Walking Corpse Syndrome: A trauma-related idiom of distress amongst Sri Lankan Tamils

Abstract

This article introduces Walking Corpse Syndrome, a common idiom of distress in Tamil Sri Lanka that is characterized by a variety of cognitive difficulties, feelings that an individual is functioning reflexively or impulsively, and acute attacks of dissociation that are accompanied with the sensation of empty-headedness. Walking Corpse Syndrome demonstrates some overlap with Western nosology, although it appears to be its own unique illness category, most likely of Ayurvedic provenance. The article comprises two studies. One is a secondary interview analysis of community members that aimed to identify the key symptoms of Walking Corpse Syndrome, allowing us to determine the local ethnopsychology of the syndrome and to elicit illustrative vignettes. The other study is a survey of Sri Lankan Tamil psychiatrists that aimed to investigate their understanding and experience of the disorder. This article outlines how, in certain cultural contexts, such syndromes emphasise the loss of attentional capacity and forgetfulness; it highlights the importance of “thinking a lot” as an idiom across cultures; and it details the many ways that Walking Corpse Syndrome is a key idiom of distress, in order to assess to give adequate mental healthcare to Sri Lankan Tamil populations.

Clinically relevant historical trauma sequelae: A systematic review

“…Hagengimana et al (2003) indicated that 35% of the sample studied met the criteria for the panic attack known as ihahamuka and that, among them, rates of PTSD, depression, and somatoform disorders were significantly higher. Recent studies in Sri Lanka (Affleck et al, 2022) have shown that Walking Corpse Syndrome is typically related to depression and PTSD, but it is a distinct syndrome specific to war victims in Sri Lanka.…”

“…Five studies with 607 participants from a convenience sample, of whom 65.4% (n = 393) were female, were conducted to examine trauma-related cultural syndromes. Three studies were quantitative cross-sectional studies using a self-report questionnaire to collect data (Hagengimana et al, 2003;Hinton et al, 2006Hinton et al, , 2010, while two studies were qualitative (Affleck et al, 2022;Chhim, 2013). Study participants were adult trauma survivors with no comparison group, and participant ages ranged from 18 to 60 years.…”

From idioms of distress, concern, and care to moral distress leading to moral injury in the time of Covid

“…On the other hand, paying credence to both cultural and idiosyncratic of idioms of distress is extremely useful when establishing rapport with patients, and gaining a sense of conflict and support in their lifeworld. It is also useful in developing culturally sensitive therapeutic interventions that enable consensual treatment negotiation (Affleck et al, 2021; Hinton & Lewis-Fernández, 2010). At issue is how local idioms of distress can be identified given that they can take myriad forms ranging from the mundane to the exotic, may be used more or less frequently by different subgroups within the same society, and can change in use over time.…”

“…In India for example, this condition is treated as a humoral disorder by ayurvedic practitioners. In Sri Lanka, rumination related to the trauma of wartime is linked to heat in the body and treated by cold water baths (Affleck et al, 2021). 4.…”

Culture-bound syndromes, idioms of distress, and cultural concepts of distress: New directions for an old concept in psychological anthropology

“…Across stakeholder groups, people identified a core set of symptoms such as thinking too much, anger, and immediate physical health impacts like palpitations and headaches, as well as longer-term harms to physical and social health in school and other group settings. Similarly, Affleck et al (2022) report two parallel studies of Walking Corpse Syndrome among conflict-exposed Tamil Sri Lankans: one focused on the individual lived experiences of this trauma response syndrome and the second examined psychiatrists' perceptions of it among their patients. Like the Figge articles, clinician perception and individual lived experience of the syndrome converged around a common core set of symptoms, though compared to patients, psychiatrists focused on more technical and clinical categorization, as well as root causes.…”