Stairing at the rude boys: A brief look at climacophilia

In a number of my previous blogs, I have mentioned sexual paraphilias that appear to have been derived from the opposite phobic behaviours. Some examples include defecaloesiophilia (sexual arousal from painful bowel movements), lockiophilia (sexual arousal from childbirth), categelophilia (sexual arousal from being ridiculed), and rupophilia (sexual arousal from dirt). Another one that I could add to this list is climacophilia (sexual arousal from falling down stairs). This particular paraphilia got a lot of media publicity a few years ago when Dr. Jesse Baring was plugging his 2013 book Perv: The Sexual Deviant In All Of Us. (which I will return to below; I ought to confess that I love reading Baring’s populist articles and Professor Paul Bloom [of Yale University] went as far as to describe him as the “Hunter S. Thompson of science writing.”). Climacophilia appears to be the opposite of climacophobia. The Wikipedia entry notes that:

“Climacophobia is the fear of climbing, especially using stairs. It is a type of specific phobia. Climacophobia is distinct from bathmophobia the fear of stairs themselves. Climacophobia is usually traced back to a negative experience, like falling down the stairs or having difficult time to climb stairs. The fear is also triggered by others, like witnessing somebody falling down stairs (either in real visualization or through media) or the other people he/she knows is suffering from climacophobia. Sufferers of climacophobia, if left untreated, end up limiting their activities and avoiding occupations that require the use of stairs or ladders. Sufferers tend to rely on elevators or disability-access ramps rather than stairs…Climacophobes tend to suffer from dizziness resembling vertigo when looking down stairs…Climacophobia can be treated using cognitive behavioural therapy [CBT], either independently or in tandem with other techniques. CBT can help sufferers stop negative thoughts about climbing while changing behaviors. Other treatment options include relaxation techniques, talk therapy, and medication for people who suffer severely from climacophobia”.

In Dr. Anil Aggrawal’s 2009 book Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices, climacophilia makes a seven-word entry between ‘clinical vampirism’ (arousal by drinking human or animal blood) and ‘coitobalnism’ (having sex in the bath), and is simply defined as deriving pleasure from falling down stairs. There was no mention of it all in Dr. Brenda Love’s Encyclopedia of Unusual Sex Practices. Various websites provide definitions including the Pro Boner website (“Climacophilia is an intriguing paraphilia characterised by sexual arousal to falling down the stairs. Climacophiles have their best orgasms when they’re falling down the stairs”) and the Buzz IO website (“Climacophilia is being sexually stimulated by seeing someone fall down a flight of stairs”). When reviewing Baring’s book, the New York Times defined it as “the erotic compulsion to tumble down stairs”. Wikipedia also has a short entry and simply states:

“Climacophilia is a rare sexual paraphilia, or fetish in which the subject experiences erotic gratification when falling down the stairs. There hasn’t been a wide body of research conducted on people affected with this particular sexual preference and/or fetish”.

All of these definitions and snippets imply slightly different things relating to the same alleged behaviour. While all involve some kind of sexual arousal from falling down stairs, the New York Times says the behaviour is an “erotic compulsion” whereas most others describe the behaviour as arousing, stimulating, and pleasurable (without being compulsive). One definition involves ‘orgasm’ being involved while the rest do not. The Wikipedia entry seems to imply that the paraphilia exists (it says “rare” rather than non-existent). The entry also says there “hasn’t been a wide body of research” suggesting there is some (perhaps a narrow body of research) – but that clearly isn’t the case. There’s none.

The journalist David DiSalvo interviewed Dr. Baring for Forbes magazine in relation to his book Perv, which covers 46 different paraphilias (all of which are listed in an article in the Huffington Post) – with paraphilias being defined by Baring as being “primary attraction to a target or activity outside of the statistical norm”. Although I agree that paraphilias tend to be non-normative, I’m not whether I’d ever use the phrase “outside of the statistical norm” as there are some paraphilic behaviours that the majority of sexually active individuals are likely to have engaged in at least peripherally (such as bondage and other milder forms of sadomasochistic behaviour). In relation to the paraphilias outlined in his book, baring told DiSalvo that:

“These included both exceptionally rare paraphilias (such as ‘climacophilia’ in which a person can only get off while tumbling down a flight of stairs) and the more run-of-the-mill ones that are detailed in the DSM-V, such as voyeurism, sadism, and frotteurism (which is gratification by touching people in crowded public places, such as subways). But that’s just a small sampling. The most authoritative list, cobbled together by an Indian psychiatrist named Anil Aggrawal, includes a total of 547 distinct paraphilias”.

If you type in Baring’s name and his book into Google, many articles appear which mention ‘climacophilia’. For instance, in an interview with Vice magazine, the journalist (Nadja Sayej) began her article by saying:

“You may have recently seen the soft-spoken Jesse Baring on Conan recalling the strangest of sexual fetishes. Be it arousal from falling down the stairs (Climacophilia) or feeling steamy from rolling around in stones and gravel (Lithophilia), nothing surprises the Western New York author and psychologist”.

Baring was asked by Sayej what the weirdest fetish he had come across but there was no mention of climacophilia (probably because no-one has ever come across it):

“According to a recent forensic resource by the psychiatrist Anil Aggrawal, there are 547 documented paraphilias. Some of them – actually, most of them – are quite carnival-like. But it’s important to remember that these more exotic manifestations of sexuality might be represented by just one lone figure in the universe: a single, sad, lascivious soul who can only, just to give two random examples, have an orgasm while fondling a mouse (“musophilia”) or while rolling around in ferns (“pteridomania”). It’s virtually impossible for me to pick the weirdest, since so many of them would fit the bill for truly bizarre. I’m reminded of one of my favorite quotes in this literature, from a sex research pioneer named Wilhelm Stekel – who, incidentally, coined the word ‘paraphilia‘ in the 1920s. “Variatio delectat! How innumerable are the variations which Eros creates in order to make the monotonous simplicity of the natural sex organ interesting to the sexologist”.

I have spent hours online trying to track down any evidence that climacophilia exists and I have drawn a complete blank. Yes, there are lots of mentions of it (particularly in the articles on Baring’s book) but no dedicated articles (except a satirical one that I came across on the Dumb Buzz Feed website which you can read here). There are no online forums where like-minded climacophiles congregate and there are no climacophiles that have written so much as a one-sentence confession of being sexually aroused either by falling down stairs or watching others fall down stairs. In an academic review of Baring’s book, in the journal Sexual and Relationship Therapy, Dr. David Ribner made a specific reference about Baring’s inclusion of climacophilia and said it was “incredulous…is there really someone out there who can only achieve orgasm by falling down a flight of stairs?”

Based on my own research I think I can answer that question in two letters. No.

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.

Baring, J. (2013). Perv: The Sexual Deviant In All Of Us. New York: Scientific American/Farrar, Strauss & Giroux.

Bergner, D. (2013). Acquired tastes. ‘Perv’, by Jesse Baring. New York Times, October 4. Located at: http://www.nytimes.com/2013/10/06/books/review/perv-by-jesse-bering.html

DiSalvo, D. (2013). Getting in touch with your inner sexual deviant. Forbes, October 24. Located at: http://www.forbes.com/sites/daviddisalvo/2013/10/24/getting-in-touch-with-your-inner-sexual-deviant/#6f0f5548568e

Dumb Buzz Feed (2015). 7 problems only people with climacophilia will understand. May 3. Located at: https://dumbuzzfeed.wordpress.com/2015/03/05/7-problems-only-people-with-climacophilia-will-understand/

Huffington Post (2013). 46 sexual fetishes you’ve never heard of. October 23. Located at: http://www.huffingtonpost.com/2013/10/23/sexual-fetish_n_4144418.html

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

Ribner, D.S. (2013). A review of ‘Perv: The sexual deviant in all of us’, by Jesse Baring. Sexual and Relationship Therapy, 30, 297-300.

More mass debating: Compulsive sexual behaviour and the internet

The issue of sex addiction as a behavioural addiction has been hotly debated over the last decade. A recent contribution to this debate is a review by Shane Kraus and his colleagues in the latest issue of the journal Addiction that examined the empirical evidence base for classifying compulsive sexual behaviour (CSB) as a behavioural (i.e., non-substance) addiction. The review raised many important issues and highlighted many of the problems in the area including the problems in defining CSB, and the lack of robust data from many different perspectives (epidemiological, longitudinal, neuropsychological, neurobiological, genetic, etc.).

As my regular blog readers will know, I have carried out empirical research into a wide variety of different behavioural addictions (gambling, video gaming, internet use, exercise, sex, work, etc.) and have argued that some types of problematic sexual behaviour can be classed as sex addiction depending upon the definition of addiction used. I was invited by the editors of Addiction to write a commentary on the review and this has just been published in the same issue as the paper by Kraus and colleagues. This blog briefly looks at the issues in that review that I highlighted in my commentary.

For instance, there are a number of areas in Kraus et al.’s paper that were briefly mentioned without any critical evaluation. For instance, in the short section on co-occurring psychopathology and CSB, reference was made to studies claiming that 4%-20% of those with CSB also display disordered gambling behaviour. I pointed out that a very comprehensive review that I published with Dr. Steve Sussman and Nadra Lisha (in the journal Evaluation and the Health Professions) examining 11 different potentially addictive behaviours also highlighted studies claiming that sex addiction could co-occur with exercise addiction (8%-12%), work addiction (28%-34%), and shopping addiction (5%-31%). While it is entirely possible for an individual to be addicted to (say) cocaine and sex concurrently (because both behaviours can be carried out simultaneously), there is little face validity that an individual could have two or more co-occurring behavioural addictions because genuine behavioural addictions consume large amounts of time every single day. My own view is that it is almost impossible for someone to be genuinely addicted to (for example) both work and sex (unless the person’s work was as an actor/actress in the pornographic film industry).

The paper by Kraus et al also made a number of references to “excessive/problematic sexual behavior” and appeared to make the assumption that ‘excessive’ behaviour is bad (i.e., problematic).  While I agree that CSB is typically excessive, excessive sex in itself is not necessarily problematic. Preoccupation with any behaviour in relation to addiction obviously needs to take into account the context of the behaviour, as the context is far more important in defining addictive behaviour than the amount of the activity undertaken. As I have constantly argued, the fundamental difference between a healthy excessive enthusiasms and addictions is that healthy excessive enthusiasms add to life whereas addictions take away from them.

The paper also appeared to have an underlying assumption that empirical research from a neurobiological and genetic perspective should be treated more seriously than that from a psychological perspective. Whether problematic sexual behaviour is described as CSB, sex addiction and/or hypersexual disorder, there are thousands of psychological therapists around the world that treat such disorders. Consequently, clinical evidence from those that help and treat such individuals should be given greater credence by the psychiatric community.

Arguably the most important development in the field of CSB and sex addiction is how the internet is changing and facilitating CSB. This was not even mentioned until the concluding paragraph yet research into online sex addiction (while comprising a small empirical base) has existed since the late 1990s including sample sizes of up to almost 10,000 individuals. In fact, there have been a number of recent reviews of the empirical data concerning online sex addiction including its treatment including ones by myself in journals such as Addiction Research and Theory (in 2012) and Current Addiction Reports (in 2015). My review papers specifically outlined the many specific features of the Internet that may facilitate and stimulate addictive tendencies in relation to sexual behaviour (accessibility, affordability, anonymity, convenience, escape, disinhibition, etc.). The internet may also be facilitating behaviours that an individual would never imagine doing offline such as cybersexual stalking.

Finally, there is also the issue of why Internet Gaming Disorder was included in the DSM-5 (in Section 3 – ‘Emerging measures and models’) but sex addiction/hypersexual disorder was not, even though the empirical base for sex addiction is arguably on a par with IGD. One of the reasons might be that the term ‘sex addiction’ is often used (and arguably misused) by high profile celebrities as an excuse to justify their infidelity (e.g., Tiger Woods, Michael Douglas, David Duchovny, Russell Brand), and is little more than a ‘functional attribution’. For instance, the golfer Tiger Woods claimed an addiction to sex after his wife found out that he had many sexual relationships during their marriage. If his wife had never found out, I doubt whether Woods would have claimed he was addicted to sex. I would argue that many celebrities are in a position where they are bombarded with sexual advances from other individuals and have succumbed. But how many people would not do the same thing if they had the opportunity? Sex only becomes a problem (and is pathologised) when the person is found to have been unfaithful. Such examples arguably give sex addiction a ‘bad name’, and provides a good reason for those not wanting to include such behaviour in diagnostic psychiatry texts.

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

Further reading

Bocij, P., Griffiths, M.D., McFarlane, L. (2002). Cyberstalking: A new challenge for criminal law. Criminal Lawyer, 122, 3-5.

Cooper, A., Delmonico, D.L., & Burg, R. (2000). Cybersex users, abusers, and compulsives: New findings and implications. Sexual Addiction and Compulsivity, 6, 79-104.

Cooper, A., Delmonico, D.L., Griffin-Shelley, E., & Mathy, R.M. (2004). Online sexual activity: An examination of potentially problematic behaviors. Sexual Addiction and Compulsivity, 11, 129-143.

Cooper, A., Galbreath, N., Becker, M.A. (2004). Sex on the Internet: Furthering our understanding of men with online sexual problems. Psychology of Addictive Behaviors, 18, 223-230.

Cooper, A., Griffin-Shelley, E., Delmonico, D.L., Mathy, R.M. (2001). Online sexual problems: Assessment and predictive variables. Sexual Addiction and Compulsivity, 8, 267-285.

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.

Griffiths, M.D. (2000).  Excessive internet use: Implications for sexual behavior. CyberPsychology and Behavior, 3, 537-552.

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

Griffiths, M.D. (2004). Sex addiction on the Internet. Janus Head: Journal of Interdisciplinary Studies in Literature, Continental Philosophy, Phenomenological Psychology and the Arts, 7(2), 188-217.

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

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

Griffiths, M.D. (2016). Compulsive sexual behaviour as a behavioural addiction: The impact of the Internet and other issues. Addiction, 111, 2107-2109.

Griffiths, M.D. & Dhuffar, M. (2014). Treatment of sexual addiction within the British National Health Service. International Journal of Mental Health and Addiction, 12, 561-571.

Kraus, S., Voon, V., & Potenza, M. (2016). Should compulsive sexual behavior be considered an addiction? Addiction 111, 2097-2106.

Orzack M.H., & Ross C.J. (2000). Should virtual sex be treated like other sex addictions? Sexual Addiction and Compulsivity, 7, 113-125.

Sussman, S., Lisha, N. & Griffiths, M.D. (2011). Prevalence of the addictions: A problem of the majority or the minority? Evaluation and the Health Professions, 34, 3-56.

Van Gordon, W., Shonin, E., & Griffiths, M.D. (2016). Meditation Awareness Training for the treatment of sex addiction: A case study. Journal of Behavioral Addictions, 5, 363–372.

 

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).

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.

CWS has been described as an obsessive–addictive 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.

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.

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 Boys’ Brian 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?

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 1^st. 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”.

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

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.