The Mystery of 18 Twitching Teenagers in Le Roy | Hacker News Reader

The Mystery of 18 Twitching Teenagers in Le Roy

nytimes.com

74 pointswallflower49 comments

Quick book recommendation if you want to read descriptions of dozens of incidents from around the world of groups of girls around the same age that go to the same school or belong to the same convent going through the exact same thing while their parents and community leaders demand answers from the government and blame pollution, demons, or witchcraft.

OUTBREAK! The Encyclopedia of Extraordinary Social Behavior by Hilary Evans and Robert Bartholomew.

This type of thing seems to potentially happen in any group, but these group Tourette's-like symptoms are particularly frequent in institutionalized young girls under stress. If this case is typical, we'll eventually find out that the girl who started twitching first was a fairly popular or influential girl within the group and has a troubled personal history, or even actually was having some sort of seizure condition that nobody was aware of. You'll be able to connect her to every other girl because they either saw her or heard about her before showing symptoms themselves.

http://www.anomalistbooks.com/book.cfm?id=37

The authors' stated goal in compiling the book was as a reference for studying whatever it is about people that makes this happen. Pretty great bedtime reading.

The classic text is (from 1841 !)

http://en.wikipedia.org/wiki/Extraordinary_Popular_Delusions...

At first I was a little irritated at the article's style and how it holds back the truth for a few pages, but the truth of this story turns out to be absolutely fascinating stuff. A quote:

"Cheerleaders frequently come up in case histories of mass psychogenic illness at schools, partly because psychogenic outbreaks often start with someone of high social status. But it might also be that their enviable unity is what makes them more susceptible. In 2002, 10 students, 5 of them cheerleaders, in a rural town in North Carolina suffered from nonepileptic seizures and fainting spells. In 1952, the Associated Press reported that 165 members of the Tigerettes cheerleading squad from Monroe, La., fainted before halftime at a high-school football game in nearby Natchez, Miss."

I would love to hear someone try to speculate on an evolutionary reason for this kind of behaviour. What kind of advantage might this sort of thing have given humans in the past?

Panglossian!

>the truth of this story turns out to be absolutely fascinating stuff

The theory of the story, more like.

The very well understood and widely studied phenomenon which is a perfect fit for observations?

Saying that it's "just a theory" that mass psychogenic illness is involved here is like saying that it's "just a theory" that humans evolved from non-human primates.

>Part of what is baffling about the Le Roy case is that it seems to combine two equally poorly understood phenomena: conversion disorder and mass psychogenic illness

Note the word "seems" and "poorly understood". They don't know what this is. They are acting on a theory.

In the language of science, they are acting on a hypothesis. Theory does not mean the same thing in science as in ordinary language - in science it typically refers to a well tested model which is capable of making predictions with a high degree of accuracy. It is far-fetched to call most things in modern psychiatry theories. The models are still underdeveloped, bad at making predictions and fail at treating ailments a lot of the time.

Three things come to mind: (1) imitating higher-status individuals may give you reproductive advantage by getting you access to a larger pool of potential mates. (2) fitting in with the herd may be beneficial in short term because that way you don't have to think for yourself (of course becoming a lemming has disadvantages as well...), (3) sharing emotions with others may help group cohesion (people develop trust of each other by observing and attempting to predict each other's behavior; the people typically deemed to be most trustworthy are those who are both friendly and easy to predict, think dog/man's best friend).

> What kind of advantage might this sort of thing have given humans in the past?

You're skipping a very important detail in all of this.

The gender.

A sick man deserves contempt, a sick woman deserves attention and caring. Which explains why most men insist they're fine, even when at the brink of death, while women are incapacitated with the slightest headache.

In my experience, women have a tendency of succumbing to periodic ill-feeling. All of it subconscious. This brings the attention of men and family. That constant and consistent caring is habit forming and serves her well in the future when she becomes genuinely sick (or pregnant). There's your evolutionary justification.

This seems like an extreme example of the above. Probably a high status female overdid it and the rest of the females were just mimicking her behavior, all of it subconsciously. While human beings are drawn to certain behaviors instinctively, the nuts and bolts of the behavior is learned and passed down culturally. In other words, women may have a predilection toward periodic ill-feeling, but in what manner they express it is up to them ... or in this case, up to the high-status female.

Not sure what anecdotal evidence you're leaning on to prop up that argument. My mother used to work herself to the bone even with a cold.

Agreed; this is not a gender thing at all.

I suffer quite continual pain in my back, and have a bad habit of working through an illness to the point of exhaustion. I know plenty of friends who do the same, rarely complaining.

A girl and her brother that I know are constantly ill - and moaning about the smallest thing.

So it is a personality issue, I suspect, nothing to do with gender.

Every rule can have exceptions. I do not know if there is any data to back this up, though. Unless you consider that it seems women seem to visit doctors or medical institutions more much often than men (at least in the countries I know of). That could be an indication of this underlying behavior.

Or it could be that women are more often targets of violence and are more prone to medical issues due to reproduction.

Casual pseudo-scientific misogyny is the new scientific racism.

I don't make a habit of responding to comments, but your response contained 4 insults in a single sentence of 8 words, which is seriously impressive. Kudos to you sir!

>A sick man deserves contempt, a sick woman deserves attention and caring.

This is unfortunate for men.

You've been viciously downvoted here, but you should have expected it. Hacker News has a pretty libertarian contingent that thinks that the acknowledgment that people have different experiences is equivalent to asserting that people have different capacities, because of an underlying assumption that the baseline experience is equal for everyone. The kind of thought process that sees it as obvious that a claim that Affirmative Action is needed is equivalent to a claim that minorities are naturally inferior.

Contrary to what some people say, these situations are very often a gender thing.

They tend to happen in places where girls are most limited in expression, at times when they are most limited in expression. The range of behavior considered normal for teenage girls in the US is severely limited compared to what is considered acceptable for teenage boys.

When I was in high school, I could wear the same dirty jeans every day, I could start a band that wore mouse ears and played top 40 pop songs backwards, I could spend 12 hours straight programming my computer at home, I could go to school without shoes on and completely ignore my hair unto entropy.

If I were a girl, not plucking my eyebrows would drop me to low social status at school, and depending on the school maybe even just not wearing makeup would do it. Combine that with letting your hair go to pot and locking yourself away in your room for 12 hours to program your computer, and you might be diagnosed with a psychiatric disorder like aversion or oppositional defiant at best, thrown out of the house at worst. In certain communities around the world, the triggers for deviance might start if you wore pants, or just asked to wear pants, or refused to go to the dance. I swear I've read nationally distributed news articles that start with girls choosing to wear a suit to prom, and end in death threats.

Being sick, or possessed by demons, isn't punished in society like the very real female transgressions of sloppy dressing, or being obsessed with math. Sickness and possession are signs of physical or spiritual attack that make you a victim, rather than signs of deviance that make you a threat to the social order.

Expression that relieves stress has a lot wider acceptable range in certain groups than in others. The groups with the narrowest options for expression tend to find more bizarre loopholes (sickness and religious mania), resulting in behaviors that seem odd.

As a boy, the only thing I was expected to avoid was "acting like a girl." Girls are actually expected to act like girls - whatever strange set of largely male-dictated behavior that entails.

edit: Fainting fits were once an expected behavior for women, and special furniture was required. Hysteria was thought of as a disease of female reproductive organs, and was cured through orgasm.

special furniture: http://en.wikipedia.org/wiki/Fainting_couch

the expert's opinion: http://books.google.com/books?id=ilXAFoFg1-8C

> You've been viciously downvoted here, but you should have expected it.

Oh, I did. I don't say things because I think they will be popular.

In fact, it isn't even Hacker News. If you drew a random group of people from any Western society and I came into the room and made that statement verbatim ... well, I would be shocked if they didn't start throwing chairs at me.

Our culture is so fundamentally sick that it not only pretends there is no significant difference between genders, it pretends there are no fundamental differences between people in general.

The differences are there and they are stark.

The absolute worst part is that after making the assumption that we are all identical, any behavior outside of the defined norm is defined as aberrant and is treated, usually with drugs. That is absolutely sick.

What's that? You can't do calculus? Well, you must be a moron. A girl that doesn't like math? We're not trying hard enough. A girl that prefers to watch The Bachelor instead of learning how to write in C? Unspeakable.

Now that is misogyny. Hatred of the feminine and its masculinization.

Those who read my comment and saw something negative in it, you're projecting. The feminine is beautiful and just because a certain behavior is disgusting in a man, doesn't make it so in a woman.

Oh, I disagree with you now, sorry. You're saying that there's a way that women are and a way that men are that isn't dictated by society, but dictates it, and any deviation is unnatural. I'm saying that women are restricted to certain manners of expression to conform to norms, so they sometimes behave in peculiar ways in order to express themselves yet not be punished. Your argument can be used to justify any form of prejudice that has ever existed, and doesn't rest on any evidence other than your own stereotypes.

You actually think that sick men deserve contempt. And that men and women who behave identically should inspire disgust. And you insist that other people are the ones who are trying to force people into norms. Very ugly.

> You're saying that there's a way that women are and a way that men are that isn't dictated by society

Yes. Just like every other sexual species on this planet has a male and female nature that dictates varied behavior, so do we.

Give me an example of a species where that isn't the case?

> and any deviation is unnatural.

Any deviation is impossible. It's hard-coded. Yes, there might be a 0.1% of the population that doesn't comply, but those are mutations.

I strongly believe that even if 1% of the population is exhibiting a behavior, it is not a deviation. It is normal. At least, normal for that 1% group.

> Your argument can be used to justify any form of prejudice that has ever existed

No. See the above. Again, if it's defined by nature, then no deviation is possible. In other words, what you're witnessing is not deviation. It is nature. On the contrary, that specific idea can be used to stop repression.

> doesn't rest on any evidence other than your own stereotypes

It's an idea derived from simple logic. Not data or stereotypes. If you're seeing a large group of people exhibiting behavior, it is natural for them. Regardless of how wrong you may think their behavior is, there is nothing wrong with it. Trying to force them to behave a certain way is wrong.

> You actually think that sick men deserve contempt.

No. However, a sickly man will be perceived as weak by other men and that will elicit contempt. Which explains why FDR desperately tried to hide the fact that he had polio and was confined to a wheel chair ... there are many many other examples of this behavior.

> And that men and women who behave identically should inspire disgust.

Men and women don't behave identically. When they do, they are forced to either by social norms or through actual threat of force. And that's sick.

Again, please provide an example of a species where the male and female behave identically?

> And you insist that other people are the ones who are trying to force people into norms.

Every day. It happens around you constantly.

Men and women often behave identically, just as men and other men often behave identically. I'm a man and I don't feel contempt for sick men. I'm sorry, I don't mean to be having this conversation, I just misinterpreted your first comment. Go on defending the completely unthreatened by force right of women to watch The Bachelor.

It just sounds like mass anxiety attacks. Everyone is hyper-sensitive of their status in the group and they crank up their sympathy with each other to stay "close". Then you get a feedback loop and everyone goes nuts. Not everything has to be a survival advantage.

It doesn't need to have conferred advantage on anybody in the past - it could just be our incredibly complex social behaviors having a tendency to misfire in some circumstances.

ad evolutionary reason (from Wiki):

An evolutionary psychology explanation for this disorder, as well as for conversion disorder more generally, is that the symptom may have been evolutionary advantageous during warfare. A non-combatant with these symptoms signals non-verbally, possibly to someone speaking a different language, that she or he is not dangerous as a combatant and also may be carrying some form of dangerous infectious disease. This can explain that conversion disorder may develop following a threatening situation, that there may be a group effect with many people simultaneously developing similar symptoms, and the gender difference in prevalence.

Interesting... there's a historical passage of the Bible in which David (who'd later be king) pretends to be insane in order to convince people that he's not a threat. So apparently that works. http://www.biblegateway.com/passage/?search=1%20Samuel%2021&... (at the bottom)

The way they explained the scientific consensus in the article, this isn't so much a selected-for behavior as a disorder in mechanisms that are generally useful, like chameleon behavior (unconsciously imitating others' mannerisms) and empathetic feeling (which helps in forming social bonds).

Evolution doesn't select for diseases, but sometimes it selects for generally-good traits that just happen to be error-prone.

It seems to me like medicine has had trouble saying "I don't know" since the beginning. Throughout the ages we've had "default" diagnoses to fall back on when we couldn't figure out anything else better. And we don't seem to learn. Medicine should be conducted solely on the basis of evidence: in lieu of a clinically proven, statistically sound diagnostic test, the default should be, "I'm sorry, but I don't know" and a referral to a higher specialist.

I suppose we always want to feel like we can do something (and who knows, maybe the psychological counseling here will help), but ultimately it's not falsifiable. Maybe they'd have spontaneously resolved anyway? Or maybe it's truly a new disease. What is absolutely true, though, is that the human body, and especially the brain, are mindblowingly complex and can do crazy things. We barely understand even the most well known neurological disorders. But this speculation-based post hoc rationalizing is just bad medicine.

As an aside, I wonder if health insurance has limited the diagnostic work up on these girls or if the publicity ensured they were taken care of there. A full neuro imaging suite and chemical workup is easily over $100k in the US.

Definition of Conversion Disorder, which the girls are "diagnosed" with:

  Conversion disorder is a condition in which a person has
  blindness, paralysis, or other nervous system (neurologic) 
  symptoms that cannot be explained by medical evaluation.[1]

Along with Mass Psychogenic Illness:

  The rapid spread of illness signs and symptoms affecting 
  members of a cohesive group, originating from a nervous 
  system disturbance involving excitation, loss or 
  alteration of function, whereby physical complaints that 
  are exhibited unconsciously have no corresponding organic 
  aetiology.[2]

[1] - http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001950/

[2] - http://bjp.rcpsych.org/content/180/4/300.full

There's a long history of weirdness surrounding this sort of illness. This one is my favorite:

http://en.wikipedia.org/wiki/Dancing_mania

And this is the link for the entire story on a single page without the annoying navbars and advertisements.

http://www.nytimes.com/2012/03/11/magazine/teenage-girls-twi...

EDIT: So you can't jump straight to the meaningful content. Cute.

http://www.readability.com/

EDIT: For those misunderstanding the context. Readability allows reading of NYT articles on a single page. Something the parent comment was unable to link to. It's a very useful plugin.

There is a single page link under print...

http://www.nytimes.com/2012/03/11/magazine/teenage-girls-twi...

I wonder how long it will be be before this type of Mass Hysteria situation can occur with geographically diverse groups who are linked via online social networking. Obviously once people start hanging out in shared video conferencing situations you have the possibility of people copying one another's visual cues and perhaps that leads to this disorder. Has anybody heard about this happening over facebook yet?

http://en.wikipedia.org/wiki/Morgellons

A spoiler would be hugely appreciated.

I sometimes feel there is a peculiar and rare speech/writing disorder endemic to writers and editors of the NYT which causes them to express everything they are trying to say in the most "litterary" (as in "litter") way possible.

You thought Victorian English was verbose, ornate, and unnecessarily obscure? Try the modern NYT! Shorter sentences but longer nearly everything else.

What's the problem? I enjoyed "like a hitchhiker's thumb that lost its way". And that opening paragraph was badass.

It's not specific to NYT, you see it in any newsmagazine type article. Washington post and Boston globe are also big offenders. I can just imagine them sitting around some pub drinking expensive liquor and talking about how bloggers will never be able to replace the sort of serious, high quality journalism they do.

The snobbery is jut dripping off every word in that article.

THPOILER ALERT!

By the end of the article, we still don't know what's affecting the girls, but the author is strongly hinting in the direction of a mass pychogenic illness, a.k.a. mass hysteria, which has been a front-runner diagnosis from the beginning (although generally rejected by the victims and their parents).

There's no evidence of environmental contamination. One doctor has come up with a fringe diagnosis, and is treating for it, with some success, but international experts on his diagnosis say it's basically impossible. Oh, and there's a pattern of weak family ties in the homes of the afflicted girls. It ends with some talk of the successes of a doctor who is pursuing psychological therapy as the main treatment (along with exhaustive testing for other causes, just in case).

One doctor has come up with a fringe diagnosis, and is treating for it, with some success, but international experts on his diagnosis say it's basically impossible.

As he comments, it's hard to distinguish between his treatment and the placebo effect. Given that his treatment is mostly harmless (unless you're a bacterium), does it really matter?

At a similar event at Qawa Primary School on the Fijian island of Vanau Levu, the girls were cured by:

"[...]a Hindu priest (pandit) who asked the Hindu elephant god for help in appeasing the disturbed spirits of [an accidentally partially bulldozed sacred pool near the school playground] during a public Om Shanti ceremony."

from: OUTBREAK! The Encyclopedia of Extraordinary Social Behavior by Hilary Evans and Robert Bartholomew.

http://www.anomalistbooks.com/book.cfm?id=37

I think the key is to be very solemn and convincing, and to either honestly believe you're effecting a cure, or never let on that you're bullshitting.

It's a shame that its so hard to convince people they have a psychogenic illness. My understanding is that the treatment is fairly straight forward and effective, as far those things go, if you can actually get someone to accept that they don't have some hot new plague.

What I found interesting was the neurologist's strategy for getting around this stigma - she would make the analogy to migraines (a common problem that people have no problem associating with mental illness) while reassuring them that she would keep checking for a physical cause.

This sort of thing has been going on for a very long time. See this, for example: http://en.wikipedia.org/wiki/Dancing_mania

I'm betting it's fraud, started first by one teen girl to get attention, then "spread" to others as it became clear it would be a cool joke to play on adults, and get attention, get famous, etc. Is it possible it's truly some kind of involuntary medical/mental phenomenon? Of course. I'm just saying that I doubt it.

This is a very destructive and incorrect attitude.

Psychogenic illness is not "faking it"...it is very real. It simply means the cause of the problems are based somewhere in the "software" rather than the "hardware". The brain is an exceptionally complicated thing, and the interactions between parts of it can result in all sorts of feedback loops, errors, etc.

If you really don't think it's perfectly possible and probable for a group of teenage girls to develop a shared psychogenic illness completely spontaneously without any sort of guile or even conscious awareness on their part, then unfortunately you have a very simplified and inaccurate understanding of just how complicated and fuzzy our brains are.

Most people have a very poor conception of just how fuzzy the line between what lay people call "sane" and "crazy", and just how easy it is for your brain to trick you. Consider this: a sizable portion of your memories are false. I don't care who you are, this is simply a fact of being human. Some of your memories are constructions based on friends/family describing the event to you some of them are just complete fabrications. However, if asked you would swear up and down they are real. It's not hard to create false memories in people...show them commercials of a non-existent product and many will remember having used it at some point. They're not liars....they're not fakers...they're not idiots...it's just that the human brain is not as simple as we like to think.

This attitude is extremely harmful because it creates an environment where nobody wants to be told they have a "psychogenic illness"....and we get people claiming that hamburgers/magnetic waves/whatever are causing their strange symptoms...and since that's not the case they won't get effective treatment. Furthermore, these people are now potentially harassed by the ignorant; accused of "faking" it for attention...so we have a whole class of illness that isn't being treated due to this ignorant idea.

You've actually got it backwards. It's "possible" that they are faking it, but this sort of involuntary tic is not easy to fake under medical examination. The most likely scenario is that to whatever extent the girls are "doing it themselves", they are unaware of it. I'm sure the attention they get is a part of the feedback loop causing the behavior, but it's important to realize that that does not mean this is some cynical plot to get attention. That's possible of course, but there's no reason to believe it's the most likely possibility and many to believe it's not.

You should reread this sentence from my comment:

> Is it possible it's truly some kind of involuntary medical/mental phenomenon? Of course. I'm just saying that I doubt it.

i still don't understand

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