Echoism

ECHOISM, a peculiar psychiatric disease, widely spread among certain peoples of Eastern Siberia in the pre-revolutionary period, chiefly the Yakuts and Buryats; however, Russians who had lived for a long time in the Yakutsk region also suffered from it (there are no precise data on the spread of Echoism at the present time). The disease is characterized chiefly by an irresistible tendency of patients to imitate the words and actions of surrounding persons (echolalia and echopraxia) and to carry out the orders given by them (Befehlsautomatie of German authors). According to Tokarsky, men and women are equally susceptible to the disease; according to Mitzkevich, women contract it more often. The clinical picture of Echoism is described not quite identically by different authors. According to Tokarsky, it manifests itself suddenly and immediately in all the fullness of its manifestations without any noticeable precursors: a person who until then was considered quite healthy unexpectedly begins, like an echo, to repeat greetings, questions, etc., addressed to him. If the speaker accompanies his words with gestures, these are also photographed by the patient in his movements. All kinds of other movements and actions of surrounding persons observed by the patient are also reproduced, even if this reproduction must cause them harm: if someone jumps or strikes himself in the presence of the patient, the patient does the same; he may throw a fragile object he values or even a child in his arms if someone throws any object before him. The reaction to a command or order can be different: in some cases it is an automatic repetition of it, in others—primarily in response to short shouts given in a commanding tone (“beat”, “throw”, “sit”, etc.)—unconditional execution of the instruction contained in it. Sometimes Echoism covers an entire group of people at once; Kashin, for example, observed how one company of a Transbaikal Cossack regiment, during a drill, began to repeat the command words; the angry commander began to shout and swear and suddenly, to his surprise, heard the same shouts, abuse, and threats that he uttered, now repeated by the soldiers' lips, at the same time the whole company threw away their rifles. The course of the disease, according to the descriptions of those who observed it, is predominantly chronic, with large fluctuations; with the exception of cases of multiple Echoism, a permanent recovery does not usually occur. Tokarsky distinguishes false Echoism from true Echoism; the latter represents a passing state, developing under the influence of an emotion, most often fear, sustained by means of intentional frightening, tickling, unexpected pushes in the side, and expressing itself in various reflex movements. Some only tremble, others make movements with their hands, throw objects in their hands, sometimes accompanying this with abuse, a third group jumps or squats, which, amusing those around them, serves as a pretext for repeating the frightening. When the latter disappear, the reflex movements also disappear. Mitzkevich, who systematically observed Echoism for a number of years during his exile in the most remote places of Yakutia (the Kolyma region), describes the course of this disease somewhat differently. He considers the isolation of “false” Echoism into a separate group erroneous. What is called false Echoism by Tokarsky, according to Mitzkevich, is simply the initial phase of the disease, which, as a rule, does not arise suddenly in full health, but develops gradually. The initial symptoms of the disease, which, according to Mitzkevich, easily affects the extremely prone to hysterical manifestations population of the Yakut region, have an undifferentiated, as if embryonic character (“false” Echoism of Tokarsky). Under the influence of frightening and other experiments performed for amusement, the disease gradually develops in patients, sometimes already in old age, into the typical picture described above. Accordingly, Mitzkevich considers Echoism one of the forms of primitive hysteria: during attacks, according to this author, the patients' state of consciousness very much resembles certain hypnotic states. Noting a number of features in Echoism that relate it to clairvoyance (see), Mitzkevich, like Tokarsky and other authors before him, correctly considers it close to, and in many cases even identical with, the lata of Malays, “jumping” of North American Indians, the “imubakko” of the Ainu, and other similar forms. The disagreements in the description and assessment of various cases of Echoism apparently explain the fact that, like other mentioned forms of psychiatric disorders in primitive peoples, Echoism is not a separate independent nosological disease, but only a symptom-complex that can occur in various diseases, which owes its peculiarity to the properties of the primitive psyche of its carriers and socio-domestic conditions of their life to the same extent as to the nature of the pathogenic process that causes it. In essence, Echoism represents a manifestation of psychic automatism and excessive pathological suggestibility, the suggestive stimulus often being not the content of a given perception, but only its external form. This syndrome is often observed in “cultural” patients under ordinary conditions, especially in the catatonic form of schizophrenia, less often in epileptics in a twilight state. In primitive people, to whom suggestibility is generally inherent, it arises especially easily, giving a peculiar character to the picture of all generally observed psychiatric diseases in them, in particular schizophrenia and epilepsy. However, most often it serves them as a form of reaction to strong emotional experiences (related to hysterical reactions), and is often also the result of direct suggestion and the result of psychic induction (i.e., contagion). The unproductiveness, imitativeness, and monotony of this syndrome find their explanation in the fact that the spiritual development of the peoples among whom it was observed, as well as those colonial peoples among whom related forms occur (lata, jumping, etc.), was forcibly retarded by political and economic exploitation and by the poverty and monotony of living conditions caused by it. Mitzkevich paid special attention to this last group of factors, attributing decisive significance to the influence of the sparse northern nature and the heavy material and associated hygienic and moral living conditions for the spread of Echoism. Among the peoples of the USSR, Echoism as a phenomenon of cultural psychopathology has disappeared due to the enormous improvement of living conditions and the raising of the cultural level. Treatment in the proper sense should aim at the disease, the manifestation of which in a given individual case is Echoism, and care should be taken to eliminate such factors of Echoism as frightening or mockery.