Protean Nature of Mass Sociogenic Illness by Bartholomew & Wessely (2002) - Article

Sometimes people can have a disturbance in their nervous system, which causes an illness and the symptoms of this illness can spread rapidly among the members of a certain group (especially in the context of credible threat). However, no organic cause is present. This is the so-called mass sociogenic illness. This illness is often characterised as a ‘somatoform disorder and according to the APA, it can also be subcategorised as a hysterical neurosis, conversion type. Mass sociogenic illness is underreported and it can cost agencies much money. Many books have been on written individual hysteria, but not so many have been written on the history of mass sociogenic illness. The nature of mass sociogenic illness is versatile and changing, because it reflects the historical and cultural world at that time and the social beliefs people have in certain eras. According to Wessely (one of the authors of the article), there are two types of mass sociogenic illness: mass motor hysteria and mass anxiety hysteria. Mass anxiety hysteria has a short duration (often one day) and it presents itself after the perception of a fake threat. The person becomes really anxious. Mass motor hysteria involves changes in one’s psychomotor activity (twitching and shaking) and dissociation. It presents itself after a person has gained a lot of stress and it usually persist for a longer time (e.g. weeks or months).

The middle ages

Before the 20^th century, most reports of mass sociogenic illness were about motor hysteria. In the Middle Ages, religion was a big part of life and people believed heavily in witches and demons. Between the 15^th and 19^th century, many reports about motor hysteria were about nuns who were supposedly possessed by demons. These reported episodes lasted months and in some cases, years. Theatrical performances seemed to be part of the syndrome. During that era, young girls were often mildly forced by elders to join religious orders and this meant that they would be living in an all-female dorm and should comply with the rigid discipline of that place. They had to agree to vows of chastity and poverty and this meant that they had to fast often and take part in diets that made them almost starve to death. The girls were punished severely for even small mistakes. The demons were exorcised by priests and women who weren’t liked were often burnt, locked up or banished. People from the community came to watch the exorcism spectacle.

There are many recorded episodes of demon possessions at nunneries. Some happened in the US, while others happened in different countries of Europe. Sometimes nuns were executed because they bewitched other members of their religious group. There are many examples throughout history, but just to name a few: Spain, 1560, some nuns bleated like sheep and took off their veils and in France during the 18^th century, some nuns meowed together every day at a certain time. People also believed that there were animals with demonic features that could possess you. In France they believed that cats could possess humans and cats were therefore hated there. These cases seem to be caused by anxiety, which caused dissociation and hyper-suggestibility. A couple of decades ago, something quit similar happened in Malaysia. Adolescent Muslim girls who were sent by their parents to isolated, religious, one-gender boarding schools were showing abnormal movements and screaming a lot. Healers were called to remove the demons out of their bodies. The girls even took hostages at knife-point. Luckily, nobody got hurt. It all ended when the girls were allowed to transfer to liberal schools.

The 18^th to 20^th century

In the 18^th, 19^th and early 20^th century, the industry was very important, but the working conditions were poor. Mass motor hysteria could be found in oppressive job settings. At that time, that were often factories. Throughout Europe people reported workers having convulsions and abnormal movements. There were not many reports of motor hysteria during the second half of the 20^th century and this is probably because of the better health and safety regulations of that time. Reports in the Soviet Union disappeared probably because of the rise of anti-capitalist systems.

In the 18^th to 20^th century schools were also affected. Many European schools reported that there were outbreaks of laughter, convulsions and trembling. One example is a girls’ school in Basel, Switzerland. In 1893, girls were shaking and unable to complete their written assignments in school. After school, the symptoms disappeared, but the next day of school the symptoms came back again.

Most epidemic hysteria cases in the 20th century were about the concerns over air, water quality and food. People were afraid of mysterious smells. The episodes had a rapid onset and recovery. These episodes were examples of anxiety hysteria. Most mass sociogenic illness outbreaks in school were caused by strange smells. One popular example occurred in Singapore, in 1985. 65 students and a teacher had trouble breathing, nausea and chills. Medical and environmental tests were done, but nothing seemed to be wrong with the classroom. The whole incident started when some of the students smelled something unusual and after certain rumours were started that a gas from a construction site had infiltrated the school. Researchers found that the people who believed this rumour was true, succumbed to the rumour and those who didn’t think it was true, didn’t show these weird behaviours. Epidemic anxiety hysteria was also triggered by strange smells in other settings. In the job setting, much productivity had been lost because of anxiety hysteria.

Biological and chemical warfare

Mass hysteria arose during the 20th century because of strange odours. The community was afraid of biological and chemical weapons. During the First World War, 90000 people were killed by poison gases and even more were injured. The scare of poison gases created certain episodes of mass sociogenic illness, decades after the First World War had ended. In the United States there were many reports between 1930 and 1945 about someone who had gassed homes. People reported being breathless, nauseas and dizzy. It turned out that nobody had attacked houses with gas, and that it was all due to imagination and anxiety. In the early 1980s, this trend became ‘popular’ again. People from the Jordan West Bank reported having headaches, being dizzy and fainting. This all happened after there were rumours that Jews had released poison gas on Palestinians. There were also reports in the late 1980s in Georgia and reports in 1995 from Japan about mass sociogenic illness. During the modern ages, media coverage has played a large role in the spreading of episodes of anxiety. It also seems that mass sociogenic illness can flourish where threats don’t seem that unlikely or imagined (in war zones, in towns that are attacked by terrorists).

The 21^st century

Terrorism has a big psychological impact and it can also strengthen the response to perceived terrorist threats. Because of the terrorist attacks in the recent 20 years and the use of anthrax as a weapon, people have become more alert and scared. People see the threat of biological and chemical terrorism closer as ever before. Anthrax isn’t seen as an effective way to cause mass physical causalities, but in the 21^st century, it does appear to cause panic in a nation. For example, in the United States more than 2300 anthrax false alarms were reported in the first two weeks of October 2001 (so, just after 9/11). Some examples include opening up letters and fearing a certain chemical came free (causing nausea and feeling chemical burns on the arm) and the so-called World Trade Centre syndrome. This entails the shortness of breath that more than 4000 firefighters of New York have reported after visiting the site of the World Trade Centre. Other New Yorkers that live and work near ground zero have also reported chest pains, shortness of breath and anxiety, despite the New York Health Department reporting that the contaminant levels are below threat level.

Predispositions

Most scientists look at abnormalities of the people affected when they research the causes of mass sociogenic illness. Many findings are conflicting and inconclusive and this is probably due to the fact that mass sociogenic illnesses are influenced by the beliefs and social realities of a certain time. Researchers who investigate modern-day mass sociogenic illness outbreaks, look at personality tests in order to see whether psychological, social and/or physical characteristics influence why a person becomes affected or not. The results are quit inconclusive: some researchers report that affected people score higher on extraversion than those unaffected, while other researchers didn’t find this correlation. Some studies reported that affected people score higher on paranoia, while others didn’t find an association. This shows that there isn’t a predisposition to mass sociogenic illness and it also implies that every person can suffer from mass sociogenic illness in the right circumstances.

Conclusions

It is difficult to make a prompt diagnosis of mass sociogenic illness. Researchers need time to analyse everything. It might come in handy to close a school or job building when waiting on the test results. This might also help to reduce the anxiety levels, because people will not be present at the perceived pollution site and the symptoms won’t be spread that quickly. The investigators can determine which (of the eight) features of mass sociogenic illness are present. These are the eight features of mass sociogenic illness:

• A rapid onset and recovery of symptoms

• No plausible organic basis of symptoms

• Benign symptoms

• Extra-ordinary anxiety

• It occurs in a segregated group

• Spreading of symptoms via sound, sight and oral communication

• Spreading of symptoms occurs from higher to low status

• Majority of victims is female

An early diagnosis can be made on the basis of these characteristics, before the results of air or food tests are presented. Mass sociogenic illness can be treated by eliminating or reducing the stimulus that causes stress. Because human beings construct their reality dynamically and continuously, nobody is immune from mass sociogenic illness. However, the threat needs to be plausible in order to cause anxiety in a group and ultimately result in mass sociogenic illness.