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Stop that! It’s not Tourette’s but a new type of mass sociogenic illness

academic.oup.com

In Germany, the current outbreak of mass social media-induced illness is initiated by a ‘virtual’ index case, who is the second most successful YouTube creator in Germany and enjoys enormous popularity among young people. Affected teenagers present with similar or identical functional ‘Tourette-like’ behaviours, which can be clearly differentiated from tics in Tourette syndrome.

Another choice quote

patients often reported to be unable to perform unpleasant tasks because of their symptoms resulting in release from obligations at school and home, while symptoms temporarily completely disappear while conducting favourite activities.

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I'm going to approve this, but for future reference, we would really prefer links be accompanied by actual commentary, not just a couple of "choice quotes."

I thought it was a good summary. If the OP doesn't have anything to add, why force them?

FWIW I thought I was doing more than necessary, based on the actual submission and the upvotes of this comment: https://www.themotte.org/post/206/back-from-the-front-a-british/37219?context=8#context

Also FWIW, while I prefer an actual commentary that explains how a given post might be relevant to the Motte or at least interesting to its userbase, I thought that your selection of quotes worked fairly well and was at the very least infinitely preferable to bare link posts.

I mean, I was formally diagnosed with a psychosomatic pain disorder because I kept claiming I had stomach cramps to get out of going to school. This whole thing strikes me as a bunch of adults becoming genuinely confused that somebody could legitimately fake illness to get out of unwelcome chores, and lie about it with a straight face.

Teenagers are monsters whose moral compass has not yet developed. There is no "mass sociogenic illness" being "spread" via social media. Infohazard? Seriously? Just don't pretend to be sick to get out of work and you're immune.

I’m really not convinced anyone is consciously deciding to fake tourette’s to get out of schoolwork.

  1. Tourette’s doesn’t really get you out of schoolwork. It’s not contagious so you don’t need to be kept away from other people and it’s not a condition that goes away after a day or two of rest so there’s no reason to allow that time.

  2. Tourette’s is a permanent condition, which means deciding to fake it credibly is a lifelong commitment.

  3. It’s a difficult condition to fake. If you tell your parents you have a stomachache or a headache, they just have to take your word for it, but someone faking tourette’s has to remember to tic regularly.

Anyone who thought about it for a minute would realize, as you did, that it makes way more sense to fake an infection.

As the article claims this decidedly isn't tourette's, no?

It's not Tourette's because it's a mass sociogenic illness that mimics Tourette's, according to the article. But I interpreted your comment as saying that it's a sociogenic illness either, it's kids consciously faking Tourette's to get out of work.

How do you go about telling someone "Im sorry, but it seems likely that your disorder/lifestyle/lived-experience is the result of a sociogenic contagion", aka 'you got meme'd on, son'. Seems like an awkward conversation.

And also, I suppose, would even a conclusively proof of sociogenic origin automatically devalue said disorder/etc? Society is pretty accustomed to giving religions at least a partial pass despite being a pretty clear case of memery. I'm also reminded of the pathogenic theory of homosexuality - so what if it's caused by a virus, if you're happy the way you are?

I wouldn't say a virus is quite the term for it. A meme, in the Dawkinian sense, describes it well.

A meme rarely spreads purely through social influence though. Religion, cultural trends, and jokes app spread because there's some deeper appeal than just fitting in.

I'd say this is a case where it's even more likely there's a deeper appeal to accepting the social contagion, since there's the obvious downside of being stigmatized for neurological disorders, whether real or imagined.

My first guess would be that there's a shared, desperate need to be unique, yet still find comfort in some sort of comraderie.

Reddit would love this but fail to see obvious parallels to transgenderism

I wrote a comment for the general CW thread, but noticed this dedicated thread here, so I'll just post it here:

This little bit of news made it through my feeds recently:

We report the first outbreak of a new type of mass sociogenic illness that in contrast to all previously reported episodes is spread solely via social media.

A mass sociogenic illness is later defined as "a constellation of symptoms suggestive of organic illness, but without an identifiable cause, that occurs between two or more people who share beliefs related to those symptoms"

The symptoms of this illness present like those of Tourette syndrome:

(...) patients presented with nearly identical movements and vocalizations that not only resemble Jan Zimmermann’s symptoms, but are in part exactly the same, such as shouting the German words Pommes (English: potatoes), Bombe (English: bomb), Heil Hitler, Du bist häßlich (English: you are ugly) and Fliegende Haie (English: flying sharks) as well as bizarre and complex behaviours such as throwing pens at school and dishes at home, and crushing eggs in the kitchen.

However, when diagnosed by an experienced professional, it turns out that these symptoms are only a shallow mimicry of Tourette syndrome:

(...) Third, patients often reported to be unable to perform unpleasant tasks because of their symptoms resulting in release from obligations at school and home, while symptoms temporarily completely disappear while conducting favourite activities. Fourth, in some patients, a rapid and complete remission occurred after exclusion of the diagnosis of Tourette syndrome.

So, in other words, what we're seeing is a memetic infection, aka infohazard.

What other memetic infections are floating around us? It would be too easy to point to grand political or religious ideas. But what about something smaller? Could things like "black pill", "gender dysphoria", "trad-life", "degrowth" be examples of sociogenic illness?

Think about it: faux-Tourette syndrome is an aesthetic that plays out as a social behavior. The things I listed above are often played out as aesthetic-based social behaviors--anecdotally, I know of few people with similar "lifestyle" beliefs that adhere to them as a result of deep self-reflection and research.

Looking toward the future, what other sociogenic illnesses can we expect given that social media is worming its way deeper and deeper into society?

Could things like "black pill", "gender dysphoria", "trad-life", "degrowth" be examples of sociogenic illness?

I think this and other online things could be and it took something like this to awaken people to the possibility. Also the flat earth movement, alien abductions (this one predates the internet a bit), "incels", etc.

Think about it: faux-Tourette syndrome is an aesthetic that plays out as a social behavior. The things I listed above are often played out as aesthetic-based social behaviors--anecdotally, I know of few people with similar "lifestyle" beliefs that adhere to them as a result of deep self-reflection and research.

Humans are social creatures that engage in social learning and mimicry. This is just basic psychology, sociology, and ethology. I don't see what calling these things infohazards or sociogenic illnesses adds. Obviously if the behavior is obviously disordered like adopting the behavioral patterns of a legitimate illness that makes sense, but would we consider religious behavior generally an infohazard or sociogenic illness?

To take it even further would uncontroversially productive, but socially learned behaviors like studying diligently or practicing for a sport be considered the same. Social media seems hardly unique and there have been countless cults, secret societies, civil religions, and arbitrarily learned taboos, norms, fads and crazes for as long as human history.

I don't see what calling these things infohazards or sociogenic illnesses adds.

I guess there's an element of choice in mimicry, but no choice when it comes to illness? It's not specified in the source whether the affected people decided to imitate a popular youtuber or just found themselves replaying the youtuber's behavior.

But you do mimic those around you subconsciously all the time, both short term and long term. Nothing about this makes this phenomenon in general a mental illness more than the fact I dress in blue jeans and speak English with an accent similar to that of my local region a mental illness.

I also doubt these people are less agentic in their mimicry than most people. The whole point of the article was that they had plenty of agency. They did the tics more when it was convenient for them and less when it wasn't.

But you do mimic those around you subconsciously all the time, both short term and long term.

I think this reduces the phenomenon that was described in the article. Perhaps I'm reading too deep into but, here's my take: you statement misses the "illness" part, which I take to mean something undesired, and the "remote" part.

Mimicking others wearing jeans around me doesn't harm me in any physical or sociological way. Plus, the impulse to wear jeans is immediate--real people around me wearing them seem happy and comfortable.

Fidget spinners were a fad. People were using them around me and I probably saw people using them on TV or youtube (the "remote" part). But they had no negative influence on my state. They also died out after a few weeks.

Youtube-Tourettes has propagated fully remotely via youtube. It also has negative consequences for the individuals, such as putting them in conflict with others around them, and the mechanism for the consequences seems to be that these individuals make it a part of their identity. None of jeans, pokemon, harry potter, or fidget spinners ever became a core part of someone's identity. Even hardcore fans of these fads have been mostly able to contain their fascination so that it doesn't interfere with their lives (work, school, community, family, etc.)

The whole point of the article was that they had plenty of agency. They did the tics more when it was convenient for them and less when it wasn't.

I don't think this is evidence for agency, because correlation doesn't imply causation. Humans are not rational creatures, especially adolescents, so I can quite easily entertain the idea that they tricked themselves into believing they had Tourettes to the point of losing agency over this. People who speak in tongues sincerely believe they have become vessels of God. I suspect they had previous beliefs that made it possible to wake up one day, have a funny feeling in their brain that caused them to babble a little bit, and completely miss the moment to make a decision because their faith allowed them to see only a single path forward: to claim they've become a vessel of God. Similarly, Youtube-Tourette's sufferers probably already had a bunch of agency-robbing views that made them certain they were afflicted with Tourette's.

If there really is a social contagion spread in this fashion...why would you tell people about it?

The meme can't infect you if you identify it as cringe.

This is, ostensibly, the whole point of edgy jokes and ironic bigotry. It exposes you to the meme in it's crippled, cringey form, innoculating you against later infection.

I do not think that is the whole point.

A lot of social games are played around the concept of the line, where e.g., you might demonstrate your social competence by walking right up to the line and just barely not crossing it. Maybe that's what we call a really good edgy joke? Or, if you don't know where the line is, you might deliberately cross it order to identify exactly where it is. I suppose that'd be a bad edgy joke. Although, a skillfully made line-crossing can plausibly be walked back to where the line is, after you've identified its location. And of course you might cross it just to make people mad. You might not even mean what you say, you just wanna piss them off and you know that crossing this line is the way to do it.

There's lots of others, like how ambiguous statements can be used to gauge mutual trust and friendship, e.g., you insult your friend and he chooses to interpret it as insincere as a display of trust. Which of course is dangerous, since the insult could be sincere, and he could end up looking or being played for a fool and suffer the negative social consequences of that. Or how groups can use offensive jokes or statements in order to forge similar bonds between themselves. And not just in the sense of saying offensive things insincerely and then being interpreted insincerely by fellow group-members, but also to say such things in order to deliberately make yourself less tolerable to others, and the more strongly you advertise social signals that make you intolerable to others, the more strongly you simultaneously signal your dedication to the group. "I am so dedicated that I am willing to forgo all other social relations, and I demonstrate this by making everyone else hate me to the point where this group is my only option." Although, that probably is not a positive aspect.

Anyway. This wasn't meant to be an exhaustive list (nor am I qualified to provide one), just to remark that there's a lot more to edgy jokes and general line-crossing than merely cleverer variations of saying that something is bad. There's lots of playing around with identifying what is bad, and with dancing around a shared understanding of something as bad in order to achieve different effects.

I feel like a lot of these points are intuitively very obvious (just look at people interacting socially, they engage in these strategies constantly and effortlessly with high levels of competence) but are rarely verbally articulated for some reason. Probably, I'm guessing, because they are so obvious and intuitive. But, then, this also makes them sometimes invisible in the verbal space. Makes me think of, although it's not quite the same, of how historians seem to be still very unsure about how e.g., roman legionaries actually fought when their line met the enemy, because nobody bothered to write that part down. They wrote lots of other important stuff down, just not that part. It was so obvious to them that there was no need to. So it's invisible to us, who are just seeing their writings. Maybe there's a danger in spending too much time in verbal spaces, like the internet, or highly formal places, like the workplace, where these social games are a lot more dangerous, and so they're played a lot less, and so people end up inexperienced with them. But I digress.

An article like this surely should amount to an inactivated form of the virus. If we identify an infohazard that can not be described in a way that does comes with negligible transmission risk, I'd find that rather more concerning.

In light of this interesting evidence what other mental illnesses might have a sociogenic component?

Multiple Personality Disorder/DID “systems”, autism, ADHD, bipolar, and even Borderline Personality Disorder can be found on /r/fakedisordercringe/ on Reddit.

How about gender dysphoria?

I mean, if you want to go for the low-hanging, excruciatingly obvious fruit, sure. But FDC is an lgbtq+ safe space, so anyone suggesting that trans kids are socially infected with a trans meme, let alone a disorder or mental illness, will get blasted from the face of Reddit.

Meanwhile, r\detrans is on super thin ice already, and only manage to survive under the eye of Sauron by restricting posts and comments to people who attest in their flair that they’re detransitioners and deserve a place for their own highly personal stories.

It’ll be interesting what historians of psychiatry will say when it becomes undeniable that the trans wave was at least partially social contagion and social media companies banned you from discussing this fact

Yes, so much of the world feels like living in "The emperor's new clothes" right now.

Rather than these teens being denied a Tourette's diagnosis, it seems more likely to me that the practical definition of Tourette's (or "Tourette's like [blah blah blah]", whatever makes them feel satisfied that they've been "heard" and can brag to their online friends about an official diagnosis) will just expand to include people like them. Anything else would run the severe risk of being attacked by a mob of the usual advocates of "disability rights", "social justice", etc.

Conversely, with the general understanding evolving to be that most tics are semi-conscious/chosen, we can expect those with genuinely involuntarily but controversial tics such as those involving repeating racial slurs, etc. to become more stigmatized (in the name of rights for the "disabled", that is other people half-pantomiming their actual illness), similarly to how the "Mental illness isn't an excuse for racism!" canard evolved (after you had thousands of people (primarily self-diagnosed) allegedly possessing X mental illness around to say "Well I also have [X] and it's never caused me to say [non-PC thing]!").

On the other hand, I think the line between performance and authenticity has always been a lot blurrier than many would like to believe. Perhaps the pseudonymous and polyonymous nature of the Internet has just made this a more practically implementable tendency, increasing its behavioral potency. As with most fads, this particular manifestation of it will probably wax and wane though, same as all fashion (and isn't all fashion inherently performance desperately grasping for authenticity?). (I for one am waiting for wheelchairs, colostomy bags, etc. to become in many cases voluntary fashion accessories.)

risk of being attacked by a mob of the usual advocates of "disability rights", "social justice", etc.

Getting an effective mob going doesn't seem easy, though. There are far more fat people than transgender people, but "fat acceptance" hasn't made many inroads while "trans rights" have expanded at a dizzying pace. A major reason for that seems to be aggressive lobbying by experienced, well-funded LGBT groups. It seems unlikely that similarly effective groups will emerge to support annoying teenagers with fake tics, DID larpers, etc.

There are far more fat people than transgender people, but "fat acceptance" hasn't made many inroads

I think this is because there are so many fat people that their acceptance (in the sense of acceptance of the fact of their existence, basic tolerance in the classical sense, not raucous approval) is essentially automatic nowadays. You don't need advocacy groups when you're 60%+ of the population. If you refuse to accommodate fat people, you simply lose access to huge portions of the population. Discrimination against them is untenable.

You also can't have much of an advocacy group when even most people that are a part of the group admit that they're inferior. So I think it's more that fat people don't want to be an advocacy mob on their own behalf because they hate themselves and that they don't really need to be since they get enough basic allowance for their existence anyway more than that they couldn't if they tried. Conversely, genuine minorities have much more of an incentive to push in these areas because they don't necessarily have safety in numbers (quantity or size).

fake tics, DID larpers

I forgot about the DID larpers. Can't wait until these kids figure out the idea of claiming that only some of their "alters" have Tourette's. That way they can stop the tics whenever they want.

So I think it's more that fat people don't want to be an advocacy mob on their own behalf because they hate themselves

I wonder what it is that gives fat people self-loathing but not trans people.

It's certainly easier to stop being trans than stop being fat ("just don't put on the skirt" Vs "run 20km a day every day for the rest of your life"), so fat people have a much higher "exit barrier", and from that angle I would think the fat people would have more to gain from advocacy.

Being an aspiring transsexual is both much more of a choice (for the most part you can't become more transsexualized than you'd like just by engaging in the wrong personal habits) and far more celebrated than being fat (though even they do get some play with the whole "love your body" stuff, promoting Lizzo, etc.). It's also probably still healthier other than in the realm of suicide risk.

Ultimately I don't think most advocacy solely comes from pragmatism. I think you really do have to believe that your identity is valid and worth advocating on behalf of to some degree. Most aspiring transsexuals are waiting for technology to potentially actually let them change their sex to a large degree. They want to become more transsexual in the future. Most fat people conversely are waiting for technology to make them skinny. (If the perfect diet pill came along tomorrow, I have no doubt that most of the members of the fat activism movement would magically slim down rather quickly.)

I for one am waiting for wheelchairs, colostomy bags, etc. to become in many cases voluntary fashion accessories

The munchies are way ahead of you, though their preferred accessories are nasogastric tubes, hickman lines and IVs (and wheelchairs).

Are you willing to make a concrete testable prediction of this, like say putting a probability on a particular modification to the definition in a given future DSM revision?

Okay, I'll try:

90% certainty: For as long as this trend continues, the number of official diagnoses of anything Tourette's-related that officially deem the involved symptoms to be caused by a sociogenic component, social contagion, social media etc. will not rise above 50% even solely amongst cases that don't fit traditional diagnostic criteria. They may get a diagnosis of "Tourette's-like functional movement disorder" or whatever instead of the real deal from more cautious docs but they won't get "You're larping this because of social media." The vast majority of providers won't touch that because why give your customer what they explicitly don't want?

To be clear I think it's likely that the actual hard definition of Tourette's will remain mostly unchanged (and articles like the OP's will continue to bemoan the conflation of fully involuntary tics with their more voluntary counterparts), but the actual practical definition in the field will become much more porous based on consumer demand. Diagnostic criteria, like all words on paper, only matter if they're followed. So I wouldn't expect to see the words on the paper describing Tourette's change necessarily, but I would expect to see it become more and more normalized for people who don't exactly fit those words to nevertheless be deemed as defined by them regardless (maybe that's not changing the definition per se, depends on your point of view about ontology).

Do doctors in Germany have "customers"?

I'm assuming they're subjected to patient evaluation to some degree. Surely people in Germany can at least indicate their wish to no longer see a particular doctor, public healthcare or not.

What part of his comment implies there will be some sort of DSM revision? What are you even disagreeing with?

Perhaps the pseudonymous and polyonymous nature of the Internet has just made this a more practically implementable tendency, increasing its behavioral potency.

I think this is key. Absent any physical reality, the need for others to validate one’s identity/perceived reality online is significantly heightened, and makes social contagion more prevalent.

That's a terrifying thought, and explains so much of what happened to the brains of people I used to know a few years ago.