Conversion Disorder and Mass Hysteria

For an episode of mass hysteria to begin, all that is necessary is troubled times in the culture, a shared set of beliefs and a final, fearful, anxiety-provoking trigger to set the phenomenon into motion.
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Recently there has been a great deal of coverage of 12 unfortunate teenage girls from the small community of Le Roy, N.Y. These teenagers had all around the same time inexplicably begun to exhibit many of the signs of Tourette's Syndrome. They stuttered, jerked and flailed with signs suggesting some severe neurological disorder. However, the girls were evaluated by a neurologist who diagnosed them as suffering what is known as "conversion disorder."

Conversion disorder is a psychiatric, rather than neurological, disorder. It arises out of the way one uses his or her brain rather than from some lesion, infection or injury of their brain tissue. Yet it is critical to understand that victims of conversion disorder do not fake symptoms. They are convinced their physical symptoms are true, and their suffering is genuine. While more often seen in women than men, one of the most dramatic forms of the disorder, so-called hysterical blindness, has been exploited in many an old war movie plot. The brave soldier witnesses the horrors of combat, and then awakens "unable to see," though with no evidence of anything being wrong with his eyes. After a great emotional catharsis, he suddenly sees again and returns to the battle. Such cases have been described in the annals of psychiatry and neurology.

It is by no means a trivial condition. The mysteries and complexities of conversion disorder were compelling enough to lead Sigmund Freud away from his studies of classical neurology to develop the entirely new field of psychoanalysis. The disorder is thought to be driven by a subconscious attempt to "convert" a strong, unbearable emotional or sexual thought into something more socially acceptable. Moreover, whereas individuals can exhibit conversion disorder, it is not at all uncommon for more than one individual to share in this trick of the mind. The sufferers can reinforce the behavior in each other, particularly if they share a common set of beliefs and are burdened by similar anxieties and fears.

What is fascinating, and perhaps even part and parcel of the same phenomenon, is the vast number of people who doubt that these girls are suffering conversion disorder. They suspect more sinister, conspiratorial explanations. As migth be expected, vaccines and other manifestations of Big Pharma and industrialized medicine come up among the usual list of suspects. Internet chatters speculate about environment poisons, power lines or installation of new fluorescent light systems in public buildings as being the real underlying causes. Now Erin Brockovich, a woman I greatly admire, has been dragged into the fray to come up withan explanation more satisfying than mere conversion disorder.

It is astonishing how many individuals uncritically accept magical powers of the mind over the body and the material world, such as in the laws of attraction, The Secret and other such nonsense, but are unwilling to accept the well-established fact that fear and anxiety can distort perception and create delusion. Unfortunately, during episodes of mass hysteria, the absurd becomes plausible and the scientific becomes suspect.

But none of this is new. There have been many episodes of mass hysteria in American history. As far as outbreaks of mass hysteria go, this recent incident in New York is small and tame. The most famous incident of conversion disorder and mass hysteria may have been the series of Salem Witch trials in colonial Massachusetts. In that case, a group of young women began to exhibit symptoms very similar to those of the Le Roy girls. However, the religious and social beliefs of those times lent credence to the conclusion that witchcraft, not Big Pharma, was the cause of the girls' symptoms. The girls even supplied names of those who were consorting with Satan, and as time went on the list of names grew longer. During the trials themselves, the intensity of their screaming and writhing in court was taken as evidence of the certainty of which the accused were actually witches. By the time it was through, the events in Salem led to the arrests of hundreds of citizens, the hangings of 19 innocent women and men, the deaths of four individuals in jail awaiting trial and the death of one very unfortunate Mr. Giles Cory, who was slowly crushed to death by rocks, whose placement was unsuccessfully used to coax him into testifying in court. The victims also included two dogs who were tried and hanged for being witches.

Such events have continued to happen in modern times. On Sept. 1, 1944, in Mattoon, Ill., a woman reported to police that a man lurking outside her bedroom window sprayed her and her daughter with a sweet-smelling gas that left them dizzy and nauseated. The mysterious stranger became known as the Phantom Anesthetist of Mattoon. After a report of the incident in the town newspaper, others began to report similar incidents. Within a few weeks, there were dozens of victims. In one case, a woman reported picking up a damp pink cloth that exuded an odor of gardenias. When she sniffed it, she felt a charge of electricity. The newspaper reported that she was "taken to the hospital suffering burns and temporary paralysis." The Illinois state criminal investigation laboratory recovered that cloth, but found nothing at all unusual about it. Fear escalated to the point that armed gangs of men began driving around neighborhoods searching for the perpetrator. By mid-September, the fears inexplicably died down. No more reports were made to police. No gas or anesthetist were ever found.

Yet another incident of mass hysteria took place in Seattle in the spring of 1954. It is known among sociologists as the Seattle Windshield Pitting Epidemic. Some residents of Bellingham, Wash. reported what they believed was unusual pitting of their car windshields. Over several weeks, the reports increased in numbers. After the story was picked up by a Seattle newspaper, reports skyrocketed. Police suspected vandalism and set up road blocks to apprehend the culprits, but none were found. By mid-April of that year, police had received over 3,000 reports of unexplained windshield pitting. Lacking answers, people began to assume the worst. Some believed the Navy's nearby communication tower was warping the glass. Some thought nuclear tests were the cause. Cosmic rays and changes in the earth's magnetic field were suspected. Eventually, the governor got involved. President Eisenhower was called as reports of damaged windshields continued. Finally, scientists from the University of Washington did studies and published their findings. Most notable among their findings was that the pitting occurred primarily on windshields of cars, rather than their back windows. They found that cars left parked had no such damage. Eventually it was concluded that the pitting was nothing more than normal wear from driving on Washington's roads. In short, nothing was happening at all! One authority suspected it all began because, "Some people started looking at, rather than through, their windshields." The concluding statement from the Seattle police crime lab was that the pitting was "5 percent hooliganism and 95 percent hysteria." No reports of pitting came after that statement.

Given the right conditions, mass hysteria can happen in any culture. One of the most peculiar outbreaks of conversion disorder and mass hysteria occurred on the island of Singapore in 1967. After an outbreak of swine fever, Chinese men on the island began to flood into Singapore's hospitals with the terrifying fear that their penises were shrinking. The belief was that if the penis withdrew all the way up into their abdomen, they would die. Nearly 500 men and a handful of women fell victim to the fear. They rushed terror-stricken to Singapore's emergency rooms, penises in hand or tied down with string, begging for help. This was an epidemic of the culture-bound illness known as koro.

For an episode of mass hysteria to begin, all that is necessary is troubled times in the culture, a shared set of beliefs and a final, fearful, anxiety-provoking trigger to set the phenomenon into motion. In the 1960s in Singapore , there were riots between Muslims and Chinese. There were fears of political upheaval and the possibility of state financial collapse. People were filled with fear and anxiety. As was the case the case with witchcraft during the Salem witch trials, in Singapore the notion of koro was deeply rooted in cultural beliefs. While absurd and with no basis whatsoever in human physiology, the epidemic of koro provided a culturally acceptable means to relieve powerful and frightening emotions. The government, media and the local medical association cooperated in spreading the word that koro was not real, no one was dying from penis shrinkage, and there was nothing to be afraid of. Over a month's time, the epidemic "petered out," so to speak.

The phenomena of conversion disorder and mass hysteria have likely been around since the beginning of human history. Though we have advanced as a species, the thin veneers of modern science, technology and instantaneous communications have not altered the underlying nature of the human mind. Episodes of conversion disorder and mass hysteria will almost certainly continue to erupt in our country and around the world, and they will increase in frequency when times are trying. They need to be addressed with sensitivity, understanding and authority, and not by allowing fanciful notions to proliferate.

Dr. Mendelson explains the psychological and cultural bases of conversion disorders and mass hysteria in his book, The Great Singapore Penis Panic and the Future of American Mass Hysteria.

For more by Scott Mendelson, M.D., click here.

For more on mental health, click here.

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