A historian named Mark Griffiths claims to have uncovered “the true face of” William Shakespeare. According to Country Life magazine, this likeness of the Bard can be found on the title page of John Gerard‘s 1597 botany book, The Herball.
The video embedded features Griffiths recounting how he made this discovery. Below, we’ve posted the cover from the May 2015 issue of Country Life magazine which showcases Shakespeare’s portrait.
The world’s greatest English playwright lived from 1564 to 1616. Given the publication date of Gerard’s plant tome, this means that the image was created during Shakespeare’s lifetime. The Guardian reports that “the only known authentic likenesses of Shakespeare are in the First Folio and the effigy on his monument at Holy Trinity church in Stratford-upon-Avon. Both of these were made posthumously.” (via CNN.com)
Researchers have noted that some addictive behaviours may partly depend upon gender. For instance, men are more likely to be addicted to drugs, gambling, and sex whereas women are more likely to suffer from ‘mall disorders’ such as eating and shopping. Food is – of course – a primary reward as it is necessary for our survival.
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If evidence for love addiction was purely based on the lyrics of pop songs (Robert Palmer, Roxy Music), there would be little doubt that love addiction exists. For those in the academic community who believe in the concept of ‘love addiction’ unsurprisingly define it as the condition in which people become addicted to the feelings of being in love.
Historically, in the psychological literature, the concept of love addiction has been around for some time. Freud’s case study of the Sergei Pankejeff (nick-named the ‘Wolf Man’ after he told Freud about a strange dream involving a tree full of white wolves), noted his “liability to compulsive attacks of falling physically in love… a compulsive falling in love that came on and passed off by sudden fits.” However, it is generally thought that Dr. Sándor Radó (the Hungarian psychoanalyst) first described the characteristics of ‘love addicts’ that used love to simultaneously increase sexual satisfaction and heighten self-esteem.
Arguably the most cited work in this area is the 1975 book Love and Addiction by Dr. Stanton Peele and Dr. Archie Brodsky. Their book suggested that some forms of love are actually forms of addiction, and tried to make the case that some forms of love addiction may be potentially more destructive and prevalent than widely recognized opiate drugs. However, Peele later said his main points had been somewhat sidelined and used for others’ own agendas. He said that the book had intended to be: “a social commentary on how our society defines and patterns intimate relationships… all of this social dimension has been removed, and the attention to love addiction has been channeled in the direction of regarding it as an individual, treatable psychopathology.”
In 1981, a paper on the development of a 20-item ‘Love Addiction Scale’ by Dr. Mary Hunter and colleagues was published in the journal Psychological Reports. They said that the defining characteristics of love addiction were:
- Wanting the partner to fill a felt void in one’s life
- Wanting the reassurance of constancy of partner
- Feeling that the partner is necessary to make life bearable
- Feeling that the sole source of one’s gratification and pleasure is one’s partner
However, the actual paper was a one-page summary and didn’t report what the individual 20 items were. Since then, the term ‘love addiction’ has been uncritically and extensively used in popular psychology and self-help books (such as Robin Norwood’s Women Who Love Too Much, Susan Peabody’s Addiction to Love, and John Moore’s Confusing Love with Obsession). Jim Hall claims there are at least nine types of love addict in his book The Love Addict in Love Addiction. He claims that some individuals “become painfully obsessed with avoidant and/or narcissistic relationship partners” and that others can become addicted to individuals outside of a romantic relationship.
I use the components model of addiction to operationally define whether addictions to certain behaviours exist. If love addiction exists, I would expect to see people with the following criteria:
- Salience: This would be when loving somebody becomes the most important activity in the person’s life and dominates their thinking (preoccupations and cognitive distortions), feelings (cravings), and behaviour (deterioration of socialized behaviour).
- Mood modification: This would refers to the subjective experiences that people report as a consequence of being in love with someone and – if it was a genuine addiction – would be used as a coping strategy to feel better about themselves (i.e., they experience love as an arousing “buzz” or a “high” or paradoxically a tranquilizing feel of “escape” or “numbing” that helps them to cope with other more stressful things in their life).
- Tolerance: This would be the process whereby the love they feel for someone plays an increasingly bigger and more important part in that persons’ life to achieve the former mood modifying effects.
- Withdrawal symptoms: These would be the unpleasant feeling states and/or physical effects that occur when love is discontinued (e.g., the other person ends the relationship or the person loved dies).
- Conflict: This would be where being in love with someone resulted in the feelings love interfering and compromising all other activity in that person’s life (e.g., job, hobbies, social friendships, etc.).
- Relapse: Here this might refer to “getting somebody out of their system” only for all the feelings of love to return when they are in the person’s company or engage in an act (e.g., kissing) that re-kindles all the previous feelings they had for that person.
By applying these basic criteria to love, I would guess (as I have never done any empirical research on this topic) that there would be very few genuine ‘love addicts’. When people first meet and fall in love, many of the criteria above may be temporarily experienced, but this is due to the effect of novelty, and may not be particularly long lasting. There is certainly some empirical evidence by Dr. Thomas Timmreck in the journal Psychological Reports suggesting that relationship break-ups and death of life-partners can lead to a range of symptoms that resemble withdrawal effects in more traditional addictions.
As I have said many times before in many different contexts, the difference between healthy enthusiasms and addictions is that healthy enthusiasms add to life whereas addictions take away from them. For the vast majority of people, falling in love (and being in love with somebody) is something that is life-affirming, life-enhancing, and in no way problematic.
In 2011, I co-authored (along with Dr Steve Sussman and Nadra Lisha, from the University of Southern California) a review paper on addiction prevalence across 11 different potentially addictive behaviours (including love addiction) in the journal Evaluation and the Health Professions. We reported that one study by MacLaren and Best in 2010, provided estimates of 12% for relationship submissive/love addiction among a sample of young adults. Most studies I have read report the prevalence of love addiction at around 3% to 6%. However, most of these studies are methodologically questionable (small samples, sample bias, etc.) and are more likely to be estimating or assessing preoccupation with love rather than genuine addiction.
Despite the lack of conclusive evidence that love addiction actually exists, we can all probably think of people we know where their love for somebody has bordered on the obsessive and/or addictive. There are also clinical cases of de Clérambault’s Syndrome in which the affected person suffers from the delusion that another person (typically a stranger or very casual acquaintance, or somebody famous or of high-status) is in love with them. This type of obsessive love is often found in people with other psychological and/or psychiatric disorders such as bipolar disorders, psychoses, and schizophrenia (and as such is a different clinical entity to love addiction).
One of the problems with the concept of ‘love addiction’ is that if it does exist, there is potential crossover and confounding effects with ‘sex addiction’ particularly as they often appear to have a symbiotic relationship. Although love and sex are different entities, they can be highly intertwined. On this note I will leave you with a couple of my favourite quotes. As actor and film director Woody Allen once said: “Love is the answer. But while you’re waiting for the answer, sex raises some pretty good questions” and “Sex alleviates tension. Love causes it.”
A version of this article originally appeared on Dr. Mark Griffiths blog.
Headline image credit: Sweet heart candies. CC0 via Pixabay.
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Over the last 15 years, research into various online addictions has greatly increased. Prior to the 2013 publication of the American Psychiatric Association’s fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), there had been some debate as to whether ‘Internet addiction’ should be introduced into the text as a separate disorder. Alongside this, there has been debate as to whether those in the online addiction field should be researching generalized Internet use and/or the potentially addictive activities that can be engaged on the Internet (e.g. gambling, video gaming, sex, shopping, etc.).
It should also be noted that given the lack of consensus as to whether video game addiction exists and/or whether the term ‘addiction’ is the most appropriate to use, some researchers have instead used terminology such as ‘excessive’ or ‘problematic’ to denote the harmful use of video games. Terminology for what appears to be for the same disorder and/or its consequences include problem video game playing, problematic online game use, video game addiction, online gaming addiction, Internet gaming addiction, and compulsive Internet use.
Following these debates, the Substance Use Disorder Work Group (SUDWG) recommended that the DSM-5 include a sub-type of problematic Internet use (i.e. Internet gaming disorder (IGD)) in Section 3 (‘Emerging Measures and Models’) as an area that needed future research before being included in future editions of the DSM. According to Dr. Nancy Petry and Dr. Charles O’Brien, IGD will not be included as a separate mental disorder until the
- (i) defining features of IGD have been identified,
- (ii) reliability and validity of specific IGD criteria have been obtained cross-culturally,
- (iii) prevalence rates have been determined in representative epidemiological samples across the world, and
- (iv) etiology and associated biological features have been evaluated.
Although there is now a rapidly growing literature on pathological video gaming, one of the key reasons that Internet gaming disorder was not included in the main text of the DSM-5 was that the Substance Use Disorder Work Group concluded that no standard diagnostic criteria were used to assess gaming addiction across these studies. In 2013, some of my colleagues and I published a paper in Clinical Psychology Review examining all instruments assessing problematic, pathological, and/or addictive gaming. We reported that 18 different screening instruments had been developed, and that these had been used in 63 quantitative studies comprising 58,415 participants. The prevalence rates for problematic gaming were highly variable depending on age (e.g. children, adolescents, young adults, older adults) and sample (e.g. college students, Internet users, gamers, etc.). Most studies’ prevalence rates of problematic gaming ranged between 1% and 10%, but higher figures have been reported (particularly amongst self-selected samples of video gamers). In our review, we also identified both strengths and weaknesses of these instruments.
The main strengths of the instrumentation included the:
- (i) the brevity and ease of scoring,
- (ii) excellent psychometric properties such as convergent validity and internal consistency, and
- (iii) robust data that will aid the development of standardized norms for adolescent populations.
However, the main weaknesses identified in the instrumentation included:
- (i) core addiction indicators being inconsistent across studies,
- (ii) a general lack of any temporal dimension,
- (iii) inconsistent cut-off scores relating to clinical status,
- (iv) poor and/or inadequate inter-rater reliability and predictive validity, and
- (v) inconsistent and/or dimensionality.
It has also been noted by many researchers (including me) that the criteria for Internet gaming disorder assessment tools are theoretically based on a variety of different potentially problematic activities including substance use disorders, pathological gambling, and/or other behavioral addiction criteria. There are also issues surrounding the settings in which diagnostic screens are used, as those used in clinical practice settings may require a different emphasis that those used in epidemiological, experimental, and neurobiological research settings.
Video gaming that is problematic, pathological, and/or addictive lacks a widely accepted definition. Some researchers in the field consider video games as the starting point for examining the characteristics of this specific disorder, while others consider the Internet as the main platform that unites different addictive Internet activities, including online games. My colleagues and I have begun to make an effort to integrate both approaches, i.e., classifying online gaming addiction as a sub-type of video game addiction but acknowledging that some situational and structural characteristics of the Internet may facilitate addictive tendencies (e.g. accessibility, anonymity, affordability, disinhibition, etc.).
Throughout my career I have argued that although all addictions have particular and idiosyncratic characteristics, they share more commonalities than differences (i.e. salience, mood modification, tolerance, withdrawal symptoms, conflict, and relapse), and likely reflects a common etiology of addictive behavior. When I started research Internet addiction in the mid-1990s, I came to the view that there is a fundamental difference between addiction to the Internet, and addictions on the Internet. However, many online games (such as Massively Multiplayer Online Role Playing Games) differ from traditional stand-alone video games as there are social and/or role-playing dimension that allow interaction with other gamers.
Irrespective of approach or model, the components and dimensions that comprise online gaming addiction outlined above are very similar to the Internet gaming disorder criteria in Section 3 of the DSM-5. For instance, my six addiction components directly map onto the nine proposed criteria for IGD (of which five or more need to be endorsed and resulting in clinically significant impairment). More specifically:
- preoccupation with Internet games [salience];
- withdrawal symptoms when Internet gaming is taken away [withdrawal];
- the need to spend increasing amounts of time engaged in Internet gaming [tolerance],
- unsuccessful attempts to control participation in Internet gaming [relapse/loss of control];
- loss of interest in hobbies and entertainment as a result of, and with the exception of, Internet gaming [conflict];
- continued excessive use of Internet games despite knowledge of psychosocial problems [conflict];
- deception of family members, therapists, or others regarding the amount of Internet gaming [conflict];
- use of the Internet gaming to escape or relieve a negative mood [mood modification]; and
- loss of a significant relationship, job, or educational or career opportunity because of participation in Internet games [conflict].
The fact that Internet gaming disorder was included in Section 3 of the DSM-5 appears to have been well received by researchers and clinicians in the gaming addiction field (and by those individuals that have sought treatment for such disorders and had their experiences psychiatrically validated and feel less stigmatized). However, for IGD to be included in the section on ‘Substance-Related and Addictive Disorders’ along with ‘Gambling Disorder’, the gaming addiction field must unite and start using the same assessment measures so that comparisons can be made across different demographic groups and different cultures.
For epidemiological purposes, my research colleagues and I have asserted that the most appropriate measures in assessing problematic online use (including Internet gaming) should meet six requirements. Such an instrument should have:
- (i) brevity (to make surveys as short as possible and help overcome question fatigue);
- (ii) comprehensiveness (to examine all core aspects of problematic gaming as possible);
- (iii) reliability and validity across age groups (e.g. adolescents vs. adults);
- (iv) reliability and validity across data collection methods (e.g. online, face-to-face interview, paper-and-pencil);
- (v) cross-cultural reliability and validity; and
- (vi) clinical validation.
We also reached the conclusion that an ideal assessment instrument should serve as the basis for defining adequate cut-off scores in terms of both specificity and sensitivity.
The good news is that research in the gaming addiction field does appear to be reaching an emerging consensus. There have also been over 20 studies using neuroimaging techniques (such as functional magnetic resonance imaging) indicating that generalized Internet addiction and online gaming addiction share neurobiological similarities with more traditional addictions. However, it is critical that a unified approach to assessment of Internet gaming disorder is urgently needed as this is the only way that there will be a strong empirical and scientific basis for IGD to be included in the next DSM.
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