Alba Gonzalez

Professor Adler
Madness in Anthropology: The Culture of Crazy
October 5, y
Cultural-Bound Syndromes: Susto and Running Amok
Culture digs deep into the roots of human interaction and communication and it
differentiates with individuals all around the world. This is primarily why, we as
humans, have to have an etic perspective. The idea to be able to see the world from the
other side of the spectrum. That being said, not only does the way we interact differ but,
the way we perceive illness differs. This is especially true about mental illness. In this
paper, I will compare and analyze two culturally based syndromes to see if the idea that
Kleinman proposed, illness behavior is strongly shaped by culture (Kleinman
1988:47) is true. Running amok and Susto are the two syndromes I will be using to
compare in this paper seeing that they are both somewhat rare and completely different.
The general appeal of this paper is to be able to identify cultural cues that may cause a
syndrome to be bound to a specific culture. Even though there are many cultures all
around the world that a very similar, we want to see if there is concrete evidence as to
why these syndromes are or are not really culturally bound. Taking the knowledge
gained from the syndromes, we will then compare it to its culture and finally to each
other.
Running Amok
Running amok is a culture-bound syndrome that is most prevalent in places such
as Malaysia, Puerto Rico, and the Philippines. In this case, the focus of the culture-

bound syndrome will be in Malaysia seeing that is where the earliest record of the
syndrome takes place. The actual name Running Amok is derived from the Malay word
mengamok, which means to make a furious, desperate charge which is precisely what
the syndrome is (Saint Martin). This syndrome is a condition in which an individual
becomes spontaneously erratic, irrational, and causes havoc along with homocidal and
subsequent suicidal actions of such individual. When this occurs it often results with
fatalities and serious injuries of other individuals, if not of the attacker him/herself.
Usually when an individual has this type of erratic behavior it occurs in a spree-like
fashion. By this I mean that the individual goes on a killing spree and does not stop or
cannot stop until someone intervenes or the individual takes his/her own life. After
experiencing an episode, the attacker may often experience amnesia.
In the Malayan culture, it is seen repeatedly that most cases occur in the male
population. These males tend to be within the age of 20-40. Although it is rare, there are
cases in which women run amok as well (Providentia). The age group in which this
occurs is generally from early adulthood to middle age. The newly revised DSM V
considers this age group to be between the ages of 20-40 (Spores). During this age
group, people are more prone to develop or discover mental breaks and illnesses. Along
with this, it has been discovered that there isn't any correlation between running amok
and socioeconomic status (Providentia) . There have been all different types of cases in
which people from different socioeconomic statuss have experienced this killing spree.
In fact, there has been cases involving an illiterate farmer killing his whole family and
animals, as well as a member of Malaysias royal family running amok and injuring
multiple people (Providentia). As you can tell, running amok has a concrete
classification in people with whom it is found.

The Malaysian culture perceives this syndrome to be both a spiritual

phenomenon and a mental disability. Malay cultural tradition holds amok to be a
possession. The reasoning behind this syndrome is that Hantu Belian, an evil tiger
spirit, enters the persons body and compels him/her to behave violently without
conscious awareness. That being said, when the evil spirit manifested, the culture would
tolerate the tragedy that occurred, being that the person had no control over the
powerful Malay spirit. Although many Malay people still believe in the evil Hantu
Belian, the culture still considers the biological aspect of the syndrome. After the study
of many case reports done by the psychiatrists and medical researchers, it was
concluded that amok was indeed related to psychosis, personality disorder, and a
delusional disorder. This is primarily because early psychiatrists found there to be a link
between psychodynamic factors such as loss of social standing, hostility, and victim
blaming (Providentia). Now in modern psychiatry, psychiatrists are starting to refute
this idea and believe that amok is a violent behavior resulting from mental illness rather
than saying amok is the disorder itself. This is highly probable seeing that many
symptoms of mood and personality disorders do exhibit small forms of violent behavior.
Mood disorders that exemplify this are Bipolar Disorder and Depressive disorder. Both
these disorders have a rapid change in emotion, primarily experiencing manic feeling in
which some patients can become violent to themselves or others.
This particular syndrome became known in the 18th century when a captain of an
all around the world voyage, Captain Cook to be exact, witness and recorded what was
said to be the first viewing of amok in a Malay tribesman. He described the attack as,
the affected individuals as behaving violently without apparent cause and
indiscriminately killing or maiming villagers and animals in a frenzied attack (Saint

Martin, 4). The average attack was seen to be the very least of ten victims and ended
when a fellow tribesman was able to take him down and was subsequently killed in the
process. Soon after the report was put out there and known, anthropological and
psychiatric researchers jumped at the opportunity to study amok. It was discovered that
this type of frenzy was not only happening in Malay tribes, but in other tribes around
the world such as the Philippines, Laos, Papua New Guinea, and Puerto Rico (Saint
Martin, 2). After establishing that this was occurring in early civilized tribes, the
prognosis for amok was that it had to be caused by cultural factors unique to each tribe
as well as the isolation where these diverse people lived. All the cases that stem from the
Malayan culture from centuries past are all very much the same, its always found in the
Peninsular Malaysian area within the Semang people. The tribesmen get possessed by
what they believed was to be the evil tiger spirit and go on a unexplainable killing spree.
Malaysian Culture
Malaysia is located in the southeastern part of Asia. It has a total land are of
about 329 square kilometers and inhibits approximately 24 million people. Of those
people, 49% of them are female and 51% of them are male. Of the Malaysian population
it was recorded that 59% of people lived in urban areas while 41% of the population lived
in rural areas.
Malaysian is very widely known for its culturally diverse setting. Malaysia has
ethnic backgrounds of all sort starting with Malays and continuing onto Bumiputras
(muslim malays), Chinese, Indian, European, Filipinos, and Vietnamese. All these
ethnic differences provide a larger range in which the syndrome of amok can arise from.
The original tribes found in Malaysia are broken down into three categories called
Semang, Senoi, and Proto-Malay. Within these tribes there are many different ethnic

groups, each tribe containing about six groups. Beginning with the Semang tribe, the
ethnic groups and subgroups found within are called Bateq, Jahai, Kensiu, Kintaq,
Lanoh, and Mendriq. The Senoi tribes ethnic groups are Chewong, Jah Hut, Mah Meri,
Semai, Semaq Beri, and Temiar. Lastly, the ethnic groups found in the Proto-Malay tribe
are Jakun, Orang Kanaq, Orang Kuala, Orang Seletar, Semelai, and Temuan. These are
primarily found on the Peninsula of Malaysia.
The religion that is primarily seen in Malaysia is Islam. In fact, approximately
60% of the population practice Islam. In Malaysia, they idolize religion, meaning that
they take their practice very seriously and with grave passion. Additional religions that
are found in Malaysia are Buddhism, Christian, Hindu, and even Confucianism.
Although all these are not seen so often, they are practiced and respected just as much.
Languages spoken in Malaysia are over 137, but most of them are just different dialects.
The official Malaysian language is called Bahasa Malaysia. English is also an active
second language in Malaysia, in fact, it is highly recommended to learn. There is also
many different hindi and chinese dialects that can be found in this country.
Susto
The culture-bound syndrome that is widely seen from Texas through Central
America is called Susto (Palffy) . Since this syndrome is found more predominately in
Mexico, that is the cultural region I will be focussing on. When translated from Spanish
to English, susto means fright, which is why it is generally known as the fright
syndrome. Susto is when the soul temporarily leaves its body because of a traumatic or
frightening experience. The types of frightful and traumatic experiences can range
anywhere from the sudden, unexpected barking of a dog to a near death experience such

as a car accident. Almost anything that will scare you can induce this condition. This
syndrome manifests symptoms such as depression, insomnia, loss of appetite, weight,
and strength (Carteret). People often experience feelings of lethargy, anxiety, irritability
and will most likely become introverted (Carteret). When someones soul leaves their
body the first thing done is they call what is known as a curandero or a folk healer. They
prepare to bring the soul back into the body with a lot of prayer ceremonies and a
lengthy series of ritual actions.
The gender classification for this syndrome is mostly female. Although there are
cases of which the male population is involved, the females tend to experience this
syndrome more often then men. It is quite interesting that with this syndrome there is
no age classification. Anyone can be at risk to the syndrome Susto and this syndrome
can even be passed from one person to another. For example, if a woman that is with
child develops Susto, the baby in her womb can develop it as well (Jacquileigh) . The
range in which you can obtain/develop this syndrome is literally from the moment you
are conceived until the moment you die. The area in which this syndrome tends to make
more of an appearance is in rural, underdeveloped areas. But, at the same token there
have been many cases in which the syndrome has affected people living in high
socioeconomic status as well as urban areas. As you can see, this syndrome although
has more occurrence in set characteristics, does indeed fluctuate.
In this particular Mexican culture, Susto is seen as in a supernatural connotation.
In a supernatural context, it is believed that a supernatural being would come and take
the soul away because you had caused shamed and failed to live up to the social
expectations that particular culture had. It is basically a punishment for being unable to
bring value and merit to your family and your culture. This was also known as a coping

mechanism called Rubel. Another supernatural ideology that is believed is what they call
La Perdida De La Sombra, or as we say in English, the loss of the shadow. This belief is
the after effect of losing your soul. Mexican culture believes that you are your soul, your
body is simply just a vessel. So when you lose your soul, you lose your shadow and
reflection as well. Now, on the other side of the spectrum you have the natural context.
Susto seems to be considered a natural occurrence because it is the way you are reacting
to something that has literally frightened you more than your mind, body, and soul can
handle. When thinking about this context it is better to view Susto from a logical
perspective.
As far as my research went Susto has been around since the 1800s (Trotter II)
and it is a syndrome that is primarily derived from an emotion. Its unlike any other
syndrome because it falls into a cause and effect category. By this I mean that there
always has to be a cause (which is the frightening experience) which results in an effect
(the soul leaving the body). Without the event in which someone gets frightened there is
no reason as to why the soul would temporarily leave the body. Its relation to the
Mexican culture dates back to the Aztecs in the city of Nahua, Mexico. Originally, this
syndrome was primarily found in the region in which this ethnic group of Aztecs resided
and mainly with their people. But once, Spain came in and conquered their land, Susto
began to spread as the Aztec people spread. Now it is seen in many different regions
throughout Mexico. This isn't saying that Susto originally developed from the actual
Aztec people but, it did indeed come from the Aztec region.
Mexican Culture

Mexicos national context is very enriching, seeing that there is so much culture
lying within its grounds. Its geography is heterogenous and has great potential in
natural resources. The country itself is approximately 2 million square kilometers and it
inhabits 97 million people. Of those people about 51% of them make up the female
population while 49% a make up the male population. Just about 75% of the 97 million
people there are of the urban population and 25% are of the rural population.
Mexico is a country that is very culturally rich. Beginning with the earliest Olmec
people all the way to the current people inhabiting the country, Mexico has been filled
and evolved with a lot of cultural history. To begin with, the people of Mexico believe
religion to be most important, it is often the center of family and community life. Most
Mexicans are Catholic while a very small percent of them are protestant. Although
currently almost extinct, the Aztec religion of animism was traditionally the most
believed religion back in the earlier centuries. Along with earlier centuries, there as
many as 100 Native American languages such as Nahuatl, Maya, Mixteco, and Zapoteco
which are still spoken today. As well as those languages there is the most common form
of communication which is Spanish.
Mexico just so happens to be one of the largest enthincally diverse countries. The
list ranges from Natives to European to Arab, Afro, and even Asia-Mexican people. With
natives just alone, you have the most known six ethnic groups which are Nahua, Maya,
Zapotec, Mixtec, Otomi and Totonac people. Along with those you have Tzotzil, Tzeltal,
Mazahua, Mazatec, Huastec, Chol, Chinatec, Purepech, Mixe, Tlapanec, and
Tarahumara. Proceeding them you have Mexicans of european descent. Most of these
people came from Italy, Spain, United Kingdom, Ireland, and Germany. Finally, there is

a small portion of those coming from Arab, African, and Asian descent. Although they
are more rare, they still cover a nice percent of the population.
As well as largely diverse, Mexico also has a developed a well balanced economic
status. Mexico has had itss ups and downs when it comes to their economic status.
There have been times in the past where it had stubbled a great amount and there have
been times where the country was in its prime estate. Generally when it comes to
Mexico, there are many region in the countries that vary drastically in wealth. About 9%
of the the population are extremely poor and 33% live at moderate poverty. These
regions are said to be more prone to experiencing Susto unlike wealthier areas.
Comparative analysis
Running Amok
Running Amok although found in many different areas around the world was
originally discovered in Malaysia. Now, seeing that it is found in different areas as well
as in Malaysia, we may ask ourselves, what do these places all have in common to have
such a syndrome present in their culture? One primary key that characterized Running
Amok was that is was found most prevalent in men. Looking back through the essay,
you will find that in Malaysia there are more men in the country than women. To be
exact it is stated above that 51% of the population is indeed male. This can be a key
factor as to why it is seen and more prone in the male population rather than the female
population.
Another reason as to how the Malaysian culture can shape Running Amok is
where and how their people live. Running Amok is not confined to a socioeconomic class
as stated above. Although it is seen more often in lower class societies than higher class

societies, it doesnt have significant difference in the syndrome. That being said, in
Malaysia it is seen that 59% of the population lives in urban areas, these areas are also
known as high stress areas. That is why I believe Running Amok can occur more often in
Malaysia. Living in high stress can cause a person to lose control of themselves out of
know where. Similarly this correlates to one of the social factors called The City. Being
in a big city can be oppressive and overwhelming. You have social pressure as well as
pressure on yourself to become someone and succeed. This pressure can in turn revert
and cause you to be more prone psychodynamic factors such as hostility. Hostility as
stated before is a more recent or modern causation to running amok.
I believe that part of the reason there are more cases in lower class societies than
in higher class societies also has to do with the rural population. These people live in
more reclusive areas, where there arent that many inhabitants. They follow the same
routine, see the same people, and do the same things everyday. I think this type of work
can develop into social isolation or even dislike for their own living. When people feel
that they are being socially isolated they tend to break out to try to avoid this. This type
of break out can be transformed into Amok. I think they feel so tired and so agitated
with their reclusion that their anger blinds them into an erratic killing frenzy.
Apart from gender and general population, I think the most important factor that
can shape Running Amok in this culture is their religious beliefs. Reviewing what was
written up top, Malay people are very passionate about their religion. Everything that
they believe is based on their religion being in modern day culture or in the past. They
present religion as a fundamental base in their belief and moral systems. I believe that is
why they put so much importance to the causation of the syndrome to be supernatural.

They believe it is an evil tiger spirit that comes and posses the body into such a killing
rage. This belief also helps them to cope with the understanding of the syndrome and
allows them to accept it. Since, religion and the supernatural go hand in hand maybe
that is why the syndrome is shaped by the Malay culture.
This particular syndrome does make sense to be found in the culture in which it is
found. Although it doesnt solidify that it should be found in this particular culture, it
does have concrete examples as to why it is found. These reasons are closely tied to the
cultural aspect of the country as well as the geographic information whether it be
gender, religious, or even geographic area that supports it. Although, I do believe there
are other cultures in which this culture bound syndrome can easily be placed in. The
grasp of this syndrome isnt perplex which means it has general characteristics. This is
why I think that any culture that has the same characteristic such as more male
population and high religious affiliation can incorporate or show signs of this syndrome.
Susto
I believe that Mexican culture is one of the most influential cultures around
because it has so much depth and beauty to it. The fact that so much of its roots and
fundamental origins of their culture are still celebrated and practiced today are what
makes it so beautiful. This also plays positively into the correlation between Susto and
this culture because much of the past is still an influential prospect in our present day
world.
To begin with, this particular syndrome is found more than not in the female
population. According to the population census of Mexico there are more female than
males living in Mexico. To be exact, out of 97 million residents in Mexico about 51% of

them make up the female population compared to the 49% of males. I believe this is the
broad perspective as to why it occurs more in females than in males. Personally, I think
that the reason it occurs in females more often than males is because females are more
emotionally connect than males. Fear itself is an emotion and women tend to feel
emotions more deeply. So when they experience something frightening, it is easier for
their spirit/soul to leave their body.
As well as gender another classification that greatly shapes this syndrome is
religion. As stated before religion in the Mexican culture is the center of family and
community life. Susto is believed to be supernatural which ties into religion and
supernatural elements. It is believed that in Susto a supernatural being would come and
take the soul away because you had caused shamed and failed to live up to the social
expectations. This also is consistent with social factors, the pressures of life and
isolation. When having a mental disorder you experience a social isolation that bring
shame and guilt into your life. This in turn causes you to experience the disorder with
more severity. I believe that these social factors do correlate with Susto as well, both on
a supernatural level and a logical level.
What was previously stated in the paragraph above also coincides with
socioeconomic status. Most people in Mexico do live in poverty regardless if they live in
urban or rural areas. This places pressures, discrimination, and creates a possibility to
social isolation. All three of these social factors result a person in failing to meet the
social expectations of their family and religion and that refers back to the supernatural
belief of your soul/spirit being taken away.
After obtaining full knowledge of this syndrome and its cultural background, I do
believe it is safe to say that it makes sense for the syndrome to reside in this Mexican

culture. This culture ties all the loose ends of the syndrome together and gives it far
more concrete reasonings as to why it occurs in this particular country and its culture.
Whether its reflected on the correlation between gender and population census or the
social factors placed that cause the supernatural context of this particular syndrome, the
evidence is there.
Susto and Running Amok Residing in Each Others Cultures
I don't believe that Susto or Running Amok would fit into each others cultures.
Sure there are particular characteristics that can support it such as the socioeconomic
status and the division of social class, but these two factor are primarily out weighed by
the importance of the others. The others in which I refer to are gender and religious
affiliation. Although they are similar in some aspects, the little differences account for
much of the make up in each culture. I feel these are the more prevalent factors of what
constitutes the syndrome. By this I mean, that these two factors account for much of the
concrete evidence showing that they would never work in the opposite culture. Apart
from that, I dont believe these syndromes would arise in each others cultures.