he was aroused specifically by the curling of the lip during crying. Two sub-themes were identified as characteristic of this individual’s interest in curled-lips: (i) attraction to lips during crying; and (ii) rarity of this dacryphilic interest.

Our study not only suggested three initial areas of interest within dacryphilia, but the data we collected implied that dacryphilia may comprise a continuum of interests that can differ from each other, but which are all connected by an overarching enjoyment or arousal from tears and crying. Our study aimed to discover the different interests within dacryphilia and explore the range of dacryphilic experience. This was successfully achieved through the implementation of a set of online interviews that focussed attention on three initial possible interests within dacryphilia and assisted in reaching a sensitive and predominantly American population. Without the use of online recruitment and data collection, it is unlikely that we would have been able to carry out our study.

However, our sample size was small and may not reflect the experiences of other individuals with dacryphilic preferences and may display gender and cultural bias. A larger sample size may have led to the construction of further interests, as the interests outlined in the present study only relate to the eight participants who were interviewed. However, the fact we identified three different types of dacryphile in a sample of only eight people suggests that there are definite sub-types of dacryphilia. In particular, there appears to be a distinct difference between those who experience sexual arousal from compassionate interests and those who experience sexual arousal from dominant/submissive interests. Based on the sample in the present study, there appears to be a gender bias towards women and a cultural bias towards Americans. However, this may be a result of the limited nature of the small sample size and, as such, any extrapolation should be treated with caution.

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

Additional input: Richard Greenhill

Further reading

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

Greenhill, R. & Griffiths, M.D. (2014). The use of online asynchronous interviews in the study of paraphilias. SAGE Research Methods Cases. Located at:

Greenhill, R. & Griffiths, M.D. (2015). Compassion, dominance/submission, and curled lips: A thematic analysis of dacryphilic experience. International Journal of Sexual Health, in press.

Griffiths, M. D. (2012). The use of online methodologies in studying paraphilias – A review. Journal of Behavioral Addictions, 1, 143-150.

Holmes, S.T. & Holmes, R.M. (2002). Sex Crimes: Patterns and Behavior. Thousand Oaks: Sage.

Milner, J. S. Dopke, C. A. & Crouch, J.L. (2008). Paraphilia not otherwise specified: Psychopathology and Theory. In Laws, D.R. & O’Donohue, W.T. (Eds.), Sexual Deviance: Theory, Assessment and Treatment (pp. 384-418). New York: Guildford Press.

Monroe, W. (2012). Fetish of the week: Dacryphilia. February 23. Located at:

Scorolli, C., Ghirlanda, S., Enquist, M., Zattoni, S. & Jannini, E. A. (2007). Relative prevalence of different fetishes. International Journal of Impotence Research, 19, 432-437.

Wikipedia (2012). Dacryphilia. Located at:

Williams, D. J. (2006). Different (painful!) strokes for different folks: A general overview of sexual sadomasochism (SM) and its diversity. Sexual Addiction and Compulsivity, 13, 333-346.

Naming desire: A personal look at my new job title

Back in 2002, I was incredibly proud when I became one of the youngest full Professors in the UK when I was bestowed the title of Professor of Gambling Studies based on my research contribitions to the gambling studies field. Anyone that has followed my career over the last decade (or this blog over the last four years) will no doubt have realised that my research interests and expertise include a lot more than gambling.

Although I still publish a lot of papers on gambling (12 to 17 papers per calendar year; see Appendix 1 below) I have carried out more and more research into non-gambling addictions and over the last six years (2010-2015) my refereed journal outputs on gambling have only constituted one-third of all my refereed journal outputs (32%) (see Appendix 1 and Figure 1).

Screen Shot 2015-10-31 at 13.15.27

The overwhelming majority of my published refereed papers since January 2010 (n=246; 88%) concern behavioural addictions (i.e., gambling addiction, videogame addiction, internet addiction, work addiction, sex addiction, exercise addiction, shopping addiction, dancing addiction, etc.). If gambling addiction is removed from these papers, this still leaves 56% of all my papers during the 2010-2015 period concerning other behavioural addictions (n=158). The remainder of my refereed journal papers (34 papers; 12%) mainly concern the topic of mindfulness carried out with my colleagues Edo Shonin and William Van Gordon. Even my three books in the 2010-2105 timeframe have been on three totally separate topics (i.e., problem gambling, internet addiction and mindfulness). Of my 71 book chapters in this 2010-2015 period, 22 have been on gambling addiction, 41 have been on other behavioural addictions, and 8 have concerned other topics (see Figure 2). In the ‘Further reading’ section below is some of the papers that I have published this year and even a quick glance will highlight that gambling papers are in the minority.

It is also worth noting that I am one of the most highly cited academics in the UK (soemthig else that I am very proud of) and a quick look at my Google Scholar citations profile (currently over 24,500 citations as of October 31, 2015) that of my top ten most highly cited papers, only one is on gambling adiction and the other nine concern my papers on videogame addiction and internet addiction.

Basically, my job title didn’t reflect what I was actually doing on the research front. And this is the very argument I put to my employer (Nottingham Trent University) a number of weeks ago. As far as I am aware, I am the first professor at NTU to ever ask for my title to be changed but last week I was informed by my line manager that the university was convinced by the case I put forward and from now on I will be Professor of Behavioural Addiction.

This new title change has pleased me greatly and of course subsumes the vast majority of the research that I am doing (including my research into gambling addiction). I don’t think I will ever stop carrying out research in the gambling field but my new job title will stop me feeling guilty about working in non-gambling areas. It may also stop some of few abusive emails I get regarding my blogs (saying in very colourful language that I should stop writing about other behavioural addictions and sexual paraphilias and “write about what I get paid to do”). Firstly, I would point out to these individuals that I don’t get paid to write my personal blog and even if I did, I write all my blogs in my spare time.

If you’ve read this far, then thank you. I promise normal service will be resumed in my next blog when it will be about something other than myself.

Appendix 1: Summary statistics of my refereed journal papers (January 1, 2010 to October 20, 2015)

  • 2010: Gambling papers (n=17); Behavioural addiction papers (n=19); Other papers (n=1)
  • 2011: Gambling papers (n=15); Behavioural addiction papers (n=15); Other papers (n=2)
  • 2012: Gambling papers (n=10); Behavioural addiction papers (n=28); Other papers (n=3)
  • 2013: Gambling papers (n=12); Behavioural addiction papers (n=23); Other papers (n=4)
  • 2014: Gambling papers (n=13); Behavioural addiction papers (n=33); Other papers (n=13)
  • 2015: Gambling papers (n=13); Behavioural addiction papers (n=27); Other papers (n=7)
  • In press: Gambling papers (n=8); Behavioural addiction papers (n=13); Other papers (n=4)


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

Further reading (some recent papers)

Andreassen, C.S., Griffiths, M.D., Pallesen, S., Bilder, R.M., Torsheim, T. Aboujaoude, E.N. (2015). The Bergen Shopping Addiction Scale: Reliability and validity of a brief screening test. Frontiers in Psychology, 6:1374. doi: 10.3389/fpsyg.2015.01374.

Atroszko, P.A., Andreassen, C.S., Griffiths, M.D. & Pallesen, S. (2015). Study addiction – A new area of psychological study: Conceptualization, assessment, and preliminary empirical findings. Journal of Behavioral Addictions, 4, 75–84.

Auer, M. & Griffiths, M.D. (2015). Testing normative and self-appraisal feedback in an online slot-machine pop-up message in a real-world setting. Frontiers in Psychology, 6, 339. doi: 10.3389/fpsyg.2015.00339.

Auer, M. & Griffiths, M.D. (2015). The use of personalized behavioral feedback for problematic online gamblers: An empirical study. Frontiers in Psychology, 6, 1406. doi: 10.3389/fpsyg.2015.01406.

Billieux, J., Maurage, P., Lopez-Fernandez, O., Kuss, D.J. & Griffiths, M.D. (2015). Can disordered mobile phone use be considered a behavioral addiction? An update on current evidence and a comprehensive model for future research. Current Addiction Reports, 2, 154-162.

Canale, N. Santinello, M. & Griffiths, M.D. (2015). Validation of the Reasons for Gambling Questionnaire (RGQ) in a British population survey. Addictive Behaviors, 45, 276-280.

Canale, N., Vieno, A., Griffiths, M.D., Rubaltelli, E., Santinello, M. (2015). Trait urgency and gambling problems in young people: the role of decision-making processes. Addictive Behaviors, 46, 39-44.

Canale, N., Vieno, A., Griffiths, M.D., Rubaltelli, E., Santinello, M. (2015). How do impulsivity traits influence problem gambling through gambling motives? The role of perceived gambling risk/benefits. Psychology of Addictive Behaviors, 29, 813–823.

Cleghorn, J. & Griffiths, M.D. (2015). Why do gamers buy ‘virtual assets’? An insight in to the psychology behind purchase behaviour. Digital Education Review, 27, 98-117.

Dhuffar, M. & Griffiths, M.D. (2015). A systematic review of online sex addiction and clinical treatments using CONSORT evaluation. Current Addiction Reports, 2, 163-174.

Dhuffar, M. & Pontes, H.M. & Griffiths, M.D. (2015). Dysphoric mood states and consequences of sexual behaviours as predictors of hypersexual behaviours in university students: An exploratory study. Journal of Behavioural Addictions, 4, 181–188.

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

Greenhill, R. & Griffiths, M.D. (2015). Compassion, dominance/submission, and curled lips: A thematic analysis of dacryphilic experience. International Journal of Sexual Health, 27, 337-350.

Griffiths, M.D. (2015). Problematic technology use during adolescence: Why don’t teenagers seek treatment? Education and Health, 33, 6-9.

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

Hanss, D., Mentzoni, R.A., Griffiths, M.D., & Pallesen, S. (2015). The impact of gambling advertising: Problem gamblers report stronger impacts on involvement, knowledge, and awareness than recreational gamblers. Psychology of Addictive Behaviors, 29, 483-491.

Hussain, Z., Williams, G. & Griffiths, M.D. (2015). An exploratory study of the association between online gaming addiction and enjoyment motivations for playing massively multiplayer online role-playing games. Computers in Human Behavior, 50, 221–230.

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

Király, O., Griffiths, M.D. & Demetrovics Z. (2015). Internet gaming disorder and the DSM-5: Conceptualization, debates, and controversies, Current Addiction Reports, 2, 254–262.

Király, O., Urbán, R., Griffiths, M.D., Ágoston, C., Nagygyörgy, K., Kökönyei, G. & Demetrovics, Z. (2015). Psychiatric symptoms and problematic online gaming: The mediating effect of gaming motivation. Journal of Medical Internet Research, 17(4) :e88.

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

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

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

Ortiz de Gortari, A.B. & Griffiths, M.D. (2015). Game Transfer Phenomena and its associated factors: An exploratory empirical online survey study. Computers in Human Behavior, 51, 195-202.

Ortiz de Gortari, A.B., Pontes, H.M. & Griffiths, M.D. (2015). The Game Transfer Phenomena Scale: An instrument for investigating the non-volitional effects of video game playing. Cyberpsychology, Behavior and Social Networking, 18, 588-594.

Pontes, H. & Griffiths, M.D. (2015). Measuring DSM-5 Internet Gaming Disorder: Development and validation of a short psychometric scale. Computers in Human Behavior, 45, 137-143.

Pontes, H.M., Kuss, D.J. & Griffiths, M.D. (2015). The clinical psychology of Internet addiction: A review of its conceptualization, prevalence, neuronal processes, and implications for treatment. Neuroscience and Neuroeconomics, 4, 11-23.

Pontes, H.M., Szabo, A. & Griffiths, M.D. (2015). The impact of Internet-based specific activities on the perceptions of Internet Addiction, Quality of Life, and excessive usage: A cross-sectional study. Addictive Behaviors Reports, 1, 19-25.

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

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

Szabo, A., Griffiths, M.D., de La Vega Marcos, R., Mervo, B. & Demetrovics, Z. (2015). Methodological and conceptual limitations in exercise addiction research. Yale Journal of Biology and Medicine, 86, 303-308.

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

Step toe and fun: Another look at trampling fetishism

“I’m a guy and I LOVE being walked on by women wearing high heels. It doesn’t hurt. Is this normal to have women step on my guy parts with high heels?” (Question posted on a Yahoo! website).

In a previous blog I briefly looked at ‘trampling fetishism’. According to a relatively new Wikipedia entry on the behaviour:

“Trampling refers to the sexual activity that involves being trampled underfoot by another person or persons. Trampling is common enough to support a sub-genre of trampling pornography. Because trampling can be used to produce pain, the trampling fetish for some adherents is closely linked to sadomasochistic fetishism. A similar fetish is to imagine themselves as being tiny under another’s feet, or being normal size, but being trampled by a giant person. This is known as ‘giant/giantess fetishism’ or macrophilia. It is not the same as trampling. The most common form of trampling is done by a male or female walking on a male or female submissive and is usually done barefooted, in socks, nylons, or shoes. The trampler will predominantly walk, jump and stomp on the person’s back, chest, stomach, genitalia, face and in some rare instances, the neck”.

If you type ‘trampling fetish’ into Google, lots of YouTube video clips appear instantly. Video clips of trampling have been present on the internet since 1997 courtesy of an number of infamous American tramples such as ‘Daddo’ ‘Kingfish’ and ‘LAF’. If you’re not into the visual side, you can read various forms of trampling fan fiction such as the stories at the Trample and Crushing website.

Since writing my previous blog on this topic, I filmed an interview about a trampling fetishist as part of the television program Forbidden (on which I was the resident psychologist). The television program that I participated in followed the story of a man called Frank O’Brien. Frank recalls his fetish developing during early to mid- adolescence. As a 15-year old teenager, he would trick the girls he knew into stepping on him by inventing games that resulted in him being trampled upon. As the show’s production notes reported:

“[Frank would] invent games to race girls to the door of his cubby house and have them wrestle or sit on him in the process. In the backyard pool he’d encourage them to step on him underwater. Ever since he can remember Frank has wanted to get under a girl’s foot…You could say Frank gets a ‘kick’ out of it. And among friends Frank is known simply as ‘Step on Me.’ For Frank, there’s nothing finer than having a woman walk all over him”.

By his early thirties Frank’s trampling fetish began to take up more and more of his time. In his social life he started attending as many sadomasochistic shows that he could and he longed and desired dominant mistresses that would help cater for his trampling fetish. The back-story I received about Frank noted that:

“The mistresses he saw early in life largely turned Frank away from the idea of trampling. They were more prostitutes than professional mistresses with an idea of what he really wanted. Back in those days there was no training for mistresses in trampling and this really has only taken off in Australia since the early 2000s. Now there are mistresses who train specifically in trampling”.

According to Frank, Melbourne is the centre of Australia’s BDSM culture and he introduced the Forbidden film crew to the niche trampling community that exists there. Frank’s favourite club is ‘Provocation’ that hosts a monthly fetish social event.

“But his idea of getting down on the dance floor is a little different to most. When Frank gets down, he literally gets down. He has a special mat that he lies on to make the experience slightly more bearable but comfort is not exactly what Frank is looking for. He’ll bring with him a platform that he’ll set up beside his mat; written across it are the words ‘step up here – girls only’. And that’s exactly what Frank wants. He’ll lie there for hours in the club, enjoying the feeling of women trampling him. Some wear stilettos, some are in platform shoes and others go barefooted – he doesn’t discriminate about what kind of footwear is permitted, but generally sharper and more pointy shoes offer greater satisfaction for [him]”.

Frank describes himself naturally submissive and he now has weekly trampling sessions with ‘Mistress Spanklet’ who is Frank’s long-term friend and a Dom-sub ‘play partner’. Frank describes these weekly sessions as his “drug fix” and something he “couldn’t live without”. Despite having some of his bowel removed (and it being dangerous for him for someone to trample on his stomach), he cannot stop it. He now tries to avoid ‘tummy trampling’ but notes that:

“Trampling can be on any part of the body, including the more sensitive regions of the face, throat and genitalia. [He] enjoys cock and ball trampling on a weekly basis with Spanklet. His face, arms and legs are also prime trampling ground in private and in public”.

In fact, Frank claims that he was responsible for the first ever penis trampling photograph on the internet. In 1999, Frank claimed he took the full weight of a woman in sharp red stilettos twisting as hard as she could on his penis. Frank claims the photograph (taken by the woman’s sexual partner) kick-started “the worldwide cock trampling trend”.

There appears to be little academic research on the topic but anecdotal evidence suggests there is (unsurprisingly) an overlap between trampling fetishes and foot fetishes (podophilia) – on which there is quote a lot of academic research given it appears to be the most prevalent type of fetishism. Obviously Frank’s case is extreme and is heavily interwoven into his life. While there appear to be addictive elements to his behaviour, I don’t believe that Frank’s trampling fetish is an addiction. Bizarre and extreme – yes. Addictive – no. But I’m happy to be proved wrong.

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

Further reading

Semple, K. (2009). Bartender, make it a stiletto. New York Times, June 10. Located at:

Sexy Tofu (2012). National Fetish Day: Interview with a trampler. January 20. Located at:

Wikipedia (2012). Talk: Crush fetish. Located at:

Wikipedia (2012). Trampling. Located at:

Making an online killing: A brief look at “suicide fetishes” and “addiction” to suicide websites

Back in March 2011, a then 46-year old American ex-nurse William Melchart-Dinkel from Minnesota was convicted of persuading two people he met online to commit suicide. Melchart-Dinkel was accused of having a “suicide fetish” because he got his kicks from frequenting online suicide chat rooms. Posing as a female nurse, he would chat online and feign compassion to depressed individuals and encourage them to commit suicide.

More specifically, a US court found him guilty of aiding the suicides of 18-year old Canadian student Nadia Kajouli (who jumped into a river and drowned), and 32-year old British IT technician Mark Drybrough (who hanged himself). During the trial, Nadia’s mother shared extracts of the online chats that took place between her daughter and Melchart-Dinkel (who was using various aliases including ‘Cami’, ‘Falcon Girl’ and ‘Li Dao’). A Minnesotan Internet crimes task force forensically examined Melchert-Dinkel’s computer and located online chats that he had with the Canadian teenager. The online conversation demonstrated that Melchart-Dinkel had urged Nadia to hang herself (rather than kill herself by drowning) and provided detailed instructions on how to kill themselves:

“If you wanted to do hanging we could have done it together online so it would not have been so scary for you…Most important is the placement of the noose on the neck…knot behind the left ear and rope across the carotid is very important for instant unconsciousness and death…I’m just trying to help you do what is best for you not me”.

Melchart-Dinkel even urged Nadia to kill herself while they were chatting online. A few hours after chatting with Melchart-Dinkel, Nadia emailed her roommate and told her she was going to “brave the weather and go ice skating” (in an effort to make it look like an accident). Nadia jumped into a frozen river (but her body was not found until 11 days after she had jumped in). In Mark’s case, Melchert-Dinkel replied to a question posted online by Mark about how he could hang himself if he didn’t have a high ceiling. Following a long email conversation, Melchert-Dinkel instructed him on what to do and convinced Mark that ‘she’ was suicidal too. Melchert-Dinkel wrote:

“I keep holding on to the hope that things might change. Caught between being suicidal and considering it. Same old story!…I don’t want to waste anyone’s time. If you want someone who’s suicidal, I’m just not there yet…Sorry. I admire your courage. I wish I had it”. 

Mark killed himself a few days later. Mark’s mother Elaine called Melchert-Dinkel her son’s “executioner”. She also told the Daily Mail in the UK:

“Mark had had a nervous breakdown and he was depressed and incredibly susceptible. [Melchert-Dinkel ]was there whispering in his ear every time he logged on. In the last email, [he] claimed to be a nurse, saying he had medical training, and proposed a suicide pact”

With the help of Celia Blay (a youth worker from Wiltshire in the UK), Mark’s mother managed to track Melchert-Dinkel. It was during their own investigation they discovered dozens of people had received similar emails to Mark’s:

“We found out everything about him on Google, including where he lived in Minnesota. He befriended them using a female identity, was very loving and sympathetic, but never suggested an alternative to death, even when they were only teenagers. He’d tell them that he intended to kill himself too, and said they should set up a web camera and he would do the same thing so they could watch each other die over the internet”.

During his testimony, Melchert-Dinkel admitted that he had asked between 15 and 20 people to commit suicide on camera while he watched (although when he was first caught, he said the online chatting must have been his teenage daughters). One report on Melchert-Dinkel’s case noted:

“While he never actually witnessed a suicide, he did believe that at least five of the people he had talked to were successful in taking their own lives. He also entered into around 10 ‘suicide pacts’ where he promised to kill himself simultaneously with the person he had been chatting with…Melchert-Dinkel was admitted to a hospital where he told doctors he had a ‘suicide fetish’ and an addiction to suicide websites”.

Before the trial, the Associated Press had interviewed Professor Jonathan Turley (George Washington University Law School), an expert on doctor-assisted suicide. It was reported that:

“[Professor Turley has] never heard of anyone being prosecuted for encouraging a suicide over the Internet. Typically, people are prosecuted only if they physically help someone end it all – for example, by giving the victim a gun, a noose or drugs. Last month, a Florida man was charged in his wife’s suicide after allegedly tossing several loaded guns onto their bed. Turley said if prosecutors file charges against Melchert-Dinkel, convicting him will be difficult – especially if the defense claims freedom of speech. The law professor said efforts to make it illegal to shout ‘Jump!’ to someone on a bridge have not survived constitutional challenges. ‘What’s the difference between calling for someone to jump off a bridge and e-mailing the same exhortation?’ he said”.

This line of defence was used by Melchert-Dinkel’s legal team. His behaviour was described as “abhorrent” by his own lawyer (Terry Watkins) but argued in court that his client’s actions were protected by the freedom of speech. Watkins said in court that:

“Freedom means you have to allow things to happen that some would find disgusting and completely unacceptable from a community or moral standpoint”.

However, the presiding judge (Thomas Neuville) said that the accused had “imminently incited the victims to commit suicide” and described Melchart-Dinkel’s online written comments as “unprotected speech”. He was sentenced to almost a year in prison (360 days) but was delayed until a ruling from the Supreme Court (SC). Earlier this year, the SC in Minnesota overturned Melchert-Dinkel’s conviction, and ruled that Minnesota’s law prohibiting the “encouraging” of suicide was unconstitutional and (as Professor Turley claimed) violated a person’s freedom of speech. However, the case (as far as I am aware) is still continuing because the original state prosecutors are trying to argue that Melchert-Dinkel “assisted” (rather than “encouraged”) people’s suicides.

My own take on this case is that Melchart-Dinkel committed a criminal act and that his claim to medics that he was addictedto encouraging people to commit suicide was made as a way of absolving responsibility for what he did. There was nothing about his online behaviour to suggest it was in any way addicted (at least not by my own criteria). Also, his own use of the word fetish is inappropriate in this instance. Although he did appear to get some kind of kick from his activity, there was nothing sexual in it. Again, his use of the word ‘fetish’ to describe his behaviour also appears to be another linguistic device to distance himself from taking the blame for his actions.

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

Further reading

Associated Press (2011). Nurse William Melchart-Dinkel had ‘suicide fetish’, went online to provoke two people’s deaths: cops. New York Daily News, October 17. Located at:

Caulfield, P. (2011). ‘Suicide fetish’ nurse found guilty of provoking people he found online to kill themselves. Daily News, March 16. Located at:

Firth, N. (2010). Revealed: The suicide voyeur nurse who ‘encouraged people to kill themselves online’. Daily Mail, March 20. Located at:

Guariglia, M. (2014). William Melchert-Dinkel: 5 Fast facts you need to know. Heavy News, March 19. Located at:

Murray, Rheana. (2008). A search for death: How the internet is used as a suicide cookbook. Chrestomathy, 7, 142-156.

Yount, K. (2014). Minnesota Supreme Court turns its back on mentally ill. (i)Pinion, March 27. Located at:

Hoovers and shakers: Another look at vacuum cleaner sex

In a previous blog I briefly looked at the medical literature relating to penile injuries arising from autoerotic interactions from vacuum cleaners. While researching that blog I also came across other literature that had examined vacuum cleaners being used for sexual purposes that I thought I would make another interesting blog. A number of references in the psychological literature make reference to particular types of people using vacuum cleaners as a source of sexual stimulation for masturbatory purposes. For instance, in a 2005 chapter by Lynne Moxon about sexuality and Asperger Syndrome (i.e., an autism spectrum disorder typically characterized by major difficulties in social interaction and non-verbal communication) noted that among Asperger’s sufferers:

“Lack of awareness of the use of the imagination for sexual fantasy can lead to the use of more physical forms of stimulation, such as the vibration of washing machines or public transport, or the use of vacuum cleaner pipes, holes in chair backs, socks, bottles and more unusual items, such as TV remote controls and golf clubs. Females unaware of the use of sex toys have used deodorant cans, scissors, keys and candles”.

In a 2013 study by Dr. Remigiusz Kijak published in the journal Sexuality and Disability, 133 people (mainly older age teenagers with ages ranging from 17 to 25 years) with mild intellectual disability were surveyed about their sexuality and sexual practices. Dr. Kijak reported that:

“During the studies it has also been determined that 7 % of the studied teenagers stimulate themselves in an untypical manner. The teenagers studied admitted to masturbating with tools, certain objects or to masturbating in a way other than a natural one. The study subjects masturbate using grease, food, furniture and even vacuum cleaners. Such masturbation can be determined as dangerous, mainly due to the fact that it fixes a certain, repeatable chain of strange rituals, often impossible to use in a partner relationship, and may result in a pleasure decrease”. 

As noted in my previous blog on the use of vacuum cleaners as a masturbatory aid, most writings on the topic concern penile injuries that have come to the attention of medics when things go wrong. However, there are a couple of case studies in the forensic literature that have featured vacuum cleaners in autoerotic deaths. In 1988, Dr. R.H. Imami and Dr. M. Kemal published a paper in the American Journal of Forensic Medicine and Pathology about a 57-year old white American male with a history of heart disease and chronic pancreatitis. The 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 faecal excrement. The man was covered in burns from the vacuum cleaner. No defect was found in the vacuum cleaner. The autopsy revealed that the man had a heart attack while engaged in the 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 (and they hadn’t had sex for five years). The death was classes as natural rather than accidental.

In 1994, Dr. Clive Cooke, Dr. Gerard Cadden and Dr. Karin Margolius published a paper concerning four “unusual fatalities where death occurred during autoerotic practice”. Three of the four accidental deaths (electrocution, hanging, and courgette inhalation) involved young to middle-aged men. However, it is the fourth case that is of interest here. This involved an elderly man that (like the previous case) had heart disease. The authors reported that:

“The naked body of this 77[-year] old widower was found in the bathroom of his home…Adjacent to the body, and switched on and working, were a vacuum cleaner and a hair dryer. A pair of men’s underpants was impacted in the hose of the vacuum cleaner. Autopsy examination showed the body of an elderly man of normal build. There was no evident injury; in particular there were no apparent marks of electrical injury. Internal examination showed enlargement of the heart with extensive ischemic fibrous scarring of the thickened left ventricular myocardium. Extensive calcified coronary arteriosclerosis was present, with no thrombosis. There was no significant valvular disease. The lungs were mildly congested and there was benign hypertensive nephrosclerosis. Toxicological analysis was unremarkable. The vacuum cleaner and hair dryer, together with the electric circuitry of the house, were assessed by an electrical inspector and cleared of malfunction. The cause of death was therefore believed to be combined arteriosclerotic and hypertensive heart disease. The scene examination suggested the likelihood that the electrical appliances were being used autoerotically”.

In their discussion of this particular case, Cooke and colleagues noted that sudden autoerotic deaths due to a natural disease process (e.g., heart disease) have seldom been reported in the forensic literature. To their knowledge, only two previous case reports had been published prior to their own study – both males who after autopsy:

“…showed significant arteriosclerotic cardiovascular disease. One was the case of a 61 [-year] old man who died whilst bound with chain restraints; a vibrator was nearby [Hazelwood, Dietz & Burgess, 1981]. The second case was of a 57 [-year] old man whose body was found naked alongside a running vacuum cleaner; the testicles, thighs and buttocks were tightly bound with pantyhose [Imami & Kemal, 1988]. Such deaths are probably less frequent than sudden natural death associated with heterosexual or homosexual activity, particularly if with a novel partner [Malik, 1979]”.

Finally, the only other vacuum cleaner-related autoerotic death I located in the forensic literature was a 2005 case study report by Dr. Andrew Hitchcock and Dr. Roger Start in the Journal of Clinical Forensic Medicine. This was actually a case of hypoxyphilia where the device built to cut off the oxygen supply involved a vacuum cleaner. More specifically, the paper reported:

“A case is reported of a 36-year-old man who died following occlusive entrapment within a device for the purpose of hypoxyphilic gratification. The device was constructed in his own home using instructions found on his home computer down-loaded from the Internet. The device comprised a tough plastic cocoon large enough to accommodate an adult human and incorporating a system of plastic piping connected to a household vacuum cleaner for the evacuation of air within the cocoon. The mechanism of death was thought to be traumatic asphyxia after examination of the deceased and re-construction of the apparatus with the body in situ”.

The prevalence of autoerotic acts involving the use of vacuum cleaners is unknown as only those cases that result in serious genital injury and/or death come to the attention of medics and/or forensic scientists. As noted in my previous blog, the number of cases that are being reported is on the decrease but this may be because the topic is less novel than it used to be and may not be seen by journal editors as worthy of publication.

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

Further reading

Benson, R. (1985). Vacuum cleaner injury to penis: A common urologic problem? Urology, 25(1), 41-44.

Citron, N.D., & Wade, P.J. (1980). Penile injuries from vacuum cleaners. British Medical Journal, 281(6232), 26.

Cooke, C.T., Cadden, G.A., & Margolius, K.A. (1994). Autoerotic deaths: Four cases. Pathology, 26(3), 276-280.

Hazelwood, R.R., Dietz, P. E., & Burgess, A.W. (1981). The investigation of autoerotic fatalities. Journal of Police Science & Administration, 9, 404-411.

Hitchcock, A., & Start, R.D. (2005). Fatal traumatic asphyxia in a middle-aged man in association with entrapment associated hypoxyphilia. Journal of Clinical Forensic Medicine, 12, 320-325.

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

Kijak, R. (2013). The sexuality of adults with intellectual disability in Poland. Sexuality and Disability, 31(2), 109-123.

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, 190-193.

Malik, M. O. (1979). Sudden coronary deaths associated with sexual activity. Journal of Forensic Sciences, 24, 216-220.

Moxon, L. (2005). Diagnosis, disclosure and self-confidence in sexuality and relationships. In D. Murray (Ed.), Coming out Asperger: Diagnosis, Disclosure and Self-Confidence (pp. 214-229). London: Jessica Kingsley Publishers.

Rossi, M., Cascini, F., & Torcigliani, S. (1991). [Penile injuries caused by masturbation with a vacuum cleaner. Description of a case and review of the literature]. Minerva Urologica e Nefrologica, 44(1), 43-45.

Slow pain coming: A brief look at benign masturbatory cephalalgia

In a previous blog, I examined the medical research on individuals that suffer severe headaches as a result of having sex (known in the clinical and medical literature as ‘coital cephalalgia’ and ‘benign coital headache’). In such circumstances, the headache typically occurs at the brink of orgasm. While researching that particular blog, I also came across a number of papers (mainly case studies) that reported that these types of headache could also occur during masturbation (known as ‘benign masturbatory cephalalgia’ (BMC). (Here, the term ‘benign’ defines a primary headache syndrome not caused by any intracranial disorder).

The first paper that I read on BMC was a case account by Dr. Frederick Vincent in a 1982 issue the Archives of Neurology. Although benign orgasmic cephalgia had already been well described in the medical literature (particularly among males), Dr. Vincent reported the case of a 28-year old woman with orgasmic cephalalgia that developed during masturbation. This was reported by Dr. Vincent as the first ever case of BMC. The young woman “suffered a sudden throbbing occipital headache as she became orgasmic by masturbation”. The headache lasted an hour accompanied by mild nausea, but no other neurologic symptoms. As a result of this case, Dr. Vincent argued that the term ‘coital cephalagia’ should be dropped and simply called ‘orgasmic cephalagia’ irrespective of whether the headache was self-induced (i.e., masturbatory) or caused by having sexual intercourse.

Following the publication of Vincent’s case study, Dr. James Lance immediately responded in the same journal saying that he had reported the cases of three of his patients whose headaches were brought on by masturbation. Lance also agreed that the term coital cephalalgia was too restrictive, but then argued that:

“Orgasmic cephalalgia ignores the premonitory headache that may build up as sexual excitement mounts before orgasm. Benign sex headache (using ‘sex’ in the popular sense) is an all-embracing, albeit unpoetic, term and is comparable with benign cough headache. It is worth emphasizing that neither condition is always benign”.

A 2004 case study published by Dr. Marcelo Valenca and colleagues in the journal Headache: The Journal of Head and Face Pain noted that only five cases of patients with thunderclap headache precipitated by sexual activity had been identified in the medical literature. In their paper, they reported the case of a 44-year-old woman that suffered both coital and masturbatory headaches during orgasm. After carrying out a number of medical tests they concluded that the women had experienced cerebral arterial narrowing shortly after her orgasmic headache attacks and that this “supported the hypothesis that segmental vasospasm may exert a role in the pathogenesis of this uncommon type of headache”.

A number of papers on orgasmic cephalagia have been published by Dr. Achim Frese and his colleagues. In a 2004 issue of the journal Neurology, Frese led a study examining the demography, clinical features, and comorbidity of headache associated with sexual activity (HSA) in interviews of 51 participants. They reported that HSA was not dependent on specific sexual habits and most often occurred during sexual activity with the usual partner (94%) and during masturbation (35%).

A 1998 paper by Dr. Daniel Jacome in Headache: The Journal of Head and Face Pain reported something slightly different but related to BMC. More specifically, Dr. Jacome reported the cases of two single men described as having masturbatory-orgasmic extracephalic pain (i.e., an ice-pick like pain that occurred in the neck of one of the men, and in the groin and genitalia of the other). Both men had pre-existing medical conditions (i.e., compressive spondylitic cervical myelopathy in the first case, and a tethered cord and intraspinal lipoma in the second case). These two unusual cases represent examples of extracephalic ice picklike pain triggered by sexual activity, in the absence of orgasmic cephalgia.

A more recent 2012 paper by Dr. Amy Gelfand and Dr. Peter Goadsby in the journal Pediatrics examined primary sexual headaches in two male adolescents. One of the two cases (a 16-year-old boy) developed headaches at the moment of orgasm, building up in intensity over 5 to 10 seconds, and then continuing for between 10 seconds to 2 minutes before stopping. The authors also reported that headaches occurred irrespective of whether orgasm was achieved through intercourse or masturbation. He was not formally treated because after several months, the patient no longer experienced the headaches with orgasm.

Finally, a 2006 paper by Dr. Ambar Chakravarty in the journal Cephalalgia examined data from 24 Indian patients (18 males and 6 females) over a 20-year period (1985–2004) that suffered preorgasmic headaches. Dr. Ambar reported that three of the youngest male patients (aged 19–23 years) had experienced masturbatory headache. One of the female patients (aged 30 years) only experienced orgasmic headache during masturbation (i.e., she never experienced headaches during sexual intercourse).

Summarizing the medical literature on orgasmic cephalagia as a whole (i.e., on coital and masturbatory cephalagia), the 2012 paper by Gelfand and Goadsby concluded that:

“The orgasmic subtype of primary sex headache is more common than the gradual onset pre-orgasm type and has received more attention in the medical literature…In the orgasmic subtype, headache onset is explosive and severe. Orgasms achieved through either sexual intercourse or masturbation can trigger the headache. The headache location is variable, although most often bilateral. The quality is typically pounding or throbbing. Duration of headache ranges from minutes to several hours. Age at onset is classically in the late thirties or early forties, and there is a male predominance. The natural history of the disorder is that after several months it typically remits, although some patients will have a chronic course lasting over a year, and recurrences are possible”.

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

Further reading

Chakravarty, A. (2006). Primary headaches associated with sexual activity—some observations in Indian patients. Cephalalgia, 26(2), 202-207.

Frese, A., Eikermann, A., Frese, K., Schwaag, S., Husstedt, I. W., & Evers, S. (2003). Headache associated with sexual activity: Demography, clinical features, and comorbidity. Neurology, 61(6), 796-800.

Gelfand, A.A., & Goadsby, P.J. (2012). Primary sex headache in adolescents. Pediatrics, 130(2), e439-e441.

Jacome, D.E. (1998). Masturbatory-orgasmic extracephalic pain. Headache: Journal of Head and Face Pain, 38(2), 138-141.

Lance, J. W. (1976). Headaches related to sexual activity. Journal of Neurology, Neurosurgery & Psychiatry, 39(12), 1226-1230.

Lance, J. W. (1983). Benign masturbatory cephalalgia. Archives of Neurology, 40(6), 393.

Østergaard, J. R., & Kraft, M. (1992). Benign coital headache. Cephalalgia, 12(6), 353-355.

Redelman, M. (2010). What if the ‘sexual headache’ is not a joke. British Journal of Medical Practitioners, 3(1), 40-44.

Valenca, M. M., Valenca, L. P., Bordini, C. A., Da Silva, W. F., Leite, J. P., Antunes‐Rodrigues, J., & Speciali, J. G. (2004). Cerebral vasospasm and headache during sexual intercourse and masturbatory orgasms. Headache: The Journal of Head and Face Pain, 44(3), 244-248.

Vincent, F. M. (1982). Benign masturbatory cephalalgia. Archives of Neurology, 39(10), 673.

Getting a leg up: A brief look at pantyhose fetishism

“As far as I can remember I have been easily aroused by women wearing pantyhose. At the age of about 14 or 15 [years] I started wearing pantyhose and masturbating with them. At the time I was ashamed to tell my girlfriend at the time about it. I continued this up until about 19 or 20, when I finally had a girlfriend who I told about my fetish. I thought that by sharing this with my significant other at the time that it would help but it did not. I would just want it more and more. Now I am in a long-term relationship with a woman that I love. I have told her about my fetish and how I masturbate with her pantyhose and she said that she did not have a problem with it. She wears pantyhose for me rather frequently because she knows that I really like them…My obsession has really intensified to the point that I am doing more to achieve a stronger orgasm…I really feel like my fetish is out of control. In general my fetish for pantyhose has lead me to do immoral things that I would not do unless pantyhose are involved” (Letter sent to Dr. Marie Hartwell-Walker)

For the benefit of my non-UK readers, here in the UK, ‘pantyhose fetishism’ is more commonly known as ‘tights fetishism’ (and is very similar to ‘stocking fetishism’, the commonality being the fact they are both clothing items worn on the legs that are often made of nylon and that have a silky veneer). The few online articles concerning pantyhose fetishism make similar claims although empirical evidence for such claims are generally lacking. For instance, the articles claim that pantyhose fetishism is (i) commonplace and (ii) usually first begins in childhood and/or early adolescence (after seeing pantyhose being worn by a significant person in the fetishist’s life such as their mother, sister, aunt, grandmother, family friend, neighbour and/or teacher).

One of the best studies published in a 2007 issue of the International Journal of Impotence Research by Dr G. Scorolli and his colleagues on the relative prevalence of different fetishes using online fetish forum data did not report the specific existence of pantyhose fetishism at all, although around 12% had fetishes concerning something associated with the body such as legs (which could have included pantyhouse). However, if you type ‘pantyhose fetishism’ into Google lots of dedicated pornographic photography and video sites can be found on the first few pages.

According to Wikipedia men may have a preference for pantyhose because unlike stocking, pantyhose has direct contact with female genitalia. An article on the Kinkly website claims individuals with a pantyhose fetish most commonly become sexually aroused by wearing pantyhose, watching other people wear (or undress wearing) pantyhose, or both. The Wikipedia article is a little more detailed and claims that the fetish manifests in one or more of the following ways (and which I have repeated verbatim):

  • “Tearing or cutting holes in pantyhose to modify the garment or gain access to the wearer’s body.
  • Wearing of pantyhose by either or both partners during sexual activity.
  • A male wearing pantyhose alone or in front of others who may praise or humiliate him.
  • Using pantyhose as bondage restraints.
  • Interacting with pantyhose in any other way or form during sexual activity.
  • Simply observing/admiring and experiencing heightened arousal/interest of females or males who are wearing pantyhose.
  • Viewing material from store catalogues to pornography of models and actors wearing pantyhose.
  • A man or woman in pantyhose encasement”.

As far as I am aware, only one paper solely devoted to pantyhose fetishism has ever been published in the psychological literature. This was a 1997 paper written from a psychodynamic perspective by Dr. L.M. Lothstein in the journal Gender and Psychoanalysis. In her paper, Lothstein describes this unique fetish” using clinical vignettes of gender dysphoric men (i.e., transgendered males). The paper claims the pantyhose served a number of different functions (such as the repairing of psychic structure, and an expression and defence against underlying aggression). More specifically, Lothstein refers to pantyhose as a functional ‘magic skin’ or ‘second skin’ in repairing a defective ego and acting as a transitional object to allay annihilation and separation anxiety.

The Wikipedia and Kinkly articles claim that there are many sub-types of pantyhose fetish and that such fetishes often co-occur with other fetishes and sexual paraphilias such as shoe fetishes, transvestism, sadomasochism, and schoolgirl fetishes. For instance, the Wikipedia article notes that pantyhose fetishism can include:

  • A focus on certain areas of the body while wearing pantyhose, [such as] feet, a variation of the very common foot fetishism.
  • Wearing pantyhose with other specific garments, e.g. shoes, boots, or skirts, uniforms that usually include pantyhose (girl at work, secretary, flight stewardess, policewoman, Hooters waitress, girl next door etc.)
  • Certain styles e.g. sheer-to-waist, opaque, patterned or specific deniers, certain brands or shades.
  • Simply admiring women who wear pantyhose (a mild form of voyeurism).
  • Finding the wearing of them to be a primarily sensual comforting experience, rather than sexual.
  • The act of purchasing pantyhose, especially when aided by a female assistant, can also generate a degree of arousal”.

One of the problems with the Wikipedia article as that it is included in the entry on underwear fetishism and the section concerning pantyhose fetishes specifically notes that the section “does not cite any references or sources”. It then goes on to claim:

“The pantyhose covered foot can be extremely arousing to men who often find satisfaction in just looking at or more in that of rubbing, sucking/licking, and massage of the penis with the nylon clad feet. Others find arousal in sniffing the sour and pungent smell of soles made by excessive sweat when in pantyhose. Foot-jobs can be very intense and stimulating and covering a woman in pantyhose in semen is a common fantasy with some men. Pantyhose fetish can also be linked to that of the women dressing as the schoolgirl where stockings, knee high socks and pantyhose can be worn with a short skirt”.

The same article also lists a number of reasons why females wear pantyhose and then claims that these reasons as to why women wear pantyhose provides possible reasons for the allure of pantyhose fetishism:

  • They remove the appearance of blemishes, making the legs ‘perfect’.
  • The reflectiveness of the material, coupled with the way they appear less transparent at the edges, often gives legs more contrast and definition, as though lit by dramatic lighting. This accentuates the curves of the legs, making them less ‘flat’, and can also make legs appear slimmer (with dark pantyhose).
  • They often have a silky texture which is pleasing to both the wearer and her partner.
  • They enhance the pleasure (and anticipation) associated with the removal of a woman’s clothes. Not only serving as an additional item to be removed; they allow the exciting moment of exposure to be drawn out much longer than other clothing items, as the pantyhose are slowly pulled down the legs. In addition to this, they do not actually hide what they cover.
  • The slipperiness and smoothness of sheer pantyhose and stockings also makes women’s low cut court shoes slip off more easily. This vulnerability is often sexually attractive, and can often result in the women engaging in shoe dangling or shoe play which is also appealing to shoe and foot fetishists”.

Although I mentioned above I only knew of one academic paper on pantyhose fetishism, there are a few academic writings that have mentioned it in passing. For instance, in a 1979 issue of the Journal of Applied Behavioral Analysis, Dr. W.L. Marshall reported the treatment of two male paedophiles with satiation therapy, one of who was also a pantyhose fetishist (but no detail was given on this aspect of their sexual behaviour except he was also a shoe fetishist). A paper by Dr. L.F. Lowenstein in a 2002 issue of Sexuality and Disability claimed that pantyhose fetishism was “very common” but the only evidence given for this was a reference to Lothstein’s paper (which contained no information on the prevalence of the fetish). Finally, in a 2008 book chapter on themes of sadomasochism self-expression by Dr. Charles Moser and Dr. Peggy Kleinplatz, they used the example of pantyhose to define and explain what fetishes are:

A fetish is characterized by sexual arousal to an inanimate object…Individuals who enjoy SM accessories often describe their interests as fetishes. They find wearing or touching the preferred articles highly arousing. The articles themselves are rarely arousing, but if they are worn by a partner, it heightens the partner’s attractiveness and heightens the eroticism of the sex. For example, pantyhose can be a fetish object, but brand new pairs, never worn, rarely become a focus of erotic interest. The same pantyhose worn by the participant or a partner can elicit a strong erotic response. Similarly an article of clothing that reminds the person of a partner or a specific erotic interlude can become a fetish object”.

Again, this simply confirms that pantyhose fetishes exist (or theoretically exist) but there is no information on incidence, prevalence, or their psychosocial impact. I did come across one online account written by someone who confesses to being a pantyhose fetishist on the Act Sensuous blog site, and which I found a lot more enlightening that anything academic that I have read on the topic:

I had tried several times before, but during my research to find scientific facts…I wanted to learn where pantyhose rank on a list of the most prevalent fetishes, but I couldn’t find credible material that could be documented.  I did find one thing I expected – that the foot fetish is still No. 1, apparently, the most common.  Suffice it to say that pantyhose are high up there somewhere. And, thankfully, pantyhose and foot fetishes seem to go hand-in-hand, or make that foot-in-hand…Obviously, there’s more to a pantyhose fetish than [what is on Wikipedia]…To me, pantyhose always have been about three things: the way they look, the way they feel to the touch, and the very concept of them in the first place. Maybe it’s just that they are designed to enhance the beauty of everything they cover. To me, there’s a profound dichotomy about pantyhose, which I find very exciting. Pantyhose possess enormous power, yet, by design, they are extremely delicate and feminine, causing an irresistible vulnerability for the wearer. This is never more evident than in the way the nylon fabric moves to the touch on a woman’s legs and feet. It’s almost as if she has a second, delicate, delicious skin. It’s as if the pantyhose are a living, breathing intimate part of the wearer. You can physically manipulate that lifeforce, and you have to be careful not to hurt it. Once on, any item of clothing a person wears, sort of disappears. You stop feeling it on your body. And even though you can touch the pantyhose on yourself, it isn’t the same as feeling them on someone else. Want your lover to feel what you feel when you caress her legs in pantyhose? All it takes is to move that delicate nylon fabric over her skin. The sensation is incredible for both parties”.

Maybe we will never know how common pantyhose fetish is but there appears to be a lot of anecdotal evidence that it exists, is male-dominated, and that there is some crossover with other more (empirically) established fetishes (such as foot fetishes).

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

Further reading

The Act Sensuous Blog (2010). What drives our pantyhose fetish? April 11. Located at:

Kinkly (2015). Pantyhose fetish. Located at:

Lothstein, L.M. (1997). Pantyhose fetishism and self cohesion: A Paraphilic Solution? Gender and Psychoanalysis, 2(1), 103-121.

Lowenstein, L.F. (2002). Fetishes and their associated behaviour. Sexuality and Disability, 20, 135-147.

Moser, C., & Kleinplatz, P.J. (2007). Themes of SM expression. In D. Langbridge, & Meg Barker (Eds.), Safe, sane and consensual: Contemporary perspectives on SM (pp.35-54). Hampshire, UK: MacMillan.

Scorolli, C., Ghirlanda, S., Enquist, M., Zattoni, S. & Jannini, E.A. (2007). Relative prevalence of different fetishes. International Journal of Impotence Research, 19, 432-437.

Wikipedia (2015). Underwear fetishism. Located at:

Write back: A brief look at Oshouji and sexual calligraphy

Anyone that has followed my blogs will know that I have more than a passing interest in Japanese sexual culture. For instance, in previous blogs I have briefly examined various Japanese sexual practices and sex-related topics including Tamakeri (i.e., the masochistic practice of getting sexual pleasure and arousal from being kicked in the testicles), Hentai (i.e., Japanese hardcore Manga cartoon pornography), Shokushu Goukan (i.e., tentacle rape), Nyotaimori (i.e., eating a variety of foods or a whole meal off somebody’s naked body), Omorashi (i.e., deriving sexual pleasure from having a full bladder or a sexual attraction to someone else experiencing the discomfort of a full bladder), and Burusera (i.e., Japanese shops that sell [amongst other things] soiled female undergarments and fetishist school uniforms). There are also some sexually paraphilic behaviours that have their own names within the Japanese sexual culture (such as frotteurism being known as chikan)

While reading an online article on ‘[Ten] sex fetishes you won’t believe exist’ I spotted one on the list that I had not written about before – Oshouji – the other nine being: dendrophilia (sexual arousal from trees), exophilia (sexual attraction for aliens and non-human life forms), objectum sexuality (sexual attraction to inanimate objects), eproctophilia (sexual arousal from flatulence), hybristophilia (sexual arousal from criminals), menophilia (sexual arousal from menstruation), acrotomophilia (sexual arousal from amputees), dacryphilia (sexual arousal from crying), and lactophilia (sexual arousal from breast feeding). In fact, not only had I not written about oshouji in a previous blog but I had never even heard of it before.

Oshouji is a calligraphy fetish (calligraphy being the art of producing decorative handwriting or lettering with a pen or brush). Oshouji specifically involves calligraphy where the decorative writing is done on a person’s (usually naked) body. According to many online websites (that all basically use the same defintion), oshouji is “an ancient tradition and refers to the writing of degrading words in calligraphy on your partner [and is] one of the more artistic fetishes Japan has to offer”. As sex blog writer Coco La More notes: “I am intrigued. Such rich beauty and absolute pleasure. The artistic passion the calligrapher must be feeling. I can just imagine the intense emotion felt by both. I will be adding this one to my list”

According to the Exapamicron website, oshouji dates back to the Edo period of feudal Japan (the Edo period – sometimes referred to as the Tokugawa period – being the period between 1603 and 1868 in the history of Japan). Like other Edo forms of eroticism (such as Shunga, a Japanese term for erotic art) oshouji is considered traditional, rich and decadent. The website also claims that oshouji is “not a fetish in the sense that the painted person becomes aroused by the paint, it’s more about the thrill of degrading someone”.

As far as I am aware there is no academic writing or research on the topic (although there are academics with the surname ‘Oshouji’ which was annoying having to wade through paper after paper to see if there was anything written on the practice). Like me, someone else (Zichao) was researching into this topic and was finding the same things as me online. His research questioned whether the word ‘oshouji’ even existed (although he did admit that the act of sexual calligraphy existed):

“I’m writing a catalogue/book for an exhibition on modern Chinese calligraphy, including references to work by Zhang Qiang…This got me interested in trying to work out the history of writing on girls in Chinese, Japanese [and] Korean culture. On various non-Japanese language sites it’s referred to as ‘oshouji’ and described as something that goes back to Edo times, but these all seem to be cribbing the information from the [Tokyo Damage Report] Hentai Dictionary…Making the idea look even more dubious is the fact that typing おしょうじ, オショウジ or even (last-ditch attempt) お書字 into Japanese Google brings up nothing helpful as far as I can see. This makes me suspect that if there’s a name for the practice it’s something else…Obviously it’s something that people do – not just Zhang Qiang, but also the characters in rape and S&M manga (though in magic marker) and there’s even a film about it [The Pillow Book]. It doesn’t help that I know very little about classical Chinese [and] Japanese porn/erotica. Does the writing-on-girls-fetish have a name and a history, or is it just something that crops up spontaneously now and then?”

Another online Hentai dictionary (the Yuribou Hentai Dictionary) noted that the

“Oshouji ‘calligraphy character’ fetish [is] fairly commonly seen in Domination-submissive play in which the Dominant writes characters on the submissive’s body in order to inflict shame and embarrassment to heighten the submissive role. Commonly seen is the writing of “niku” (“meat”) on the forehead”.

As noted in the extract from Zichao above, the most high profile example of oshouji body calligraphy is the 1996 film The Pillow Book film (directed by Peter Greenaway) in which a Japanese model (Nagiko) “goes in search of pleasure and new cultural experience from various lovers. The film is a rich and artistic melding of dark modern drama with idealised Chinese and Japanese cultural themes and settings, and centres on body painting (Wikipedia entry on The Pillow Book)

Sexual calligraphy has also crept into the world of modern art via the work of Pokras Lampas. Lampras has a background in graffiti and street art. As an online Wide Walls profile piece on him notes:

“Lampas works in various spaces and using different mediums, from canvas and walls to the naked body. To a certain extent, the artist is involved in the art of tattoo, providing council and creating sketches when it comes to calligraphy work. However, the aspect of the artist’s practice which is most interesting, resonates the new possibilities of calligraphy within the world of digital urban art. This notion is part of one of his biggest projects…Recently, the artist became involved in a project called Calligraphy on Girls, which aims to show his calligraphy skills to a wider audience through sessions of body painting and photography. The project is an exploration of the female human form, executed with a particular aesthetics and a unique visual language of the artist”.

Whether Lampas’ work can be called an example of oshouji is debatable because it doesn’t appear to involve the use of degrading words (in fact there are few words at all as far as I can see). Oshouji (if it really exists) appears to be a much less prevalent activity than some of the other Japanese sexual practices I have written about although in the absence of any research papers on most forms of Japanese sexual subculture no-one can be really sure how widespread any of these activities are.

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.

Tokyo Damage Report (2009). Hentai dictionary. February 27. Located at:

Wide Walls (2014). Calligraphy on girls, February 1. Located at:

Wikipedia (2015). Shunga. Located at:

Yuribou Hentai Dictionary (2008). Welcome to the Yuribou Hentai Dictionary! July 11. Located at:


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