Kyol Goeu(‘Wind Overload’) Part I: A Cultural Syndrome of Orthostatic Panic among Khmer Refugees

Abstract

Certain cultural syndromes seem to increase the risk of panic attacks by generating catastrophic cognitions about symptoms of autonomic arousal. These schemas create a constant anxious scanning of the body, hence facilitating, maintaining, and producing panic. As a case in point, a Khmer fainting syndrome,'wind overload' (kyol goeu), results in dire expectations concerning the autonomic symptoms experienced upon standing, thus contributing to the high rate of orthostatically induced panic observed in this population.

Olfactory-Triggered Panic Attacks among Khmer Refugees: A Contextual Approach

“…18 Khmer believe that limb paralysis (e.g. stroke) results from peripheral vessel blockage (see Hinton et al, 2001bHinton et al, , 2001c. 19 As described elsewhere, a history of near drowning is common among female Khmer refugees (Hinton et al, 2000).…”

“…Just after the Khmer Rouge takeover of the country in 1975, Leilee recalls walking along a field in the countryside, she had a 1-month-old child at that time and thus felt quite vulnerable. (In the post-partum state, emotional or physical stresses should be avoided lest permanent bodily disorder result; see Hinton et al, 2001bHinton et al, , 2001c.) She squatted down to rest, then noticed the mounds of freshly dug graves all around her.…”

“…The color of the streaks reveals how much wind has accumulated in the body. 15 On the Khmer ethnophysiology of wind, see Hinton et al (2001bHinton et al ( , 2001c. 16 In the Cambodian language, the expression 'big liver' means insolent.…”

“…See later for a fuller discussion. 13 On the Khmer syndrome of 'wind overload' and orthostatic panic, see Hinton et al (2001bHinton et al ( , 2001c. Cambodians commonly talk of three stages of increasing severity of inner wind.…”

“…To be 'on the verge of a wind attack' (caŋ kaət k h yal) is to be in a state of somewhat increased inner wind. 14 For a description of coining, see Hinton et al (2001bHinton et al ( , 2001c. Coining is a method thought to remove 'wind' from the body and to restore proper blood and wind flow in the vessels.…”