Study of Hysteria. (shared by colleague)

by RihanNa (bukan Nama Sebenar)


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untuk bacaan umum.

 

A STUDY OF HYSTERIA AMONG YOUTH IN A SECONDARY SCHOOL IN MALAYSIA
Fariza Md. Sham, 
Salasiah Hanin Hamjah, Mohd Izhar Ariff, 
Rozmi Ismail, Siti Norlina Mohamed, Ruzanna Zamzam &Jalal Yusuf 
Universiti Kebangsaan Malaysia 

ABSTRACT

 Hysteria is regarded as symptoms of emotional disturbance and mental disorder which is common among adolescent girls. It often occurs in schools during their classes. Hysteria occur involving one student subsequently spread to other students and the number increased between 20-50 persons at one time. These bizarre involves symptoms of  sudden shouting, struggling, crying for no reason, talking alone and not understand its words and body becoming paralyzed (Mohammad Hussain Habil, 2010). Past research related to the study of Hysteria involves psychologists, psychiatrists and physician's Islamic alternative approach, finds that there are many factors that cause hysteria. In addition, hysteria has the relation to cultural factors, values and Beliefs of one person (Sapora Sipon, 2008). Psychologists believe, the main factor of hysteria is due to the emotional stress experienced by the patient. This reaction is one of the way out for them to release their emotional stress (Landy, 1987). Teenagers, who are under uncontrolled stress, can cause them to express themselves through Hysteria (Fariza, 2005).  Psychiatrist also states that the hysteria occurs as a result of extreme emotional stress because of long emotional conflicts within them that cannot be solved or expressed (Azhar Zain, 2008). The Islamic psychologies; al-Ghazali, and Miskawayh and Uthman Najati, explained emotional stress from the point of anxiety or emotional expression of human emotion through agitation, depress, extreme worries and fear. Such Situation can lead to hysteria. From the cultural aspect, as in the Malay culture, hysteria is a manifestation of being possessed by supernatural powers. In 2008 and 2009, the hysteria that occurs among adolescent students in Malaysia is relatively frequent and involves students in boarding school and in daily schools. This is an alarming situation for the schools and parents as the phenomenon has an effect to the learning process and having the psychological impact on students. Therefore, a study of hysteria is being done, to study the phenomenon in terms of hysteria factors, its symptoms and how to handle it. The study was conducted on students in the schools who experienced hysteria. Respondent is comprised of 41 girls, who experienced hysteria at Bandar Tasik Puteri Rawang School in Selangor, Malaysia. Methodology study is conducted through questionnaires and interviews. The studies found that there are few factors that cause hysteria;such as psychological factors, psychiatric disorders and the religion factor. Meanwhile, in terms of symptoms was found in hysteria are difficult to sleep, feeling achy and pains, extreme anxiety, hallucinations and having a night mare. Overall, hysteria could have the impact to the psychology of adolescents who experience it. Therefore, ways of handling hysteria; should be highlighted, especially from the perspective of Islamic psychology.

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This paper will be presented in International Conference of Pscyology.14-16 May 2011.University of Tehran, Iran.

 

                                                  INTRODUCTION 

Hysteria has been the controversy subject for many years, with theorists arguing on whether it is best explained by a hidden organic cause or by malingering and deception (Vignemont, 2009). The researchers in the field of psychology, psychiatry and alternative Islamic medical’s treatment are still looking for ways and collecting information to form a conceptual framework about hysteria. Previous studies states that hysteria usually occurs among women in their teens (Atkins, 1953). Cases that occurred in Malaysia also found that hysteria are common among adolescent women, particularly to the students in the school. Therefore this study is aimed to identify the causes of hysteria, symptoms and how to handle it. These studies are based on case study using the questionnaires and interviews methodology. Respondents were comprised of 41 students who had experienced hysteria in one of the secondary school in Selangor. The interview was also conducted towards the teachers in schools involved. 

                                           DEFINITIONS OF HYSTERIA  

The term of hysteria is often being debate in the history of medical world. There are many similar explanations from the perspective of psychology and modern medicine. Efforts to identify sources of hysteria will much depend on the culture, values and beliefs (Sapora Sipon, 2008). 

     The term for hysteria in Arabic is called al-darra’. According to Musfir bin Said Al-Zahrawi (2005), there are various definitions of hysteria. However, he was limiting the definition of hysteria as a mental disorder of the human that will make a person not aware of what she was saying. 

     Mu'jam Ilm al-Nafs state hysteria is the nature of extreme confusion and anxiety resulting in the victim experiencing mental disorder and non normal function (Fakhir Akil, 1985).Hysteria is described as a kind of nerves related diseases that seems to be express as uncontrollable emotion either cause of too excited,scared or sad (Ministry of Religious Affairs of Brunei, 2005). 

     In the 20th century, Sigmund Freud and Joseph Breuer1974) write a book entitled "Study on Hysteria”. Their writing in the book has contributed in the hysteria studies. They have come out with their views and findings that not all cases of hysteria is due to ideogenic. Ideogenic refers to symptoms caused by a wrong perception believing in something. It can be concluded based on their observations of the condition of their patients who experience symptoms of hysteria. 

     On the medical perspective, hysteria is a conversion disorder or histrionic personality disorder (Merskey, 2004). Consistent with this view is the article by Alan Krohn (2005) which states: 
     "Hysteric was someone who presented conversion reactions along with some  other  surface behavioural traits such as passivity, emotional lability,childishness and flirtatiousness."

 
     In the psychological perspective, hysteria is associated with emotional disturbance including depression, stress reactions and some physical disorder (Merskey,2004,Nazar Mahmood,1992,UthmanNajati,1991). 
 

     From the perspective of alternative Islamic approach and treatment, hysteria is link with disturbance of spirits or demons. According to Sheikh Osama al-'Audha in the book entitled "Al-Manhaj al-Qur'ani fi ' Ilaj al-Sihr wa al-mass al-Syaitaniy.,says the possession of hysteria was caused by demons. According to Mohamed Hatta Shaharom (2008), the controversial issue is the extent to how much the demons can influence and control one person. He believes the demons can influence in the life of one patients and it is a challenge to the world of psychiatric. The existence of demons and spirits can be quote in the al-Quran. For example, in Surah al-Baqarah, 2:102, means:

And follow (instead)that which the evil ones used to practice during Solomon’s reign-for it was not Solomon who denied the truth, but those evil ones denied it by teaching people sorcery.

          The Malay community in Malaysia have also link hysteria as being possessed by ghost. In the Malay community, the ghost is considered as agents of diseases. When a person is sick due to the disturbance of a ghost, he is deemed to have possessed by ghosts (Amran & Zulkarnain, 1994).

     Based on the explanations from experts of psychiatric, psychology and alternative Islamic medical treatment, this study concludes that hysteria is a psychological phenomenon that can affect mental and physical functions of a human being. Hysteria can be addressed through a combination of modern medical (psychiatric), counselling (psychologist) and alternative Islamic medical treatment. 

                              HYSTERIA PHENOMENON OF STUDENTS IN SCHOOL 

Based on previous studies, found that cases of hysteria occurs among students in Malaysia occurred when the students are preparing for the exam, sports training and school assemblies (Amran & Zulkarnain, 1994). Hysteria phenomenon starts from one students at first, then followed by others. This hysteria eventually ends up with a big group. It usually lasts several days and there is time when it last one to three months. Most cases, it involves the same individual. 

     During the year 2010 there were two cases of hysteria that were reported, one case in one of primary school in Teluk Intan, Perak. During school assemblies, all of a sudden nine students aged eleven got into hysteria.  They scream and claim being disturbed by the spirit (Kosmo, 21 April 2010).

 
     The second case occurred in August 2010 at one of secondary school in Kuala Lumpur during the school assembly. The hysteria happens to a girl aged fifteen and then spread to nine other students, including a male student. All of the student screamed loudly and struggle violently (Harian Metro, August 3, 2010).

 
     This year, in January 2011, two case of hysteria reported, one in a secondary school in Temerloh, Pahang and another secondary school in Teluk Intan, Perak. The first case in Temerloh, involving a female student where she started shouting and tried to jumped out from the corridor. Shortly after that other students also suffered with hysteria but not that aggressive (Berita Harian, 25 Jan.2011). The second case occurred at a school in Salak Tinggi, Selangor, when twelve students who are currently studying being attacked hysteria. They continue screaming and crying(Berita Harian, January 26,2011). 
Hysteria victim will normally be taken home by the family and treated either in hospital or getting traditional treatment .Hysteria phenomena among students in Malaysia occur every year. Small cases are usually not reported and handled by the school and the parents. If hysteria continues to takes hold, the factor should be studied and know how to prevent it. 

                                                 HYSTERIA FACTORS 

     Referring to previous studies, there are many factors that cause hysteria. Some claimed it was caused by emotional stress, which cannot be controlled (Kasmini Kassim, 1992).Having a weak body immune system with continues stress can lead to hysteria. That is why hysteria occurs more easily with women because of their gentle nature and lesser strength of physiological systems(Hashim Awang, 1990). 

In modern medicine, hysteria can be caused by environmental factors and cultural, social and economic (Amran Kasimin & Zulkarnain Zakaria, 1994). Ones beliefs, culture and religion also can be a contributing factor in the hysteria. For example, in the Malay community, they believe in the powers of supernatural creatures such as ghosts and spirits. From their early childhood they are being reminded and scared by stories of ghosts and spirits It eventually become a permanent memory in the mind and soul, and somehow will appeared clearly in their sub- conscious mind((Amran Kasimin & Zulkarnain Zakaria, 1994).       Based on research findings, the researcher concluded that hysteria can be attributed by psychological factors, psychic function disorder factors, environmental factors and religious factors. When these factors being experience continuously, they bound to possessed by hysteria. Therefore, the discussion in this paper is based on studies that being made on the psychological factors, psychic function disorder and religious factors.   a)Psychologicalfactors                                                                                                                            Psychologists believe that the main cause of hysteria is due to emotional stress being experience by the patients. A person is reacting in such a way as it is the way out to release their stress and pressure of a responsibility and to get attention and affection (Landy, 1987).       Hans Selye (1956), a psychologist who writes a lot about the stress, defined stress as a uncertain reactions of one body or non-specific reaction for a specific situation being faced (Fariza, 2005). Teenagers, who experienced uncontrollable stressed, may cause them to express their stress through hysteria.       Emotionally unstable can lead to hysteria. Emotional instability occurs especially when the death of loved ones such as a parent. Emotion is a human condition suffered by the various changes in physiological processes, personal and psychological. Bruno (1984) defines emotion as a state of the disturbing rise of the baseline homeostasis. He saw this from the perspective of emotion as when a person is experiencing emotional, almost the entire state of homeostasis disturbed by various physiological changes that occur in the body(MahmoodNazarMohamed,1990).       As such, they who are attacked by the hysteria are the person who discloses their emotional state and the state of their soul either through words or acts beyond their control, such as crying, moaning, and so forth. The eruption of emotions that cannot be controlled is called hysteria.       This statement is supported by a Senior Consultant Psychiatrist, Medical University Putra Malaysia (UPM), Assoc. Dr. Azhar Zain, hysteria occurs due to extreme stress, having to suffer an old and long emotional conflicts within them that cannot be resolved or discharged (Anon,2008).       This means that the undemonstrative feeling or unable to express would be destructive. So every individual should express their problems and try to resolve it. If not it will continue within oneself that ultimately lead to stress. This stress is said to be the main cause of hysteria. Mahmood Nazar Mohamed (1990) also lists the sources of stress that includes having frustration, family problems and social pressures.        Hysteria is a form of reaction to the stress, which is experienced by a person or group of individuals who are not able to overcome these stress. It is one of the selected ways to relieve the stress that being barred by them. (Alec Roy, 1982).       Members of the Islamic psychology, such as al-Ghazali, al-Razi, Muhammad Uthman Najati and others see the emotional stress from the point of mental or emotional anxiety of human being such as agitated, upset, excessive worry and fear. These emotions exist because the human heart to do not have faith and believe in Allah swt. In addition, stress is also associated with heart disease, such as jealousy and being too proud (Fariza, 2005).       Uthman Najati (1992) also explains that the human will face disturbance and an uncertainty of emotion disorder when the psychological conflict happens which is the clash between two human souls, one who believes in Allah s.w.t. and one just follows what’s soul desires.       In Islam, faith anxiety, uncertainty in believes and disturbance of the human mind is in fact caused by several factors. Among them is caused by the sin they have done. People who often commit sin would cause unrest in their life. This occurs when they are overshadowed by the guilt of sin that they have committed before. This guilt will lead to a sense of anxiety and worry as long as they do not repent for their sins. (Hanafi Mohamed, 1998).       Psychological depression is termed by the Malay community by being possessed by ghosts. For the Malays, the symptoms of hysteria are a manifestation of being possessed by supernatural powers and extraordinary physical symptoms, violent, aggressive, destructive and scary. This is the doing of supernatural powers that used the spiritual and physical of their victim who are considered 'vulnerable'.       Freud also concluded that hysteria was caused by the person experiencing a painful event which is hidden in the soul of the person without knowing that this has made them depressed and in a state of extreme sadness (Irwan Shah 2002).       Therefore, before the hysteria happens, they will first be in the state of sadness and extreme depress. These psychological factors are also supported by the field studies conducted on 41 students from a secondary school in Selangor in June 2010. Results showed that students who experienced stress and having doubt in the decision-making gets a high percentage (75.6 and 73.2 per cent), as shown in Table 1.  TABLE 1.  Psychological Factors
No	Item	Never		Sometimes		Often		No Answer		Sum
		N	%	N	%	N	%	N	%	N	%
1.	I am depressed with life	6	14.6	31	75.6	3	7.3	1	2.4	41	100
2.	I am in doubt and confuse in the action / decision making	6	14.6	30	73.2	3	7.3	2	4.9	41	100
3.	I am disappointed with studies	7	17.1	25	61.0	7	17.1	2	4.9	41	100
4.	I am disappointed in my love life	21	51.2	19	46.3	1	2.4	-	-	41	100
5.	I am disappointed with my family	14	34.1	18	43.9	8	19.5	1	2.4	41	100
6.	I am worried about my health	14	34.1	16	39.0	9	22.0	2	4.9	41	100
7.	I am not satisfied with my physical appearances	16	39.0	19	46.3	5	12.2	1	2.4	41	100
8.	I felt for past mistakes	4	9.8	18	43.9	17	41.5	2	4.9	41	100
9.	I am easily scared without any reason	12	29.3	17	41.5	11	26.8	1	2.4	41	100
10.	I am easily agitated	4	9.8	26	63.4	8	19.5	3	7.3	41	100
11.	I am a hot tempered person	5	12.2	25	61.0	9	22.0	2	4.9	41	100
12.	I am a rebellious person	18	43.9	15	36.6	6	14.6	2	4.9	41	100
13.	I always keep things to my self	3	7.3	16	39.0	18	43.9	4	9.8	41	100
14.	I feel emptiness in my life	22	53.7	12	29.3	5	12.2	2	4.9	41	100
15.	I can easily get upset	17	41.5	12	29.3	9	22.0	3	7.3	41	100
16.	I like to be alone	7	17.1	20	48.8	12	29.3	2	4.9	41	100
17.	I feel lonely	13	31.7	18	43.9	9	22.0	1	2.4	41	100
18.	I hate my self	22	53.7	14	34.1	3	7.3	2	4.9	41	100
19.	I have no confident	8	19.5	25	61.0	5	12.2	3	7.3	41	100

Source: Questionnaire 2010 

b)PsychicFunctionDisordersFactors

Psychiatrist says, hysteria is a symptom of psychic function disorder. It is a disorder of human neurosis with certain features (Krohn, A, 2005). The situation involves a person experienced by their level of consciousness, actions and feelings .Disorders affecting the movement of one’s act and one’s individual sensitivities. A neurosis is also being named psychoneurosis. It is a general term that refers to mental disorder that may cause hysteria. 

     Mental disorder associated with human neurological nerves and brain (Mahmood Nazar Mohamed 1990). When a person being attack by hysteria, they are actually having neurosis disorders that cause them are not to be sensitive with surrounding things. They are unconscious and act aggressively. This is because they are mentally disturbed and this is how the person expresses their emotions. 

     Psychic function disorders towards children aged 10-12 years who has lack with the communication skills and unable to express out are prone to hysteria (Kasmini Kassim, 1992). This situation is because they cannot express their feelings and emotions. 


     Individuals who experience psychic function disorders due to stress and mental disorder can lead to hysteria and this is known as hysterical neurosis. 

c)Cultural and  Religious  Factors                                                                                                                                                                                                

Cultural factors and beliefs play an important role in the occurrence of hysteria (Amran & Zulkarnain, 1994). In a society that has values and norms that put weight on their children academics performance, will easily lead a person into stress and hysteria if they have a low academic performance. Similarly, in the aspect of Malay culture and believes, they are convince that supernatural power have some  affect on the lives of their young children. These children are being fed and scared with ghost and spiritual story and with these extreme fears the children can be easily attack by hysteria. 
  
     This belief was also supported by practitioners of traditional treatment, by saying hysteria caused by disturbance of outside forces such as spirits and demons that possessed into the human body and control their behaviour and thoughts. When this happens, there will be hysteria that being possessed by unknown supernatural powers. They experience extreme emotions of fear that make it easier for the spirit to disturb and possessed and lead to hysteria (Abd Majid Hassan, 2009). 

     According to Haron Din, who had been treating the symptoms being possessed, explained the root causes of the illness is due to the mix between internal and external influence factors. Among them is when a person having a breakdown on their feelings or soul. When this happens they will experience extreme emotions of fear that make it easier for spirit to disturb and ultimately lead to hysteria (Abd Majid Hassan, 2009). 

     Hysteria is also being associated with the religion factor. When an individual is not practicing Islam as the way of their lives such as not praying, not reciting the Quran and behave badly can open up themselves hysteria. 

     Referring to the survey data and the religious beliefs factors derived from field studies, it is found that the teenagers do lack of prayer, zikrullah and reciting the al-Quran as shown in Table 2. This shows that youth with less of religion knowledge and believes in the spirits are easily attack by hysteria. 

TABLE 2. Cultural and Religious Factors
No	Item	Never		Sometimes		Always		No Answer		Sum
		N	%	N	%	N	%	N	%	N	%
1.	Recited shahadah	-	-	23	56.1	18	43.9	-	-	41	100
2.	I believe strongly in the teacing of Islam	-	-	4	9.8	36	87.8	1	2.4	41	100
3.	Performs prayer five times a day	-	-	35	85.4	6	14.6	-	-	41	100
4.	Recite al-Qur’an at least ones a week.	2	4.9	26	63.4	11	26.8	2	4.9	41	100
5.	No motivation in doing ibadah	10	24.4	29	70.7	1	2.4	1	2.4	41	100
6.	Reciting zikrullah	-	-	34	82.9	6	14.6	1	2.4	41	100
7.	Confident in Allah and His punishment	-	-	2	4.9	39	95.1	-	-	41	100
8.	I am afraid of  ALLAH punishment	-	-	6	14.6	34	15.0	1	2.4	41	100
9.	I more afraid of supernatural power/spirit than ALLAH	20	48.8	17	41.5	4	9.8	-	-	41	100
10.	I believe in Allah to protect me from supernatural power/spirit	-	-	8	19.5	32	78.0	1	2.4	41	100
11.	I am not mentally strong	8	19.5	27	65.9	6	14.6	-	-	41	100
12.	My family always being disturbed by supernatural power/spirit	22	53.7	14	34.1	3	7.3	2	4.9	41	100
13.	My family is practising black magic	37	90.2	2	4.9	1	2.4	1	2.4	41	100
14.	I believe my family has befriended and worship spirit	31	75.6	5	12.2	4	9.8	1	2.4	41	100
15.	My family has a possession items to worship spirit  such as dagger, ring, yellow cloth etc.	33	80.5	3	7.3	5	12.2	-	-	41	100

SYMPTOMS OF HYSTERIA

Researchers have concludes some of hysteria symptoms according to their field of studies. The psychiatric divides the symptoms into physical symptoms and mental symptoms. Physical symptom is usually in the nature of some incapacity, partial or complete, involving the sense organs or voluntary musculature- aphonia, mutism, deafness, blindness, paresis or anaesthesia. The mental symptoms are amnesias, fits, and disturbances of consciousness-fugues, stupors and so called twilight states (Atkins, 1953). 

     Psychologists, refer it to psychological symptoms such as anxiety and aggregation of traits which has been called the hysterical personality. 

     In the Malay community in Malaysia, symptom of hysteria includes screaming, crying and running without directions. They talks very loud and speak language that is not understood (Amran and Zulkarnain, 1994). 

     In the study of Islamic psychological and its perspective, says symptoms of hysteria includes difficult to sleep, anxiety, stress, having a nightmares and so forth. There was also other symptoms that can be observed such as appears in the unconscious, continuous feeling dizzy, refused to mention the name of Allah, do not want perform usual prayers, easily forgotten and lazy (Musfir bin Said Al-Zahrawi, 2005).

     Victims of hysteria seemed to lose their memories due to brain disorders in the nervous system. Individual acts in chaos with having movements and action without a purpose and have no control of it. There were times when the victim was also missing the ability to control their movement (Musfir bin Said Al-Zahrawi, 2005). Ahmad Subhi Iwadullah in his Istisqa 'bi al-Quran considers general hysteria is chaos and confusion that occurs suddenly in the brain that affects the flow functions. These disorders can be divided into two types, namely, first, the disruption of bodily functions that bring about change and loss of sensory physiology in full. Second, psychiatric disorders (Musfir bin Said Al-Zahrawi, 2005). 

     Abdul Salam Bali (1992) has divided the signs of hysteria into two parts, namely, symptoms while sleeping, such as having nightmares and secondly, other signs while being awakes, such as seeing ghost or spirits. 

    The results from  the study, shows that the symptoms of hysteria, experienced by the students is body trembling and feeling cold (92.7), insomnia and headaches (80.5), had a nightmares (73.2), anxiety (80.5) and seeing spirits (80.5 ).Other symptoms, are as in Table 3. 

Table3. Symptoms of Hysteria
No	Item	Yes		No		No Answer		Sum
		N	%	N	%	N	%	N	%
1.	Hysteria to having a period	17	41.5	22	53.7	2	4.9	41	100
2.	Having trouble sleeping	33	80.5	8	19.5	-	-	41	100
3.	Continuous headache	32	78.0	9	22.0	-	-	41	100
4.	Unable to control their movement	27	65.9	13	31.7	1	2.4	41	100
5.	Having a night-mare	30	73.2	11	26.8	-	-	41	100
6.	Agitated	33	80.5	8	19.5	-	-	41	100
7.	Always hearing things like whispering voice, wind hissing, bells etc	30	73.2	11	26.8	-	-	41	100
8.	Losing one senses(blurred vision, loss of hearing and etc)	13	31.7	26	63.4	2	4.9	41	100
9.	Body aching	34	82.9	7	17.1	-	-	41	100
10.	Easily forgetting things	25	61.0	16	39.0	-	-	41	100
11.	Loss of eating appetite	26	63.4	14	34.1	1	2.4	41	100
12.	Weeping for no reasons	31	75.6	9	22.0	1	2.4	41	100
13.	Feel sleepy	25	61.0	16	39.0	-	-	41	100
14.	Laughing without any reasons	28	68.3	12	29.3	1	2.4	41	100
15.	The body feel cold and trembling	38	92.7	3	7.3	-	-	41	100
16.	Feel like in a fantasy	21	51.2	19	46.3	1	2.4	41	100
17.	Having loss of memory	5	12.2	34	82.9	2	4.9	41	100
18.	The vision turn black out	13	31.7	26	63.4	2	4.9	41	100
19.	Having an extreme fear feeling	29	70.7	11	26.8	1	2.4	41	100
20.	Seeing the spirit	33	80.5	6	14.6	2	4.9	41	100

Source: Questionnaire 2010 


                                                CONCLUSION 

1.     
Based on studies conducted, it appears that the prevailing hysteria has to do with psychological factors, and religious beliefs and psychic function disorders. The students, who had the hysteria, had also shows hysteria symptoms. They show it through their physical, psychological and physiology. As the conclusion, the views and findings of psychologists, psychiatrists and alternative Islamic medicine treatment can be combined and used in order to deal with hysteria. 

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