Grisi siknis
Encyclopedia
Grisi siknis is a contagious, culture-bound syndrome
that occurs predominantly among the Miskito People of eastern Central America
and affects mainly young women. It is also known as “grisi munaia”, “Chipil siknis” and “Nil siknis”. More recently cases occurring amongst people of Spanish descent have also been reported.
, grisi siknis is typically characterized by longer periods of anxiety, nausea, dizziness, irrational anger and fear, interlaced with short periods of rapid frenzy, in which the victim “lose[s] consciousness, believe[s] that devils beat them and have sexual relations with them” and runs away.
Often the outbreak of the syndrome is violent in nature, with victims grabbing weapons, attacking unseen enemies and/or hurting themselves.
The causes of grisi siknis are indefinite, says the American Psychology Association, but the prevailing Western theory calls this syndrome a “psychological disorder due to stress, upheaval and despair”.
Traditional Miskito belief, says Dennis, holds that grisi siknis is the result of evil spirits or black sorcerers. While Western medicine typically has no effect on those afflicted with the disease, the remedies of Miskito herbalists or witch doctors are often successful in curing grisi siknis.
at Oklahoma University, states that a culturally-bound syndrome is defined as “certain trance-like disturbances occur with unusual frequencies in certain societies”. These syndromes, he says, actually occur in a wide variety of cultures separated by great distance that have similar symptoms including “fear, anxiety, amnesia, aimless escape, psychophysiological symptoms, social withdrawal, behavioral deviance and nondirected violence”.”. However, these symptoms are not confined to culturally-bound syndromes, as others, such as “personality disorder
, neurasthenia
, crisis/judgment disorders, organic brain syndrome
s, drug
-induced delirium
, major depression
, mania
, schizophreniform and schizophrenia
” might constitute the true psychiatric diagnosis.”. Because of these cross-cultural symptoms, it is argued that these syndromes are not necessarily unique ”. and that applying the term ‘culturally-bound’ to them hampers science’s ability to explore them on the same level as other psychological problems. Outbreaks of these symptoms are sporadic and epidemic.” Some culturally-bound syndromes, in addition to grisi siknis, include:
According to the American Psychiatry Association, pibloktoq, “frenzy” witchcraft, chakore and amok, are all, like grisi siknis, classified as “running” syndromes, in that they contain “sudden high-level activity, [a] trance-like state, potentially dangerous behavior in the form of running [and] exhaustion, sleep [and/or] amnesia”. It is generally applied to purposeless roving.
In addition, Dr. Richard Castillo, as quoted by Dr. C. George Boeree, believes that amok (with very similar symptoms to grisi siknis), pibloktoq, latah, “falling out”, “indisposition”, and the “fits” are all related to impulse control disorders, and thus are associated with trichotillomania
, compulsive gambling, pyromania, and kleptomania in Western medicine.
argues that grisi siknis does not correlate with Western scientific cultural perspectives, and the cross-cultural translation of symptoms is an inaccurate device wherewith to understand the disease.
, as quoted by Nicola Ross in The Walrus
magazine, upholds this argument, proposing that grisi siknis is caused by poverty and stress among the Miskito. Culturally-bound syndromes, Simons says, are often strongly influenced by behavior and experience and have become a local way of expressing misfortune. Dr. Wolfgang Jilek, of the University of Columbia’s psychiatry department, also quoted by Ross in The Walrus, calls culturally-bound syndromes “real” despite a general lack of evidence for organic causes. They are primarily the result of trauma and stress, Jilek claims, that end in mental dissociation problems. Susan Kellogg, Associate Professor and Chair of the History Department at the University of Houston
, says that grisi siknis is the result of the cultural “physical and emotional stresses” that Miskito women endure. Ariel Shlomo, Co-Director of the Integrative Psychotherapy Center in Ramat Gan, Israel
, says that such disorders are the product of the culture, delineates acceptable coping mechanisms for dealing with external or internal changes. In a typical homeostatic function, Ariel says, “emotional or behavioral disorders in the individual are defined as such by the culture”, which culture subsequently imposes treatment in order to restore equilibrium. Grisi siknis can be considered a ritualized behavior associated with the adolescent to adult transition among the Miskito, says Mark Jamieson, professor of social anthropology at the University of Manchester
. Girls in Miskito culture, claims Jamieson, are faced with the culturally inconsistent task of attracting a husband sexually while remaining safe and pure to maintain societal status quo. The contradictory familial pressures to both protect and marry off the daughter adds to this. Thus, says Shlomo, “the syndrome may be viewed as a safety valve” to maintain equilibrium between these conflicting pressures. Miskito girls express transitional sexuality through the syndrome while maintaining social purity, with the culture holding the victims blameless for their actions while attacked by the disease.
or witch doctors, the latter particularly, if evil spirits are believed to be involved. These healers use an assortment of vapor baths, anointing, teas and potions, all of which are organically derived. According to Dennis, the Miskito healers use a variety of undisclosed steamed herbal remedies that are generally more successful than any Western medicine. However, the cures can be counteracted, Dennis says, by exposure to dead people, pregnant women and various meats.
in March 2009 in Puerto Cabezas
and Siuna
where many students of the National Institute of Technology and other schools, suffered attacks. Most of the victims were girls. The Miskito people argued that it was due to the action of black sorcerers to oblige the people to pay the expensive cures. Some scholars in the country conclude that it is due to the extreme poverty that the Miskito people endure and that was worsened by Hurricane Felix
of September 2007.
Culture-bound syndrome
In medicine and medical anthropology, a culture-bound syndrome, culture-specific syndrome or folk illness is a combination of psychiatric and somatic symptoms that are considered to be a recognizable disease only within a specific society or culture...
that occurs predominantly among the Miskito People of eastern Central America
Central America
Central America is the central geographic region of the Americas. It is the southernmost, isthmian portion of the North American continent, which connects with South America on the southeast. When considered part of the unified continental model, it is considered a subcontinent...
and affects mainly young women. It is also known as “grisi munaia”, “Chipil siknis” and “Nil siknis”. More recently cases occurring amongst people of Spanish descent have also been reported.
Description
According to Dr. Phil Dennis of Texas Tech UniversityTexas Tech University
Texas Tech University, often referred to as Texas Tech or TTU, is a public research university in Lubbock, Texas, United States. Established on February 10, 1923, and originally known as Texas Technological College, it is the leading institution of the Texas Tech University System and has the...
, grisi siknis is typically characterized by longer periods of anxiety, nausea, dizziness, irrational anger and fear, interlaced with short periods of rapid frenzy, in which the victim “lose[s] consciousness, believe[s] that devils beat them and have sexual relations with them” and runs away.
Often the outbreak of the syndrome is violent in nature, with victims grabbing weapons, attacking unseen enemies and/or hurting themselves.
The causes of grisi siknis are indefinite, says the American Psychology Association, but the prevailing Western theory calls this syndrome a “psychological disorder due to stress, upheaval and despair”.
Traditional Miskito belief, says Dennis, holds that grisi siknis is the result of evil spirits or black sorcerers. While Western medicine typically has no effect on those afflicted with the disease, the remedies of Miskito herbalists or witch doctors are often successful in curing grisi siknis.
Symptoms
Symptoms of grisi siknis vary, but there is a distinct set of central characteristics. Most of the victims are young girls from 15 to 18 years old. The attacks are prefaced by headaches, dizziness, anxiety, nausea, irrational anger and/or fear. During the attack, the “victim loses consciousness” and falls to the ground, subsequently running away, which running Dennis calls “perhaps the most distinctive defining characteristic of grisi siknis behavior”. The victim may view other people as devils, feel no pain for bodily injuries and have absolute amnesia regarding their physical circumstances. Some grab machetes or broken bottles to wave off unseen assailants. Other victims are reported to have performed superhuman feats, vomited strange objects such as spiders, hair and coins and spoken in tongues. In some cases the semi-conscious victim will speak the names of the next to be infected, although it is not always accurate. It is still highly contagious. During attacks, victims report mental visions in which devils or evil spirits come for them, and have sex with them. These visions also include anything from horrifying nightmares to pleasant experiences, and many anthropologists claim these are sexual experiences. This is a disputed fact, as not all cases involve sexual encounters. Attacks occur anywhere from multiple times a day to rarely when one is infected with grisi siknis. A person typically remains with the disease for several months to a year without medical attention, although some cases have been documented to recur for much longer.Grisi siknis in relation to culturally-bound syndromes
Joseph Westermeyer, Head of PsychiatryPsychiatry
Psychiatry is the medical specialty devoted to the study and treatment of mental disorders. These mental disorders include various affective, behavioural, cognitive and perceptual abnormalities...
at Oklahoma University, states that a culturally-bound syndrome is defined as “certain trance-like disturbances occur with unusual frequencies in certain societies”. These syndromes, he says, actually occur in a wide variety of cultures separated by great distance that have similar symptoms including “fear, anxiety, amnesia, aimless escape, psychophysiological symptoms, social withdrawal, behavioral deviance and nondirected violence”.”. However, these symptoms are not confined to culturally-bound syndromes, as others, such as “personality disorder
Personality disorder
Personality disorders, formerly referred to as character disorders, are a class of personality types and behaviors. Personality disorders are noted on Axis II of the Diagnostic and Statistical Manual of Mental Disorders or DSM-IV-TR of the American Psychiatric Association.Personality disorders are...
, neurasthenia
Neurasthenia
Neurasthenia is a psycho-pathological term first used by George Miller Beard in 1869 to denote a condition with symptoms of fatigue, anxiety, headache, neuralgia and depressed mood...
, crisis/judgment disorders, organic brain syndrome
Organic Brain Syndrome
Organic brain syndrome , also known as organic brain disease or organic brain disorder, is an older and nearly obsolete general term from psychiatry, referring to many physical disorders that cause impaired mental function. It usually does not include psychiatric disorders...
s, drug
Drug
A drug, broadly speaking, is any substance that, when absorbed into the body of a living organism, alters normal bodily function. There is no single, precise definition, as there are different meanings in drug control law, government regulations, medicine, and colloquial usage.In pharmacology, a...
-induced delirium
Delirium
Delirium or acute confusional state is a common and severe neuropsychiatric syndrome with core features of acute onset and fluctuating course, attentional deficits and generalized severe disorganization of behavior...
, major depression
Depression (mood)
Depression is a state of low mood and aversion to activity that can affect a person's thoughts, behaviour, feelings and physical well-being. Depressed people may feel sad, anxious, empty, hopeless, helpless, worthless, guilty, irritable, or restless...
, mania
Mania
Mania, the presence of which is a criterion for certain psychiatric diagnoses, is a state of abnormally elevated or irritable mood, arousal, and/ or energy levels. In a sense, it is the opposite of depression...
, schizophreniform and schizophrenia
Schizophrenia
Schizophrenia is a mental disorder characterized by a disintegration of thought processes and of emotional responsiveness. It most commonly manifests itself as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social...
” might constitute the true psychiatric diagnosis.”. Because of these cross-cultural symptoms, it is argued that these syndromes are not necessarily unique ”. and that applying the term ‘culturally-bound’ to them hampers science’s ability to explore them on the same level as other psychological problems. Outbreaks of these symptoms are sporadic and epidemic.” Some culturally-bound syndromes, in addition to grisi siknis, include:
- Amok: Among Malay, IndonesiaIndonesiaIndonesia , officially the Republic of Indonesia , is a country in Southeast Asia and Oceania. Indonesia is an archipelago comprising approximately 13,000 islands. It has 33 provinces with over 238 million people, and is the world's fourth most populous country. Indonesia is a republic, with an...
n or Pacific Islander males - AnthropophobiaAnthropophobiaAnthropophobia or Anthrophobia , also called interpersonal relation phobia or social phobia, is pathological fear of people or human company. It is prevalent amongst Chinese and Japanese societies.Anthropophobia is an extreme, pathological form of shyness and timidity...
in JapanJapanJapan is an island nation in East Asia. Located in the Pacific Ocean, it lies to the east of the Sea of Japan, China, North Korea, South Korea and Russia, stretching from the Sea of Okhotsk in the north to the East China Sea and Taiwan in the south... - Bulimia nervosaBulimia nervosaBulimia nervosa is an eating disorder characterized by binge eating and purging or consuming a large amount of food in a short amount of time, followed by an attempt to rid oneself of the food consumed, usually by purging and/or by laxative, diuretics or excessive exercise. Bulimia nervosa is...
or anorexia nervosaAnorexia nervosaAnorexia nervosa is an eating disorder characterized by refusal to maintain a healthy body weight and an obsessive fear of gaining weight. Although commonly called "anorexia", that term on its own denotes any symptomatic loss of appetite and is not strictly accurate...
, among Western Euroamericans - Cathard in PolynesiaPolynesiaPolynesia is a subregion of Oceania, made up of over 1,000 islands scattered over the central and southern Pacific Ocean. The indigenous people who inhabit the islands of Polynesia are termed Polynesians and they share many similar traits including language, culture and beliefs...
- Chakore among Ngawbere of PanamaPanamaPanama , officially the Republic of Panama , is the southernmost country of Central America. Situated on the isthmus connecting North and South America, it is bordered by Costa Rica to the northwest, Colombia to the southeast, the Caribbean Sea to the north and the Pacific Ocean to the south. The...
- Falling out, among African-Americans or in the Bahamas
- FitsPsychogenic non-epileptic seizuresPsychogenic non-epileptic seizures , also known as Non-Epileptic Attack Disorders, are events superficially resembling an epileptic seizure, but without the characteristic electrical discharges associated with epilepsy. Instead, PNES are psychological in origin, and may be thought of as similar to...
in IndiaIndiaIndia , officially the Republic of India , is a country in South Asia. It is the seventh-largest country by geographical area, the second-most populous country with over 1.2 billion people, and the most populous democracy in the world... - Frenzy witchcraft (among the NavajoNavajo peopleThe Navajo of the Southwestern United States are the largest single federally recognized tribe of the United States of America. The Navajo Nation has 300,048 enrolled tribal members. The Navajo Nation constitutes an independent governmental body which manages the Navajo Indian reservation in the...
) - Indisposition (disease) in HaitiHaitiHaiti , officially the Republic of Haiti , is a Caribbean country. It occupies the western, smaller portion of the island of Hispaniola, in the Greater Antillean archipelago, which it shares with the Dominican Republic. Ayiti was the indigenous Taíno or Amerindian name for the island...
- KoroGenital retraction syndromeKoro is a culture-specific syndrome from Southeast Asia in which the patient has an overpowering belief that his penis is shrinking and will shortly disappear. Also known as shrinking penis, the syndrome is listed in the Diagnostic and Statistical Manual of Mental Disorders...
among AsiaAsiaAsia is the world's largest and most populous continent, located primarily in the eastern and northern hemispheres. It covers 8.7% of the Earth's total surface area and with approximately 3.879 billion people, it hosts 60% of the world's current human population...
n males - LatahLatahLatah is a condition where, triggered by the startle reflex, victims fall into a trance in which they engage in repetitive speech or movements. Often these take the form of echopraxic and/or echolaliac automatisms...
among Southeast AsiaSoutheast AsiaSoutheast Asia, South-East Asia, South East Asia or Southeastern Asia is a subregion of Asia, consisting of the countries that are geographically south of China, east of India, west of New Guinea and north of Australia. The region lies on the intersection of geological plates, with heavy seismic...
n females - Mal de pelea in Puerto RicoPuerto RicoPuerto Rico , officially the Commonwealth of Puerto Rico , is an unincorporated territory of the United States, located in the northeastern Caribbean, east of the Dominican Republic and west of both the United States Virgin Islands and the British Virgin Islands.Puerto Rico comprises an...
- PibloktoPibloktoPiblokto, Pibloktoq or Arctic hysteria is a condition exclusively appearing in Inughuit societies living within the Arctic Circle. Appearing most prevalently in winter, it is considered to be a form of a culture-bound syndrome, although more recent studies question whether it exists at...
q or arctic hysteria among InuitInuitThe Inuit are a group of culturally similar indigenous peoples inhabiting the Arctic regions of Canada , Denmark , Russia and the United States . Inuit means “the people” in the Inuktitut language... - Wild-man behavior in New GuineaNew GuineaNew Guinea is the world's second largest island, after Greenland, covering a land area of 786,000 km2. Located in the southwest Pacific Ocean, it lies geographically to the east of the Malay Archipelago, with which it is sometimes included as part of a greater Indo-Australian Archipelago...
According to the American Psychiatry Association, pibloktoq, “frenzy” witchcraft, chakore and amok, are all, like grisi siknis, classified as “running” syndromes, in that they contain “sudden high-level activity, [a] trance-like state, potentially dangerous behavior in the form of running [and] exhaustion, sleep [and/or] amnesia”. It is generally applied to purposeless roving.
In addition, Dr. Richard Castillo, as quoted by Dr. C. George Boeree, believes that amok (with very similar symptoms to grisi siknis), pibloktoq, latah, “falling out”, “indisposition”, and the “fits” are all related to impulse control disorders, and thus are associated with trichotillomania
Trichotillomania
Trichotillomania, which is classified as an impulse control disorder by DSM-IV, is the compulsive urge to pull out one's own hair leading to noticeable hair loss, distress, and social or functional impairment. It is often chronic and difficult to treat....
, compulsive gambling, pyromania, and kleptomania in Western medicine.
Grisi siknis in relation to Western medicine
According to the American Psychiatric Association, a Western medical condition similar in many aspects to culturally-bound syndromes, particularly the “running” syndromes, of which grisi siknis is part, is dissociative (or psychogenic) fugue. In any fugal state, a person appears normal, but has amnesia or identity forgetfulness. Dissociative fugue is distinguished by impulsive travel and amnesia, identity uncertainty, stress, and impediment to normal social function, all of which must not be influenced by substance intake. It is most often related to intense emotional stress and occurs randomly. However, some argue that “running” syndromes are really not dissociative fugue, and have no proper Western medical classification. Others contend that associating culturally-bound symptoms with known ailments severely limits the discovery of new psychiatric disorders in folk culture. Edgardo Ruiz, PhD at the University of PittsburghUniversity of Pittsburgh
The University of Pittsburgh, commonly referred to as Pitt, is a state-related research university located in Pittsburgh, Pennsylvania, United States. Founded as Pittsburgh Academy in 1787 on what was then the American frontier, Pitt is one of the oldest continuously chartered institutions of...
argues that grisi siknis does not correlate with Western scientific cultural perspectives, and the cross-cultural translation of symptoms is an inaccurate device wherewith to understand the disease.
Miskito theories
Miskito tradition, according to Dennis, holds that grisi siknis is caused by possession by evil spirits. This belief stems from the combination of traditional Native American animism. and Miskito Christian idea of the devil. When epidemic outbreaks of the disease occur, the Miskito hold that it is the result of an imbalance with spirits, says Nicola Ross, a reporter for The Walrus magazine, which predicament they believe to be caused by a dilman or evil sorcerer.Western theories
There is no definitively known cause of grisi siknis, although there are some theories which attempt to explain its origin. Although it has no discovered organic cause, says Dennis, grisi siknis still “follow[s] the classic model for contagious disease”. Dennis claims that grisi siknis is the source of the emotionally volatile Miskito culture, saying “it is clear that grisi siknis is related to emotional upset, worry, fear and general anxiety”, while microorganisms, if involved, are intermediate. Dr. Ronald C. Simons, professor emeritus of psychiatry and anthropology at Michigan State UniversityMichigan State University
Michigan State University is a public research university in East Lansing, Michigan, USA. Founded in 1855, it was the pioneer land-grant institution and served as a model for future land-grant colleges in the United States under the 1862 Morrill Act.MSU pioneered the studies of packaging,...
, as quoted by Nicola Ross in The Walrus
The Walrus
The Walrus is a Canadian general interest magazine which publishes long form journalism on Canadian and international affairs, along with fiction and poetry by Canadian writers. It launched in September 2003, as an attempt to create a Canadian equivalent to American magazines such as Harper's, The...
magazine, upholds this argument, proposing that grisi siknis is caused by poverty and stress among the Miskito. Culturally-bound syndromes, Simons says, are often strongly influenced by behavior and experience and have become a local way of expressing misfortune. Dr. Wolfgang Jilek, of the University of Columbia’s psychiatry department, also quoted by Ross in The Walrus, calls culturally-bound syndromes “real” despite a general lack of evidence for organic causes. They are primarily the result of trauma and stress, Jilek claims, that end in mental dissociation problems. Susan Kellogg, Associate Professor and Chair of the History Department at the University of Houston
University of Houston
The University of Houston is a state research university, and is the flagship institution of the University of Houston System. Founded in 1927, it is Texas's third-largest university with nearly 40,000 students. Its campus spans 667 acres in southeast Houston, and was known as University of...
, says that grisi siknis is the result of the cultural “physical and emotional stresses” that Miskito women endure. Ariel Shlomo, Co-Director of the Integrative Psychotherapy Center in Ramat Gan, Israel
Israel
The State of Israel is a parliamentary republic located in the Middle East, along the eastern shore of the Mediterranean Sea...
, says that such disorders are the product of the culture, delineates acceptable coping mechanisms for dealing with external or internal changes. In a typical homeostatic function, Ariel says, “emotional or behavioral disorders in the individual are defined as such by the culture”, which culture subsequently imposes treatment in order to restore equilibrium. Grisi siknis can be considered a ritualized behavior associated with the adolescent to adult transition among the Miskito, says Mark Jamieson, professor of social anthropology at the University of Manchester
University of Manchester
The University of Manchester is a public research university located in Manchester, United Kingdom. It is a "red brick" university and a member of the Russell Group of research-intensive British universities and the N8 Group...
. Girls in Miskito culture, claims Jamieson, are faced with the culturally inconsistent task of attracting a husband sexually while remaining safe and pure to maintain societal status quo. The contradictory familial pressures to both protect and marry off the daughter adds to this. Thus, says Shlomo, “the syndrome may be viewed as a safety valve” to maintain equilibrium between these conflicting pressures. Miskito girls express transitional sexuality through the syndrome while maintaining social purity, with the culture holding the victims blameless for their actions while attacked by the disease.
Cures
Grisi siknis is generally only cured by traditional Miskito healing methods, according to The Journal of the American Botanical Council. In treating the ailment, the Miskito typically follow a hierarchy of remedies, turning first to home-based remedies, second to modern health facilities and finally to curanderoCurandero
A curandero or curandeiro is a traditional folk healer or shaman in Latin America, who is dedicated to curing physical or spiritual illnesses. The role of a curandero or curandera can also incorporate the roles of psychiatrist along with that of doctor and healer. Many curanderos use Catholic...
or witch doctors, the latter particularly, if evil spirits are believed to be involved. These healers use an assortment of vapor baths, anointing, teas and potions, all of which are organically derived. According to Dennis, the Miskito healers use a variety of undisclosed steamed herbal remedies that are generally more successful than any Western medicine. However, the cures can be counteracted, Dennis says, by exposure to dead people, pregnant women and various meats.
Notable cases
Cases of grisi siknis were registered in NicaraguaNicaragua
Nicaragua is the largest country in the Central American American isthmus, bordered by Honduras to the north and Costa Rica to the south. The country is situated between 11 and 14 degrees north of the Equator in the Northern Hemisphere, which places it entirely within the tropics. The Pacific Ocean...
in March 2009 in Puerto Cabezas
Puerto Cabezas
Puerto Cabezas is a municipality in, and capital of, the North Atlantic Coast department of Nicaragua....
and Siuna
Siuna
Siuna is a municipality in the Región Autónoma del Atlántico Norte department of Nicaragua.The town of Siuna was the site of several mines operated by foreign corporations in the past...
where many students of the National Institute of Technology and other schools, suffered attacks. Most of the victims were girls. The Miskito people argued that it was due to the action of black sorcerers to oblige the people to pay the expensive cures. Some scholars in the country conclude that it is due to the extreme poverty that the Miskito people endure and that was worsened by Hurricane Felix
Hurricane Felix
The name Felix was used for four tropical cyclones in the Atlantic Ocean.* 1989's Hurricane Felix - A Category 1 storm that dissipated in the Atlantic without threatening land....
of September 2007.