Category Archives: Unusual deaths

Trip it up and start again: Dark tourism (revisited)

Last week, there were numerous stories in the British press about plans to display the car that Princess Diana was killed in a US museum. Much of this coverage described the plans as ‘sick’ and ‘distasteful’ but is the latest in a very long line of an example of ‘dark tourism’. In a previous blog I briefly examined ‘disaster tourism’, a form of ‘dark tourism’. Since writing that blog I came across an interesting book chapter by the Slovenian researcher Dr. Lea Kuznik entitled ‘Fifty shades of dark stories’ examining the many motivations for engaging in the seedier side of tourism. Dark tourism is something that I have been guilty of myself. For instance, as a Beatles fanatic, when I first went to New York, I went to the Dakota apartments where John Lennon had been shot by Mark David Chapman. In her chapter, Dr. Kuznik notes that:

“Dark tourism is a special type of tourism, which involves visits to tourist attractions and destinations that are associated with death, suffering, disasters and tragedies venues. Visiting dark tourist destinations in the world is the phenomenon of the twenty-first century, but also has a very long heritage. Number of visitors of war areas, scenes of accidents, tragedies, disasters, places connected with ghosts, paranormal activities, witches and witchhunt trials, cursed places, is rising steeply”.

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As I noted in my previous blog, the motivations for such behaviour is varied. Those working in the print and broadcast media often live by the maxim that ‘if it bleeds, it leads’ (meaning that death and disaster sell). Clearly whenever anything hits the front of newspapers or is the lead story on radio and television, it gains notoriety and infamy. This applies to bad things as well as good things and is one of the reasons why dark tourism has become so popular. Kuznik notes that although dark tourism has a long history, it has only become a topic for academic study since the mid-1990s. Dr. Kuznik observes that:

“The term dark tourism was coined by Foley and Lennon (1996) to describe the attraction of visitors to tourism sites associated with death, disaster, and depravity. Other notable definitions of dark tourism include the act of travel to sites associated with death, suffering and the seemingly macabre (Stone, 2006), and as visitations to places where tragedies or historically noteworthy death has occurred and that continue to impact our lives (Tarlow, 2005). Scholars have further developed and applied alternative terminology in dealing with such travel and visitation, including thanatourism (Seaton, 1996), black spot tourism (Rojek, 1993), atrocity heritage tourism (Tunbridge & Ashworth, 1996), and morbid tourism (Blom, 2000). In a context similar to ‘dark tourism’, terms like ‘macabre tourism’, ‘tourism of mourning’ and ‘dark heritage tourism’ are also in use. Among these terms, dark tourism remains the most widely applied in academic research (Sharpley, 2009)”.

Kuznik also notes that dark tourism has been referred to as “place-specific tourism”. Consequently, some researchers began to classify dark tourism sites based upon their defining characteristics. As Kuznik notes:

“Miles (2002) proposed a darker-lighter tourism paradigm in which there remains a distinction between dark and darker tourism according to the greater or lesser extent of the macabre and the morose. In this way, the sites of the holocaust, for example, can be divided into dark and darker tourism when it comes to their authenticity and scope of interpretation…On the basis of the dark tourism paradigm of Miles (2002), Stone (2006) proposed a spectrum of dark tourism supply which classifies sites according to their perceived features, and from these, the degree or shade of darkness (darkest to lightest) with which they can be characterised. This spectrum has seven types of dark tourism suppliers, ranging from Dark Fun Factories as the lightest, to Dark Camps of Genocide as the darkest. A specific example of the lightest suppliers would be dungeon attractions, such as London Dungeon, or planned ventures such as Dracula Park in Romania. In contrast, examples of the darkest sites include genocide sites in Rwanda, Cambodia, or Kosovo, as well as holocaust sites such as Auschwitz-Birkenau”.

In relation to the reasons for visiting dark tourism sites, Kuznik came up with seven main motivations for why we as humans seek out such experiences (i.e., curiosity, education, survivor guilt, remembrance, nostalgia, empathy, and horror) that are outlined below (please note that the descriptions are edited verbatim from Kuznik’s chapter)

  • Curiosity: “Many tourists are interested in the unusual and the unique, whether this be a natural phenomenon (e.g. Niagara Falls), an artistic or historical structure (e.g. the pyramids in Egypt), or spectacular events (e.g. a royal wedding). Importantly, the reasons why tourists are attracted to dark tourism sites derive, at least in part, from the same curiosity which motivates a visit to Niagara Falls. Visiting dark tourism sites is an out of the ordinary experience, and thus attractive for its uniqueness and as a means of satisfying human curiosity. So the main reason is the experience of the unusual”.
  • Empathy: “One of the reasons for visiting dark tourism sites may be empathy, which is an acceptable way of expressing a fascination with horror…In many respects, the interpretation of dark tourism sites can be difficult and sensitive, given the message of the site as forwarded by exhibition curators can at times conflict with the understandings of visitors”.
  • Horror: Horror is regarded as one of the key reasons for visiting dark tourism sites, and in particular, sites of atrocity…Relating atrocity as heritage at a site is thus as entertaining as any media depiction of a story, and for precisely the same reasons and with the same moral overtones. Such tourism products or examples are: Ghost Walks around sites of execution or murder (Ghost Tour of Prague), Murder Trails found in many cities like Jack the Ripper in London”.
  • Education: “In much tourism literature it has been claimed that one of the main motivations for travel is the gaining of knowledge, and the quest for authentic experiences. One of the core missions of cultural and heritage tourism in particular is to provide educational opportunities to visitors through guided tours and interpretation. Similarly, individual visits to dark tourism sites to gain knowledge, understanding, and educational opportunities, continue to have intrinsic educational value…many dark tourism attractions or sites are considered important destinations for school educational field trips, achieving education through experiential learning”.
  • Nostalgia: “Nostalgia can be broadly described as yearning for the past…or as a wistful mood that an object, a scene, a smell or a strain of music evokes…In this respect Smith (1996) examined war tourism sites and concluded that old soldiers do go back to the battlefields, to revisit and remember the days of their youth”.
  • Remembrance: “Remembrance is a vital human activity connecting us to our past…Remembrance helps people formulate an identity, allowing them to learn from past mistakes, and to go forward with a clear vision of the future. In the context of dark tourism, remembrance and memory are considered key elements in the importance of sites”.
  • Survivor’s guilt: “One of the distinctive characteristics of dark tourism is the type of visitors such sites attract, which include survivors and victim‘s families returning to the scene of death or disaster. These types of visitors are particularly prevalent at sites associated with Second World War and the holocaust. For many survivors returning to the scene of death and atrocity can achieve a therapeutic effect by resolving grief, and can build understanding of how terrible things came to have happened. This can be very emotional experience”.

Dr. Kuznik also developed a new typology of “dark places in nature”. The typology comprised 17 types of dark places and are briefly outlined below.

  • Disaster area tourism: Visiting places of natural disaster after hurricanes, tsunamis, volcanic destructions, etc.
  • Grave tourism: Visiting famous cemeteries, or graves and mausoleums of famous individuals.
  • War or battlefield tourism: Visiting places where wars and battles took place.
  • Holocaust tourism: Visiting Nazi concentration camps, memorial sites, memorial museums, etc.
  • Genocide tourism: Visiting places where genocide took place such as the killing fields in Cambodia.
  • Prison tourism: Visiting former prisons such as Alcatraz.
  • Communism tourism: Visiting places like North Korea.
  • Cold war and iron curtain tourism: Visiting places and remains associated with the cold war such as the Berlin Wall.
  • Nuclear tourism: Visiting sites where nuclear disasters took place (e.g. Chernobyl in the Ukraine) or where nuclear bombs were exploded (e.g., Hiroshima and Nagasaki in Japan).
  • Murderers and murderous places tourism: Visiting sites where killers and serial killers murdered their victims (‘Jack the Ripper’ walks in London, where Lee Harvey Oswald killed J.F. Kennedy in Dallas)
  • Slum tourism: Visiting impoverished and slum areas in countries such as India and Brazil, Kenya.
  • Terrorist tourism: Visiting places such Ground Zero (where the Twin Towers used to be) in New York City
  • Paranormal tourism: Visiting crop circle sites, places where UFO sightings took place, haunted houses (e.g., Amityville), etc.
  • Witched tourism: Visiting towns or cities where witches congregated (e.g., Salem in Massachusetts).
  • Accident tourism: Visiting places where infamous accidents took place (e.g. the Paris tunnel where Princess Diana died in a car accident).
  • Icky medical tourism: Visiting medical museums and body exhibitions.
  • Dark amusement tourism: Visiting themed walks and amusement parks that are based on ghosts and horror figures (e.g., Dracula).

Looking at these different types quickly I reached the conclusion that I would class myself as a ‘dark tourist’ as I have engaged in many of these and no doubt reflects my own interest in the more extreme aspects of the lived human experience.

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

Further reading

Ashworth, G., & Hartmann, R. (2005). Introduction: managing atrocity for tourism. In G. Ashworth & R. Hartmann (Eds.), Horror and human tragedy revisited: the management of sites of atrocities for tourism (pp. 1–14). Sydney: Cognizant Communication Corporation. 

Blom, T. (2000). Morbid tourism – a postmodern market niche with an example from Althorp. Norwegian Journal of Geography, 54(1), 29–36.

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

Foley, M., & Lennon, J. (1996). JFK and dark tourism: A fascination with assassination. International Journal of Heritage Studies, 2(4), 198–211.

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

Kuznik, L. (2018). Fifty shades of dark stories. In Mehdi Khosrow-Pour, D.B.A. (Ed.). Encyclopedia of Information Science and Technology (Fourth Edition). (pp.4077-4087). Pennsylvania: IGI Global.

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

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

Rojek, C. (1993). Ways of escape. Basingstoke, UK: Macmillan.

Seaton, A. V. (1996). From thanatopsis to thanatourism: Guided by the dark. International Journal of Heritage Studies, 2(4), 234–244.

Sharpley, R., & Stone, P. R. (Eds.). (2009). The darker side of travel: the theory and practice of dark tourism. Bristol: Channel View.

Smith, V. L. (1996). War and its tourist attractions. In A. Pizam & Y. Mansfeld (Eds.), Tourism, crime and international security issues (pp. 247–264). New York: John Wiley & Sons.

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

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

Tarlow, P.E. (2005). Dark tourism: the appealing dark side of tourism and more. In M. Novelli (Ed.), Niche tourism – Contemporary issues, trends and cases (pp. 47–58). Oxford, UK: Butterworth-Heinemann.

Tunbridge, J.E., & Ashworth, G. (1996). Dissonant heritage: The management of the past as a resource in conflict. New York: John Wiley & Sons.

Serial delights: Killing as an addiction

A couple of days ago I watched the 2007 US psychological thriller Mr. Brooks. The film is about a celebrated businessman (Mr. Earl Brooks played by Kevin Costner) who also happens to be serial killer (known as the ‘thumbprint killer’). The reason I mention all this is that the explanation given in the film by Earl for the serial killing is that it was an addiction. A number of times in the film he is seem attending Alcoholics Anonymous and quoting from the 12-step recovery program to help him ‘beat his addiction’. With the help of the AA Fellowship, he had managed not to kill anyone for two years but at the start of the film, Earl’s psychological alter-ego (‘Marshall’ played by William Hurt) manages to coerce Earl into killing once again. I won’t spoil the plot for people who have not seen the film but the underlying theme that serial killing is an addiction that Earl is constantly fighting against, is embedded in an implicit narrative that addiction somehow ‘explains’ his behaviour and that he is not really responsible for it. This is not a view I hold myself as all addicts have to take some responsibility for their behaviour.

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The idea of serial killing being conceptualized as an addiction in popular culture is not new. For instance, Brian Masters book about British serial killer Dennis Nilsen (who killed at least 12 young men and was also a necrophile) was entitled Killing for Company: The Story of a Man Addicted to Murder, and Mikaela Sitford’s book about Harold Shipman, the British GP (aka ‘Dr. Death’) who killed over 200 people, was entitled Addicted to Murder: The True Story of Dr. Harold Shipman.

One of the things that I have always argued throughout my career, is that someone cannot become addicted to an activity or a substance unless they are constantly being rewarded (either by continual positive and/or negative reinforcement). Given that serial killing is a discontinuous activity (i.e., it happens relatively infrequently rather than every hour or day) how could killing be an addiction? One answer is that the act of killing is part of the wider behaviour in that the preoccupation with killing can also include the re-enacting of past kills and the keeping of ‘trophies’ from the victims (which I overviewed in a previous blog). As the author of the book Freud, Profiled: Serial Killer noted:

“The serial killer is most often described as a kind of addict. Murder is his addiction, the thrill achieved in murder his ‘kick.’ This addiction requires a maintenance ‘fix.’ At first, the experience is wonderfully exhilarating, later the fix is needed to just feel normal again. It is a hard habit to break, the hungering sensation to consume another life returns. Between murders, they often play back video or sound recordings or look at photos made of their previous murders. This voyeurism provides a surrogate death-meal until their next feeding”.

In Eric Hickey’s 2010 book Serial Murderers and Their Victims, Dr. Hickey makes reference to an unpublished 1990 monograph by Dr. Victor Cline who outlined a four-factor addiction syndrome in relation to sexual serial killers who (so-called ‘lust murderers’ that I also examined in a previous blog). More specifically:

“The offender first experiences ‘addiction’ similar to the physiological/psychological addiction to drugs, which then generates stress in his or her everyday activities. The person then enters a stage of ‘escalation’, in which the appetite for more deviant, bizarre, and explicit sexual material is fostered. Third, the person gradually becomes ‘desensitized’ to that which was once revolting and taboo-breaking. Finally, the person begins to ‘act out’ the things that he or she has seen”.

This four-stage model is arguably applicable to serial killing more generally. It also appears to be backed up by one of the most notorious serial killers, Ted Bundy. In an interview with psychologist Dr. James Dobson (found in Harold Schecter’s 2003 book The Serial Killer Files: The Who, What, Where, How, and Why of the World’s Most Terrifying Murderers), Bundy claimed:

“Once you become addicted to [pornography], and I look at this as a kind of addiction, you look for more potent, more explicit, more graphic kinds of material. Like an addiction, you keep craving something which is harder and gives you a greater sense of excitement, until you reach the point where the pornography only goes so far – that jumping-off point where you begin to think maybe actually doing it will give you that which is just beyond reading about it and looking at it”.

Dr. Hickey claims that such urges to kill are fuelled by fantasies that have become well-developed and killers to vicariously gain control of other individual. He also believes that fantasies for lust killers are far greater than an escape, and becomes the focal point of all behaviour. He concludes by saying that “even though the killer is able to maintain contact with reality, the world of fantasy becomes as addictive as an escape into drugs”. In the book The Serial Killer Files, Harold Schechter notes that:

“For homicidal psychopaths, lust-killing often becomes an addiction. Like heroin users, they not only become dependent on the thrilling sensation – the rush – of torture, rape, and murder; they come to require ever greater and more frequent fixes. After a while, merely stabbing a co-ed to death every few months isn’t enough. They have to kill every few weeks, then every few days. And to achieve the highest pitch of arousal, they have to torture the victim before putting her to death. This kind of escalation can easily lead to the killer’s own destruction. Like a junkie who ODs in his urgent quest to satisfy his cravings, serial killers are often undone by their increasingly unbridled sadism, which drives them to such reckless extremes that they are finally caught. Monsters tend to be sadists, deriving sexual gratification from imposing pain on others. Their secret perversions, at first sporadic, often trap them in a pattern as the intervals between indulgences become briefer: it is a pattern whose repetitions develop into a hysterical crescendo, as if from one outrage to another the monster were seeking as a climax his own annihilation”.

Schecter uses the ‘addiction’ explanation for serial killing throughout his writings even for serial killers from the past including American nurse Jane Toppan (the ‘Angel of Death’) who confessed to 33 murders in 1901 and died in 1938 (“she became addicted to murder”), cannibalistic child serial killers Gilles Garnier (died in 1573) and Peter Stubbe (died 1589) (“both became addicted to murder and cannibalism, both preferred to prey upon children”), and Lydia Sherman (died 1878) who killed 8 children including six of her own (“confirmed predator, addicted to cruelty and death”).

In a recent 2012 paper on mental disorders in serial killers in the Iranian Journal of Medical Law, Dr. N. Mehra and A.S. Pirouz quoted the literary academic Akira Lippit who argued that in films, the “completion of each serial murder lays the foundation for the next act which in turn precipitates future acts, leaving the serial subject always wanting more, always hungry, addicted”. They then go on to conclude that:

“Once a killer has tasted the success of a kill, and is not apprehended, it will ultimately mean he will strike again. He put it simply, that once something good has happened, something that made the killer feel good, and powerful, and then they will not hesitate to try it again. The first attempt may leave them with a feeling of fear but at the same time, it is like an addictive drug. Some killers revisit the crime scene or take trophies, such as jewelry or body parts, or video tape the scenario so as to be able to re-live the actual feeling of power at a later date”.

Although I haven’t done an extensive review of the literature, I do think it’s possible – even on the slimmest of empirical bases presented here – to conceptualize serial killing as a potential behavioural addiction for some individuals. However, it will always depend upon how addiction is defined in the first place.

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.

Brophy, J. (1967). The Meaning of Murder. London: Crowell.

Hickey, E.W. (2010). Serial Murderers and Their Victims (Fifth Edition). Pacific Grove, CA: Brooks/Cole.

Lippit, A.M. (1996). The infinite series: Fathers, cannibals, chemists. Criticism, Summer, 1-18.

Masters, B. (1986). Killing for Company: The Story of a Man Addicted to Murder. New York: Stein and Day.

Mehra, N., & Pirouz, A. S. (2012). A study on mental disorder in serial killers. Iranian Journal of Medical Law, 1(1), 38-51.

Miller, E. (2014). Freud, Profiled: Serial Killer. San Diego: New Directions Publishing.

Schecter, H. (2003). The Serial Killer Files: The Who, What, Where, How, and Why of the World’s Most Terrifying Murderers. New York: Ballantine Books

Sitford, M. (2000). Addicted to Murder: The True Story of Dr. Harold Shipman. London: Virgin Publishing.

Taylor, T. (2014). Is serial killing an addiction? IOL, April 9. Located at: http://www.iol.co.za/news/crime-courts/is-serial-killing-an-addiction-1673542

Art in the right place: Cosey Fanni Tutti’s ‘Art Sex Music’

Five years ago I wrote a blog about one of my favourite bands, Throbbing Gristle (TG; Yorkshire slang for a penile erection). In that article, I noted that TG were arguably one of “the most extreme bands of all time” and “highly confrontational”. They were also the pioneers of ‘industrial music’ and in terms of their ‘songs’, no topic was seen as taboo or off-limits. In short, they explored the dark and obsessive side of the human condition. Their ‘music’ featured highly provocative and disturbing imagery including hard-core pornography, sexual manipulation, school bullying, ultra-violence, sado-masochism, masturbation, ejaculation, castration, cannibalism, Nazism, burns victims, suicide, and serial killers (Myra Hindley and Ian Brady).

I mention all this because I have just spent the last few days reading the autobiography (‘Art Sex Music‘) of Cosey Fanni Tutti (born Christine Newbie), one of the four founding members of TG. It was a fascinating (and in places a harrowing) read. As someone who is a record-collecting completist and having amassed almost everything that TG ever recorded, I found Cosey’s book gripping and read the last 350 pages (out of 500) in a single eight-hour sitting into the small hours of Sunday morning earlier today.

cosey_fanni_tutti_paperback_signed

TG grew out of the ‘performance art’ group COUM Transmissions in the mid-1970s comprising Genesis P-Orridge (‘Gen’, born Neil Megson in 1950) and Cosey. At the time, Cosey and Gen were a ‘couple’ (although after reading Cosey’s book, it was an unconventional relationship to say the least). TG officially formed in 1975 when Chris Carter (born 1953) and Peter ‘Sleazy’ Christopherson (1955-2010). Conservative MP Sir Nicholas Fairburn famously called the group “wreckers of civilisation” (which eventually became the title of their 1999 biography by Simon Ford).

As I noted in my previous article, TG are – psychologically – one of the most interesting groups I have ever come across and Cosey’s book pulled no punches. To some extent, Cosey’s book attempted to put the record straight in response to Simon Ford’s book which was arguably a more Gen-oriented account of TG. Anyone reading Cosey’s book will know within a few pages who she sees as the villain of the TG story. Gen is portrayed as an egomaniacal tyrant who manipulated her. Furthermore, she was psychologically and physically abused by Gen throughout their long relationship in the 1970s. Thankfully, Cosey fell in love with fellow band member Chris Carter and he is still the “heartbeat” of the relationship and to who her book is dedicated.

Like many of my favourite groups (The Beatles, The Smiths, The Velvet Underground, Depeche Mode), TG were (in Gestaltian terms) more than the sum of their parts and all four members were critical in them becoming a cult phenomenon. The story of their break up in the early 1980s and their reformation years later had many parallels with that of the Velvet Underground’s split and reformation – particularly the similarities between Gen and Lou Reed who both believed they were leaders of “their” band and who both walked out during their second incarnations.

Cosey is clearly a woman of many talents and after reading her book I would describe her as an artist (and not just a ‘performance artist’), musician (or maybe ‘anti-musician in the Brian Eno sense of the word), writer, and lecturer, as well as former pornographic actress, model, and stripper. It is perhaps her vivid descriptions of her life in the porn industry and as a stripper that (in addition to her accounts of physical and psychological abuse by Gen) were the most difficult to read. For someone as intelligent as Cosey (after leaving school with few academic qualifications but eventually gaining a first-class degree via the Open University), I wasn’t overly convinced by her arguments that her time working in the porn industry both as a model and actress was little more than an art project that she engaged in on her own terms. But that was Cosey’s justification and I have no right to challenge her on it.

What I found even more interesting was how she little connection between her ‘pornographic’ acting and modelling work and her time as a stripper (the latter she did purely for money and to help make ends meet during the 1980s). Her work as a porn model and actress was covert, private, seemingly enjoyable, and done behind closed doors without knowing who the paying end-users were seeing her naked. Her work as a stripper was overt, public, not so enjoyable, and played out on stage directly in front of those paying to see her naked. Two very different types of work and two very different psychologies (at least in the way that Cosey described it).

Obviously both jobs involved getting naked but for Cosey, that appeared to be the only similarity. She never ever had sex for money with any of the clientele that paid to see her strip yet she willingly made money for sex within the porn industry. For Cosey, there was a moral sexual code that she worked within, and that sex as a stripper was a complete no-no. The relationship with Gen was (as I said above) ‘unconventional’ and Gen often urged her and wanted her to have sex with other men (and although she never mentioned it in her book, I could speculate that Gen had some kind of ‘cuckold fetish’ that I examined in a previous blog as well as some kind of voyeur). There were a number of times in the book when Cosey appeared to see herself as some kind of magnet for unwanted attention (particularly exhibitionists – so-called ‘flashers’ – who would non-consensually expose their genitalia in front of Cosey from a young age through to adulthood). Other parts of the book describe emotionally painful experiences (and not just those caused by Gen) including both her parents disowning her and a heartfelt account of a miscarriage (and the hospital that kept her foetus without her knowledge or consent). There are other sections in the book that some readers may find troubling including her menstruation art projects (something that I perhaps should have mentioned in my blog  on artists who use their bodily fluids for artistic purposes).

Cosey’s book is a real ‘warts and all’ account of her life including her many health problems, many of which surprisingly matched my own (arrhythmic heart condition, herniated spinal discs, repeated breaking of feet across the lifespan). Another unexpected connection was that her son with Chris Carter (Nick) studied (and almost died of peritonitis) as an undergraduate studying at art at Nottingham University or Nottingham Trent University. I say ‘or’ because at one stage in the book it says that Nick studied at Nottingham University and in another extract it says they were proud parents attending his final degree art show at Nottingham Trent University. I hope it was the latter.

Anyone reading the book would be interested in many of the psychological topics that make an appearance in the book including alcoholism, depression, claustrophobia, egomania, and suicide to name just a few. In previous blogs I’ve looked at whether celebrities are more prone to some psychological conditions including addictions and egomania and the book provides some interesting case study evidence. As a psychologist and a TG fan I loved reading the book.

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

Further reading

Cooper, D. (2012). Sypha presents … Music from the Death Factory: A Throbbing Gristle primer. Located at: http://denniscooper-theweaklings.blogspot.co.uk/2012/02/sypha-presents-music-from-death-factory.html?zx=c19a3a826c3170a7

Fanni Tutti, C. (2017). Art Sex Music. Faber & Faber: London.

Ford, S. (1999). Wreckers of Civilization: The Story of Coum Transmissions and Throbbing Gristle. London: Black Dog Publishing.

Kirby, D. (2011). Transgressive representations: Satanic ritual abuse, Thee Temple ov Psychick Youth, and First Transmission. Literature and Aesthetics, 21, 134-149.

Kromhout, M. (2007). ‘The Impossible Real Transpires’ – The Concept of Noise in the Twentieth Century: a Kittlerian Analysis. Located at: http://www.mellekromhout.nl/wp-content/uploads/The-Impossible-Real-Transpires.pdf

Reynolds, S. (2006). Rip It Up and Start Again: Postpunk, 1978–1984. New York: Penguin.

Sarig, R. (1998). The Secret History of Rock: The Most Influential Bands You’ve Never Heard Of. New York: Watson-Guptill Publications.

Walker, J.A. (2009). Cosey Fanni Tutti & Genesis P-Orridge in 1976: Media frenzy, Prostitution-style, Art Design Café, August 10. Located at: http://www.artdesigncafe.com/cosey-fanni-tutti-genesis-p-orridge-1-2009

Wells, S. (2007). A Throbbing Gristle primer. The Guardian, May 27. Located at: http://www.guardian.co.uk/music/musicblog/2007/may/29/athrobbinggristleprimer

Tub zero: A brief look at bath-related illnesses and fatalities

Regular readers of my blog will know that I have an interest in all things bizarre and out of the ordinary. In previous blogs I have examined coital cephalagia (people that get headaches from having sex) and masturbatory cephalagia (people that get headaches from masturbation). It was while researching those articles that I came across a 2005 paper on ‘bath-related headaches’ (BRHs) by Dr. Mak and colleagues in the journal Cephalagia.

BRH is rare headache syndrome. They reported 13 case studies (six from their own case files collected over a seven-year period and seven from other reports in the medical literature). They reported that all the cases involved “Oriental women” aged 32 to 67 years (with an average age of 51 years). The cases were reported in females from Hong Kong (n=6), Taiwan (n=4) and Japan (n=3). All of the women reported severe headaches (lasting from 30 minutes to 30 hours) that were triggered by bathing or other activities involving contact with water. Typically, the onset of the headaches were “hyperacute” and were like ‘thunderclap’ headaches (a severe headache that takes seconds to minutes to reach maximum intensity). The paper reported that no underlying secondary causes were identified and that drug treatment was generally unsatisfactory (although use of the drug Nimodipine was reported to shorten the length of the headache in some cases). Unfortunately, the only way that such headaches could be prevented was to avoid bathing.

After reading this paper I looked for other papers relating to bath-related illnesses. A 2000 paper by Dr. S. Cerovac and Dr. A. Roberts reported on 57 cases of burns sustained by hot bath and shower water (in the journal Burns) over an eight-year period. None of the 57 cases died as a result of the burns. The authors worked at Stoke Mandeville Hospital (in the UK) and they divided the cases into child (below the age of 16 years) and adult groups. Most of the children (n=39) were under the age of three years (83%), with two-fifths having superficial burns (41%). Most of these cases occurred due to what the authors described as “inadequate supervision” by the child’s parents (85%). Among the adult group, 83% of the adults were over 60 years of age with around 65% of them having “some form of psycho-motor disorder that predisposed to an accident which should have been anticipated”. The adult group had more extensive burns which resulted in eight deaths (out of 18 cases; 44%). They reported that the number of cases had been declining over the eight-year period but the study highlighted that fatal incidents could be caused by something as simple as bathing.

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A 1995 study by Dr. J. Lavelle in the Annals of Emergency Medicine evaluated the risk factors associated with bathtub submersion injury and their relationship to child abuse and neglect over a 10-year period (1982-1992). They reported that there had been 21 patients treated for bathtub near-drownings (nine of which had subsequently died). Of these, two-thirds of the children (67%) had “historic and/or physical findings suspicious for abuse or neglect, including incompatible history for the injury, other physical injuries, previous child abuse reports, psychiatric history of the caretaker, and/or psychosocial concerns noted in the chart”. The mortality rate of 42% was significant. However, findings showed that no demographic characteristics identified at-risk children.

Perhaps the most common form of bathtub deaths are infant drownings. A paper by Dr. John Pearn and Dr. James Nixon examined the socio-demographic factors surrounding drowning accidents among children aged 0-15 years in a 1978 issue of Social Science & Medicine. Obviously this paper examined all drownings but did note that those that involved bathtub drownings occur “almost exclusively in lower social class homes” In a follow-up study specifically on bathtub drownings, Dr. Pearn and his colleagues reported the cases of seven bathtub drownings in the journal Pediatrics. All of the seven cases were infants in the US state of Hawaii. As with the previous paper, the authors reported that the families of the infant were typically of lower socioeconomic status but also added that the deaths had occurred when the father “had immediate care of the infant at the time of the accident”. In five of the cases, the drowned infant was being looked after by older sibling.

In 1985, Dr. Lawrence Budnick and Dr. D. Ross published a study on bathtub-related drownings in the USA in the American Journal of Public Health. They analysed information (1979-1981) on such deaths using data from the (i) National Center for Health Statistics and (ii) Consumer Product Safety Commission data. They reported 710 individuals had drowned in the bath during this period with an estimated mortality rate of 1.6 per million individuals per year. They reported an excess of deaths in the spring but this was not statistically significant. However, they did note that individuals “at the extremes of age were at greatest risk of death, with mortality rates of 5-6 per million per year”. Unsurprisingly, there was a frequent history of children below the age of five years being left unattended by parents. Amongst young to middle-aged adults, there was a frequent history of seizures or history of alcohol or drug use. Among more elderly individuals there was frequent evidence of having fallen in the bath.

Similarly, in 2006, Dr. G. Somers and colleagues carried out a 20-year review of bathtub drownings published in the American Journal of Forensic Medicine and Pathology. The authors retrospectively retrospective reviewed US autopsy records over a 20-year period (1984–2003). They identified 18 cases of bathtub drownings (8 boys and 10 girls) aged 6 months to 70 months (average of 17 months) almost three-quarters aged under one year (72%). The factors leading to the death were reported as inadequate adult supervision (89%), cobathing (39%), the use of infant bath seats (17%), and coexistent medical disorders predisposing the child to the drowning episode (17%).

A paper by Dr. R. Rauchschwalbe and colleagues in a 1997 issue of Pediatrics examined the role of bathtub seats and rings as a primary cause of death in US infant drowning deaths (1983-1995). The paper reported 32 deaths by drowning involving bath seats/rings with the victims’ ages at the time of the death ranging from 5 to 15 months (average 8 months old). Nine in ten deaths was due to a “reported lapse in adult supervision”. The authors concluded that infant drownings associated with bath seats/rings are increasing in the US and that very young children “should never be left in the bathtub unsupervised, even for brief moments”.

A more recent 2004 study by Dr. R. Byard and Dr. T. Donald in the Journal of Paediatrics and Child Health examined the possible role of infant bathtub seats in drowning and near-drowning (1998-2003). The authors used files from the Forensic Science Centre and Child Protection Unit, Women’s and Children’s Hospital in Adelaide (Australia). In the six-year period, there were six cases of drowning in children aged under two years. They noted:

“One of these cases, a 7-month-old boy, had been left unattended for some time in an adult bath in a bathtub seat. He was found drowned, having submerged after slipping down and becoming trapped in the seat. Three near-drowning episodes occurred in children under the age of 2 years, including two boys aged 7 and 8 months, both of whom had been left for some time in adult baths in bath seats. Both were successfully resuscitated and treated in hospital…These cases demonstrate the vulnerability of infants to immersion incidents when left unattended in bathtubs”.

In a 1984 paper in the Journal of the American Medical Association, Dr. Lawrence Budnick examined bathtub-related electrocutions in the USA (1979 to 1982). He reported that at least 95 Americans had been electrocuted in the bath and that the use of hair dryers in the bathroom had caused 60% of the deaths. It was also noted that two-thirds of the deaths had occurred during spring and winter, and that those under five years of age had the highest mortality rate.

A 2003 paper by Dr. N. Yoshioka and his colleagues in the journal Legal Medicine examined bathtub deaths in Japan. The authors claimed that approximately 100–120 cases of “sudden death in bathroom” are reported there every year and accounts for around “8–10% of the total number of what is considered unnatural deaths”. Most of the deaths occur in winter and 80% of cases involve the elderly and the authors described the deaths as “baffling” as the autopsies rarely locate the exact cause of death. By testing physiological changes 54 volunteers in both winter and summer, the authors reported that many heart conditions occurred during the winter months in their volunteers (e.g., cardiac arrhythmia including ventricular tachycardia, ventricular extrasystole, supraventricular extrasystole, and bradycardia) and that these conditions might lead to an increased risk for cardiac arrest while bathing.

Another possible reason for bathtub-related drownings is epileptic seizures while bathing. A paper by Dr. C. Ryan and Dr. G. examined drowning deaths among epileptics in a 1993 issue of the Canadian Medical Association Journal. The authors retrospectively reviewed deaths from drowning in Alberta (Canada) from 1981 to 1990. Of these drownings in Alberta (n=482), 5% (n=25) were directly related to epileptic seizures of which 60% (n=15) occurred while the individual was taking an unsupervised bath. The authors advised that all people with epilepsy should take showers (while sitting) instead of baths.

While most of these bath-related health issues and fatalities are rare, they do highlight the issue that accidents can happen anywhere and that in the bath can be a vulnerable location for infants left unattended or those with medical conditions that cause immobility.

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

Further reading

Budnick, L.D. (1984). Bathtub-related electrocutions in the United States, 1979 to 1982. JAMA, 252(7), 918-920.

Budnick, L.D., & Ross, D.A. (1985). Bathtub-related drownings in the United States, 1979-81. American Journal of Public Health, 75(6), 630-633.

Byard, R. W., & Donald, T. (2004). Infant bath seats, drowning and near‐drowning. Journal of Paediatrics and Child Health, 40(5‐6), 305-307.

Cerovac, S., & Roberts, A.H. (2000). Burns sustained by hot bath and shower water. Burns, 26(3), 251-259.

Lavelle, J. M., Shaw, K. N., Seidl, T., & Ludwig, S. (1995). Ten-year review of pediatric bathtub near-drownings: evaluation for child abuse and neglect. Annals of Emergency Medicine, 25(3), 344-348.

Mak, W., Tsang, K.L., Tsoi, T.H., Au Yeung, K.M., Chan, K.H., Cheng, T. S., … & Ho, S.L. (2005). Bath‐related headache. Cephalalgia, 25(3), 191-198.

Pearn, J. H., Brown, J., Wong, R., & Bart, R. (1979). Bathtub drownings: Report of seven cases. Pediatrics, 64(1), 68-70.

Nixon, J., & Pearn, J. (1978). An investigation of socio-demographic factors surrounding childhood drowning accidents. Social Science & Medicine. Part A: Medical Psychology & Medical Sociology, 12, 387-390.

Rauchschwalbe, R., Brenner, R.A., & Smith, G.S. (1997). The role of bathtub seats and rings in infant drowning deaths. Pediatrics, 100(4), e1.

Ryan, C. A., & Dowling, G. (1993). Drowning deaths in people with epilepsy. CMAJ: Canadian Medical Association Journal, 148(5), 781-784.

Somers, G. R., Chiasson, D. A., & Smith, C. R. (2006). Pediatric drowning: A 20-year review of autopsied cases: III. Bathtub drownings. American Journal of Forensic Medicine and Pathology, 27(2), 113-116.

Yoshioka, N., Chiba, T., Yamauchi, M., Monma, T., & Yoshizaki, K. (2003). Forensic consideration of death in the bathtub. Legal Medicine, 5, S375-S381.

To pee or not to pee? Another look at paraphilic behaviours

Strange, bizarre and unusual human sexual behaviour is a topic that fascinates many people (including myself of course). Last week I got a fair bit of international media coverage being interviewed about the allegations that Donald Trump hired women to perform ‘golden showers’ in front of him (i.e., watching someone urinate for sexual pleasure, typically referred to as urophilia). I was interviewed by the Daily Mirror (and many stories used my quotes in this particular story for other stories elsewhere). I was also commissioned to write an article on the topic for the International Business Times (and on which this blog is primarily based). The IBT wanted me to write an article on whether having a liking for strange and/or bizarre sexual preferences makes that individual more generally deviant.

it-makes-perfect-sense-that-a-politican-like-donald-trump-would-be-into-pee-golden-showers-pee-gate-fetish-kink-urolagnia-urophilia

Although the general public may view many of these behaviours as sexual perversions, those of us that study these behaviours prefer to call them paraphilias (from the Greek “beyond usual or typical love”). Regular readers of my blog will know I’ve written hundreds of articles on this topic. For those of you who have no idea what parahilias really are, they are uncommon types of sexual expression that may appear bizarre and/or socially unacceptable, and represent the extreme end of the sexual continuum. They are typically accompanied by intense sexual arousal to unconventional or non-sexual stimuli. Most adults are aware of paraphilic behaviour where individuals derive sexual pleasure and arousal from sex with children (paedophilia), the giving and/or receiving of pain (sadomasochism), dressing in the clothes of the opposite sex (transvestism), sex with animals (zoophilia), and sex with dead people (necrophilia).

However, there are literally hundreds of paraphilias that are not so well known or researched including sexual arousal from amputees (acrotomophilia), the desire to be an amputee (apotemnophilia), flatulence (eproctophilia), rubbing one’s genitals against another person without their consent (frotteurism), urine (urophilia), faeces (coprophilia), pretending to be a baby (infantilism), tight spaces (claustrophilia), restricted oxygen supply (hypoxyphilia), trees (dendrophilia), vomit (emetophilia), enemas (klismaphilia), sleep (somnophilia), statues (agalmatophilia), and food (sitophilia). [I’ve covered all of these (and more) in my blog so just click on the hyperlinks of you want to know more about the ones I’ve mentioned in this paragraph].

It is thought that paraphilias are rare and affect only a very small percentage of adults. It has been difficult for researchers to estimate the proportion of the population that experience unusual sexual behaviours because much of the scientific literature is based on case studies. However, there is general agreement among the psychiatric community that almost all paraphilias are male dominated (with at least 90% of all those affected being men).

One of the most asked questions in this field is the extent to which engaging in unusual sex acts is deviant? Psychologists and psychiatrists differentiate between paraphilias and paraphilic disorders. Most individuals with paraphilic interests are normal people with absolutely no mental health issues whatsoever. I personally believe that there is nothing wrong with any paraphilic act involving non-normative sex between two or more consenting adults. Those with paraphilic disorders are individuals where their sexual preferences cause the person distress or whose sexual behaviour results in personal harm, or risk of harm, to others. In short, unusual sexual behaviour by itself does not necessarily justify or require treatment.

The element of coercion is another key distinguishing characteristic of paraphilias. Some paraphilias (e.g., sadism, masochism, fetishism, hypoxyphilia, urophilia, coprophilia, klismaphilia) are engaged in alone, or include consensual adults who participate in, observe, or tolerate the particular paraphilic behaviour. These atypical non-coercive behaviours are considered by many psychiatrists to be relatively benign or harmless because there is no violation of anyone’s rights. Atypical coercive paraphilic behaviours are considered much more serious and almost always require treatment (e.g., paedophilia, exhibitionism [exposing one’s genitals to another person without their consent], frotteurism, necrophilia, zoophilia).

For me, informed consent between two or more adults is also critical and is where I draw the line between acceptable and unacceptable. This is why I would class sexual acts with children, animals, and dead people as morally and legally unacceptable. However, I would also class consensual sexual acts between adults that involve criminal activity as unacceptable. For instance, Armin Meiwes, the so-called ‘Rotenburg Cannibal’ gained worldwide notoriety for killing and eating a fellow German male victim (Bernd Jürgen Brande). Brande’s ultimate sexual desire was to be eaten (known as vorarephilia). Here was a case of a highly unusual sexual behaviour where there were two consenting adults but involved the killing of one human being by another.

Because paraphilias typically offer pleasure, many individuals affected do not seek psychological or psychiatric treatment as they live happily with their sexual preference. In short, there is little scientific evidence that unusual sexual behaviour makes you more deviant generally.

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

Further reading

Abel, G. G., Becker, J. V., Cunningham-Rathner, J., Mittelman, M., & Rouleau, J. L. (1988). Multiple paraphilic diagnoses among sex offenders. Bulletin of the American Academy of Psychiatry and the Law, 16, 153-168.

Buhrich, N. (1983). The association of erotic piercing with homosexuality, sadomasochism, bondage, fetishism, and tattoos. Archives of Sexual Behavior, 12, 167-171.

Collacott, R.A. & Cooper, S.A. (1995). Urine fetish in a man with learning disabilities. Journal of Intellectual Disability Research, 39, 145-147.

Couture, L.A. (2000). Forced retention of bodily waste: The most overlooked form of child maltreatment. Located at: http://www.nospank.net/couture2.htm

Denson, R. (1982). Undinism: The fetishizaton of urine. Canadian Journal of Psychiatry, 27, 336–338.

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

Greenhill, R. & Griffiths, M.D. (2016). Sexual interest as performance, intellect and pathological dilemma: A critical discursive case study of dacryphilia. Psychology and Sexuality, 7, 265-278.

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

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

Griffiths, M.D. (2013). Bizarre sex. New Turn Magazine, 3, 49-51.

Massion-verniory, L. & Dumont, E. (1958). Four cases of undinism. Acta Neurol Psychiatr Belg. 58, 446-59.

Money, J. (1980). Love and Love Sickness: The Science of Sex, Gender Difference and Pair-bonding, John Hopkins University Press.

Mundinger-Klow, G. (2009). The Golden Fetish: Case Histories in the Wild World of Watersports. Paris: Olympia Press.

Skinner, L. J., & Becker, J. V. (1985). Sexual dysfunctions and deviations. In M. Hersen & S. M. Turner (Eds.), Diagnostic interviewing (pp. 211–239). New York: Plenum Press.

Spengler, A. (1977). Manifest sadomasochism of males: Results of an empirical study. Archives of Sexual Behavior, 6, 441–456.

More cock tales: A brief look at genital drug injection

The idea for this blog was initiated when I read a snippet in The Fortean Times about a 34-year old man from New York who injected cocaine into his penis and ended up with gangrene and further medical complications. It turns out that this report was based on a letter published in a 1988 issue of the Journal of the American Medical Association by Drs. John Mahler, Samuel Perry and Bruce Sutton (and subsequently reported in a June 1988 issue of the New York Times).

The man in question came in for medical treatment following three days of priapism (i.e., prolonged and painful penile erection) and paraphimosis (i.e., foreskin in uncircumcised males can no longer be pulled over the tip of the penis). To enhance his sexual performance, he had administered cocaine directly into his urethra. After three days, both the priapism and the paraphimosis “spontaneously resolved”. However, the blood that had caused the priapism then leaked to other areas of his body over the next 12 hours (including his feet, hands, genitals, chest, and back). To stop the spread of gangrene, the medics had to partially amputate both of his legs (above the knee), and nine of his fingers. Following this, his penis also developed gangrene and fell off by itself while he was taking a bath. The exact reason for the spread of gangrene was unknown but sexologists (such as Professor John Money) speculated that it may have been because of impure cocaine being used.

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When I started to search for medical literature on the topic of injecting drugs directly into male genitalia I was surprised to find quite a few papers on the topic (but unsurprisingly all case study reports given the rarity of such behaviour). One of the earliest I located was one from 1986 in the Journal of Urology by Dr. W. Somers and Dr. F. Lowe. They reported the cases of four heroin abusers with localized gangrene of the genitalia, although only one of these had actually injected heroin directly into his genitalia, in this case his scrotum and perineum (the area between the anus and the scrotum). This latter case developed more severe gangrene and was described as a “more lethal entity” than the gangrene in the other three heroin users’ genitalia.

Later, in a 1999 issue of the American Journal of Forensic Medicine and Pathology, Dr. Charles Winek and his colleagues reported the rare case of a fatality due to a male injecting heroin directly into his penis. The cause of death was determined to be due to heroin and ethanol intoxication. More recently, in a 2005 issue of the Medical Journal of the Iranian Red Crescent, Dr. Z. Ahmadinezhad and his colleagues reported a case of heroin-associated priapism. In their paper, they reported the case of a 32-year old man who was admitted to hospital following pain and swelling after injecting heroin into his penis two weeks earlier. Unfortunately, the person left the hospital following initial consultation and never came back so the outcome of the treatment provided is unknown.

In a 2011 issue of the Internet Journal of Surgery, Dr. I. Malek and colleagues reported the case of a 35-year old long-term intra-venous drug user who injected citric acid laced with heroin into the dorsal vein of his penis. This caused worsening pain and his penis developed gangrene. Over the (non-operative) treatment period, the man’s pain became worse and he had trouble urinating (so he was catheterised). Eventually, the treatment with antibiotics led to a good recovery at three-month follow-up.

Another unusual case was reported by Dr. Francois Brecheteau and his colleagues in a 2013 issue of the Journal of Sexual Medicine. They reported the successful treatment of a 26-year old male drug addict who had injected the opiate drug buprenorphine directly into the dorsal vein of his penis. After unsuccessful antibiotic treatment on its own, they then used a number of simultaneous treatments including heparin, anti-platelet drugs, antibiotics, and hyperbaric oxygen therapy, the man made a successful recovery.

Returning to cocaine rather than opiates, a case report by Dr. V. B. Mouraviev and his colleagues in a 2002 issue of the Scandinavian Journal of Urology and Nephrology reported the case of a 31-year-old Canadian man who had injected cocaine directly into his penis. He turned up at the emergency having endured penile pain for 22 hours following the injection. Twelve hours after injecting the cocaine, the man noticed swelling and bruising starting to appear on the right side of his penis where he had made the injection. As a consequence, his penis developed gangrene (localized death and decomposition of body tissue, resulting from obstructed circulation or bacterial infection”) most probably from bacterial infection via the injection. He had to undergo reconstructive skin graft surgery and was given antibiotics. In this particular case, the treatment was successful. Other similar reports of medical complications (usually gangrene) following the injection of cocaine into the penis have since appeared in a number of papers including a 2013 paper by Dr. Fahd Khan and colleagues in the Journal of Sexual Medicine.

Cocaine and heroin aren’t the only recreational drugs to have been injected into male genitalia. A paper in a 2014 issue of Urology Case Reports by Dr. Cindy Garcia and her colleagues reported the case of a 45-year-old male intravenous drug user who developed an abscess after he injected amphetamine into his penis. The man chose a penile vein after being unable to find any other suitable peripheral vein. He was treated with intravenous antibiotics and had to have his abscess drained via a penile incision. Within a month he had been all but successfully treated. In their paper (which also included a review of the literature on penile abscesses), they concluded that:

Penile abscesses are an uncommon condition. There are multiple aetiologies of penile abscesses, including penile injection, penile trauma, and disseminated infection. Penile abscesses might also occur in the absence of an underlying cause. The treatment of penile abscesses should depend on the extent of infection and the cause of the abscess. Most cases of penile abscess necessitate surgical debridement [removal of dead or infected tissue]”.

Similarly, in a 2015 issue of Case Reports in Urology, Dr. Thomas W. Gaither and his colleagues reported two cases of men who had injected metamphetamine into their penis. The first case was a 47-year-old gay man who had a history of “methamphetamine use, prior penile abscesses, urethral foreign body insertions, HIV, hepatitis C, and diabetes mellitus”. He attended the hospital emergency department suffering from severe penile pain and scrotal swelling having injected methamphetamine into the shaft of his penis a few days before. On the same day that he went to the emergency department he was immediately taken into the operating room where an incision was made in his penis, and the abscess was drained of its “purulent foul-smelling fluid” and washed out with saline solution. The second case was a 33-year-old heterosexual male with no previous medical history (apart from a history of depression) turned up at the hospital emergency department with acute penile pain, a day after he had injected methamphetamine directly into his penis. Again, he was immediately taken to the operating room where his penile abscess was drained after an incision. Neither of the cases involved any penile gangrene and both men were also given antibiotics to treat the infected area. In both cases, the authors speculated that the abscesses formed as a result of direct contamination from repeated penile injections.

Finally, Dr. Lucas Prado and his colleagues reported a case study in a 2012 issue of the Journal of Andrology of a 31-year-old man who was admitted to the emergency department after he had injected 10ml of methadone into his penis in an attempt to commit suicide (the first case of penile methadone injection). The man had a 15-year history of drug abuse over the past year and had attempted a drug-related suicide three times. This particular suicide attempt led to acute liver and renal failure as well as erectile dysfunction. Although the man survived, ten months after the suicide attempt, the man still had complete erectile dysfunction.

Although I didn’t do a systematic review of all the literature, it is clear that the injection of recreational drugs directly into male genitalia appears to be relatively rare although all the literature I located was based on those who end up seeking treatment for when things go horribly wrong. There could of course be many hundreds or thousands of people out there that have engaged in such practices but don’t end up in a hospital emergency ward. However, I certainly wouldn’t recommend such a practice to anyone.

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

Further reading

Ahmadinezhad, Z., Jabbari, B.H., Saberi, H., Khaledi, F., & Safavi, F. (2005). Heroin associated priapism. Medical Journal of the Iranian Red Crescent, 7(3), 67-68.

Brecheteau, F., Grison, P., Abraham, P., Lebdai, S., Kemgang, S., Souday, V., … & Bigot, P. (2013). Successful medical treatment of glans ischemia after voluntary buprenorphine injection. Journal of Sexual Medicine, 10(11), 2866-2870.

Cunningham, D.L., & Persky, L. (1989). Penile ecthyma gangrenosum: Complication of drug addiction. Urology, 34(2), 109-110.

Gaither, T.W., Osterberg, E.C., Awad, M. A., & Breyer, B.N. (2015). Surgical intervention for penile methamphetamine injections. Case Reports in Urology, 467683, doi.org/10.1155/2015/467683

Garcia, C., Winter, M., Chalasani, V., & Dean, T. (2014). Penile abscess: a case report and review of literature. Urology Case Reports, 2(1), 17-19.

Khan, F., Mukhtar, S., Anjum, F., Tripathi, B., Sriprasad, S., Dickinson, I. K., & Madaan, S. (2013). Fournier’s gangrene associated with intradermal injection of cocaine. Journal of Sexual Medicine, 10(4), 1184-1186.

Malek, I., Parmar, C., McCabe, J., & Irwin, P. (2011). Successful non-operative management of penile wet gangrene following self-injection of heroin in dorsal vein of penis. Internet Journal of Surgery, 11(1), 1-3.

Mireku-Boateng, A.O., & Tasie, B. (2001). Priapism associated with intracavernosal injection of cocaine. Urologia Internationalis, 67(1), 109-110.

Mouraviev, V. B., Pautler, S. E., & Hayman, W. P. (2002). Fournier’s gangrene following penile self-injection with cocaine. Scandinavian Journal of Urology and Nephrology, 36(4), 317-318.

Munarriz, R., Hwang, J., Goldstein, I., Traish, A.M., & Kim, N.N. (2003). Cocaine and ephedrine-induced priapism: case reports and investigation of potential adrenergic mechanisms. Urology, 62(1), 187-192.

Prado, L. G., Huber, J., Huber, C. G., Mogler, C., Ehrenheim, J., Nyarangi‐Dix, J., … & Hohenfellner, M. (2012). Penile methadone injection in suicidal intent: Life‐threatening and fatal for erectile function. Journal of Andrology, 33(5), 801-804.

Singh, V., Sinha, R. J., & Sankhwar, S. N. (2011). Penile gangrene: A devastating and lethal entity. Saudi Journal of Kidney Diseases and Transplantation, 22(2), 359.

Somers, W.J., & Lowe, F.C. (1986). Localized gangrene of the scrotum and penis: A complication of heroin injection into the femoral vessels. Journal of Urology, 136, 111-113.

Winek, C. L., Wahba, W. W., & Rozin, L. (1999). Heroin fatality due to penile injection. American Journal of Forensic Medicine and Pathology, 20(1), 90-92.

Dying for it: Bizarre autoerotic deaths (Part 2)

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

Case 1: Autoerotic death by aerosol propellant

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

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

Case 2: Autoerotic death by clothing

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

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

Case 3: Autoerotic death by hanging (female)

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

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

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Case 4: Autoerotic death by vacuum cleaner

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

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

Case 5: Autoerotic death by hydraulic tractor shovel

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

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

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

Further reading

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

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

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

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

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

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

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

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

Dying for it: Bizarre autoerotic deaths (Part 1)

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

Case 1: Autoerotic death by car

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

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

Case 2: Autoerotic death by hanging (male)

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

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

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Case 3: Autoerotic death by blankets

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

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

Case 4: Autoerotic death by dental anaesthetic

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

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

Case 5: Autoerotic death by electrocution

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

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

(Part 2 can be found here).

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

Further reading

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

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

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

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

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

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

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

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

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

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

Getting to the point: A brief look at injection fetishes

In a previous blog I examined ‘medical fetishism’. One of the sub-types of medical fetishism comprises individuals who derive sexual pleasure and arousal from being the recipients of a medical or clinical procedure (typically some kind of bodily examination). This includes genital and urological examinations (e.g., a gynaecological examination), genital procedures (e.g., fitting a catheter or menstrual cup), rectal procedures (e.g., inserting suppositories, taking a rectal temperature, prostate massage), the application of medical dressings and accessories (e.g., putting on a bandage or nappy, fitting a dental retainer, putting someone’s arm in plaster), and the application and fitting of medical devices (e.g., fitting a splint, orthopaedic cast or brace).

One type of medical fetish that I did not mention was that involving individuals that have ‘injection fetishes’. Obviously this fetish appears to be a very niche sexual behaviour within medical fetishism but there are various online forums and websites that cater for individuals who derive sexual pleasure from the giving or receiving of injections (or watching such acts). For instance, there is a dedicated forum within the Voy.com website where individuals share their injection stories, the Real Injection website (which features stories and clips from films and news stories where injections are administered), the Needing Needles page on Tumblr (which mainly consists of photographic pictures featuring hypodermic needles), The Injection Girls website (which doesn’t appear to be overtly sexual but would be highly arousing for those with an injection fetish), the Fetish Clinic website (featuring lots of medical fetish videos including injections), and even a dedicated Facebook page on the topic.

In researching this article I came across many online accounts (of various degrees of detail) of people claiming to have an injection fetish. I can’t vouch for the veracity of the statements but they appeared genuine to me:

  • Extract 1: “I am an injection fetish person. [I] Iike to watch injection pictures [and] videos particularly a female being the administrator”.
  • Extract 2: “At [the] age of 18 [years] I was hospitalized for a week. I had to [have an] injection every day [from a] nurse…On [the] first two days she told me to lower my pants [to give the] injection. [She] slowly injected the needle in my fatty butt. On [the] third day I told her to [take] down my jeans by herself. First she hesitated, but [did] it. [The] next day she came and [did it without me asking]. She lowered my jeans…[and] gave [me the] injection on [my] butt…She gave me injections and then made me horny by keeping her hand & finger on [where she had injected me. It felt] uncomfortable. but she still smiled. She obviously teased me and on the same day I [returned] home with an injection fetish”.
  • Extract 3: “I ejaculate [and am] more happy if a nice woman dressed in nurse [gives] me an injection…I like very much the preparation protocol before injection…I have [had] this fetish since I received [my] first injection made by a nurse when I was 10 years old…This is a nice fetish. I know that is not very common but I know some people [who] like it, so we are not alone [in having] curious pleasures”.
  • Extract 4: “I have an injection fetish…When I was younger I got a shot from a nurse and after injected she was getting very fresh and touchy with me. I could not turn her down when she said we must go somewhere and get it on…I have never felt so satisfied after she [injected] me. That’s where it started. She was forceful and demanding. The [injection] shot was large and scary. I wasn’t real thrilled about getting it but she said it [was in my] best interest. So I bent over. She swabbed me. I was a bit resistant. She was persuasive in her words…It was hurting. Then while she was injecting that was hurting too. I was squirming and moaning. But I would love for this to happen again someday”
  • Extract 5: “I have an ‘injection fetish’. That means that I get only sexually attracted when thinking about women getting injections in their butt. I also like to have fantasies about myself getting injections in the butt by woman. This fetish is apparently rare, but also not that uncommon…As such, a fetish might not be something bad, but this one prevents me from having orgasm in normal sexual intercourse. The female vagina does not sexually really attract me…It basically destroys any relationship because I cannot have an orgasm or ejaculate during normal sexual intercourse…Has this specific type of medical fetish (or similar ones…suppositories, enemas, gyno) been researched in medical/psychological science? Once I know where this [fetish] is from, I can understand it and I can control it…To me, it appears I had this fetish from day one (of course, that was not the case, but [that is how] it feels)”.

Unlike the others quoted here, this last extract is from a person also provided further description about himself. He was 39 years of age when he posted his comments and claimed to have developed the fetish in childhood some time between the ages of six to eight years. He claims not to know where the fetish originated, and his only description of his childhood was that he had a father who used to beat him and who wouldn’t let him bring any friends to his house (including girlfriends). Although the accounts here are brief, all five are males, and three of the five extracts mention getting an injection from a nurse at some point on their lives had kick-started their injection fetish and would appear to suggest that associative pairing took place and that their sexual arousal from injections arises as a result of classical conditioning.

It’s also worth mentioning that there are also hard-core pornographic films where injections are central to the ‘plot’ – the 2011 film Lethal Injection being the most infamous example. (I say “infamous” because many newspapers – such as a piece in the Daily Mail – reported that China’s leading state-run news agency Xinhua posted the screen shots from the film on its website under the headline ‘Actual Record of Female Inmate’s Execution – Exposing the World’s Darkest Side’ and claimed it showed a real execution by lethal injection in the United States. In the film itself, a doctor has sex with a woman after she has been given a lethal injection and arguably is more about necrophilia and lust murders than it is about injection fetishes).

Academically, I’m not aware of any research specifically focusing on injection fetishes although a paper by Dr. Allen Bartholomew published back in 1973 in the Australian and New Zealand Journal of Psychiatry alluded to behaviours that have similarities to injection fetishes. Bartholomew was studying the characteristics of intravenous drug users and noted three cases of autohaemofetishism (i.e., deriving sexual pleasure from sight of blood drawn into a syringe during intravenous drug practice, something that I briefly mentioned in a previous blog on vampirism as a sexual paraphilia). He also noted three cases of ‘injection masochism’ in which users were sexually aroused from giving themselves injections. In both of these two features, it was argued by Bartholomew that both of the two features were considered to be brought about by classical conditioning.

More recently, in 2012 issue of the journal Rhizomes in Emerging Knowledge, Dr. Varpu Rantala examined the recurrence of drug injection scenes in contemporary mainstream cinema from a cultural studies perspective. She argued that in cinematic terms:

Injection is a fetish – not only of drug users but a collective one. The injection shots momentarily fix the images of what is thinkable and sayable about intravenous drug use, centering it on an overindulgence in injection and reducing ‘addicted bodies”.

However, the word ‘fetish’ in this context is not being used in any sexual sense. She also makes reference to the portrayal of drug addicts in the work of US writer William Burroughs. Again, this is not used in a sexual sense but she does make some interesting observations about obsession and addiction:

The coolness in Burroughs’s description of a junkie is paradoxically both ice-cold and mobilizing, or attractive, as understood in relation to the attraction image. These images may also be fetishized. Intravenous drug users may develop a fetish for injection, the ‘needle fixation’, an addiction to the injection itself that is often experienced as both repulsive and seductive (Pates et al 2001). But, it seems that “needle fixation” is not only about intravenous drug users: this kind of ambiguous fascination with the injection image as part of late modern mainstream everyday audiovisual culture may even be described a ‘cinematic obsession’: as the ‘hold [of drugs] on the modern imagination [is] seemingly as strong as the hold it has over those addicted to it’ (Boothroyd 2007, 9), ‘it is the ambiguity and duality of the symbolism [of the syringe] that is the source for conflict, and intense pleasurable obsession’ (Fitzgerald 2010, 205). The recurrence of these images in their over-indulgence of sensuous material of extreme explicitness reminds one of the processes of addiction as unwilled repetition of excessive sensual experience: a cinematic addiction…Repetitive, fixed and fetishized, late modern drug injection images are clichés that may ‘penetrate each one of us’ (Deleuze 2005, 212). This may also be about an intense encounter that moves us. In case of the injection shot, they form a place of intensity in a film; an attraction image (Gunning 1990) that reaches towards the viewer and that Williams (1991) has further discussed with respect to porn, horror and melodrama”

Finally, (and staying with films), a few years ago there was an interesting article on the Hannibal Studio Lo website (a site dedicated to critical analysis of all things Hannibal Lecter). Unfortunately, the website is no longer on the internet but one of the contributors to the site made the observation that the author of all the ‘Hannibal Lecter’ books (Thomas Harris) has (in his writing) a fetish for injections, a love-hate relationship for the meaning of getting an injection and its purpose”. The article made references to the many passages in Harris’ books that concern injections but asserts that:

“The most impressive descriptions of injections in the [novel] of ‘Hannibal’ are those given by Dr. Lecter to Clarice Starling. Appearing in Chapter 94 there is a ‘Tiny sting of the finest needle – Starling did not even look down’ and in Chapter 91 there is ‘Day and evening again, the smell of fresh flowers in the house, and once the faint sting of a needle’. The essence of those injections, which would lead her from one life to another and help her cross the final threshold to her transformation. So what do you think is the significance of injections according to the Harris realm? Could it be that one of the ingredients of a dark and profound romance is the intimate enigmatic comfort of Hannibal’s injections? I think it is very interesting to note how Harris’s equation promises that from an ambiguous act that could be considered controlling, true freedom and tranquility are born”.

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

(Note: the original weblink for the article concerning Thomas Harris’ “fetish for injections” was at: http://www.hannibalstudiolo.com/phpBB2/viewtopic.php?t=1095&start=-1&sid=0f25ca4b4c2dca0bd9f85038ae600a03)

Further reading

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

Bartholomew, A. A. (1973). Two features occasionally associated with intravenous drug users: A note. Australian and New Zealand Journal of Psychiatry, 7(3), 206-207.

Bizarre Magazine (2010). Medical fetishism. December 1. Located at: http://www.bizarremag.com/fetish/fetish/10393/medical_fetish.html?xc=1

Boothroyd, D. (2007). Cinematic heroin and narcotic modernity. In Ahrens, R. and Stierstorfer, K. (eds.), Symbolism: An International Annual of Critical Aesthetics (pp. 7-28). New York: AMS Press.

Deleuze, G. (2005a) Cinema 1: The Movement-Image. London: Continuum.

Fitzgerald, J. (2010). Images of the desire for drugs. Health Sociology Review, 12(2), 205-217.

Pates, R.M., McBride, A.J., Ball, N. & Arnold, K (2001). Towards an holistic understanding of injecting drug use: An overview of needle fixation. Addiction Research and Theory, 9, 3-17.

Rantala, V. (2012). Hardcore: Schizoanalysis as audiovisual thinking of cinematic drug injection images. Rhizomes: Cultural Studies in Emerging Knowledge, 24, 1-12

Wikipedia (2012). Medical fetishism. Located at: http://en.wikipedia.org/wiki/Medical_fetishism

Williams, L. (1991). Film bodies: Gender, genre and excess. Film Quarterly, 44(4), 2-13.

Imitate modern: Why do people commit copycat killings?

The nine people murdered in Munich a couple of days ago by 18-year-old German-Iranian gunman David Ali Sonboly made headlines around the world. It has been claimed that Sonboly (who subsequently killed himself) was obsessed with mass shootings” and that the police found lots of material in his room about mass killings including the massacre by Norway’s Anders Behring Breivik. Whether the murders by Sonboly are ‘copycat’ killings remains to be determined but there are dozens of other cases where copycat killings have been proven.

Back in 2014, the gruesome killing of two prostitutes in Hong King by British banking trader Rurik Jutting drew comparisons with the fictional character Patrick Bateman, the Wall Street investment banker and serial killer in the film American Psycho (based on the Bret Easton Ellis book of the same name).

As you might expect, a copycat murder is defined as a murder that has been modelled, motivated and/or inspired either by a real life murderer that has been reported by the print or broadcast media, or is based on a murderer portrayed in books, television or film. The term ‘copycat killer’ has been in use for almost 100 years and was first used in relation to murders that mimicked those of Jack the Ripper. Early research by criminologists began to speculate that the sensationalist publicity in the print media about the Ripper murders was the inspiration for Ripper-like copycat killings.

In addition to murder, copycat crimes have been shown to occur in many other equally destructive acts including suicides, murder-suicides, familicides, and rampage killings. Arguably the most well known writing on the topic was Loren Coleman’s 2004 book The Copycat Effect. Coleman believes that because shocking crimes receive widespread media publicity it makes the perpetrators infamous. He argues that the notoriety and ‘fame’ that serial killers receive is one of the main reasons why copycats commit similar crimes. Put more simply, copycats may believe that by committing heinous crimes, they may end up being the subject of a book or film themselves. The Copycat Effect is so well known that it was even the subject of a Hollywood film – the 1995 psychological thriller Copycat starring Sigourney Weaver as a criminal psychologist involved in a case where each murder in the film is made by a serial killer meticulously copying previous high profile murderers such as Ted Bundy, Jeffrey Dahmer (the ‘Milwaukie Cannibal’), David Berkowitz (the ‘Son of Sam’), and the Hillside Strangler (actually two men, Kenneth Bianchi and Angelo Buono).

But is the media to blame for copycat murders? Well, partly – but not totally. Research has shown that although most people convicted of copycat murders admit to being motivated by something they had seen on the news or in a film, they already had a criminal record (often violent crime) and/or were mentally ill before they began killing. What this suggests is that media coverage and fictionalized accounts of serial killers tend to affect those that already have a criminal predisposition and/or mental health issues rather than have a more widespread effect on people more generally. In such extreme and minority cases, it does appear that watching or reading about high profile murderers (e.g., Jeffrey Dahmer, Ed Gein) or infamous fictionalised killers (e.g., Dexter Morgan in Dexter or Patrick Batemen in American Psycho) does at the very least give emotionally undeveloped people ideas on how they could kill someone.

Copycat murderers do appear to realise that the more shocking and heinous the killing, the more newsworthy it will be. This also appears to have had an impact on films too. It appears some cinema-going audience want to see more depraved, deranged and twisted ways in which people can be killed (as evidenced by the so-called ‘torture porn’ franchises of Saw and Hostel). The more blood and pain, the better. Methods to kill in such films may be the inspiration of copycat killers to come.

Although there is a relationship between copycat killers and what they have seen or read about in the media, there are many other risk factors that have been associated with (and have an interplay with) copycat killings. Men are more likely to be copycat killers than females, and many copycat killers are young adults (below the age of 30 years). Copycat killers are more likely to suffer from personality (and other mental health) disorders, come from socially dysfunctional and alienating family backgrounds, be emotionally vulnerable, be trusting of the media, and – as noted above – a previous criminal history (as well as self-identifying with criminals they have watched or seen in fact and/or fiction).

Psychologists have also noted there appears to be a natural human inhibition against killing (even in acts of lawful killing such as fighting in a war). However, if individuals adopt some kind of a persona, such inhibitions can be reduced (often referred to by psychologists as ‘depersonalization’). If copycat killers temporarily take on the persona of the person they are copying in addition to the act of killing, this may also play a contributory role in some of their actions. American evolutionary psychologist Dr.Nigel Barber has also noted in relation to rampage killing that: “Most copycats have their private agenda in a rampage killing but seek to tie it in to other events that received a lot of publicity. In this way, they bask in the reflected publicity, so to speak. In many cases, the rampage killer wants to commit suicide but opts to take others with him”.

Although there are many reasons as to how and why an individual becomes a copycat killer, the evidence does seem to suggest that the media perhaps need to take a more cautionary approach when reporting the details of murders, and also suggests that the police and other criminal agencies should not go into every detail about how the murders were committed. Such actions alone will not stop copycat killings, but it may help reduce the overall number occurring in the first place.

(Material in this blog first appeared in an article I wrote for The Independent in November 2014 – see ‘Further reading’ below)

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

Further reading

Barber, N. (2012). Copycat killings: Making sense of the senseless. Psychology Today, July 27. Located at: https://www.psychologytoday.com/blog/the-human-beast/201207/copycat-killings

Boyle, K. (2001). What’s natural about killing? Gender, copycat violence and Natural Born Killers. Journal of Gender Studies, 10(3), 311-321.

Coleman, L. (2004). The copycat effect: How the media and popular culture trigger the mayhem in tomorrow’s headlines. New York: Simon and Schuster.

Fox, J.A., & Levin, J. (2014). Extreme killing: Understanding serial and mass murder. London: Sage.

Griffiths, M.D. (2014). Hong Kong murder: Why do people commit copycat killings? The Independent, November 4. Located at: http://www.independent.co.uk/life-style/health-and-families/features/hong-kong-murder-why-do-people-commit-copycat-killings-9838892.html

Kunich, J.C. (2000). Natural born copycat killers and the law of shock torts. Washington University Law Quarterly, 78(4), 1157-1270.

Surette, R. (2002). Self-reported copycat crime among a population of serious and violent juvenile offenders. Crime and Delinquency, 48(1), 46-69.

Wikipedia (2016). Copycat crime. Located at: https://en.wikipedia.org/wiki/Copycat_crime