An attack of Open Mole

Stress, anxiety and depression are common terms used in the West to describe ways in which we become mentally distressed. We tend to think these are universal ways of experiencing mental strain but they are not. In fact, the words cannot be directly translated into many of the world’s languages because the concepts do not exist.

The latest issue of the journal Culture, Medicine and Psychiatry is a special collection of articles on ‘cultural idioms of distress’ and tackles ways in which people experience distress after difficult situations from cultures around the world.

One particularly fascinating article discusses a condition from Liberia called ‘Open Mole’ which is widely believed to occur after sudden shocks or after living through tough times.

Across Liberia, a single unified characteristic defines Open Mole. Open Mole is understood to be a soft spot in the center of the skull similar to the soft areas in an infant’s unformed skull, or the sunken fontanel associated with infant dehydration. However, in contrast to the infant skeletal development processes and the dehydration-induced softening with which the Western medical literature is familiar, Open Mole is understood to be an acquired disease state that can occur to adults who experience a sudden fright or shock or who endure chronic adversity and stress. While its defining symptom is the soft spot on top of the skull, Open Mole is commonly associated with many symptoms, including: severe headache, neck pain, back pain, fatigue, weakness, nightmares, troubled sleep, loss of appetite and social withdrawal. Many additional symptoms are believed to accompany Open Mole, but there is little consensus among Liberians about Open Mole’s ethnophysiology [local beliefs about its biological basis].

The etiology of Open Mole is heterogeneous. Although a belief in the existence of Open Mole exists across geographical boundaries and ethnic groupings, it is contested among Liberians on a number of indicators. Some understand Open Mole to be contagious, while others believe that it is not. Some believe that Open Mole is caused by tampering with dangerous spiritual forces, practicing witchcraft or having a dangerous nightmare, while others believe that it can be caused by sharing a hairbrush or a headscarf, getting caught in the rain or sitting in the sun too long. Some believed that Open Mole is caused by committing an act of wrongdoing (like violence, theft or sorcery), while others believed that Open Mole is a victim’s affliction, carried by those who have had wrong done to them.

The issue also has an open-access article on how spirit possession in Nigeria is more likely in people who have lived through traumatic experiences.

It’s a fascinating study, because alongside traditional diagnostic interviews from Western psychiatry the research team create and validate a diagnostic scale for spirit possession symptoms, allowing an empirical look into some of the psychology behind it without ignoring the experience or dismissing it.

Link to special issue (via the excellent Somatosphere)
Link to PubMed entry for Open Mole article.
Link to full text of spirit possession article.

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