296 Comments
Feb 27, 2023·edited Feb 27, 2023

Reposting an edited version of my comment to the original post, since I probably posted it too late for anyone to see it:

It seems useful to distinguish between false beliefs and impossible beliefs. The belief that ants are on your skin may be false, but it is hardly impossible. The belief that witches stole your penis is basically impossible.

The belief that are male souls trapped in women's bodies similarly seems like impossible thinking, rather than just false thinking. [This seems to be the presentation of "transgender" that I see most frequently. If it does not reflect what most people mean by "being trans," please drop a link to what they do mean. E.g. if most people don't think that they were born with the wrong body or are "really" the opposite sex, but just that they have certain characteristics more commonly associated with the opposite sex, and they think that they would therefore be better suited trying to make their bodies look like that of the opposite sex, and presenting themselves as it.]

Sure, both penis stealing and wrong-body having can be construed in false but possible ways, e.g. it is literally possible to cut off a penis and steal it, and it is literally possible to be born with various conditions which affect the state of the genitalia, but witch-penis-stealing is distinct from "violent castration" just as "transgender" is distinct from intersex medical conditions.

While as noted in the article, all beliefs are a result of some combination of physical stimuli and a priori social stimuli, beliefs in the impossible seem predicated on a specific false belief.

Just as modernizing societies that stopped believing in magic experienced near universal elimination of "witches-stealing-penises," even though they probably retained many of the sorts of physical stimuli that prompted people to experience particular episodes, our society too may (hopefully) eliminate "transgender," by emphasizing that the underlying belief is magical and false.

Hopefully acknowledging the impossibility of the delusion can lead to those with the unfortunate associated physical stimuli to seek out more productive, or at least less destructive solutions. Just as people in formerly koro believing regions much less frequently mutilate themselves attempting to protect or recover their genitals, hopefully people uncomfortable with their bodies can be conditioned away from mutilating them and towards less destructive solutions.

However, it seems like many critics of the transgender craze are fueling the delusion by implicitly acknowledging the underlying thinking and just questioning whether in a given case a person falsely believes they have a body of the wrong sex, rather than actually having a body of the wrong sex.

Expand full comment

Regarding blaming a Tiger spirit to get away with running amok, at least one person was able to do something similar in Canada:

https://en.wikipedia.org/wiki/Killing_of_Tim_McLean

Expand full comment
Feb 27, 2023·edited Feb 27, 2023

Edit: Scott has since fixed the issue. Leaving the old comment for reference.

I think you misread Aella's poll. It's more like 83% of supernatural believers get PMS while "only" 64% of materialists get it. Still, more than half of women across the board seem to get it.

Expand full comment

I was too late to post this to the Review and got no hits on the Open Thread, but will try one more time.

Does the social contagion version of a disease (e.g., delusional parasitosis) improve if the patient changes social settings (e.g., moves out of the house where one roommate is spreading the delusion)? Or once their prior is trapped, does the original social cause not matter anymore?

If the former, it would seem to have implications for treating conditions with a social origin.

Expand full comment

On women's sexuality you noted that

A) First world women today tend to have lower libido's than men (easy to see in surveys and interviews)

B) Women in antiquity were known as the higher libido gender.

I'd probably chalk that up to hormonal birth control lowering libidos.

Expand full comment

Carpal tunnel can be triggered by use birth control (and menopause). Also pregnancy, DM, thyroid issues. Hormonal changes can lead to swelling putting pressure on median nerve at wrist.

So a freshman women might develop some CTS symptoms (which might also present as a tendinitis) for reasons other than a violin playing roommate.

SA's last two sentences of follow up essay are weird.

Expand full comment

I had carpal tunnel surgery a year ago. I had been losing sensation in my fingers slowly over time, but never had pain except late in pregnancy when I was holding onto a lot of fluid. Once my last kid was born, I had a nerve test, and it showed delayed impulse responses consistent with nerve compression. This test is pretty standard in determining the progression of carpal tunnel, and I don't think your brain can easily fudge those electrical signals. I mean, this is a test where they insert a needle and fire a mild electrical current through your hand. (Not to discourage anyone from treatment- if I'd read a description before going in for that test, I would have freaked out. But in reality it wasn't that bad.) And when I did have the surgery, the surgeon commented that there were calcium deposits, which are typical and I think come from pressure on the ligaments. It can't be just cultural.

It is probably mostly genetic, though- my hand surgeon said the repetitive stress explanation hasn't really panned out. Both of my parents had carpal tunnel syndrome, and had surgery on both hands. I suppose I could have been primed by my exposure to that to develop it, but I think inheriting their weird wrists is a more plausible explanation.

Apropos something completely different: for more on how witches became "WITCHES!" who steal your penis and why we started burning them, then stopped, check out Keith Thomas's seminal (no pun intended) 1972 tome "Religion and the Decline of Magic". It's great on many levels.

Expand full comment

Sigh. It kind of looks like a lot of the problems involved could be avoided with a clearer distinction between "sex" and "gender" - or maybe we can just go back to the good old days of "abolish gender"; somebody's desire to play with dolls shouldn't effect what other people think ought to be between their legs (as distinct from what is).

Modern gender discourse has increasingly just looked to me like the evil twin of gender essentialism.

Expand full comment

I think the rational psychiatry link is wrong, it goes to article that Reilly isn't an author o

Expand full comment

> If I’m reading that poll right, 39% of ghost believers get PMS, but only 19% of ghost skeptics do.

I'm not sure where you got these numbers from but I'm getting something different. 27.5% + 5.5% = 33% believe in ghosts and of those 27.5% also get PMS so this gives a conditional probability of 83.3% that's the probability of getting PMS conditional on believing in ghosts.

Similarly we can calculate a conditional probability of 43.1/(43.1+23.9) = 64.3% that's the probability of getting PMS conditional on not believing in ghosts.

So the numbers show the same trend as you thought but the overall incidence of PMS is much higher

Expand full comment
Feb 27, 2023·edited Feb 27, 2023

"This encouraged me to look into the school shooting statistics further, and I take back my claim that Columbine was a break from trend. This article claims the first mass shooting in US history was in 1949, and that the initiating factor seemed to be advances in gun technology; there have been violent sprees since forever, but semi-automatic weapons raised the death count to levels that made national news."

I don't think it's a good explanation. The iconic Mauser "broomhandle" semiauto pistol has been mass produced since about 1900, Colt 1911 was adopted by the US Army in 1911, revolvers and repeating rifles were widespread since before the Civil War.

On the other hand, the 1949 murderer killed the people he personally knew, the 1966 U of T shooter had a literal brain tumor, and the 1978 girl had brain damage and other severe issues. This sounds like nitpicking, but really it is exactly what you'd expect from your "random malfunctions vs social contagion" model: you get these widely spaced apart events in genuinely insane people, but if the idea that this is what you do in certain circumstances gets culturally fixed, you gradually get a lot of otherwise more or less normal (if maladjusted) people doing it, like in Columbine.

Also you obviously can't trust Vox not to conflate genuine mass shootings, again like Columbine, with gang-related activity etc completely drowning it in that noise, unless you can look at their raw data and go through it yourself. Those are very distinct categories and that's important not only for the present discussion about socially contagious mental illnesses (which shooting rival drug dealers probably isn't) but also policy responses in general.

Expand full comment
Feb 27, 2023·edited Feb 27, 2023

One of my closest friends is married to a Japanese woman. After the previous post I asked her about jikoshu-kyofu. That's the body odor one. She was more than familiar with the issue but seem a bit confused about it being a distinct psychiatric disorder or culture bound syndrome, but her take otherwise was interesting. Essentially she said the following. Japanese people live and work very close together. Aside from incense in buildings like temples they really don't have a tradition of 'fragrance'. They don't wear cologne or perfume and deodorant is designed to smell like nothing. Additionally everyone needs to individually also strive to smell like 'nothing'. There are no positive personal odors, natural or otherwise. A polite person is from an olfactory perspective invisible. That being said, some people in Japan do have a smell and they are damaging the mental calm of the people around them everywhere they go like a cloud of misery. Foreigners are the worst but forgivable; they bring their foreign products with them. Especially western women but they don't know any better and no one really makes an issue of telling them as they are assumed to be guests and that would be rude. Still its very common to for guests in a restaurant, theatre etc to ask to be moved if they can smell a westerner near them. For the Japanese themselves though there is no excuse for others being able to smell them. They *should* feel bad. If others can actually smell them and they don't correct this problem they really ought to be miserable (by themselves please), or at least avoid the public. She genuinely got a little upset recounting smelly Japanese people. I could easily imagine a culture with beliefs like this developing a culture bound syndrome about smell paranoia. The idea that they don't actually have a detectable odor and its some sort of delusion didn't really register; some level of smell-fear is expected and polite. (mental illness also carries a larger stigma, people need to just knock it off and act right).

Expand full comment

One extension of the thinking about mental illness here is the blindness of the observer about themselves when running around the world applying psychiatry which is mostly a cultural expression in and of itself. The biggest cultural element in terms of mental disease isn't the expressions and possible failure states of misfiring or whatnot in the brain and body. I'd say it is the edifice, frameworks, mindsets, and the entire cultural-conceptual space of psychiatry, mental health, and mental illness coming from the Euro-American perspectives.

The desire to taxonomise and break things down is itself a western framework which is in opposition to the more holistic frameworks and understandings of eastern medicine. In the same way we get kidney doctors and liver doctors and OCD treatment specialists in the west, you don't get that in the eastern systems and they view every problem as a whole body system problem.

Taking a step back, one can see this is the true difference of frameworks rather than detailed definitions within a western cultural framework. Sure if you go into the eastern cultures or into African cultures with your rulers and measuring sticks you can indeed take them out and measure things according to your own ideas.

The issue here in terms of true cultural differences is not that you can not go to African and measure the height of a giraffe with a western meter or foot ruler, it is to begin by engaging and asking if and how the people there think about giraffes first. Not even front loading the question to ask about giraffe height, but simply to learn about their relationship with the animal. Perhaps the very concept of measuring this makes no sense to them as there are other more practical concerns about dealing with giraffes. In this way psychiatry is also something an anthropologist could study for why these curious humans in a few cultures have all fixated on semantics and taxonomies.

It just seems to me you are in a circular argument world where you think nothing escapes measurement of rulers and no matter where you go in the world and what the locals think, you can 100% slap a ruler on any object and get a measurement. This is a self-reinforcing idea and low and behold after that intellectually limited activity one finds that they were right all along. But one hasn't really learned anything or understood that they've simply applied their own framework for mental illness over top of another culture's framework for dealing with people who behave strangely. Of course people behave strangely in every part of the world.

But but but...the ruler still works everywhere, so I'm clearly wrong. Ugh! So tiring and limited. There is no meaningful new truth in doing this and these sorts of semantics and win by definition and win by imposing your framework are just meta-steps in the wrong direction towards limited understanding which always ends up with your original idea being correct no mater what you encounter. Maybe we can define sadness in 10 different ways and measure it in other cultures and compare rates and apply some statistics to it, but we've learned nothing about how they experience, understand, and deal with experiences of being sad. Only that we can apply more of the same with our pills, talk therapy, studies, and such.

Win by framework is just as silly as win by definition. At least that's the steel manning I can do for that position. If the question then becomes 'well what do we do if we don't go around the world to other cultures applying science to them?' The answer is...I don't know and wouldn't it be exciting to engage with other modes and mental frameworks for understanding reality. But it is true imperialism and cultural supremacist thinking to imagine there is nothing worthwhile to find in all other cultures and we just need to apply science at/towards them enough to know everything worth knowing. As long as we show up with our DSM, studies, and rulers, then we're just applying our culture to theirs with some implicit biases involved in that.

Expand full comment

1) On the issue of acute and transient psychotic disorder -- A decade ago, I spent a little less than a year as a psychiatry trainee in Doha, Qatar, and during that year, I saw a few clear cases of brief reactive psychosis. Typical profile was that of a laborer from South Asian region with no prior psychopathology who comes to Doha to do manual labor, finds himself trapped in extremely harsh working and living conditions and unable to leave the country, and then experiences an acute and transient episode of psychosis in that stressful environment. In contrast, my experience of brief psychotic disorder has been very uncommon in the US (the cases I have seen have been in the context of interfacing with first episode psychosis programs), and I have worked in the US for many more years.

2) I did once treat a case of geriatric-onset Olfactory Reference Syndrome in an African-American woman in the US who also had mild dementia. The ORS was successfully treated with Duloxetine and Memantine. I reported on that case as a trainee back then (https://www.psychiatrist.com/pcc/mental/geriatric-onset-olfactory-reference-syndrome-treated-with-duloxetine-and-memantine/ ). In terms of shifting brain's priors, this is probably similar to how an individual with schizophrenia might experience a koro-like picture.

Expand full comment

"I don’t think it’s obvious that “believes in ghosts” is a proxy for “more likely to develop culture-bound illnesses”, but I can’t think of a better reason why these should be so connected."

Perhaps those who believe in ghosts might tend to feel entitled to easy explanations of complex phenomena.

Research done at universities worldwide finds a negative relationship between both belief in astrology and belief in paranormal phenomena, on the one hand, and performance in courses requiring “critical thinking,” on the other. The negative effect of belief in paranormal phenomena has consistently been found to be larger than the negative effect of belief in astrology.

Thomas J. Mowen, Amanda Heitkamp & John Boman, “Paranormal Activity: Self-control Theory and Belief in the Paranormal,” Deviant Behavior (2021), DOI: 10.1080/01639625.2021.1915723 rely on self-control theory where: “… low self-control … encompasses six characteristics: impulsivity, risk-seeking, self-centeredness, low frustration tolerance, preferring simple tasks over more difficult ones, and preferring physical tasks over mental ones …. Our findings suggest that adopting a greater number of paranormal beliefs may reflect a decision-making process whereby scientific evidence is cast aside in lieu of an easy explanation for some of life’s greatest mysteries. Individuals with low levels of self-control may be more likely to accept the notion ‘ . . . that the relative position of the planets and the stars could have a special deep significance or meaning that exclusively applies to only [them]’, instead of taking a more critical approach to understanding complex social phenomena and existential questions. Endorsing more paranormal beliefs may be a characteristic of an individual susceptible to getting ripped off in return for the promise of easy and cheap explanations for some of the biggest and unresolved events in life.”

Ida Andersson, Julia Persson, Petri Kajonius, “Even the stars think that I am superior: Personality, intelligence and belief in astrology,” Personality and Individual Differences (November 2021) https://doi.org/10.1016/j.paid.2021.111389 say that, “Narcissism was surprisingly the strongest predictor [of belief in astrology], and intelligence showed a negative relationship with belief in astrology.”

It would be interesting to discover if there’s a significant, positive correlation between belief in astrology and PMDD, and how any such correlation compares to the reported correlation with belief in ghosts.

Expand full comment

I can assure you that gender dysphoria does not exist as a well-defined concept. Different people who report having gender dysphoria report their feelings very differently. For example, the famous transsexual academic, Deirdre MacCloskey, said that when she was a he, that he got the idea of changing his sex based on his evaluation of transsexuals in a crossdressing convention; she said deciding on sex-change was like deciding on purchasing a car. Quite distinct from the way that young teenage girls who claim to be boys report their feelings of gender dysphoria.

As Helen Joyce explained in interviews, the whole concept of transsexualism is an American superstition that came about when sexist American psychologists/doctors in the 1950s decided to pump up gender non-conforming homosexuals with cross-sex hormones. They considered men who have crossdressing fetishism (a quite common fetish, prevalent in about 3-5% of all men) to suffer from a partial degree of the transsexual condition and that very feminine gay men suffer from a full transsexual condition (as homosexuals are sexually attracted to men, and that was to them was the highest markers of inner femininity, so heterosexual crossdressers were not regarded as true transsexuals).

The reality is very simple: there are sex-related stereotypes, and there exist people who do not fit well within these stereotypes. Nobody can fit perfectly, but most people fit well enough that nobody questions their manhood/womanhood. In most societies, it is widely accepted that some gender-nonconforming people exist, and these societies just accept their existence.

The idea that gender nonconforming people are actually "members of the opposite sex on inside" and that they should be castrated and surgically modified to try to approximate the appearance of the opposite sex, as some form of "medical treatment" is a mid-20th century American invention that essentially derives from the bigotry of the mid-20th American society in it not being capable of accepting the reality that some men are feminine homosexuals or that they are heterosexual men who enjoy cross-dressing.

For example, consider this German guy: https://www.youtube.com/watch?v=Z4-hrKBrIc4, in America he would be regarded as transgender, and then he would be forced to have to choose between being a stereotypically masculine man or "transitioning into a woman" because of his desire for looking in a stereotypically feminine manner. To force a person to choose between these artificial boxes is what creates anxiety and unease, and it is what most cases of "gender dysphoria" are.

In a modern enlightened society, we should accept that not everybody conforms to their sex-related stereotypes (as the German guy above), and there is no need for them to feel like they are not really real men or real women. They can do anything, including any kind of cosmetic procedure, without society requiring us to suspend disbelief regarding the fantasy that people can change sex. That is better for them, as they can live as themselves without being forced to choose between boxes, and for us, who do not need to pretend that people can change sex.

There are certain mental conditions that are universal and not culturally constructed: anxiety, rage, sadness, hunger, etc. Gender dysphoria is not one of these conditions.

Expand full comment

Flowers of virtue - just to add: yes, it was written 1411, but printed first in 1486 (no printed books before 1450 as we all know) . - https://de.wikipedia.org/wiki/Hans_Vintler has more content than the English entry ;) - The illustration might have been used for this book anyways. Or not. Nice pic. Weird? Well, I remember a SF-novel I bought because its cover showed a sexy robot. And no such robot in the novel. Weird, in der Tat.

Expand full comment
Feb 27, 2023·edited Feb 27, 2023

The final point regarding fear-induced penis shrinkage has even been argued to be an intentional feature of Michelangelo's David:

https://www.theguardian.com/world/2005/jan/22/science.highereducation

Expand full comment

> This article claims the first mass shooting in US history was in 1949, and that the initiating factor seemed to be advances in gun technology; there have been violent sprees since forever, but semi-automatic weapons raised the death count to levels that made national news.

I linked previously to Paul Harrell debunking that idea: the 1911 semi-automatic pistol dates back to 1911, well before the 1949 German Luger rampage discussed in the link.

> I’m realizing I have only Ethan Watters’ account of how unknown anorexia was in pre-1994 Hong Kong

How often were young women winding up in hospitals from malnourishment?

> In 21st-century America, women are less enthusiastic about sex, often unsatisfied by it; therefore, it's only natural that men initiate most sexual encounters. In ancient Athens, women, the irrational sex, were slaves to their desires, and part of the humor of the Lysistrata was the idea that the women took their protest so seriously that they could restrain their sexual appetites.

I don't buy that. The fundamental difference between males & females, across species, is that sperm is cheap & eggs are expensive. Thus males are always more on the lookout for mating opportunities, as it costs them essentially nothing.

Expand full comment

Mass violence at schools goes back at least as far as 1927. The Bath School Massacre (https://en.m.wikipedia.org/wiki/Bath_School_disaster) was conducted using bombs instead of guns, but it resulted in the same kind of media attention the Columbine mass school shooting did.

Expand full comment

Regarding 'David Chapman writes about the “choiceless” nature of traditional societies; if you were born in a peasant village in medieval England, you would be straight, cis, Christian, monarchist, and a farmer - neither because you loved those things and chose them voluntarily, nor because evil outsiders forced you to do those things which you secretly hated, but because you couldn’t conceive of doing anything else.' - many ancient societies had a third gender, and this third gender had to come from somewhere (some people were clearly different enough that they were put in another category).

Additionally, there are many accounts of non-cis or non-straight people in ancient, 'choiceless' societies (e.g. Sappho). It seems much easier to imagine most people ignored their urges because they had no other choice, than say that they didn't even think of having those urges.

Expand full comment

>There is a contingent of people who think of tendonitis, repetitive stress injury, carpal tunnel, etc as somewhere between 50% and 99% cultural.

But there is a real, physical, carpal tunnel thing, right?

I had it at round 30 from bagging potting soil on a production line. You could put your hand on my wrist and feel the internal grinding. The doctor I saw asked if he could call in an associate so he could learn how to feel for it and diagnose a patient.

It went away with a week of rest.

Expand full comment

What about those panic attacks that people used to have the first time they were on a high speed train? Thinking the speed prevented them from breathing. Then after a few trips, they notice no one else has them, and are fine.

One of my dogs has a similar panic attack during a car ride, but not the other. Can animals have culture bound diseases?

Expand full comment

>In 21st-century America, women are less enthusiastic about sex, often unsatisfied by it; therefore, it's only natural that men initiate most sexual encounters. In ancient Athens, women, the irrational sex, were slaves to their desires, and part of the humor of the Lysistrata was the idea that the women took their protest so seriously that they could restrain their sexual appetites.

The evolutionary arguments for why men should be more interested in sex than women seem very good. Are there any modern societies where women seem more interested in sex?

If Athens actually is an example of women seeming more interested in sex, I wonder if the high prevalence of homosexuality among men is the cause?

https://en.wikipedia.org/wiki/Prostitution_in_ancient_Greece

I notice that Wikipedia page discusses men hiring women for sex much more often than the reverse. That suggests ancient Greece was not an exception.

Expand full comment

Scott, context implies you are (entirely reasonably) reading antimemetics division as "against memes", but it is in fact referring to "antimemes" and the excellent SCP wiki series "There Is No Antimemetics Division" (https://scp-wiki.wikidot.com/antimemetics-division-hub , apparently also now a book published on Amazon).

Unless of course reading antimemetics as "against memes" is an extremely subtle bit and/or unsettling inevitability when attempting to discuss that concept. What was I talking about again?

Expand full comment

I remembered something from a class back in college about Shiva trying to preserve semen, and saw references to it when looking it up, e.g. "It explains that the loss of bindu, the vital force of the semen, causes death, while its retention causes life." https://en.wikipedia.org/wiki/Vajroli_mudra

So I guess the Indians might be in on the NoFap too.

Expand full comment
Feb 28, 2023·edited Feb 28, 2023

when I saw you mention NoFap, I instantly thought how awesome it would be if you did a “NoFap: Much More Than You Wanted To Know”, given how both medically and culturally it’s quite a double-edged sword

Expand full comment

Don't anorexics turn up at hospitals with malnutrition, i.e. anorexia rate should be measurable indirectly via rate of malnutrition cases?

Expand full comment

> There is a contingent of people who think of tendonitis, repetitive stress injury, carpal tunnel, etc as somewhere between 50% and 99% cultural.

n=1 observation on this - I had carpal tunnel on my mind due to it being a topic I ran into several times for coincidental reasons, and soon started to feel more-than-usual (I work a job that has me typing for several hours per day so some is normal) soreness in my wrists.

I eventually came to realize that I was feeling some stiffness, then vigorously flexing my wrists to "loosen them up", and after doing this many times per day, *making them sore by doing so.*

So... Psychosomatic -> genuinely physical due to screwing around with the issue too much?

Expand full comment

> Aella also has written about her own experience with trauma - and how it changed once she left her culty upbringing, learned what trauma was, and understood that other people expected her to have it - here.

After reading the article, I think there are essentially three possible reactions to other people's bad experience, and people often conflate two of them.

a) what happened to you is no big deal, and you are a bad person for whining about it;

b) what happened to you was bad, but it only reflects negatively on the perpetrator, not you;

c) what happened to you was bad, and by contagion, it makes you a bad person.

I understand why (a) could be preferable to (c) even for the victim. If you are a bad person for whining about something what is not a big deal, you still have the option to... stop whining. If you are a bad/broken person by association with the bad things that happened to you, there is nothing you can do about it.

The problem with (b) is that people who claim/try to do it, often do (c) instead. They may say "it does not reflect negatively on you", but if they afterwards start avoiding you, or behave weirdly and uncomfortably in your presence, they are de facto punishing you for being hurt in the past and mentioning it.

I still think that (b) is in theory the correct reaction, but if your experience is that people usually do it wrong, the objection makes sense.

Expand full comment

"The other culture-bound illness I mentioned on the post was shenkui, a Chinese condition where people who believe in yin and yang feel like orgasming depletes them of vitality."

Hasn't that been a trope since forever? Indeed, don't many people feel sleepy after orgasm.

General Jack D. Ripper: [somewhat embarassed] Well, I, uh... I... I... first became aware of it, Mandrake, during the physical act of love.

Group Capt. Lionel Mandrake: Hmm.

General Jack D. Ripper: Yes, a uh, a profound sense of fatigue... a feeling of emptiness followed. Luckily I... I was able to interpret these feelings correctly. Loss of essence.

Expand full comment

"Maybe this is an argument for gender dysphoria not being like culture-bound mental illness; I don’t think there’s any sense in which, given a choice to believe that a witch stole your penis, some people are going to choose yes."

I think there's a sense in which this could happen. I imagine the following scenario: first, you feel discomfort and unhappiness, maybe vaguely penis-themed. Then, you are given a choice (maybe not a conscious one) to attribute this to a witch stealing your penis. Then, some people choose yes (over not having an explanation at all), and then the magic of human psychology rounds off as many other symptoms as it can to fit more closely with the witch theory.

Expand full comment

Re: "Romans didn't get PSTD": r/AskHistorians quoted by HN comment quoted in the comments of the linked ACOUP post, now quoted by me in ACX:

> Cross-cultural psychologists have observed that, regardless of cultural background, people who suffer persistent emotional disturbances in the wake of a traumatic event exhibit intrusive memory symptoms in some form. Here in the US, these are closely related to what we commonly call “flashbacks.” For the Romans, people experiencing intrusive memories were said to be haunted by ghosts. These individuals show up in historical, philosophical, and even medical texts.

> Josephus, who was an outsider to Roman culture, also describes this phenomenon in his history of The Great Revolt. Those haunted by ghosts are constantly depicted showing many symptoms which would be familiar to the modern PTSD sufferer. Insomnia, depression, mood swings, being easily startled, frequent eye movement, alertness all day and night, paranoia, avoidance of crowds, suicidal thoughts/attempts, loss of appetite, shaking/shivering, self-hatred, and impulsive violence have all turned up in association with these individuals.

> Since in almost every case the person experiencing these things had made himself an object of public shame, the “ghosts” in question often came in the form of those he had killed or wronged in the past. These would either appear spontaneously to the sufferer, or would come in the form of vivid, frightening nightmares.

> The key component to these experiences, as with modern cases of PTSD, was that the sufferer had no control over his own symptoms. Thoughts or vivid memories would occur unexpectedly and uncontrollably. It is easy to see why the Romans, who were religiously superstitious to begin with, would attribute such things to the foul play of malicious spirits.

https://www.reddit.com/r/AskHistorians/comments/1j6ssm/are_there_any_indications_of_combat_ptsd_in/cbbvfib/

Expand full comment

Previously on SSC, related concepts were discussed in the posts Going Loopy

https://slatestarcodex.com/2014/04/11/going-loopy/

and Can It Be Wrong To Crystallize Patterns?

https://slatestarcodex.com/2014/03/15/can-it-be-wrong-to-crystallize-patterns/

How it relates to Geography of Madness: The mechanism by which penis-stealing fears or certain sudden hysterias may appear could be a fearful feedback loop, discussed in Going Loopy as somewhat speculative accounts of how OCD and anxiety disorders work.

The question of whether it can be wrong to crystallize patterns, relates to whether the introduction of the language and concepts of western medicine can indirectly cause people to find ideas with negative side effects, i.e. anorexia and disorders which previously could not be comprehended in your culture.

Expand full comment

I almost made the same comment about bouffée délirante being brief psychotic disorder! Though in my case I would have merely raised the question, being far from an expert, and I decided not to. (I only know about the condition due to researching it for a novel. Very relatedly, thank you to Scott and to Thomas Reilly for providing me with the most culturally appropriate translation of "brief psychotic disorder" for the French version--and just in time before we send in the translation to the publisher.)

Expand full comment

Maybe we culturally resolved the fear of losing the penis by systematically maiming the penises of most infants in our society

Expand full comment

I'm skeptical that the concept of a culture bound mental illness is particularly useful.

Ok, so if you are going to worry/panic about something it's more likely to be something that seems plausible to you. Sure, that's not surprising but I don't really see how much follows from that. True, there are the cases of social contagion but that doesn't really seem very different from the general issue of rumors or disinformation (what's different from accepting the election was stolen based o. shaky evidence)

Especially in the trans case it seems like what we really want to know is something more like: is there reason to suspect that taking the feeling at face value isn't likely to be the most cost/beneficial way to improve lives. That's almost certainly true in the case of penis thefts but PMS is likely better dealt with by just treating symptoms (even tho perceived severity is increased by cultural acceptance you can't practically hide the existence of the real effect or make everyone treat it as no biggie by fiat).

And here I expect the fact that the culture bound concept packs together different things causes trouble. I mean is it true that there are probably a fair number of 'trans' teens who are really just having normal sexual worries/exploration? Sure, but they are probably much less likely to be getting surgery or taking medications with truly serious side effects. They are just applying a different name to the same gender non-conformity we've seen forever. They are just projecting their worries/concerns onto culturally relevant notions and, unlike those who help stoke witch panic, there isn't much cost.

So it's really all back to the empirical question about cost/benefit to high cost transitioning and this doesn't seem to throw much light on the topic.

Expand full comment

Hey Scott, quick comment that I'm leaving here because you're probably more likely to see it: You have used the "the the" example so many darned times that my husband and I have a prior for it the size of an elephant. It no longer works for your loyal readers! Please stop, we always role our eyes when we get to that example yet again.

Expand full comment

No mention of the two most topical and controversial cases of (potential) social contagion: Havana Syndrome and Long Covid…

Expand full comment

There is a non-invasive treatment that is better than a placebo: time! It takes no more than about 9 months to work.

Expand full comment

I suspect PTSD isn't so much culture bound as it is the product of changing warfare, when it came unto existence it was under the name "shell-shock", because it was suspected to be the result of repeated concussions and loud noises that come from being shelled, as it was one of the main changes in the way warfare was fought. It was renamed PTSD afterwards when it became clear being shelled was not a necessary requisite, but I think the idea that it came into existence as war changed to be on the right track, reading war memoirs from men on the front lines you really get the sense that being constantly at risk of death at any second with not much you can do for extremely extended periods of time really does a number on a man in a way that didn't happen prior to the invention of accurate firearms, plus engagements are much deadlier overall, with old wars ending in routs after a much lower percentage of casualties and after much shorter engagements.

Modern war straight up sets your stress levels so high and for so long it's no wonder your body can't return to baseline at all.

Expand full comment

Basically, our brains have "maps" of our bodies that are based on an expectation of an internal body map. When people lose a leg they have phantom leg syndrome, or sometimes an arm will feel like an alien part of their body. We've discovered there are parts of the brain that have different average sizes in males and females. Transgender people tend to have a brain of the opposite sex in this sense to their physical bodies. They have a brain map for a sex that doesnt match their actual sex, hence the dysphori and the comfort provided when their bodies more closely match their internal map. the description of having a different gender "spirit" is probably a primitive attempt to describe this.

Expand full comment

Concerning "Bouffée délirante", in German and Scandinavian context a similar rare condition is named "psycloid psychosis" that is characterised by a sudden onset of disorganised psychosis, confusion, motor agitation, with full remission even if the episodes are sometimes recurrent. It's debated whether it should be considered as more on a bipolar spectrum, maybe partly since it seems to respond to ECT.

https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2017.17030282

Expand full comment

Lyman Stone claims that researchers into TikTok tics are seeing them 4x-40x more often in trans kids. If true does that point to the idea that some teenagers are more suggestible than others? https://twitter.com/lymanstoneky/status/1633118263990276101?s=46&t=Z89FS5K_L6mX5SqGXceuCw

Expand full comment