Last summer, a mystery illness struck the remote town of El Carmen de Bolívar, northern Colombia. In the four months between May and September, a total of 240 pre-teen and teenage girls were hospitalised with perplexing symptoms including fainting spells, shortness of breath, severe headaches, numb hands, nausea and convulsions.
The town’s limited medical facilities were overwhelmed and doctors were baffled. The girls were given oxygen, taught breathing techniques and subjected to an array of tests conducted by physicians and psychologists flown in from all over Colombia. But the origin of the illness was never found.
The people of El Carmen de Bolívar – encouraged by reports in the media – believed the symptoms were a side-effect of Gardasil, the vaccine against human papillomavirus, which is used to protect against cervical cancer and had recently been administered to the girls. But when they marched in protest to demand an explanation, President Juan Manuel Santos said there was no reason to suspect Gardasil was unsafe and suggested the mysterious malaise was a “phenomenon of collective suggestion”, or a case of mass hysteria.
Cases like this have become an obsession for me over the past decade. It started with a phone conversation with Bev Zalcock, my former film teacher, who inspired me to become a film-maker. We began to laugh at length over something trivial, and afterwards Bev mentioned a village in medieval times where the inhabitants couldn’t stop laughing. Intrigued by this, I searched the internet. I never did find the medieval village; instead, I discovered a village in Tanzania, where in 1962 there had been an outbreak of laughing contagion in a girls’ missionary boarding school. The laughing was accompanied by other symptoms including fainting, crying and agitation and the outbreak seemed to come under a diagnosis of mass hysteria.
A few weeks later, I went to meet the president of the Royal College of Psychiatrists, Simon Wessely, in his office at King’s College, London, where he is also professor of psychological medicine. I found him behind his desk piled high with papers, his wispy hair standing on end and – luckily for me – ready to share his vast knowledge. He told me how mass hysteria had been an interest of his for nearly 25 years. “I actually wrote a paper on mass hysteria for my medical student finals. What turned me on to psychiatry was that people could do bizarre things and believe bizarre things and yet not be insane.”
The term mass hysteria is often used haphazardly to describe a wide range of things, such as group emotional reactions to a public figure’s death or a reaction to a pop idol at a concert. I asked Simon to make it clearer for me what the clinical definition was. “I define it in a narrow way. I avoid mixing it up with social movements and moral panics. With mass hysteria people have to believe they are ill and collectively communicate that illness through psychological means.”
Fainting and non-epileptic fits are common symptoms of a mass psychogenic illness. So too are nausea, vomiting, headaches, weakness, dizziness, chest pain, abdominal pain, hyperventilation and twitches. I soon learned that they usually happen in closed settings, with people in close physical and social proximity. They often break out in factories, convents, hospitals and army barracks, but the overwhelming majority of reported cases are in schools.
For an outbreak to happen there is usually a trigger, some kind of stress factor. It could be a school examination or an emotional event, such as an illness or a death. It could stem from a belief in an evil spirit or ghost. Triggers are often environmental, such as people reacting to smog, or an odour – or even the perception of an odour – or the threat of contamination in water or food. A true mass hysteria event would result in no laboratory findings that could link it to an organic cause, and so would be viewed as originating from the mind, therefore psychogenic in origin.
Simon told me about a case in Belgium that received a lot of publicity in medical journals and newspapers. “There were these girls, from one particular school, who would drink Coca-Cola and faint and so a rumour went around that the drink had been contaminated at the plant. This spread to other schools in Belgium and in the end Coca-Cola had to withdraw their product. But the penny dropped that people were collapsing from drinking Coke from different origins and it was actually a mass hysteria.”
Ninety per cent of participants in reported epidemics are female. I asked Simon why he thought that was. “I think there is evidence that girls are slightly more suggestible,” he replied. “Particularly as teenagers, and with social pressures on girls’ groups.” Females were also more likely to talk to each other about their symptoms and how they were feeling, which tended to spread the outbreak.
Studies that try to explain mass psychogenic illnesses have uncovered a familiar pattern. They are transmitted by sight and sound, so you have to witness the events happening to be affected. They often begin very suddenly and spread rapidly. Adolescents and pre-adolescents are particularly susceptible to them. They are also more likely to escalate if the people involved know each other. Seeing a friend who you admire becoming sick is the best predictor of getting symptoms. She faints and then immediately you start to feel shaky and sick too and it starts to spread. As Simon suggested: “Anxiety itself goes up and you get more symptoms. You get breathless, you start to shake, feel nauseous and sick. But instead of saying, ‘I’m getting anxious’, you think you’re possibly getting poisoned.”
Talking to Simon, my eyes kept being drawn to two overstuffed box files on the shelf behind him marked “mass hysteria”. Greedy for their contents, I asked him if I could go through them.
I spent two days reading the articles he had collected over 25 years. Particularly intriguing was a British Medical Journal piece from 1982 that reported on a “Chronic Epidemic of Hysterical Blackouts in a Comprehensive School”. This particular epidemic started in September 1978 and lasted nearly two years, with 60 girls and three boys having a total of 447 blackouts, which took the form of simple faints or suddenly falling asleep. Eight of the girls were treated for epilepsy. Research showed that the first girl had begun fainting soon after the death of her father and that all the eight key girls involved had severe emotional and family problems.
One of the cases I came across described an epidemic of overbreathing among schoolgirls in Blackburn in 1965. This was in the aftermath of an outbreak of polio, which caused lorry drivers to refuse to enter the town, and landladies of guesthouses across the country to refuse to take bookings from Blackburn residents. Eighty-five girls were admitted to hospital. There were various symptoms, but the main ones were dizziness and fainting. A range of culprits was blamed: viruses, food poisoning, gases, but nothing was ever found. The Blackburn incident is widely regarded as a mass hysteria, probably resulting from anxieties around the polio outbreak.
When I emerged into the fresh air after my absorption in Simon’s dusty articles I felt so euphoric I had to sit down on a nearby wall. I decided that one day I would make a feature film about a mass psychogenic outbreak set in a girls’ school. Nearly 10 years later, The Falling, my fictional account of an epidemic of fainting set in a girls’ grammar school in 1969, featuring Maisie Williams, Maxine Peake, Greta Scacchi, Monica Dolan and newcomer Florence Pugh, opens later this month.
But before making the feature, I began to explore the history of mass psychogenic illnesses in a 2006 short film entitled Madness of the Dance, featuring Maxine Peake as a psychology professor, which was about a series of dancing manias in Europe between the 13th and 17th centuries involving hundreds, sometimes thousands, of people dancing in strange ways. During the Italian outbreaks the dancing manias were put down to the bite of a tarantula. They are now widely regarded as being mass psychogenic in origin.
In Madness of the Dance I reconstructed an event that took place in a 1939 Louisiana high school. The girl who had been selected to lead the high school dance developed a twitching leg and, over a two-week period, 20 other girls became affected with the same symptom. Rumours spread that the water at the school was infected with typhoid and had caused the twitches, so the school was shut down. Investigations subsequently revealed that the girl, who was a novice dancer, was so anxious about dancing with a more experienced partner that her anxiety had converted itself into a twitching leg.
Madness of the Dance screened at the Freud Museum, alongside a video entitled Programme by artist Richard Squires, which looked at Jean-Martin Charcot’s work in the 1880s at Salpêtrière, a women’s hospital in Paris, where he treated female patients going through so-called hysterical symptoms, including swooning and falling, for which no medical cause could be found. Charcot looked at the connection between the mind and the body and believed hysteria was a neurological condition, though others before him from Hippocrates on had argued that hysteria had a connection to problems with the female reproductive organs.
While working on the script for The Falling I attended the SXSW film festival in Texas with my film Dreams of a Life, which explored the life of 38-year-old Joyce Vincent, who died in her flat but was not discovered for nearly three years. That same week the New York Times Magazine featured a cover story about 18 high-school girls, many of them cheerleaders, in the small town of Le Roy in New York, who had become affected by twitching and some incidents of falling. The outbreak had occurred between late 2011 and early 2012 and some of the girls were still showing symptoms at the time of the article in March.
Many medical professionals viewed the Le Roy outbreak as a mass psychogenic illness that had arisen from social and emotional stresses. Others saw the illness as environmental in nature, coming from a toxic source. One of the parents contacted environmental activist Erin Brockovich who visited the town, but her attempts to do tests on the school grounds were refused. This made it seem as though the school was hiding something, which coupled with Brockovich’s celebrity made the girls of Le Roy a media sensation (most cases of mass hysteria are not widely covered in the press). At the time of the New York Times article, half of the pupils were receiving psychological counselling, while the other half were on antibiotics and some of them had posted films of themselves on YouTube.
Lori Brownell, 16, tells on her YouTube video how she had hyperventilated and passed out at a concert, and then after the Le Roy school homecoming dance the passing out had become more frequent until it was daily and she developed seizures. She was also overtaken with tics, and noises from her nose and throat, and clapping and blinking. Lori asks the YouTube viewers ‘How do you cope with it? If anyone wants to talk about this or if anyone is starting this, I’d be willing to talk.” I was struck by her clear need for her symptoms to be discussed and to be visible and wondered if social media would alter the way in which mass psychogenic illnesses spread; whether to see someone in an online video with symptoms could affect the viewer if they admired the person who posted it. Among the comments beneath Lori’s video someone from Iceland had written: “Stay positive, and I hope someone gets to the bottom of it. By the way you are very beautiful.”
I asked Simon Wessely about the Le Roy outbreak. He questioned why, if there was a toxic cause, the symptoms were only happening – with one exception – to girls of a similar age. Mass psychogenic illness should always be suspected when it selectively affects adolescent schoolgirls.
I asked Simon about the stigma of illnesses of the mind, and the resistance to a diagnosis of mass psychogenic illness for many involved in the Le Roy outbreak. “It’s not even a mental illness actually, it’s just a collective response, but people are still terrified of the spectrum of mental disorder and will go to great lengths to avoid receiving the label.” Simon flicked through the article, looking at the pictures of the girls. “If you look at a well-documented case of mass hysteria, afterwards the passionate desire of those involved, or the parents if they were children, is to not believe the diagnosis.”
Simon mentioned a recent case at a school that was thought to be a mass psychogenic illness, but on closer inspection turned out to be a reaction to the pesticide on cucumbers. While there may be events that are wrongly termed as psychogenic, such as an outbreak of food poisoning or people collapsing in a factory due to poor working conditions, there is always the danger that if people affected by mass hysteria begin to think there is some kind of toxic poison at work they may not be able to recover, preferring to think that maybe there is an undetectable medical cause because the alternative of thinking it is a mental phenomenon is too hard to accept.
More people might think there is a cover-up. The most recent advice from the UK Health Protection Agency on how to respond to incidents of mass psychogenic illness is not to tell people that the outbreak is mass psychogenic in origin, but to say instead it is “unexplained” or “stress-related”. It also repeated the widely held opinion that it is important to minimise unnecessary medical attention and to try and prevent rumours and media reports.
Simon told me about one of the very first cases of a mass psychogenic illness to be written up in a medical context, in 1797. “Women in a mill town in Lancashire were collapsing at their looms. When the doctor said it was a product of their imagination it just stopped, which was easier to do in a day when doctors had major authority. Nowadays people just think you’re covering it up.”
I followed Lori Brownell’s YouTube posts. After two years of suffering with her symptoms, in June 2013, she had finally been given a positive results test for Lyme disease. Long after the other Le Roy girls had recovered, she said she was finally receiving the correct treatment and getting better, all signs of her tics gone.
Mass psychogenic illnesses produce real, not sham, physiological effects – though there may be a trigger of a person starting it who has a real medical condition that causes anxiety among others and becomes unconsciously copied. In addition, they are most certainly reactions to the stresses of the age they occur in.
I decided to set The Falling in the 1960s because much of the research I had carried out, certainly into mass psychogenic outbreaks at that time, suggested sexual guilt, or a preoccupation with sexual matters as a factor. I felt it would be an interesting way of looking at the complexity of young female identity and sexuality and the changing nature of sexual morality for women in particular, so the outbreaks could also be linked to cultural and social stresses.
In the 1966 Report on a Phantom Epidemic of Gonorrhoea, the article outlined how a school doctor had been called to an elementary school in the US, where a hysterical epidemic was occurring due to a supposed outbreak of gonorrhoea among the girls. The article looked at how the focus on the school toilets as a source of the disease “may have masked the more threatening possibility the children were involved in sexual contact”. Another article, from 1964, concluded that the fear among high-school students that sexual promiscuity was going to be punished by a stint in a state correctional facility led to a fainting epidemic.
Robert E Bartholomew, who has written on mass psychogenic illness since 1986, writes in his book Little Green Men, Meowing Nuns and Head-Hunting Panics that “many episodes have a quasi-religious quality. It is as though an unseen force has seized control of the participants’ minds.” In The Falling it is Kenneth (Joe Cole), the brother of Maisie William’s character Lydia, who looks at ley lines and ideas that the fainting epidemic could come out of a different route: not chemical, not emotional, not neurological or psychological, but something occult and devilish in origin.
In advance of shooting the film I watched The Devils, by Ken Russell. His film is partly based on The Devils of Loudun by Aldous Huxley, his historical non-fiction book about Father Grandier, a priest who was accused of bewitching a convent into hysterical fits. Early explanations of forms of mass hysteria were that people were possessed by the devil. Similar symptoms and beliefs were held during the Salem witch trials of 1692. Here outbreaks of fainting, twitching and shaking took place and the first person who claimed she had been possessed was Abigail Williams, after whom I named Abigail in The Falling.
When I first talked to Greta Scacchi about the possibility of her playing strict deputy head Miss Mantel in the film, she said the script reminded her of Picnic at Hanging Rock. I told her I loved Peter Weir’s film, and especially how you never discover what caused the disappearance of the schoolgirls or their teacher. I had seeded through various possibilities in my script, so that the audience could make their own decision as to what had caused the faintings. For this reason I was pleased at a recent YouTube comment posted underneath the trailer for The Falling – from the user name Triple A Gaming: “I think the culprit is asbestos or fungi growing beneath the walls of the school that are causing problems for the kids.”
While we were editing The Falling, Robert E Bartholomew and Bob Rickard’s book Mass Hysteria in Schools was published, which outlined cases around the world since 1566. It included a section on the Le Roy high school outbreak and suggested social media could alter the way future outbreaks occur and how “social media is eliminating the necessity of being in direct visual or verbal contact with other victims”.
In June 2014, when I was involved in completing post production on The Falling, I read about a school in Yanagawa, in Japan, where after a trip to Mount Hiko, which legend says has a ghost of a headless girl, a girl began to scream in the middle of class, and over the course of a few hours twenty six girls began to feel numb and started to collapse, forcing the closure of the school. Internet reports describe how pupils posted pictures and messages to their social media accounts. ‘Our school. Rumor’s going around that an evil spirit was brought back from the mountain. Now over 15 people are dropping like flies. The girls are saying things like ‘Kill me!’ and ‘Die!’ It’s too crazy…” Underneath the story, which was on various websites, there were comments saying it must be contamination in the girls’ tampons from the machine in the school toilet, or that women are weak and therefore more susceptible to possession by devils.
Following the premiere of The Falling at last year’s BFI London film festival there were some tweets about people fainting after seeing the film. I recalled the 1974 article I had read in Simon’s office, from the Rhode Island Medical Journal entitled “Psychiatric Casualties of The Exorcist”. The article outlined six people on separate occasions who had seen The Exorcist, or been exposed to the publicity around the film, and had subsequently sought out medical professionals and complained of possession by the devil. While the response to the festival screening of The Falling and to The Exorcist was not mass psychogenic, it did make me think of the power of suggestion, and the need to connect, which seems to play a huge part in an outbreak.
We later screened the film for Maxine Peake, who plays Eileen, mother of Lydia in the film. Maxine came along with her actor friend, Michelle, unaware of how much the film would resonate with Michelle. Afterwards Michelle, who didn’t want to be identified, told me about her experiences at her own school, which carried out an exorcism.
My research had revealed that a ceremony of exorcism often led to a worsening of mass hysteria, but Michelle told me that in her school’s case it worked. “I was 12, it was 1982 and it was this big Catholic mixed school. There was a period of time where people at school pretended to faint. One girl was brilliant at it, and she used to do it in woodwork and other people started doing it and it spread. We enjoyed the drama of it, and the teachers freaking out. We’d got control.”
Michelle recalled another time when what happened didn’t feel fake. “There were eight girls, including me, and we formed a gang. We started dressing the same, box pleat skirts, tiny collars, sheepskin coats, moccasin shoes, and we decided to do the Ouija board. The next day at school it was all we could talk about and suddenly there was a girl walking down the corridor speaking in Latin and tongues and it became chaos. We all quickly became hysterical, thinking that something was going to happen to us. There were girls crying in the toilet, saying ‘I saw the devil in the mirror’ and one of them swore at a nun.”
Michelle recalled how vomiting and headaches spread among the girls. “It only happened to the girls, I can’t remember the boys at all. What I remember most about it was it felt like we were sharing something important. It felt sexy – it’s an odd word to use, but it did feel thrilling.”
On the fourth day of the outbreak, Michelle was in the playground, where they all went to great lengths to make sure they were seen going through their symptoms. “The deputy head came running towards me going, ‘You are a witch!’ She blamed me. They singled out three of us as the ringleaders and the visiting priest who had done exorcisms in Africa exorcised us after school in this tiny chapel. We were given candles and we were shaking and crying. The priest threw holy water on us and asked us to renounce the devil. I don’t know if it was a real exorcism, but that cured it. The next day everything was back to normal.”
I asked Michelle if there were stressful factors around the time. “Actually yes, the school was changing and becoming a comprehensive. My parents had got a divorce which was unheard of at the school at that time and it was Vocation Week, where the nuns and priests would come to the school to see if anyone had the calling.” I tell Michelle that her school outbreak was a classic example of a mass psychogenic illness. The loss of restraint releases a previously repressed behaviour and it offers an otherwise unavailable escape from the tensions of the time.
Many cases of mass psychogenic illness are contained and don’t become newsworthy. They happen more than we know. Nobody has written anything definitive about why they happen and while the pattern is quite well defined, they are still shrouded in mystery.
In the 10 years since I first sought out Simon Wessley, I have filled up my own box file on mass psychogenic illness and I realise what kept me so committed to making the dreamed-about feature film that eventually became The Falling. It is the collective nature of an outbreak that has compelled me, the idea of a group of girls responding defiantly and resisting the world around them. While the experience of going through a mass psychogenic illness is a distressing one in most cases, I also liked the idea that you only get it if you identify with another person, if you feel empathy.
No matter how strange and mysterious mass psychogenic outbreaks appear, or how misunderstood, they remain a powerful group activity and a challenging collective response to our modern lives. Whatever lies behind them, it seems unlikely they will ever be eradicated. They are part of the human condition and at their heart lies our overwhelming need for a sense of belonging and connection.
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