Amok: a mirror of time and people. A historical review of literature

Prior to 1800

Before 1800, regions around India, Malaya and Indonesia were characterized by the presence of similar events: conflicts between small countries within the region (in the 1000s), an accelerated influx of Islam (in the 1300s), expansion of overseas trade (in the 1400s), an increase in the influence of European countries (in the 1500s), and the establishment of European colonization (in the 1600s). During this period, there was no established concept of psychiatry, and the term ‘Psychiatrie’ was first coined in 1808 by Johann Christian Reil, a German medical doctor (Marneros, 2008). The pre-1800 reports we reviewed were provided mainly by business people and travellers.

Early forms of the term ‘amok’ varied, and they included amock, amuck, amuco, amaucos and amocchi. The word ‘amok’ is said to be a derivative of the Malayan word amar-kkan, which means warrior (amar meaning fight or war), or the Sanskrit word amokshya, which refers to something that cannot be loosened; however, these meanings are not definitive (Yule, Burnell and Crooke, 1968). In fact, the concept of amok was frequently associated with war or honour during this period, and this relationship was found in approximately 55 per cent of the articles reviewed for this period. Amok involved choosing to die for one’s lord, or for honour or revenge after being shamed in war, or in a fierce fight between soldiers. In addition, it was regarded as an honourable cause of death regardless of the reason (Yule et al., 1968). It appears to have been accepted as positive behaviour, as shown in the quotations below.

The King of Cochi hath a great number of gentlemen which he called Amocchi, and some are called Nairi: these two sorts of men esteem not their lives anything, so that it may be for the honour of their King (Yule et al., 1968: 20; amok was called Amocchi in 1566)

… the whole kingdom of the slain or wounded king would be bound to avenge him with the complete destruction of the enemy …The greater the king’s dignity among these people, the longer period lasts this obligation to furious revenge … this period or method of revenge is termed Amoco. (Yule et al., 1968: 21; amok was called amoco in 1624)

Around the year 1000, small countries in these regions were fighting each other for dominance. Considering the origin of the word ‘amok’, it could originally have been used to describe brave soldiers, particularly those with honour. However, it was also used to express an honourable death unrelated to war. Nicolo Conti, a Venetian businessman and traveller, first described amok in 1430 and posited that it was caused by insult resulting from subordination. These points are demonstrated in the following quotations:

… debtors are made over to their creditors as slaves; and some of these, preferring death to slavery, will with drawn swords rush on, stabbing all whom they fall in with of less strength than themselves, until they meet death at the hands of someone more than a match for them. (Yule et al., 1968: 20)

There are some of them (Javanese) who if they fall ill of any severe illness vow to God that if they remain in health they will of their own accord seek another more honourable death for his service, and as soon as they get well they take a dagger in their hands, and go out into the streets and kill as many persons as they meet, both men, women, and children, in such wise that they go like mad dogs, killing until they are killed. These are called Amuco. (Yule et al., 1968: 20; amok was described as amuco in 1516)

Between the eleventh and thirteenth centuries, the introduction of Islam was accelerated. In Indonesia, until the tenth century the primary religions were Hinduism and Buddhism because of the influence of the king of Mataram and the Sailendra dynasty, respectively. New Mataram became the centre for the propagation of Islam in the thirteenth century (Gagliano, 1996). In India, the power of those of the Muslim faith increased in the thirteenth century, and their influence was extended from North to South India (Calkins, 1987). During this century, Islam spread via Arabian and Indian businessmen and became the official religion of the Malacca Sultanate.

Other concepts of amok appear to have been influenced by this trend, and the term was used in relation to Islam. Some people believed that amok was performed exclusively by people who practised Islam (Ball and Tavernier, 1889; Yule et al., 1968), and it was considered a negative behaviour. It is likely that a number of people were hostile towards the newly introduced religion:

But the natives of Guzarat stood in such fear of Sultan Badur that they would not consent to the terms. And so, like people determined on death, all that night they shaved their heads (this is a superstitious practice of those who despise life, people whom they call Amaucos in India) and betook themselves to their mosque, and there devoted their persons to death – and as an earnest of this vow, and an example of this resolution, the Captain ordered a great fire to be made, and cast into it his wife, and a little son that he had, and all his household and his goods, in fear lest anything of his should fall into our possession. (Yule et al., 1968: 20; amok was called Amaucos in 1552)

… they (the Mohammedans) are hardly restrained from running amuck (which is to kill whoever they meet, till they be slain themselves), especially if they have been at Hodge [Hajj] a Pilgrimage to Mecca. (Yule et al., 1968: 21; amok was called amuck, 1673)

Following the introduction and increasing influence of the Islamic religion and empire, European traders travelled to these regions and expanded their influence, and European colonization was established around the sixteenth century. The Portuguese and Spanish arrived in India in that century, and the British and Dutch began colonization in the seventeenth century (Soboul, 1987). In Malaysia, the Malacca Sultanate was established in the thirteenth century and was occupied by the Portuguese in 1511 and the Netherlands in 1641. European countries became interested in Indonesia as a trading partner in the spice industry in the sixteenth century, and the Dutch East India Company advanced into Indonesia in 1602. Opium trade increased with European colonization, and the Dutch East India Company secured an exclusive contract for opium imports to Java. These events strengthened the Netherlands’ colonization (Bone, 1996).

The native people were subjected to oppression, and during the colonization process there were exploitation, debt and harsh treatments; also, opium was an important product for European countries. The meaning of amok reflected these events: it was no longer related to war or self-sacrificial behaviour for one’s lord; instead, revenge and opium use were described as a means of revenge (Stavorinus and Wilcocke, 1969). Amok, which had once been considered honourable or heroic behaviour, came to be regarded as madness or behaviour that led to punishment under European law. Amok was used in courts of law for the first time during this period, with the purpose of suppressing native people’s tendency to regard amok as heroic (Murphy, 1973); for example:

I saw in this month of February at Batavia the breasts torn with red-hot tongs off a black Indian by the executioner and after this he was broken on the wheel from below upward. This was because through the evil habit of eating opium … he had become mad and raised the cry of Amocle [misspelling of Amock] … in which mad state he had slain five persons … Such a murderer and Amock-runner has sometimes the fame of being an invincible hero because he has so manfully repulsed all who tried to seize him … So the Netherlands Government is compelled when such an Amock-runner is taken alive to punish him in a terrific [sic] manner’ (Yule et al., 1968: 21; amok was called amock in 1659).

These changes in the concept of amok reflect the transition from a period of conflict between countries or with European countries to the establishment of colonization.

1800–1850

In this period, a description of amok was provided by a medical doctor. Dr Thomas Oxley described a patient with amok who insisted that he was possessed by the devil, but Oxley concluded that his symptoms were caused by gastritis or the exacerbation of a gastric ulcer (Oxley, 1849). After this, reports from the medical field increased.

The period between the late eighteenth and early nineteenth centuries represents the beginning of modern psychiatry. As mentioned above, Reil introduced the term ‘Psychiatrie’ in 1808. Then in 1820 Étienne-Jean Georget proposed that ‘delire’ resulted from general illness or illness of the brain (Berrios and Porter, 1995: 5), and in 1838 Esquirol categorized melancholy into two types: ‘lypemanie’, characterized by a depressive state, and ‘monomanie’, characterized by a passionate state (Huertas, 2008). In accordance with these newly developed psychiatric concepts, Logan (1849) suggested that monomania was the cause of amok.

During this period, revenge was still considered to be one of the causes of amok. However, from a social perspective, the concept of revenge had changed from one involving ‘revenge for one’s lord’ to that involving irrationality (Winzeler, 1990: 116), restraint, status (Newbold and Turnbull, 1971: 185, 186), or revenge for injustice (Marsden and Bastin, 1986: 279). These changes also appear to reflect a change in the social environment from one of confrontation between countries to one involving the establishment of colonies.

1850–1900

As the medical literature regarding amok grew, the number of articles related to physical or mental illness increased. For example, gastroenteric disorder, febrile delirium and varicella were regarded as physical illnesses that caused amok (Bird, 1883: LetterXXII; Clifford, 1897: 78–95; Crawfurd, 1856: 12; McNair, 1878: 212–17; Murphy, 1973: 37), and chronic dementia, monomania and psychosis were considered to be psychiatric causes (Bird, 1883: LetterXXII; Crawfurd, 1856: 12; Ellis, 1893; Gimlette, 1897; Murphy, 1973: 38). Some authors suggested that amok was caused by monomania induced by gastroenteric disorder (Bird, 1883: LetterXXII; McNair, 1878: 213). Both alcohol and opium were also considered causes of amok during this period (Murphy, 1973).

The advent of modern psychiatry in the early nineteenth century engendered the concept of organic causes of mental illness, which included monomania (mentioned in the previous section); the term ‘dementia praecox’ had been used by Arnold Pick in 1891 (Huertas, 2008). These events appear to have influenced the idea that amok was a consequence of psychiatric illness, for which diagnoses (e.g. organic, monomania, chronic dementia) were derived from the new psychiatric concepts during the period.

The number of articles describing opium as the cause of amok also increased during this period, as the importance of opium production increased in the colonies. The first Opium War in China was fought in 1839–42. Income from and consumption of opium then increased during the nineteenth century and caused political debate in the Netherlands. It led to ‘opium regie’ in 1893 (state monopoly of the importation, preparation and distribution of opium), which began on the island of Madura near the Javanese coast and spread throughout Java in 1898 (van Ours, 1995). The use of alcohol is unusual in Islamic society; however, the number of Europeans in the area increased with colonization, which led to an increase in alcohol consumption.

After 1850, psychiatric medicine was characterized by the emergence of psychodynamic psychiatry. Pierre Janet and Jean-Martin Charcot introduced hypnotics and the theory of hysteria, Sigmund Freud proposed the concepts of the unconscious mind and defence mechanisms, and Emil Kraepelin and Karl Theodor Jaspers established descriptive psychiatry. In addition, various causal relationships were clarified in general medicine; for example, Gregor Johann Mendel discovered the law of genetics in 1865 (Weiling, 1991), Heinrich Hermann Robert Koch discovered the aetiological agent of anthrax in 1876 (Kaufmann and Schaible, 2005), Ronald Ross discovered the malarial parasite in the mosquito gastrointestinal tract in 1898 (Ross, 2002), and bromide was used as the first antiepileptic medicine in 1857 (Pearce, 2002).

The ideas suggested by Freud and the discoveries of the pathogenicity of bacteria, the malaria parasite and heredity in the late nineteenth century appear to have influenced the interpretation of amok during the next period.

1900–1950

Defence mechanisms, personality and heredity first appeared as potential causes of amok during this period. Defence mechanisms and personality are closely related to psychodynamic theory. Some articles suggested that regression, hysteria, expression of conflict, or personality could cause amok (Ballard, 1912; Langen and Lichtenstein, 1936; Westermeyer, 1973).

An article published in 1912 suggested that amok was a hereditary disease (Ballard, 1912). With respect to physical diseases as causes of amok, infectious diseases (van Loon, 1927), malaria and epilepsy (Winzeler, 1990) were all suggested between 1923 and 1927. In addition, cannabinoids were first mentioned as a possible cause of amok during this period (Di Marzo, 2006). This might have occurred because cannabinol, which is the class of compound contained in hemp, was identified in 1899 (Di Marzo, 2006). Fitzgerald proposed the following complex explanation for amok in 1923:

… the weakness of will-power and defective development of character due to a neurotic nature and an oppressed condition, coupled with numerous invasions of fever, and finally a lack of outlet or the emotions, all combined together to provide the fuel to which the match (whatever it may be) has but to be added. (Winzeler, 1990: 109)

The early twentieth century was a turbulent period. There were two world wars, followed by national independence movements. Indonesia declared independence in 1945, followed by India and the Federation of Malaya in 1950 and 1957, respectively. In the psychiatric field, Adolf Meyer put forward the concept of psychobiology, proposing that mental illness resulted from interaction between personality dysfunction and social and environmental factors, rather than organic causes; he explained psychiatric disorder as biopsychosocial reaction (Mohl, 2009). Also, new biological, physical and intrusive therapies were developed during this period, such as electroencephalography (Haas, 2003), pentylenetetrazol-induced seizure therapy (Fink, 1984) and lobotomy (Tierney, 2000).

After 1950

From articles reviewed in the present study, it was found that, by 1936, psychodynamic concepts of amok, such as those involving regression and conflict, had been replaced by sociocultural explanations focusing on cultural norms, background and ways of thinking (Browne, 2001; Carr, 1978; Gullick, 1958; Lee, 1981; Murphy, 1973; Schmidt, Hill and Guthrie, 1977; Tan and Carr, 1977; Teoh, 1972; Trujillo, 2005; Westermeyer, 1972; Yap, 1951). Some assumed that the relationship between individual fragility and sociocultural background caused amok (Martin, 1999; Tan and Carr, 1977); this assumption could have been influenced by Myer’s idea of reaction. Political explanations, positing that amok was politically motivated (Ugarte, 1992) and reflected political concerns (Browne, 2001), emerged in the 1990s. Aggressive behaviour, regardless of the reason that it occurred, also emerged as a new explanation for amok during this period, and at least one report indicated that amok was no longer referred to, even in psychiatric hospitals (Hatta, 1996).

Subsequent to 1950, psychiatry was characterized by biological and social, rather than psychological, trends. Chlorpromazine was discovered in 1952. Three books that were important in the antipsychiatry movement were published in the 1960s: The Divided Self: An Existential Study in Sanity and Madness by Ronald David Laing (1960), The Myth of Mental Illness: Foundations of a Theory of Personal Conduct by Thomas Szasz (1961) and Psychiatry and Anti-psychiatry by David Cooper (1967). Pow Meng Yap used the term ‘culture-bound syndrome’ for the first time in 1967 (Yap, 1967). In 1982, Raphael Osheroff successfully sued a hospital in the USA for its unsuccessful attempt to treat his depression using psychoanalysis, before having successful treatment with antidepressants at another hospital (Klerman, 1990). Thus, psychoanalysis went through a difficult period, and a more biological or sociological standpoint was adopted instead of a psychodynamic point of view.

Social problems resulted from World War II and from racial independence after decolonization. The Vietnam War occurred in 1960, and post-traumatic stress disorder was included in the DSM-III in 1980 (APA, 1980). Psychiatry was then associated with external and social rather than internal or personal issues, and the concept of amok appeared to reflect this.

The changing concept of amok

The use of some amok concepts disappeared and reappeared during different periods, and this pattern seemed to correspond with historical events and advances in medical science. For example, the emergence of Islam, colonization and the accompanying events influenced perception of causes of amok in certain periods. The notion of heredity led to the concept of heritable amok, and the discovery of the malarial parasite in the digestive organ of the mosquito led to the perception of malaria as a cause of amok. Even within the same category, the concept changed across time according to the prevalent theories in each period. As psychiatric notions changed, the suggested psychiatric causes also changed.

In contrast, some concepts of amok existed continuously, such as those related to honour, religion, revenge, drugs and suicide. These persistent concepts are easy to understand, even for non-specialists (e.g. for many people, their daily reality involves drugs). Thus, simple and easily observed concepts apparently remained unchanged over time, whereas more complex and unobservable concepts changed according to the views and knowledge of the writer.

The frequency of amok

Some studies discussed the frequency of amok, with differing results. Teoh (1972) indicated that its incidence increased between the early twentieth century and the 1960s, and the nature of the cause of amok changed from conscious to unconscious during this period, because of negative social sanctions. However, Murphy (1973), Spores (1988) and Winzeler (1990) all disagreed and suggested instead that the incidence of amok actually decreased during this period.

Spores (1988) asserted that amok decreased as a result of the establishment of peace, political stability, economic development with an emphasis on economically rational behaviour, development of a complex administrative structure, elimination of traditional practices, establishment of a judicial system, increased control over the physiological basis of amok, and psychological distance from the traditional social context.

Murphy (1973) attributed the reduction to colonization, which inhibited major social change, and the development of alternative means of escaping distress. Winzeler (1990) suspected that the frequency of changes to the concept of amok resulted from bias in numerous European reports, such as that produced by Kiefer (1973, as cited in Winzler, 1990: 118):

It is rather curious that accounts of this phenomenon in greater Indonesia are more common in medical literature than in ethnography. Even within the medical literature there are few documented cases. Most of the later writers apparently fed off the meager data presented in the few articles presented around the turn of the century. As far as I can tell, amok is a phenomenon which is recalled more often than observed, and as such, was subject to all manner of fanciful distortions. I am convinced that a history of the mythology of amok would tell us more about Europeans than Malaysians.

In addition, Teoh’s (1972) article was based on Malaysian newspaper reports, whereas the others were based on European publications.

The reason for the change to the concept of amok

The findings described above indicate that the changes in the observed frequency and concept of amok resulted from the social background and knowledge of authors during each period. However, why did these changes occur? One possible explanation involves ‘bricolage’ (Lévi-Strauss, 1966), whereby people (termed ‘bricoleur’) attempt to express their thoughts using limited resources. In contrast, ‘engineers’, or scientists, attempt to explain events through concepts.

These ideas correspond to the transition of amok, whereby people (bricoleur) attempted to explain sudden mass assault in terms of their current environments, whereas medical doctors (engineers) attempted to explain it in terms of medical and psychiatric concepts. In addition, the change in the concept of amok corresponds to differences in knowledge and the history of knowledge.

De Certeau examined bricolage extensively and explained the term ‘bricoleur’ in terms of oppressors and the oppressed. He defined ‘strategy’ as the means via which people are repressed by ‘products’ generated via the structure of power, and ‘tactics’ representing consumers’ reorganization of the ‘products’ for their benefit (de Certeau and Rendall, 1988).

Therefore, at times, amok was a means by which to counteract social oppression and to help native people to recognize harmful habits. Debtors, losers in war and servants who experienced amok were often regarded as heroes. In earlier times, amok represented conflict between religions, with Muslim people depicted negatively. Opium, alcohol and cannabis were thought to be related to amok, and this belief could have been accompanied by increases in use and production.

Western visitors also used the term; their view of amok sometimes distinguished between them and native individuals, and it could have provided a means of introducing Western traditions to Eastern countries. Native individuals who considered amok heroic were punished cruelly by Western colonial courts during earlier periods. This can be seen as part of the process of orientalism (Said, 1978). Existing amok was analysed by European visitors and changed to something to be controlled or punished, which may have been a means to distinguish the natives from Europeans and as an expression of domination of the natives by the Europeans. In reality, amok was sometimes used to rule native people, as suggested in the previous example. Amok was mentioned repeatedly – in relation to culture, personality, heredity and the backgrounds of native people – as being somewhat abnormal to the Europeans.

Although several studies have shown that amok is not culture-specific (Arboleda-Florez, 1979; Kon, 1994; Martin, 1999), they were conducted after 1900, when many colonial countries had declared independence. The phenomenon of amok is considered similar to cathard in Polynesia, pseudonite in the Sahara, mal de pelea in Puerto Rico, whitiko among the Cree Indians, the Jumping Frenchman of Maine in Canada, imu in Japan, mirachit in Siberia, pibloktoq among polar Eskimos, frenzied anxiety state in Kenya, wild-man behavior in New Guinea, Whitman syndrome in the USA (Carr, 1978) and fureur des berserks in ancient Scandinavia (Ellenberger, 1974).

This change could be one of the processes involved in bricolage. That is, it is a mysterious phenomenon, and people attempted to define it according to their knowledge. In addition, oppressors and oppressed people used it to their benefit, either intentionally or unintentionally. Further, the phenomenon is generalized and sometimes ceases to occur. The driving force of generalization involves science or independence from domination such as that involved in colonization and medicalization.

We have shown that there are various possible explanations for amok, which tend to be affected by new discoveries in medicine and science, and sometimes by social events. Over time, amok was transferred from the hands of the ‘bricoleur’ to those of the ‘engineer’. Amok has been discussed by academics more often than in ordinary life, and the majority of reports were produced by professionals.