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Games without frontiers: A brief look at the psychology of play

In a previous blog I examined my favourite board game (Scrabble) and the extent to which someone could become addicted to it. Today’s blog takes a broader look at the psychology of play more generally. Arguably, many of the topics that I research involve the psychology of playing games with video games and gambling games being my two most obvious areas of interest.

It’s been argued by myself (and others) that the ritualized play of several childhood games provides ‘training’ in the acquisition of gambling behaviour and that some games are pre-cursors to actual gambling (e.g., playing marbles, card flipping, etc.). Some authors (such as Igor Kusyszyn) hold the view that gambling is in itself ‘adult play’. Unsurprisingly, Freud was one of the first people to concentrate on the ‘functions’ of play and concluded that play in all its varieties (a) provides a wish-fulfilment, (b) leads to conflict reduction, (c) provides temporary leave of absence from reality, and (d) brings about a change from the passive to the active.

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Since Freud, most psychologists have concentrated on the idea of ‘conflict reduction’ and in doing so have ignored his other three postulations. A more modern approach in the 1970s by Mihalyi Czikszentmihalyi asserted that during play a person can “concentrate on a limited stimulus field, in which he or she can use skills to meet clear demands, thereby forgetting his or her own problems and separate identity” (and provides one of the reasons that a small minority of people can develop problems playing games). Seminal research on the sociology of play by Roger Caillois states notes that play is a “free and voluntary activity”, “a source of joy and amusement” and “bounded by precise limits of time and space” whereas Erving Goffman views it as a “world building activity”.

Games provide the opportunity to prove one’s superiority, the desire to challenge and overcome an obstacle, and a medium by which to test one’s skill, endurance and ingenuity. Games, unlike some activities (including life itself!), tell us whether we have won or lost. As observed by James Smith and Vicki Abt in the 1980s:

“…in the context of a competitive and materialistic culture that has become increasingly regimented and standardized with little room for individual creativity and personal achievement, games (including gambling) offer the illusion of control over destiny and circumstance”.

Perhaps the best categorisation of game types was formulated by Roger Caillois who listed four classifications – agon (competition), alea (chance), mimicry (simulation), and ilinx (vertigo). In the context of games involving gambling, alea and agon are crucial in that they offer a combination of skill, chance and luck. As was previously asserted, most people desire opportunities to test their strength and skill against an adversary, and those games which offer a component of skill or talent combined with luck and chance provide the most favourable conditions. This is particularly prevalent in males who are deemed ‘masculine’ if during the socialization process they show (socially) important traits such as courage, independence, and bravery.

According to Caillois, play is “an occasion of pure waste: waste of time, energy, ingenuity, skill, and often of money” and is a “free and voluntary activity that occurs in a pure space, isolated and protected from the rest of life”. According to Caillois, play is best described by six core characteristics:

  • It is free, or not obligatory.
  • It is separate (from the routine of life) occupying its own time and space.
  • It is uncertain, so that the results of play cannot be pre-determined and so that the player’s initiative is involved.
  • It is unproductive in that it creates no wealth and ends as it begins.
  • It is governed by rules that suspend ordinary laws and behaviours and that must be followed by players.
  • It involves make-believe that confirms for players the existence of imagined realities that may be set against ‘real life’.

Back in 2000, I published an article on the psychology of games in Psychology Review and what makes a good game. I noted that:

  • All good games are relatively easy to play but can take a lifetime to become truly adept. In short, there will always room for improvement.
  • For games of any complexity there must be a bibliography that people can reference and consult. Without books and magazines to instruct and provide information there will be no development and the activity will die.
  • There needs to be competitions and tournaments. Without somewhere to play (and likeminded people to play with) there will be little development within the field over long periods of time.
  • Finally – and very much a sign of the times – no leisure activity can succeed today without corporate sponsorship of some kind.

I was recently interviewed by Lucy Orr for an article on board games for The Register – particularly about the psychology of winning. For instance, why is winning so important? I responded to Orr by pointing out that winning makes us feel good both psychologically and physiologically. Winning something – especially if it is a result of something skilful rather than by chance – can feel even better (unless the chance winning is something life changing like winning the lottery). Winning something using your own skill can demand respect from other competitors and brings about esteem (that can feed into one’s own self-esteem). Winning can be a validation that what you are doing is worthwhile. Other parts of my interview were not used.

I was asked whether beating other people makes winning more rewarding? Of course it does. Any time we engage in a behaviour that feels good we want to do it again (and again). Winning can be reinforcing on many different levels. There may be financial rewards, social rewards (peer praise, admiration and respect from others), psychological rewards (feeling better about oneself and feeling that the activity is a life-affirming and life-enhancing activity that feeds into self-esteem), and physiological rewards (increases in adrenaline and serotonin that trigger dopamine and makes us feel happy).

For some people, winning can become addictive. You can’t become addicted to something unless you are constantly reinforced and rewarded for engaging in the behaviour, and (as mentioned above) there are many different types of rewards (e.g., financial, social, psychological and physiological). Any (or all of these) could lead to repetitive and habitual behaviour and in a small minority of cases be addictive. However, as I have noted in a number of my papers, doing something to excess is not addiction. The difference between a healthy excessive enthusiasm and an addiction is that excessive enthusiasms add to life and addictions take away from it. For most people, winning behaviour – particularly in the context of playing board games – will be highly rewarding without being in any way problematic

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

Further reading

Brown, J. (2011). Scrabble addict. Sabotage Times, May 16. Located at: http://sabotagetimes.com/life/scrabble-addict/

Caillois, R. (1961). Man, play and games. Paris: Simon and Schuster.

Csikszentmihalyi, M. (1976). Play and intrinsic rewards. Journal of Humanistic Psychology, 16, 41-63.

Goffman, E. (1967). Interaction Ritual: Essays on face-to-face behavior. Garden City, New York: Doubleday Anchor.

Griffiths, M.D. (2000). The psychology of games. Psychology Review, 7(2), 24-26.

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

Griffiths, M.D. (2010). The role of context in online gaming excess and addiction: Some case study evidence. International Journal of Mental Health and Addiction, 8, 119-125.

Kusyszyn, I. (1984). The psychology of gambling. Annals of American Academy of Political and Social Sciences, 474, 133-145.

Orr, L. (2016). Winner! Crush your loved ones at Connect Four this Christmas. The Register, December 16. Located at: http://www.theregister.co.uk/2016/12/15/beating_your_family_and_winning_this_christmas/

Smith, J. F. & Abt, V. (1984). Gambling as play Annals of the American Academy of Political and Social Sciences, 474, 122-132.

Walsh, J. (2004). Scrabble addicts. The Independent, October 9. Located at: http://www.independent.co.uk/news/uk/this-britain/scrabble-addicts-535160.html

Meditation as self-medication: Can mindfulness be addictive?

(Please note, the following blog is an extended version of an article by my research colleagues Dr. Edo Shonin and William Van Gordon (that was first published hereand to which I have added some further text. If citing this article, we recommend: Shonin, E., Van Gordon, W. & Griffiths, M.D. (2016). Meditation as self-medication: Can mindfulness be addictive? Located at: https://drmarkgriffiths.wordpress.com/2016/10/24/meditation-as-self-medication-can-mindfulness-be-addictive/).

Mindfulness is growing in popularity and is increasingly being used by healthcare professionals for treating mental health problems. There has also been a gradual uptake of mindfulness by a range of organisations including schools, universities, large corporations, and the armed forces. However, the rate at which mindfulness has been assimilated by Western society has – in our opinion – meant that there has been a lack of research exploring the circumstances where mindfulness may actually cause a person harm. An example of a potentially harmful consequence of mindfulness that we have identified in our own research is that of a person developing an addiction to mindfulness.

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In a previous blog, the issue of whether meditation more generally can be addictive was examined. In a 2010 article by Michael Sigman in the Huffington Post entitled “Meditation and Addiction: A Two-Way Street?”, Sigman recounted the story about how one of his friends spent over two hours every day engaging in meditation while sat in the lotus position. He then claimed:

“There are those few for whom meditation can become compulsive, even addictive. The irony here is that an increasing body of research shows that meditation – in particular Buddhist Vipassana meditation – is an effective tool in treating addiction. One category of meditation addiction is related to the so-called ‘spiritual bypass’. Those who experience bliss when they meditate may practice relentlessly to recreate that experience, at the expense of authentic self-awareness. A close friend who’s done Transcendental Meditation for decades feels so addicted to it, she has a hard time functioning when she hasn’t ‘transcended’”.

Obviously, this is purely anecdotal but at least raises the issue that maybe for a very small minority, meditation might be addictive. In addition, empirical studies have shown that meditation can increase pain tolerance, and that the body produces its own morphine-like substances (i.e., endorphins). Therefore, the addictive qualities of meditation may be due to increased endorphin production that creates a semi-dissociative blissful state.

Being addicted to meditation – and more specifically mindfulness – would constitute a form of behavioural addiction (i.e., as opposed to chemical addiction). Examples of better known forms of behavioural addiction are gambling disorder, internet gaming disorder, problematic internet use, sex addiction, and workaholism. According to the components model of addiction, a person would suffer from an addiction to mindfulness if they satisfied the following six criteria:

  • Salience: Mindfulness has become the single most important activity in their life.
  • Mood modification: Mindfulness is used in order to alleviate emotional stress (i.e., escape) or to experience euphoria (i.e., a ‘high’).
  • Tolerance: Practising mindfulness for longer durations in order to derive the same mood-modifying effects.
  • Withdrawal: Experiencing emotional and physical distress (e.g., painful bodily sensations) when not practising mindfulness.
  • Conflict: The individual’s routine of mindfulness practice causes (i) interpersonal conflict with family members and friends, (ii) conflict with activities such as work, socialising, and exercising, and (iii) psychological and emotional conflict (also known as intra-psychic conflict).
  • Relapse: Reverting to earlier patterns of excessive mindfulness practice following periods of control or abstinence.

In modern society, the word ‘addiction’ has negative connotations but it should be remembered that addictions have been described by some as both positive and negative (for instance, Dr. Bill Glasser has spent his whole career talking about ‘positive’ addictions). For example, in separate clinical case studies that we conducted with individuals suffering from pathological gambling, sex addiction, and workaholism, it was observed that the participants substituted their addiction to gambling, work, or sex with mindfulness (and maybe even developed an addiction to it, depending upon the definition of addiction). In the beginning phases of psychotherapy, this process of addiction substitution represented a move forward in terms of the individual’s therapeutic recovery. However, as the therapy progressed and the individual’s dependency on gambling, work, or sex began to weaken, their “addiction” to mindfulness was restricting their personal and spiritual growth, and was starting to cause conflict in other areas of their life. Therefore, it became necessary to help them change the way they practiced and related to mindfulness.

Mindfulness is a technique or behaviour that an individual can choose to practice. However, the idea is that the individual doesn’t separate mindfulness from the rest of their lives. If an individual sees mindfulness as a practice or something that they need to do in order to find calm and escape from their problems, there is a risk that they will become addicted to it. It is for this reason that we always exercise caution before recommending that people follow a strict daily routine of mindfulness practice. In fact, in the mindfulness intervention that we (Shonin and Van Gordon) developed called Meditation Awareness Training, we don’t encourage participants to practice at set times of day or to adhere to a rigid routine. Rather, we guide participants to follow a dynamic routine of mindfulness practice that is flexible and that can be adapted according to the demands of daily living. For example, if a baby decides to wake up earlier than usual one morning, the mother can’t tell it to wait and be quite because it’s interfering with her time for practising mindfulness meditation. Rather, she has to tend to the baby and find another time to sit in meditation. Or better still, she can tend to the baby with love and awareness, and turn the encounter with her child into a form of mindfulness practice. We live in a very uncertain world and so it is valuable if we can learn to be accommodating and work mindfully with situations as they unfold around us.

One of the components in the components model of addiction is ‘salience’ (put more simply, importance). In general, if an individual prioritises a behaviour (such as gambling) or a substance (such as cannabis) above all other aspects of their life, then it’s probably fair to say that their perspective on life is misguided and that they are in need of help and support. However, as far as mindfulness is concerned, we would argue that it’s good if it becomes the most important thing in a person’s life. Human beings don’t live very long and there can be no guarantee that a person will survive the next week, let alone the next year. Therefore, it’s our view that it is a wise move to dedicate oneself to some form of authentic spiritual practice. However, there is a big difference between understanding the importance of mindfulness and correctly assimilating it into one’s life, and becoming dependent upon it.

If a person becomes dependent upon mindfulness, it means that it has remained external to their being. It means that they don’t live and breathe mindfulness, and that they see it as a method of coping with (or even avoiding) the rest of their life. Under these circumstances, it’s easy to see how a person can develop an addiction to mindfulness, and how they can become irritable with both themselves and others when they don’t receive their normal ‘fix’ of mindfulness on a given day.

Mindfulness is a relatively simple practice but it’s also very subtle. It takes a highly skilled and experienced meditation teacher to correctly and safely instruct people in how to practise mindfulness. It’s our view that because the rate of uptake of mindfulness in the West has been relatively fast, in the future there will be more and more people who experience problems – including mental health problems such as being addicted to mindfulness – as a result of practising mindfulness. Of course, it’s not mindfulness itself that will cause their problems to arise. Rather, problems will arise because people have been taught how to practice mindfulness by instructors who are not teaching from an experiential perspective and who don’t really know what they are talking about. From personal experience, we know that mindfulness works and that it is good for a person’s physical, mental, and spiritual health. However, we also know that teaching mindfulness and meditation incorrectly can give rise to harmful consequences, including developing an addiction to mindfulness.

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

Further Reading

Glasser, W. (1976). Positive addictions. Harper & Row, New York, NY.

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

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

Griffiths, M.D. (2011). Behavioural addiction: The case for a biopsychosocial approach. Trangressive Culture, 1, 7-28.

Larkin, M., Wood, R.T.A. & Griffiths, M.D. (2006). Towards addiction as relationship. Addiction Research and Theory, 14, 207-215.

Shonin, E., Van Gordon, W., & Griffiths, M. D. (2013). Buddhist philosophy for the treatment of problem gambling. Journal of Behavioral Addictions, 2, 63-71.

Shonin, E., Van Gordon, W., & Griffiths, M.D. (2014). The treatment of workaholism with Meditation Awareness Training: A case study. Explore: The Journal of Science and Healing, 10, 193-195.

Shonin, E., Van Gordon W., & Griffiths, M.D. (2014). Mindfulness as a treatment for behavioral addiction. Journal of Addiction Research and Therapy, 5, e122. doi: 10.4172/2155- 6105.1000e122.

Shonin, E., Van Gordon W., & Griffiths, M.D. (2015). Are there risks associated with using mindfulness for the treatment of psychopathology? Clinical Practice, 11, 389-382.

Shonin, E., Van Gordon, W., & Griffiths, M.D. (2016). Mindfulness and Buddhist-derived Approaches in Mental Health and Addiction. New York: Springer.

Sigman, M. (2010). Meditation and addiction: A two-way street? Huffington Post, November 15. Located at: http://www.huffingtonpost.com/michael-sigman/meditation-and-addiction_b_783552.htm

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

Van Gordon, W., Shonin, E., & Griffiths, M.D. (2015). Mindfulness in mental health: A critical reflection. Journal of Psychology, Neuropsychiatric Disorders and Brain Stimulation, 1(1), 102.

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

Van Gordon, W., Shonin, E., & Griffiths, M.D. (2016). Ontological addiction: Classification, etiology, and treatment. Mindfulness, 7, 660-671.

Confession session: The psychology of apology

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

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

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

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

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

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

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

bill-clinton-monica-lewinsky

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

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

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

Further reading

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

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

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

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

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

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

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

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

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

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

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

“Every breath you take”: A brief look at love obsessions in popular music

“You are an obsession/I cannot sleep/I am your possession/Unopened at your feet
/There’s no balance/No equality/Be still I will not accept defeat/I will have you/Yes, I will have you/I will find a way and I will have you/Like a butterfly/A wild butterfly/I will collect you and capture you” (Lyrics to the song ‘Obsession’ by Animotion)

Like the word ‘addiction’, one thing we can say about the word ‘obsession’ that there is no absolute agreed definition. Dictionary definitions of obsession refer to an obsession as:

  • “…an idea or thought that continually preoccupies or intrudes on a person’s mind” or “a state in which someone thinks about someone or something constantly or frequently especially in a way that is not normal” (Oxford Dictionary).
  • “…unable to stop thinking about something; too interested in or worried about something” (Cambridge Dictionary)
  • http://dictionary.cambridge.org/dictionary/english/obsessed
  • “…a state in which someone thinks about someone or something constantly or frequently especially in a way that is not normal” (Merriam-Webster Dictionary)
  • “…an emotional state in which someone or something is so important to you that you are always thinking about them, in a way that seems extreme to other people” (Macmillan Dictionary).

More medical definitions (such as Dorland’s Medical Dictionary) describe obsession as a recurrent, persistent thought, image, or impulse that is unwanted and distressing (ego-dystonic) and comes involuntarily to mind despite attempts to ignore or suppress it”. Given all these overlapping but differing definitions, it can be concluded that obsession means slightly different things to different people. In the latest (fifth) edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), an obsession must be distressing to be classed as a disorder. (And that’s why my obsession with music is not problematic).

I deliberately mentioned my self-confessed obsession with music because this article is a (somewhat self-admittedly) frivolous look at obsession in song lyrics. The first song I remember listening to called ‘Obsession’ was in 1981 by Scottish band Scars (from one of my all-time favourite LPs Author! Author!), quickly followed by Siouxsie and the Banshees’ song ‘Obsession’ on their 1982 LP A Kiss In The Dreamhouse (which reached No.11 in the UK albums chart). Arguably the most famous song entitled ‘Obsession’ was 1984’s top five hit by the US band Animotion (which was actually a cover version as the original was released by Holly Knight and Michael Des Barres) and later covered by The Sugababes and Karen O (lead singer of Yeah Yeah Yeahs, and the theme song to the US TV mini-series Flesh and Bone). Many artists have recorded songs simply called ‘Obsession’ including Tich, Tinie Tempah, Future Cut, The Subways, Jake Quickenden, Jesus Culture, and Blue Eyed Christ (amongst others).

Almost all songs with the title of ‘Obsession’ have been about being obsessed (or obsessively in love) with another person and are probably not that far removed from songs about love addiction (such as Roxy Music’s ‘Love Is The Drug’, Robert Palmer’s ‘Addicted To Love’, and Nine Inch Nail’s ‘The Perfect Drug’). Not all obsessional songs have the word ‘obsession’ in their title and probably the most famous songs about being obsessed with someone are ‘Every Breath You Take’ (The Police) and ‘Stan’ (Eminem; in fact the word ‘Stan’ is now sometimes used as a term for overly-obsessive fans of someone or something). As the Wikipedia entry on ‘Every Breath You Take’ notes:

Sting wrote the song in 1982 in the aftermath of his separation from [actress] Frances Tomelty and the beginning of his relationship with [actress, film producer and director] Trudy Styler. The split was controversial…The lyrics are the words of a possessive lover who is watching ‘every breath you take; every move you make’. [Sting said he] ‘woke up in the middle of the night with that line in my head, sat down at the piano and had written it in half an hour…It sounds like a comforting love song. I didn’t realize at the time how sinister it is. I think I was thinking of Big Brother surveillance and control…[Sting] insists [the song is] about the obsession with a lost lover, and the jealousy and surveillance that follow”.

Sting’s experience of writing from what you know and feel is a staple motivation for many songwriters (and probably no different from academics like myself – I tend to write about what I know about). An article in the New York Post by Kirsten Fleming (‘When rockers are stalkers: ‘Love songs’ that cross into obsession‘) features a top ten list of ‘obsessional love’ songs (although I think very few of them are. Much better is the list of ‘greatest stalking songs’ put together by The Scientist on the Rate Your Music website). However, I do think the song-writing process can border on the obsessional and I think the Canadian-American singer-songwriter Alanis Morissette has a realistic (and perhaps representative) take on her song-writing as she noted in an online article:

“For me, what writes songs is passion. So if I’m passionately angry about something or if I’m passionately in love with something or if I’m passionately addicted to something or if I’m passionately curious or scared, this is what creates worlds in art. I think love and anger are two of the most gorgeous life forces, with love being the only one that is bottomless. All of these different feelings that I’ve been running away from my whole life, the only one that has remained bottomless and endless is love. All other emotions seem to ebb and flow and move through once they get my attention long enough to really feel, but love is the one that remains limitless”.

In this interview extract, Morissette uses the word “addicted” in an arguably positive way and echoes a quote I used in a previous blog from Dr. Isaac Marks who said that “life is a series of addictions and without them we die”. Morissette (in a different interview) was also quoted as saying:

“My top addictions are really recovering from love addictions, which is a tough withdrawal that I’ve also written records in the midst of. Probably the worst withdrawal I’ve experienced. Food addiction, which I’ve been struggling with since I was 14, and work addiction it’s the respectable addiction in the west, but it’s actually an addiction to busy-ness and the fear of stopping and being still, and all that would come up from that. Those three are my top ones, and I’ve dabbled in all the other ones but none of them have grasped hold of me like the first one did”.

The band that I think have lyrically explored obsessive love more than any other is Depeche Mode. I’ve followed them from before their first hit right up until the present day. I’ve included their songs on almost every mix tape I’ve made for any girlfriend I’ve had over the last 35 years. Their main songwriter, Martin Gore, explores the dark side of love better than any lyricist I can think of. Whereas Adam Ant wins the prize for the most songs about different types of fetishes and paraphilias, Martin Gore is the lyrical king of obsessive love (although he does occasionally wander into more paraphilic kinds of love such as the sado-masochisticMaster and Servant’. Here are just a few selected lyrics that I hope help argue my case:

  • Extract 1: “Dark obsession in the name of love/This addiction that we’re both part of/
Leads us deeper into mystery/
Keeps us craving endlessly/Strange compulsions/That I can’t control/Pure possession of my heart and soul
/I must live with this reality/I am you and you are me” (‘I Am You’ from Exciter, 2001)
  • Extract 2: I want somebody who cares for me passionately/With every thought and with every breath/Someone who’ll help me see things in a different light/All the things I detest I will almost like” (‘Somebody’ from Some Great Reward, 1984)
  • Extract 3: “Well I’m down on my knees again/And I pray to the only one/Who has the strength to bear the pain/To forgive all the things that I’ve done/Oh girl, lead me into your darkness/When this world is trying it’s hardest
/To leave me unimpressed/
Just one caress from you and I’m blessed” (‘One Caress’ from Songs Of Faith And Devotion, 1993).
  • Extract 4: “Taking hold of the hem of your dress/
Cleanliness only comes in small doses/
Bodily whole but my head’s in a mess/Do you know obsession that borders psychosis?/It’s a sad disease/Creeping through my mind/Causing disabilities/Of the strangest kind/Getting lost in the folds of your skirt/There’s a price that I pay for my mission/Body in heaven and a mind full of dirt/How I suffer the sweetest condition” (‘The Sweetest Condition’ from Exciter, 2001)
  • Extract 5: “It’s only when I lose myself with someone else/That I find myself/I find myself/Something beautiful is happening inside for me/Something sensual, it’s full of fire and mystery/I feel hypnotized, I feel paralized/I have found heaven/Did I need to sell my soul/For pleasure like this?/Did I have to lose control/To treasure your kiss?/Did I need to place my heart/In the palm of your hand?/Before I could even start/To understand” (‘Only When I Lose Myself’ from The Singles, 86-98)
  • Extract 6: “I want you now/
Tomorrow won’t do/
There’s a yearning inside/And it’s showing through/Reach out your hands/And accept my love/We’ve waited for too long/Enough is enough/I want you now” (‘I Want You Now’ from Music For The Masses, 1987)
  • Extract 7: “Don’t say you’re happy/Out there without me/I know you can’t be
/’Because it’s no good/I’m going to take my time/I have all the time in the world
/To make you mine/It is written in the stars above” (‘It’s No Good’ from Ultra, 1997)
  • Extract 8: “Wisdom of ages/Rush over me/Heighten my senses/Enlighten me/Lead me on, eternally/And the spirit of love/Is rising within me/Talking to you now/Telling you clearly/The fire still burns” (‘Insight’ from Ultra, 1997).

These are just a few of the ‘obsessional’ lyrics from Depeche Mode’s back catalogue (and there are plenty of other songs I could have featured). I often think that the lyrics in songs or poetry say far more about the human condition than any paper I have published on the topic, and that is why I am (and will continue to be) a music obsessive.

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

Further reading

Dorrell, P. (2005). Is music a drug? 1729.com, July 3. Located at: http://www.1729.com/blog/IsMusicADrug.html

Fleming, K. (2014). When rockers are stalkers: ‘Love songs’ that cross into obsession. New York Post, July 2. Located at: http://nypost.com/2014/07/02/the-10-creepiest-musical-stalkers/

Griffiths, M.D (1999). Adam Ant: Sex and perversion for teenyboppers. Headpress: The Journal of Sex, Death and Religion, 19, 116-119.

Griffiths, M.D. (2012). Music addiction. Record Collector, 406 (October), p.20.

Morrison, E. (2011). Researchers show why music is so addictive. Medhill Reports, January 21. Located at: http://news.medill.northwestern.edu/chicago/news.aspx?id=176870

Salimpoor, V.N., Benovoy, M., Larcher, K. Dagher, A. & Zatorre, R.J. (2011). Anatomically distinct dopamine release during anticipation and experience of peak emotion to music. Nature Neuroscience 14, 257–262.

Smith, J. (1989). Senses and Sensibilities. New York: Wiley.

Myth world: Addictive personality does not exist

(Please note: This article is a slightly expanded and original version of an article that was first published in The Conversation).

“Life is a series of addictions and without them we die”. This is my favourite quote in the academic addiction literature and was made back in 1990 in the British Journal of Addiction by Professor Isaac Marks. This deliberately provocative and controversial statement was made to stimulate debate about whether excessive and potentially problematic activities such as gambling, sex and work can really be classed as genuine addictive behaviours. Many of us might say to ourselves that we are ‘addicted’ to tea or coffee, our work, or know others who we might describe as having addictions watching the television or using pornography. But is this really true?

The issue all comes down to how addiction is defined in the first place as many of us in the field disagree on what the core components of addiction are. Many would argue that the word ‘addiction’ or ‘addictive’ is used so much in everyday circumstances that word has become meaningless. For instance, saying that a book is an ‘addictive read’ or that a specific television series is ‘addictive viewing’ renders the word useless in a clinical setting. Here the word ‘addictive’ is arguably used in a positive way and as such it devalues the real meaning of the word.

The question I get asked most – particularly by the broadcast media – is what is the difference between a healthy excessive enthusiasm and an addiction and my response is simple – a healthy excessive enthusiasm adds to life whereas an addiction takes away from it. I also believe that to be classed as an addiction, any such behaviour should comprise a number of key components including overriding preoccupation with the behaviour, conflict with other activities and relationships, withdrawal symptoms when unable to engage in the activity, an increase in the behaviour over time (tolerance), and use of the behaviour to alter mood state. Other consequences such as feeling out of control with the behaviour and cravings for the behaviour are often present. If all these signs and symptoms are present I would call the behaviour a true addiction. However, that hasn’t stopped others accusing me of ‘watering down’ the concept of addiction.

A few years ago, Dr. Steve Sussman, Nadra Lisha and I published a large and comprehensive review in the journal Evaluation and the Health Professions examining the co-relationship between eleven different potentially addictive behaviours reported in the academic literature (smoking tobacco, drinking alcohol, taking illicit drugs, eating, gambling, internet use, love, sex, exercise, work, and shopping). We examined the data from 83 large-scale studies and reported an overall 12-month prevalence of an addiction among U.S. adults varies from 15% to 61%. We also reported it plausible that 47% of the U.S. adult population suffers from maladaptive signs of an addictive disorder over a 12-month period, and that it may be useful to think of addictions as due to problems of lifestyle as well as to person-level factors. In short – and with many caveats – our paper argued that at any one time almost half the US population are addicted to one or more behaviours.

There is a lot of scientific literature showing that having one addiction increases the propensity to have other co-occurring addictions. For instance, in my own research I have come across alcoholic pathological gamblers and we can all probably think of individuals that we might describe as caffeine-addicted workaholics. It is also very common for individuals that give up one addiction to replace it with another (which we psychologists call ‘reciprocity’). This is easily understandable as when an individual gives up one addiction it leaves a large hole in the waking lives (often referred to as the ‘void’) and often the only activities that can fill the void and give similar experiences are other potentially addictive behaviours. This has led many people to describe such people as having an ‘addictive personality’.

While there are many pre-disposing factors for addictive behaviour including genetic factors and psychological personality traits such as high neuroticism (anxious, unhappy, prone to negative emotions) and low conscientiousness (impulsive, careless, disorganised), I would argue that ‘addictive personality’ is a complete myth. Even though there is good scientific evidence that most people with addictions are highly neurotic, neuroticism in itself is not predictive of addiction (for instance, there are individuals who are highly neurotic but are not addicted to anything so neuroticism is not predictive of addiction). In short, there is no good evidence that there is a specific personality trait (or set of traits) that is predictive of addiction and addiction alone.

Doing something habitually or excessively does not necessarily make it problematic. While there are many behaviours such as drinking too much caffeine or watching too much television that could theoretically be described as addictive behaviours, they are more likely to be habitual behaviours that are important in an individual’s life but actually cause little or no problems. As such, these behaviours should not be described as an addiction unless the behaviour causes significant psychological and/or physiological effects in their day-to-day lives.

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

Further reading

Andreassen, C.S., Griffiths, M.D., Gjertsen, S.R., Krossbakken, E., Kvan, S., & Ståle Pallesen, S. (2013). The relationships between behavioral addictions and the five-factor model of personality. Journal of Behavioral Addictions, 2, 90-99.

Goodman, A. (2008). Neurobiology of addiction: An integrative review. Biochemical Pharmacology, 75(1), 266-322.

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

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

Griffiths, M.D. (2010). The role of context in online gaming excess and addiction: Some case study evidence. International Journal of Mental Health and Addiction, 8, 119-125.

Griffiths, M.D. & Larkin, M. (2004). Conceptualizing addiction: The case for a ‘complex systems’ account. Addiction Research and Theory, 12, 99-102.

Kerr, J. S. (1996). Two myths of addiction: the addictive personality and the issue of free choice. Human Psychopharmacology: Clinical and Experimental, 11(S1), S9-S13.

Kotov, R., Gamez, W., Schmidt, F., & Watson, D. (2010). Linking “big” personality traits to anxiety, depressive, and substance use disorders: A meta-analysis. Psychological Bulletin, 136(5), 768-821.

Larkin, M., Wood, R.T.A. & Griffiths, M.D. (2006). Towards addiction as relationship. Addiction Research and Theory, 14, 207-215.

Marks, I. (1990). Behaviour (non-chemical) addictions. British Journal of Addiction, 85, 1389-1394.

Nakken, C. (2009). The addictive personality: Understanding the addictive process and compulsive behavior. Hazelden, Minnesota: Hazelden Publishing.

Nathan, P. E. (1988). The addictive personality is the behavior of the addict. Journal of Consulting and Clinical Psychology, 56(2), 183-188.

Stick in the Buddhism: Mindfulness in the treatment of addiction and improved psychological wellbeing (Part 2)

Following on from my previous blog, here are some of my more recent papers with Dr. Edo Shonin and William Van Gordon on mindfulness that have been appearing on my Research Gate and Academia.edu webpages. We are happy for anyone interested in these papers to contact us at the email addresses below.

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Griffiths, M.D., Shonin, E.S., & Van Gordon, W. (2015). Mindfulness as a treatment for gambling disorder. Journal of Gambling and Commercial Gaming Research, 1, 1-6.

  • Mindfulness is a form of meditation that derives from Buddhist practice and is one of the fastest growing areas of psychological research. Studies investigating the role of mindfulness in the treatment of behavioural addictions have – to date – primarily focused on gambling disorder. Recent pilot studies and clinical case studies have demonstrated that weekly mindfulness therapy sessions can lead to clinically significant change among individuals with gambling problems. This purpose of this paper is to appraise current directions in gambling disorder research as it relates to mindfulness approaches, and discuss issues that are likely to hinder the wider acceptance of mindfulness as a treatment for gambling disorder. It is concluded that although preliminary findings indicate that there are applications for mindfulness approaches in the treatment of gambling disorder, further empirical and clinical research utilizing larger-sample controlled study designs is clearly needed.

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

  • Although clinical interest has predominantly focused on mindfulness meditation, interest into the clinical utility of Buddhist-derived loving-kindness meditation (LKM) and compassion meditation (CM) is also growing. This paper follows the PRISMA (preferred reporting items for systematic reviews and meta-analysis) guidelines and provides an evaluative systematic review of LKM and CM intervention studies. Five electronic academic databases were systematically searched to identify all intervention studies assessing changes in the symptom severity of Diagnostic and Statistical Manual of Mental Disorders (text revision fourth edition) Axis I disorders in clinical samples and/or known concomitants thereof in sub-clinical/healthy samples. The comprehensive database search yielded 342 papers and 20 studies (comprising a total of 1,312 participants) were eligible for inclusion. The Quality Assessment Tool for Quantitative Studies was then used to assess study quality. Participants demonstrated significant improvements across five psychopathology-relevant outcome domains: (i) positive and negative affect, (ii) psychological distress, (iii) positive thinking, (iv) interpersonal relations, and (v) empathic accuracy. It is concluded that LKM and CM interventions may have utility for treating a variety of psychopathologies. However, to overcome obstacles to clinical integration, a lessons-learned approach is recommended whereby issues encountered during the (ongoing) operationalization of mindfulness interventions are duly considered. In particular, there is a need to establish accurate working definitions for LKM and CM.

Shonin, E., Van Gordon W., & Griffiths M.D. (2014). The emerging role of Buddhism in clinical psychology: Towards effective integration. Psychology of Religion and Spirituality, 6, 123-137.

  • Research into the clinical utility of Buddhist-derived interventions (BDIs) has increased greatly over the last decade. Although clinical interest has predominantly focused on mindfulness meditation, there also has been an increase in the scientific investigation of interventions that integrate other Buddhist principles such as compassion, loving kindness, and “non-self.” However, due to the rapidity at which Buddhism has been assimilated into the mental health setting, issues relating to the misapplication of Buddhist terms and practices have sometimes arisen. Indeed, hitherto, there has been no unified system for the effective clinical operationalization of Buddhist principles. Therefore, this paper aims to establish robust foundations for the ongoing clinical implementation of Buddhist principles by providing: (i) succinct and accurate interpretations of Buddhist terms and principles that have become embedded into the clinical practice literature, (ii) an overview of current directions in the clinical operationalization of BDIs, and (iii) an assessment of BDI clinical integration issues. It is concluded that BDIs may be effective treatments for a variety of psychopathologies including mood-spectrum disorders, substance-use disorders, and schizophrenia. However, further research and clinical evaluation is required to strengthen the evidence-base for existent interventions and for establishing new treatment applications. More important, there is a need for greater dialogue between Buddhist teachers and mental health clinicians and researchers to safeguard the ethical values, efficacy, and credibility of BDIs.

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

  • This commentary provides an alternative perspective to some of the key arguments and observations outlined by Monteiro and colleagues (2015) concerning the relative deficiency of authenticity in secular mindfulness-based approaches compared with mainstream Buddhist practice traditions. Furthermore, this is achieved by critically examining the underlying assumption that if secular mindfulness-based approaches represent a more ‘superficial’ construction of mindfulness, then the ‘superior’ approach embodied by present-day Buddhist teachers and traditions should be easily identifiable. More specifically, a means of understanding mindfulness (and related Buddhist meditative principles) is presented that attempts to communicate the versatility and underlying unity of the Buddha’s teachings, and the fact that the scriptural, empirical, and logical grounds for asserting that secular mindfulness-based approaches offer a less authentic practice mode than mainstream Buddhist modalities are not as robust as contemporary general opinion might suggest.

Shonin, E., Van Gordon, W. & Griffiths, M.D. (2015). Does mindfulness work? Reasonably convincing evidence in depression and anxiety. British Medical Journal, 351, h6919 doi: 10.1136/bmj.h6919.

  • In 2014, over 700 scientific papers on mindfulness were published, which is more than double the amount of mindfulness papers published in 2010. Approximately 80% of adults and 70% of General Practitioners in the UK believe that practising mindfulness can lead to health benefits. The most convincing evidence exists for the use of mindfulness-based interventions (MBIs) in the treatment of depression and anxiety. Meta-analytic studies assessing the efficacy of mindfulness as a treatment for these two disorders have typically reported effect sizes in the moderate-strong to strong range. There is increasing evidence suggesting that mindfulness is an effective means of increasing perceptual distance from distressing psychological and somatic stimuli, and that it leads to functional neuroplastic changes in the brain. However, the aforementioned ‘fashionable’ status of mindfulness amongst both the general public and scientific community has likely overshadowed the need to address a number of key methodological and operational issues concerning its treatment efficacy.

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

Further reading

Griffiths, M.D., Shonin, E.S., & Van Gordon, W. (2015). Mindfulness as a treatment for gambling disorder. Journal of Gambling and Commercial Gaming Research, 1, 1-6.

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

Shonin, E.S., Van Gordon, W. & Griffiths, M.D. (2015). Mindfulness in psychology: A breath of fresh air? The Psychologist: Bulletin of the British Psychological Society, 28, 28-31.

Shonin, E.S., Van Gordon, W. & Griffiths, M.D. (2015). Teaching ethics in mindfulness-based interventions. Mindfulness, 6, 1491–1493.

Shonin, E., Van Gordon, W. & Griffiths, M.D. (2015). Does mindfulness work? Reasonably convincing evidence in depression and anxiety. British Medical Journal, 351, h6919 doi: 10.1136/bmj.h6919.

Shonin, E., Van Gordon, W., & Griffiths, M.D. (2016). Mindfulness and Buddhist-derived treatment techniques in mental health and addiction settings. In Shonin, E., Van Gordon, W., & Griffiths, M.D. (Eds.), Mindfulness and Buddhist-derived Approached in Mental Health and Addiction (pp. 1-6). New York: Springer.

Van Gordon, W., Shonin, E., Griffiths, M.D., & Singh. N.N. (2015). Mindfulness and the Four Noble Truths. In: Shonin, E., Van Gordon, W., & Singh, N. N. (Eds). Buddhist Foundations of Mindfulness. (pp. 9-27). New York: Springer.

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

Van Gordon, W., Shonin, E., & Griffiths, M.D. (2015). Can second generation of mindfulness-based interventions be helpful in treating psychiatric disorders? Australian and New Zealand Journal of Psychiatry, 49, 591-592.

Shonin, E., Van Gordon, W., & Griffiths, M.D. (2016), Mindfulness and Buddhist-derived Approaches in Mental Health and Addiction. New York: Springer.

Van Gordon, W., Shonin, E., Singh. N.N. & Griffiths, M.D. (2015). The mindfulness of emptiness and the emptiness of mindfulness. In: Shonin, E., Van Gordon, W., & Singh, N. N. (Eds). Buddhist Foundations of Mindfulness (pp. 159-179). New York: Springer.

Van Gordon, W., Shonin, E., & Griffiths, M.D. (2015). Mindfulness in mental health: A critical reflection. Journal of Psychology, Neuropsychiatric Disorders and Brain Stimulation, 1(1), 102.

Van Gordon, W., Shonin, E., & Griffiths, M.D. (2016). Are contemporary mindfulness-based interventions unethical? British Journal of General Practice, 66, 94-95.

Van Gordon, W., Shonin, E., & Griffiths, M.D. (2016). Meditation Awareness Training for individuals with fibromyalgia syndrome: An interpretative phenomenological analysis of participants’ experience. Mindfulness, in press.

Van Gordon, W., Shonin, E., & Griffiths, M.D. (2016). Buddhist emptiness theory: Implications for the self and psychology. Psychology of Religion and Spirituality, in press.

Van Gordon, W., Shonin, E., Cavalli, G. & Griffiths, M.D. (2016). Ontological addiction: Classification, aetiology and treatment. Mindfulness, in press.

Stick in the Buddhism: Mindfulness in the treatment of addiction and improved psychological wellbeing (Part 1)

Over the last year I’ve been receiving a lot of emails (well, about nine or ten to be honest but it seems like a lot) expressing surprise at the increasing numbers of papers on mindfulness that have been appearing on my Research Gate and Academia.edu webpages. This research program is actually being led by my friends and Nottingham Trent University research colleagues, Dr. Edo Shonin and Willliam Van Gordon. Given this increasing level of interest, I thought I would use my next two blogs to briefly overview some of these publications. My research colleagues and I are happy for anyone interested in these papers to contact us at the email addresses below. We also have a new book on the topic too (Mindfulness and Buddhist-derived Approaches in Mental Health and Addiction).

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Shonin, E., Van Gordon, W., & Griffiths M.D. (2014). Cognitive Behavioral Therapy (CBT) and Meditation Awareness Training (MAT) for the treatment of co-occurring schizophrenia with pathological gambling: A case study. International Journal of Mental Health and Addiction, 12, 806–823.

  • There is a paucity of interventional approaches that are sensitive to the complex needs of individuals with co-occurring schizophrenia and pathological gambling. Utilizing a single-participant design, this study conducted the first clinical evaluation of a novel and integrated non-pharmacological treatment for a participant with dual-diagnosis schizophrenia and pathological gambling. The participant underwent a 20-week treatment course comprising: (i) an initial phase of second-wave cognitive behavioral therapy (CBT), and (ii) a subsequent phase employing a meditation-based recovery model (involving the administering of an intervention known as Meditation Awareness Training). The primary outcome was diagnostic change (based on DSM-IV-TR criteria) for schizophrenia and pathological gambling. Secondary outcomes were: (i) psychiatric symptom severity, (ii) pathological gambling symptom severity, (iii) psychosocial functioning, and (iv) dispositional mindfulness. Findings demonstrated that the participant was successfully treated for both schizophrenia and pathological gambling. Significant improvements were also observed across all other outcome variables and positive outcomes were maintained at three-month follow-up. An initial phase of CBT to improve social coping skills and environmental mastery, followed by a phase of meditation-based therapy to increase perceptual distance from mental urges and intrusive thoughts, may be a diagnostically-syntonic treatment for co-occurring schizophrenia and pathological gambling.

Shonin, E., Van Gordon, W., & Griffiths M.D. (2014). The treatment of workaholism with Meditation Awareness Training: A case study. Explore: Journal of Science and Healing, 10, 193-195.

  • Recent decades have witnessed a marked increase in research investigating the etiology, typology, symptoms, prevalence, and correlates of workaholism. However, despite increasing prevalence rates for workaholism, there is a paucity of workaholism treatment studies. Indeed, guidelines for the treatment of workaholism tend to be based on either theoretical proposals or anecdotal reports elicited during clinical practice. Thus, there is a need to establish dedicated and effective treatments for workaholism. A novel broad-application interventional approach receiving increasing attention by occupational and healthcare stakeholders is that of third-wave cognitive behavioral therapies (CBTs). Third-wave CBTs integrate aspects of Eastern philosophy and typically employ a meditation-based recovery model. A primary treatment mechanism of these techniques involves the regulation of psychological and autonomic arousal by increasing perceptual distance from faulty thoughts and mental urges. A ‘meditative anchor’, such as observing the breath, is typically used to aid concentration and to help maintain an open-awareness of present moment sensory and cognitive-affective experience. The purpose of this case study was to conduct the first evaluation of a treatment employing a meditation-based recovery model for a workaholic.

Shonin, E.S., van Gordon, W. & Griffiths, M.D. (2013). Buddhist philosophy for the treatment of problem gambling. Journal of Behavioral Addictions, 2, 63-71.

  • In the last five years, scientific interest into the potential applications of Buddhist-derived interventions (BDIs) for the treatment of problem gambling has been growing. This paper reviews current directions, proposes conceptual applications, and discusses integration issues relating to the utilisation of BDIs as problem gambling treatments. A literature search and evaluation of the empirical literature for BDIs as problem gambling treatments was undertaken. To date, research has been limited to cross-sectional studies and clinical case studies and findings indicate that Buddhist-derived mindfulness practices have the potential to play an important role in ameliorating problem gambling symptomatology. As an adjunct to mindfulness, other Buddhist-derived practices are also of interest including: (i) insight meditation techniques (e.g., meditation on ‘emptiness’) to overcome avoidance and dissociation strategies, (ii) ‘antidotes’ (e.g., patience, impermanence, etc.) to attenuate impulsivity and salience-related issues, (iii) loving-kindness and compassion meditation to foster positive thinking and reduce conflict, and (iv) ‘middle-way’ principles and ‘bliss-substitution’ to reduce relapse and temper withdrawal symptoms. In addition to an absence of controlled treatment studies, the successful operationalisation of BDIs as effective treatments for problem gambling may be impeded by issues such as a deficiency of suitably experienced BDI clinicians, and the poor provision by service providers of both BDIs and dedicated gambling interventions. Preliminary findings for BDIs as problem gambling treatments are promising, however, further research is required.

Shonin, E.S., van Gordon, W., Slade, K. & Griffiths, M.D. (2013). Mindfulness and other Buddhist-derived interventions in correctional settings: A systematic review. Aggression and Violent Behavior, 18, 365-372.

  • Throughout the last decade, there has been a growth of interest into the rehabilitative utility of Buddhist-derived interventions (BDIs) for incarcerated populations. The purpose of this study was to systematically review the evidence for BDIs in correctional settings. MEDLINE, Science Direct, ISI Web of Knowledge, PsychInfo, and Google Scholar electronic databases were systematically searched. Reference lists of retrieved articles and review papers were also examined for any further studies. Controlled intervention studies of BDIs that utilised incarcerated samples were included. Jaded scoring was used to evaluate methodological quality. PRISMA (preferred reporting items for systematic reviews and meta-analysis) guidelines were followed. The initial comprehensive literature search yielded 85 papers but only eight studies met all the inclusion criteria. The eight eligible studies comprised two mindfulness studies, four vipassana meditation studies, and two studies utilizing other BDIs. Intervention participants demonstrated significant improvements across five key criminogenic variables: (i) negative affective, (ii) substance use (and related attitudes), (iii) anger and hostility, (iv) relaxation capacity, and (v) self-esteem and optimism. There were a number of major quality issues. It is concluded that BDIs may be feasible and effective rehabilitative interventions for incarcerated populations. However, if the potential suitability and efficacy of BDIs for prisoner populations is to be evaluated in earnest, it is essential that methodological rigour is substantially improved. Studies that can overcome the ethical issues relating to randomisation in correctional settings and employ robust randomised controlled trial designs are favoured.

Shonin, E., Van Gordon, W., & Griffiths M.D. (2014). Mindfulness meditation in American correctional facilities: A ‘what-works’ approach to reducing reoffending. Corrections Today: Journal of the American Correctional Association, March/April, 48-51.

  • Throughout the last decade, there has been a growth of interest into the rehabilitative utility of Buddhist-derived interventions (BDIs) for incarcerated populations. The purpose of this study was to systematically review the evidence for BDIs in correctional settings. MEDLINE, Science Direct, ISI Web of Knowledge, PsychInfo, and Google Scholar electronic databases were systematically searched. Reference lists of retrieved articles and review papers were also examined for any further studies. Controlled intervention studies of BDIs that utilised incarcerated samples were included. Jaded scoring was used to evaluate methodological quality. PRISMA (preferred reporting items for systematic reviews and meta-analysis) guidelines were followed. The initial comprehensive literature search yielded 85 papers and but only eight studies met all the inclusion criteria. The eight eligible studies comprised two mindfulness studies, four vipassana meditation studies, and two studies utilizing other BDIs. Intervention participants demonstrated significant improvements across five key criminogenic variables: (i) negative affective, (ii) substance use (and related attitudes), (iii) anger and hostility, (iv) relaxation capacity, and (v) self-esteem and optimism. There were a number of major quality issues. It is concluded that BDIs may be feasible and effective rehabilitative interventions for incarcerated populations. However, if the potential suitability and efficacy of BDIs for prisoner populations is to be evaluated in earnest, it is essential that methodological rigour is substantially improved. Studies that can overcome the ethical issues relating to randomisation in correctional settings and employ robust randomised controlled trial designs are favoured.

Contact details

e.shonin@awaketowisdom.co.ukwilliam@awaketowisdom.co.ukmark.griffiths@ntu.ac.uk

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

Additional input by Edo Shonin and William Van Gordon

Further reading

Shonin, E.S., van Gordon, W. & Griffiths, M.D. (2012). The health benefits of mindfulness-based interventions for children and adolescents, Education and Health, 30, 94-97.

Shonin, E.S., van Gordon, W. & Griffiths, M.D. (2013). Mindfulness-based interventions: Towards mindful clinical integration. Frontiers in Psychology, 4, 194, doi: 10.3389/fpsyg.2013.00194.

Shonin, E.S., van Gordon, W. & Griffiths, M.D. (2013). Buddhist philosophy for the treatment of problem gambling. Journal of Behavioral Addictions, 2, 63-71.

Shonin, E.S., van Gordon, W. & Griffiths, M.D. (2013). Meditation as medication: Are attitudes changing? British Journal of General Practice, 617, 654-654.

Shonin, E., Van Gordon, W. & Griffiths, M.D. (2013). Mindfulness and addiction: Sending out an SOS. Addiction Today, March, 18-19.

Shonin, E., Van Gordon, W. & Griffiths, M.D. (2013). Mindfulness-based therapy: A tool for spiritual growth? Thresholds, Summer, 14-18.

Shonin, E.S., van Gordon, W. & Griffiths, M.D. (2014). Practical tips for using mindfulness in general practice. British Journal of General Practice, 624 368-369.

Shonin, E.S., van Gordon, W. & Griffiths, M.D. (2014). Meditation Based Awareness Training (MBAT) for psychological wellbeing: A qualitative examination of participant experiences. Journal of Religion and Health, 53, 849–863.

Shonin, E., Van Gordon, W., & Griffiths M.D. (2014). Mindfulness meditation in American correctional facilities: A ‘what-works’ approach to reducing reoffending. Corrections Today: Journal of the American Correctional Association, March/April, 48-51.

Shonin, E., Van Gordon, W., & Griffiths M.D. (2014). Does mindfulness meditation have a role in the treatment of psychosis? Australian and New Zealand Journal of Psychiatry, 48, 124-127.

Shonin, E., Van Gordon W., & Griffiths M.D. (2014). The emerging role of Buddhism in clinical psychology: Towards effective integration. Psychology of Religion and Spirituality, 6, 123-137.

Shonin, E., Van Gordon, W., & Griffiths M.D. (2014). The treatment of workaholism with Meditation Awareness Training: A case study. Explore: Journal of Science and Healing, 10, 193-195.

Shonin, E.S., Van Gordon, W. & Griffiths, M.D. (2014). Mindfulness and the Social Media, Mass Communication and Journalism, 4: 194. doi: 10.4172/2165-7912.1000194.

Shonin, E., Van Gordon, W., & Griffiths M.D. (2014). Cognitive Behavioral Therapy (CBT) and Meditation Awareness Training (MAT) for the treatment of co-occurring schizophrenia with pathological gambling: A case study. International Journal of Mental Health and Addiction, 12, 181-196.

Shonin, E., Van Gordon, W., & Griffiths, M.D. (2016), Mindfulness and Buddhist-derived Approaches in Mental Health and Addiction. New York: Springer.

Shonin, E.S., van Gordon, W., Slade, K. & Griffiths, M.D. (2013). Mindfulness and other Buddhist-derived interventions in correctional settings: A systematic review. Aggression and Violent Behavior, 18, 365-372.

Shonin, E., Van Gordon W., & Griffiths, M.D. (2014). Are there risks associated with using mindfulness for the treatment of psychopathology? Clinical Practice, 11, 389-392.

Van Gordon, W. Shonin, E.S., Skelton, K. & Griffiths, M.D. (2014). Working mindfully: Can mindfulness improve work-related wellbeing and work? Counselling at Work, 87, 14-19.

Van Gordon, W., Shonin, E., Sumich, A., Sundin, E., & Griffiths, M.D. (2014). Meditation Awareness Training (MAT) for psychological wellbeing in a sub-clinical sample of university students: A controlled pilot study. Mindfulness, 12, 806–823.

Target practice: The psychology of New Year’s resolutions and how to keep them

(Please note: This blog is a slightly extended and fully referenced version of an article that was first published in The Conversation).

Academic research by Dr. John Norcross and his colleagues has shown that up to 50% of adults make New Year’s resolutions (NYRs) and the most common resolutions are wanting to lose weight, doing more exercise, quitting smoking, and saving money. It’s a time that individuals want to re-invent themselves but less than 10% actually manage to keep the NYRs after a few months.

We’ve all made NYRs that we begin with the best of intentions but within a few weeks are back to our old ways. As a Professor of Behavioural Addiction I know how easy people can fall into bad habits, and why on trying to give up those habits is easy to relapse. NYRs usually come in the form of lifestyle changes and changing behaviour that has become routine and habitual (even if they are not problematic) can be very hard to break.

The main reason that people don’t stick to their NYRs is that they set too many and/or they are unrealistic to achieve. There has also been some research by Dr. Janet Polivy and Dr. Peter Herman into ‘false hope syndrome’ (FHS) that is applicable to NYRs. FHS is characterized by an individual’s unrealistic expectations about the likely speed, amount, ease, and consequences of changing their behaviour.

For some people, it takes something radical for them to change their ways. It took a medical diagnosis to make me give up alcohol and caffeine, and it took pregnancy for my partner to give up cigarette smoking. To change your day-to-day behaviour you also have to change your thinking. But there are tried and tested ways that can help individuals stick to their NYRs and here are my personal favourites:

Be realistic You need to begin by making NYRs that you can keep and that are practical. If you want to reduce your alcohol intake because you tend to drink alcohol every day, don’t immediately go teetotal. Try to cut out alcohol every other day or have a drink once every three days. Also, breaking up the longer-term goal into more manageable short-term goals can also be beneficial and more rewarding. The same principle can be applied to exercise or eating more healthily.

Do one thing at a time One of the easiest ways routes to failure is to have too many NYRs. If you want to be fitter and healthier, do just one thing at a time. Give up drinking. Give up smoking. Join a gym. Eat more healthily. But don’t do them all at once. Chose just one and do your best to stick to it. Once you have got one thing under your control, you can begin a second resolution.

Be SMART Anyone working in a jobs that includes objective-setting will know that any goal should be SMART (i.e., specific, measurable, achievable, realist and time-bound). NYRs should be no different. Cutting down alcohol drinking is an admirable goal but it’s not SMART. Drinking no more than two units of alcohol every other day for one month is a SMART resolution. Connecting the NYR to a specific aspirational goal can also be motivating (e.g., dropping a dress size or losing two inches off your waistline in time for the next summer holiday).

Tell someone your resolution(s) Letting family and friends around you know that you have a NYR that you really want to keep will act as both a safety barrier and a face-saver. If you really want to cut down smoking or drinking, real friends will not put temptation in your way and can help you in monitoring your day-to-day behaviour. Never be afraid to ask for help and support from those around you.

Change your behaviour with others – Trying to change habitual behaviour on your own can be difficult. For instance, if you and your partner both smoke, drink and/or eat unhealthily, it is really hard for one partner to change their behaviour if the other is still engaged in the same old bad habits. By having the same NYR (e.g., going on a diet), the chances of success will improve if you are both in it together.

Behavioural change isn’t limited to the New Year Changing your behaviour (or some aspect of it) doesn’t have to be restricted to the start of the New Year. It can be anytime.

Accept lapses as part of the process – It is inevitable that when trying to give up something (alcohol, cigarettes, junk food) that there will be lapses. You shouldn’t feel guilty about giving in to your cravings but accept that it is part of the learning process in enabling behavioural change. Bad habits can take years to become engrained and there are no quick fixes in making major lifestyle changes. These may be clichés but we learn by our mistakes and every day is a new day and you can start each day afresh. Right here. Right now.

Finally, some of you reading this might think all of this sounds like too much hard work and that it’s not worth making NYRs to begin with. However, research by John Norcross and colleagues has also shown that individuals who make NYRs are ten times more likely to achieve their goals than those that don’t make explicit NYRs. Food for thought (rather than thought for food)!

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

Further reading

Koestner, R. (2008). Reaching one’s personal goals: A motivational perspective focused on autonomy. Canadian Psychology/Psychologie Canadienne, 49(1), 60-67.

Marlatt, G. A., & Kaplan, B. E. (1972). Self-initiated attempts to change behavior: A study of New Year’s resolutions. Psychological Reports, 30(1), 123-131.

Norcross, J. C. (2006). Integrating self-help into psychotherapy: 16 practical suggestions. Professional Psychology: Research and Practice, 37(6), 683-693.

Norcross, J. C., & Mrykalo, M. S. (2002). Auld Lang Syne: Success predictors, change Processes, and self-reported outcomes of New Year’s resolvers and nonresolvers. Journal of Clinical Psychology, 58, 397-405.

Norcross, J. C., Ratzin, A. C., & Payne, D. (1989). Ringing in the New Year: The change processes and reported outcomes of resolutions. Addictive Behaviors, 14(2), 205-212.

Norcross, J. C., & Vangarelli, D. J. (1989). The resolution solution: longitudinal examination of New Year’s change attempts. Journal of Substance Abuse, 1(2), 127-134.

Polivy, J. (2001). The false hope syndrome: Unrealistic expectations of self-change. International Journal of Obesity and Related Metabolic Disorders, 25, S80-84.

Polivy, J., & Herman, C. P. (2000). The False-Hope Syndrome Unfulfilled Expectations of Self-Change. Current Directions in Psychological Science, 9(4), 128-131.

Polivy, J., & Herman, C. P. (2002). If at first you don’t succeed: False hopes of self-change. American Psychologist, 57(9), 677-689.

Beating the habit: A brief look at ‘cane therapy’ as a treatment for addiction

In 2014, I was the resident psychologist on 12-episode television series called Forbidden made for the Discovery Channel. One of the strangest stories that the series reported on was ‘cane therapy’ for the ‘Twisted Treatments’ episode. Before I was interviewed for the story, I had to research the story and was also given some production notes as background material. According to the material I was provided with: 

Caning treatment was pioneered in Siberia by Dr Sergei Speransky a biologist from the Novosibirsk Institute of Medicine who together with Dr Marina Chuhrova released a research report in 2005 on whipping as a therapy. Dr Speransky and Dr Chukhrova developed the medical theory behind caning. Importantly Dr Chukhrova notes that, ‘It is not some warped sado-masochistic activity,’ but has a clear medical purpose. Apparently, there are some sound scientific principles behind these beatings. Namely the theory that pain activates the body’s immune system, causing it to perform much more effectively than under ‘normal circumstances.’ Dr Chukhrova taught [Dr. German Pilipenko] the theory as a student at university and controversially he has taken her theory and put it into practice, combining it with his own unique psychology treatment. 50-year old German Pilipenko has been caning people for nine years. In his spare time German enjoys the blissful serenity of mountain skiing in his local town. But in his professional life German has to bear the yelps, tears and groans of his patients – German canes and whips people for a living. German started to practice cane therapy in a medical clinic in 2004. Though the clinic no longer exists he’s continued the controversial practice as a private psychologist in a rented 14 square meter room in Novosibirsk’s Business Centre”.

Dr. Pilipenko is a psychotherapist and a hypnotist and claims that cane therapy can cure addictions (both chemical addictions such as alcohol and other drug addictions, and behavioural addictions such as sex addiction and work addiction), depression, phobias and neuroses. Along with Dr. Chukhrova, they have successfully treated over 1000 individuals (aged between 17 and 70 years) of their problems. The therapy appears to be arguably similar to primal therapy (which I briefly examined in a previous blog) and according to Pilipenko can be used as a kind of anti-stress injection”. Via intense caning sessions Pilipenko not only draws physical pain from his clients but also their emotional reactions. It is the release of these emotions (as with primal therapy) is what he believes cures his patients of their addictions, stresses, depression, and anxieties. (If you are a journalist or an artist he offers the therapy free as a way of promoting his therapeutic practice). For the television programme, one of Dr. Pilipenko’s female clients (Anzhelika Alexeyev, a 22-year old, fifth-year medical student) was interviewed. The production notes I was given noted:

“Anzhelika is only at the beginning of her life, but she’s already experienced hardship and emotional difficulties. Receiving a beating from Dr Pilipenko has been her solution. She’s already visited him once but German believes there is more work to be done. [The programme will] follow Anzhelika through pain and tears as she returns for more caning. She also introduces her father to the treatment and we see her bring him for a session…Her first caning experience was at the start of [the] year…Anzhelika had been suffering stress after miraculously surviving a car crash. German’s advice was that ‘she really needed a lashing.’ She agreed. Initially at the start of the session Anzhelika wanted to leave. She suffered through the first beating in tears, though she persisted, knowing the pain was temporary. She believes the treatment has been successful in curing her trauma and stress related to the accident. In fact she is a big supporter of German’s caning and believes it helps to get rid of emotions that are deeply hidden, unacknowledged and out of control”.

Many newspaper reports have covered the ‘therapy’ over the last few years but nothing has been published on it in peer-reviewed scientific journals. According to one report on the Alternet news site:

“Practitioners Dr. German Pilipenko and Professor Marina Chukhrova say that their treatment is grounded in science: ‘We cane the patients on the buttocks with a clear and definite medical purpose’…The pair say that addicts suffer from a lack of endorphins, and that pain can stimulate the brain to release the feel-good chemicals, ‘making patients feel happier in their own skins.’ Mainstream doctors dismiss the practice, saying that exercise, acupuncture, massage, chocolate or sex are all better at stimulating endorphin secretion. Dr. Pilipenko admits, ‘we get a lot of skepticism…but so do all pioneers.’ The Siberian Times reports that ‘the reaction of most people is predictable: to snigger, scoff or make jokes loaded with sexual innuendo.’ And one recipient of the treatment, 41-year-old recovering alcoholic Yuri, says his girlfriend accused him of simply visiting a dominatrix. But he adds that although ‘the first strike was sickening…Somehow I got through all 30 lashes. The next day I got up with a stinging backside but no desire at all to touch the vodka in the fridge. The bottle has stayed there now for a year’.”

The Alternet story also interviewed another patient (Natasha, a 22-year-old recovering heroin addict with several months clean) who had been paying $100 for a two-hour session and claimed:

“I am the proof that this controversial treatment works, and I recommend it to anyone suffering from an addiction or depression. It hurts like crazy – but it’s given me back my life…With each lash, I scream and grip tight to the end of the surgical table. It’s a stinging pain, real agony, and my whole body jolts…I’m not a masochist. My parents never beat me or even slapped me, so this was my first real physical pain and it was truly shocking. If people think there’s anything sexual about it, then it’s nonsense.”

The article reported that Natasha had received 60 strokes of the cane per session (noting that drug addicts get double the number of lashes than alcoholics). Professor Chukhrova was then quoted as saying that extreme care is taken to ensure patient safety, and that:

“The beating is really the end of the treatment. We do a lot of psychological counseling first, and also use detox. It is only after all the counseling, and heart and pain resistance checks, that we start with the beating. [We use willow branches because they] are flexible and can’t be broken nor cause bleeding…If any patients get sexual pleasure from the beatings, we stop immediately…This is not what our treatment is about. If they’re looking for that, there are plenty of other places to go.” 

According to Dr Pilipenko, the unusual combination of psychology and corporal-style punishment is designed to train patients in endurance, tolerance and resistance as ways of coping with stress. Pilipenko believes he provides his clients with the tools to deal with stress and problems in their lives. More specifically he claims that:

Psychological stimulation is aimed to convince a patient that aggression, idleness and depression will cause problems in life…Usually a patient is prescribed three separate visits, before they can be cured but it might be necessary for anything up to 10 sessions, depending on the severity of the individual case”.

Dr. Pilipenko also claims that cane therapy that was practiced by monks in the Middle Ages. However, I also noted that following each caning, his clients receive both psychotherapy and hypnotherapy. This begs the question as to whether it is these additional forms of intervention that are key to therapeutic success rather than the caning in and of itself.

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

Further reading

Alternet (2013). Weird science: Siberian psychologists caning patients “on the buttocks” in new addiction treatment. January 7. Located at: http://www.alternet.org/weird-science-siberian-psychologists-caning-patients-buttocks-new-addiction-treatment

Daily News (2014). Russian patients pay therapists to cane them in bizarre treatment. October 2. Located at: http://www.nydailynews.com/life-style/russian-patients-pay-therapists-cane-article-1.1960979

Siberian Times (2013). Beating the addiction out of you – literally. January 7. Located at: http://siberiantimes.com/other/others/features/beating-addiction-out-of-you-literally/

Stewart, W. (2013). How to beat your demons, literally: Siberian psychologists thrash patients with sticks to help them kick their addictions. Daily Mail, January 7. Located at: http://www.dailymail.co.uk/news/article-2258395/How-beat-addictions-literally-Siberian-psychologists-thrash-patients-sticks-help-kick-habits.html

Good buy to love: Introducing the Bergen Shopping Addiction Scale

(Please note that the following article was co-written using material provided by my research colleague Dr. Cecilie Schou Andreassen and our fellow researchers).

In two of my previous blogs I took a brief look at the area of shopping addiction (that you can read here and here). Since writing those blogs I’ve co-written a few papers on compulsive buying and shopping addiction (see ‘Further reading’ below), the latest of which was published in the journal Frontiers in Psychology (FiP) and led by my friend and research colleague Dr. Cecilie Schou Andreassen at the University of Bergen in Norway. In the FiP paper we reported on the development of a newly created instrument to assess this disorder called the Bergen Shopping Addiction Scale (BSAS).

Whether compulsive and excessive shopping represents an impulse-control, obsessive-compulsive or addictive disorder has been debated for several years This fact is reflected in the many names that have been given to this disorder including ‘oniomania’, ‘shopaholism’, ‘compulsive shopping’, ‘compulsive consumption’, ‘impulsive buying’, “compulsive buying’ and ‘compulsive spending’. In a review by Dr. Andreasson in the Journal of Norwegian Psychological Association, she argued that shopping disorder is best understood from an addiction perspective, and defined it as “being overly concerned about shopping, driven by an uncontrollable shopping motivation, and to investing so much time and effort into shopping that it impairs other important life areas”. Several authors (including myself) share this view as a growing body of research shows that those with problematic shopping behaviour report specific addiction symptoms such as craving, withdrawal, loss of control, and tolerance.

Research also suggests that the typical shopping addict is young, female, and of lower educational background. Some personality factors have also been shown to be associated with shopping addiction including extroversion and neuroticism. It has been suggested that neurotic individuals (typically being anxious, depressive, and self-conscious) may use shopping as means of reducing their negative emotional feelings. Other personality factors may actually protect individuals from developing shopping addictions (e.g., conscientiousness). Empirical research (including some research I carried out with Kate Davenport and James Houston published in a 2012 issue of the International Journal of Mental Health and Addiction) has consistently reported significantly lower levels of self-esteem among shopping addicts. Such findings suggest that irrational beliefs such as “buying a product will make life better” and “shopping this item will enhance my self-image” may trigger excessive shopping behaviour in people with low self-esteem. However, this may be related to depression, which has been shown to be highly comorbid with problematic shopping.

Other factors, such as anxiety have also often been associated with shopping, and it has also been suggested that self-critical people shop in order to escape, or cope with, negative feelings. In addition, shopping addiction has also been explained (by such people as Dr. Marc Potenza and Dr. Eric Hollander) as a way of regulating neurochemical (e.g., serotonergic, dopaminergic, opioid) abnormalities and has been successfully treated with pharmacological agents, including selective serotonin reuptake inhibitors (SSRIs) and opioid antagonists.

One of the key problems that we outlined in our new FiP paper is that in prior research there is a lack of a common understanding about how problematic shopping should be defined, conceptualized, and measured. Consequently, there are huge disparities and unreliable prevalence estimates of shopping addiction ranging from 1% to 20% and beyond (depending upon the criteria used to assess the disorder). Although several scales for assessing shopping addiction have been developed (mainly in the late 1980s and early 1990s) many of them have poor theoretical anchoring and/or are primarily rooted within the impulse-control paradigm. We also argued that several items of existing scales are outdated with regards to modern consumer patterns (such as people using cheques or no reference to online shopping). Newer scales that have been developed don’t view problematic shopping behaviour as an addiction in terms of core addiction criteria (i.e., salience, mood modification, tolerance, withdrawal, conflict, relapse and resulting problems).

This is why we decided to develop a new shopping addiction scale (i.e., the BSAS) containing a small number of items that reflect the core elements of addiction (and if you want to take the test yourself, it’s at the end of this article). We examined the psychometric properties of the new scale among a large sample of Norwegian individuals (n=23,537), and the testing phase began with 28 items (four statements for each of the seven components of addiction outlined above). The BSAS was constructed simply by taking the highest scoring item from each of seven 4-item clusters. We found that scores on the BSAS were significantly higher among females, as well as being inversely related to age (and therefore in line with previous research). We also found that scores on the BSAS were positively associated with extroversion and neuroticism.

The association of shopping addiction with extroversion may reflect that, in general, extroverts need more stimulation than non-extroverted individuals, a notion that is in line with studies showing that extroversion is associated with addictions more generally. It may also reflect the notion that extroverts purchase specific types of products excessively as a means to express their individuality, enhance personal attractiveness, or as a way to belong to a certain privileged group a (e.g., the buying of high end luxury goods). The association of shopping addiction with neuroticism may be because neuroticism is a general vulnerability factor for the development of psychopathology and that people scoring high on neuroticism engage excessively in different behaviours in order to escape from dysphoric feelings.

We also found that shopping addiction was inversely related to self-esteem. This is also in line with the findings of previous studies and implies that some individuals shop excessively in order to obtain higher self-esteem (e.g., associated “rub-off” effects from high status items such as popularity, compliments, in-group ‘likes’, omnipotent feelings while buying items, attention during the shopping process from helping retail personnel), to escape from feelings of low self-esteem, or that shopping addiction lowers self-esteem. Obviously our new scale needs to be further evaluated in future studies (as it has only been investigated in this one study) and it also requires validation in other cultures.

Overall, we concluded that the BSAS has good psychometrics – basically the scale is quick to administer, reliable and valid. With the advent of new technology and modern consumer patterns we may be witnessing an increase in problematic shopping behaviour. It is likely that new Internet-related technologies can greatly facilitate the emergence of problematic shopping behaviour because of factors such as accessibility, affordability, anonymity, convenience, and disinhibition. Therefore, we encourage other researchers to consider using the BSAS in epidemiological studies and treatment settings.

Want to take the test?  

Answer each of the following questions with one of the following five responses: ‘completely disagree’, ‘disagree’, ‘neither disagree nor agree’, ‘agree’, and ‘completely agree’.

  • You think about shopping/buying things all the time
  • You shop/buy things in order to change your mood
  • You shop/buy so much that it negatively affects your daily obligations (e.g., school and work)
  • You feel you have to shop/buy more and more to obtain the same satisfaction as before.
  • You have decided to shop/buy less, but have not been able to do so
  • You feel bad if you for some reason are prevented from shopping/buying things
  • You shop/buy so much that it has impaired your well-being

If you answer “agree” or “completely agree” on at least four of the seven items, you may be a shopping addict.

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

Further reading

Aboujaoude, E. (2014). Compulsive buying disorder: A review and update. Current Pharmaceutical Design, 20, 4021-4025.

Andreassen, C. S. (2014). Shopping addiction: An overview. Journal of Norwegian Psychological Association, 51, 194–209.

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

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

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

McQueen, P., Moulding, R., & Kyrios, M. (2014). Experimental evidence for the influence of cognitions on compulsive buying. Journal of Behavior Therapy and Experimental Psychiatry, 45, 496–501.

Workman, L., & Paper, D. (2010). Compulsive buying: A theoretical framework. Journal of Business Inquiry, 9, 89–126.