This post is part of a series of guest posts on GPS by the graduate students in my Psychopathology course. As part of their work for the course, each student had to demonstrate mastery of the skill of “Educating the Public about Mental Health.” To that end, each student has to prepare two 1,000ish word posts on a particular class of mental disorders.
Mysterious but Not Unknown: Famous Conversion Disorder Cases by Sarai Peguero
Conversion Disorder, also known as hysteria or functional neurological symptom disorder, is a mental disorder in the Somatic Symptoms and Related Disorders category in the DSM-5. This disorder is characterized by underlying stress in the individual that is then converted into physical symptoms that resemble a neurological deficit. Symptoms can occur as temporary paralysis or blindness, psychogenic seizures, or tics.
Conversion disorder recently gained popularity in the media with the girls from LeRoy, New York between 2011 and 2012. In this case, up to 20 girls all began to develop the same symptoms around the same time. These symptoms included tics, stuttering, seizures, and verbal outbursts and were debilitating to the girls lives. Girls reported missing months of school and not being able to function normally as they once could. When doctors were not able to find a neurological cause for the symptoms the girls were presenting, a diagnosis of conversion disorder and mass psychogenic illness was made. Parents were insulted by this diagnosis and felt the diagnosis was outdated. The guardian of one of the girls affected said to the New York Times, “What are we, living in the 1600s?” Frustrated and afraid, parents took it upon themselves to reach out to the media to hopefully find the actual cause of their daughters’ symptoms.
Girls and their mothers appeared on the Today Show, on Dr. Drew, and received a huge amount of media attention. News headlines about a “mystery illness” spread like wildfire. From news stations like NPR, CNN, and TIME, to online blogs dedicated to Tourette’s and Autism, everyone was putting in their two cents as to what might be causing this inexplicable illness. One neurologist suggested the girls were suffering from the theorized neurological disorder PANDAS (pediatric autoimmune neuropsychiatric disorders associated with Streptococcal infections). The HPV vaccine, a 1970 chemical spill, and even demonic possession were also proposed as causes for the outbreak. As far as environmental factors, the New York State Department of Health tested the water and soil at and around the school, and evaluated the indoor air quality and mold within the high school and found nothing. Erin Brockovich also conducted her own investigation and also discovered nothing.
Parents might have believed heading to the media would help them in their search for a cause, but media attention only worsened the girls’ symptoms. The girls who were appearing on television, doing interviews, and uploading statuses and videos on social media were getting worse, while the ones who did not were getting better. The school district released a statement saying they will no longer comment on student health issues due to media attention negatively impacting the students. Along with the statement, the results of the environmental tests conducted were also posted. After the media attention died down and the girls received appropriate treatment for conversion disorder, they all returned to regular functioning.
This specific case of conversion disorder gained a lot of media and national attention, but conversion disorder accompanied by mass psychogenic illness is actually not that uncommon; there are numerous cases throughout history depicting this phenomenon.
- Probably the most well-known case is the Salem witch trials in 1692. Initially, two girls age 11 and 12 began exhibiting verbal outbursts, muscle spasms, and sudden movements. Soon, numerous other girls began displaying the same symptoms. The town doctor could not find evidence of any ailments and referred the girls to the priest. These girls were then labeled as witches and as a result were hung. Marion Starkey describes in her book The Devil in Massachusetts that this case of conversion disorder manifested itself in girls that were repressed due to Puritanism, and the condition was exacerbated by the priests.
- Several centuries later in 1893 Switzerland the Writing Tremor Epidemic Twenty girls were affected by trembling and convulsions upon entering school grounds. These symptoms were only present at school, and prevented the girls from completing in-school assignments. In 1905 in Germany, the same thing happened to middle school aged girls who had “excessive writing assignments”.
- In Bellevue, Louisiana in 1939 a “twitching epidemic” occurred in a high school. The first to exhibit these symptoms of conversion disorder was a 17-year-old girl named Helen. Helen had her eye on a senior boy named Maurice who was a very good dancer; Helen did not dance and was not interested in learning how to dance, but was jealous of the attention a tap-dancing freshman was receiving from Maurice. Helen’s leg first started twitching at the Homecoming Dance, and only got worse from there. It was hypothesized that Helen’s leg began twitching and spazzing due to her unconscious stress about the tap-dancing freshman and Maurice. Soon thereafter, other girls began experiencing convulsive jerking in their legs, chest, and/or neck similar to what Helen was experiencing.
- In England in 1965, a few girls from an all-girls school were complaining of dizziness and lightheadedness. Within a few hours, 85 girls from the same school fainted and were rushed to the hospital. These girls also experienced symptoms of moaning and psychogenic seizures. No evidence of contamination was found at the school.
- One of the first reported incidences of conversion disorder and mass psychogenic illness in the 21st century happened in 2002 at a North Carolina high school, several cheerleaders began having seizures along with fainting spells and twitching muscles. The school nurse reported they were unlike any seizure she had ever seen. After a doctor examined the girl’s brain waves, it was determined that the seizures were not epileptic, and were psychogenic. All of the girls returned to full functioning after about four months.
- Just five years later in Mexico City 2007, at least 500 girls and one teacher at a Catholic Boarding school suffered from a gait abnormality. The incident began when a girl called Maria played with a Ouija board and was then suspended; while leaving, Maria “cursed” her peers and exclaimed that they would all get sick in their legs, just like another girl had months earlier. Just as Maria had said, the girls had trouble walking and reported severe pain in the hips, knees, and legs. Most of the girls in the boarding school came from abusive homes. It was theorized that when Maria “cursed” her classmates, they identified with her and unconsciously re-experience the trauma they experienced at home. This stress was then converted into the “curse” that Maria had placed while leaving.
Other fascinating cases of mass psychogenic illness that may not involve conversion disorder are the Dancing Plague of 1518, where 400 people took to the streets of Stasbourg and danced for weeks. Eventually some died of exhaustion, stroke, or heart attacks. There is also the Tanganyika Laughter Epidemic of 1962 where students at a girls boarding school had laughing and crying attacks. Conversion disorder accompanied by mass psychogenic illness can definitely be a frightening thing to experience. In most cases, individuals returned to full functioning after treatment or a period of time. It is important to understand that the symptoms exhibited by the individuals are not feigned in any way, and are very real.