Madness is universal.
Globally, rates of schizophrenia, for example, have remained constant over the past 50 years, affecting on average one out of every 285 people. This might vary (urban areas have higher rates of schizophrenia), but only slightly. Whether you’re in Kampala, Uganda or California, insanity is a shared reality.
But what is perhaps lesser known, according to Joel Gold, a psychiatrist, and his brother, philosophy professor Ian Gold, is that the content of madness differs across cultures — the subject of their remarkable new book, “Suspicious Minds” (Free Press).
Gold noticed the phenomenon while working on the psychiatric unit at Manhattan’s Bellevue Hospital, which he refers to as “the United Nations of Madness.” There he saw up close how environment influences madness.
Just how these beliefs spread is largely unknown (some can be explained by underlying physical conditions common to the area or ethnic group), but Gold says these differences reveal the nuanced relationship between environment and genetics in mental illness.
From “puppy pregnancies” in West Bengal to “koro” — the fear that the penis is disappearing — in Malaysia, The Post has rounded up the most fascinating and bizarre culturally specific delusions from around the world.
San Mateo, Calif.
Stanford published a study last month comparing the content of hallucinations among Californians, Ghanaians, and South Indians — and, sadly, those in the US had the worst prognosis for treatment.The 20 Americans sampled uniformly described the voices they heard as negative and even “violent and hateful,” whereas as the Ghanaians and South Indians had a much more playful and positive relationship with the voices.
One American participant described a voice he heard as telling him to “take [an] eye out with a fork or cut someone’s head off and drink their blood, really nasty stuff.”
Distressing about this data: More positive relationships with the voices one hears are linked with better recovery rates.
At Bellevue, Dr. Joel Gold soon discovered how events can precipitate culture-bound delusions. After Sept. 11, 2001, he and his group of doctors began treating “African-American women from the South [who] were coming up to New York . . . with the fervent belief that they could raise the dead at Ground Zero.”
Sometimes movies are particularly popular inspirations for delusions. Though “The Matrix” has been a standby since it came out in 1998, Gold also discerned what he calls “The Truman Show Delusion.” As in the film starring Jim Carrey, “Truman” patients often believe that camera crews are following them and that their lives are just scripted reality TV shows. Since Gold first described it in the medical literature in 2006, he’s seen well over 100 cases.
Time also plays a role in what shapes delusions. In a study released in the 1980s, two psychologists compared the hallucinations of patients at an East Texas psychiatric hospital with those of patients at the same hospital 60 years earlier.
In the 1930s, patients focused on possessing material goods (perhaps unsurprising, given the era). Most of the hallucinations were of a religious nature. Patients heard statements, often from a force they attributed to God, that said, “Live right” or “Lean on the Lord.”
By 1980, religious delusions had become less common and the hallucinations had turned more harmful. Now people heard “Kill yourself” or “Kill your mother.” Fear in the form of modern technology, the KGB, the Mafia, and, oddly, from lesbians were most commonly reported.
You’d think that the remote tribes of the Amazon would experience similar delusions when ingesting the same hallucinatory drugs. Not so. While tripping, the Cashinahua tribe often saw or heard “spiritual guidance;” the Siona tribe saw an opening to an alternate reality; and the Schuar believed that that hallucinogens gave them access to the real world.Though these differences may seem minor, it shows, yet again, how different environments create different forms of madness.
“Susto,” or “fright sickness,” occurs when the sufferer believes that the soul has left the body after a traumatic experience. This has been linked to depressive and post-traumatic stress disorders, but is only seen in this area.
Hispanics all over the world also commonly experience other culturally specific delusions, including “mal de ojo,” evil eye, and “ataques de nervios,” nervous attacks.
A 2002 study revealed that Brits were more likely to hear a negative “running commentary” than their immigrant counterparts. The voices often berated the voice-hearers’ behavior, personality, and commanded them to commit suicide or kill others.
Inuit people experience “Arctic hysteria” (or piblokto), a condition that mostly affects women during the winter months. Irrational acts — like stripping naked and running through the snow — have been reported. Some believe that this is a reaction to the lack of sunlight and an outgrowth of repression of women in the tribal culture.
Central Turkey had the highest rates of poisoning delusions in the world, according to “Suspicious Minds.”
For example, only 8 percent of people with delusions polled in Tokyo felt they were being poisoned, while in Turkey 26.2% of people reported this belief. One follow-up study theorized that in Turkey’s family-centered culture, many acutely psychotic patients are treated at home, their anti-psychotic drugs mixed in with food.
One of the most bizarre cultural-bound delusion occurs in China: Here, people often report that their brain has or will be extracted. Brain and other organ removal, as well as fear of being pricked by poison needles, are often reported here, but not in Taiwan or South Korea.One participant summed up the delusion: “They [political authorities] pulled out my brain, so I could not think any more.” Could this delusion be a literal manifestation of Communist thought policing?
Seoul, South Korea
Koreans are more likely than people polled in China or Taiwan to suffer from jealous- and guilt-based delusions, according to a 2001 study out of Hanyang University. Koreans also reported high rates of rape delusions, but those were virtually non-existent in China or Taiwan.Those polled in Seoul often expressed higher-than-normal beliefs that they were being followed. A common refrain, the researchers found, was “I know he is a spy from North Korea.”
Here, people experience high rates of a social phobia called taijin kyofusho: the belief that their bodies are repulsive (smelly, for example) and make others uncomfortable. This differs from social phobias common in other countries because the person fears that they will humiliate others, but not themselves. Experts in Japanese culture say it’s a result of a society that values the interest of the group over the individual.
West Bengal, India
West Bengal is the only place in the world where you will find something called “puppy pregnancies,” or the belief that a woman will start carrying puppies if she is bitten by a dog. This delusion is based on longtime local lore.
“Wind attacks,” or khyal cap, cause dizziness, heart palpitations and general feelings of anxiety. In Cambodia the cause of this is believed to be wind rushing through the body, but experts believe they are panic attacks or an outgrowth of other anxiety disorders. This disease, also prevalent in Cambodian immigrants, is listed in the DSM.
Freud would have a field day. Malaysians experience the common delusional belief that sex organs — penis, breasts — are being reabsorbed into the body or disappearing entirely. Called “koro,” this delusion is so common that it’s found all over the world and is listed in the Diagnostic Statistical Manual of Mental Disorders, but is seen in its highest rates here and in China.
“Wild pig syndrome” is a case of cultural-and gender-specific delusions. In New Guinea men “go wild:” They steal from homes, exhibit antisocial behavior, stop speaking and disappear into the forest for days at a time.
This typically occurs, studies show, in recently married men facing financial or emotional difficulties. This delusion has only been reported in New Guinea.