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Sunday, November 6, 2011

Running Amok: A Modern Perspective on a Culture-Bound Syndrome


Amok, or running amok, is derived from the Malay word mengamok, which means to make a furious and desperate charge. Captain Cook is credited with making the first outside observations and recordings of amok in the Malay tribesmen in 1770 during his around-the-world voyage. He described the affected individuals as behaving violently without apparent cause and indiscriminately killing or maiming villagers and animals in a frenzied attack.

Amok attacks involved an average of 10 victims and ended when the individual was subdued or “put down” by his fellow tribesmen, and frequently killed in the process. According to Malay mythology, running amok was an involuntary behavior caused by the “hantu belian,” or evil tiger spirit entering a person's body and compelling him or her to behave violently without conscious awareness. Because of their spiritual beliefs, those in the Malay culture tolerated running amok despite its devastating effects on the tribe.

Shortly after Captain Cook's report, anthropologic and psychiatric researchers observed amok in primitive tribes located in the Philippines, Laos, Papua New Guinea, and Puerto Rico. These observers reinforced the belief that cultural factors unique to the primitive tribes caused amok, making culture the accepted explanation for its pathogenesis in these geographically isolated and culturally diverse people. Over the next 2 centuries, occurrences of amok and interest in it as a psychiatric condition waned.

The decreasing incidence of amok was attributed to Western civilization's influence on the primitive tribes, thereby eliminating the cultural factors thought to cause the violent behavior. Modern occurrences of amok in the remaining tribes are almost unheard of, and reports in the psychiatric literature ceased around the mid-20th century. Inexplicably, while the frequency of and interest in amok among primitive tribes were decreasing, similar occurrences of violence in industrial societies were increasing. However, since the belief that amok is culturally induced had become deeply entrenched, its connection with modern day episodes of mass violence went unnoticed.

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