magazine issue 12 2012 / Issue 16

House, M.D. and the science of psychogenic illness

• written by Ted Cascio
• edited by Ashley Waggoner Denton

Emotional contagion, however, is not exclusively responsible for the events that transpired in “Airborne.” The situation was actually quite a bit worse than that. The passengers became truly ill, with many genuine physical symptoms to show for it. At the end of the episode, we’re led to believe that these ailments had only psychological origins. People became convinced that they were getting sick, which caused them to actually get sick. Mass hysteria had gone beyond the emotional sphere and engendered bona fide physical ailments. Is something like that possible?

Yes, and in fact there’s even a term for it: Mass Psychogenic Illness (MPI), or the outbreak of physical disease with no apparent organic cause.

An article in the New England Journal of Medicine detailed one incidence of MPI that took place at a high school in Tennessee: In November 1998, a teacher noticed a 'gasoline-like' smell in her classroom, and soon thereafter she had a headache, nausea, shortness of breath, and dizziness. The school was evacuated, and 80 students and 19 staff members went to the emergency room at the local hospital; 38 persons were hospitalized overnight. Five days later, after the school had reopened, another 71 persons went to the emergency room. An extensive investigation was performed by several government agencies (Jones et al., 2000).

The most frequent symptoms exhibited by those afflicted were headache, dizziness, nausea, and drowsiness. Importantly, these symptoms all appeared to be real, not invented. As in Tanzania, the investigation found no medical or environmental causes. Rather, the symptoms appeared to be psychogenic; they were positively associated with factors such as female sex and directly observing another afflicted person during the outbreak. That is, those who were female and/or who watched somebody else act sick were more likely to develop symptoms themselves. This is considered a clear case of MPI, one of many similar cases that have been reported in the scientific literature (e.g., Moss & McEvedy, 1966).

Despite the mass of documented cases, MPI remains somewhat of a mystery to experts across a wide variety of disciplines. The etiology is thought to involve some of the psychological factors we discussed earlier: mass hysteria and emotional contagion. But how exactly MPI symptoms bridge the gap between the mental and the physical is still unclear. What is clear is that something like what happened in “Airborne” could indeed occur in real life. So, watch out!

What’s also clear is that, as House correctly asserts, females are indeed more susceptible to MPI effects than males. One might actually assume that there would be many factors that could predispose one to experience such effects (possibly education, or personality), but of those factors that have been studied, only being female (Weir, 2005) and being younger (Jones, 2000) seem to matter very much.

Perhaps to avoid sounding sexist like House, many researchers may be disinclined to contemplate the reasons for this gender disparity. What do you think? Should we consider the conclusion that women are more susceptible to this sort of influence than men subversive and therefore off-limits to discussion? I personally don’t think so. But that’s really neither here nor there. Any way you slice it, “Airborne” scores in the realism department.

Whether that would come as a relief for the writers of House, or something they knew all along, we can’t be sure. One thing we can be sure of is that this single success doesn’t vindicate House (or TV in general) as a reliable medium for factual information. More often than not, rather than conveying accurate knowledge, TV simply magnifies deep-seated sources of bias, such as stereotypes, wishful thinking, and the like. This is where we as viewers have to be careful and do our own independent fact-checking.

Television does, however, have the capacity to raise interesting questions, even if it is not generally in such a good position to definitively answer them. This is where the shows that capture our attention can really show their strength and make a positive impact in our lives. House is particularly good at posing the sorts of intriguing questions that are likely to bolster the intellectual curiosity of its viewers. The next step, seeking scientifically-informed answers to those questions, is up to you…

References

Chartrand, T.L., & Bargh, J.A. (1999). The chameleon effect: The perception-behavior link and social interaction. Journal of Personality and Social Psychology, 76, 893-910.

Durkheim, E. (1912). The Elementary Forms of the Religious Life. London, England: Oxford University Press.