Mass Hysteria: The Mysterious Psychosomatic Phenomenon That May Not Even Exist

In 1518, the citizens of Strasbourg in the Holy Roman Empire were overcome by a plague. However, this was no ordinary illness; coined “The Dancing Plague of 1518,” the city’s streets were filled with people who had started to dance and could not stop. Some even died due to heat stroke or heart attack, and attempts to halt this bizarre behavior failed for months (Cohut, 2018). This event is a historical example of Mass Hysteria. Officially termed “Mass Psychogenic Illness” (MPI), this phenomenon is a simultaneous group experience of a conversion disorder. Mayo Clinic defines a conversion disorder as one “fx” (Mayo Clinic, 2019). The neurological mechanisms of MPI have stumped scientists for decades. There is conflicting literature on its etiology and the lack of ability to establish controlled research trials continues to mystify this illness. Some scholars go as far to doubt its existence, citing environmental causes as explanations for symptoms attributed to MPI. This review serves to highlight the inconsistencies and persisting confusion concerning MPI research. Additionally, an avenue for further research that investigators can explore is prioritizing more neuroimaging studies, comparative case studies and other forms of research so the underlying mechanisms of MPI can be illuminated and potential treatments can be explored.

Outbreaks of mass hysteria have been recognized for centuries, along with variable explanations for how they came about. Some scholars believe it is a separate neurological disorder, claiming that it is often misdiagnosed, or don’t believe in its existence at all (Nicholson et al., 2010). The infamous Sigmund Freud postulated that each individual who suffered as part of a mass hysterical event had a trauma that they had yet to deal with. More modern perspectives disagree with this viewpoint:biological, chemical, and physical stressors have all been considered as roots of MPI, but no consensus has been reached. However, neuroimaging studies that have been performed on subjects with conversion disorder could provide insight into the neurological mechanisms for its pathology (Burke et al., 2014). These studies have found more than 10 abnormally active brain regions in these patients. Notably, significant activity was observed in the temporal lobe, which is involved in memory encoding and auditory processing. The general limbic cortices found in this lobe were also heavily involved. The limbic system is involved with emotional processing and regulation, which explains the emotionally distressing, fear-mongering aspect of MPI (Cretton et al., 2020). In addition, the temporoparietal junction (TPJ), involved in language processing, was also found to display heavy activity (Burke et al., 2014). Beyond this, however, many of these neuroimaging studies have few findings in common, further supporting the complex nature of MPI.

Aside from its neurological mechanisms, MPI is suspected to be involved in many misdiagnoses, and many question its categorization due to the prevalence of many MPI symptoms, such as headache, dizziness, and a choking sensation, in other conditions from several common symptoms like, which are also overactive in stressful situations (Cohut, 2018). MPI is confirmed when several people get sick at the same time, but there are no disturbances in physical exams, and no environmental changes (change in water acidity, food, and air). Treatment for MPI has only involved removing the individuals affected from any others who have been affected, containing the area of illness, and most importantly, accepting and validating the individuals experiencing this illness (Staff, 2021). As the symptoms coincide with anxiety and stress, the usage of anti-anxiety drugs were long deemed to be the solution; however, effective treatment to MPI involves cognitive behavioral therapy and addressing and resolving the threat felt by the individuals, which cannot be ‘cured’ by any sedatives (Staff, 2021).

Mass hysteria is surrounded with conflicting research and documented misdiagnoses. From the city of dancing people to being an untreatable phenomenon, mass hysteria is shown to affect individuals of any age, background, health record, and sex. The only recurring evident symptom appearing in each case is a group of people being affected. Ideally, more attention in research will be given to this mystical illness so its neurological mechanisms can be illuminated and treatments further developed.

References

Burke, M. J., Ghaffar, O., Staines, W. R., Downar, J., & Feinstein, A. (2014, September 30).

Functional neuroimaging of conversion disorder: The role of ancillary activation. NeuroImage:Clinical.

https://www.sciencedirect.com/science/article/pii/S2213158214001521.

Mayo Foundation for Medical Education and Research. (2019, October 5). Functional

neurologic disorders/conversion disorder. Mayo Clinic. Retrieved December 28, 2021, from

https://www.mayoclinic.org/diseases-conditions/conversion-disorder/symptoms-causes/syc-20355197

Cretton, A., Brown, R. J., LaFrance, W. C., & Aybek, S. (2020). What does neuroscience

tell us about the conversion model of functional neurological disorders? The Journal of Neuropsychiatry and Clinial Neurosicences 32(1), 24–32. https://doi.org/10.1176/appi.neuropsych.19040089

MediLexicon International. (n.d.). What is mass hysteria? Medical News Today.

https://www.medicalnewstoday.com/articles/322607#What-is-mass-hysteria?

Nicholson, T. R., Stone, J., & Kanaan, R. A. (2010). Conversion disorder: A problematic

diagnosis. Journal of Neurology, Neurosurgery & Psychiatry, 82(11), 1267–1273. https://doi.org/10.1136/jnnp.2008.171306

Staff, F. E. (2021, January 22). Mass psychogenic illness. familydoctor.org.

https://familydoctor.org/condition/mass-psychogenic-illness/.

Voon, V., Cavanna, A. E., Coburn, K., Sampson, S., Reeve, A., & LaFrance, W. C. (2016).

Functional neuroanatomy and Neurophysiology of Functional Neurological Disorders (conversion disorder). The Journal of Neuropsychiatry and Clinical Neurosciences, 28(3), 168–190. https://doi.org/10.1176/appi.neuropsych.14090217