x Abu Dhabi, UAEMonday 24 July 2017

Today's psychiatric disorders dance to a different beat

As society changes, so too do the ways we find to express distress.

Between the 13th and 16th century a mysterious "mental illness" swept across most of Northern Europe. Those afflicted didn't hear voices or see frightening visions, this was a radical departure from the classical presentation of insanity. This was a totally new form of mania; a severe and enduring disorder rather curiously characterised by an overwhelming urge to dance.

And dance the afflicted did. Some unfortunate souls literally danced themselves to death, reportedly expiring from exhaustion or cardio vascular complications.

Perhaps an even more bizarre attribute of this medieval psychopathology is that it appeared to be socially contagious.

Reports from the German city of Strasbourg in 1581 describe how an initially solitary victim to the disorder, Frau Troffea, in less than a month, was gradually joined by a further 400 men, women and children all similarly afflicted. These outbreaks of dancing mania have never been conclusively explained.

Unfortunately, this lack of a definitive explanation is also applicable to the majority of contemporary psychiatric disorders too. Most of today's complaints are equally debilitating, and those experiencing such conditions want answers. However, the truth is, we really don't have definitive answers. There are, of course, competing theories - as there were for dancing mania - but after more than a century of research, we appear no closer to conclusive answers.

Many of our current ideas about the causes of psychological disorder involve theories concerning chemical imbalances in the brain. Such ideas may ultimately prove fruitful, however they are not radically new. Similar chemical theories were offered as explanations of the medieval dancing mania too. One form of the dancing mania, known as Tarantism, commonly reported in southern Italy, was attributed to a toxic spider bite, in other words, it was viewed as having a direct chemical basis.

This idea was tested at the time by one particularly daring doctor who allowed himself to be bitten by the offending spider. The doctor didn't develop Tarantism (dance mania) nor did he dance the Tarantella (the name given to the dance of those afflicted by Tarantism). But perhaps this idea of an arachnid etiology is the origin of the phrase jitterbug - an energetic North America dance style, emerging in the early part of the 20th century?

Another popular theory for certain contemporary psychiatric disorders is that they are, to some extent, socially transmitted. Eating disorders have often been described as being profoundly influenced, if not caused by, social forces. Similar to the medieval dancing mania, it is not uncommon for eating disorders to appear like a contagious outbreak, with a spate of cases all appearing almost overnight in the same high school.

A colleague of mine described how she undertook an awareness day in a remote high school in a small US town. Before the preventive awareness raising visit, the school had never had a reported case of eating disorders. A few months after the preventive event, the school nurse reported an outbreak of five or six cases. Did the awareness raising event increase the likelihood of students reporting such problems, or did it actually teach a new set of behaviours with which to express distress? Again, nothing really new here, such ideas were advanced to explain the dancing mania.

Another similarity with contemporary psychiatric discourse is the idea that the dancing mania provided a socially acceptable cover for engaging in behaviour otherwise considered immoral or indecent. In a medieval Christian society, public dancing, which might also involve de-robing and suggestive movements, would at the very least raise a moral eyebrow or two. For some commentators, the dancing mania was just an excuse for some people to indulge in reprehensible behaviours.

The dancing mania vanished by the middle of the 17th century, or so I thought. A little while back I came home to find two of my young daughters dancing with manic abandon in front of the TV. I was partially comforted to discover that this was a new Xbox kinect game, "Just Dance".

As society changes, so too do the ways we find to express distress. What will be the psychiatric malaise of our Information Age?

 

Justin Thomas is an associate professor of psychology at Zayed University in Abu Dhabi

 

Michael Simkins' London Eye column will appear tomorrow