by Anjali Arackal
Culture-bound syndromes (also known, charmingly, as folk illnesses) are those which are isolated to a single, specific society. There are no objective bodily biochemical or structural alterations, and yet they are undeniably real. The DSM-V defines them as “cultural concepts of distress”, suggesting that these conditions may be a socially acceptable way to vocalise suffering - they frequently affect marginalised groups, such as young women in conservative societies, so one could argue that they give a voice to the voiceless.
In Sweden, hundreds of refugee children appear to have gone into a coma - but with their brains fully active. First identified in the 90s and labelled “resignation syndrome”, these children must be fed via feeding tubes and are clearly unresponsive. This is thought to be an involuntary response to the trauma of fleeing their home countries and then being subjected to the long process of applying for asylum in Sweden, where they could be forced away at any moment. The only cure is to be granted asylum; upon hearing the news, the children gradually come back to an active participation in life. Although there have been one or two cases where children were forced to fake RS by a parent in order to gain asylum, on the whole it has been shown to be a legitimate condition. Neurologist Dr. Suzanne O’Sullivan suggests that the children are unconsciously embodying expectations - they’ve seen other refugee children withdraw in this manner, and thus their bodies subconsciously follow the same pattern to cope with their trauma. Asylum being the “cure” is well-publicised; once the family is allowed to stay, the patient embodies the expectation of healing from their illness.
Grisi siknis (a Miskito language interpretation) of the English “crazy sickness”) affects young women from the Miskito people of Central America. Symptoms vary, but there is a core sign: an “attack” of the victim entering a fugue state and running away, often with greatly enhanced strength meaning that several grown men may be needed to hold down one patient. These visually resemble seizures. Victims report seeing mental visions of demons, with sexual intentions, but these hallucinations can be both pleasant or nightmarish. It can only be cured by traditional Miskito healing methods, usually involving a witch doctor. It has been hypothesised that grisi siknis is a way for girls aged 15-18 to transition to adulthood and express sexuality while remaining “socially pure”, as Miskito culture blames the demons possessing the girls instead of the girls themselves.
We have culture-bound syndromes in Western society too. Some argue that depression should be defined as such: its prevalence is leagues higher in anglophone (English-speaking) and westernised cultures, and clinical tests are iffy at best in terms of showing a single objective biological change. Although this doesn’t diminish the very real effects of the condition, it does show that perhaps there are more social factors at play. With the rise of globalisation, it has been suggested that by 2050, the cultural dominance of depression is likely to be “severely challenged”.
Culture-bound illnesses have an important role in society, as a culturally acceptable way to express distress and thus receive support.
References:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3635547/
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