Mental Health

Fascinating Account of Mental Illness: Psychotic Inuits in 1910

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Robert Peary's Arctic explorations at the turn of the 20th century are still legendary.  Although his claim to have reached the geographical North Pole is disputed, Peary's reports of his Arctic expedition provided a fascinating glimpse of the inhabitants who lived their lives in the frozen north.  In a 1910 account of the "Eskimos" (Inuit is preferred these days)  Peary wrote:

Aside from rheumatism and bronchial troubles, the Eskimos are fairly healthy; but the adults are subject to a peculiar affliction which they call pibloktoq, a form of hysteria. The patient, usually a woman, begins to scream and tear off and destroy her clothing. If on the ship, she will walk up and down the deck, screaming and gesticulating, and generally in a state of nudity, though the temperature may be in the minus forties. As the intensity of the attack increases, she will sometimes leap over the rail upon the ice, running perhaps half a mile. The attack may last a few minutes, an hour, or even more; and some sufferers become so wild that they would continue running about on the ice perfectly naked until they froze to death if they were not forcibly brought back.

Though classified as a culture-specific psychiatric disorder, pibloktoq (also spelled piblokto) is an acute dissociative reaction that is not actually unique to the Inuit and has been occasionally observed in other cultures as well.  In one of the first clinical papers to be written on the subject,  A.A. Brill described pibloktoq as a "primitive hysteria" precipitated by sexual or emotional trauma.  Virtually all cases are said to occur in females, last no longer than two hours, and end after the victim collapses into a crying spell and/or sleep.   Following the pibloktoq episode, the victim usually recovers completely.

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Since pibloktoq is most common during long Arctic nights, Inuit tradition holds that it is caused by evil spirits possessing the living.  Shamanism and animism are dominant themes in Inuit traditional beliefs with the angakkuk (healer) acting as a mediator with the various supernatural forces.  Considering angakkuit used trance states to communicate with spirits and carry out faith healing, there is a longstanding view among Inuit that individuals entering trance states be treated with respect given the possibility of a new "revelation" emerging as a result.  For that reason,  treatment with pibloktoq cases usually involved simply allowing the episode to run its course without interference.  While pibloktoq can often be confused with other conditions (including epilepsy) in which failure to intervene can lead to the victim coming to harm, most cases tend to be more typical. 

Although pibloktoq is typically viewed as a benign state, two vivid examples of more pathological cases are described in the clinical literature.  Brill's paper described one unusual episode of pibloktoq in which the victim foamed at the mouth, became violent, and had bloodshot eyes although the symptoms were more suggestive of epilepsy.    In another account published in 1965,  Peter Freuchen described a first-hand description of a male suicide which was apparently linked to an episode of pibloktoq.  According to Freuchen:

Miuk suddenly got the feeling the pibloktoq was to come over him.  He began to chant louder and louder, and nobody dared to come near him [since] it would be dangerous to touch Miuk.  For the spirits who wat revenge do not consider whom they punish.  But in a short time, he became quite violent and began to should.  Then he struck [a] nife into his wrist so that the blood sprayed out.  But Miuk laughed and carried the knife up along his ar, ripping up the skin up to the shoulder and across the chst.  Soon he got back his thoughts [and] said that he didn't know what moved him to use the knife.  When he had said this, his voice left him and in another moment he was dead. 

Although Brill classified pibloktoq as a hysteria (since women were the most common victims), later authors have argued that it is a form of primitive dissociation or, perhaps, an acute psychotic reaction with multiple possible causes that can include epilepsy or depression.  A more recent author has suggested that pibloktoq may be linked to an overdose of vitamin A considering that humans and animals suffering from hypervitaminosis A can show many of the same symptoms as a pibloktoq episode. 

Pibloktoq is not the only unusual condition seen in circum-Arctic societies.  In addition to windigo psychosis (which may or may not actually exist), many of the native peoples of Siberia have reported experiencing latah.   Most typically known as a condition linked to the startle reflex, latah sufferers can react to unexpected stressors by lapsing into a trance in which they can engage in automaton-like  movements or verbalizations.  In addition to Siberian natives, latah cases have also been been reported in Japan (especially among Ainus), Lapland, the Phillipines, Malaysia, and Indonesia.   The word "latah" actually comes from the Malay language where it means "ticklish" or "love madness".  While the official Russian term for latah is "miryachit", there are numerous other colourful names in the different languages found in Siberia including  "aurakh", "olan" "irkunii, and "ikoto".    Another common clinical term for latah is olonism which is derived from a Tungus word meaning "to be suddenly frightened".   

Common symptoms noted in latah and other forms of arctic hysteria include: 1. seizures, 2. unconscious state, 3. impressionableness, 4. unintentional visual suggestion, 5. mania of imitation by an inclination to repeat all visual and auditory impressions, gestures, and word, 6. hypnotic suggestability, 7. clairvoyance, 8. susceptibility to fighting, 9.  feeling frightened or timid, 10.  monotonous improvisation, 11. singing while asleep, 12. spasms, 13. depression, 14. suicidal behaviour, and occasionally 15. coprolalia or sexually suggestive language.  Most often affecting older women, there have been recorded cases of "mass latah" involving a number of sufferers at the same time. 

Often considered to be due to possession, latah cases are rarely regarded as mental illness and relatives may not seek medical attention when it occurs.  Latah tends to defy classification by Western academics who usually consider it to be a culture-bound psychosis like pibloktoq.  Despite various attempts at theorizing why latah occurs, no real causal explantion exists.  While latah is far more geographically distributed than pibloktoq, there are still similarities which lead to their being classified together as "arctic hysteria".  Another striking similarity is the fact that both latah and pibloktoq are becoming rarer.  Most of the references to these syndromes are decades old and new cases occur much less frequently than before.  Whether this is due to the spread of Western psychiatry or just a greater awareness of the role that culture plays in mental ilness, those few case histories that remain may eventually be the only evidence that these strange syndromes ever existed.