There is no evidence schoolgirls in Iran have been the target of chemical attacks, but neither are they ‘making it up’ – it's a collective stress response based on a belief
Opinion: With no evidence of a toxic agent, no deaths, and nearly all victims recovering quickly, reports of 'poisoning' of schoolgirls in Iran should be viewed with caution; studies of several similar reports of mass poisonings were eventually identified as having a psychological origin.
At an all-female school a young Muslim girl gasps for air, then passes out – quickly followed by several others. Soon dozens of girls are rushed to a local hospital suffering from what appears to be deliberate poisoning from a noxious gas. Symptoms include headache, nausea, dizziness, and loss of consciousness. This would be a description of the effects of the recent mass poisonings that have been reported in Iran this year, but it could equally describe news reports from Afghanistan in 2009.
Students at another female Islamic school in Iran have also reportedly suffered from headaches, nausea, abdominal pain and blurred vision – some have fainted and been taken to hospital. This describes recent events in Iran, but also what took place in the West Bank in 1983.
Since last year, women-led headscarf protests in Iran have generated prolonged anxiety in Iranian society. Then, in November 2022, a wave of reports of schoolgirl poisonings began, involving nearly a dozen separate incidents.
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Media accounts of these "attacks" use words such as “mysterious” and “unexplained”. A popular folk theory holds that the girls are being punished for defying attempts by religious authorities to force them to wear their headscarves in public. Iranian officials have made no arrests and have been unable to identify a chemical agent despite numerous hospital exams that have included blood tests.
The parallels between the events in Iran, Afghanistan and the West Bank in recent history are striking. The Iranian 'poisonings' have coincided with an unfamiliar odour – the number one trigger of mass psychogenic illness over the past century.
Despite thousands of girls being affected in these outbreaks, none died, nearly all recovered quickly and no toxin was ever identified in the air, water or food
History has a way of repeating itself. Between 2009 and 2016, dozens of schools in at least seven provinces across Afghanistan were affected by incidents that were widely reported at the time as mass poisonings. In 2016, I was a consultant to a member of the Afghan government on an outbreak in Herat province. Our conclusion was that the girls were suffering from mass psychogenic illness.
In Afghanistan, the girls were attending schools in defiance of the Taliban, stoking fears of reprisals. But Taliban spokesmen have always denied their involvement. Despite thousands of girls being affected in these outbreaks, none died, nearly all recovered quickly and no toxin was ever identified in the air, water or food. Thus far, no toxin has been identified in Iran either, with nearly a thousand victims.
We weren’t the only ones to conclude that the girls in Herat were suffering from psychogenic illness. A separate study by the World Health Organisation, which examined similar outbreaks at 22 schools across the country, reached the same conclusion, after analysis of blood, urine, and water.
In 2013, it was revealed that separate unreleased investigations had been carried out by the United Nations and the International Security Assistance Force – a multinational military mission overseeing Afghan security between 2001 and 2014. Both reached the same conclusions.
The Palestinian schoolgirl ‘poisonings’
The events described above followed similar events in March-April 1983, when nearly a thousand Palestinian schoolgirls in the Israeli-occupied West Bank were stricken with headaches, dizziness, blurred vision, stomach pain, and weakness. Many lost consciousness.
The episode made headlines around the world and also led to alarming accusations of mass poisonings, and sparked rumours that Israeli agents or civilian extremists were to blame. The initial incident that triggered the outbreak occurred at a school and was later traced to an odour, from a latrine. Two separate investigations published in The Lancet concluded the illness was psychological.
The symptoms are as real as any organic illness, and people are genuinely suffering. The use of terms such as ‘mass hysteria’ to describe this condition only amplifies the stigma that surrounds the label.
Another investigation published in the American Journal of Psychiatry found that an Israeli newspaper report in which a journalist erroneously reported that some of the victims had gone blind was a significant contribution to the outbreak.
There have been several documented instances where incidents of apparent state terrorism turned out to be psychogenic in origin in recent history. There were also the reported poisoning of Islamic schoolgirls in Egypt in 1993 when about 1,500 students between nine and 16 experienced nausea, headaches, and fainting spells, resulting in the closure of 32 schools. It was rumoured the girls were being targeted by Israeli agents intent on rendering them sterile.
What do these schoolgirls have in common? All of these cases involved young Islamic girls under extraordinary stress, with no opportunity for redress, at a time of political turmoil, who fell ill from a mystery condition that was typically attributed to poison gas after someone drew attention to an unusual odour.
This is likely the case in Iran. After three-and-a-half months of investigations there is no evidence they have been the target of chemical attacks. It is far more likely they are suffering from psychogenic symptoms generated by stress – a condition that has been documented for millennia and which typically affects young girls undergoing extreme, prolonged stress. And yes, psychogenic illness is contagious.
Psychogenic illness is a very real illness
It is important to dispel popular myths about psychogenic illness. While it is created in the mind, it is not ‘all in their heads’. The symptoms are as real as any organic illness, and people are genuinely suffering. The use of terms such as ‘mass hysteria’ to describe this condition only amplifies the stigma that surrounds the label.
They are not ‘crazy’ or mentally disturbed or ‘making it up’. They are victims. Mass psychogenic illness is perhaps best described as a collective stress response based on a belief. We all have beliefs. We are all potential victims of psychogenic illness.
Some may suggest my assessment of the recent events in Iran is sexist, but mass psychogenic illness is overwhelmingly a female phenomenon. I have collected more than 3,000 cases dating back to 1566 and 99 percent are majority female. This may not have anything to do with female biology but could reflect gender roles, particularly in places such as Iran where young girls have to adhere to many restrictions. This tension and frustration, combined with the current political turmoil, can lead to pent-up emotions that contribute to outbreaks of psychogenic illness.
Addendum: 12 March 2022
The head of UNESCO Audrey Azoulay tweeted on March 8, 2023: “ I am deeply concerned about the reported poisoning of schoolgirls in Iran over the past three months. This is a violation of their right to safe education.” UNESCO, the UN Human Rights Council and the United States State Department have called for independent investigations. Newsroom and the University of Auckland, Waipapa Taumata Rau support the need for a full and transparent investigation.
