`Hit by the Wind' and Temperature-Shift Panic among Vietnamese Refugees

Abstract

Surveying 60 Vietnamese patients with either current or past post-traumatic stress disorder, this article aims to phenomenologically characterize the syndrome of 'hit by the wind' in a multidimensional manner. This includes determining the patient conceptualization of the disorder, profiling 'hit by the wind' episodes suffered by patients in the previous month, and presenting case vignettes. Eighteen of the 60 patients (30%) suffered at least one episode of 'hit by the wind' in the last month; all 18 patients had at least one episode of 'hit by the wind' in the last month that met panic attack criteria. For the 18 patients, 33 episodes of'hit by the wind' that met panic attack criteria were experienced in the previous month. For these 33 episodes, the most frequently reported DSM-IV panic attack symptoms were chills (100%; 33/33) and dizziness (88%; 29/33). Flashbacks played a role in the 'hit by the wind' episodes for 5 of the 18 patients (28%). In the discussion, a model of how the syndrome of 'hit by the wind' generates panic is adduced; also, possible Chinese origins of the disorder are discussed.

Symptom Presentation and Symptom Meaning Among Traumatized Cambodian Refugees: Relevance to a Somatically Focused Cognitive-Behavior Therapy

“…As can be seen, Cambodians interpret multiple somatic symptom of anxiety in terms of the pathomechanics of Wind, so that most anxiety states generate catastrophic cognitions about imminent bodily dysfunction. (Of note, this interpretation of anxiety-type symptoms-as being generated by the pathomechanics of a Wind-like substance-is extremely widespread in Southeast Asia, including in Laos [Hinton, 2000] and Vietnam [Hinton, Pham, Chau, Tran, & Hinton, 2003]; this Wind ethnophysiology seems to have its origins in Ayurvedic medicine, which had a great influence on Southeast Asian medical practices. )…”

“…Often a somatic symptom will have correlated metaphors of distress; these metaphors, which vary by culture, guide somatization and affect the selection-as a result of emotional valences and meaning-of the symptom of anxious concern (e.g., cardiophobia, Eifert, 1992;see too, Kirmayer, 1984). Certain languages contain elaborate metaphors that configure distress as dizziness (Hinton, Chau, et al, 2001;Hinton, Pham, et al, 2003). As a result, for persons in these cultural groups, dizziness will-by means of metaphor-guided distress evocation-elicit current life-distress issues (e.g., debt, marital conflict); and, in turn, thinking about current life-distress issues will-by means of metaphor-guided somatizationinduce dizziness.…”

“…Chills and cold extremities were repeatedly experienced in malaria episodes. (As described above, malaria episodes involve an initial period of rigor-type chills along with various other symptoms, including anxiety, shortness of breath, and extreme dysphoria, which constitutes what might be referred to as biologically induced cold-type panic attack [see Hinton, Pham, et al, 2003]. ) Metaphoric associations-Many Cambodian idioms express personal connectedness as a sense of bodily warmth: a good relationship is described as "warm" (kâ kdaw).…”

Culture and the Anxiety Disorders: Recommendations for DSM-V

“…Due to the availability of this cultural syndrome, Cambodians may be more likely to experience PAs that include symptoms of khyâl attacks, such as neck soreness or tinnitus, owing to their cultural association in a known illness cluster. [32] Other examples of cultural syndromes that influence the cross-cultural presentation of PAs are trung gió (wind-related) attacks in Vietnam (which are associated with headaches) [33,34] and ataque de nervios (attack of nerves) among Latin Americans. [35,36] Ataques in Puerto Ricans and Dominicans may meet criteria for PAs, or instead be better characterized as anger episodes or grief reactions.…”

Sensing the Airs: The Cultural Context for Breathing and Breathlessness in Uruguay

“…Subsequent works on climate have drawn on notions of environmental citizenship (Orlove et al 2011), socio-materiality, and biopolitics (Knox 2014) to explore the cultural politics of climate change and climate information. While there is less focus on the sentient body in these works, other works concerned more generally with climate, wind, and air, both historical and contemporary, have highlighted the links to health and breathing (CrandonMalamud 1991, Golinski 2016, Hinton et al 2003, Jankovic 2007Strauss 2007). For example, Hinton and colleagues' (2003) phenomenological study of "Hit by the Wind" syndrome among Vietnamese refugees illustrates the link between the interpretation of wind and weather and shared embodiment of past traumatic events.…”