Sex starved: A beginner’s guide to sexual anorexia

In previous blogs I have looked at anorexia nervosa in the context of addictive eating disorders, ‘tanorexia’ (excessive tanning) and ‘fanorexia’ (excessive following of a celebrity or sports team). Today’s blog takes a brief look at ‘sexual anorexia’ that according to Dr. Douglas Weiss in his 1998 book Sexual Anorexia, Beyond Sexual, Emotional and Spiritual Withholding, typically refers to “the active, almost compulsive withholding of emotional, spiritual and sexual intimacy from the primary partner”. The 12-Step group Sex and Love Addicts Anonymous offers this definition and analogy:

“As an eating disorder, anorexia is defined as the compulsive avoidance of food. In the area of sex and love, anorexia has a similar definition: Anorexia is the compulsive avoidance of giving or receiving social, sexual, or emotional nourishment”

A paper by Dr. Randy Hardman and Dr. David Gardner in a 1986 issue of the Journal of Sex Education and Therapy compared anorexia nervosa and sexual anorexia. They highlighted the four most significant characteristic similarities of these self-perpetuating disorders from both an intrapsychic and interpersonal level. These were (i) control (i.e., overt personal control and covert relationship power), (ii) fear (i.e., fear of losing control and fear of personal sexuality), (iii) anger (i.e., passive and active expressions of anger based on devaluation), and (iv) justification (i.e., an elaborate system of denial, delusion, and misperception).

Along with Dr. Weiss, most of the key writings on the topic have been written by Dr. Patrick Carnes (the author of many articles and books on sex addiction). Dr. Carnes defines sexual anorexia as: “an obsessive state in which the physical, mental and emotional task of avoiding sex dominates one’s life. Like self-starvation with food, deprivation with sex can make one feel powerful and defended against all hurts.” In a 1998 paper in the journal Sexual Addiction and Compulsivity, he also notes that: “the term “sexual anorexia” has been used to describe sexual aversion disorder [in the Diagnostic and Statistical Manual of Mental Disorders], a state in which the patient has a profound disgust and horror at anything sexual in themselves and others”.

According to the Wikipedia entry on sexual anorexia, the term ‘sexual anorexia’ has been around for over 35 years, and the first use it the term is generally attributed to psychologist Nathan Hare, a psychologist who coined the term in his 1975 PhD thesis. (However, I have failed to track this down, and none of the academic papers I have read on sexual anorexia ever mention Hare).

Dr. Carnes claims to have identified three causative factors in the formation of sexual anorexia. These are (i) a probable history of sexual exploitation or severely traumatic sexual rejection, (ii) family history of extremes in thought or behavior (often very repressive/religious or it’s polar opposite of “anything-goes” permissiveness), and (iii) cultural, social or religious influences that view sex negatively and supports sexual oppression and repression. Dr. Weiss adds that there are three key criteria in the formation of anorexia: (i) sexual abuse, (ii) attachment disorder with the opposite sex parent and (iii) sex addiction.

In his 1997 book Sexual Anorexia: Overcoming Sexual Self-Hatred, Dr. Carnes views the symptom cluster of the sexual anorexic as primarily sexual and includes: (i) a dread of sexual pleasure, (ii) a morbid and persistent fear of sexual contact, (iii) obsession and hyper-vigilance around sexual matters, (iv) avoidance of anything connected with sex, (v) preoccupation with others being sexual, (vi) distortions of body appearance, (vii) extreme loathing of body functions, (viii) obsessional self-doubt about sexual adequacy, (ix) rigid, judgmental attitudes about sexual behaviour, (x) excessive fear and preoccupation with sexually transmitted diseases, (xi) obsessive concern or worry about the sexual intentions of others, (xii) shame and self-loathing over sexual experiences, (xiii) depression about sexual adequacy and functioning, (xiv) intimacy avoidance because of sexual fear, and (xv) self-destructive behavior to limit, stop, or avoid sex.

The 1998 paper published in the journal Sexual Addiction and Compulsivity by Dr. Carnes is one of the very few in the literature to collect empirical data. The data were collected from 144 patients at his treatment clinic that were diagnosed with sexual anorexia. Of these, 41% were male and 59% female aged between 19 and 58 years (all of whom were Caucasian). The main findings were that:

• 67% reported a history of sexual abuse
• 41% reported a history of physical abuse
• 86% reported a history of emotional abuse
• 65% reported members of the immediate family as some type of addict
• 40% reported having a sex addict in the immediate family
• 60% described their family as “rigid”
• 67% described their family as “disengaged”

Carnes also reported that over two-thirds of the sexually anorexic population claimed to have other compulsive and/or addictive problems including alcoholism (33%), substance abuse (25%), compulsive eating (25%), caffeine abuse (26%), nicotine addiction (23%), compulsive spending (22%), and/or bulimia/anorexia with food (19%). Of most interest was the fact that Carnes compared his group of sexual anorexics with a group of sex addicts (also from his treatment centre). Carnes concluded that:

“By contrasting that profile with data from sex addicts who were in the same patient pool, some important contrasts can be made. The data for sex addicts and sexual anorexics were very parallel in terms of family system, abuse history, and related patterns of addiction, compulsion, and deprivation. Even the criteria for sex addiction and sexual anorexia have important parallels in terms of powerlessness, obsession, consequences, and distress…Such comparisons tend to confirm the proposition that extreme sexual disorders stem from many of the same factors and are variations of the same illness. Of equal importance is the possibility that extreme behaviors in various disorders (food, chemical, sexual, financial) whether in excess or in deprivation are for many patients interchangeable parts representing much deeper patterns of distress”

Finally, if you would like to know if you are sexually anorexic, you can take this simple test that I found at the Freedom In Grace website (and appears to be based on the world of Weiss and Carnes). If you endorse five or more of the following nine statements “you or your partner are currently struggling with sexual anorexia”.

• Withholding love from partner
• Withholding praise or appreciation from partner
• Controlling by silence or anger
• Ongoing or ungrounded criticism causing isolation
• Withholding sex from your partner
• Unwillingness or inability to discuss feelings with partner
• Staying so busy that they have no relational time for the partner
• Making the problems or issues about your partner instead of owning their own issues
• Controlling or shaming partner with money issues

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

Further reading

Carnes, P. (1997). Sexual Anorexia: Overcoming Sexual Self-Hatred. Center City, MN: Hazelden.

Carnes, P. (1998). The case for sexual anorexia: An interim report on 144 patients with sexual disorders. Sexual Addiction and Compulsivity, 5, 293–309.

Hardman, R.K. & Gardner, D.J. (1986). Sexual anorexia: A look at inhibited sexual desire. Journal of Sex Education and Therapy, 12, 55-59.

Nelson, Laura (2003). Sexual addiction versus sexual anorexia and the church’s impact. Sexual Addiction and Compulsivity, 10, 179–191.

Sex and Love Addicts Anonymous (undated). Sexual anorexia. Located at: http://www.slaauk.org/files/anorexia.pdf

Weiss, D. (1998). Sexual Anorexia, Beyond Sexual, Emotional and Spiritual Withholding. Fort Worth, TX: Discovery

Weiss, D. (2005). Sexual anorexia: A new paradigm for hyposexual desire disorder. Located at: http://www.sexaddict.com/eBooks/SAeBk.pdf

Wikipedia (2012). Sexual anorexia. Located at: http://en.wikipedia.org/wiki/Sexual_anorexia

The write stuff: A brief overview of typomania and graphomania

“Life is a series of addictions and without them we die”

This opening quote is one of my favourite quotes from the addiction literature and was made by Professor Isaac Marks in a 1990 issue of the British Journal of Addiction. Whether the statement is true or not depends upon what the definition of addiction is. It’s also a quote that makes me think about my own life and to what extent I have any addictions. Most people that know me well would say that my passion for listening to music borders on the obsessive. Others have called me a ‘workaholic’ (which again depends on the definition of workaholism). Personally, I don’t think I’m addicted to either work or music (and no, I’m not in denial), but I did come across a condition called ‘typomania’ that I can’t so easily deny.

Most definitions of typomania are similar but have slight subtle differences in emphasis. For instance, I have come across six definitions indicating that it is either (i) a craze for seeing one’s writings or name in print, (ii) a mania for writing for publication, (iii) an obsession with the expectation of publication, (iv) an obsession with the business of printing or publishing, (v) an unhealthy passion to write, (vi) an obsessive impulse to write, and (vii) an addiction to writing (where people write for the sake of writing without caring about the quality of the written word).

These latter definitional variations (i.e., obsessive impulse or unhealthy passion to write) has been observed in the psychiatric community as in addition to typomania, has also been termed ‘graphomania’ and ‘scribomania’ (although some of these other definitions claim that the condition concerns the obsession to write books). The term ‘graphomania’ has been used since the early 19th century by both French psychiatrist Dr. Jean-Étienne Esquirol and Swiss psychiatrist Dr. Eugen Bleuler (the man who first coined the term ‘schizophrenia’). A number of independent sources (such as Svetlana Boym in her 1995 book Common Places. Mythologies in Everyday Life in Russia) also claim that the term ‘graphomania’ is a well established concept in Russian culture.

In a 2004 issue of the journal Neurocase, two French academics (I. Barrière and M. Lorch) wrote a paper called “Premature thoughts on writing disorders”. They noted (based on some earlier work by Artières) that writing disorders were one of the “hallmarks” of the 19th century medical world. The paper reported:

 “The identification of a disease contracted by children whose sight and general health were thought to be affected by too much writing labelled “graphomania”. More importantly for the topic under investigation, writing was perceived by clinicians as the privileged means to gain access to the mental states of atypical individuals, including geniuses (see for instance the study on the handwriting of Leonardo de Vinci), criminals, and those affected by a medical condition. This led to numerous studies on the writing of patients affected by various pathologies including dementia, epilepsy and Parkinson”

One of the first uses of the word ‘graphomania’ in a wider public context, was in the New York Times (September 27, 1896) in an article about US Democratic presidential candidate William Jennings Bryan (under the title ‘Bryan’s Mental Condition’). The article noted that:

“The habit of excessive writing, of explaining, amplifying, and reiterating, of letter making and pamphleteering, forms a morbid symptom of known as ‘graphomania’. Some men may overload their natural tendency to write, but a certain class of lunatics use nearly all their mental activities in this occupation, to the endless annoyance of their friends, relatives and physicians”.

In a psychiatric context, graphomania refers to a morbid mental condition that manifests itself in written ramblings and confused statements. Much of the written content is meaningless nonsense and is also referred to as graphorrhea. Graphomania in a non-psychiatric context concerns the urge or need to write to excess (and not necessarily in a professional context). This is certainly something I can relate to.

In his 1979 Book of Laughter and Forgetting, the Czech novelist Milan Kundera noted that:

“Graphomania (an obsession with writing books) takes on the proportions of a mass epidemic whenever society develops to the point where it can provide three basic conditions: (1) a high enough degree of general wellbeing to enable people to devote their energies to useless activities; (2) an advanced state of social atomisation and the resultant general feeling of the isolation of the individual; (3) a radical absence of significant social change in the internal development of the nation. (In this connection, I find it symptomatic that in France, a country where nothing really happens, the percentage of writers is twenty one times higher than in Israel)…The irresisitable proliferation of graphomania among politicians, taxi drivers, childbearers, lovers, murderers, thieves, prostitutes, officials, doctors, and patients shows me that everyone without exception bears a potential writer within him, so that the entire human species has good reason to go down the streets and shout: ‘We are all writers!'”

There doesn’t appear to be much academic or clinical research on graphomania although papers dating back to the early twentieth century exist. For instance, in 1921, Dr. F.T. Hunter wrote about graphomania when reviewing the 1920 French book La Graphomanie (Essai de Psychologie Morbide) by Ossip-Lourie. Graphomania was described as a “psychopathic tendency to write”. To differentiate between whether writing was normal or abnormal, it was observed that:

“All writings which do not convey a positive fact, the result of observation or of experience, which do not bring forth an idea, which do not materialize an image – a personal artistic product – which do not reflect the interior life and the personality of the author, are in the domain of graphomania”.

Graphomania was believed to be “psychosocially acquired” and was acquired as a consequence of the educational methods of the time that taught children to copy rather than to write creatively. Dr. Hunter said that psychiatrists wouldn’t take Ossip-Lourie’s book seriously. More recently, a 1988 paper in a French neurology journal, Dr, J. Cambler and his colleagues described the case of “compulsive graphic activity” as a consequence of fronto-callosal glioma (a kind of brain tumour). They reported that spontaneous and graphomanic writing “were abundant and incoercible”. They noted that the behaviour was comparable with that of the compulsive activity that may result from other types of brain lesion (e.g., pallidal lesions or bilateral frontal lesions).

So, do I suffer from typomania and/or graphomania? Based on what I have read, absolutely not. Life may well be a series of addictions, but – as yet – I don’t think I have any.

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

Further reading

Artières, P. (1998). Clinique de l’écriture: une histoire du regard médical sur l’écriture. Institut Synthélabo pour le progrès de la connaissance. Le Plessis-Robinson.

Barrière, I. & Lorch, M. (2004). Premature thoughts on writing disorders. Neurocase, 10, 91-108.

Boym, S. (1995), Common Places. Mythologies in Everyday Life in Russia. Cambridge, Mass: Harvard Univ. Press.

Cambler, J., Masson, C., Benammou, S. & Robine, B. (1988). [Graphomania. Compulsive graphic activity as a manifestation of fronto-callosal glioma]. Revue Neurol, 144, 158-164.

Hellweg, P. (1986). Manifestly manifolded manias. Journal of Recreational Linguistics, 19(2), 100-108.

History Matters (undated). “Bryan’s Mental Condition:” One Psychiatrist’s View.Located at: http://historymatters.gmu.edu/d/5353/

Hunter, F.T. (1921). Review of La graphomanie (Essai de psychologie morbide). Journal of Abnormal Psychology and Social Psychology, 16, 279-280.

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

Wayne R. LaFave (2003). Rotunda: Il professore prolifico ma piccolo. University of Illinois Law Review, 5, 1161-1168.

Wikipedia (2012). Graphomania. Located at: http://en.wikipedia.org/wiki/Graphomania

Working out: Are Olympic athletes addicted to exercise and/or work?

As someone who has spent over 25 years carrying out research into behavioural addiction, I have published a fair amount on exercise addiction over the years. One question I am often asked when the Olympics comes around is to what extent athletes are addicted to exercise. One of the problems answering this question is that in spite of the widespread usage of the term ‘exercise addiction’ there are many different terminologies that describe excessive exercise syndrome. Such terms include (i) exercise dependence, (ii) obligatory exercising, (iii) exercise abuse, and (iv) compulsive exercise.

In a review on excessive exercise that I co-wrote with colleagues at Eotvos Lorand University (Budapest) and to be published in the journal Substance Use and Misuse, we argued that the term ‘addiction’ is the most appropriate because it incorporates both dependence and compulsion. Based on research carried out internationally, we believe that exercise addiction should be classified within the category of behavioural addictions. The resemblance is evidenced not only in several common symptoms (e.g., salience, mood modification, withdrawal symptoms, tolerance, conflict, relapse, etc.), but also in demographic characteristics, the prognosis of the disorder, co-morbidity, response to treatment, prevalence in the family, and etiology.

However, when it comes to Olympic athletes, we all know that they engage excessively in exercise and spend hours and hours every single day either training and competing. For many Olympians, their whole life is dominated by the activity and may impact on their relationships and family life. But does this mean they are addicted to exercise? In short, no! Why? Because the excessive exercise is clearly a by-product of the activity being their job. I would not call myself an internet addict just because I spend 5-10 hours a day on the internet. My excessive internet use is a by-product of the job I have as an academic. In short, the excessive internet use is functional.

However, just because I don’t believe Olympic athletes are addicted to exercise, it could perhaps be argued that they are addicted to work (and in this case, their work comprises the activity of exercise). I’m often asked what the difference is between a healthy enthusiasm and an addiction. In short, healthy enthusiasms add to life but addictions takes away from it. On this simple criterion, maybe there are some Olympic athletes who are ‘addicted’ to their work.

The term ‘workaholism’ has been around for over 40 years since the publication of Wayne Oates’ 1971 book Confessions of a Workaholic, and has now passed into the public mainstream. Despite four decades of research into workaholism (and like exercise addiction), no single definition or conceptualization of this phenomenon has emerged. Workaholics have been conceptualized in different ways. For instance, workaholics are typically viewed as one (or a combination) of the following:

• Those viewed as hyper-performers
• Those viewed as unhappy and obsessive individuals who do not perform well in their jobs
• Those who work as a way of stopping themselves thinking about their emotional and personal lives
• Those who are over concerned with their work and neglect other areas of their lives.

Some of these may indeed be applied to Olympic athletes (particularly the reference to ‘hyper-performers’ and the fact that other areas of their lives may be neglected in pursuit of the ultimate goal). Some authors note that there is a behavioural component and a psychological component to workaholism. The behavioural component comprises working excessively hard (i.e., a high number of hours per day and/or week), whereas the psychological (dispositional) component comprises being obsessed with work (i.e., working compulsively and being unable to detach from work. Again, these behavioural and psychological components could potentially be applied to Olympic athletes.

There are also those scholars who differentiate between positive and negative forms of workaholism. For instance, some view workaholism as both a negative and complex process that eventually affects the person’s ability to function properly. In contrast, others highlight the workaholics who are totally achievement oriented and have perfectionist and compulsive-dependent traits. Here, the Olympic athlete might be viewed as a more positive form of workaholism. Research appears to indicate there are a number of central characteristics of workaholics. In short, they typically:

• Spend a great deal of time in work activities
• Are preoccupied with work even when they are not working
• Work beyond what is reasonably expected from them to meet their job requirements.
• Spend more time working because of an inner compulsion, rather than because of any external factors.

Again, some or all of these characteristics could be applied to Olympians. Hopefully, very few Olympic athletes are addicted, but if they are addicted, I would argue that it is more likely to be to their work rather than the exercise itself.

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

Further reading

Allegre, B., Souville, M., Therme, P. & Griffiths, M.D. (2006). Definitions and measures of exercise dependence, Addiction Research and Theory,14, 631-646.

Allegre, B., Therme, P. & Griffiths, M.D. (2007). Individual factors and the context of physical activity in exercise dependence: A prospective study of ‘ultra-marathoners’. International Journal of Mental Health and Addiction, 5, 233-243.

Andreassen, C.S., Griffiths, M.D., Hetland, J. & Pallesen, S. (2012). Development of a Work Addiction Scale. Scandinavian Journal of Psychology, 53, 265-272.

Berczik, K., Szabó, A., Griffiths, M.D., Kurimay, T., Kun, B. & Demetrovics, Z. (2012). Exercise addiction: symptoms, diagnosis, epidemiology, and etiology. Substance Use and Misuse, 47, 403-417.

Griffiths, M.D. (1997). Exercise addiction: A case study. Addiction Research,  5, 161-168.

Griffiths, M.D. (2005).  Workaholism is still a useful construct  Addiction Research and Theory, 13, 97-100.

Griffiths, M.D. (2011). Workaholism: A 21^st century addiction. The Psychologist: Bulletin of the British Psychological Society, 24, 740-744.

Griffiths, M.D., Szabo, A. & Terry, A. (2005). The Exercise Addiction Inventory: A quick and easy screening tool for health practitioners. British Journal of Sports Medicine, 39, 30-31.

Mónok, K., Berczik, K., Urbán, R., Szabó^, A., Griffiths, M.D., Farkas, J., Magi, A., Eisinger, A., Kurimay, T., Kökönyei, G., Kun, B., Paksi, B. & Demetrovics, Z. (2012). Psychometric properties and concurrent validity of two exercise addiction measures: A population wide study in Hungary. Psychology of Sport and Exercise, 13, 739-746.

Oates, W. (1971), Confessions of a Workaholic: The Facts About Work Addiction, World, New York.

Szabo, A. & Griffiths, M.D. (2007). Exercise addiction in British sport science students. International Journal of Mental Health and Addiction, 5, 25-28.

Terry, A., Szabo, A. & Griffiths, M. (2004). The Exercise Addiction Inventory: A new brief screening tool, Addiction Research and Theory, 12, 489-499.

Job rule: The development of a new scale for workaholism

In a previous blog, I examined the concept of workaholism. Yesterday, a paper that I co-wrote with some of my research colleagues from the University of Bergen (Norway) – and led by Dr. Cecilie Andreasson –  featured in a lot of the national newspapers including the Daily Telegraph, Daily Mail, The Guardian, China Daily and USA Today.

In a nutshell, our new paper presents a new instrument to assess ‘work addiction’ and is based on core elements of addiction outlined in my very first blog and which are recognised as key diagnostic criteria for addictions. In the press release of our study, Dr Andreassen noted in the wake of globalisation, new technology and blurred boundaries between work and private life, we are witnessing an increase in work addiction. A number of studies show that work addiction has been associated with insomnia, health problems, burnout and stress, as well as creating conflict between work and family life.

To date, a few measures of workaholism have been developed. The first quantitative measure of work addiction or workaholism was the Work Addiction Risk Test (WART), developed in 1989 by Dr. Bryan Robinson. Items were based on symptoms reported by clinicians working with both clients and families experiencing work addiction problems. Several studies by Robinson and his colleagues have attested to the psychometric properties of the WART. The total composite scores of the WART have been shown to be positively associated with scores on measures of anxiety and Type A behaviour.

The WART comprises 25 items, all rated on a 4-point scale ranging from 1 (never true) to 4 (always true). Initially, the 25 items appeared to be distributed between five factors/subscales: (i) compulsive tendencies; (ii) control; (iii) impaired communication/self-absorption; (iv) inability to delegate; and (v) self-worth. However, further investigation revealed that only 15 items, distributed across the three initial factors, were useful for correctly discriminating between workaholics and a control group. The authors concluded that the Compulsive Tendencies subscale was the most important in making this distinction, and suggested using the revised scale in future studies. However, the WART has been criticized for overlapping little with more contemporary and widely accepted views on workaholism.

In 1992, Dr. Janet Spence developed the most frequently used measure of workaholism (i.e., the Workaholism Battery; Work-BAT). They argued that the typical workaholic is heavily involved in work, feels motivated to work by an inner drive, and has low enjoyment of work. In line with these ideas, they created three self-report scales assessing (i) work involvement; (ii) drive; and (iii) enjoyment of work. Potential items were first administered to students. Items showing poor psychometric properties were dropped or rewritten before the scale was administered to an adult sample. The WorkBAT comprises 25 items answered on a 5-point scale ranging from ‘‘strongly disagree’’ to ‘‘strongly agree’’. Although the WorkBAT is currently the most used measure of Workaholism, the Work Involvement subscale has in several studies failed to display appropriate psychometric properties. The concept of the ‘Enjoyment of Work’ subscale has been criticized by many researchers because it is not regarded as defining the characteristics of workaholism.

In 2009, Dr. Wilmar Schaufeli and colleagues developed a new workaholism scale. From a theoretical perspective, they argued that workaholics typically spend a great deal of time on work activities, and that additionally they are obsessed with their work. On this basis, they constructed the Dutch Workaholism Scale (DUWAS). The scale reflected these two dimensions, using five items from the Compulsive Tendencies Scale of the WART that they renamed Working Excessively, and five items from the Drive scale of the WorkBAT, which were denoted as Working Compulsively. The DUWAS has shown good psychometric properties in several studies

However, we argued that because the concept of workaholism stems from the field of addiction, measures of workaholism or work addiction should be expected to be closely linked to the core elements of addictions. When reviewing the construction processes of the three workaholism instruments outlined above, few of them have specifically been developed with the addiction perspective in mind and could be argued to lack face validity.

Our new scale – The Bergen Work Addiction Scale (BWAS) – was published this week in the Scandinavian Journal of Psychology. By using our scale, anyone can find out their degree of work addiction: non-addicted, mildly addicted or workaholic. More than 12,000 Norwegian employees from 25 different industries participated in the development of the scale. The scale was administrated to two cross-occupational samples and reflects the seven core elements of addiction: salience, mood modification, tolerance, withdrawal, conflict, relapse, and problems. The results of our study showed that the scale as reliably differentiating between workaholics and non-workaholics.

We believe the scale may add value to work addiction research and practice, particularly when it comes to facilitating treatment and estimating prevalence of work addiction in the general population worldwide. It uses just seven basic criteria to identify work addiction, where all items are scored on the following scale: (1)=Never, (2)=Rarely, (3)=Sometimes, (4)=Often, and (5)=Always. The seven items are:

• You think of how you can free up more time to work
• You spend much more time working than initially intended
• You work in order to reduce feelings of guilt, anxiety, helplessness and depression
• You have been told by others to cut down on work without listening to them
• You become stressed if you are prohibited from working
• You deprioritise hobbies, leisure activities, and exercise because of your work
• You work so much that it has negatively influenced your health

If you respond ‘often’ or ‘always’ on at least four of the seven items it may be indicative of being a workaholic. Although there are other ‘workaholism’ scales that have been developed, this is the first scale to use core concepts of addiction found in other more traditional addictions.

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

Further reading

Andreassen, C.S., Griffiths, M.D., Hetland, J. & Pallesen, S. (2012). Development of a Work Addiction Scale. Scandinavian Journal of Psychology, DOI: 10.1111/j.1467-9450.2012.00947.x.

Griffiths, M.D. (2005). Workaholism is still a useful construct. Addiction Research and Theory, 13, 97-100.

Griffiths, M.D. (2011). Workaholism: A 21^st century addiction. The Psychologist: Bulletin of the British Psychological Society, 24, 740-744.

Matuska, K.M. (2010). Workaholism, life balance, and well-being: A comparative analysis. Journal of Occupational Science, 17, 104-111.

Schaufeli, W.B., Shimazu, A. & Taris, T. W. (2009). Being driven to work excessively hard. The evaluation of a two-factor measure of workaholism in the Netherlands and Japan. Cross-Cultural Research, 43, 320–348

Schaufeli, W.B., Taris, T.W., & Bakker, A.B. (2006). Doctor Jekyll or Mr Hyde? On the differences between work engagement and workaholism. In R. Burke (Ed.), Workaholism and long working hours (pp. 193-217). Cheltenham: Edward Elgar.

Spence, J. T. & Robbins, A. S. (1992). Workaholism – definition, mea- surement, and preliminary results. Journal of Personality Assessment, 58, 160-178.

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

van Beek, I., T.W., Taris, & Schaufeli, W.B. (2011). Workaholic and work engaged employees: Dead ringers or worlds apart? Journal of Occupational Health Psychology, 16, 468-482.

Workaholism: Healthy enthusiasm or an addiction?

As someone who is often called a ‘workaholic’ by both my friends and colleagues, I have always been interested in whether people can be genuinely addicted to their jobs. The term ‘workaholism’ has been around for over 40 years since the publication of Wayne Oates’ 1971 book Confessions of a Workaholic, and has now passed into the public mainstream. Despite four decades of research into workaholism, no single definition or conceptualization of this phenomenon has emerged. Much of the work into the area has used operational definitions that do not conceptualize workaholism as an addiction or if they do conceptualize it as an addiction, the criteria used are somewhat dissimilar to the criteria used when examining other behavioural addictions such as gambling addiction, Internet addiction, sex addiction, exercise addiction, video game addiction, etc.

Reliable statistics on the prevalence of workaholism are hard to come by, although some researchers claim that one in four employed people are workaholics. It has also been claimed that amongst professional groups, the rate of workaholism is high especially in occupations such as medicine. As a result they work long hours, rarely delegate, expend high effort, and may not necessarily be more productive.

Workaholics have been conceptualized in different ways. For instance, workaholics are typically viewed as one (or a combination) of the following:

• Those viewed as hyper-performers
• Those viewed as unhappy and obsessive individuals who do not perform well in their jobs
• Those who work as a way of stopping themselves thinking about their emotional and personal lives
• Those who are over concerned with their work and neglect other areas of their lives.

Some authors note that there is a behavioural component and a psychological component to workaholism. The behavioural component comprises working excessively hard (i.e., a high number of hours per day and/or week), whereas the psychological (dispositional) component comprises being obsessed with work (i.e., working compulsively and being unable to detach from work. This may sometimes be accompanied by other characteristics such as low work enjoyment.

There are those scholars who differentiate between positive and negative forms of workaholism. For instance, some view workaholism as both a negative and complex process that eventually affects the person’s ability to function properly. In contrast, others highlight the workaholics who are totally achievement oriented and have perfectionist and compulsive-dependent traits. Workaholics appear to have a compulsive drive to gain approval and success but it can result in impaired judgment and personality breakdowns.

In relation to studies of workaholism, the most widely employed empirical approach proposes three underlying dimensions. These are (i) work involvement, (ii) drive, and (iii) work enjoyment. I have noted in my own writings on the topic that what starts out as love of work can often end up with the person developing perfectionist and obsessional traits. Some have argued that workaholism can be deadly and dangerous with an onset (e.g., busyness), a progression (e.g., loss of productivity, relationships etc.), and a conclusion (e.g., hospitalization or death from a heart attack). Others have argued that the final stage of workaholism is narcissism, often characterised by a complete loss of compassion and empathy. Furthermore, psychological research has shown links between workaholism and personality types including those with Type A Behaviour Patterns (i.e., competitive, achievement-oriented individuals) and those with obsessive-compulsive traits.

Research appears to indicate there are three central characteristics of workaholics. In short, they typically:

• Spend a great deal of time in work activities
• Are preoccupied with work even when they are not working
• Work beyond what is reasonably expected from them to meet their job requirements.
• Spend more time working because of an inner compulsion, rather than because of any external factors.

Workaholism as a syndrome is characterized by the number of hours spent on work, and the inability to detach psychologically from work. Although these features of workaholism appear to have good face validity, I have argued in a number of my papers that the amount of activity engaged in is not necessarily a core feature of addiction.

Some in the field view workaholism as much a ‘system addiction’ as an individual one. Although the manifestations of workaholism are at the level of the individual, workaholic behaviour is socially acceptable and even encouraged by major organizations. Organizations can potentially facilitate addictive work in a number of ways. For employees, an organization can provide the structure and/or the mechanisms and dynamics for both the addictive substance (e.g., adrenalin) and/or the process (i.e., work itself). I have argued that for someone working too much, it makes little practical difference if they are dependent or addicted. In relation to excessive work, the public understands notions of ‘addiction’ and ‘workaholism’ and these are therefore still very useful constructs for both academic (research) and educational purposes.

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

Further reading

Griffiths, M.D. (2005). Workaholism is still a useful construct. Addiction Research and Theory, 13, 97-100.

Griffiths, M.D. (2011). Workaholism: A 21^st century addiction. The Psychologist: Bulletin of the British Psychological Society, 24, 740-744.

Matuska, K.M. (2010). Workaholism, life balance, and well-being: A comparative analysis. Journal of Occupational Science, 17, 104-111.

Schaufeli, W.B., Taris, T.W., & Bakker, A.B. (2006). Doctor Jekyll or Mr Hyde? On the differences between work engagement and workaholism. In R. Burke (Ed.), Workaholism and long working hours (pp. 193-217). Cheltenham: Edward Elgar.

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

van Beek, I., T.W., Taris, & Schaufeli, W.B. (2011). Workaholic and work engaged employees: Dead ringers or worlds apart? Journal of Occupational Health Psychology, 16, 468-482.

Positive addiction: Fact or fiction?

I am often asked by the media “What is the difference between healthy excessive enthusiasms and addiction?”, and my stock answer is always that healthy excessive enthusiasms add to life but that addiction takes away from it. This suggests that addictions are purely negative, yet it could be argued that for some people there are many benefits of engaging in their addiction of choice. If we were to write a list of possible benefits of addiction, it may include some of the following:

• Reliable changes of mood and subjective experience (e.g., enhances subjective wellbeing through excitement and arousal, and/or provides feelings of being able to relax or escape)
• Positive experience of pleasure, excitement, relaxation
• Disinhibition of behaviour aiding sociability (e.g., initiating sexual behaviour)
• Coping strategy for all vulnerabilities (e.g., insults, injuries, social anxiety, fear, tension, etc.)
• Simplifier of decisions as all behaviour is related to one activity
• Maintainer of emotional distance (i.e., prevents people from getting close to the addict)
• Strategy for threatening, rebelling, revenging, etc
• Source of identity and/or meaning of life (e.g., a person’s social circle may consist entirely of other addicted individuals who condone and reinforce the addictive behaviour)

This list suggests that for the addict there are some genuine benefits, at least from their own perception. The idea that there are “positive addictions” is not new and was first forwarded by Bill Glasser in his 1976 book Positive Addictions (Harper & Row, New York). Glasser argued that activities such as jogging and transcendental meditation were positive addictions and were the kinds of activity that could be deliberately cultivated to wean addicts away from more harmful and sinister preoccupations. According to Glasser, positive addictions must be new rewarding activities such as exercise and relaxation that produce increased feelings of self-efficacy.

However, one of my great mentors, psychologist Iain Brown (now retired from Glasgow University) suggested it might be better to call some activities “mixed blessing addictions”, since even positive addictions such as exercise addiction (suggested by Glasser) might have some negative consequences. For me, one of the defining features of addiction is that the short-term-benefits (particularly like those the list above) are always outnumbered by the long-term downsides (i.e., over time, the long-term disadvantages start to outweigh the short-term disadvantages).

For me, there is also the question of whether positive addictions are “addictions” at all. Have a quick look at Glasser’s criteria for positive addictions. In short, for an activity to be classed as a positive addiction, the behaviour must be:

• Non-competitive and needing about an hour a day
• Easy, so no mental effort is required
• Easy to be done alone, not dependent on people
• Believed to be having some value (physical, mental, spiritual)
• Believed that if persisted in, some improvement will result
• Involve no self-criticism.

To me, these criteria have little resemblance to the core criteria or components of addictions (such as salience, withdrawal, tolerance, mood modification, conflict, relapse, etc.). My own view I that ‘positive addiction’ is an oxymoron and although I am the first to admit that some potential addictions might have benefits that are more than just short-term (as in the case of addictions to work or exercise), addictions will always be negative for the individual in the long run.

Dr Mark Griffiths, Professor of Gambling Studies, 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.