What Is Koro Syndrome - Essay Example

?Koro Syndrome Introduction Depersonalization is a strange feeling in which a person may experience an alien feeling of unreality and peculiarity about themselves. They can even feel their body to be radically changing in somewhat bizarre manner. These kinds of experiences are quite common in our society. Gentle forms of “out-of-the-body” experiences generally fall within the dissociative disorder categories. In different parts of the world, there have been proofs of various disorders that have been marked as instances of de-personalization, which differs greatly from those typically seen in the West. For example, there has been the existence of varied anxiety syndromes that involve fright of death, fear of getting castrated and concerns regarding sexual potency. The Nigerian Yoruba believed that the main cause of male impotence was “bewitchment”, in such cases a male witch would steal a mortal man’s penis to use it for having intercourse with the wife of the victim or any other woman and then return it back in an altered and manipulated form thus making him impotent for life (Koro-A culture-bound depersonalization syndrome, n.d.) What is Koro Syndrome? Koro is primarily an anxiety disorder characterized with sexual dysfunction hysteria and death. In psychological terminology, koro is basically “genital retraction syndrome” (GRS). In layman terms, it is the delusion that the genitals will be completely shrinked into the body. The male victims of Koro mainly suffer from the fear of the fact that their penises are retracting to their abdomen and as a result they will die when the process gets completed. In females, it is characterized by shrinking of nipples inside the breast mass. Koro mainly occurs to men and is occasionally seen in women. ( Koro- the Genital Retraction Syndrome, 2001) However, Koro is often considered a culture-specific disorder, which means only people of certain specific cultures and territories get affected by this disease, and it is not really one of those diseases generally recognized by Western medicines. It is seen mostly in Southern China, Malaysia, Singapore as well as certain parts of Africa, Afghanistan, India and even in some parts of the West. Every region has different names for the disease, like in China it is known as “suo-yang” (suo=shrinkage yang=penis), in Cantonese it is known as “suk-yeong”, in India “jhinjhini bimari” (=tangling disease) etc. (Garlipp, 2008). Koro, primarily seen in the South China region, mainly affects young normal Chinese males in the age range of 21-40 years who have prior experiences of premorbid sexual inadequacies and maladjustments. Most commonly cited reasons of Koro Syndrome mainly include masturbation, illicit sexual encounters with prostitutes, witchcraft etc. Psychologists who laterally analyze different cultures are of the view that koro is closely integrated to panic attacks due to sexual apprehensions. Attacks are often experienced by men in situations which generally cause genitals to retract slightly, such as cold weather or emotional anguish (Koro-the Genital Retraction Syndrome, 2001). Most koro attacks occur usually at nights with common symptoms like senselessness, palpitation, pounding heart rate, fear of death, loss of penile shape and muscular tone, loss of sexual desire and power and genital tingling. It has been argued that these can be sufficient criteria for diagnosis of koro but not really necessary in any ways. The fear of depersonalization is so acute in certain cases that people often hold on to their penis all along during the course of the attack in fear that it might disappear inside their abdomen forever. They prefer to visually inspect their penis and touch them often to be sure of its existence and size (Koro-A culture-bound depersonalization syndrome, n.d.) Cultural Stigma One can get some insights into the causes of Koro from the Basic Chinese Culture. Koro means head of a turtle in Chinese. The Chinese, for long have been using the turtle symbol for long lasting lives and for denoting vital forces within a person. Fears of impotence, nightfalls etc helped create the belief of koro. A mixture of social, cultural and mental build-ups makes a common individual distort the reasons related to koro syndrome. Cultural underpinnings related koro as a curse that befalls a person due to the loss of male essence thus making a man feel guilty of his sexual expressions, especially about masturbation and sexual promiscuity. Cultural barriers more often than not create a psychological effect on individuals who find them hard to deal with. The Chinese believe that koro is a dangerous illness and can result to death of a person afflicted by it. Now, normal persons who encounter sexual drive might associate themselves with koro ending up helpless and dissatisfied (Koro-A culture-bound depersonalization syndrome, n.d.)The form of depersonalization in case of koro is very different from other forms and here a person realizes that he may be “spaced out” due to extreme stress. Although unsure of the condition of the affected, yet one has to suffer more emotional trauma. Thus Koro is more of a cultural ethnicity disorder, specific to the Chinese Culture (Koro- A culture-bound depersonalization syndrome, n.d.) Not only China, some other cultures are also inflicted by some of the elements of koro. The Hindu culture has certain psychological beliefs that contain ideas of male-female physical union much in the resemblance of yin-yang (female-male) union concept of the Chinese. The general Hindu belief is that losing male essence in any other format than proper heterosexual union is injurious to a man’s health. Even the nineteenth –century Victorian culture had beliefs in the same line as the Chinese or the Hindus. During that time, medical doctors prescribed to stay away from overindulgence in sexual encounters or masturbation, which could lead to erectile dysfunction problems and even madness. Facts and beliefs about Koro Syndrome: Fear being the underpinning factor, beliefs of the causes of Koro has been different in various socio racial cultures. Several cases can be found where beliefs of koro have been turned out to be false with proper medical intervention. In the Koro prone zones of Africa, people generally have a belief of the existence of the so-called “penis-snatchers” who are claimed to be the evildoers who with the aid of witchcraft caused their genitals to shrink to their abdomen. Medical examinations proved that the accusing men were not even inflicted with the disease; it was only the panic that had set in inside them. In China, people are of the belief that yin (female)-yang (male) sexual equilibrium is disturbed fatally if “male essence” is released in any way other than spousal intercourse, like in the case of masturbation. Although this can be interpreted as a Samaritan view towards marital life but medical proofs show that masturbation is not really fatal in nature and controlled usage of masturbation helps to flush out old and excess semen from the body while overindulgence of sex with multiple partners can indeed result in Sexually Transmitted Disease(STD), like AIDS, Gonorrhea etc. In 1967, Singapore was inflicted by mass hysteria of Koro epidemics caused by consuming contaminated pork. The people feared of an epidemic arising out of it. The Singapore hospitals were flooded with thousands of men convinced of their penises being shrinking and withdrawing. Many of them tried mechanical means like using clamps, weights hung via chords from penises, other relatives pulling and grabbing penises to prevent them from retracting, etc. Doctors and the State itself came out to reassure of the non existence of koro in Singapore which proved enough to suppress the epidemic. The mass hysteria of Koro epidemic was also seen in North East India during the early 1980’s where thousands of parents brought their young male children to hospitals, with penises being bound up firmly or in some other fashion to prevent further retraction. The rumor was dissipated by the medical personnel who surveyed the whole area with loudspeakers, reassuring nervous citizens of the futility of the rumor. They even conducted mass penis-measurement programs at regular intervals to reassure the citizens that there was no shrinkage in penis size. Coming to Europe, a Greek Cypriot man was concerned that his genitals were shrinking inside his abdomen. He was also diagnosed with acute depression, anxiety and psychotic symptoms. He was treated by the psychiatrists with mood stabilizing and anti depressant medications after which his penile problems were quelled. Thus the disease cycle appears as follows: Sexual fears and genital sensation of any form, normal during intercourse, defaecation or micturition or any uncanny feeling in the penis such as an insect bite plus fear leads to Koro which in turn leads to Fear and hence Koro again, thus creating a vicious circle. Thus fear can be overcome only with proper education. (Leng,1963; Simons, & Hughes, 1985) The rapid improvement in the condition of the panic-ridden patients with proper education shows that the condition is not only psychological but more like a conversion hysteria which can be properly cured. The only point of difference between psychotic disorder and conversion hysteria is that in case of the latter, the motivation is not at all clear and the patient’s approach towards disability is mainly due to indifference whereas in the case of Koro, the major cause is basically sexual in most of the cases with belief ingrained that sexual activity is a bad practice and is health weakening with emotional state being over ruled predominantly with panic (Leng, 1963). Physicians and psychiatrists have also come up with the possibility of presence of somatic disorders in koro patients. Various common contagious and degenerative diseases like cholera, asthma, malaria, heart attacks, tuberculosis etc have symptoms that are amply similar to that diagnosed with the koro patients although possibility of native misdiagnosis still remains. The very rare physical check-ups of koro patients have more often than not proved to be negative, but that does not simply imply that the possibility of somatic diseases can be totally rejected; it may be the case that their influence is on a particular culture or community, not on an entire basis. Koro outbreaks are never accompanied by fever, which would seem to take malaria out of the equation but falciparum malaria, the most well known as well as the most dangerous form of malaria in South East Asia can occur with uncharacteristic manifestations such as non-existent(non-clinical) fever. Various medical practitioners suggesting cerebral malaria as a mysterious disease can also be a significant fundamental factor in the genital retraction syndromes in the recent years (Simons, & Hughes, 1985, pp. 180-182). The biomedical facts often extend ahead of the so called penile- withdrawal disorders in response to illness and cultural atrocities. The main symptom of Koro, withdrawal of the genitals, has generally been regarded as a concept lacking any physio-anatomical truth. Even anthropologists and psychiatrists have rejected the genital retraction problems as complete apparition (Simons, Hughes, 1985, pp 180-182). As far as medication is concerned, along with the available Western medication-oriented psychological services, people often tend to try out herbal folk medicinal systems. Many of the herbs contain high levels of active psychoactive components such as anticholinergies, stimulants and sedatives. However, drug related symptoms have also been identified and in these cases, the age range is usually as high as 13years to 75 years of age. But it is mostly combined with frequent cases of mental disorder, so the treatment mainly aims at the recovery of the primal disease and sometimes the genital retraction syndrome is often seen to be cured or suppressed. These treatments often show varied results but presence of a trend of antidepressants like SSRIs being successful can be noticed. Benzodiazepines had n’t been successful in reducing the symptoms since they can be used to reduce any kind of fears, be it neurotic or psychological. Antipsychotics like olanzapine in such cases can be useful to an extent. However, whether the koro symptom reductions can always be described by medical treatment or it can be a natural illness is a question that still needs to be determined (Garlipp, 2008, pp. 7-8). Genital Retraction Syndrome may be present more often than reported, often covered by urinological problems and not diagnosed by a psychiatrist, and patients also often are reluctant to discuss the syndromes due to the social stigmas of guilt and shame (Garlipp, 2008, pp7-8). Concluding Remarks: This topic has been an eye opener due to the very fact that it deals with a very sensitive issue. Although this is more of a psychotic problem, it is more often than not mistaken with diseases as Sexually Transmitted Disease (STD) and Erectile Dysfunction even when in reality koro symptom has nothing to do with any such things. Its existence has been a well known fact since ages; we also find its traces in the ancient Chinese literature “The Yellow Emperor’s Classic of Internal Medicine” dated back from about 300 B.C (Vaughan, 2002). However, common to human instincts, people suffering from this disease are still very apprehensive about it. One interesting fact that has come to notice while pursuing this project is that there has been marked similarity in the way of treating these patients by their communities although they have been culturally diversified. This is very evident from the fact that patients diagnosed with koro symptom have been marked by their communities as victims of witchcrafts and as sinners whose male essence has not been channelized properly thereby bringing in catastrophic outcomes to themselves and their family members. In this light, the topic can be a revelation since it has taken a scientific approach towards this problem thereby answering many questions about this disease that were priorly unknown. This can help communities to be culturally a bit more sensitive when it comes to treating those patients suffering from this disease. Multiculturalism is the only feasible way by which humanity as a whole becomes greater than its sub-parts. Only acknowledging, tolerating and working in tandem with diversified cultures will help us get out of this mono-cultural pot-boiler. This can also help us broaden our minds to the extent that we can forget the differences among ourselves so that the work is smooth and easy-going. Although very often we use the term Human Diversity, we fail to differentiate the words symptom and syndrome when it comes to mental illness. A person’s behavior as well as his feelings can be thought of as a symptom, while syndrome is somewhat a collection of accumulative syndromes of a man. This is what we fail to understand and that is where the problem lies. Only proper education can teach us to be a bit more sympathetic towards these patients and treat them with care and love. The term Koro should be used carefully to define the socio-cultural processes often known as “epidemics”. All medical phenomena that are being associated with sexual problems presented in a broader perspective with primal symptom being fear should be termed as Genital Retraction Syndromes or Koro Syndrome. All other kinds such as Koro-like Syndrome, Secondary Koro etc, should be upright rejected as misleading (Garlipp, 2008). Last but not the least, proper knowledge of origin and incidence of Koro as well as other related forms of genital retraction syndromes is of grave importance to the psychologists, urologists and doctors because of the increasing incidence of co cultural psychiatry and intra boundary migration of patients. Proper knowledge of the symptom’s presence will help recognize it if and when it occurs; treat it by removing the symptomatic fear and disorder arising out of it. It is only then can we get rid of this disease from the core. Bibliography: 1. Garlipp, P. (2008) Koro-a Culture-Bound Phenomenon Intercultural Psychiatric Implications Retrieved on May 12, 2011 from: http://www.gjpsy.uni-goettingen.de/gjp-article-garlipp.pdf 2. Kaplan and Saddock (2003)”Kaplan and Saddock’s synopsis of psychiatry: behavioural sciences/clinical psychiatry”, U.S.A, Lippinkot Williams and Wilkins. 3. Koro-A culture-bound depersonalization syndrome (n.d). Sinclair, Retrieved on May 12, 2011 from: http://www.sinclair.edu/academics/lcs/departments/soc/pub/casilab/koro/koro.pdf 4. Koro- the Genital Retraction Syndrome(2001) BBC Home Retrieved on May 12, 2011 from: http://www.bbc.co.uk/dna/h2g2/A593354 5. Leng,G.A. (1963) Koro-A Cultural Disease Singapore Medical Journal , 4(3)120-121,Retrieved on May 12, 2011 from: http://smj.sma.org.sg/0403/0403smj4.pdf 6. Simons, R.C and C.C Hughes (1985) “The Culture-Bound Syndromes Folk Illnesses of Psychiatric and Anthropological Interest”Holland, Reidel Publishing Company 7. Vaughan, (2002) Koro: A Natural History of Penis Panics Retrieved on May 12, 2011 from: http://www.kuro5hin.org/story/2002/9/16/81843/6555 Read More