Pokemon Contagion: Photosensitive Epilepsy or Mass Psychogenic Illness?

South Med J. 2001;94(2) 

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Epidemic Hysteria in Japan

Periodic outbreaks of collective frenetic emotional displays labeled as mass hysterical outbreaks have been recorded in Japan, occurring in 1705, 1771, 1830, and 1867. These episodes conspicuously coincided with oppressive feudal regimes and accompanying social crises and may have functioned as cathartic responses to long-standing repression by releasing pent-up anxiety. Norman[27] labeled these events as a combination of hysteria and ritual through which a collective catharsis was achieved under the guise of okage-mairi, a custom involving a pilgrimage to give thanks to the Sun Goddess by visiting the Ise Shrine. Outbreaks were characterized by collective frenetic dancing, crying, singing, obscene and bizarre behavior, amnesia, trance states, and transient ailments. In 1771, Shinto philosopher Motoori Norinaga described an outbreak firsthand. People flooded roads to make the pilgrimage, many carrying paper pictures that depicted obscene or absurd figures or events.

There is much roistering and noisy talk going on and some of it of a nature similar to the pictures. The people go along clapping their hands, shouting, singing "okage de sa! nuketa to sa!" and becoming more and more excited. Both young men and old women forget their natural modesty and indulge in this frenzy so that it is quite a disturbing sight to see. They seem to have abandoned themselves to utter madness, as well as ribaldry and horse-play. [27]

These episodes resemble the more famous medieval dancing manias[28] involving masses of Europeans who, it has been widely argued, were engaging in a ritualistic mass catharsis by partaking in pilgrimages to St. Vitus shrines and chapels during periods of famine, pestilence, and disease to obtain divine favor. Mora[29] and Rosen[30,31] take this view. Mora stated that dance manias were a socially acceptable means of "expression, through ritual, of deeply rooted emotional conflicts," with participants engaging in psychotherapeutic coping strategies in response to individual or societal problems.[29]

In modern times, epidemic hysteria outbreaks in Japan have taken a different form to reflect changing fears that characterize the industrial age -- namely, environmental contaminants. Twentieth century outbreaks commonly involve the sudden manifestation of mass anxiety symptoms of a transient, benign nature. These have occurred in response to the perception of an imaginary or exaggerated harmful agent thought to be in the immediate environment.[33,34] The one known exception to this trend occurred in 1960, when a Japanese hospital staff of mostly women was swept by an epidemic characterized by digestive disorders and mood liability that has been interpreted as an outbreak of epidemic hysteria.[35] The modern trend of epidemic hysteria in Japan manifesting in response to environmental concerns continued into the mid-1990s, as several incidents of sudden anxiety hysteria typified by fainting and breathing problems were reported in the Japanese subway system. These were triggered by a few well-publicized real attacks involving sarin nerve gas by the Aum Shinrikyo sect.[36]

Stress frequently plays an important role in cases of mass hysteria, and Japanese youth are under tremendous academic and social pressures to achieve. Japanese schools in particular are notorious as stress-generating institutions, and students with low or mediocre grades have been known to kill themselves. The week that Pokémon episode 38 aired, many Japanese youths were preparing for high school entrance examinations and were therefore already under added pressure.[37] However, this does not explain why mass hysteria reports among Japanese students is relatively rare in the scientific literature, and the incidents reported are linked to sudden anxiety from strange odors. Stress as a cause is also problematic. Groups of people are under great stress all the time, including platoons of soldiers and communities experiencing floods or famine; yet, there are few if any reports of mass hysteria affecting these people. Why? Because extraordinary stress per se does not and cannot trigger epidemic hysteria. Psychosocial stress occurs in combination with a specific context in which there is a perceived harmful agent.

However, another aspect of Japanese culture may contribute to mass hysteria -- the strong compulsion to conform. Robert Riel, a cross-cultural training manager, observes, "One of the most important traits of the Japanese mindset is its collective nature. In Japan, we comes before I -- a concept that is taught early on. Unlike Western children, who are taught to be independent self-thinkers, Japanese children are educated in a way that stresses interdependence, and reliance on others. Many Japanese habits and customs stem from this desire to maintain the group."[38] This type of collective social order makes a fertile ground for contagion. Some facets of Japanese culture may also foster acting out. When Japanese rock star "Hide" Matsumoto hung himself in May 1998, three people tried to follow him in suicide; one 14-year-old girl hung herself using a towel, the same method Matsumoto used. A rash of Japanese youth suicides also followed the death of singer Yutaka Ozaki in 1992.[39]

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