Does "Susto" Really Exist? Indigenous Knowledge and Fright Disorders Among Q'eqchi' Maya in Belize

They Will Surveil You to Death: Gangstalking as a Cultural Concept of Distress

Understanding local worldviews is a challenge during clinical encounters, especially when they involve cultural references without acceptance from the medical community. Gangstalking is a Western cultural notion which refers to systematic harassment, surveillance, and torture from unseen or covert assailants or networks. It is not a 'real phenomenon' compared with genuine stalking, but experients report worse depression, post-traumatic symptoms, suicidal ideation, and longer lasting encounters. They report physical pain and impossible feats of espionage technologically orchestrated by unknown malevolent actors. Using conversational data from targeted individual podcasts, I explore gangstalking as a cultural concept of distress (CCD) by highlighting associated explanations, idioms, and symptoms. Clinically, gangstalking is likely diagnosed as paranoid schizophrenia. However, its association with frightening events parallels Susto and Nervios. Physical symptoms parallel Open Mole and Brain Fag Syndrome. Like many CCDs, gangstalking is a multi-dimensional phenomenon not neatly mapped onto psychiatric categories. Misinterpreting gangstalking cases as unique or isolated is a likely outcome even when they fit within a well-known Western subculture and techno-science belief system. Moving past prior, outdated notions of folk illnesses and culture-bound syndromes, gangstalking as a CCD helps end the assumption that only the other has exotic or non-psychiatric categories of distress.

Susto as a cultural conceptualization of distress: Existing research and aspects to consider for future investigations

Among the cultural conceptualizations of distress, susto is defined in the DSM-5 as "a cultural explanation of distress and misfortune in Latin America that refers to an illness attributed to a terrifying event that causes the soul to leave the body and leads to unhappiness and illness, as well as difficulties in performing key social functions" (American Psychiatric Association (APA) (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Washington, DC: APA, p. 836). Thus, susto represents a cultural explanation that encompasses the symptoms of various mental disorders and physical diseases. We analyzed the descriptions of susto from different scientific fields and related them to definitions of DSM-5 syndromes. Three syndromic subtypes of susto show a symptomatic overlap with depression, post-traumatic stress disorder (PTSD) and somatic disorder. However, linguistic metaphors describing symptoms and perceived causes that are specific for Latin American culture support the concept of susto as a specific idiom of distress (e.g., loss of soul, shadow or ajayu; sunken, closed or white eyes; jumping and screaming in the night; being thrown to the ground). In addition, if diagnostic criteria are met for mental disorders, then susto describes a perceived cause of psychopathological states (e.g., depressive disorder, PTSD, somatic disorder, panic disorder, generalized anxiety disorder). Future research with people who have experienced susto is needed to clarify whether susto precedes the onset of other mental disorders (perceived cause) or whether it is a way of designating distress (idiom of distress).

"Backing Weakness:" Conceptualizations of Q'Eqchi' Women's Vulnerability in Belize

Q'eqchi' women's health is the product of inherent, acquired, and induced vulnerabilities that inform an idiom of "weakness" characteristic of women compared to men, reflecting both biological difference and gender-specific demands placed upon them within the context of village life. While women are understood to be uniquely vulnerable to sickness - their "weakness" - they demonstrate great strength and vigor to perform culturally prescribed roles, such as "backing" heavy loads. A framework grounded in Indigenous culture and ideology interprets Q'eqchi' understandings of women's health and broader position within society, arguing the need to take seriously Indigenous explanatory frameworks.