Psychologists recommend calling the ustaz to treat hysteria. Here’s why it makes sense

Of all the things happening in Malaysian high schools, mass hysteria might be the weirdest. Because think about it; a person who starts panicking and screaming for no apparent reason is not that crazy, but one the whole group people at the same time? Now it is Something.

In fact, it’s become so prevalent here (especially in Kelantan), that Malaysia has been dubbed the ‘Mass Hysteria Capital’. It’s such a problem that Universiti Malaysia Pahang has even come up with a ‘anti-hysteria kit’ worth RM8,750.

An occurrence of hysteria at SMK Pengkalan Chepa 2, Kota Baru, Kelantan. Image by: NST

And as you might expect, the supernatural has often been cited as the root cause:

“Science is important, but it cannot completely explain the supernatural. Non-believers will not understand these attacks unless it happens to them. – Zaki Ya, Muslim spiritual healer

But of course, although we recognize the important role that spirituality plays in Malaysian society, we were very interested to hear the scientific point of view on mass hysteria. For this, we contacted two mental health professionals of MentCouch Psychology Center Malaysia.

Counselor Syahirah Husna binti Rusdi (left) and psychologist Tanjina Ashraf Khan Mou (right) of MentCouch psychology center.

And from this discussion, we discovered some very interesting things about hysteria. For a…

No, it’s not just women who kena

Having existed for millennia, hysteria as a phenomenon has been called by many names, but more recently it has officially been replaced by ‘messy conversion’ in the DSM-5 (which is basically the Bible of mental disorders). To put it in simple terms:

“Hysteria is defined as individual experiences that include altered emotional behavior and impaired motor and sensory functioning. Mass hysteria is when a group of people get this idea that something abnormal is happening, and the the whole group begins to show symptoms of hysteria. – Tanjina Khan

Throughout the passage of history, he has been considered a “predominantly female phenomenon”, as seems to happen more to women, but Tanjina’s colleague Syahirah Husna binti Rusdi said this is actually not the case:

“In ancient Egypt, he was described as “spontaneous movement of the uterus”. But in 1697, an anatomist named Thomas Sydenham said it wasn’t because of the uterus, but because of the brain. So it can happen to men too. –Syahirah Husna

In ancient Egypt, mental disorders were believed to be caused by the heart and the uterus. Image by: Twitter user @surimana16

And apparently this idea that hysteria is a feminine thing has grown stronger through the ages, persisting into modern times:

“If we look at the statistics, (sociologist and specialist in hysteria) Robert Barthelemy researched in Malaysia and Singapore. It is not really proven that it is only women. Both sexes suffer almost equally. – Tanjina Khan

Syahirah adds that the main difference is more than How? ‘Or’ What it is expressed, rather than who:

“Men tend to express it through violence and aggression more than women. –Syahirah Husna

But why is this happening in the first place? Our professional friends say…

It’s caused by what’s called the nocebo effect.

Similar to the placebo effect, a nocebo is when something bad happens because someone expects a bad result.

One thing that immediately jumps out is that it seems to happen more frequently in specific places, like schools, and especially in State of Kelantan. Indeed, in 2016, there was a ‘epidemic’ cases of mass hysteria in Kelantan which saw hundreds of students and teachers showing the symptoms, while in 2018, a school in Kelantan got it three times in a month. Tanjina says the nocebo effect is to blame for this:

“If you look at the article, Kelantan and all the areas that have had hysteria are the most religiously conservative regions. That’s not a bad thing; what happens is that when a certain place is very religious and conservative, and maybe the level of education and awareness is slightly lower, they tend to lean towards the spiritual side of things . – Tanjina Khan

For illustrative purposes only. Image from: The Star/Asia News Network

Expanding on this, Tanjina says a spiritual belief in hysteria reinforces the idea, resulting in a very powerful wedding effect. Citing a research paper by Bartholomew in a boarding school in Kedah, she says this nocebo, coupled with the various stressors that schoolchildren face, may explain why this tends to happen more in rural schools.

“When you live in a certain household or community where they have such spiritual beliefs, you tend to inherit a personality that believes in such things.” – Tanjina Khan

Interestingly, Bartholomew himself thinks these outbreaks tend to happen more in female-only boarding schools, because these are the strictest:

“The girls, aged 13 to 17, complained of too much religion and studies, and too little leisure. – Robert Bartholomew, in an email to the BBC

That being said, Tanjina points out that because it takes place collectively, it is not fair to say that it is due to mental weakness, but rather that it happens because of a great lack of conscience and a lack of scientific and practical thought.

That being said, the treatment they prescribed for hysteria was actually quite surprising, as they say…

People should call an ustaz if there’s an outbreak of hysteria

Yes, you heard right. Image by: Kabar Serasan

Wait what?

So, after all the talk of the scientific method, do professional psychologists still tell us to call a ustaz? Don’t they believe in their own formation? Well, it turns out there’s a very clever logic behind this approach. You see, because a community might already be nurtured enough with spirituality, a psychologist coming in to say “it’s completely psychological” would likely be kicked out. Their suggested approach? A joint campaign involving both religious and medical aspects:

“I would like to bring both the Ustaz and the Psychologist together and reaching out to particular local communities where mass hysteria is prevalent. An Ustaz can best convey a message to them as they have a certain level of trust already developed by the local audience. – Tanjina Khan

But suppose a patient approaches them completely open to the idea of scientific method of treatment? Tanjina says they would then do a screening to first determine that the person is actually suffering from hysteria rather than guessing. Once done, they would go through the usual counseling, cognitive behavioral therapy (CBT) and/or desensitization treatments. And never fear, as Tanjina describes it as a pleasant experience for an individual.

For illustrative purposes only. Image by: NST/Nor Amalina Alias

Good, you have it now. Of course, religion and science prescribe certain treatments for hysteria, but whichever one you choose depends on what you think you need. And ultimately, it’s important to understand that you can’t be forced to seek any particular form of treatment; you have to want to be helped to look for it.

Anyway, as a take-home message, Tanjina hopes for more public awareness about Critical mind, especially on the placebo/nocebo effect, to better help you make informed decisions:

“I’m not completely degrading the spiritual or religious aspects, I’m just saying a person should have this idea of weighing scientific and spiritual ideas together. – Tanjina

Special thanks to Tanjina and Syahirah from MentCouch, who were kind enough to not only sit down and answer our questions in person, but also to prepare 3 full pages of notes for our reference! Because as Tanjina says:

“We are psychologists and counsellors; we do not want to give personal opinions that are not supported by research.– Tanjina Khan

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