Culture-Bound Syndromes Run Amok

A recent Slate article by Jesse Bering outlines the strange and true world of culture-bound syndromes — mental illnesses that occur in certain geo-specific populations or “sociocultural milieus.”  Perhaps the most famous is “amok,” the root of “run amok,” and a problem in Malaysia, Polynesia, Puerto Rico and the Navajo Nation.  The syndrome affects males 20–45, who become homicidally violent after a perceived insult. After which, of course, the subject remembers very little.  Sound like a good cover?  It gets weirder.

In China, we find Koro: in which the patient is convinced that protruding bodily organs, such as the male genitalia or female nipples, are retracting or disappearing into his or her body.” Koro, however, has a habit of jumping all over the globe, and has been well documented in Thailand, India and Africa. Koro’s internationalism, like that of other culture-bound diseases, throws the specificity of “culture” into question, and the genre of these illnesses remains murky, nearly impossible to define, and fertile ground for wild postulating. Mythology in particular permeates the “culture-bound” discussion. Perhaps it is the particular oral traditions of a people who jump beyond the campfire into the lives – and bodies – of their listeners.


And as for what America has to add? Muscle dysmorphia! Bering writes: “The condition is limited to Western males, who suffer the delusion that they are insufficiently ripped.”  Citing a recent article in the Harvard Review of Psychiatry by Gen Kanayama and Harrison Pope, Bering ties together the American male body, and the American male hero:

Unlike hypermasculine Western heroes such as Hercules, Thor, and the chiseled Arnold of yesteryear, the Japanese and Chinese have tended to prefer their heroes fully clothed, mentally acute, and lithe, argue Kanayama and Pope. In fact, they say anabolic steroid use is virtually nonexistent in Asian countries, even though the drugs are considerably easier to obtain, being available without a prescription at most neighborhood drugstores.”


Joe Westhead

How about Japanese tourists suffering "Paris Syndrome"?

"Paris syndrome is a transient psychological disorder encountered by some people visiting or vacationing in Paris and more generally France and Spain...

Japanese visitors are observed to be especially susceptible...From the estimated six million yearly visitors, the number of reported cases is significant: according to an administrator at the Japanese embassy in France, around twenty Japanese tourists a year are affected by the syndrome. The susceptilibity of Japanese people may be linked to the popularity of Paris in Japanese culture, notably the idealized image of Paris prevalent in Japanese advertising, which does not correspond to reality."


Ian Tindale

Don’t forget the China Syndrome.


It gets sicker in the muscle dysmorphia world of body building. In fact, the MORE repugnant and sickening a muscle head looks to normal folks, the more satisfaction they take.

I've heard--no lie--of body builders who put tampons up their tail to keep from blowing their guts or feces out their backsides due to the tremendous strain the place on their bodies when doing squats, etc.

I finally concluded that there was some sort of mental illness going on. But I attribute it more to being part of a small, weird community. I'm not talking about body sculpting. I'm talking about the guys who can't hardly touch their heads because of the muscles in their arms, of guys who dress in bikinis and compete in body building...OK, wait, I was wrong, that is actually women, apparently.

You and I would say, "Oh, man, that is sick!" The aspiring body-builder will say, "Oh, yeah! Dude, that is awesomely sick!" They live on steroids. They aren't bad people...but when it comes to their bodies, they have lost touch with reality.



As a bodybuilding economist, I will certainly agree that the bodybuilding world is a "small, weird community." However, the stereotyping of bodybuilders as steroid-induced freaks who only care about the gym is unfortunate. The natural (drug-free) bodybuilding movement has made tremendous strides in the past 10 years. In these organizations, a typical stage weight is 170 lbs, pretty scrawny compared to the 270 lbs on the Olympia stage.

Being a successful competitive bodybuilder requires a level of commitment and motivation similar to what is required in other 'extreme' sports such as endurance bicycle racing or marathons. Lots of people might consider running 26.2 miles at one time "sick." There is little money in the natural organizations, so ALL competitors have real-world jobs and are relatively well-adjusted. Some of us even publish peer-reviewed articles and teach college classes.

I push myself hard to be the best that I can in my chosen hobby (bodybuilding), and I always want to improve. However, I don't think I suffer from muscle dysmorphia, and I don't think I'm out of touch with reality either.


Miley Cyrax

When it comes to Western males and muscles, it's an arms-race (pun noted). If all young males are jacked, you have to be jacked as well or be at a disadvantage when it comes to garnering female attraction.

Being significantly more muscular and athletic-looking than the local men is a huge advantage as an American traveling abroad, looking to sample the local "cuisine."

Eric M Jones

How about Harley-Davidson-o-philia syndrome? You don't actually need a motorcycle, just the leather jacket and some helmet-but-not-a-helmet will get you laid in most bars.

How about tattoed contrameritocratic syndrome? Why is it that badasses have all the fun?


eating disorders

Brian Salerni

There's also Ghost Sickness which is found in Native American Cultures. The person believes that dead ancestors are the reason they are getting sick.

Eric M. Jones

I think there are thousands of such cultural syndromes. E.g.:

I have known many guys whose sexual preferences were frozen at some early age, and now can't possibly appreciate (e.g.) the sexuality of women in their 40's-50's-60's (e.g.). This has always struck me as sad. These guys want their school cheerleader girlfriend....

I have known women with the same syndrome. They consider a guy as attractive with numerous grave faults as long as he has a full head of hair (e.g.). It took me a while to figure this out.

Another: I saw a psychiatrist at a wedding who looked as much as it was possible like Sigmund Freud; down to the pipe, beard and wire-rimmed glasses. I'll bet he stood in front of a mirror und practiced hiss Austrian accent at night. "Und now, what zzzzeems to be ze problem, hmmmmm?"


Eric, I totally agree with the frozen preferences in women. I have friends who, in their 60s, still pine away for some young thing that would bore them crazy outside the bedroom.

I also have noticed that some men who married early on, later divorcing, have frozen notions of dating. I've seen 50+ year-old men still playing the little "games" that we played as teens. That is, they matured...but their understanding of attracting women did not.

Speaking of the psychiatrist, there is a whole "professor-thing" that goes on with many professors. It's almost pretentiously unpretentious in some cases...and unpretentiously pretentious in others. I can't really pinpoint it precisely, but you can almost always tell a professor from, say, a tax collector, etc.

Eric M. Jones

And let's not forget "Shrinking-Bird Disease".


In Japan there is a phenomenon called "hikikomori", where young individuals become so scared of reality that they hide in their bedrooms and refuse to engage with the world. This seems to have gotten a lot of media attention.

So, why Japan? Some commentators pointed to the stresses of a collectivist culture or of high expectations in education and work.

But it occurred to me also that this phenomenon might exist in other developed countries, but that only in Japan had some social commentator decided to give it a name, and thus start a conversation about it. Discussing it in public might make it more prevalent as troubled teenagers see it as an option and embrace hikikomori as an identity.

I've no idea if this is true, but it seems plausible that the observation and discussion of a social phenomenon could change its prevalence. So perceived differences in prevalence of such syndromes might be coincidental and not particularly rooted in or explained by the wider culture.


Brian Salerni

From your description is seems that Hikikomori is similar to agoraphobia. Agoraphobia is present in the US, as well as other places in the world. I would imagine that high expectations plays a role in both of these to some extent.


How about all the people who suffered from depression after having watched Avatar?

I got depressed realizing how many people didn't comprehend how terrible the plot was, but I'm referring to the people who got depressed over the thought of not being able to live on Pandora.

Also, during the 2008 Presidential elections, I knew several people who became very distraught at the idea John McCain might become President. Not just your typical concerned voter, but having panic attacks about the whole thing. What was really bizarre is that they would show little knowledge about the platforms of either candidate, and after Obama won, they showed no interest in what he actually did. It was like they were simply suffering from McCainphobia. (There may be corresponding Obamaphobia, I just didn't see it because I was living in the ultra-blue Manhattan.)


Since there's no universally accepted standard of sufficient ripped-ness, it is questionable whether muscle dysmorphia qualifies as a mental illness. Here is a more interesting story: the multiple personality disorder is almost exclusively an American phenomenon. Nobody seems to know why.


Isn't all psychology just a placebo? (See, e.g., Daniel E. Moerman, Meaning, Medicine, and the Placebo Effect, Chapter 7.)Doesn't that mean its diagnoses are just as culture-bound as the foreign ones?


As frankenduf said, anorexia and bulimia are culture syndromes and research needs to be pursued in this direction. And what about Jerusalem Syndrome: .


I would hesitate to call these syndromes "mental illnesses". Culturally accepted mental states like Koro are typically considered exempt from that label.