One idle evening I was surfing the net looking for blog ideas when I came across a November 2011 article by David Reinstein entitled “Egomania: An adaptive and necessary illness for politicians”. Given that some individuals have described me as an egomaniac over the years, and the fact that I am academically interested in manias and personally interested in politics, I couldn’t help but want to read the article (which I’ll come to in a minute).
There are countless definitions of egomania all of which have considerable overlaps. Reinstein’s article defines it as “an obsessive (driven, constant and uncontrollable) preoccupation with the self” (which pretty much hits the nail on the head as far as I am concerned). Other definitions often mention things like ‘an irresistible love of the self’ and ‘an obsessive concern for one’s own needs’ that again are again how I would define it myself. Dr. Andrew Colman in The Oxford Dictionary of Psychology defines it as ““a pathological love for, or preoccupation with, oneself”. The Wikipedia entry is a bit more long-winded:
“Egomania is an obsessive preoccupation with one’s self and applies to someone who follows their own ungoverned impulses and is possessed by delusions of personal greatness and feels a lack of appreciation. Someone suffering from this extreme egocentric focus is an egomaniac. The condition is psychologically abnormal. The term egomania is often used by laypersons in a pejorative fashion to describe an individual who is intolerably self-centred”.
Egomaniacs are typically characterized as individuals who believe the ‘whole world revolves around them’ and that they are ‘the centre of the universe’. Reinstein also claims in his article that “most egomaniacs suffer from delusions of personal greatness that cover over deeper feelings of inadequacy and insecurity. Everything is to, from, for and about them”. (And on that definition I would certainly rule out myself as being an egomaniac). Egomania also seems to be a close cousin of megalomania (i.e., a disorder in which individuals believe they are more powerful, important, or influential than is actually true – and a possible contender for a future blog!).
Egomania is not listed in the most recent (fourth) version of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders [DSM-IV] (and as far as I an aware it won’t be in the next one either). However, many people believe that egomania is highly prevalent particularly among celebrities and politicians (and is something that at the very least has good face validity). In fact I read a 2011 article in Variety magazine by Peter Bart arguing that it was a “close call” as to whether egomania was a mental illness. However, we appear to tolerate (and arguably even value) egomania if the person is a politician rather than someone we personally know. As Reinstein notes:
“Why would we be so prone to accept this otherwise off-putting quality in the people we elect to represent us? One possible explanation comes immediately to mind. Many people in the general population have reservations about themselves. Perhaps we are drawn to people who seem to be (or at least present themselves as being) more self-assured. People who seem more capable, more assured and assuring, more in control and consistently authoritative may appeal to the electorate as they often do to the movie-going public”.
Again, these assertions appear to have good face validity as we are hardly going to vote for someone who doesn’t come across as confident and cocksure. As a casual observer of American politics, I didn’t give a damn about Bill Clinton’s infidelities. All I would be bothered about if I was an American voter is whether he can do the job (which personally I think he did). From a more psychological standpoint, Gretchen Reevy’s 2011 Encyclopedia of Emotion notes that egomaniacs may perhaps be suffering from Narcissistic Personality Disorder (NPD) as individuals with NPD are incredibly self-centred and appear to match the criteria for being an egomaniac (although NPD is often linked more with megalomania than egomania). Such individuals also have ‘disordered relationships’. Reinstein argued in his article that he couldn’t think of anyone in American politics whether they were running for the presidency or running for Congress that wouldn’t meet the criteria for NPD. As he argues:
“How could someone not afflicted with a substantial dose of Egomania ever consider themselves to be worthy of being elected to such an office? The roles, their responsibilities, trappings and perquisites tend to attract such people. They may not always be the ‘best’ that we have, but their egos are never significantly deficient! Thus, our culture seems to require some egomaniacs. To entertain us and to lead us. It is probably not a coincidence that many entertainers have found their way into major political jobs”
I am presuming here that Reinstein is referring to (among others) Ronald Reagan, Arnold Schwarzenegger, Clint Eastwood, Jesse Ventura, and Sonny Bono. Here in the UK, we have similar (if not such high profile) examples including Glenda Jackson, Andrew Faulds, and Michael Cashman. In the Encyclopedia of Emotion also notes that:
“Narcissistic personality disorder affects less than 1 percent of the population (American Psychiatric Association, 2000). The cause of the disorder is unknown; the two most accepted theories are contradictory. Some theorists (e.g., Wink, 1996) say that narcissism begins with cold, rejecting parents. The child then creates the self- absorption and grandiosity as a defense against feelings of worthlessness. Others (e.g., Sperry, 2003) argue that people who become adult narcissists were spoiled as children and were taught by their parents that they were superior and special. Thus far, treatment of narcissistic personality disorder is of limited success”.
To be diagnosed with NPD an individual must show at least five of the following characteristics (although it’s worth noting that NPD is being removed from the new DSM-V). This version was taken from Sarah Myers article on ‘manic behaviour’:
- A grandiose sense of self-importance: Egomaniacs exaggerate their achievements and talents, and want other people to recognise them as superior.
- Preoccupation with success and power: Egomaniacs are obsessed with fantasies involving their own brilliance or beauty.
- Arrogance: Egomaniacs’ behaviour is haughty, their attitude conceited and they show rage when frustrated, contradicted, or confronted.
- Need for excessive admiration: Egomaniacs need attention, they want to be adored or, failing that, feared.
- A sense of entitlement: Egomaniacs have unreasonable expectations and believe they deserve favourable treatment.
- Exploitative: Egomaniacs are happy to take advantage of others and use people to get what they want.
- Lack of empathy: Egomaniacs can’t and/or won’t acknowledge other people’s feelings.
- A belief of being unique: Egomaniacs believe that they’re special and can only be understood by and associate with people of high status.
- Feel envy towards others: Egomaniacs believe others feel envious of them.
Myers’ article claims approximately six million people across the world have NPD (and thankfully, having completed the diagnostic test above, I’m not one of them). However, Myers claims that there are many more undiagnosed (as such people are unlikely to think there is anything wrong with them). The Encyclopedia of Emotion notes that:
“Underneath the apparent over-confidence and bravado [of an egomaniac] lies a fragile personality. The narcissistic individual actually fears that he is unworthy or a fraud. His self-esteem may be highly dependent on being recognized as the best or perfect. For instance, he may believe that he is the best salesperson in his office, and if another individual wins the salesperson award, the narcissistic person will react with extreme humiliation. He has grandiose fantasies of boundless success or power or perfect love. He is jealous of those whom he perceives as being more successful in these areas that are valued. Be- cause of the extreme insecurity, the narcissistic person often seeks attention and fishes for compliments”.
After my own brief look at some of the literature on egomania, I am now 100% confident that I am not an egomaniac (although that doesn’t mean I don’t have a big ego).
Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
Bart, P. (2011). Egomania or mental illness: A close call. Variety, March 7. Located at: http://www.variety.com/article/VR1118033402
Myers, S. (2007). Manic behaviour. Channel 4 Health. November 1. Located at: http://www.channel4.com/health/microsites//0-9/4health/mind/wwr_manic.html
Parker, Pope, T. (2010). Narcissism no longer a psychiatric disorder. New York Times, November 29. Located at: http://well.blogs.nytimes.com/2010/11/29/narcissism-no-longer-a-psychiatric-disorder/
Reevy, G. (2011). Encyclopedia of Emotion. Oxford: Greenwood.
Reinstein, D.A. (2011). Egomania: An Adaptive and Necessary Illness for Politicians. Yahoo! Voices, November 11. Located at: http://voices.yahoo.com/egomania-adaptive-necessary-10348579.html?cat=5
Sperry, L. (2003). Handbook of Diagnosis and Treatment of DSM-IV-TR Personality Disorders (2nd ed.). New York: Brunner-Routledge.
Wikipedia (2012). Egomania. Located at: http://en.wikipedia.org/wiki/Egomania
Wikipedia (2012). Narcissistic personality disorder. Located at: http://en.wikipedia.org/wiki/Narcissistic_personality_disorder
Wink, P. (1996). Narcissism. In C.G. Costello (Ed.), Personality characteristics of the personality disordered (pp. 146–172). New York: John Wiley.
In a previous blog I examined Stendhal Syndrome where some people when exposed to the concentrated works of art, experience a wide range of symptoms including physical and emotional anxiety (rapid heart rate and intense dizziness, that often results in panic attacks and/or fainting), feelings of confusion and disorientation, nausea, dissociative episodes, temporary amnesia, paranoia, and – in extreme cases – hallucinations and temporary ‘madness’. While researching that article, I also came across another condition that would appear to be related to Stendhal Syndrome, namely ‘Jerusalem Syndrome’ – a condition that I have some empathy with.
One of the things I love about my job is all the wonderful places I have been able to travel to and visit as part of my work. Back in 2010, I did some consultancy on social responsibility practices for the online gambling company 888 and was flown to Tel Aviv to speak to various departments about my work. Once my talks and meeting were over, I experienced one of the best days of my life when I given a personal guide around the whole of Jerusalem. I am not religious but I found myself totally overcome with emotion as I visited one tourist attraction after another.
I say all this by way of introduction to what has been reported in the psychological literature as the aforementioned ‘Jerusalem Syndrome’ where visitors to the holy city are totally overcome by the weight of its history. The condition was first described (perhaps unsurprisingly) by an Israeli psychiatrist – Haim Herman – in the 1930s. However, psychiatrists did not begin keeping comprehensive clinical and statistical information on these cases until the late 1970s. One of the most infamous cases often cited in relation to Jerusalem Syndrome occurred in 1969, when a male Australian tourist (Denis Michael Rohan) set alight the al-Asqa Mosque following an overwhelming feeling of divine mission.
In 1999, Dr. Eliezer Witzum and Dr. Moshe Kalian wrote the first paper on Jerusalem Syndrome in an issue of the Israelian Journal of Psychiatry and Related Sciences. The condition became more widely known in 2000, when Dr. Yair Bar-El and colleagues published a paper in it in the British Journal of Psychiatry (BJP). Since 1980, Dr. Bar-El and his colleagues reported that Jerusalem’s psychiatric services had encountered over 1000 tourists with Jerusalem Syndrome (approximately 100 a year and overwhelmingly evangelical Christians). All cases were sent to one central facility (the Kfar Shaul Mental Health Centre [KSMHC]) for psychological counselling, psychiatric intervention, and/or admission to hospital. Between 1980 and 1993 approximately 1200 tourists with severe, Jerusalem-generated mental problems were referred to the KSMHC (with 470 being admitted to hospital). Based on those requiring treatment, the 2000 BJP paper outlined what the authors believed were the three main categories of the syndrome.
- Type I: Comprises individuals that have already been diagnosed as having a psychosis (e.g., schizophrenia, bipolar illness) prior to visiting Israel. They usually travel alone and come to Israel for psychiatric religious ideation.
- Type II: Comprises individuals with mental disorders (e.g., personality disorders, obsessions) but don’t have a clear mental illness and whose strange thoughts would not be classified as delusional or psychotic. They usually travel in groups (but sometimes alone) and come to Israel for curiosity reasons.
- Type III: Comprises individuals that have no previous history of mental illness, but who become victim to a psychotic episode while in Israel (particularly Jerusalem). Type III individuals are said to recover spontaneously, and enjoy normality on their return to their home country. They usually travel with friends or family (often as part of an organized tour) and come to Israel as regular tourists (and have a religious home background).
The authors reported that the third type was the most was “perhaps the most fascinating” because it included individuals with no prior history of mental illness and whose symptoms were context-specific and recover spontaneously with little psychological intervention. Therefore, the authors noted that Type III Jerusalem Syndrome is not associated with other psychopathologies, and is this is a “pure” or “unconfounded” form of the syndrome. Of the 1200 or so cases, only 42 were classified as Type III.
Despite the many reported case of Jerusalem Syndrome, in subsequent responses to the BJP paper, Kalian and Witzum then disputed its existence and claimed it is just a variant of schizophrenic illness. They wrote in a letter that:
“Our accumulated data indicate that Jerusalem should not be regarded as a pathogenic factor, because the morbid ideation of the affected travelers started elsewhere. Jerusalem syndrome should be viewed as an aggravation of a chronic mental illness and not a transient psychotic episode. The eccentric conduct and bizarre behavior of these colorful but mainly psychotic travelers become dramatically overt once they reach the Holy City – a geographical locus containing the axis mundi of their religious beliefs”.
The authors of the original paper then responded with yet another letter and pointed out that:
“Our initial account of Jerusalem syndrome clearly distinguished between patients with Jerusalem syndrome who also have a history of psychotic illness – Jerusalem syndrome superimposed on a previous psychotic illness – and those with no previous psychopathology, whom we referred to as having the discrete form of the syndrome. In either case, the symptoms of the syndrome appear on arrival in Jerusalem and exposure to the holy places”.
There have been a number of explanations as to why Jerusalem Syndrome occurs. Some authors suggest that mental state changes can occur as a result of a significant change in routine and circumstances (e.g., culture clash, geographical isolation, unfamiliar surroundings, proximity to strangers and/or foreigners). These factors compounded with the religious significance to many different faiths (Christians, Jews and Muslims), may be the stimuli that to trigger acute psychotic episodes. Such ‘spiritual’ travel may represent a modern-day version of a pilgrimage. There are of course limitations of the work by Bar-El and colleagues that the authors duly acknowledge including the fact that the study (i) was based on a phenomenological description and was not a research study, (jj) lacked follow-up information, and (iii) did not taken into account changes in circumstances associated with the expected influx of tourists in the millennial year.
Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
Bar-El, Y., Durst, R., Katz, G., Zislin, J., Strauss, Z. & Knobler, H.Y. (2000) Jerusalem syndrome. British Journal of Psychiatry, 176, 86-90.
Bar-El, Y., Kalian, M. & Eisenberg, B. (1991) Tourists and psychiatric hospitalization with reference to ethical aspects concerning management and treatment. Psychiatry, 10, 487 -492.
Bar-El, I., Witztum, E., Kalian, M., et al (1991) Psychiatric hospitalization of tourists in Jerusalem. Comprehensive Psychiatry, 32, 238 -244.
Fastovsky N, Teitelbaum A, Zislin J, et al (2000). The Jerusalem syndrome. Psychiatric Services, 5, 1052.
Gordon, H., Kingham, M. & Goodwin, T. (2004). Air travel by passengers with mental disorder. The Psychiatrist, 28, 295-297.
Halim, N. (2009). Mad tourists: The “vectors” and meanings of city-syndromes. In K. White (Ed.), Configuring Madness. Oxford: Inter-Disciplinary Press.
Kalian, M. & Witzum, E. (2000) Comments on Jerusalem syndrome. British Journal of Psychiatry, 176, 492.
Kalian M. & Witzum, E. (2002) Jerusalem syndrome as reflected in the pilgrimage and biographies of four extraordinary women from the 14th century to the end of the second millennium. Mental Health, Religion and Culture, 5, 1-16.
Monden, C. (2005). Development of psychopathology in international tourists. In van Tilburg, M. & Vingerhoets, A. (Eds.), Psychological Aspects of Geographical Moves: Homesickness and Acculturation Stress (pp. 213-226). Amsterdam: Amsterdam Academic Archive.
Witztum, E., & Kalian, M. (1999). The “Jerusalem syndrome” – fantasy and reality. A survey of accounts from the 19th century to the end of the second millennium. Israelian Journal of Psychiatry and Related Sciences, 36, 260-271.
In a previous blog I briefly looked at graphomania, which in a psychiatric context, relates to a morbid mental condition that manifests itself in written ramblings and confused statements. Graphomania in a non-psychiatric context typically concerns the urge or need to write to excess (and not necessarily in a professional context). Today’s blog looks at what I see as a sub-variant of this that has been termed ‘erotographomania’ although compared to ‘graphomania’ more generally, there seems to be a lot of different operational definitions of what erotographomania actually refers to. For instance:
- Dr. Anil Aggrawal’s book Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices defines erotographomania as when individuals derive sexual pleasure and arousal from writing love poems or letters.
- Like Dr. Aggrawal’s book, Dr. Brenda Love’s Encyclopedia of Unusual Sex Practices defines erotographomania as sexual arousal from writing love poems or letters but adds that the condition was “more common before the invention of the telephone”.
- In the 2005 edition of the Comprehensive Textbook of Sexual Medicine (edited by Dr. Nilamadhab Kar and Gopal Chandra Kar), erotographomania is defined as sexual gratification through obscene writing. Citing from Dr. J.B. Mukherjee’s 1985 book Forensic Medicine and Toxicology, it is reported that erotographomania comprises “drawing obscene pictures and diagrams in lavatories, public urinals or writing obscene anonymous letters to young girls”.
- In an article on ‘manifestly manifolded manias’ in a 1986 issue of the Journal of Recreational Linguistics, Paul Hellweg defined erotographomania as the “abnormal interest in erotic literature”.
- The Right Diagnosis website claims that erotographomania can comprise either and/or the (i) compulsive desire to write love letters, (ii) compulsive desire to write love poems, and (iii) abnormal interest in erotic literature. It also claims that treatment for the condition “may not be sought unless the condition becomes problematic for the person in some way, and they feel compelled to address their condition. Many people simply learn to accept their fetish and manage to achieve sexual gratification in a satisfactory manner”.
- The Encyclo (online encyclopedia) defines erotographomania as (i) an obsession to write love letters or to write erotic or pornographic literature, (ii) an abnormal interest in erotic literature, and (iii) in psychiatry, a morbid impulse to write love letters (generally written anonymously).
Obviously the numerous definitions outlined have clear overlaps, but there is no consensus on the exact erotic or (potentially paraphilic) focus. In my research for this article I couldn’t find a single academic or clinical article on the topic, just brief definitional mentions (of which the above list was comprised). Brenda Love’s comment (above) that the condition was more common before the telephone may be why there appear more mentions of the condition historically than in contemporary texts (for instance, erotographomania was mentioned in Edward Podolsky’s 1953 Encyclopedia of Aberrations, although again, there was no substance to what was written).
I did come across two books both entitled ‘Erotographomania’. The first was published in 2005 by Mike Martin (the full title of which was Erotographomania: Cruel Nostalgia), while the second one was published in 2008 by Rebecca Smith (and simply called Erotographomania). However, neither book was academic and neither provided any insight into the condition. I also came across an online academic article written in 2010 on love letters written by Kristine Trever. Writing about her own urges to write love letters:
“What happens to that urge to write out our love and desires and emotions in some concrete, tangible way to someone else..? And more importantly where does that urge come from?…I recall an overwhelming need to express something because of the influence of something else, because of an experience that touched me, reminded me, inspired me to share. I read a story that included a poem and through the existence of these two external items, the urge hooked me, the impulse too great to deny. I was overcome. The power of the pencil took over…If this all sounds crazy, impulsive, erratic, wild, unabashed and/or idiotic, itʼs critical to note that there is an actual disease called erotographomania, which is the compulsive act of writing and writing and writing and writing and writing and writing love letters. The OCD recipe for lovers”.
The Australian musician and songwriter Nick Cave gave a lecture in 1999 on love songs and claimed that he and a friend both had erotographomania. In his lecture he said:
“The reasons why I feel compelled to sit down and write love songs are legion. Some of these came clearer to me when I sat down with a friend of mine, who for the sake of his anonymity I will refer to as J.J. and I admitted to each other that we both suffered from psychological disorder that the medical profession call erotographomania. Erotographomania is the obsessive desire to write love letters. My friend shared that he had written and sent, over the last five years, more than seven thousand love letters to his wife. My friend looked exhausted and his shame was almost palpable. I suffer from the same disease but happily have yet to reach such an advanced stage as my poor friend J. We discussed the power of the love letter and found that it was, not surprisingly, very similar to the love song. Both served as extended meditations on ones beloved. Both served to shorten the distance between the writer and the recipient. Both held within them a permanence and power that the spoken word did not. Both were erotic exercises, in themselves. Both had the potential to reinvent, through words, like Pygmalion with his self-created lover of stone, one’s beloved. Alas, the most endearing form of correspondence, the love letter, like the love song has suffered at the hands of the cold speed of technology, at the carelessness and soullessness of our age”.
Maybe there is something in the Australian psyche when it comes to erotographomania as (during my research) I came across an Australian art exhibition on the topic that featured the work of Dejan Kaludjerovic, Claire Lambe, Nancy Mauro-Flude, Sally Rees, Noel Skrzypczak, Ben Terakes, and Paul Emmanuel. The exhibition was curated by Sarah Jones, who wrote that:
“Erotographomania (originally a term for perverse and obsessive love letter writing) aims to make parallels between the unconscious investment that artists make to address an audience and the intense erotic delusions played out in the exchange of love letters. Both produce a circuit of libidinal exchange that demands recognition. Both involve a fraught transferential displacement centred on an object of communication. Erotographomania explores pathos; the element of sadness and regret that flows between the ‘sender’ and the ‘addressee’ that becomes injected into the dubious presence of the world of objects; reflected there; contaminated by a past relentlessly regurgitated into the present. The exchange between the artist, the work and the audience remains confused and in flux, like that of the lover, the loved, the author and the intended beneficiary”.
Given an almost complete absence of academic and clinical reference to erotographomania, it begs the question of why it’s not been a topic of empirical investigation. Maybe the topic is being actively researched but no-one is calling it erotographomania. Many cyberpsychologists (including myself) have studied cybersexual behaviour that includes the sending of sexually arousing erotic emails to each other. Some of my academic papers on online sex (a few of which I’ve listed in the ‘further reading’ section below) make reference to online behaviours that fit some of the operational definitions of erotographomania outlined at the start of this article. Maybe it’s about time I wrote an article letting the cyberpsychology community know that they are simply researching an old phenomenon in a new environment.
Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
Aggrawal A. (2009). Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices. Boca Raton: CRC Press.
Cave, N. (1999). Love Song Lecture September 25. Transcription of lecture at: http://everything2.com/title/Nick+Cave%2527s+Love+Song+Lecture
Encyclo Online Encyclopedia (2012). Erotographomania. Located at: http://www.encyclo.co.uk/define/erotographomania
Griffiths, M.D. (2000). Excessive internet use: Implications for sexual behavior. CyberPsychology and Behavior, 3, 537-552.
Griffiths, M.D. (2001). Sex on the internet: Observations and implications for sex addiction. Journal of Sex Research, 38, 333-342.
Griffiths, M.D. (2004). Sex addiction on the Internet. Janus Head: Journal of Interdisciplinary Studies in Literature, Continental Philosophy, Phenomenological Psychology and the Arts, 7(2), 188-217.
Griffiths, M.D. (2012). Internet sex addiction: A review of empirical research. Addiction Research and Theory, 20, 111-124.
Hellweg, P. (1986). Manifestly manifolded manias. Journal of Recreational Linguistics, 19(2), 100-108.
Kar, N. & Kar, G.C. (2005). Comprehensive Textbook of Sexual Medicine. New Delhi: Jaypee Brothers Medical Publishers.
Love, B. (2001). Encyclopedia of Unusual Sex Practices. London: Greenwich Editions.
Martin, M. (2005). Erotographomania: Cruel Nostalgia. BookSurge Publishing.
Mukherjee, J.B. (1985). Forensic Medicine and Toxicology. London: Academic Publishers.
Podolsky, E. (1953). Encyclopedia of Aberrations: A Psychiatric Handbook. London: Arco.
Right Diagnosis (2012). Erotographomania, February 1. http://www.rightdiagnosis.com/e/erotographomania/intro.htm
Smith, R. (2008). Erotographomania. Blurb Publishing (http://www.blurb.com/bookstore/detail/1468330)
Trever, K. (2010). How to write a love letter, or how do you write a love letter? Located at: http://www.kristinetrever.com/pdf/LoveLetter-Trever.pdf
In a previous blog, I briefly looked at to what extent love can be addictive. However, recent history has seen the rise of the term ‘obsessive love’. Obsessive love is typically associated with unrequited love, but there are relationships in which individuals could be said to obsess over each other and relationships in which one member obsesses over their partner. According to Dr. Helen Fisher in her 2005 book Why We Love: The Nature and Chemistry of Romantic Love, some people believe that all love is obsessive as it can be characterised by feelings of exhilaration, and intrusive, obsessive thoughts about the object of one’s affection. One common view is that love and relationships are a specialized kind of mutual addiction.
It may be useful to categorise obsessive love as an addiction because the behaviour is often similar. It is possible to see the resemblance between the definitions given for obsessions and addictions. In 2003, Griffin and Tyrrell stated that “obsessions are thoughts, images or impulses that cause marked degrees of anxiety or distress”. Similarly, Stanton Peele and Archie Brodsky in their 1975 book Love and Addiction defined addiction as “a single overwhelming involvement with one thing that serves to cut a person off from life, to close him or her off to experience, to debilitate him, to make him less open, free, and positive in dealing with the world”. From this it is obvious that there is a resemblance in the fact that both can be debilitating. However, though it seems that certain aspects of obsessive love resemble a behavioural addiction, it has not been fully investigated.
Current literature uses the term ‘obsessive love’ to describe erotomania or love addiction. Obsessive love can therefore be seen as an umbrella term that covers subgroups such as erotomanics and love addicts, although no literature has been found that uses both concepts within the context of obsessive love. A common conception of obsessive love is generally that of a person being infatuated with a particular individual. However, another category includes those who feel the need to be in love generally. These are commonly known as ‘love addicts’. A more medically accepted category of obsessive love is that of erotomania.
Erotomania is a ‘rare delusional disorder’ also known as De Clerembault’s Syndrome. This type of obsessive lover develops a fixation on a person and becomes convinced that they are having a romantic relationship regardless of attempts by the recipient to convince them otherwise. Although erotomania and love addiction are dealt with as individual disorders, they share a number of characteristics. Obsessive love is seen predominantly in women although it has been realised that there are male sufferers. Also, more specifically, erotomania usually occurs in unmarried women that are isolated and lonely and have low self-esteem. However, recent studies have shown the disorder to be present in men who have a history of substance abuse or mental illness.
Obsessive lovers lack the ability to develop and are obsessed with impossible needs and unrealistic expectations. They engage in desperate hopes and unending fears. Obsessive lovers often have a past history of mental illness and/or a criminal record. Erotomania is also often associated with other mental disorders, in particular paranoid schizophrenia. Only ten percent of those that suffer erotomania do not suffer any other forms of mental illness. Typically the recipient is often higher in social status – often a boss or a celebrity. Symptoms of this form of obsessive love include delusions of passion followed by delusions of persecution. The individual creates reasons as to why the recipient cannot be with them such as their job or shyness. The person also believes that the recipient is more in love with them than vice versa.
Obsessive love can take place both in and out of a relationship. It can be a past partner, a friend, an acquaintance or even a stranger. Characteristics shared by all types of obsessive love include addictive personalities and low self-esteem. Obsessive lovers also have a tendency for violence and self-destruction. A person with such an obsession is likely to avoid change, and is typically dependent with a need for security. As this disorder is of an obsessive nature, the love the person feels is not particularly intimate. It is often the case that the love interest is the biggest thing in their life and so they dedicate lots of time to it.
Generally, the obsessed person’s life revolves around the person they are obsessed with. Whether in a relationship or not, the happiness of the obsessed is a direct result of the actions of the love object. As a result of this, the obsessed may beg to be told of how to make the other person happy so that they become the person the love object would want them to be. Obsessive lovers will go to great lengths to achieve or maintain the love of the love interest. Behaviour can become unpleasant for the recipient. Such actions include obscene phone calls, criminal damage or even physical violence and stalking. Their behaviour may necessitate the interest of the law.
This is frequently an occupational hazard for celebrities. In 1995, Madonna was stalked by Robert Hoskins. The man suffered from erotomania and believed that she was his wife. In an attempt to see his ‘wife’ he gained access to her home and assaulted a security guard. He was sentenced to ten years imprisonment. There are always fans that take their love for their idol into obsession.
Stalking is clearly a form of obsessive behaviour, and it has been found that those patients who have been stalked have described it as ‘psychological rape’. This can only further illustrate the devastating consequences of obsessive love. Stalking has even been given the clinical term ‘obsessional following’, and can be defined as the wilful, malicious and repeated following and harassing of another person. There is no single stalker profile and no two research centres can agree on what to call different types of stalkers. The only exception is erotomania. This is the only psychiatric diagnosis routinely associated with stalking.
Bogerts, B. (2005). Delusional jealousy and obsessive love – causes and forms. MMW Fortschritte der Medizin, 147(6), 28-9.
Debbelt, P. & Assion, H.J. (2001). Paranoia erotica (de Clerambault syndrome) in affective disorder. Der Nervenarzt. 72, 879-83.
Fisher, H. (2005). Why We Love: The Nature and Chemistry of Romantic Love. New York: Henry Holt and Company.
Graziano, W.G. & Musser L.M. (1982). The joining and parting of the ways. In Duck, S (Ed.). Personal Relationships 4: Dissolving Personal Relationships (pp.75-106). London: Academic Press.
Kennedy, N., McDonough, M., Kelly, B., & Berrios, G.E. (2002). Erotomania revisited: Clinical course and treatment. Comprehensive Psychiatry, 43, 1-6.
McCann, J.T. (1998). Subtypes of stalking (obsessional following) in adolescence. Journal of Adolescence, 21, 667-75.
Meloy, J. R. (1998). The psychology of stalking: Clinical and Forensic Perspectives. New York: Academic Press.
Orion, D. (1997). I Know You Really Love Me: A Psychiatrist’s Journal of Erotomania, Stalking, and Obsessive Love. London: MacMillan Publishing Company.
Peabody, S. (1994). Addiction to love. California: Celestial Arts.
Peele, S. & Brodsky, A. (1975). Love and Addiction. New York: Taplinger.
Sinclair, H.C, and Frieze, I.H. (2000). Initial courtship behaviour and stalking: how should we draw the line? Violence and Victims. 15(1), 23-40.
Stanbury, A. & Griffiths, M.D. (2007). Obsessive love as an addiction. Psychology Review, 12(3), 2-4.
In a previous blog, I examined a case of so-called ‘hair dryer dependence’. The source material for this blog came from one of the people who had appeared on the TLC (The Learning Channel) documentary television series My Strange Addiction. Immediately after I had written the blog I was emailed by one of the researchers on the show asking if I could help getting people on the show for the next series (Season 4).
For those who have no idea what I am talking about, My Strange Addiction is a US TV documentary show that features stories about people with unusual behaviours. Very few of the behaviours they have featured so far would be classed as addictions in the way that I define them. However, some of the behaviours are genuine obsessions and/or compulsions while others have not been the focus of any kind of medical and/or psychiatric diagnosis.
So far, the show has featured people with various obsessive-compulsive disorders (some of which I have examined in my blog) including body dysmorphic disorder, pica (the eating of non-food such as paper, mud, glass, metal), exercise bulimia, trichotillomania (compulsive hair pulling), dermatillomania (compulsive skin picking), thumb-sucking, furry fandom, excessive laxative use, urine drinking, paraphilic infantilism (being an adult baby), and dating cars.
MY STRANGE ADDICTION: A CALL FOR PARTICIPANTS
If anyone out there thinks they have an interesting story that My Strange Addiction might like to hear about, the show’s producers would really appreciate any help they can get in reaching people who may be good potential candidates for their TV show.
- Are you currently struggling to overcome a strange obsession, addiction or compulsive behavior that is taking over your life?
- Do you spend countless hours obsessing about something or engaging in behavior that others would say is strange?
- Have you drained all of your finances into this obsession?
- Are your friends and family members concerned about your wellbeing?
- Would you like to regain control of your life and your health?
If you found yourself answering yes to any of these questions, you may qualify to be a participant in a major documentary series that offers professional assistance for those struggling with a strange obsession, compulsion, or addiction.
For consideration, please reply to this advert with your name, age, contact information, and brief explanation of how a strange addiction is taking over your life. You can also contact us directly at 312-467-8145 or email@example.com. All submissions will remain confidential. Thank you for sharing your story.
Postscript: Alternatively, if you would like to tell me your story as part of my own academic research, then feel free to contact me at my academic email address: firstname.lastname@example.org.
Further reading and viewing
Griffiths, J. (2011). Review: My Strange Addiction. US Weekly January 25. http://www.usmagazine.com/entertainment/news/review–my-strange-addiction-2011251#ixzz1tYHsItPh
Internet Movie Database. My Strange Addiction. Located at: http://www.imdb.com/title/tt1809014/
My Strange Addiction Official Website. Located at: http://tlc.howstuffworks.com/tv/my-strange-addiction
TV.com. My Strange Addiction. Located at: http://www.tv.com/shows/my-strange-addiction/
Warming Glow. The 10 strangest addictions from ‘My Strange Addiction’. http://warmingglow.uproxx.com/2012/02/10-strangest-my-strange-addictions#page/1
Wikipedia. My Strange Addiction. Located at: http://en.wikipedia.org/wiki/My_Strange_Addiction
Wikipedia. List of My Strange Addiction episodes. Located at: http://en.wikipedia.org/wiki/List_of_My_Strange_Addiction_episodes
Ever since I can remember, I’ve always had an unhealthy interest in punning. Whether it’s the titles of my blogs or everyday conversation, I can’t seem to resist getting in a pun wherever I can. (I also have a whole section on my CV dedicated to my ‘humorous’ articles including ones that feature nothing but puns). For the purposes of being clear as to what I am actually talking about, a pun – according to the Oxford English Dictionary – is a form of word play that suggests two (or in some cases more) meanings, by exploiting multiple meanings of words, or of similar-sounding words. Author and lexicographer Samuel Johnson went as far as to claim punning the lowest form of humour. In his book ‘Jokes and Their Relation to the Unconscious’, Sigmund Freud asserted that puns are “the lowest form of verbal joke, probably because they are the cheapest – can be made with the least trouble…[and] merely form a sub-species of the group which reaches its peak in the play upon words proper”.
There are a number of references to various forms of ‘compulsive punning’ in the psychological literature. One such name is that of “Foerster’s syndrome”. This was coined by the Hungarian-British author and journalist Arthur Koestler (1905-1983) in a description of the compulsive punning first described by the German neurologist Otfrid Foerster (1873-1941). Back in 1929, Dr Foerster was carrying out brain surgery on a fully conscious male patient who had a brain tumour. When Foerster began to manipulate the patient’s tumor, the patient began a manic outburst of telling one pun after another.
In 1929, a psychiatrist Dr. A.A. Brill reported what he believed were the first cases of Witzelsücht (“punning mania”) in the International Journal of Psychoanalysis. The word ‘Witzelsücht’ comes from the German words ‘witzeln’ (to make jokes or wisecracks), and ‘sücht’ (a yearning or addiction). This rare condition is characterized as a set of neurological symptoms resulting in an uncontrollable tendency to tell puns, inappropriate jokes, and/or pointless or irrelevant stories at inappropriate times. The patient nevertheless finds these utterances intensely amusing. Brill described some of the cases he had come across including a 31-year man with a brain tumour who made puns “about anything and everything”.
This observation by Dr. Brill is not unsurprising as the condition is most commonly seen in those people that have damaged the brain’s orbitofrontal cortex (situated in the frontal lobes of the brain) and often caused by brain trauma, stroke, or a tumour. It is this part of the brain that is most involved in the cognitive processing of decision-making. Old aged people are thought to be most prone to Witzelsucht because of the decreasing amount of grey matter. The condition is also listed in Dorland’s Illustrated Medical Dictionary, which defines Witzelsücht as “a mental condition characteristic of frontal lesions and marked by the making of poor jokes and puns…at which the patient himself is intensely amused”.
It has also been observed that those people with hypomanic disorders are also more prone to engage in excessive punning. During hypomanic epidodes, people’s speech is typically louder and more rapid than usual. Furthermore, it may be full of jokes, puns, plays on words, and irrelevancies. Others have noted that hypomanic episodes may comprise unexplained tearfulness alternating with excessive punning and jocularity.
Neurologist Dr. Kenneth Heilman (University of Florida, USA) says he sees several cases of Witzelsücht each year. “One of the most dramatic cases (that I’ve seen) appeared to be attracted to my reflex hammer. After I checked his deep tendon reflexes and put my hammer down, he picked up the hammer and started to check my reflexes, while giggling”. However, Dr. Heilman (as far as I am aware) has not published any of his findings or clinical observations.
A case study published by Dr. Mario Mendez (University of California at Los Angeles, USA) in a 2005 issue of the Journal of Neuropsychiatry and Clinical Neuroscience claimed that Witzselsucht can occur in those with frontotemporal dementia (FTD). Over a period of two years and as dementia set in, a 57-year-old woman became the life and soul of parties, and would laugh, joke, and sing all the time. During medical examinations, she was highly talkative, animated, and disinhibited. Dr. Mendez reported that she was preoccupied with continuous silly laughter, excitement and frequent childish jokes and puns (i.e., Witzelsücht). Magnetic resonance imaging revealed major atrophy in the anterior temporal lobes of the brain. Citing previous (mostly old German) psychiatric literature, Mendez asserted that FTD is a disorder with a range of neuropsychiatric symptoms that can include Witzelsücht. This includes excessive and inappropriate facetiousness, jokes, and pranks. The woman was given a serotonin selective reuptake inhibitor (SSRI) and other psychoactive medications and her Witzelsucht subsided.
Also in 2005, Ying-Chu Chen and colleagues (National Cheng Kung University Medical Center, Taiwan) published a case report of Witzelsücht and hypersexuality after a stroke. The case involved a 56-year-old man who suffered a stroke. The stroke caused a facial palsy and dysphagia (i.e., difficulty in swallowing). Over the next few days, he became gradually more alert. By the fifth day following the stroke, the man became highly talkative. However, he started telling inappropriate jokes and witticisms, and became euphoric, prankish, and opinionated. He was concerned about his resulting functional deficits, but talked about them in a humorous fashion. Simultaneously with the punning, he also developed hypersexual tendencies, and used erotic words when women were nearby. He also harassed young nurses and other female caregivers. He was unable to correct his inappropriate behaviours. His relatives were very surprised at his inappropriate jokes and the hypersexual behaviours, which were different from that before he had the stroke.
Like the case mentioned previously, he was also given an SSRI as part of his treatment. The use of SSRIs produced a moderate reduction of the man’s aberrant behaviours. Although the physical consequences of the stroke improved, the man’s wife reported that his endless jokes were not only inappropriate in terms of context, but were often obscene. His medication was changed and he was given a noradrenaline reuptake inhibitor. Over the following two months, the inappropriate punning and hypersexual behaviors were rarely noticed.
Finally, (for no other reason than to leave you with a smile on your face), I thought I’d leave you with my top 10 favourite puns that have some connection with the topics of my blogs.
- A good pun is its own reword
- A pessimist’s blood type is always b-negative.
- A Freudian slip is when you say one thing but mean your mother.
- A man needs a mistress just to break the monogamy
- Is a book on voyeurism a peeping tome?
- Dancing cheek-to-cheek is really a form of floor play.
- Does the name Pavlov ring a bell?
- A gossip is someone with a great sense of rumour
- When you dream in colour it’s a pigment of your imagination
- When two egotists meet, it’s an I for an I
Brill, A.A. (1929). Unconscious insight: Some of its manifestations. International Journal of Psychoanalysis, 10, 145-161.
Chen, Y-C., Tseng, C-Y. & Pai, M-C. (2005). Witzelsucht after right putaminal hemorrhage: A case report. Acta Neurol Taiwan, 14, 195-200.
Freud, S. (1960). Jokes and Their Relation to the Unconsciousness. New York: W.W. Norton
Garfield, E. (1987). The crime of pun-ishment. Essays of an Information Scientist, 10, 174-178.
Griffiths, M.D. (1989). It’s not funny: A case study of ‘punning mania’. The Psychologist: Bulletin of the British Psychological Society, 2, 272.
Koestler, A. (1964). The Act of Creation. New York: Penguin Books, New York.
Mendez, M.F. (2005). Moria and Witzelsucht from frontotemporal dementia. Journal of Neuropsychiatry and Clinical Neuroscience, 17, 429-430.
Shammi, P. & Stuss, D.T. (1999). Humour appreciation: a role of the right frontal lobe. Brain, 122, 657-66.
Like many people, I save and collect various items (in my case, records and CDs). Collecting is a natural human activity and some evolutionary psychologists have argued that it may have had an evolutionary advantage in our past history (e.g., there may have been periods of severe deprivation where hoarding was adaptive and enhanced the probability of reproductive success and human survival). However, for a small minority, collecting and hoarding can become excessive and pathological as demonstrated a few months ago (December 2011), when Channel 4 broadcast a television programme on compulsive hoarders as part of the Cutting Edge series of documentaries
Compulsive hoarding – also known as pathological collecting in some scientific circles – is a behaviour typically characterized by the excessive acquisition and keeping of seemingly worthless objects that have little or no material value. According to a recent review led by Dr Albert Pertusa (Institute of Psychiatry, London), a widely accepted definition of compulsive hoarding is “the excessive collection and failure to discard objects of apparently little value, leading to clutter, distress, and disability” (p.371). The difficulty in discarding or letting go of the accumulated possessions is the critical criterion of pathological hoarding. It is also worth noting that some leading figures in the hoarding field don’t like the term ‘compulsive hoarding’ for many of the same reasons that those in the gambling studies field don’t like the term ‘compulsive gambling’.
There has been a substantial increase in research into the disorder in recent years. Interestingly, it appears to be inversely related to income (as it is far more common among the economically deprived). Based on empirical research, the prevalence of compulsive hoarding is thought to be around 2-5% among adult populations although there are certain socio-demographic groups where the prevalence is known to be higher (e.g., there is a higher prevalence among men and the elderly).
As with most behaviours that involve a compulsive element, there are associated physical health risks with compulsive hoarding. There are also reports that the behaviour can lead to detriments in other areas of the affected person’s life including impaired psychological functioning, financial difficulties, and the compromising of relationships with family and friends.
Given that excessive hoarding impacts on the physical living space of the individual and can take over in every room in an affected person’s home (such as people who never throw away a single newspaper or magazine), it can lead to a negatively detrimental effect on life’s essential activities such as personal hygiene and house sanitation – both of which may lead to increased health risks. Other activities such as sleeping and cooking food can also be seriously affected. Mobility in the person’s day-to-day living space may be affected and some hoarded items (such as newspapers and household waste) may lead to increased fire risks. It has also been noted that at a societal level, compulsive hoarding is a burden on public health in terms of poor physical health, occupational impairment, and the utilization of social services.
Although the collecting behaviour may be pathological, there is still a lot of scientific debate as to whether it is a stand alone disorder or symptomatic of other conditions, most notably obsessive-compulsive disorder [OCD] – particularly as approximately 20%-40% of people with OCD patients are known to have various hoarding compulsions and obsessions. Some researchers also suggest that other psychological traits such as perfectionism and indecisiveness may underpin some hoarding behaviour. Other co-morbidities are known to exist including alcoholism, in addition to paranoid, avoidant, and schizotypal traits. Compulsive hoarding also appears to be similar to impulse control disorders, particularly that of compulsive buying as many hoarders’ homes are full of bought items that are often unopened and still in their original packaging. Approximately three-quarters of hoarders also engage in excessive buying, and over half also accumulate items and possessions for free. Research has indicated that the condition of hoarders’ homes have been described as “merely cluttered” to “squalid”.
In fact, Dr Pertusa and his colleagues claim that the majority of hoarding studies are actually based on the assumption that the behaviour is a form of OCD. However, there is accumulating evidence that hoarding may be a separate entity to OCD. As is also pointed out by Pertusa and colleagues, there is no reference to hoarding behaviour in the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM-IV) criteria for OCD. Furthermore, in relation to obsessive-compulsive personality disorder, hoarding is mentioned in only one of the eight diagnostic criteria.
A recent meta-analytic study led by Dr Michael Bloch (Yale School of Medicine, USA) examined 21 worldwide studies with over 5000 OCD individuals and concluded that hoarding is an independent factor in both in children and adults. The study also reported that unlike typical OCD sufferers, compulsive hoarders don’t experience intrusive thoughts about possessions urging them to perform ritualized behaviour. It has also been observed that around a third of compulsive hoarders don’t show any other OCD symptoms. Dr Bloch and colleagues conclude that compulsive hoarding is a more passive behaviour where intense distress is only triggered when the hoarders face the prospect of having to get rid of their accumulated possessions.
Although there are many published studies where compulsive hoarders are treated pharmacologically with serotonin reuptake inhibitors (that show very mixed results in relation to their effectiveness), the most effective treatment appears to be cognitive behavioural therapy (CBT). This typically involves hoarders learning (through cognitive restructuring and response prevention) how to deal with situations that cause intense anxiety. Research also suggests that some types of CBT are better than others. CBT approaches that focus on the hoarder’s motivation, acquisition of new items, and removal of items from the hoarder’s home appear to show the best outcome. Treatment studies also suggest that pathological hoarding may be best classified as a discrete disorder with its own diagnostic criteria rather than as a form of OCD.
Abramowitz, J. S., Wheaton, M. G., & Storch, E. A. (2008). The status of hoarding as a symptom of obsessive–compulsive disorder. Behaviour Research and Therapy, 46, 1026-1033.
Bloch, M.H., Landeros-Weisenberger, A., Rosario, M.C., Pittenger, C., & Leckman, J.F. (2008). Meta-analysis of the symptom structure of obsessive–compulsive disorder. American Journal of Psychiatry, 165, 1532-1542.
Frost, R. & Gross, R. (1993). The hoarding of possessions. Behaviour Research and Therapy, 31, 367-382.
Frost, R.O., Tolin, D.F., Steketee, G., Fitch, K.E., & Selbo-Bruns, A. (2009). Excessive acquisition in hoarding. Journal of Anxiety Disorders, 23, 632-639.
Mataix-Cols, D., Nakatani, E., Micali, N. & Heyman, I. (2008). Structure of obsessive– compulsive symptoms in pediatric OCD. Journal of the American Academy of Child and Adolescent Psychiatry, 47, 773-778.
Muroff, J., Steketee, G., Rasmussen, J., Gibson, A., Bratiotis, C. & Sorrentino, C. (2009). Group cognitive and behavioral treatment for compulsive hoarding: A preliminary trial. Depression and Anxiety, 26, 634-640.
Pertusa, A., Frost, R.O., Fullana, M.A., Samuels, J., Steketee, G., Tolin, D., Saxena, S., Leckman, J.F., Mataix-Cols, D. (2010). Refining the diagnostic boundaries of compulsive hoarding: A critical review. Clinical Psychology Review, 30, 371-386.
Pertusa, A., Fullana, M. A., Singh, S., Alonso, P., Menchon, J. M., & Mataix-Cols, D. (2008). Compulsive hoarding: OCD symptom, distinct clinical syndrome, or both. American Journal of Psychiatry, 165, 1289-1298.
Saxena, S. (2008). Neurobiology and treatment of compulsive hoarding. CNS Spectrums, 13 (Suppl 14), 29-36.
Tolin, D.F., Frost, R.O. & Steketee, G. (2007). An open trial of cognitive-behavioral therapy for compulsive hoarding. Behaviour Research and Therapy, 45, 1461-1470.
Tolin, D.F., Frost, R.O., Steketee, G., & Fitch, K.E. (2008). Family burden of compulsive hoarding: Results of an internet survey. Behaviour Research and Therapy, 46, 334-344.