From upstate New York to the Salem Witch Trials, a podcast explores 'mass psychogenic illness'

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What does it mean if a person has physical symptoms of an illness — with no apparent medical origin?

The patient could have “functional neurologic disorder,” also known as “conversion disorder.” The symptoms of this condition are real. They affect the body in measurable ways. Sometimes, although not always, they take the form of vocal or physical tics, or seizures. Some patients even experience paralysis.

But the cause isn’t an infection, genetic disorder, toxin or neurological disease. It's the mind. Even more fascinating, the symptoms are contagious.

When it spreads, this condition is called “mass psychogenic illness,” a phenomenon explored in the podcast “Hysterical” through the lens of an outbreak at a high school in Le Roy, New York.

"It's not like pretending. It's not sort of like, ‘I feel like acting like this person,’ " the podcast's creator, Dan Taberski, explained. "You physically assume the symptoms. It's fascinating. It's fascinating how connected we are."

The causes of mass psychogenic illness are not fully known. Doctors believe stress often plays a role, but there are other factors too, such as a social component.

“I think the one thing I learned is that the brain is really freaking complicated,” Taberski said. “There's a lot going on in the brain and the mind and how it relates to the body that we don't understand.”

For many patients, the diagnosis feels insulting, Taberski said. So are the treatments, which can include meditation and stress relief.

After listening to the podcast, I reached out to Taberski to learn more about mass psychogenic illnesses, some suspected outbreaks in Massachusetts and how he became interested in the subject.

Here are some highlights from our conversation, edited for length and clarity.

Elisabeth Harrison: Of all the health conditions out there, what made you want to spend months immersed in mass psychogenic illness?

Dan Taberski: I was interested in "Havana syndrome" and how people were talking about Havana syndrome. But reporters were having a really hard time broaching the subject of whether or not it was possibly a mass psychogenic illness. And the echoes of that, of course, are that it's basically telling somebody: "What if it's all in your head?"

And so many people who were suffering from Havana syndrome had such a hard time even countenancing the possibility that it would somehow not be 100% physically real.

So that got me looking at other cases of mass psychogenic illness. And the story in Le Roy was so different in that it was almost all girls. And what was happening in Havana syndrome is it's almost all men, and men who are known for their grit and being able to handle stress. And so I just like the confluence of both of those things, trying to compare the two.

EH: Were you concerned at all that people would be insulted by the title you chose for the podcast? 

DT: Totally, 100%. I know that it's a really charged word, especially when you're talking about women, or in this case, girls, calling them hysterical. But I also feel like if you're going to use the name, if you're going to use the word, it's clear that we're tackling it head on. I feel like embracing the word and all its complexities was sort of part of the fun of the project.

EH: The podcast focuses largely on Le Roy, New York, but you also mention other examples of mass psychogenic illness, including a couple of high schools on the North Shore of Massachusetts — one in Danvers. That outbreak didn't seem to last as long or spread as widely. So, tell me a little bit more about what was happening there in Danvers. 

DT: It was so kept on the down-low. They didn't have town halls, they didn't have big public meetings. They didn't make big public announcements about what this health issue was. And I think Danvers had like 95% of the cases that were happening in this area at one school. But it didn't become public. It didn't become the sort of hysteria part of mass hysteria. It didn't become the sort of social part of it. And I think that in terms of ending mass psychogenic illnesses, that is a great way to do it.

EH: I was intrigued by one of the ironies you mentioned, which is that Danvers was once Salem Village, one of the sites involved in the Salem Witch Trials. And you explore briefly a theory that the women suspected of being witches might've been experiencing mass psychogenic illness. I was hoping you could explain more about this theory. 

DT: A lot of people feel like it was potentially a mass psychogenic illness. They were very stressful places to live. They were incredibly tight-knit places to live with very little access to the outside world. And that is what makes a mass psychogenic illness ripe for spread.

And so the thinking is that it's possible that one and more of these girls in Salem was originally having a conversion reaction because of the stress that they were undergoing, and they were having tremors and shakes and outbursts, and all the things that could potentially look like the devil in the 1600s. I'm sure nobody will ever be able to prove it, but that's certainly one of the running theories among scholars of that time.

EH: So if keeping it quiet — sort of keeping the media from getting involved — is part of the prescription, I guess you might say, for ending one of these outbreaks or not letting it spread quite as widely, I'm curious how you see the role of the media and social media in all of this.

DT: It's sort of an intractable problem because I think the media is a really important part of solving these things. Because one of the things you need to know about any sort of mass psychogenic illness, is that it is — in essence  — a diagnosis of exclusion. You do have to rule everything else out before you can say, "Okay, we've ruled everything else out."

And very often it's not a psychogenic illness. Most of the time it's not. And so you really do have to investigate. You have to find out what's really going on.

Sometimes health officials can do that without the help of media or journalists, but sometimes that additional help is necessary. We talked [in the podcast] about Love Canal, which was one of the biggest environmental disasters in history, and they were having really similar symptoms to what they were having in Le Roy. Like kids were getting sick, and nobody understood why. And they literally called the mothers who were trying to get attention to this medical issue, they literally called them hysterical.

But [the mothers] were right. And so it wasn't in their heads. It was the ground beneath their feet. And so you can't say, "Media step away," because very often that's what actually finds the real problem.

EH: Some of the patients in the podcast, particularly the young women, described feeling like they were disrespected by doctors. And one patient talked about how when she finally found a doctor she felt listened to her and didn't condescend to her, that's when she started to feel better. So, I was curious whether working on this changed the way you see the practice of medicine at all, or the role of doctors in curing patients.

DT: I talked to the head of the department that deals with this sort of thing at the National Institutes of Health, and he was saying that he believes as many as a third of patients that he's seen have some sort of conversion disorder element related to their illness — that it's not just all physical, that for a third of those patients, there is some sort of psychological component. That's a lot. And so a lot of it is about doctors and neurologists and psychologists all sort of understanding the interconnections between the brain and the body a little bit better.

And I think it seems to be, maybe, a little more humility in terms of knowing when you might not know. And that, sometimes, being totally certain that, "Oh, it's all in your head. Don't worry about it. It's going to go away." It's not the right thing to do that. To have a little humility about what's going on and to take the feeling of being ill seriously.